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A Critical Appraisal of Molecular Xenomonitoring as a Tool for Assessing Progress toward Elimination of Lymphatic Filariasis

We used molecular xenomonitoring (MX, detection of filarial DNA in mosquitoes) to evaluate the impact of mass drug administration (MDA) in sentinel locations in Egypt with high (11.5%) and low (4.1%) baseline microfilaria prevalence rates. Blood-fed Culex pipiens were pooled by household and tested for Wuchereria bancrofti DNA by PCR. There was no significant relationship between the infection status of household residents and parasite DNA status of mosquitoes from the same houses. After 5 MDA rounds, parasite DNA rates in mosquitoes in high- and low-prevalence areas were reduced by 93.8% and 100% to 0.19% (95% CI: 0.076–0.382%) and 0% (95% CI: 0–0.045%), respectively. These changes were consistent with decreases in microfilaria prevalence rates in these sites; they provide insight regarding the minimal mosquito DNA rates necessary for sustained transmission of filariasis in Egypt. We conclude that MX is a powerful tool for monitoring the impact of MDA on filariasis endemicity and transmission.

Received March 6, 2007. Accepted for publication June 13, 2007.

Acknowledgments: We acknowledge the contributions of the laboratory and field technical staff of the Research and Training Center on Vectors of Diseases. This project would not have been possible without their dedication and effort in activities such as late-night mosquito collection and careful laboratory work over a period of many years.

Financial support: This work was supported by NIH grants AI-35855 and AI-65715.

Disclaimer: The filiarial card test used in this study uses reagents licensed from Barnes–Jewish Hospital, an affiliation of G.J. Weil. All royalties from the sales of this test are donated to the Barnes–Jewish Hospital Foundation, a registered not-for-profit organization. This statement is made in the interest of full disclosure and not because the authors consider this to be a conflict of interest.

^* Address correspondence to Gary J. Weil, Box 8051, 660 S. Euclid Avenue, Washington University School of Medicine, St. Louis, MO 63110. E-mail: gweil{at}im.wustl.edu

Authors’ addresses: Hoda A. Farid, Zakaria S. Morsy, Hanan Helmy, Reda M.R. Ramzy, and Maged El Setouhy, Research and Training Center on Vectors of Diseases, Faculty of Science Building, Ain Shams University, Abbassia, Cairo, Egypt, Telephone/Fax: +20-2-6839622. Gary J. Weil, Infectious Diseases Division, Campus Box 8051, Washington University School of Medicine, 660 S. Euclid Ave., St. Louis, MO 63110, Telephone: +1 (314) 454-7782; Fax: +1 (314) 454-5293, E-mail: gweil{at}im.wustl.edu.

Reprint requests to: Gary J. Weil, Infectious Diseases Division, Campus Box 8051, Washington University School of Medicine, 660 S. Euclid Ave., St. Louis, MO 63110, Telephone: +1 (314) 454-7782; Fax: +1 (314) 454-5293, E-mail: gweil{at}im.wustl.edu.