Diagnostics

To assess filarial exposure in the study population and mosquito infection status prior to and after the start of intensified malaria control interventions.

Field validation of the diagnostic performance of the Wb123/Ov16 biplex rapid diagnostic test and Wb123 ELISA, compared to the filariasis test strip (FTS) in a setting initially found to be non-endemic for lymphatic filariasis, in which clinical cases have been identified.

To compare the performance of antigen (FTS) and antibody (Wb123 monoplex) tools in programmatic settings (TAS).

To evaluate strategies to improve the sensitivity of the TAS for detecting evidence of recent lymphatic filariasis transmission in an evaluation unit (EU). The TAS Strengthening Study in American Samoa is designed to assess additional indicators that may be added to the current TAS platform in order to strengthen the resulting stopping or surveillance decisions. A comprehensive analysis will be conducted to understand the correlation between antigen and antibody in adults and children with the mosquito data. A spatial analysis looking at microfoci of infection will also be conducted.  Xenomonitoring work to assess Aedes mosquitoes is underway.

The results from this study will be combined into a multi-country analysis and are expected to help inform WHO guidance on stopping and surveillance for LF. 

• To define a cost-effective and accurate method to map ivermectin-naïve districts for Onchocerciasis, Lymphatic Filariasis and Loiasis and identify districts eligible for safe treatment with ivermectin MDA.
• To validate a statistical model of Loiasis prevalence and intensity by comparing the model results to data from a prevalence assessment.

To assess the relationships between the prevalence of the clinical sign TF compared to prevalence of infection and antibody in Chikwawa and Mchinji districts

To establish relationship between clinical signs of trachoma, presence of infection, and anti-trachoma antibody in children aged 1-9 years

To study the feasibility of LF and Oncho (Filariases) integrated transmission assessment survey (F-TAS)  according to both LF and Onchocerciasis  WHO elimination guidelines

To study the feasibility of LF and Oncho (Filariases) integrated transmission assessment survey (F-TAS) according to both LF and Onchocerciasis WHO elimination guidelines

To determine if a standardized multi-parallel-PCR assay is a more sensitive diagnostic tool for detecting Hookworm, Trichuris trichiura, Ascaris lumbricoides, and Strongyloides prevalence compared to the Kato-Katz stool test.