Anti-filarial antibodies are sensitive indicators of lymphatic filariasis transmission and enable identification of high-risk populations and hotspots

•Antibodies (Abs) were a more sensitive indicator of transmission than antigen (Ag).•Higher seroprevalence of Bm14 Ab, Bm33 Ab, and Wb123 Ab compared to Ag was found.•Ab seroprevalence was significantly higher among older males in suspected hotspots.•Significant clustering of Ab seropositivity was s...

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Bibliographic Details
Published in:	International journal of infectious diseases Vol. 147; pp. 107194 - None
Main Authors:	Lawford, Harriet, Mayfield, Helen, Sam, Filipina Amosa-Lei, Viali, Satupaitea, Kamu, Tito, Cooley, Gretchen, Simon, Ashley, Martin, Diana, Lau, Colleen L
Format:	Journal Article
Language:	English
Published:	Canada Elsevier Ltd 01-10-2024 Elsevier
Subjects:	Age-specific associations Antifilarial antibodies Lymphatic filariasis Samoa Seroprevalence Lymphatic filariasis Age-specific associations Antifilarial antibodies Samoa Seroprevalence seroprevalence age-specific associations antifilarial antibodies
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Summary:	•Antibodies (Abs) were a more sensitive indicator of transmission than antigen (Ag).•Higher seroprevalence of Bm14 Ab, Bm33 Ab, and Wb123 Ab compared to Ag was found.•Ab seroprevalence was significantly higher among older males in suspected hotspots.•Significant clustering of Ab seropositivity was seen at the household-level.•Further research is needed to define Ab thresholds for active versus past infection. Circulating filarial antigen (Ag) is used by elimination programs to monitor lymphatic filariasis (LF) transmission; however, antifilarial antibodies (Ab) may be more sensitive than Ag for detecting LF. Our objectives were to describe Ab seroprevalence, identify risk factors for Ab seropositivity, investigate age-specific associations between Ag and Ab, and evaluate geographic clustering of seropositivity. Community-based serosurveys of participants aged ≥5 years were conducted in 35 primary sampling units (PSUs). Ag-positivity was detected using Alere™ Filariasis Test Strips and Ab-seropositivity using multiplex bead assays. Seroprevalence was adjusted for study design. Of 3795 participants (range:5-90 years), adjusted prevalence for Ag, Bm14 Ab, Wb123 Ab, and Bm33 Ab were 3.7% (n=117), 20.3% (n=583), 32.2% (n=987), and 51.0% (n=1659), respectively. Male sex, older age, and residents of suspected hotspots had higher odds of seropositivity to all seromarkers. Seroprevalence was lower in 5-9-year-olds vs ≥10-year-olds (P<0.001). Clustering was significantly higher in households (intra-cluster correlation for Ag:0.45; Bm14 Ab:0.32; Bm33 Ab:0.31; Wb123 Ab:0.29) compared to PSUs or region. Abs enabled identification of risk factors for seropositivity and geographical clustering to inform targeted interventions for LF programmes. Further research is needed to define Ab thresholds for active versus past infection and elimination targets.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	1201-9712 1878-3511 1878-3511
DOI:	10.1016/j.ijid.2024.107194