Assessing the presence of Wuchereria bancrofti in vector and human populations from urban communities in Conakry, Guinea
Identifieur interne : 000E05 ( Pmc/Corpus ); précédent : 000E04; suivant : 000E06Assessing the presence of Wuchereria bancrofti in vector and human populations from urban communities in Conakry, Guinea
Auteurs : Bernard L. Kouassi ; Dziedzom K. De Souza ; Andre Goepogui ; Charles A. Narh ; Sandra A. King ; Baldé S. Mamadou ; Lamia Diakité ; Samuel K. Dadzie ; Daniel A. Boakye ; Jürg Utzinger ; Moses J. Bockarie ; Benjamin G. KoudouSource :
- Parasites & Vectors [ 1756-3305 ] ; 2015.
Abstract
The Global Programme to Eliminate Lymphatic Filariasis was launched in 2000 with the goal of interrupting transmission of lymphatic filariasis (LF) through multiple rounds of mass drug administration (MDA). In Guinea, there is evidence of ongoing LF transmission, but little is known about the most densely populated parts of the country, including the capital Conakry. In order to guide the LF control and elimination efforts, serological and entomological surveys were carried out to determine whether or not LF transmission occurs in Conakry.
The prevalence of circulating filarial antigen (CFA) of
CFA test revealed no infection in the 611 individuals examined. A total of 14,334 mosquitoes were collected; 14,135
This study revealed the presence of
Url:
DOI: 10.1186/s13071-015-1077-x
PubMed: 26410739
PubMed Central: 4583765
Links to Exploration step
PMC:4583765Le document en format XML
<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Assessing the presence of <italic>Wuchereria bancrofti</italic> in vector and human populations from urban communities in Conakry, Guinea</title><author><name sortKey="Kouassi, Bernard L" sort="Kouassi, Bernard L" uniqKey="Kouassi B" first="Bernard L." last="Kouassi">Bernard L. Kouassi</name><affiliation><nlm:aff id="Aff1">Centre Suisse de Recherches Scientifiques en Côte d’Ivoire, Abidjan, Côte d’Ivoire</nlm:aff></affiliation><affiliation><nlm:aff id="Aff2">Unité de Formation et de Recherche Science de la Nature, Université Nangui Abrogoua, Abidjan, Côte d’Ivoire</nlm:aff></affiliation><affiliation><nlm:aff id="Aff3">Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland</nlm:aff></affiliation><affiliation><nlm:aff id="Aff4">University of Basel, Basel, Switzerland</nlm:aff></affiliation></author><author><name sortKey="De Souza, Dziedzom K" sort="De Souza, Dziedzom K" uniqKey="De Souza D" first="Dziedzom K." last="De Souza">Dziedzom K. De Souza</name><affiliation><nlm:aff id="Aff5">Parasitology Department, Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Accra, Ghana</nlm:aff></affiliation></author><author><name sortKey="Goepogui, Andre" sort="Goepogui, Andre" uniqKey="Goepogui A" first="Andre" last="Goepogui">Andre Goepogui</name><affiliation><nlm:aff id="Aff6">Programme National de Lutte contre l’Onchocercose, le Trachome et les autres Maladies Tropicales Négligées, Ministère de la Santé Publique, Conakry, Guinea</nlm:aff></affiliation></author><author><name sortKey="Narh, Charles A" sort="Narh, Charles A" uniqKey="Narh C" first="Charles A." last="Narh">Charles A. Narh</name><affiliation><nlm:aff id="Aff5">Parasitology Department, Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Accra, Ghana</nlm:aff></affiliation></author><author><name sortKey="King, Sandra A" sort="King, Sandra A" uniqKey="King S" first="Sandra A." last="King">Sandra A. King</name><affiliation><nlm:aff id="Aff5">Parasitology Department, Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Accra, Ghana</nlm:aff></affiliation></author><author><name sortKey="Mamadou, Balde S" sort="Mamadou, Balde S" uniqKey="Mamadou B" first="Baldé S." last="Mamadou">Baldé S. Mamadou</name><affiliation><nlm:aff id="Aff6">Programme National de Lutte contre l’Onchocercose, le Trachome et les autres Maladies Tropicales Négligées, Ministère de la Santé Publique, Conakry, Guinea</nlm:aff></affiliation></author><author><name sortKey="Diakite, Lamia" sort="Diakite, Lamia" uniqKey="Diakite L" first="Lamia" last="Diakité">Lamia Diakité</name><affiliation><nlm:aff id="Aff6">Programme National de Lutte contre l’Onchocercose, le Trachome et les autres Maladies Tropicales Négligées, Ministère de la Santé Publique, Conakry, Guinea</nlm:aff></affiliation></author><author><name sortKey="Dadzie, Samuel K" sort="Dadzie, Samuel K" uniqKey="Dadzie S" first="Samuel K." last="Dadzie">Samuel K. Dadzie</name><affiliation><nlm:aff id="Aff5">Parasitology Department, Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Accra, Ghana</nlm:aff></affiliation></author><author><name sortKey="Boakye, Daniel A" sort="Boakye, Daniel A" uniqKey="Boakye D" first="Daniel A." last="Boakye">Daniel A. Boakye</name><affiliation><nlm:aff id="Aff5">Parasitology Department, Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Accra, Ghana</nlm:aff></affiliation></author><author><name sortKey="Utzinger, Jurg" sort="Utzinger, Jurg" uniqKey="Utzinger J" first="Jürg" last="Utzinger">Jürg Utzinger</name><affiliation><nlm:aff id="Aff3">Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland</nlm:aff></affiliation><affiliation><nlm:aff id="Aff4">University of Basel, Basel, Switzerland</nlm:aff></affiliation></author><author><name sortKey="Bockarie, Moses J" sort="Bockarie, Moses J" uniqKey="Bockarie M" first="Moses J." last="Bockarie">Moses J. Bockarie</name><affiliation><nlm:aff id="Aff7">Centre for Neglected Tropical Diseases, Liverpool School of Tropical Medicine, Liverpool, UK</nlm:aff></affiliation></author><author><name sortKey="Koudou, Benjamin G" sort="Koudou, Benjamin G" uniqKey="Koudou B" first="Benjamin G." last="Koudou">Benjamin G. Koudou</name><affiliation><nlm:aff id="Aff1">Centre Suisse de Recherches Scientifiques en Côte d’Ivoire, Abidjan, Côte d’Ivoire</nlm:aff></affiliation><affiliation><nlm:aff id="Aff2">Unité de Formation et de Recherche Science de la Nature, Université Nangui Abrogoua, Abidjan, Côte d’Ivoire</nlm:aff></affiliation><affiliation><nlm:aff id="Aff7">Centre for Neglected Tropical Diseases, Liverpool School of Tropical Medicine, Liverpool, UK</nlm:aff></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">26410739</idno><idno type="pmc">4583765</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4583765</idno><idno