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Shrinking the lymphatic filariasis map: update on diagnostic tools for mapping and transmission monitoring



Lymphatic filariasis (LF), which is highly endemic in 73 countries worldwide, is targeted for elimination by 2020. The strategy for achieving this goal is based on 4 sequential programmatic steps: mapping, Mass drug administration (MDA) implementation, post-MDA surveillance and verification of LF elimination. All 4 stages of the implementation process are dependent on the availability of user friendly and highly sensitive rapid diagnostic tools. By the end of 2012, 59 countries had completed mapping for LF and Eritrea was the only country yet to start the process. Rolling out new diagnostic tools to facilitate the mapping process will enable an accelerated shrinking of the LF map to zero endemic countries by 2020. When the Global Programme to Eliminate Lymphatic Filariasis was launched in 2000, diagnostic tools for LF were limited to clinical examination, detection of microfilaria (MF) by microscopy in night blood samples and detection of antibodies to native-antigen preparations. There has been a significant improvement in the traditional LF diagnostic methods in recent years and some new tools are now available. This paper provides an update on the human diagnostic tests available for LF and their current applications as tools in mapping and transmission monitoring. The values of entomological indicators and parasite detection and speciation methods applied to vector populations are also discussed.


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*Corresponding author: Department of Parasitology, Liverpool School of Tropical Medicine, Centre for Neglected Tropical Diseases, Pembroke Place, Liverpool L3 5QA, UK. E-mail:


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Aonuma, H., Yoshimura, A., Perera, N., Shinzawa, N., Bando, H., Oshiro, S., Nelson, B., Fukumoto, S. and Kanuka, H. (2009). Loop-mediated isothermal amplification applied to filarial parasites detection in the mosquito vectors: Dirofilaria immitis as a study model. Parasite and Vectors 2, 15.
Aonuma, H., Yoshimura, A., Kobayashi, T., Okado, K., Badolo, A., Nelson, B., Kanuka, H. and Fukumoto, S. (2010). A single fluorescence-based LAMP reaction for identifying multiple parasites in mosquitoes. Experimental Parasitology 125, 179183.
Bockarie, M. J., Fischer, P., Williams, S. A., Zimmerman, P. A., Griffin, L., Alpers, M. P. and Kazura, J. W. (2000). Application of a polymerase chain reaction-ELISA to detect Wuchereria bancrofti in pools of wild-caught Anopheles punctulatus in a filariasis control area in Papua New Guinea. American Journal of Tropical Medicine and Hygiene 62, 363367.
Bockarie, M. J., Tisch, D. J., Kastens, W., Alexander, N. D., Dimber, Z., Bockarie, F., Ibam, E., Alpers, M. P. and Kazura, J. W. (2002). Mass treatment to eliminate filariasis in Papua New Guinea. New England Journal of Medicine 347, 18411848.
Bockarie, M. J., Pedersen, E. M., White, G. B. and Michael, E. (2009 a). Role of vector control in the global program to eliminate lymphatic filariasis. Annual Review Entomology 54, 469487.
Bockarie, M. J., Taylor, M. J. and Gyapong, J. O. (2009 b). Current practices in the management of lymphatic filariasis. Expert Review Anti-Infective Therapy 7, 595605.
Chesnais, C. B., Missamou, F., Pion, S. D., Bopda, J., Louya, F., Majewski, A. C., Weil, G. J. and Boussinesq, M. (2013). Semi-quantitative scoring of an immunochromatographic test for circulating filarial antigen. American Journal of Tropical Medicine and Hygiene 89, 916918.
de Souza, D. K., Sesay, S., Moore, M. G., Ansumana, R., Narh, C. A., Kollie, K., Rebollo, M. P., Koudou, B. G., Koroma, J. B., Bolay, F. K., Boakye, D. A. and Bockarie, M. J. (2014). No evidence for lymphatic filariasis transmission in big cities affected by conflict related rural-urban migration in Sierra Leone and Liberia. PLoS Neglected Tropical Diseases 8, e2700.
Drame, P. M., Fink, D. L., Kamgno, J., Herrick, J. A. and Nutman, T. B. (2014). Loop-mediated isothermal amplification for rapid and semiquantitative detection of Loa loa infection. Journal of Clinical Microbiology 52, 20712077.
Fernandez-Soto, P., Mvoulouga, P. O., Akue, J. P., Aban, J. L., Santiago, B. V., Sanchez, M. C. and Muro, A. (2014). Development of a highly sensitive loop-mediated isothermal amplification (LAMP) method for the detection of Loa loa. PLoS ONE 9, e94664.
Fischer, P., Bonow, I., Supali, T., Ruckert, P. and Rahmah, N. (2005). Detection of filaria-specific IgG4 antibodies and filarial DNA, for the screening of blood spots for Brugia timori. Annals of Tropical Medicine and Parasitology 99, 5360.
