Mali International Center for Excellence in Research: Filariasis

一年来，我们在马里的研究取得了以下进展： 1)我们评估了SD Bioline Onchocerciasis/LF IgG 4 Rapid Test作为淋巴丝虫病（LF）和盘尾丝虫病消除综合监测工具的性能。我们的研究表明，该测试可用于治疗后监测，并可能取代目前可用的其他方法。 2)我们已经提供了深入了解持续性水肿后停止大规模药物管理在3个前W。马里的班克罗夫特病流行区。 这为马里控制发病率的公共卫生措施提供了信息。 3.使用综合监测工具评估消除盘尾丝虫病和淋巴丝虫病的潜力，我们对位于塞内加尔边境的马里以前高度流行地区的6000多人进行了血清学评估。 我们的数据表明，这种消除是可能的。 4)在确定了与丝虫病合并感染的流行率之后，（班氏吴策线虫和持久曼氏曼氏线虫）和主要利什曼原虫寄生在马里的两个生态上不同的地区，我们进行了免疫学分析以检查丝虫感染对白蛉衍生的唾液蛋白的先天性应答的影响。我们的数据表明丝虫抗原驱动CCL 22的上调，这反过来驱动单核细胞募集，但它们不能改变对白蛉载体唾液蛋白的反应。 5)我们开始对一项多国、多中心研究中的200名患者进行为期18个月的随访，以检查6周疗程的强力霉素对W。班氏感染。24个月（最终评估）正在进行中。

Over the past year, our research in Mali has made progress as follows: 1) We assessed the performance of the SD Bioline Onchocerciasis/LF IgG4 Rapid Test as an integrated surveillance tool for lymphatic filariasis (LF) and onchocericiasis elimination. Our study indicated that this test can be used in post-treatment surveillance and potentially will supplant other approaches that are currently available. 2) We have provided insight into the persistence of lymphedema following cessation of mass drug administration in 3 formerly W. bancrofti-endemic health districts in Mali. This has informed public health measures for morbidity control through Mali. 3. Using integrated surveillance tools to evaluate the potential of elimination of both onchocerciasis and lymphatic filariasis, we performed serologic assessment of >6000 people in a formerly highly endemic region of Mali that sits at the border with Senegal. Our data suggests that this elimination is likely. 4) Having determined the prevalence of co-infection with filarial (Wuchereria bancrofti and Mansonella perstans) and Leishmania major parasites in two ecologically distinct areas of Mali we performed immunologic analyses to examine the effect of filarial infection on the innate response to sandfly-derived salivary proteins Our data suggests that filarial antigens drive upregulation of CCL22 that in turn drives monocyte recruitment, but that they fail to alter the response to salivary proteins from the sandfly vector. 5) We began completed the 18 month followup in a cohort of 200 patients enrolled in a multi-national, multi-site study to examine the efficacy of a 6 week course of doxycycline on lymphedema in W. bancrofti infection. 24 month (final assessment) is underway.