02401nas a2200445   4500000000100000008004100001260002100042653002500063653002500088653001000113653001200123653002100135653002900156653000900185653002500194100001500219700001300234700001400247700001400261700001900275700001600294700001300310700001400323700001200337700001200349700001700361700001200378700002100390700001300411700001200424700001300436700001100449700001100460245014600471856006800617300001200685490000700697520123700704022001401941       2026                            d  c09/2026bMDPI AG10aLymphatic filariasis10aconfirmatory mapping10aGabon10aLoa loa10across-reactivity10aMass drug administration10aQFAT10aWuchereria bancrofti1 aBakajika D1 aAtsame J1 aPambou JR1 aKoumba PK1 aNtsame Ella SA1 aKombila RFK1 aMawule D1 aAsseko GN1 aZongo K1 aSerme M1 aBonkoungou A1 aKarim S1 aSounkalo Sanfo M1 aAdjami A1 aYumba D1 aZouré H1 aCano J1 aJuma E00aAntigen Positivity Without Infection: Confirmatory Mapping in Children Rules out Lymphatic Filariasis in Loiasis Co-Endemic Settings in Gabon  uhttps://www.mdpi.com/2414-6366/11/10/261/pdf?version=1790145196  a 1 - 130 v113 a<jats:p>Precise mapping is essential for guiding lymphatic filariasis (LF) elimination programmes, yet antigen tests in loiasis co-endemic settings must be read with caution because of cross-reactivity. Gabon’s 2015 national mapping flagged 18 of 52 health districts (HDs) as potentially endemic, but that signal needed confirmation before committing populations to mass drug administration (MDA). We surveyed all 18 HDs between July and August 2025, enrolling 6688 children aged 9–14 years from 341 communities and testing them with the STANDARD™ Q Filariasis Antigen Test (QFAT); every QFAT-positive child then underwent nocturnal calibrated thick-smear microscopy and Wb-LDR quantitative PCR (qPCR) on dried blood spots. Thirteen children (0.19%) were QFAT-positive across eight HDs, and 17 of 18 HDs fell below the confirmatory mapping threshold for MDA. None of the thirteen carried Wuchereria bancrofti microfilariae or DNA; microscopy instead identified Loa loa in three and Mansonella perstans in one. MDA for LF is not warranted in the surveyed HDs, and these findings show why antigen results in loiasis co-endemic settings require parasitological or molecular confirmation before any programmatic decision.</jats:p>  a2414-6366