type="RBID">PMC:4583765</idno><idno type="doi">10.1186/s13071-015-1077-x</idno><date when="2015">2015</date><idno type="wicri:Area/Pmc/Corpus">000E05</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000E05</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Assessing the presence of <italic>Wuchereria bancrofti</italic> in vector and human populations from urban communities in Conakry, Guinea</title><author><name sortKey="Kouassi, Bernard L" sort="Kouassi, Bernard L" uniqKey="Kouassi B" first="Bernard L." last="Kouassi">Bernard L. Kouassi</name><affiliation><nlm:aff id="Aff1">Centre Suisse de Recherches Scientifiques en Côte d’Ivoire, Abidjan, Côte d’Ivoire</nlm:aff></affiliation><affiliation><nlm:aff id="Aff2">Unité de Formation et de Recherche Science de la Nature, Université Nangui Abrogoua, Abidjan, Côte d’Ivoire</nlm:aff></affiliation><affiliation><nlm:aff id="Aff3">Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland</nlm:aff></affiliation><affiliation><nlm:aff id="Aff4">University of Basel, Basel, Switzerland</nlm:aff></affiliation></author><author><name sortKey="De Souza, Dziedzom K" sort="De Souza, Dziedzom K" uniqKey="De Souza D" first="Dziedzom K." last="De Souza">Dziedzom K. De Souza</name><affiliation><nlm:aff id="Aff5">Parasitology Department, Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Accra, Ghana</nlm:aff></affiliation></author><author><name sortKey="Goepogui, Andre" sort="Goepogui, Andre" uniqKey="Goepogui A" first="Andre" last="Goepogui">Andre Goepogui</name><affiliation><nlm:aff id="Aff6">Programme National de Lutte contre l’Onchocercose, le Trachome et les autres Maladies Tropicales Négligées, Ministère de la Santé Publique, Conakry, Guinea</nlm:aff></affiliation></author><author><name sortKey="Narh, Charles A" sort="Narh, Charles A" uniqKey="Narh C" first="Charles A." last="Narh">Charles A. Narh</name><affiliation><nlm:aff id="Aff5">Parasitology Department, Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Accra, Ghana</nlm:aff></affiliation></author><author><name sortKey="King, Sandra A" sort="King, Sandra A" uniqKey="King S" first="Sandra A." last="King">Sandra A. King</name><affiliation><nlm:aff id="Aff5">Parasitology Department, Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Accra, Ghana</nlm:aff></affiliation></author><author><name sortKey="Mamadou, Balde S" sort="Mamadou, Balde S" uniqKey="Mamadou B" first="Baldé S." last="Mamadou">Baldé S. Mamadou</name><affiliation><nlm:aff id="Aff6">Programme National de Lutte contre l’Onchocercose, le Trachome et les autres Maladies Tropicales Négligées, Ministère de la Santé Publique, Conakry, Guinea</nlm:aff></affiliation></author><author><name sortKey="Diakite, Lamia" sort="Diakite, Lamia" uniqKey="Diakite L" first="Lamia" last="Diakité">Lamia Diakité</name><affiliation><nlm:aff id="Aff6">Programme National de Lutte contre l’Onchocercose, le Trachome et les autres Maladies Tropicales Négligées, Ministère de la Santé Publique, Conakry, Guinea</nlm:aff></affiliation></author><author><name sortKey="Dadzie, Samuel K" sort="Dadzie, Samuel K" uniqKey="Dadzie S" first="Samuel K." last="Dadzie">Samuel K. Dadzie</name><affiliation><nlm:aff id="Aff5">Parasitology Department, Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Accra, Ghana</nlm:aff></affiliation></author><author><name sortKey="Boakye, Daniel A" sort="Boakye, Daniel A" uniqKey="Boakye D" first="Daniel A." last="Boakye">Daniel A. Boakye</name><affiliation><nlm:aff id="Aff5">Parasitology Department, Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Accra, Ghana</nlm:aff></affiliation></author><author><name sortKey="Utzinger, Jurg" sort="Utzinger, Jurg" uniqKey="Utzinger J" first="Jürg" last="Utzinger">Jürg Utzinger</name><affiliation><nlm:aff id="Aff3">Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland</nlm:aff></affiliation><affiliation><nlm:aff id="Aff4">University of Basel, Basel, Switzerland</nlm:aff></affiliation></author><author><name sortKey="Bockarie, Moses J" sort="Bockarie, Moses J" uniqKey="Bockarie M" first="Moses J." last="Bockarie">Moses J. Bockarie</name><affiliation><nlm:aff id="Aff7">Centre for Neglected Tropical Diseases, Liverpool School of Tropical Medicine, Liverpool, UK</nlm:aff></affiliation></author><author><name sortKey="Koudou, Benjamin G" sort="Koudou, Benjamin G" uniqKey="Koudou B" first="Benjamin G." last="Koudou">Benjamin G. Koudou</name><affiliation><nlm:aff id="Aff1">Centre Suisse de Recherches Scientifiques en Côte d’Ivoire, Abidjan, Côte d’Ivoire</nlm:aff></affiliation><affiliation><nlm:aff id="Aff2">Unité de Formation et de Recherche Science de la Nature, Université Nangui Abrogoua, Abidjan, Côte d’Ivoire</nlm:aff></affiliation><affiliation><nlm:aff id="Aff7">Centre for Neglected Tropical Diseases, Liverpool School of Tropical Medicine, Liverpool, UK</nlm:aff></affiliation></author></analytic><series><title level="j">Parasites & Vectors</title><idno type="eISSN">1756-3305</idno><imprint><date when="2015">2015</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Background</title><p>The Global Programme to Eliminate Lymphatic Filariasis was launched in 2000 with the goal of interrupting transmission of lymphatic filariasis (LF) through multiple rounds of mass drug administration (MDA). In Guinea, there is evidence of ongoing LF transmission, but little is known about the most densely populated parts of the country, including the capital Conakry. In order to guide the LF control and elimination efforts, serological and entomological surveys were carried out to determine whether or not LF transmission occurs in Conakry.</p></sec><sec><title>Methods</title><p>The prevalence of circulating filarial antigen (CFA) of <italic>Wuchereria bancrofti</italic> was assessed by an immuno-chromatography test (ICT) in people recruited from all five districts of Conakry. Mosquitoes were collected over a 1-year period, in 195 households in 15 communities. A proportion of mosquitoes were analysed for <italic>W. bancrofti</italic>, using dissection, loop-mediated isothermal amplification (LAMP) assay and conventional polymerase chain reaction (PCR).