Fischer, P., Erickson, S. M., Fischer, K., Fuchs, J. F., Rao, R. U., Christensen, B. M. and Weil, G. J. (2007). Persistence of Brugia malayi DNA in vector and non-vector mosquitoes: implications for xenomonitoring and transmission monitoring of lymphatic filariasis. American Journal of Tropical Medicine and Hygiene 76, 502507.
Gass, K., Beau de Rochars, M. V., Boakye, D., Bradley, M., Fischer, P. U., Gyapong, J., Itoh, M., Ituaso-Conway, N., Joseph, H., Kyelem, D., Laney, S. J., Legrand, A. M., Liyanage, T. S., Melrose, W., Mohammed, K., Pilotte, N., Ottesen, E. A., Plichart, C., Ramaiah, K., Rao, R. U., Talbot, J., Weil, G. J., Williams, S. A., Won, K. Y. and Lammie, P. (2012). A multicenter evaluation of diagnostic tools to define endpoints for programs to eliminate bancroftian filariasis. PLoS Neglected Tropical Diseases 6, e1479.
Hamlin, K. L., Moss, D. M., Priest, J. W., Roberts, J., Kubofcik, J., Gass, K., Streit, T. G., Nutman, T. B., Eberhard, M. L. and Lammie, P. J. (2012). Longitudinal monitoring of the development of antifilarial antibodies and acquisition of Wuchereria bancrofti in a highly endemic area of Haiti. PLoS Neglected Tropical Diseases 6, e1941.
Joseph, H., Maiava, F., Naseri, T., Silva, U., Lammie, P. and Melrose, W. (2011). Epidemiological assessment of continuing transmission of lymphatic filariasis in Samoa. Annals of Tropical Medicine and Parasitology 105, 567578.
Lancet (2014). Neglected tropical diseases: becoming less neglected. Lancet 383, 1269.
Laney, S. J., Buttaro, C. J., Visconti, S., Pilotte, N., Ramzy, R. M., Weil, G. J. and Williams, S. A. (2008). A reverse transcriptase-PCR assay for detecting filarial infective larvae in mosquitoes. PLoS Neglected Tropical Diseases 2, e251.
Laney, S. J., Ramzy, R. M., Helmy, H. H., Farid, H. A., Ashour, A. A., Weil, G. J. and Williams, S. A. (2010). Detection of Wuchereria bancrofti L3 larvae in mosquitoes: a reverse transcriptase PCR assay evaluating infection and infectivity. PLoS Neglected Tropical Diseases 4, e602.
Makhsin, S. R., Razak, K. A., Noordin, R., Zakaria, N. D. and Chun, T. S. (2012). The effects of size and synthesis methods of gold nanoparticle-conjugated MalphaHIgG4 for use in an immunochromatographic strip test to detect brugian filariasis. Nanotechnology 23, 495719.
Molyneux, D. H. (2009). Filaria control and elimination: diagnostic, monitoring and surveillance needs. Transactions of the Royal Society of Tropical Medicine and Hygiene 103, 338341.
Moss, D. M., Priest, J. W., Boyd, A., Weinkopff, T., Kucerova, Z., Beach, M. J. and Lammie, P. J. (2011). Multiplex bead assay for serum samples from children in Haiti enrolled in a drug study for the treatment of lymphatic filariasis. American Journal of Tropical Medicine and Hygiene 85, 229237.
Noordin, R., Muhi, J., Md Idris, Z., Arifin, N. and Kiyu, A. (2012). Duration of detection of anti-BmR1 IgG4 antibodies after mass-drug administration (MDA) in Sarawak, Malaysia. Tropical Biomedicine 29, 191196.
Poole, C. B., Tanner, N. A., Zhang, Y., Evans, T. C. Jr. and Carlow, C. K. (2012). Diagnosis of brugian filariasis by loop-mediated isothermal amplification. PLoS Neglected Tropical Diseases 6, e1948.
Ramzy, R. M. (2002). Recent advances in molecular diagnostic techniques for human lymphatic filariasis and their use in epidemiological research. Transaction of the Royal Society of Tropical Medicine and Hygiene 96(Suppl. 1), S225S229.
Ramzy, R. M., Farid, H. A., Kamal, I. H., Ibrahim, G. H., Morsy, Z. S., Faris, R., Weil, G. J., Williams, S. A. and Gad, A. M. (1997). A polymerase chain reaction-based assay for detection of Wuchereria bancrofti in human blood and Culex pipiens. Transactions of the Royal Society of Tropical Medicine and Hygiene 91, 156160.
Ramzy, R. M., El Setouhy, M., Helmy, H., Ahmed, E. S., Abd Elaziz, K. M., Farid, H. A., Shannon, W. D. and Weil, G. J. (2006). Effect of yearly mass drug administration with diethylcarbamazine and albendazole on bancroftian filariasis in Egypt: a comprehensive assessment. Lancet 367, 992999.
