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Abstract
In the global effort to eliminate lymphatic filariasis (LF), rapid field-applicable tests are useful tools that will allow on-site testing to be performed in remote places and the results to be obtained rapidly. Exclusive reliance on the few existing tests may jeopardize the progress of the LF elimination program, thus the introduction of other rapid tests would be useful to address this issue. Two new rapid immunochromatographic IgG4 cassette tests have been produced, namely WB rapid and panLF rapid, for detection of bancroftian filariasis and all three species of lymphatic filaria respectively. WB rapid was developed using BmSXP recombinant antigen, while PanLF rapid was developed using BmR1 and BmSXP recombinant antigens. A total of 165 WB rapid and 276 panLF rapid tests respectively were evaluated at USM and the rest were couriered to another university in Malaysia (98 WB rapid, 129 panLF rapid) and to universities in Indonesia (56 WB rapid, 62 panLF rapid), Japan (152 of each test) and India (18 of each test) where each of the tests underwent independent evaluations in a blinded manner. The average sensitivities of WB rapid and panLF rapid were found to be 97.6% (94%–100%) and 96.5% (94%–100%) respectively; while their average specificities were both 99.6% (99%–100%). Thus this study demonstrated that both the IgG4 rapid tests were highly sensitive and specific, and would be useful additional tests to facilitate the global drive to eliminate this disease.
Highlights
PCR-based assays for both brugian and bancroftian filariasis are promising tools for the GPELF which can be employed for monitoring infections in both human and vector [5,6]
Diagnostic tools in the format of rapid tests, those based on immunochromatography technology, are most suitable to be employed for the GPELF, since they allow easy on-site testing, followed by rapid, simple reading and interpretation of results
Two new rapid immunochromatographic cassette tests based on detection of anti-filarial IgG4 antibody are commercially available namely WB rapid and panLF rapid
Summary
The panLF rapid test consists of three lines namely two test lines, one comprising BmSXP and the other BmR1 recombinant antigens; and a control line. The average overall sensitivity of panLF rapid test was 96.5% (390/404), ranging from 94% to 100%; the sensitivity for detection of W. bancrofti infection was 96.0% (217/226) [94% to 100%] while that for detection of brugian filariasis was 97.2% (173/178) [92% to 100%].
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