Comparing facility-based and molecular xenomonitoring pre-validation surveys for lymphatic filariasis

Primary objective:

• To compare the prevalence of W. bancrofti infection through facility-based integration of malaria and LF diagnosis with molecular Mx of
  LF for pre-validation surveys.

Secondary objectives:

• To design and evaluate the LF pre-validation survey protocol;
• To confirm the prevalence of W. bancrofti infection in Gomoa West and Komenda-Edina-Eguafo-Abirem (KEEA) districts over 10 years after mass drug administration was stopped;
• To assess the comparative feasibility of facility-based surveillance and molecular xenomonitoring;
• To identify the barriers and facilitators to facility-based surveillance and recommend procedures for implementation;
• To assess the cost of facility-based surveillance and Mx for LF pre-validation surveys.

This collaborative study, led by the Noguchi Memorial Institute for Medical Research at the University of Ghana, aims to develop an integrated survey protocol to support surveillance strategies while countries await validation of the elimination of lymphatic filariasis (LF) as a public health problem.

The facility-based component integrates the diagnosis of LF and malaria, an approach expected to improve LF testing efficiency and reduce operational costs by building on existing malaria-related health-seeking behaviour. The molecular xenomonitoring (Mx) component, which involves PCR-based detection of the parasite Wuchereria bancrofti in vector mosquitoes, aims to provide a broader view of LF transmission in mosquito populations.

It is expected that this study will guide further efforts in developing:

• Surveillance systems (both pre- and post- validation) to detect and address any recrudescence of infection
• Integrated surveillance platforms with potential for improved testing efficiency and reduced operational costs
• Evidence to inform the use of Mx in LF surveillance activities

• Quantitative methods