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A novel rapid test for detecting antibody responses to Loa loa infections.

Abstract Ivermectin-based mass drug administration (MDA) programs have achieved remarkable success towards the elimination of onchocerciasis and lymphatic filariasis. However, their full implementation has been hindered in Central Africa by the occurrence of ivermectin-related severe adverse events (SAEs) in a subset of individuals with high circulating levels of Loa loa microfilariae. Extending MDA to areas with coincident L. loa infection is problematic, and inexpensive point-of-care tests for L. loa are acutely needed. Herein, we present a lateral flow assay (LFA) to identify subjects with a serological response to Ll-SXP-1, a specific and validated marker of L. loa. The test was evaluated on serum samples from patients infected with L. loa (n = 109) and other helminths (n = 204), as well as on uninfected controls (n = 77). When read with the naked eye, the test was 94% sensitive for L. loa infection and was 100% specific when sera from healthy endemic and non-endemic controls or from those with S. stercoralis infections were used as the comparators. When sera of patients with O. volvulus, W. bancrofti, or M. perstans were used as the comparators, the specificity of the LFA was 82%, 87%, and 88%, respectively. A companion smartphone reader allowed measurement of the test line intensities and establishment of cutoff values. With a cutoff of 600 Units, the assay sensitivity decreased to 71%, but the specificity increased to 96% for O. volvulus, 100% for W. bancrofti, and 100% for M. perstans-infected individuals. The LFA may find applications in refining the current maps of L. loa prevalence, which are needed to eliminate onchocerciasis and lymphatic filariasis from the African continent.
PMID
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Authors

Mayor MeshTerms

Point-of-Care Systems

Keywords
Journal Title plos neglected tropical diseases
Publication Year Start




PMID- 28749939
OWN - NLM
STAT- MEDLINE
DA  - 20170727
DCOM- 20170808
LR  - 20170808
IS  - 1935-2735 (Electronic)
IS  - 1935-2727 (Linking)
VI  - 11
IP  - 7
DP  - 2017 Jul
TI  - A novel rapid test for detecting antibody responses to Loa loa infections.
PG  - e0005741
LID - 10.1371/journal.pntd.0005741 [doi]
AB  - Ivermectin-based mass drug administration (MDA) programs have achieved remarkable
      success towards the elimination of onchocerciasis and lymphatic filariasis.
      However, their full implementation has been hindered in Central Africa by the
      occurrence of ivermectin-related severe adverse events (SAEs) in a subset of
      individuals with high circulating levels of Loa loa microfilariae. Extending MDA 
      to areas with coincident L. loa infection is problematic, and inexpensive
      point-of-care tests for L. loa are acutely needed. Herein, we present a lateral
      flow assay (LFA) to identify subjects with a serological response to Ll-SXP-1, a 
      specific and validated marker of L. loa. The test was evaluated on serum samples 
      from patients infected with L. loa (n = 109) and other helminths (n = 204), as
      well as on uninfected controls (n = 77). When read with the naked eye, the test
      was 94% sensitive for L. loa infection and was 100% specific when sera from
      healthy endemic and non-endemic controls or from those with S. stercoralis
      infections were used as the comparators. When sera of patients with O. volvulus, 
      W. bancrofti, or M. perstans were used as the comparators, the specificity of the
      LFA was 82%, 87%, and 88%, respectively. A companion smartphone reader allowed
      measurement of the test line intensities and establishment of cutoff values. With
      a cutoff of 600 Units, the assay sensitivity decreased to 71%, but the
      specificity increased to 96% for O. volvulus, 100% for W. bancrofti, and 100% for
      M. perstans-infected individuals. The LFA may find applications in refining the
      current maps of L. loa prevalence, which are needed to eliminate onchocerciasis
      and lymphatic filariasis from the African continent.
FAU - Pedram, Bijan
AU  - Pedram B
AD  - Drugs & Diagnostics for Tropical Diseases, San Diego, California, United States
      of America.
FAU - Pasquetto, Valerie
AU  - Pasquetto V
AD  - Drugs & Diagnostics for Tropical Diseases, San Diego, California, United States
      of America.
FAU - Drame, Papa M
AU  - Drame PM
AD  - Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious
      Diseases, National Institutes of Health, Bethesda, Maryland, United States of
      America.
FAU - Ji, Yongchang
AU  - Ji Y
AD  - Drugs & Diagnostics for Tropical Diseases, San Diego, California, United States
      of America.
FAU - Gonzalez-Moa, Maria J
AU  - Gonzalez-Moa MJ
AD  - Drugs & Diagnostics for Tropical Diseases, San Diego, California, United States
      of America.
FAU - Baldwin, Richard K
AU  - Baldwin RK
AD  - nanoComposix, San Diego, California, United States of America.
FAU - Nutman, Thomas B
AU  - Nutman TB
AD  - Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious
      Diseases, National Institutes of Health, Bethesda, Maryland, United States of
      America.
FAU - Biamonte, Marco A
AU  - Biamonte MA
AUID- ORCID: http://orcid.org/0000-0002-6870-6283
AD  - Drugs & Diagnostics for Tropical Diseases, San Diego, California, United States
      of America.
LA  - eng
PT  - Evaluation Studies
PT  - Journal Article
DEP - 20170727
PL  - United States
TA  - PLoS Negl Trop Dis
JT  - PLoS neglected tropical diseases
JID - 101291488
RN  - 0 (Antibodies, Helminth)
SB  - IM
MH  - Africa, Central
MH  - Animals
MH  - Antibodies, Helminth/*blood
MH  - Diagnostic Tests, Routine/*methods
MH  - Humans
MH  - Immunochromatography/*methods
MH  - Loa/*immunology
MH  - Loiasis/*diagnosis
MH  - *Point-of-Care Systems
MH  - Sensitivity and Specificity
PMC - PMC5531435
EDAT- 2017/07/28 06:00
MHDA- 2017/08/09 06:00
CRDT- 2017/07/28 06:00
PHST- 2017/02/28 [received]
PHST- 2017/06/23 [accepted]
AID - 10.1371/journal.pntd.0005741 [doi]
AID - PNTD-D-17-00292 [pii]
PST - epublish
SO  - PLoS Negl Trop Dis. 2017 Jul 27;11(7):e0005741. doi:
      10.1371/journal.pntd.0005741. eCollection 2017 Jul.