Rebollo, M. P. and Bockarie, M. J. (2013 a). Rapid diagnostics for the endgame in lymphatic filariasis elimination. American Journal of Tropical Medicine and Hygiene 89, 34.
Rebollo, M. P. and Bockarie, M. J. (2013 b). Toward the elimination of lymphatic filariasis by 2020: treatment update and impact assessment for the endgame. Expert Review of Anti-Infection Therapy 11, 723731.
Reimer, L. J., Thomsen, E. K., Tisch, D. J., Henry-Halldin, C. N., Zimmerman, P. A., Baea, M. E., Dagoro, H., Susapu, M., Hetzel, M. W., Bockarie, M. J., Michael, E., Siba, P. M. and Kazura, J. W. (2013). Insecticidal bed nets and filariasis transmission in Papua New Guinea. New England Journal of Medicine 369, 745753.
Samad, M. S., Itoh, M., Moji, K., Hossain, M., Mondal, D., Alam, M. S. and Kimura, E. (2013). Enzyme-linked immunosorbent assay for the diagnosis of Wuchereria bancrofti infection using urine samples and its application in Bangladesh. Parasitology International 62, 564567.
Steel, C., Golden, A., Kubofcik, J., LaRue, N., de Los Santos, T., Domingo, G. J. and Nutman, T. B. (2013). Rapid Wuchereria bancrofti-specific antigen Wb123-based IgG4 immunoassays as tools for surveillance following mass drug administration programs on lymphatic filariasis. Clinical Vaccine Immunology 20, 11551161.
Takagi, H., Itoh, M., Kasai, S., Yahathugoda, T. C., Weerasooriya, M. V. and Kimura, E. (2011). Development of loop-mediated isothermal amplification method for detecting Wuchereria bancrofti DNA in human blood and vector mosquitoes. Parasitology International 60, 493497.
Taylor, M. J., Hoerauf, A. and Bockarie, M. (2010). Lymphatic filariasis and onchocerciasis. Lancet 376, 11751185.
Weil, G. J. and Ramzy, R. M. (2007). Diagnostic tools for filariasis elimination programs. Trends in Parasitology 23, 7882.
Weil, G. J., Kastens, W., Susapu, M., Laney, S. J., Williams, S. A., King, C. L., Kazura, J. W. and Bockarie, M. J. (2008). The impact of repeated rounds of mass drug administration with diethylcarbamazine plus albendazole on bancroftian filariasis in Papua New Guinea. PLoS Neglected Tropical Diseases 2, e344.
Weil, G. J., Curtis, K. C., Fischer, P. U., Won, K. Y., Lammie, P. J., Joseph, H., Melrose, W. D. and Brattig, N. W. (2011). A multicenter evaluation of a new antibody test kit for lymphatic filariasis employing recombinant Brugia malayi antigen Bm-14. Acta Tropica 120 (Suppl. 1), S19S22.
Weil, G. J., Curtis, K. C., Fakoli, L., Fischer, K., Gankpala, L., Lammie, P. J., Majewski, A. C., Pelletreau, S., Won, K. Y., Bolay, F. K. and Fischer, P. U. (2013). Laboratory and field evaluation of a new rapid test for detecting Wuchereria bancrofti antigen in human blood. American Journal of Tropical Medicine and Hygiene 89, 1115.
WHO (2003). Lymphatic filariasis. Epidemiology Bulletin 25, 1415.
WHO (2011 a). Monitoring and Epidemiological Assessment of Mass Drug Administration: A Manual for National Elimination Programmes. World Health Organization (WHO/HTM/NTD/PCT/2011.4), Geneva.
WHO (2011 b). Progress toward elimination of lymphatic filariasis – Togo, 2000–2009. MMWR Morbidity and Mortality Weekly Report 60, 989991.
WHO (2012). Global programme to eliminate lymphatic filariasis: progress report, 2011. Weekly Epidemiological Record 87, 346356.
WHO (2013). Global programme to eliminate lymphatic filariasis: progress report for 2012. Weekly Epidemiological Record 88, 389399.
WHO (2014). Meeting of the International Task Force for Disease Eradication, January 2014. Weekly Epidemiological Record 89, 153160.
Wongkamchai, S., Chiangjong, W., Sinchaikul, S., Chen, S. T., Choochote, W. and Thongboonkerd, V. (2011). Identification of Brugia malayi immunogens by an immunoproteomics approach. Journal of Proteomics 74, 16071613.
Yahathugoda, T. C., Weerasooriya, M. V., Sunahara, T., Kimura, E., Samarawickrema, W. A. and Itoh, M. (2014). Rapid assessment procedures to detect hidden endemic foci in areas not subjected to mass drug administration in Sri Lanka. Parasitology International 63, 8793.
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