Date of Award

Fall 1-10-2020

Degree Type

Thesis

Degree Name

Master of Public Health (MPH)

Department

Public Health

First Advisor

Richard Rothenberg

Second Advisor

Kimberly Won

Abstract

In the global effort to eliminate lymphatic filariasis (LF) additional treatment regimens like triple drug therapy and diagnostic tools like Wb123 anti-filarial antibody have become increasingly available. This study aimed to look at two components, time and treatment regimen, in order to assess prevalence of anti-filarial antibody and its programmatic potential in the evolving Global Programme to Eliminate Lymphatic Filariasis (GPELF) setting. At year 0, 2,394 (47.4%) samples were collected from participants before mass drug administration (MDA) was administered and 2,656 (52.6%) were collected 12 months later (year 1). Blood samples from 4,939 (97.8%) participants 5 years of age and older were tested for antigen status by filariasis test strip (FTS) and dried blood spots (DBS) from 4,740 (93.9%) participants were tested for Wb123 antibodies. Our results show older individuals were more likely to be both antigen and antibody positive than younger children. Overall and across most age groups antibody prevalence was higher than antigen prevalence for both drug arms. Individuals living in localities treated with the double drug regimen had 66% greater chance of demonstrating declining antibody prevalence than those living in localities treated with the triple drug regimen. The results of this investigation support treatment with both MDA regimens and the addition of antibody testing as a surveillance tool. Our results have contributed to the evidence base surrounding population-level antibody data and help to inform programmatic decision making around treatment strategies.

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