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The rapid immunochromatographic card test (ICT) for Wuchereria bancrofti circulating filarial antigen is being used to map areas endemic for lymphatic filariasis. However, the ICT is expensive; thus, surveys based on this test must be relatively limited. Our study was conducted to determine if village-based hydrocele surveys could be used to supplement the ICT surveys in the mapping activities. We compared in 144 Nigerian villages the two assessment methods, ICT and examination for clinical hydrocele, in random samples of 30 adults selected using a procedure that obtained 15 younger males (reported age = 16–39 years old) and 15 older males (
40 years), based on the assumption that hydrocele rates may be more prevalent in older age groups. The men were asked if they had scrotal swelling, then examined and tested by the ICT. We found a weakly positive correlation between village prevalence determined by the ICT and hydrocele (r = 0.041, P < 0.001). Only villages with hydrocele rates of 20% or greater were also consistently classified as having endemic filariasis by the ICT. There was no correlation between an individual’s ICT positivity and clinical presence of hydrocele, and questioning about scrotal swelling was not predictive for presence of hydrocele. More research is needed to determine if community level hydrocele prevalence surveys can offer an economical and broadly applicable supplement to the ICT for determining the endemicity of filariasis.
Acknowledgments: We thank the following individuals for their help: B. Bagnall, R. Barwick, I. Dhillon, M. Iwamoto, J. Jiya, C. MacKenzie, J. Roberts, and A. Hightower. The Carter Center assisted the Ministry of Health Program for Onchocerciasis in Plateau and Nasarawa States, and is in partnership with the Lions Club’s SightFirst Program and the African Program for Onchocerciasis Control. We also thank L. Rakers for providing invaluable help in manuscript preparation and editing.
Financial support: Activities in this project were carried out with grant support from GlaxoSmithKline.
Authors’ addresses: Abel Eigege, Frank O. Richards Jr., Emmanuel S. Miri, John Umaru, Wanjira Mathai, Stanley Amadiegwu, and Donald R. Hopkins, River Blindness Program, The Carter Center, One Copenhill, Atlanta, GA 30307, Telephone: 770-488-4511, Fax: 770-488-4521, E-mail: sdsulli{at}emory.edu. David D. Blaney, Rollins School of Public Health, Emory University, Grace Crum Rollins Building, 1518 Clifton Road NE, Atlanta, GA 30322. Ibrahim Gontor, Plateau State Ministry of Health, State Secretariat, Jos, Nigeria. Gladys Ogah, Nasarawa State Ministry of Health, State Secretariat, Lafia, Nigeria. M. Y. Jinadu, Room 913, Phase II, Federal Secretariat, Lagos, Nigeria.
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