Laboratory Evaluation of a Rapid IgG4 Antibody Test (BLF Rapid™) for Bancroftian Filariasis

Rahmah Noordin Institute for Research in Molecular Medicine (INFORMM), Universiti Sains Malaysia, Pulau Pinang, Malaysia;

Search for other papers by Rahmah Noordin in
Current site
Google Scholar
PubMed
Close
,
Muhammad Hafiznur Yunus Institute for Research in Molecular Medicine (INFORMM), Universiti Sains Malaysia, Pulau Pinang, Malaysia;

Search for other papers by Muhammad Hafiznur Yunus in
Current site
Google Scholar
PubMed
Close
,
Keri Robinson Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia;

Search for other papers by Keri Robinson in
Current site
Google Scholar
PubMed
Close
,
Kimberly Y. Won Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia;

Search for other papers by Kimberly Y. Won in
Current site
Google Scholar
PubMed
Close
,
Subash Babu National Institutes of Health-International Center for Excellence in Research, National Institute of Research in Tuberculosis, Chennai, India;

Search for other papers by Subash Babu in
Current site
Google Scholar
PubMed
Close
,
Peter U. Fischer Infectious Diseases Division, Washington University School of Medicine, St. Louis, Missouri;

Search for other papers by Peter U. Fischer in
Current site
Google Scholar
PubMed
Close
,
Shamilah Hisam Parasitology Unit, Institute for Medical Research, Kuala Lumpur, Malaysia;

Search for other papers by Shamilah Hisam in
Current site
Google Scholar
PubMed
Close
, and
Rohela Mahmud Department of Parasitology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia

Search for other papers by Rohela Mahmud in
Current site
Google Scholar
PubMed
Close
Restricted access

At the end phase of the Global Programme to Eliminate Lymphatic Filariasis, antibody testing may have a role in decision-making for bancroftian filariasis–endemic areas. This study evaluated the diagnostic performance of BLF Rapid, a prototype immunochromatographic IgG4-based test using BmSXP recombinant protein, for detection of bancroftian filariasis. The test was evaluated using 258 serum samples, comprising 96 samples tested at Universiti Sains Malaysia (in-house) and 162 samples tested independently at three international laboratories in the USA and India, and two laboratories in Malaysia. The independent testing involved 99 samples from Wuchereria bancrofti microfilaria or antigen positive individuals and 63 samples from people who were healthy or had other infections. The in-house evaluation showed 100% diagnostic sensitivity and specificity. The independent evaluations showed a diagnostic sensitivity of 84–100% and 100% specificity (excluding non-lymphatic filarial infections). BLF Rapid has potential as a surveillance diagnostic tool to make “Transmission Assessment Survey”–stopping decisions and conduct post-elimination surveillance.

Author Notes

Address correspondence to Rahmah Noordin, Institute for Research in Molecular Medicine (INFORMM), Universiti Sains Malaysia, 11800 USM, Pulau Pinang, Malaysia. E-mail: rahmah@usm.my

Financial support: This study was funded by USM APEX DE 2012 grant [1002/CIPPM/910316], and additional funding was obtained from the Malaysian Ministry of Education through the Higher Institution Centre of Excellence Program [HICoE grant no. 311/CIPPM/4401005].

Authors’ addresses: Rahmah Noordin and Muhammad Hafiznur Yunus, Institute for Research in Molecular Medicine, Universiti Sains Malaysia, Pulau Pinang, Malaysia, E-mails: rahmah8485@gmail.com and mhn1016@yahoo.com. Keri Robinson and Kimberly Y. Won, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, GA, E-mails: yly4@cdc.gov and kfw7@cdc.gov. Subash Babu, National Institutes of Health-International Center for Excellence in Research, National Institute of Research in Tuberculosis, Chennai, India, E-mail: sbabu@nirt.res.in. Peter U. Fischer, Infectious Diseases Division, Washington University School of Medicine, St. Louis, MO, E-mail: pufischer@wustl.edu. Shamilah Hisam, Parasitology Unit, Institute for Medical Research, Kuala Lumpur, Malaysia, E-mail: shamilah@imr.gov.my. Rohela Mahmud, Department of Parasitology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia, E-mail: rohela@ummc.edu.my.

Disclosure: R. N. is named as an inventor in a patent application related to the BmSXP recombinant protein.

  • 1.

