title: Brugia Rapid™ antibody responses in communities of Indonesia in relation to the results of 'transmission assessment surveys' (TAS) for the lymphatic filariasis elimination program.
abstract: BACKGROUND
  The Global Programme to Eliminate Lymphatic Filariasis recommends the transmission assessment survey (TAS) as the preferred methodology for determining whether mass drug administration can be stopped in an endemic area. Because of the limited experience available globally with the use of Brugia Rapid™ tests in conducting TAS in Brugia spp. areas, we explored the relationship between the antibody test results and Brugia spp. infection as detected by microfilaremia in different epidemiological settings.
  
  
  METHODS
  The study analyzes the Brugia Rapid™ antibody responses and microfilaremia in all ages at three study sites in: i) a district which was classified as non-endemic, ii) a district which passed TAS, and iii) a district which failed TAS. Convenience sampling was done in each site, in one to three purposefully selected villages with a goal of 500 samples in each district.
  
  
  RESULTS
  A total of 1543 samples were collected from residents in all three study sites. In the site which was classified as non-endemic and where MDA had not been conducted, 5 % of study participants were antibody positive, none was positive for microfilaremia, and age-specific antibody prevalence peaked at almost 8 % in the 25-34 year-old age range, with no antibody-positive results found in children under eight years of age. In the site that had passed TAS, 1 % of participants were antibody positive and none was positive for microfilaremia. In the site which failed TAS, 15 % of participants were antibody positive, 0.2 % were microfilaremic, and age-specific antibody prevalence was highest in 6-7 year olds (30 %), but above 8 % in all age levels above 8 years old.
  
  
  CONCLUSIONS
  These results from districts which followed the current WHO guidance for mapping, MDA, and implementing TAS, while providing antibody profiles of treated and untreated populations under programmatic settings, support the choice of antibody prevalence in the 6- and 7-year-old age group in TAS for making stopping MDA decisions. Since only one study participant was microfilaremic, no conclusions could be drawn about the relationship between antibodies and microfilaremia and further longitudinal studies are required to understand this relationship.
authors.affiliation: National Institute of Health Research and Development, Indonesia Ministry of Health, Jl. Percetakan Negara No. 29, Jakarta, 10560, Indonesia. rmdewi@gmail.com.
authors.forename: Rita M
authors.initials: RM
authors.lastname: Dewi
authors.affiliation: National Institute of Health Research and Development, Indonesia Ministry of Health, Jl. Percetakan Negara No. 29, Jakarta, 10560, Indonesia. sekartuti@yahoo.com.
authors.forename: Sekar
authors.initials: S
authors.lastname: Tuti
authors.affiliation: Sub-Directorate of Filariasis & Helminthiasis Control, Directorate of Vector Borne Disease Control, Directorate General of Communicable Disease and Environmental Health, Indonesia Ministry of Health, Jl. Percetakan Negara No. 29, Jakarta, 10560, Indonesia. sittiganefa@gmail.com.
authors.forename: Sitti
authors.initials: S
authors.lastname: Ganefa
authors.affiliation: Sub-Directorate of Filariasis & Helminthiasis Control, Directorate of Vector Borne Disease Control, Directorate General of Communicable Disease and Environmental Health, Indonesia Ministry of Health, Jl. Percetakan Negara No. 29, Jakarta, 10560, Indonesia. chairiyah2004@yahoo.com.
authors.forename: Chairiyah
authors.initials: C
authors.lastname: Anwar
authors.affiliation: RTI International-Indonesia, Menara Thamrin, 15th Floor, Suite 1503, Jl. M.H. Thamrin Kav. 3, Jakarta, 10250, Indonesia. rlarasati@id-ntd.rti.org.
authors.forename: Ria
authors.initials: R
authors.lastname: Larasati
authors.affiliation: National Institute of Health Research and Development, Indonesia Ministry of Health, Jl. Percetakan Negara No. 29, Jakarta, 10560, Indonesia. endah@litbang.depkes.go.id.
authors.forename: Endah
authors.initials: E
authors.lastname: Ariyanti
authors.affiliation: RTI International-Indonesia, Menara Thamrin, 15th Floor, Suite 1503, Jl. M.H. Thamrin Kav. 3, Jakarta, 10250, Indonesia. hherjati@rti.org.
authors.forename: Herty
authors.initials: H
authors.lastname: Herjati
authors.affiliation: RTI International, 701 13th Street NW, Suite 750, Washington, DC, 20008, USA. mbrady@rti.org.
authors.forename: Molly
authors.initials: M
authors.lastname: Brady
mesh_terms: D000293:Adolescent; D000328:Adult; D000818:Animals; D000909:Antibodies, Helminth / Q000097:blood*; D002009:Brugia / Q000276:immunology*; D002648:Child; D002675:Child, Preschool; D018562:Disease Transmission, Infectious / Q000517:prevention & control; D004605:Elephantiasis, Filarial / Q000175:diagnosis* / Q000453:epidemiology / Q000276:immunology / Q000517:prevention & control*; D062665:Epidemiological Monitoring; D005260:Female; D005369:Filaricides / Q000627:therapeutic use; D014943:Global Health; D006801:Humans; D007214:Indonesia / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D055815:Young Adult
chemical_list: D000909:Antibodies, Helminth; D005369:Filaricides