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

我们开发了一种利用尿液样本检测丝虫感染的ELISA方法（尿液ELISA），并研究了该方法是否适用于现场发现丝虫病流行区，评估治疗效果和确认消除丝虫病.在斯里兰卡学习：（i）对每年的大规模治疗进行了5年的监测，结果表明，社区中的抗体滴度逐渐下降，最终达到负水平。(ii)根据当地居民提供的象皮病和鞘膜积液资料，编制了丝虫病分布图。用尿ELISA证实了他们的信息的可靠性。(iii)在南部省的3个区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。(iv)在斯里兰卡，象皮病的家族积累是已知的。为阐明其遗传背景进行了基础研究。在中国的一项研究：在我国已消灭丝虫病的地区进行了尿ELISA的现场研究，以探讨尿ELISA能否再次确认丝虫病的消灭。这项研究显示，所有超过10000名儿童的尿液检测结果均为ELISA阴性。肯尼亚的一项研究：埃及血吸虫感染产生与尿液ELISA交叉反应的抗体，从而导致特异性差。用重组SXP-1抗原建立的新的尿液ELISA成功地消除了交叉反应4。东帝汶的一项研究：用尿酶联免疫吸附试验（ELISA）对34所学校5661名学生进行了流行病学调查，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%.