02674nas a2200373   4500000000100000008004100001653001100042653001200053653001200065653001500077653001300092653002100105653001200126653001100138653002500149653000800174653001200182653002600194653003200220100001300252700001600265700001300281700000900294700002000303700001400323700001300337700001600350245007900366856009800445300001300543490000700556520172300563022001402286       2017                            d10aAfrica10aCentral10aAnimals10aAntibodies10ahelminth10aDiagnostic Tests10aRoutine10aHumans10aImmunochromatography10aLoa10aLoiasis10aPoint-of-Care Systems10aSensitivity and Specificity1 aPedram B1 aPasquetto V1 aDrame PM1 aJi Y1 aGonzalez-Moa MJ1 aBaldwin R1 aNutman T1 aBiamonte MA00aA novel rapid test for detecting antibody responses to Loa loa infections.  uhttp://journals.plos.org/plosntds/article/file?id=10.1371/journal.pntd.0005741&type=printable  ae00057410 v113 a<p>Ivermectin-based mass drug administration (MDA) programs have achieved remarkable success towards the elimination of onchocerciasis and lymphatic filariasis. However, their full implementation has been hindered in Central Africa by the occurrence of ivermectin-related severe adverse events (SAEs) in a subset of individuals with high circulating levels of Loa loa microfilariae. Extending MDA to areas with coincident L. loa infection is problematic, and inexpensive point-of-care tests for L. loa are acutely needed. Herein, we present a lateral flow assay (LFA) to identify subjects with a serological response to Ll-SXP-1, a specific and validated marker of L. loa. The test was evaluated on serum samples from patients infected with L. loa (n = 109) and other helminths (n = 204), as well as on uninfected controls (n = 77). When read with the naked eye, the test was 94% sensitive for L. loa infection and was 100% specific when sera from healthy endemic and non-endemic controls or from those with S. stercoralis infections were used as the comparators. When sera of patients with O. volvulus, W. bancrofti, or M. perstans were used as the comparators, the specificity of the LFA was 82%, 87%, and 88%, respectively. A companion smartphone reader allowed measurement of the test line intensities and establishment of cutoff values. With a cutoff of 600 Units, the assay sensitivity decreased to 71%, but the specificity increased to 96% for O. volvulus, 100% for W. bancrofti, and 100% for M. perstans-infected individuals. The LFA may find applications in refining the current maps of L. loa prevalence, which are needed to eliminate onchocerciasis and lymphatic filariasis from the African continent.</p>
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