</p></sec><sec><title>Results</title><p>CFA test revealed no infection in the 611 individuals examined. A total of 14,334 mosquitoes were collected; 14,135 <italic>Culex</italic> (98.6 %), 161 <italic>Anopheles</italic> (1.1 %) and a few other species. Out of 1,312 <italic>Culex</italic> spp. (9.3 %) and 51 <italic>An. gambiae</italic> (31.7 %) dissected, none was infected with any stage of the <italic>W. bancrofti</italic> parasite. However, the LAMP assay revealed that 1.8 % of <italic>An. gambiae</italic> and 0.31 % of <italic>Culex</italic> spp. were positive, while PCR determined respective prevalences of 0 % and 0.19 %.</p></sec><sec><title>Conclusions</title><p>This study revealed the presence of <italic>W. bancrofti</italic> DNA in mosquitoes, despite the apparent absence of infection in the human population. Although MDA interventions are not recommended where the prevalence of ICT is below 1 %, the entomological results are suggestive of the circulation of the parasite in the population of Conakry. 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<front><journal-meta><journal-id journal-id-type="nlm-ta">Parasit Vectors</journal-id><journal-id journal-id-type="iso-abbrev">Parasit Vectors</journal-id><journal-title-group><journal-title>Parasites & Vectors</journal-title></journal-title-group><issn pub-type="epub">1756-3305</issn><publisher><publisher-name>BioMed Central</publisher-name><publisher-loc>London</publisher-loc></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">26410739</article-id><article-id pub-id-type="pmc">4583765</article-id><article-id pub-id-type="publisher-id">1077</article-id><article-id pub-id-type="doi">10.1186/s13071-015-1077-x</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research</subject></subj-group></article-categories><title-group><article-title>Assessing the presence of <italic>Wuchereria bancrofti</italic> in vector and human populations from urban communities in Conakry, Guinea</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Kouassi</surname><given-names>Bernard L.</given-names></name><xref ref-type="aff" rid="Aff1"></xref><xref ref-type="aff" rid="Aff2"></xref><xref ref-type="aff" rid="Aff3"></xref><xref ref-type="aff" rid="Aff4"></xref></contrib><contrib contrib-type="author"><name><surname>de Souza</surname><given-names>Dziedzom K.</given-names></name><xref ref-type="aff" rid="Aff5"></xref></contrib><contrib contrib-type="author"><name><surname>Goepogui</surname><given-names>Andre</given-names></name><xref ref-type="aff" rid="Aff6"></xref></contrib><contrib contrib-type="author"><name><surname>Narh</surname><given-names>Charles A.</given-names></name><xref ref-type="aff" rid="Aff5"></xref></contrib><contrib contrib-type="author"><name><surname>King</surname><given-names>Sandra A.</given-names></name><xref ref-type="aff" rid="Aff5"></xref></contrib><contrib contrib-type="author"><name><surname>Mamadou</surname><given-names>Baldé S.</given-names></name><xref ref-type="aff" rid="Aff6"></xref></contrib><contrib contrib-type="author"><name><surname>Diakité</surname><given-names>Lamia</given-names></name><xref ref-type="aff" rid="Aff6"></xref></contrib><contrib contrib-type="author"><name><surname>Dadzie</surname><given-names>Samuel K.</given-names></name><xref ref-type="aff" rid="Aff5"></xref></contrib><contrib contrib-type="author"><name><surname>Boakye</surname><given-names>Daniel A.</given-names></name><xref ref-type="aff" rid="Aff5"></xref></contrib><contrib contrib-type="author"><name><surname>Utzinger</surname><given-names>Jürg</given-names></name><xref ref-type="aff" rid="Aff3"></xref><xref ref-type="aff" rid="Aff4"></xref></contrib><contrib contrib-type="author"><name><surname>Bockarie</surname><given-names>Moses J.</given-names></name><xref ref-type="aff" rid="Aff7"></xref></contrib><contrib contrib-type="author" corresp="yes"><name><surname>Koudou</surname><given-names>Benjamin G.</given-names></name><address><email>benjamin.koudou@lstmed.ac.uk</email></address><xref ref-type="aff" rid="Aff1"></xref><xref ref-type="aff" rid="Aff2"></xref><xref ref-type="aff" rid="Aff7"></xref></contrib><aff id="Aff1"><label></label>Centre Suisse de Recherches Scientifiques en Côte d’Ivoire, Abidjan, Côte d’Ivoire</aff><aff id="Aff2"><label></label>Unité de Formation et de Recherche Science de la Nature, Université Nangui Abrogoua, Abidjan, Côte d’Ivoire</aff><aff id="Aff3"><label></label>Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland</aff><aff id="Aff4"><label></label>University of Basel, Basel, Switzerland</aff><aff id="Aff5"><label></label>Parasitology Department, Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Accra, Ghana</aff><aff id="Aff6"><label></label>Programme National de Lutte contre l’Onchocercose, le Trachome et les autres Maladies Tropicales Négligées, Ministère de la Santé Publique, Conakry, Guinea</aff><aff id="Aff7"><label></label>Centre for Neglected Tropical Diseases, Liverpool School of Tropical Medicine, Liverpool, UK</aff></contrib-group><pub-date pub-type="epub"><day>26</day><month>9</month><year>2015</year></pub-date><pub-date pub-type="pmc-release"><day>26</day><month>9</month><year>2015</year></pub-date><pub-date pub-type="collection"><year>2015</year></pub-date><volume>8</volume><elocation-id>492</elocation-id><history><date date-type="received"><day>21</day><month>5</month><year>2015</year></date><date date-type="accepted"><day>8</day><month>9</month><year>2015</year></date></history><permissions><copyright-statement>© Kouassi et al. 2015</copyright-statement><license license-type="OpenAccess"><license-p><bold>Open Access</bold>This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by/4.0/">http://creativecommons.org/licenses/by/4.0/</ext-link>), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/publicdomain/zero/1.0/">http://creativecommons.org/publicdomain/zero/1.0/</ext-link>) applies to the data made available in this article, unless otherwise stated.</license-p></license></permissions><abstract id="Abs1"><sec><title>Background</title><p>The Global Programme to Eliminate Lymphatic Filariasis was launched in 2000 with the goal of interrupting transmission of lymphatic filariasis (LF) through multiple rounds of mass drug administration (MDA). In Guinea, there is evidence of ongoing LF transmission, but little is known about the most densely populated parts of the country, including the capital Conakry. In order to guide the LF control and elimination efforts, serological and entomological surveys were carried out to determine whether or not LF transmission occurs in Conakry.