A New Strategy for Elimination of Lymphatic Filariasis-Development and Application of Diagnostic Methods Using Urine Samples

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Development and standardization of a diagnostic method using urine samples to find out endemic foci and to evaluate control programs, which is essential for a global program to eliminate lymphatic filariasis' launched by WHO, is the main purpose of this study.1. Development of diagnostic method with urine samples for bancroftian filariasisWe developed an ELISA method using urine samples for bancroftian filariasis, which detect antigen specific IgG4 in urine. Both the sensitivity and specificity of the method were high; 96% and 99%, respectively. Little diurnal fluctuation of antibody titers and preservability of the urine samples after addition of sodium azide are advantage of this method for application to field studies.2. Application of the urine-ELISA to find out endemic foci in Sri LankaThe urine ELISA was used to find out endemic foci in a mountainous area in Sri Lanka where no information on filariasis was available. We examined 2,500 urine samples and found positives (4%). This … More positive rate was higher than the rate obtained by antigen detection kit with serum samples (0.6%) showing that the urine-ELISA is useful for finding endemic foci.3. Application of the urine-ELISA to evaluate a control program in ChinaThe urine-ELISA was used to evaluate a control program carried out in Yongjia in Zhejiang Province where no microfilaria positives has not been found for 10 years. All the samples collected from school age children, 2,800 samples, were urine-ELISA negative. Measurement of antigen specific IgG4 in urine samples from young generation with this method is considered a useful means for evaluation of filariasis control.4. Application of the urine-ELISA to another lymphatic filariasis, malayan filariasisThe urine-ELISA was used to detect antigen specific IgG4 in urine samples from residents in Brugia malayi endemic Islands in Korea. All microfilaria positives were urine-ELISA positive. All urine samples from young generation were negative, showing no recent transmission. Basic study to show sensitivity of the method for malayan filariasis is under study. Less