Mass Treatment to Eliminate Filariasis in Papua New Guinea

Bockarie, Moses J.; Tisch, Daniel J.; Kastens, Will; Nast, Alexander; Dimber, Zachary; Bockarie, Florence; Ibam, Ervin; Alpers, Michael P.; Kazura, James W.

doi:10.1056/nejmoa021309

Cited by 138 publications

(131 citation statements)

References 35 publications

(35 reference statements)

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“…The sample size was calculated assuming a prevalence of adverse effects of 10% 23 , a standard error of 3%, a 95% confidence interval and design effect of 1.5 (to take into account the variation of positives in each household). This yielded a sample of 450 individuals in each area.…”

Section: Sample Size Calculation and Sampling Strategymentioning

confidence: 99%

Adverse reactions following mass drug administration with diethylcarbamazine in lymphatic filariasis endemic areas in the Northeast of Brazil

Lima

Medeiros

Santos

et al. 2012

Rev. Soc. Bras. Med. Trop.

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Introduction:The Global Programme to Eliminate Lymphatic Filariasis was launched with the goal of eliminating this disease via the annual mass drug administration (MDA) of a single dose of antifilarial drugs. Adverse drug reactions following MDA are a major factor of poor treatment adherence in several countries. This study assessed the occurrence of adverse drug reactions (ADRs) following the first round of mass treatment in two communities treated with different dosages of diethylcarbamazine (DEC) in the City of Recife, Brazil. Methods: Population-based cross-sectional surveys were conducted in a random sample of the population living in both communities (Areas I and II). The dose of DEC recommended by the WHO (6mg/kg) was calculated based on the individual's weight-for-age. In Area II, weight differences between the genders were also considered when determining dosage. Data were obtained through interviews conducted in the first 12 to 48h and on the 5 th day after MDA during household visits. Results: A total of 487 and 365 individuals were interviewed in Areas I and II, respectively. The prevalence of ADRs in Area I (23.6; 95%CI: 19.1-29.5) was higher than in Area II (16.2; 95%CI:11.9-21.5)(p=0.0078). The prevalence of ADRs among females was higher than in males in Area I (p=0.0021). In Area II, no significant difference between the genders was observed (p=0.1840). Age was not associated with ADRs in either area. Conclusions: Adjusting MDA dosage schedules according to weight-for-age and sex may be may contribute to reduce the occurrence of adverse drug reactions in the population.

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Section: Sample Size Calculation and Sampling Strategymentioning

confidence: 99%

Adverse reactions following mass drug administration with diethylcarbamazine in lymphatic filariasis endemic areas in the Northeast of Brazil

Lima

Medeiros

Santos

et al. 2012

Rev. Soc. Bras. Med. Trop.

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“…4 Second, the definition of infection and disease phenotypes in the two studies differed in several respects. In Papua New Guinea, none of the subjects had previously been treated with antifilarial drugs (all were residents of a remote area who subsequently participated in trials to assess the impact of mass treatment with antifilarial medications), 19 and infection status was determined by measurements of both blood-borne microfilariae and filarial antigen in plasma. The study from India found a statistically significant association between the chitotriosidase mutation and a combined measure of presence of microfilaremia and antigenemia and chronic lymphatic disease.…”

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Polymorphisms of innate immunity genes and susceptibility to lymphatic filariasis

et al. 2003

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We examined 906 residents of an area of Papua New Guinea where bancroftian filariasis is endemic for genetic polymorphisms in three innate immunity genes suspected of contributing to susceptibility to infection and lymphatic pathology. Active infection was confirmed by the presence of blood-borne microfilariae and circulating filarial antigen in plasma. Disease was ascertained by physical examination for the presence of overt lymphedema (severe swelling of an arm or leg) or hydrocele. There was no association of infection status, lymphedema of an extremity, or hydrocele with chitotriosidase genotype (CHIT1). Polymorphisms of toll-like receptor-2 and toll-like receptor-4 genes (TLR4 A896G; TLR2 T2178A, G2258A) were not detected (N¼200-625 individuals genotyped) except for two individuals heterozygous for a TLR2 mutation (C2029 T). These results indicate that a CHIT1 genotype associated previously with susceptibility to filariasis in residents of southern India and TLR2 and TLR4 polymorphisms do not correlate with infection status or disease phenotype in this Melanesian population. Genes and Immunity (2003) 4, 524-527. doi:10.1038/sj.gene.6364015Keywords: filariasis; chitotriosidase; toll-like receptor; polymorphism; genetics Lymphatic filariasis is a mosquito-transmitted helminth infection endemic in sub-Saharan Africa, Asia, tropical islands of the Pacific Ocean, and focal areas of Latin America. Humans are infected when mosquitoes inoculate infective larvae into the skin that develop into lymphatic-dwelling adult worms and produce millions of microfilariae that circulate in the bloodstream. The life cycle is completed when microfilariae are taken up in the blood meal of the mosquito vector, where they develop into infective larvae over 10-14 days. The pathological consequences of Wuchereria bancrofti infection (there are also two less common filarial species that infect humans, Brugia malayi and B. timori) are mainly due to lymphatic dysfunction clinically manifested as lymphedema of the extremities or elephantiasis and disfigurement of the genitalia, especially hydroceles in men.Infection and disease due to W. bancrofti have a characteristic distribution in populations living in endemic areas. The frequency of infection is generally higher in adults than children, consistent with the notion that the parasite burden increases with cumulative exposure to mosquito-borne larvae. The prevalence of overt clinical manifestations among adult residents of endemic areas is usually less than 10% despite the fact that most individuals are presumably inoculated with infective larvae throughout life. In high transmission areas of Papua New Guinea, for example, communityspecific infection rates documented by the presence of blood-borne microfilariae and filarial antigenemia range from 50% to over 80% in persons older than 20 years of age, whereas fewer than 10% have lymphedema of the extremities.

