Projects

District-Level Integrated Mapping of Onchocerciasis, Lymphatic Filariasis, and Loiasis in Nigeria

  • 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.
Countries: Nigeria

Field-testing a Lateral Flow Assay for anti-Chlamydial Antibody Responses

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.

Countries: Tanzania
Diseases: Trachoma

Doxycycline for Clinical Management of Filarial Lymphedema (India)

Determine whether doxycycline treatment daily for 6 weeks improves clinical outcomes (swelling, acute attacks) in lymphedema patients.

Countries: India

TAS Strengthening in Tanzania

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 Tanzania 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. Because the EU is also endemic for onchocerciasis, the new Ov16 monoplex RDT was used in the field. The Wb123 and Ov16 antibodies were assessed via ELISA in the NIMR lab in Tanga and the results will soon be compiled.  Xenomonitoring work to assess Culex and Anopheles mosquitoes, as well as black flies, is underway.

Preliminary Findings and Lessons Learned

The ultimate goal of this study is to strengthen the existing TAS platform so that the programs can be more confident with their stopping and surveillance decisions.   In order to strengthen the existing TAS platform we need to better understand which target population(s) and diagnostic indicator(s) are best-suited for identifying areas with persistent transmission that is not expected to cease on its own, knowing that the answer may vary according the primary vector and stage of the program.  In the selected sites a community-based TAS was conducted using the standard sampling of 6-7 year olds while a community TAS (individuals >8 years) was conducted concurrently.  All samples were tested via FTS and DBS (for Wb123 ELISA).  In these same communities a molecular xenomonitoring study will take place and the mosquitoes will be tested for filarial DNA to relate back to the human specimens.  To date human sampling has been completed in all sites and laboratory analysis of the specimens is complete. Mosquito collection has been completed in Haiti and Tanzania and the PCR analysis has been completed in Haiti and is planned for Tanzania (pending the arrival of a new PCR machine).  In American Samoa xenomonitoring has been delayed due to weather conditions and arbovirus outbreaks; work is expected to commence spring 2018.

Countries: Tanzania

TAS Strengthening in Haiti

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 Haiti 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 Culex mosquitoes will be conducted in the same sites as the human sampling. 

Preliminary Findings and Lessons Learned

The ultimate goal of this study is to strengthen the existing TAS platform so that the programs can be more confident with their stopping and surveillance decisions.   In order to strengthen the existing TAS platform we need to better understand which target population(s) and diagnostic indicator(s) are best-suited for identifying areas with persistent transmission that is not expected to cease on its own, knowing that the answer may vary according the primary vector and stage of the program.  In the selected sites a community-based TAS was conducted using the standard sampling of 6-7 year olds while a community TAS (individuals >8 years) was conducted concurrently.  All samples were tested via FTS and DBS (for Wb123 ELISA).  In these same communities a molecular xenomonitoring study will take place and the mosquitoes will be tested for filarial DNA to relate back to the human specimens.  To date human sampling has been completed in all sites and laboratory analysis of the specimens is complete. Mosquito collection has been completed in Haiti and Tanzania and the PCR analysis has been completed in Haiti and is planned for Tanzania (pending the arrival of a new PCR machine).  In American Samoa xenomonitoring has been delayed due to weather conditions and arbovirus outbreaks; work is expected to commence spring 2018.

Countries: Haiti

Single vs. multiple treatments of praziquantel in intestinal African schistosomiasis: a randomized, double-blind, placebo controlled trial investigation using new diagnostic tools

Rigorous assessment of the efficacy of (multiple) doses with Praziquantel in the treatment of S. mansoni infections using standard and novel highly sensitive diagnostic tools.

Countries: Cote d'Ivoire
Diseases: Schistosomiasis

Triple Drug Therapy (India)

To determine the frequency, type and severity of adverse events following triple-drug therapy (IVM+DEC+ALB, IDA) compared to the standard two-drug treatment (DEC+ALB, DA) in infected and uninfected individuals in a community.

To compare the efficacy of IDA vs. DA administered in communities for clearance of Mf and filarial antigenemia (Ag) in cohort and effectiveness (prevalence) in community settings. To assess the presence and intensity of filarial infection on the frequency and severity of adverse events. To compare community acceptance of MDA with IDA vs. DA.

Countries: India

Ongoing Post-treatment Surveillance for Lymphatic Filariasis in Bangladesh

To evaluate the utility of ongoing surveillance of adults in a post-treatment setting.

To determine if post-treatment surveillance of adults represents a more effective surveillance strategy than TAS or xenomonitoring.

 

Countries: Bangladesh

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