ArticlePLoS neglected tropical diseases2019
Systematic sampling of adults as a sensitive means of detecting persistence of lymphatic filariasis following mass drug administration in Sri Lanka.
Article in PLoS neglected tropical diseases, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 1 of them a synthesis that pooled it.
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16 citing papers in PubMed, 1 synthesis or guideline pooled it, 19 citations in OpenAlex.
- A systematic review of alternative surveillance approaches for lymphatic filariasis in low prevalence settings: Implications for post-validation settings.PLoS neglected tropical diseases · 2020Pooled it
- Spatial Clustering of Lymphatic Filariasis in Relation to Potential Mansonia Mosquito Habitats in Endemic Communities of Belitung Regency, Indonesia.Acta parasitologica · 2026Article
- Article
- Persistent lymphatic filariasis transmission seven years after validation of elimination as a public health problem: a cross-sectional study in Tonga.The Lancet regional health. Western Pacific · 2025Article
- Sensitivity of anti-filarial antibodies for lymphatic filariasis surveillance: Insights from a serological survey in Samoa in 2018.PLoS neglected tropical diseases · 2025Article
- Anti-filarial antibodies are sensitive indicators of lymphatic filariasis transmission and enable identification of high-risk populations and hotspots.International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases · 2024Article
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- Comparing antigenaemia- and microfilaraemia as criteria for stopping decisions in lymphatic filariasis elimination programmes in Africa.PLoS neglected tropical diseases · 2022Article
- Characterization of a novel microfilarial antigen for diagnosis of Wuchereria bancrofti infections.PLoS neglected tropical diseases · 2022Article
- The use of molecular xenomonitoring for surveillance of mosquito-borne diseases.Philosophical transactions of the Royal Society of London. Series B, Biological sciences · 2021Review
- Progress and impact of 20 years of a lymphatic filariasis elimination programme in South-East Asia.International health · 2020Article
- Potential strategies for strengthening surveillance of lymphatic filariasis in American Samoa after mass drug administration: Reducing 'number needed to test' by targeting older age groups, hotspots, and household members of infected persons.PLoS neglected tropical diseases · 2020Article
- Post-Treatment Surveillance for Lymphatic Filariasis in Plateau and Nasarawa States, Nigeria: Results of Transmission Assessment Surveys.The American journal of tropical medicine and hygiene · 2020Article
- Demographic, socioeconomic and disease knowledge factors, but not population mobility, associated with lymphatic filariasis infection in adult workers in American Samoa in 2014.Parasites & vectors · 2020Article
- Article
- An Expanded Transmission Assessment Survey to Confirm the Interruption of Lymphatic Filariasis Transmission in Wallis and Futuna.The American journal of tropical medicine and hygiene · 2019Article
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6 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundSri Lanka's Anti-Filariasis Campaign conducted 5 annual rounds of mass drug administration (MDA) with diethylcarbamazine (DEC) plus albendazole to eliminate lymphatic filariasis (LF) in all endemic districts between 2002 and 2006. Post-MDA surveillance has consistently documented Wuchereria bancrofti microfilaremia (Mf) rates below 1% in all sentinel and spot check sites since that time, and all implementation units easily satisfied WHO's target for school-based transmission assessment surveys (school-TAS) in 2013. However, more detailed studies have identified foci of persistent infection in the large coastal evaluation unit (EU) (population about 0.6 million) in Galle district. Therefore, the purpose of this study was to assess the sensitivity and feasibility of community-based TAS in adults (adult-TAS) and to compare results obtained by adult-TAS with prior school-TAS and molecular xenomonitoring (MX, molecular detection of filarial DNA in systematically sampled mosquitoes) results in this known problem area. METHODOLOGY AND PRINCIPAL
findingsTwo cluster surveys were performed in independent samples of 30 evaluation areas (EAs) in the coastal Galle EU in 2015. Each survey tested approximately 1,800 adults for circulating filarial antigenemia (CFA) with the Alere Filariasis Test Strip. The CFA prevalence for all persons tested (N = 3,612) was 1.8% (CI 1.4-2.2), and this was significantly higher than the CFA rate of 0.4% obtained by school-TAS in 2013. CFA prevalences in the two samples were similar [1.5% (CI 1.0-2.2), and 2.0% (CI 1.4-2.7)]. Antigenemia prevalence in sampled EUs was highly variable (range 0-11%), and it exceeded 5% in 6 EAs. The 30 EAs sampled in one of our adult-TAS surveys had recently been assessed for persistent filariasis by molecular xenomonitoring (MX). CFA prevalence in adults and filarial DNA prevalence in mosquitoes in these EAs were significantly correlated (r = 0.43; P = 0.02).
conclusionsCommunity based adult-TAS provided a reproducible measure of persistent W. bancrofti infection in a large evaluation unit in Sri Lanka that has low-level persistence of LF following multiple rounds of MDA. In addition, adult-TAS and MX results illustrate the focality of persistent LF in this setting. Adult-TAS may be more sensitive than school-TAS for this purpose. Adult-TAS and MX are potential options for post-MDA and post-validation surveillance programs to identify problem areas that require mop-up activities. Adult-TAS should also be useful for remapping areas with uncertain LF endemicity for possible inclusion in national LF elimination programs.
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