Mali International Center for Excellence in Research: Filariasis

在过去的一年里，我们在马里的研究取得了以下进展： 1)我们评估了SD Bioline丝虫病/LFIgG4快速检测作为淋巴丝虫病(LF)和消除丝虫病的综合监测工具的性能。我们的研究表明，这项测试可以用于治疗后监测，并有可能取代目前可用的其他方法。 2)我们对马里3个前W.Bancrofti流行卫生区停止大规模用药后淋巴水肿的持续性提供了洞察。这为通过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灭盘尾丝虫病和淋巴丝虫病的可能性，我们对马里与塞内加尔接壤的一个以前高度流行的地区的6000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)在确定了马里两个生态不同地区丝虫(Wuchereria bancrofti和Mansonella perstans)和利什曼原虫混合感染的流行率后，我们进行了免疫学分析，以检查丝虫感染对沙蝇唾液蛋白固有反应的影响，我们的数据表明，丝虫抗原驱动CCL22上调，进而驱动单核细胞募集，但它们无法改变对沙蝇载体唾液蛋白的反应。 5)我们开始对200名患者进行为期18个月的随访，这些患者参加了一项多国家、多地点的研究，以检验6周疗程的多西环素对班克罗夫蒂念珠菌感染患者淋巴水肿的疗效。24个月(期末评估)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.