Antibody to the Filarial Antigen Wb123 Reflects Reduced Transmission and Decreased Exposure in Children Born following Single Mass Drug Administration (MDA).docVIP

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Antibody to the Filarial Antigen Wb123 Reflects Reduced Transmission and Decreased Exposure in Children Born following Single Mass Drug Administration (MDA).doc

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Antibody to the Filarial Antigen Wb123 Reflects Reduced Transmission and Decreased Exposure in Children Born following Single Mass Drug Administration (MDA)

AntibodytotheFilarialAntigenWb123ReflectsReduced TransmissionandDecreasedExposureinChildrenBorn followingSingleMassDrugAdministration(MDA) CathySteel1*,JosephKubofcik1,EricA.Ottesen2,ThomasB.Nutman1 1LaboratoryofParasiticDiseases,NationalInstitutesofHealth,Bethesda,Maryland,UnitedStatesofAmerica,2LymphaticFilariasisSupportCenter,TheTaskForcefor GlobalHealth,Decatur,Georgia,UnitedStatesofAmerica Abstract Background: Antibody (Ab) to the Wuchereria bancrofti (Wb) infective larval (L3) antigen Wb123, using a Luciferase ImmunoprecipitationSystem(LIPS)assay,hasbeenshowntobeaspecies-specific,earlymarkerofinfectiondevelopedfor potential use as a surveillance tool following transmission interruption post mass drug administration. To examine its usefulnessinasinglefilarial-endemicislandassessedattwotimepointswithmarkedlydifferentlevelsoftransmission,Abto Wb123wasmeasuredinseracollectedfromsubjectsfromMauke,CookIslandsin1975(noprevioustreatment)and1992(5 yearsafteraonetimeisland-widetreatmentwithdiethylcarbamazine[DEC]). Findings: Between 1975 and 1992, Wb transmission decreased dramatically as evidenced by reduced prevalences of microfilariae (31% vs. 5%) and circulating Ag (CAg, 49% vs. 16%). Age specific prevalence analysis showed a dramatic reductioninWb123Abpositivityfrom54%(25/46)in1975to8%(3/38)in1992inchildren1–5years(p,0.0001),reflecting theeffectsofsingle-dosetreatmentfiveyearsearlier.By1992,Wb123Abprevalenceinchildren6–10yearshadfallenfrom 75% (42/56)in 1975 to42% (33/79) consistentwith alower cumulativetransmission potential. Inthe wholepopulation, Wb123seropositivitydecreasedfrom86%to60%between1975and1992.InCAg+subjectsthelevelsofWb123Abwere indistinguishablebetweenthe2timepointsbutdifferedinthosewhowereCAg2(p,0.0001).Inpairedsampleanalysis, individualswhowereCAg+in1975butbecameCAg2in1992hadsignificantlylowerAblevelsin1992(p,0.0001),with9/ 40(23%)becomingseronegativeforWb123. Conclusions:TherelationshipbetweenreductioninWb123Abprevalenceandthereductionoftransmi