</p></sec><sec><title>Methods</title><p>The prevalence of circulating filarial antigen (CFA) of <italic>Wuchereria bancrofti</italic> was assessed by an immuno-chromatography test (ICT) in people recruited from all five districts of Conakry. Mosquitoes were collected over a 1-year period, in 195 households in 15 communities. A proportion of mosquitoes were analysed for <italic>W. bancrofti</italic>, using dissection, loop-mediated isothermal amplification (LAMP) assay and conventional polymerase chain reaction (PCR).</p></sec><sec><title>Results</title><p>CFA test revealed no infection in the 611 individuals examined. A total of 14,334 mosquitoes were collected; 14,135 <italic>Culex</italic> (98.6 %), 161 <italic>Anopheles</italic> (1.1 %) and a few other species. Out of 1,312 <italic>Culex</italic> spp. (9.3 %) and 51 <italic>An. gambiae</italic> (31.7 %) dissected, none was infected with any stage of the <italic>W. bancrofti</italic> parasite. However, the LAMP assay revealed that 1.8 % of <italic>An. gambiae</italic> and 0.31 % of <italic>Culex</italic> spp. were positive, while PCR determined respective prevalences of 0 % and 0.19 %.</p></sec><sec><title>Conclusions</title><p>This study revealed the presence of <italic>W. bancrofti</italic> DNA in mosquitoes, despite the apparent absence of infection in the human population. Although MDA interventions are not recommended where the prevalence of ICT is below 1 %, the entomological results are suggestive of the circulation of the parasite in the population of Conakry. Therefore, rigorous surveillance is still warranted so that LF transmission in Conakry would be identified rapidly and adequate responses being implemented.</p></sec></abstract><kwd-group xml:lang="en"><title>Keywords</title><kwd>Guinea</kwd><kwd>Lymphatic filariasis</kwd><kwd>Mass drug administration</kwd><kwd>Transmission</kwd><kwd><italic>Wuchereria bancrofti</italic></kwd></kwd-group><custom-meta-group><custom-meta><meta-name>issue-copyright-statement</meta-name><meta-value>© The Author(s) 2015</meta-value></custom-meta></custom-meta-group></article-meta></front><body><sec id="Sec1"><title>Background</title><p>Annual mass drug administration (MDA) with single-dose diethylcarbamazine (DEC) or ivermectin (IVM), in combination with albendazole (ALB), for 4–6 years is the global strategy for the elimination of lymphatic filariasis [<xref ref-type="bibr" rid="CR1">1</xref>]. While it may be perceived that achieving a proper MDA coverage might be easier in urban settings in Africa where the public health system usually is stronger (in comparison to rural areas), the implementation of MDA interventions can be a challenge under certain conditions in urban settings that are characterised by overcrowded slums, intense population movements, poor definition of risk factors, low levels of transmission, uncertainty to determine local transmission, etc. [<xref ref-type="bibr" rid="CR2">2</xref>], particularly in view of the need to achieve at least 65 % effective coverage [<xref ref-type="bibr" rid="CR3">3</xref>].</p><p>For many years, the diagnosis of bancroftian filariasis depended exclusively on the identification of microfilariae (MF) in blood specimens taken at night [<xref ref-type="bibr" rid="CR4">4</xref>]. Likewise, studies on the prevalence of <italic>Wuchereria bancrofti</italic> in mosquitoes have traditionally relied on manual dissection and examination [<xref ref-type="bibr" rid="CR5">5</xref>]. Other diagnostic tests have recently been developed that include sero-diagnostic methods based on the detection of circulating filarial antigens (CFA) [<xref ref-type="bibr" rid="CR6">6</xref>], the detection of IgG4 antibody as a marker for patent MF and the polymerase chain reaction (PCR)-based detection of <italic>W. bancrofti</italic> DNA in mosquitoes and human blood sample [<xref ref-type="bibr" rid="CR7">7</xref>]. These advances have allowed sampling during the day for humans and high-throughput analysis for both human and vector samples, and in turn increased the sensitivity of LF diagnosis.</p><p>The neglected tropical diseases (NTDs) master plan for Guinea reported the prevalence of CFA of <italic>W. bancrofti</italic> to range between 4.5 % and 46.3 % and that of MF between 3.0 % and 16.7 % [<xref ref-type="bibr" rid="CR8">8</xref>]. However, rural–urban migration is an important risk factor of LF transmission in endemic countries [<xref ref-type="bibr" rid="CR9">9</xref>]. Population movements may help spread LF infection from endemic to non-endemic areas where potential LF vectors are present, or may also lead to the resurgence of infection in areas under control [<xref ref-type="bibr" rid="CR10">10</xref>]. Interpretation of the importance of infection rates in humans is also confounded by large movements of infected individuals from endemic to non-endemic areas, especially in conflict areas in West Africa, where some transient populations or internally displaced persons or refugees from the neighbouring countries settle in large cities not directly affected by conflict [<xref ref-type="bibr" rid="CR11">11</xref>]. Conakry, the capital of Guinea, accounts for about one quarter of the total population of the country of whom most originated from other geographical regions of the country and neighbouring Côte d’Ivoire, Liberia and Sierra Leone [<xref ref-type="bibr" rid="CR11">11</xref>, <xref ref-type="bibr" rid="CR12">12</xref>].</p><p>Establishing and maintaining transmission of LF in new areas depends on the presence of appropriate vectors and their capability to sustain transmission [<xref ref-type="bibr" rid="CR10">10</xref>]. Thus, monitoring the LF infection in populations through mosquitoes (xenomonitoring) provides an important way of demonstrating potential transmission in an area, and has been suggested as a tool for monitoring the impact of MDA on LF transmission [<xref ref-type="bibr" rid="CR13">13</xref>, <xref ref-type="bibr" rid="CR14">14</xref>]. To date, while good epidemiological data on LF exist in rural areas in Guinea, there have been no reports on the status of the infection in Conakry. A mapping study carried out in Kassa, an island close to Conakry in 2005 [<xref ref-type="bibr" rid="CR8">8</xref>], indicated no infection. However, this finding might not be representative for the city of Conakry, due to demographic, ecologic and socioeconomic differences. In view of the paucity of epidemiological data, the World Health Organization (WHO) recommended a re-mapping of LF in Conakry. Hence, the study presented here was designed to obtain baseline data on the prevalence of <italic>W. bancrofti</italic> infection, coupled with entomological surveys, in order to determine whether or not LF transmission occurs in Conakry, which would require MDA.