Skip to main content
×
Home
    • Aa
    • Aa

Meta-analysis of age-prevalence patterns in lymphatic filariasis: no decline in microfilaraemia prevalence in older age groups as predicted by models with acquired immunity

  • W. A. STOLK (a1), K. D. RAMAIAH (a2), G. J. VAN OORTMARSSEN (a1), P. K. DAS (a2), J. D. F. HABBEMA (a1) and S. J. DE VLAS (a1)...
Abstract

The role of acquired immunity in lymphatic filariasis is uncertain. Assuming that immunity against new infections develops gradually with accumulated experience of infection, models predict a decline in prevalence after teenage or early adulthood. A strong indication for acquired immunity was found in longitudinal data from Pondicherry, India, where Mf prevalence was highest around the age of 20 and declined thereafter. We reviewed published studies from India and Subsaharan Africa to investigate whether their age-prevalence patterns support the models with acquired immunity. By comparing prevalence levels in 2 adult age groups we tested whether prevalence declined at older age. For India, comparison of age groups 20–39 and 40+ revealed a significant decline in only 6 out of 53 sites, whereas a significant increase occurred more often (10 sites). Comparison of older age groups provided no indication that a decline would start at a later age. Results from Africa were even more striking, with many more significant increases than declines, irrespective of the age groups compared. The occurrence of a decline was not related to the overall Mf prevalence and seems to be a chance finding. We conclude that there is no evidence of a general age-prevalence pattern that would correspond to the acquired immunity models. The Pondicherry study is an exceptional situation that may have guided us in the wrong direction.

Copyright
Corresponding author
Department of Public Health, Erasmus MC, University Medical Center Rotterdam, P.O. Box 1738, 3000 DR Rotterdam, The Netherlands. Tel: +31 10 4087730/7714. Fax: +31 10 4089449. E-mail: w.stolk@erasmusmc.nl
Linked references
Hide All

This list contains references from the content that can be linked to their source. For a full set of references and notes please see the PDF or HTML where available.

ANDERSON, R. M. & MAY, R. M. ( 1985). Herd immunity to helminth infection and implications for parasite control. Nature, London315, 493496.

DAS, P. K., MANOHARAN, A., SUBRAMANIAN, S., RAMAIAH, K. D., PANI, S. P., RAJAVEL, A. R. & RAJAGOPALAN, P. K. ( 1992). Bancroftian filariasis in Pondicherry, south India – epidemiological impact of recovery of the vector population. Epidemiology and Infection108, 483493.

DAY, K. P., GREGORY, W. F. & MAIZELS, R. M. ( 1991a). Age-specific acquisition of immunity to infective larvae in a bancroftian filariasis endemic area of Papua New Guinea. Parasite Immunology13, 277290.

HAGAN, P. ( 1992). Reinfection, exposure and immunity in human schistosomiasis. Parasitology Today8, 1216.

KAZURA, J. W. ( 2000). Resistance to infection with lymphatic-dwelling filarial parasites. In Lymphatic Filariasis (ed. Nutman, T. B.), pp. 83102. Imperial College Press, London.

MAIZELS, R. M., ALLEN, J. E. & YAZDANBAKHSH, M. ( 2000). Immunology of lymphatic filariasis: current controversies. In Lymphatic Filariasis (ed. Nutman, T. B.), pp. 217264. Imperial College Press, London.

MICHAEL, E. & BUNDY, D. A. ( 1998). Herd immunity to filarial infection is a function of vector biting rate. Proceedings of the Royal Society of London, Series B265, 855860.

MICHAEL, E., SIMONSEN, P. E., MALECELA, M., JAOKO, W. G., PEDERSEN, E. M., MUKOKO, D., RWEGOSHORA, R. T. & MEYROWITSCH, D. W. ( 2001). Transmission intensity and the immunoepidemiology of bancroftian filariasis in East Africa. Parasite Immunology23, 373388.

ONAPA, A. W., SIMONSEN, P. E., PEDERSEN, E. M. & OKELLO, D. O. ( 2001). Lymphatic filariasis in Uganda: baseline investigations in Lira, Soroti and Katakwi districts. Transactions of the Royal Society of Tropical Medicine and Hygiene95, 161167.

RAJAGOPALAN, P. K., DAS, P. K., SUBRAMANIAN, S., VANAMAIL, P. & RAMAIAH, K. D. ( 1989). Bancroftian filariasis in Pondicherry, south India: 1. Pre-control epidemiological observations. Epidemiology and Infection103, 685692.

SELKIRK, M. E., MAIZELS, R. M. & YAZDANBAKHSH, M. ( 1992). Immunity and the prospects for vaccination against filariasis. Immunobiology184, 263281.

STOLK, W. A., SUBRAMANIAN, S., OORTMARSSEN, G. J., DAS, P. K. & HABBEMA, J. D. ( 2003). Prospects for elimination of bancroftian filariasis by mass drug treatment in Pondicherry, India: a simulation study. Journal of Infectious Diseases188, 13711381.

SUBRAMANIAN, S., PANI, S. P., DAS, P. K. & RAJAGOPALAN, P. K. ( 1989). Bancroftian filariasis in Pondicherry, south India: 2. Epidemiological evaluation of the effect of vector control. Epidemiology and Infection103, 693702.

SUBRAMANIAN, S., STOLK, W. A., RAMAIAH, K. D., PLAISIER, A. P., KRISHNAMOORTHY, K., OORTMARSSEN, G. J. V., AMALRAJ, D., HABBEMA, J. D. F. & DAS, P. K. ( 2004). The dynamics of Wuchereria bancrofti infection: a model-based analysis of longitudinal data from Pondicherry, India. Parasitology128, 467482.

TISCH, D. J., HAZLETT, F. E., KASTENS, W., ALPERS, M. P., BOCKARIE, M. J. & KAZURA, J. W. ( 2001). Ecologic and biologic determinants of filarial antigenemia in bancroftian filariasis in Papua New Guinea. Journal of Infectious Diseases184, 898904.

VANAMAIL, P., SUBRAMANIAN, S., DAS, P. K., PANI, S. P., RAJAGOPALAN, P. K., BUNDY, D. A. & GRENFELL, B. T. ( 1989). Estimation of age-specific rates of acquisition and loss of Wuchereria bancrofti infection. Transactions of the Royal Society of Tropical Medicine and Hygiene83, 689693.

WOOLHOUSE, M. E. ( 1992). A theoretical framework for the immunoepidemiology of helminth infection. Parasite Immunology14, 563578.

Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Parasitology
  • ISSN: 0031-1820
  • EISSN: 1469-8161
  • URL: /core/journals/parasitology
Please enter your name
Please enter a valid email address
Who would you like to send this to? *
×

Keywords:

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 5
Total number of PDF views: 9 *
Loading metrics...

Abstract views

Total abstract views: 56 *
Loading metrics...

* Views captured on Cambridge Core between September 2016 - 24th May 2017. This data will be updated every 24 hours.