Over the past year, our research in Mali has made progress in 4 distinct areas: 1) We determined the prevalence of co-infection with filarial (Wuchereria bancrofti and Mansonella perstans) and Leishmania major parasites in two ecologically distinct areas of Mali, the Kolokani district (villages of Tieneguebougou and Bougoudiana) in North Sudan Savanna area, and the district of Kolondieba (village of Boundioba) in the South Sudan Savanna area (Sangare et al. Parasit Vectors 2018). A total of 930 volunteers between the age of 18 and 65 were included from the two endemic areas of Kolokani and Kolondieba. In general, in both areas, filarial infection was more prevalent than Leishmania infection with an overall prevalence of 15.27% (142/930) including 8.7% (81/930) for Mansonella perstans and 8% (74/930) for Wuchereria bancrofti-specific circulating antigen. The prevalence of Leishmania major infection was 7.7% (72/930) and was significantly higher in Tieneguebougou and Bougoudiana (15.05%; 64/425) than in Boundioba (2.04%; 8/505) (2=58.66, P<0.0001). Among the filarial infected population, nearly 10% (14/142) were also positive for Leishmania with an overall prevalence of co-infection of 1.50% (14/930) varying from 2.82% (12/425) in Tieneguebougou and Bougoudiana to 0.39% (2/505) in Boundioba (P=0.0048). 2) We sought to understand, using geospatial and parasitologic data, the factors associated with patent (microfilarial positive) infection with Wuchereria bancrofti (Wb), the causative agent of lymphatic filariasis (Dolo et al. Am J Trop Med Hyg 2018). In multivariate analysis, village of residence, Mp Mf positivity and gender were significantly associated with Wb Mf positivity. After controlling for age, gender, and village of residence, the odds of being Wb Mf positive was 2.67 times higher in Mp positive individuals (95% confidence interval 1.42-5.01). 3) We began enrolling in a multi-national, multi-site study to examine the efficacy of a 6 week course of doxycycline on lymphedema in W. bancrofti infection. 4) Having become increasing more interested in the O volvulus and W. bancrofti infections -- both infections in the process of moving toward elimination -- we assessed the performance of the SD Bioline Onchocerciasis/LF IgG4 Rapid Test as an integrated surveillance tool for lymphatic filariasis (LF) and onchocericiasis elimination. Our study indicated that this test can be used in post-treatment surveillance and potentially will supplant other approaches that are currently available.
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