</p></sec><sec id="Sec2" sec-type="methods"><title>Methods</title><sec id="Sec3"><title>Ethics statement</title><p>The surveys were conducted in accordance with the study protocol approved by the Institutional Ethics Review Board of the Liverpool School of Tropical Medicine (1189RS) and from the National Ethics Committee for Research in Health (CNERS) from the Republic of Guinea (20/CNERS/12). Written informed consent was obtained from individuals aged 18 years and above. For minors (aged <18 years), written informed consent was obtained from parents or legal guardians, while minors provided oral assent. Due to high illiteracy rate, in some households, oral rather than written informed consent was obtained. CNERS explicitly approved our consent procedures.</p><p>Participants were informed about the purpose and procedures of the study, including potential risks and benefits. The data were analysed and reported to exclude any directly identifiable information, in order to maintain anonymity of participants.</p></sec><sec id="Sec4"><title>Study sites</title><p>This study was carried out in Conakry, the capital of Guinea. The country is located at the coast in West Africa and shares borders with six countries: Côte d’Ivoire, Guinea Bissau, Liberia, Mali, Senegal and Sierra Leone [<xref ref-type="bibr" rid="CR12">12</xref>]. Conakry is a peninsula of 308 km<sup>2</sup>, with a length of 34 km and a width of 1–6 km. According to a census done in 1999, the population was about 1.5 million, which is likely to have increased by more than 40 % taking into account annual growth rates. Conakry accounts for about a quarter of the total population of Guinea, and about 60 % of the urban population [<xref ref-type="bibr" rid="CR15">15</xref>].</p></sec><sec id="Sec5"><title>Detection of <italic>W. bancrofti</italic> antigen in blood</title><p>A serological survey was carried out following the WHO mapping guidelines [<xref ref-type="bibr" rid="CR16">16</xref>] with slight modifications, as follows. First, in order to cover the entire city, sample collection sites were chosen randomly in the five districts of Conakry (Fig. <xref rid="Fig1" ref-type="fig">1</xref>). Second, only individuals’ aged ≥15 years from the five districts were included in the survey. We employed an immunochromatography card test (ICT) (Alere, NOW, ICT filariasis kits; Binax, Portland, USA) for the detection of circulating filarial antigen in finger-prick blood samples taken during the day. All results were read after 10 min according to the manufacturer’s instructions. Clinical examination for signs of lymphoedema was conducted for all subjects.<fig id="Fig1"><label>Fig. 1</label><caption><p>Survey locations for collection of mosquitoes in Conakry, Guinea, between December 2012 and November 2013. Blue circle, window exit trap and pyrethrum spraying catches; red circle, window exit trap, pyrethrum spraying catches and ICT test sites</p></caption><graphic xlink:href="13071_2015_1077_Fig1_HTML" id="MO1"></graphic></fig></p></sec><sec id="Sec6"><title>Mosquito collection</title><p>Using a map of the city, a survey of larval breeding sites was undertaken. Based on the information gathered, 15 sectors were chosen based on the potential exposure of the population to mosquito bites, according to information provided by district leaders and observation of risk factors associated to the presence of mosquito breeding sites. From this information, mosquito collection sites were selected to represent different sectors of the city (Fig. <xref rid="Fig1" ref-type="fig">1</xref>). This was to allow the collection of as many samples as possible. Mosquitoes were collected over a 1-year period from December 2012 to November 2013, using exit traps and pyrethrum knock-down spray sheet collections (PSC) [<xref ref-type="bibr" rid="CR17">17</xref>] in different households. Collections were undertaken in 15 communities in all five districts of Conakry (Fig. <xref rid="Fig1" ref-type="fig">1</xref>). In each community, 9–10 days a month, exit traps were operated in 10 households. Exit traps and PSC were not performed in the same households. However, in case of unavailability, mosquitoes were collected in a neighbouring household. PSC collections were done once every month, between 06:00 and 09:00 h in three households.</p></sec><sec id="Sec7"><title>Mosquito processing and dissection</title><p>The collected mosquitoes were identified based on their morphological characteristics [<xref ref-type="bibr" rid="CR18">18</xref>, <xref ref-type="bibr" rid="CR19">19</xref>]. All dissectible female specimens of the genera of <italic>Anopheles</italic> and <italic>Culex</italic> were analysed for parity, by dissecting and inspecting the ovaries and Malpighian tubes under a microscope [<xref ref-type="bibr" rid="CR20">20</xref>] (Table <xref rid="Tab3" ref-type="table">3</xref>). Ten to 15 % of mosquitoes collected from each site were also dissected for detection of <italic>W. bancrofti</italic> larvae. The head, thorax and abdomen were dissected separately on a glass slide in three drops of saline and examined under a compound microscope for larval detection [<xref ref-type="bibr" rid="CR21">21</xref>]. The dissected mosquitoes were scraped into individual Eppendorf tubes and all other mosquitoes were also stored individually on silica gel and sent to the Noguchi Memorial Institute for Medical Research, University of Ghana (Accra, Ghana), for subsequent molecular analyses.