Mali International Center for Excellence in Research: Filariasis

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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) 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. 3) 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 have completed the 24month 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. Data indicate that doxycycline adds very little to the reversal of lymphedema, though hygienic methods (soap/treatment of intertriginous infections/clean water) provides significant benefit.