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Am. J. Trop. Med. Hyg., 78(2), 2008, pp. 289-293
Copyright © 2008 by The American Society of Tropical Medicine and Hygiene

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Mass Drug Administration Trial to Eliminate Lymphatic Filariasis in Papua New Guinea: Changes in Microfilaremia, Filarial Antigen, and Bm14 Antibody after Cessation

Daniel J. Tisch, Moses J. Bockarie, Zachary Dimber, Benson Kiniboro, Nandao Tarongka, Fred E. Hazlett, Will Kastens, Michael P. Alpers, AND James W. Kazura*
Center for Global Health and Diseases, Case Western Reserve University, Cleveland, Ohio; Papua New Guinea Institute of Medical Research, Madang, Papua New Guinea; Centre for International Health, Curtin University of Technology, Perth, Australia

Laboratory tools to monitor infection burden are important to evaluate progress and determine endpoints in programs to eliminate lymphatic filariasis. We evaluated changes in Wuchereria bancrofti microfilaria, filarial antigen and Bm14 antibody in individuals who participated in a five-year mass drug administration trial in Papua New Guinea. Comparing values before treatment and one year after four annual treatments, the proportion of microfilaria positive individuals declined to the greatest degree, with less marked change in antibody and antigen rates. Considering children as sentinel groups who reflect recent transmission intensity, children surveyed before the trial were more frequently microfilaria and antibody positive than those examined one year after the trial stopped. In contrast, antigen positive rates were similar in the two groups. All infection indicators continued to decline five years after cessation of mass drug administration; Bm14 antibody persisted in the greatest proportion of individuals. These data suggest that Bm14 antibody may be a sensitive test to monitor continuing transmission during and after mass drug administration aimed at eliminating transmission of lymphatic filariasis.

Received August 17, 2007. Accepted for publication September 14, 2007.

Acknowledgments: The authors thank the people of Dreikikir district, East Sepik Province, who generously agreed to participate in this study.

Financial support: This study was supported by World Health Organization Grant HQ/98/700382 F30/181/145 and NIH/NIAID AI065717.

* Address correspondence to James W. Kazura, Center for Global Health and Diseases, Case Western Reserve University, Cleveland, OH 44106-7286. E-mail jxk14{at}po.cwru.edu

Authors’ addresses: Daniel J. Tisch, Moses J. Bockarie, Fred E. Hazlett, Will Kastens, and James W. Kazura, Case Western Reserve University, Cleveland, OH. Zachary Dimber, Benson Kiniboro, and Nandao Tarongka, Papua New Guinea Institute of Medical Research, Madang, Papua New Guinea. Michael P. Alpers, Curtin University of Technology, Perth, Australia.






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Copyright © 2008 by the American Society of Tropical Medicine and Hygiene.