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Development of a Specimen-Sparing Multichannel Bead Assay to Detect Antiparasite IgG4 for the Diagnosis of Schistosoma and Wuchereria Infections on the Coast of Kenya

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  • Center for Global Health and Diseases, Case Western Reserve University School of Medicine, Cleveland, Ohio; Division of Vector Borne and Neglected Tropical Diseases, Ministry of Public Health and Sanitation, Nairobi, Kenya; Department of Environmental Sciences, Emory University, Atlanta, Georgia

To better delineate the impact of parasitic coinfection in coastal Kenya, we developed a novel specimen-sparing bead assay using multiplex flow immunoassay (MFI) technology to simultaneously measure serum or plasma immunoglobulin G4 (IgG4) against Brugia malayi antigen (BMA) and Schistosoma haematobium soluble worm antigen (SWAP). Properties of the bead assay were estimated by latent class analysis using data from S. haematobium egg counts/filarial rapid diagnostic cards (RDTs), parasite-specific enzyme-linked immunosorbent assays (ELISAs), and the multichannel IgG4 assay. For schistosomiasis, the bead assay had an estimated sensitivity of 81% and a specificity of 45%, and it was more sensitive than ELISA or urine egg counts for diagnosing infection. For filariasis, it had a sensitivity of 86% and a specificity of 39%, and it was more sensitive than ELISA or RDT. Measuring antibody by MFI is feasible and may provide more accurate epidemiological information than current parasitological tests, especially in the setting of low-intensity infections.

Author Notes

* Address correspondence to Jessica K. Fairley, 550 Peachtree Street, NE, MOT Building, 7th Floor, Atlanta, GA 30306. E-mail: jessica.fairley@emory.edu† These authors contributed equally.

Financial support: This study was supported by National Institutes of Health Research Grant R01TW008067, which was funded by the Ecology of Infectious Diseases Program of the Fogarty International Center.

Authors' addresses: Adam S. DuVall, Department of Internal Medicine and Pediatrics, University of Michigan Health System, Ann Arbor, MI, E-mail: duvalla@med.umich.edu. Jessica K. Fairley, Department of Medicine, Division of Infectious Diseases, Emory University School of Medicine, Atlanta, GA, E-mail: jessica.fairley@emory.edu. Laura Sutherland, Peter L. Mungai, Indu Malhotra, and Charles H. King, Center for Global Health and Diseases, Case Western Reserve University, Cleveland, OH, E-mails: chikungunya.ljs@gmail.com, plmungai@yahoo.com, ijm@cwru.edu, and chk@cwru.edu. Amaya L. Bustinduy, Centre for Tropical and Infectious Diseases, Liverpool School of Tropical Medicine, Liverpool, UK, E-mail: Amaya.Bustinduy@liverpool.ac.uk. Eric M. Muchiri, Division of Vector Borne and Neglected Tropical Diseases, Nairobi, Kenya, E-mail ericmmuchiri@gmail.com. Uriel Kitron, Department of Environmental Studies, Emory University, Atlanta, GA, E-mail: ukitron@emory.edu.

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