</p></sec><sec id="Sec8"><title>Detection of <italic>W. bancrofti</italic> DNA in mosquitoes</title><p><italic>Culex</italic> mosquitoes were grouped into pools, with a maximum of 20 mosquitoes per pool. <italic>Anopheles</italic> mosquitoes were analysed individually. DNA was extracted from the mosquitoes using the Qiagen DNeasy tissue kit (QiagenDNeasy<sup><strike>®</strike></sup> kit; Mississauga, Canada). Identification of parasite DNA in the mosquitoes was done using the loop-mediated isothermal amplification (LAMP) assay [<xref ref-type="bibr" rid="CR22">22</xref>] and a PCR method [<xref ref-type="bibr" rid="CR23">23</xref>] for detection of <italic>W. bancrofti</italic>. The LAMP assay enables the formation of a turbid solution, indicative of product amplification, and sample confirmation can therefore be done visually, or through florescent detection under UV light directly in the Eppendorf tubes. The assays were performed as described by de Souza and colleagues [<xref ref-type="bibr" rid="CR22">22</xref>]. All LAMP-positive samples were confirmed twice and PCR analysis was conducted to confirm samples positive for the LAMP assay. A negative and positive control was included in all LAMP and PCR assays.</p></sec><sec id="Sec9"><title>Statistical analysis</title><p>Data were entered onto a Microsoft Excel spreadsheet and transferred to STATA version 11 (Stata Corporation; College Station, United States of America). Pool screen version 2.0.3 [<xref ref-type="bibr" rid="CR24">24</xref>] was used to calculate the maximum likelihood estimate of infection in the vector populations together with the associated 95 % confidence interval (CI). ArcGIS version 10.2.1 software was used for mapping the study site.</p></sec></sec><sec id="Sec10" sec-type="results"><title>Results</title><sec id="Sec11"><title>Detection of <italic>W. bancrofti</italic> prevalence</title><p>A total of 611 individuals (347 females, 56.8 %) were sampled for the detection of CFA. None (0 %) of the subjects had detectable levels of circulating parasite antigen (Table <xref rid="Tab1" ref-type="table">1</xref>). However, three cases of elephantiasis of the legs were identified (two males, one female; all aged >20 years), accounting for 0.5 % of all individuals sampled.<table-wrap id="Tab1"><label>Table 1</label><caption><p>Prevalence of <italic>W. bancrofti</italic> infection in Conakry, Guinea between December 2012 and November 2013, as estimated by ICT</p></caption><table frame="hsides" rules="groups"><thead><tr><th>District</th><th>No. sampled</th><th>Female</th><th>Male</th><th>No. of lymphoedema</th><th>ICT-positive</th></tr></thead><tbody><tr><td>Matoto</td><td>153</td><td>91</td><td>62</td><td>1</td><td>0</td></tr><tr><td>Matam</td><td>104</td><td>48</td><td>56</td><td>2</td><td>0</td></tr><tr><td>Ratoma</td><td>114</td><td>79</td><td>39</td><td>0</td><td>0</td></tr><tr><td>Dixinn</td><td>122</td><td>74</td><td>48</td><td>0</td><td>0</td></tr><tr><td>Kaloum</td><td>118</td><td>55</td><td>59</td><td>0</td><td>0</td></tr><tr><td>Total</td><td>611</td><td>347</td><td>264</td><td>3 (0.5 %)</td><td>0 (0 %)</td></tr></tbody></table></table-wrap></p><p>In this survey, microfilaremia was not determined since all individuals tested by ICT were negative.</p></sec><sec id="Sec12"><title>Mosquito collection and dissection</title><p>Overall, 14,334 mosquitoes were collected, of which 14,135 (98.6 %) were <italic>Culex</italic> and 161 (1.1 %) were <italic>Anopheles</italic> (Table <xref rid="Tab2" ref-type="table">2</xref>). Other mosquito species, specifically <italic>Mansonia uniformis</italic> and <italic>Aedes aegypti</italic>, were also collected, but at very low numbers. Overall, 13,190 (93.3 %) of female <italic>Culex</italic> and 147 (91.3 %) of female <italic>Anopheles</italic> mosquitoes were analysed for parity, by dissecting and inspecting the ovaries and Malpighian tubes under a microscope. The parity rates in <italic>Culex</italic> and <italic>Anopheles</italic> mosquitoes were 46.5 % and 38.8 %, respectively (Table <xref rid="Tab3" ref-type="table">3</xref>). Results of the dissections revealed no <italic>W. bancrofti</italic> larval stages in the head, thorax or abdomen of the examined <italic>An. gambiae</italic> and <italic>Culex</italic> mosquitoes (Tables <xref rid="Tab4" ref-type="table">4</xref> and <xref rid="Tab5" ref-type="table">5</xref>).<table-wrap id="Tab2"><label>Table 2</label><caption><p>Species composition of mosquitoes collected using window exit traps and pyrethrum spray catches (PSC)</p></caption><table frame="hsides" rules="groups"><thead><tr><th>Genus</th><th>Species</th><th>Window exit traps</th><th>PSC</th><th>Total (%)</th></tr></thead><tbody><tr><td rowspan="7"><italic>Culex</italic></td><td><italic>decens</italic></td><td>5,751</td><td>4,868</td><td>10,619 (74.1)</td></tr><tr><td><italic>quinquefasciatus</italic></td><td>1,668</td><td>1,812</td><td>3,480 (24.3)</td></tr><tr><td><italic>annulioris</italic></td><td>2</td><td>2</td><td>4 (0.0)</td></tr><tr><td><italic>poicilipes</italic></td><td>3</td><td>3</td><td>6 (0.0)</td></tr><tr><td><italic>nebulosus</italic></td><td>1</td><td>2</td><td>3 (0.0)</td></tr><tr><td><italic>ingrami</italic></td><td>17</td><td>4</td><td>21 (0.15)</td></tr><tr><td><italic>cinereus</italic></td><td>0</td><td>2</td><td>2 (0.0)</td></tr><tr><td><italic>Culex sub-total</italic></td><td></td><td></td><td></td><td>14,135 (98.6)</td></tr><tr><td><italic>Anopheles</italic></td><td><italic>gambiae</italic></td><td>121</td><td>40</td><td>161 (1.1)</td></tr><tr><td><italic>Aedes</italic></td><td><italic>aegypti</italic></td><td>20</td><td>7</td><td>27 (0.19)</td></tr><tr><td><italic>Mansonia</italic></td><td><italic>uniformis</italic></td><td>11</td><td>0</td><td>11 (0.08)</td></tr><tr><td colspan="2">Total</td><td>7,594</td><td>6,740</td><td>14,334 (100)</td></tr></tbody></table></table-wrap><table-wrap id="Tab3"><label>Table 3</label><caption><p>Distribution of mosquitoes collected from Conakry, Guinea between December 2012 and November 2013</p></caption><table frame="hsides" rules="groups"><thead><tr><th></th><th></th><th colspan="4"><italic>Culex</italic></th><th colspan="4"><italic>Anopheles</italic></th></tr><tr><th>District</th><th>Community</th><th>No. of mosquitoes collected</th><th>Dissected for parity</th><th>No. nulliparous</th><th>No. parous</th><th>No. of mosquitoes collected</th><th>Dissected for