Surveillance

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

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 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 determine if there is evidence of ongoing transmission of lymphatic filariasis in Mindoro Oriental, following a TAS 2 failure.

To compare the performance of the diagnostic tools currently available for O. volvulus in terms of their relative sensitivity, species-specificity and practical use by countries.  Comparison of the utility of these tools for mapping and surveillance in settings with different levels of endemicity for onchocerciasis (Oncho), lymphatic filariasis (LF) and/or loiasis.

To field-test the Pgp3 lateral flow assay to compare data obtained in the field on the rapid test to that from DBS collected from the same individual tested on the Pgp3 multiplex bead array.

Will providing enhanced MDA at the community level while achieving treatment coverage of 75% or greater in children (5-17) and adults substantially decrease S. mansoni infection in previously identified persistent hot-spot communities?  

Is molecular detection of schistosome infection (patent and pre-patent) in snails a useful tool for program managers as prevalence and intensity of infection in people approaches very low levels?