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“…24,[29][30][31] All sequences were 100% identical with the W. bancrofti sequence in GenBank (accession no. AY297458).…”

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confidence: 98%

“…32 Furthermore, we sequenced the PCR product from five pooled third-stage larvae dissected from mosquitoes that were collected in the Dreikikir District (East Sepik Province, Papua New Guinea), where malaria and lymphatic filariasis are endemic. 24,[29][30][31] All sequences were 100% identical with the W. bancrofti sequence in GenBank (accession no. AY297458).…”

mentioning

confidence: 98%

“…28 We have been using the density of microfilariae in blood and an enzyme-linked immunosorbent assay (detection of Og4C3 antigen and anti-Bm14 IgG4) as measures of W. bancrofti infection in our ongoing lymphatic filariasis-related epidemiologic studies. [29][30][31] However, with decreasing prevalence of W. bancrofti infections, lower microfilaremia, and increasing importance of xenodiagnosis of infection in mosquitoes because of the anticipated success of filariasis elimination programs, DNA-based methods may be more efficient for performing the population-level diagnostic surveillance. Expanding our existing post-PCR LDR-FMA assay, we report the development of a multiplex assay that has the capability to simultaneously detect P. falciparum , P. vivax , P. malariae , and P. ovale , and W. bancrofti infections with high sensitivity and specificity in blood samples.…”

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confidence: 99%

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Molecular-Based Assay for Simultaneous Detection of Four Plasmodium spp. and Wuchereria bancrofti Infections

Mehlotra

Gray

Blood-Zikursh

et al. 2010

The American Journal of Tropical Medicine and Hygiene

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† These authors contributed equally to this study. MULTIPLEX DETECTION OF MALARIA AND FILARIASIS PARASITESP. vivax , P. malariae , and P. ovale , 25 and W. bancrofti in a sequence-specific manner. The PCR reagents and conditions for Plasmodium spp. amplification have been described. 24,25 For the multiplex PCR, we evaluated the dNTP concentrations (dATP, dTTP, dGTP, and dCTP) from 200 μM to 800 μM to ensure nucleotide availability for the amplification of both Plasmodium spp. and W. bancrofti genomic regions, and added 0.12 μM of each of W. bancrofti UP (5¢-GATGGTGTATAATAGCAGCA-3¢) and W. bancrofti DN (5¢-GTCATTTATTTCTCCGTCGACTGTC-3¢) amplification primers to the PCR master mixture. The dNTP concentration that performed with consistently high efficiency was 400 μM. The PCR products were subjected to electrophoresis on agarose gels to visualize distinct Plasmodium spp. (491-500 basepairs) 25 and W. bancrofti (174 basepairs) amplicons. The PCR products were then subjected to LDR-FMA as described, 25 with minor modifications that included use of LDR primers: a W. bancrofti -specific primer (tacactttatcaaatcttacaatcTATATCTGCCCATAGAAATAACTA [sequence in lower case letters represents a 24-basepair oligonucleotide tag]) and a W. bancrofti common primer (Phos 5¢-CGGTGGATCTCTGGTTATCACTCTG-3¢Biotin). In the LDR-fluorescent microsphere hybridization solution containing Plasmodium species-specific fluorescent microspheres, 25 we added W. bancrofti -specific fluorescent micro sphere #3. Our W. bancrofti PCR and LDR primer sequences are based on the W. bancrofti sequence in GenBank (accession no. AY297458). 18To confirm the specificity of our W. bancrofti PCR primers, we amplified an approximately 170-basepair genomic DNA region from one microfilaria isolated from a person in Papua New Guinea and sequenced it. We also sequenced the PCR products from two microfilaria-positive persons from Papua New Guinea whose blood samples were collected as a part of ongoing studies.32 Furthermore, we sequenced the PCR product from five pooled third-stage larvae dissected from mosquitoes that were collected in the Dreikikir District (East Sepik Province, Papua New Guinea), where malaria and lymphatic filariasis are endemic. 24,[29][30][31] All sequences were 100% identical with the W. bancrofti sequence in GenBank (accession no. AY297458).The specificity of the assay was further demonstrated by using P. falciparum , P. vivax , P. malariae , and P. ovale , and W. bancrofti genomic DNA samples ( Figure 1 ). Using these genomic DNA samples individually in LDR-FMA reactions containing primers and microspheres for all five species, we found that the assay detected only the parasite species DNA present, and background signals for all other species DNAs were below a median fluorescence intensity of 500. We then performed multiplex PCR LDR-FMA diagnosis to detect Plasmodium spp. and W. bancrofti infections in the blood samples from 517 persons living in the Dreikikir District (East Sepik Province, Papua New Guinea).Using this assay, we found that 44...

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Mass Treatment to Eliminate Filariasis in Papua New Guinea

Cited by 138 publications

References 35 publications

Adverse reactions following mass drug administration with diethylcarbamazine in lymphatic filariasis endemic areas in the Northeast of Brazil

Adverse reactions following mass drug administration with diethylcarbamazine in lymphatic filariasis endemic areas in the Northeast of Brazil

Polymorphisms of innate immunity genes and susceptibility to lymphatic filariasis

Molecular-Based Assay for Simultaneous Detection of Four Plasmodium spp. and Wuchereria bancrofti Infections

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