parity</th><th>No. nulliparous</th><th>No. parous</th></tr></thead><tbody><tr><td>Matoto</td><td>Tombolia</td><td>1,261</td><td>1,079</td><td>622</td><td>457</td><td>0</td><td>0</td><td>0</td><td>0</td></tr><tr><td></td><td>Gbessia</td><td>1,320</td><td>1,261</td><td>533</td><td>728</td><td>0</td><td>0</td><td>0</td><td>0</td></tr><tr><td></td><td>Bonagui</td><td>665</td><td>617</td><td>280</td><td>337</td><td>0</td><td>0</td><td>0</td><td>0</td></tr><tr><td></td><td>Lassanaya</td><td>535</td><td>499</td><td>269</td><td>230</td><td>8</td><td>8</td><td>1</td><td>7</td></tr><tr><td>Matam</td><td>Boussoura</td><td>1,247</td><td>1,193</td><td>601</td><td>592</td><td>4</td><td>3</td><td>2</td><td>1</td></tr><tr><td></td><td>Bonfi</td><td>731</td><td>710</td><td>386</td><td>324</td><td>0</td><td>0</td><td>0</td><td>0</td></tr><tr><td></td><td>Mafanko</td><td>600</td><td>564</td><td>289</td><td>275</td><td>0</td><td>0</td><td>0</td><td>0</td></tr><tr><td>Ratoma</td><td>Taouya</td><td>1,085</td><td>1,036</td><td>660</td><td>376</td><td>4</td><td>4</td><td>3</td><td>1</td></tr><tr><td></td><td>Dar es Alaam</td><td>915</td><td>811</td><td>395</td><td>416</td><td>1</td><td>1</td><td>0</td><td>1</td></tr><tr><td></td><td>Sonfonia I</td><td>633</td><td>609</td><td>361</td><td>248</td><td>107</td><td>100</td><td>62</td><td>38</td></tr><tr><td></td><td>Sonfonia II</td><td>710</td><td>673</td><td>459</td><td>214</td><td>28</td><td>23</td><td>18</td><td>5</td></tr><tr><td>Dixinn</td><td>Belle Vue</td><td>1,954</td><td>1,812</td><td>990</td><td>822</td><td>3</td><td>3</td><td>3</td><td>0</td></tr><tr><td></td><td>Camayenne</td><td>701</td><td>681</td><td>393</td><td>288</td><td>0</td><td>0</td><td>0</td><td>0</td></tr><tr><td>Kaloum</td><td>Tombolia</td><td>1,497</td><td>1,397</td><td>712</td><td>685</td><td>2</td><td>2</td><td>1</td><td>1</td></tr><tr><td></td><td>Coronthie</td><td>281</td><td>248</td><td>104</td><td>144</td><td>4</td><td>3</td><td>0</td><td>3</td></tr><tr><td></td><td>Total</td><td>14,135</td><td>13,190 (93.3 %)</td><td>7,054 (53.5 %)</td><td>6,136 (46.5 %)</td><td>161</td><td>147 (91.3 %)</td><td>90 (46.5 %)</td><td>57 (38.8 %)</td></tr></tbody></table></table-wrap><table-wrap id="Tab4"><label>Table 4</label><caption><p><italic>Wuchereria bancrofti</italic> infection rates in <italic>An. gambiae s.l.</italic> collected from Conakry, Guinea between December 2012 and November 2013</p></caption><table frame="hsides" rules="groups"><thead><tr><th></th><th></th><th colspan="3">Dissection</th><th colspan="3">Molecular methods</th></tr><tr><th>District</th><th>Community</th><th>No. collected</th><th>No. dissected</th><th>No. positive (%)</th><th>No. examined</th><th>LF LAMP-positive (%)</th><th>PCR-positive (%)</th></tr></thead><tbody><tr><td rowspan="4">Matoto</td><td>Tombolia</td><td>0</td><td>-</td><td>-</td><td>0</td><td>-</td><td>-</td></tr><tr><td>Gbessia</td><td>0</td><td>-</td><td>-</td><td>0</td><td>-</td><td>-</td></tr><tr><td>Bonagui</td><td>0</td><td>-</td><td>-</td><td>0</td><td>-</td><td>-</td></tr><tr><td>Lassanaya</td><td>8</td><td>4</td><td>0 (0)</td><td>4</td><td>(0)</td><td>0 (0)</td></tr><tr><td rowspan="3">Matam</td><td>Boussoura</td><td>4</td><td>2</td><td>0 (0)</td><td>2</td><td>0 (0)</td><td>-</td></tr><tr><td>Bonfi</td><td>0</td><td>-</td><td>-</td><td>0</td><td>-</td><td>-</td></tr><tr><td>Mafanko</td><td>0</td><td>-</td><td>-</td><td>0</td><td>-</td><td>-</td></tr><tr><td rowspan="4">Ratoma</td><td>Taouya</td><td>4</td><td>3</td><td>0 (0)</td><td>1</td><td>0 (0)</td><td>-</td></tr><tr><td>Dar es Salaam</td><td>1</td><td>0</td><td></td><td>1</td><td>0 (0)</td><td>-</td></tr><tr><td>Sonfonia I</td><td>107</td><td>26</td><td>0 (0)</td><td>81</td><td>1 (1.2)</td><td>0 (0)</td></tr><tr><td>Sonfonia II</td><td>28</td><td>10</td><td>0 (0)</td><td>18</td><td>1 (5.6)</td><td>0 (0)</td></tr><tr><td rowspan="2">Dixinn</td><td>Belle Vue</td><td>3</td><td>3</td><td>0 (0)</td><td>0</td><td>-</td><td>-</td></tr><tr><td>Camayenne</td><td>0</td><td>-</td><td>-</td><td>0</td><td>-</td><td>-</td></tr><tr><td rowspan="2">Kaloum</td><td>Tombo</td><td>2</td><td>2</td><td>0 (0)</td><td>2</td><td>0 (0)</td><td>-</td></tr><tr><td>Coronthie</td><td>4</td><td>1</td><td>0 (0)</td><td>3</td><td>0 (0)</td><td>-</td></tr><tr><td colspan="2">Total</td><td>161</td><td>51</td><td>0 (0)</td><td>112</td><td>2 (1.8)</td><td>0 (0)</td></tr></tbody></table></table-wrap><table-wrap id="Tab5"><label>Table 5</label><caption><p><italic>W. bancrofti</italic> infection rates in <italic>Culex</italic> species collected from Conakry, Guinea between December 2012 and November 2013</p></caption><table frame="hsides" rules="groups"><thead><tr><th></th><th></th><th colspan="3">Dissection</th><th colspan="6">Pool screening</th></tr><tr><th>District</th><th>Community</th><th>No. collected</th><th>No. dissected</th><th>Positive (%)</th><th>No. examined</th><th>Pools examined</th><th>LAMP-positive (MLE %)</th><th>95 % CI</th><th>PCR-positive (MLE %)</th><th>95 % CI</th></tr></thead><tbody><tr><td rowspan="4">Matoto</td><td>Tombolia</td><td>1,261</td><td>79</td><td>0</td><td>240</td><td>12</td><td>0 (0)</td><td char="(" align="char">-</td><td>-</td><td char="(" align="char">-</td></tr><tr><td>Gbessia</td><td>1,320</td><td>149</td><td>0</td><td>240</td><td>12</td><td>0 (0)</td><td char="(" align="char">-</td><td>-</td><td char="(" align="char">-</td></tr><tr><td>Bonagui</td><td>665</td><td>88</td><td>0</td><td>240</td><td>12</td><td>0 (0)</td><td char="(" align="char">-</td><td>-</td><td char="(" align="char">-</td></tr><tr><td>Lassanaya</td><td>535</td><td>30</td><td>0</td><td>287</td><td>15</td><td>1 (0.96)</td><td char="(" align="char">(0.11–3.36)</td><td>1 (0.96)</td><td char="(" align="char">(0.11–3.36)</td></tr><tr><td rowspan="3">Matam</td><td>Boussoura</td><td>1,247</td><td>110</td><td>0</td><td>240</td><td>12</td><td>0 (0)</td><td char="(" align="char">-</td><td>-</td><td char="(" align="char">-</td></tr><tr><td>Bonfi</td><td>728</td><td>53</td><td>0</td><td>240</td><td>12</td><td>3 (1.43)</td><td char="(" align="char">(0.27–4.11)</td><td>2 (0.91)</td><td char="(" align="char">(0.11–3.16)</td></tr><tr><td>Mafanko</td><td>600</td><td>55</td><td>0</td><td>271</td><td>14</td><td>1 (0.38)</td><td char="(" align="char">(0.01–1.95)</td><td>1 (0.38)</td><td char="(" align="char">(0.01–1.95)</td></tr><tr><td