Abstract
.Accurate and cost-effective identification of areas where co-endemic infections occur would enable public health managers to identify opportunities for implementation of integrated control programs. Dried blood spots collected during cross-sectional lymphatic filariasis surveys in coastal Kenya were used for exploratory integrated detection of IgG antibodies against antigens from several parasitic infections (Wuchereria bancrofti, Schistosoma mansoni, Plasmodium spp., Ascaris lumbricoides, and Strongyloides stercoralis) as well as for detection of responses to immunizing agents used against vaccine-preventable diseases (VPDs) (measles, diphtheria, and tetanus) using a multiplex bead assay (MBA) platform. High heterogeneity was observed in antibody responses by pathogen and antigen across the sentinel sites. Antibody seroprevalence against filarial antigens were generally higher in Ndau Island (P < 0.0001), which also had the highest prevalence of filarial antigenemia compared with other communities. Antibody responses to the Plasmodium species antigens circumsporozoite protein (CSP) and merozoite surface protein-1 (MSP-1)19 were higher in Kilifi and Kwale counties, with Jaribuni community showing higher overall mean seroprevalence (P < 0.0001). Kimorigo community in Taita–Taveta County was the only area where antibody responses against S. mansoni Sm25 recombinant antigen were detected. Seroprevalence rates to Strongyloides antigen NIE ranged between 3% and 26%, and there was high heterogeneity in immune responses against an Ascaris antigen among the study communities. Differences were observed between communities in terms of seroprevalence to VPDs. Seroprotection to tetanus was generally lower in Kwale County than in other counties. This study has demonstrated that MBA holds promise for rapid integrated monitoring of trends of infections of public health importance in endemic areas.
Highlights
Dried blood spots collected during cross-sectional lymphatic filariasis surveys in coastal Kenya were used for exploratory integrated detection of IgG antibodies against antigens from several parasitic infections (Wuchereria bancrofti, Schistosoma mansoni, Plasmodium spp., Ascaris lumbricoides, and Strongyloides stercoralis) as well as for detection of responses to immunizing agents used against vaccine-preventable diseases (VPDs) using a multiplex bead assay (MBA) platform
In 2000, the WHO Global Programme to Eliminate Lymphatic Filariasis (GPELF), launched in response to World Health Assembly resolution WHA50.29, urged member states to initiate activities to eliminate Lymphatic filariasis (LF) as a public health problem, a goal subsequently targeted for 2020.11 Community-wide mass drug administration (MDA) of antifilarial drugs for 4–6 years is recommended for LF
Antibody distributions varied by pathogen and antigen, and seropositivity cutoff values for malaria, LF, and helminth antibody responses derived through receiver operator characteristic (ROC) curve analysis or mean plus three SD calculations were very close to those derived by Gaussian mixture model analysis (Figure 1)
Summary
Several major infectious diseases occur in sub-Saharan Africa including malaria and neglected tropical diseases (NTDs), which are common among resource-poor populations.[1,2,3] several of these diseases are co-endemic and past studies in the region have identified subgroups that are polyparasitized with soil-transmitted helminth (STH) infections, filarial parasites, and malaria.[4,5,6] Lymphatic filariasis (LF) caused by Wuchereria bancrofti is principally confined to the coastal region of Kenya where ecological factors are suitable for its transmission[7]; the disease cooccurs with other infectious diseases such as STH infections, schistosomiasis, lower respiratory infections, and malaria.[8,9,10]. Lack of resources often compounded by competing health priorities in sub-Saharan Africa has led to insufficient commitments to control NTDs. More recently, implementation of successful public–private partnerships for health have availed resources for control and/or elimination of NTDs as public health problems. In 2000, the WHO Global Programme to Eliminate Lymphatic Filariasis (GPELF), launched in response to World Health Assembly resolution WHA50.29, urged member states to initiate activities to eliminate LF as a public health problem, a goal subsequently targeted for 2020.11 Community-wide mass drug administration (MDA) of antifilarial drugs for 4–6 years is recommended for LF
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