Research to Facilitate Elimination of Lymphatic Filariasis in Asia and Africa, and the Application of the Results

我们开发了一种检测尿样丝虫病感染的酶联免疫吸附试验（尿液酶联免疫吸附试验），并研究该方法是否适用于现场发现丝虫病流行区、评价治疗效果和确认丝虫病的消除。在斯里兰卡进行的研究：(i)对每年的大规模治疗进行了5年的监测，结果显示，一个社区的抗体滴度逐渐下降，最终达到阴性水平。㈡根据当地人民提供的关于象皮病和鞘膜积液的资料绘制了丝虫病分布图。尿液ELISA法证实了其信息的可靠性。在南部省的3个县进行了流行病学研究。发现沿海地区的感染率高于内陆地区。已知象皮病在斯里兰卡有家族性累积。进行了基础研究以阐明该症状的遗传背景。在中国的研究：在中国研究人员确认丝虫病已消除的地区进行尿液ELISA实地研究，以调查ELISA是否可以再次确认丝虫病已消除。这项研究表明，所有接受检查的一万多名儿童的尿液都呈elisa阴性。肯尼亚的一项研究：血血吸虫感染与尿液ELISA产生交叉反应性抗体，从而导致特异性差。新的尿液ELISA使用重组SXP-1抗原成功地消除了交叉反应4。东帝汶的一项研究：对34所学校5661名学生进行了尿液ELISA流行病学研究，阳性率为2.9%。

We developed an ELISA to detect filarial infection using urine samples (urine ELISA), and studied if the method was applicable in the field to find endemic areas, evaluate treatment effects and to confirm elimination of filariasis.1. Studies in Sri Lanka: (i) Annual mass treatments were monitored for 5 years, which revealed that antibody titers in a community reduced gradually and eventually reached negative levels. (ii) A filariasis distribution map was made based on information on elephantiasis and hydrocele given by lccal people. The reliability of their information was confirmed with urine ELISA. (iii) An epidemiological study was carried out in 3 districts in Southern province. It was found that coastal regions had higher infection rates than inland areas. (iv) Familial accumulation of elephantiasis had been known in Sri Lanka. Basic studies were carried out to clarify genetic backgrounds of the symptom.2. Astudy in China : Afield study with urine ELISA was conducted in the area where filariasis elimination had been confirmed by Chinese researchers to investigate if the ELISA could re-confirm the elimination. The study revealed that all of more than 10, 000 children examined were urine ELISAnegative.3. A study in Kenya : Schistosoma haematobium infection produces cross reactive antibodies with urine ELISA, thus resulting in poor specificity. Anew urine ELISA using a recombinant SXP-1 antigen successfully eliminated the cross reactivity4. A study in East Timor : An epidemiological study was conducted with urine ELISA at 34 schools with 5, 661 students, and revealed a low positive rate of 2.9%.