    WHO, 2017. Global programme to eliminate lymphatic filariasis: progress report, 2016. Wkly Epidemiol Rec 92: 594607.

  • 2.

    Shenoy RK, 2008. Clinical and pathological aspects of filarial lymphedema and its management. Korean J Parasitol 46: 119125.

  • 3.

    GBD 2016 DALYs and HALE Collaborators, 2017. Global, regional, and national disability-adjusted life-years (DALYs) for 333 diseases and injuries and healthy life expectancy (HALE) for 195 countries and territories, 1990–2013; 2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet 390: 12601344.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 4.

    World Health Organization, 2011. Lymphatic Filariasis: Monitoring and Epidemiological Assessment of Mass Drug Administration: A Manual for National Elimination Programmes. Geneva, Switzerland: WHO/HTM/NTD/PCT/2011.4.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 5.

    Kwan-Lim GE, Forsyth KP, Maizels RM, 1990. Filarial-specific IgG4 response correlates with active Wuchereria bancrofti infection. J Immunol 145: 42984305.

  • 6.

    Dewi RM, Tuti S, Ganefa S, Anwar C, Larasati R, Ariyanti E, Herjati H, Brady M, 2015. Brugia rapid antibody responses in communities of Indonesia in relation to the results of 'transmission assessment surveys' (TAS) for the lymphatic filariasis elimination program. Parasit Vectors 8: 499.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 7.

    Noordin R, Mohd Zain SN, Yunus MH, Sahimin N, 2017. Seroprevalence of lymphatic filariasis among migrant workers in Peninsular Malaysia. Trans R Soc Trop Med Hyg 111: 370372.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 8.

    Vythilingam I, 2012. Plasmodium knowlesi and Wuchereria bancrofti: their vectors and challenges for the future. Front Physiol 3: 115.

  • 9.

    Ismail MM, Weil GJ, Jayasinghe KS, Premaratne UN, Abeyewickreme W, Rajaratnam HN, Sheriff MH, Perera CS, Dissanaike AS, 1996. Prolonged clearance of microfilaraemia in patients with bancroftian filariasis after multiple high doses of ivermectin or diethylcarbamazine. Trans R Soc Trop Med Hyg 90: 684688.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 10.

    Won KY, Sambou S, Barry A, Robinson K, Jaye M, Sanneh B, Sanyang A, Gass K, Lammie PJ, Rebollo M, 2018. Use of antibody tools to provide serologic evidence of elimination of lymphatic filariasis in the Gambia. Am J Trop Med Hyg 98: 1520.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 11.

    Gass K et al. 2012. A multicenter evaluation of diagnostic tools to define endpoints for programs to eliminate bancroftian filariasis. PLoS Negl Trop Dis 6: e1479.

  • 12.

    Washington CH et al. 2004. Spatial clustering of filarial transmission before and after a mass drug administration in a setting of low infection prevalence. Filaria J 3: 3.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 13.

    Won KY et al. 2018. Comparison of antigen and antibody responses in repeat lymphatic filariasis transmission assessment surveys in American Samoa. PLoS Negl Trop Dis 12: e0006347.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 14.

    Weil GJ, Ramzy RM, 2007. Diagnostic tools for filariasis elimination programs. Trends Parasitol 23: 7882.

  • 15.

    Ramzy RM, El Setouhy M, Helmy H, Ahmed ES, Abd Elaziz KM, Farid HA, Shannon WD, Weil GJ, 2006. Effect of yearly mass drug administration with diethylcarbamazine and albendazole on bancroftian filariasis in Egypt: a comprehensive assessment. Lancet 367: 992999.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 16.

    Steel C, Golden A, Kubofcik J, LaRue N, de los Santos T, Domingo GJ, Nutman TB, 2013. Rapid Wuchereria bancrofti-specific antigen Wb123-based IgG4 immunoassays as tools for surveillance following mass drug administration programs on lymphatic filariasis. Clin Vaccine Immunol 20: 11551161.

    • PubMed
    • Search Google Scholar
    • Export Citation
Past two years Past Year Past 30 Days
Abstract Views 410 341 39
Full Text Views 533 15 0
PDF Downloads 192 11 0
 
 
 
 
Affiliate Membership Banner
 
 
Research for Health Information Banner
 
 
CLOCKSS
 
 
 
Society Publishers Coalition Banner
Save