rowspan="4">Ratoma</td><td>Taouya</td><td>1,085</td><td>57</td><td>0</td><td>260</td><td>13</td><td>0 (0)</td><td char="(" align="char">-</td><td>-</td><td char="(" align="char">-</td></tr><tr><td>Dar es Alaam</td><td>915</td><td>118</td><td>0</td><td>240</td><td>12</td><td>0 (0)</td><td char="(" align="char">-</td><td>-</td><td char="(" align="char">-</td></tr><tr><td>Sonfonia I</td><td>635</td><td>48</td><td>0</td><td>237</td><td>12</td><td>0 (0)</td><td char="(" align="char">-</td><td>-</td><td char="(" align="char">-</td></tr><tr><td>Sonfonia II</td><td>711</td><td>61</td><td>0</td><td>191</td><td>10</td><td>0 (0)</td><td char="(" align="char">-</td><td>-</td><td char="(" align="char">-</td></tr><tr><td rowspan="2">Dixinn</td><td>Belle Vue</td><td>1,954</td><td>164</td><td>0</td><td>240</td><td>12</td><td>2 (0.91)</td><td char="(" align="char">(0.11–3.16)</td><td>2 (0.55)</td><td char="(" align="char">(0.11–3.16)</td></tr><tr><td>Camayenne</td><td>701</td><td>43</td><td>0</td><td>278</td><td>14</td><td>1 (0.37)</td><td char="(" align="char">(0.01–1.90)</td><td>1 (0.37)</td><td char="(" align="char">(0.01–1.90)</td></tr><tr><td rowspan="2">Kaloum</td><td>Tombo</td><td>1,497</td><td>212</td><td>0</td><td>240</td><td>12</td><td>0 (0)</td><td char="(" align="char">-</td><td>-</td><td char="(" align="char">-</td></tr><tr><td>Coronthie</td><td>281</td><td>45</td><td>0</td><td>191</td><td>10</td><td>3 (1.86)</td><td char="(" align="char">(0.36–5.38)</td><td>0 (0)</td><td char="(" align="char">–</td></tr><tr><td colspan="2">Total</td><td>14,135</td><td>1,312</td><td>0 (0 %)</td><td>3,635</td><td>184</td><td>11 (0.31)</td><td char="(" align="char">(0.15–0.57)</td><td>7 (0.19)</td><td char="(" align="char">(0.07–0.41)</td></tr></tbody></table></table-wrap></p></sec><sec id="Sec13"><title>Detection of <italic>W. bancrofti</italic> DNA in mosquitoes</title><p>Overall, 112 <italic>Anopheles</italic> mosquitoes were analysed individually, and 3,635 <italic>Culex</italic> were sorted into 184 pools with a range of 7–20 mosquitoes per pool. Of the mosquitoes processed, 2 (1.8 %) <italic>An. gambiae</italic> and 11 pools of <italic>Culex</italic> were found positive (Tables <xref rid="Tab4" ref-type="table">4</xref> and <xref rid="Tab5" ref-type="table">5</xref>), when subjected to a LAMP assay. The pool screening calculation indicated a maximum likelihood estimate (MLE) of infection of 0.31 % (95 % CI: 0.15–0.57 %) for <italic>Culex</italic>. All LAMP-positive samples were further analysed using PCR. The two LAMP-positive <italic>An. gambiae</italic> samples were negative by PCR. Seven of the 11 <italic>Culex</italic> pools positive by LAMP were also positive by PCR. The pool screening calculation indicated a MLE of 0.20 % (95 % CI: 0.07–0.41 %).</p></sec></sec><sec id="Sec14" sec-type="discussion"><title>Discussion</title><p>A cross-sectional ICT antigen detection survey carried out in all five districts of the capital city of Guinea revealed that none of the 611 individuals aged ≥15 years had detectable levels of CFA. This is in accordance with the result of a study performed in 2005 at Kassa, an island community of Conakry [<xref ref-type="bibr" rid="CR8">8</xref>], which also reported a zero prevalence using the same diagnostic approach. Based on these results and WHO recommendations to treat only those endemic areas where the prevalence is above 1 %, the city of Conakry does not qualify for MDA.</p><p>To demonstrate the potential for active transmission in this urban environment, <italic>An. gambiae</italic> and <italic>Culex</italic> mosquitoes were collected and processed for detection of <italic>W. bancrofti</italic> infection, using standard dissections, followed by more sophisticated molecular methods. Importantly, none of the dissected mosquitoes was found positive. However, some mosquitoes further processed by molecular tests were found positive. Arguments have been made against dissection as opposed to molecular methods for monitoring transmission. A major constraint of dissections is the difficulty to detect MF and third-stage larvae (L<sub>3</sub>) [<xref ref-type="bibr" rid="CR14">14</xref>, <xref ref-type="bibr" rid="CR25">25</xref>] and the large numbers of mosquitoes that need to be processed to find infections in areas with low endemicity [<xref ref-type="bibr" rid="CR14">14</xref>, <xref ref-type="bibr" rid="CR26">26</xref>]. Thus, there has been an increased interest in molecular-based detection methods that can either use individual mosquitoes or pools, resulting in rapid, high-throughput screening of mosquito vectors [<xref ref-type="bibr" rid="CR26">26</xref>, <xref ref-type="bibr" rid="CR27">27</xref>]. Our study confirms that molecular methods are more sensitive than standard dissection for the detection of infections in mosquito vectors [<xref ref-type="bibr" rid="CR28">28</xref>].</p><p>Very low numbers of <italic>An. gambiae</italic> were collected in this study. While this might bring into question the effectiveness of the collection method, it is important to note that 12 monthly collections were undertaken and the same methods were used for the collection of both <italic>Anopheles</italic> and <italic>Culex</italic> mosquitoes. Mosquitoes were collected by two different methods, namely window exit traps and PSC [<xref ref-type="bibr" rid="CR17">17</xref>]. The latter has been widely used in sampling <italic>Anopheles</italic> mosquitoes in malaria intervention programmes [<xref ref-type="bibr" rid="CR29">29</xref>] and remains the ‘gold’ standard for collecting indoor-resting, blood-fed and gravid mosquitoes [<xref ref-type="bibr" rid="CR29">29</xref>, <xref ref-type="bibr" rid="CR30">30</xref>]. In West African cities and urban areas with high pollution levels, <italic>Culex</italic> mosquitoes are the predominant mosquito species [<xref ref-type="bibr" rid="CR22">22</xref>, <xref ref-type="bibr" rid="CR31">31</xref>]. Likewise, the use of the same collection methods in rural areas reveals higher proportions of <italic>Anopheles</italic> compared to <italic>Culex</italic> [<xref ref-type="bibr" rid="CR32">32</xref>]. As such, the low numbers of <italic>An. gambiae</italic> collected in this study cannot be attributed to the collection method, but rather to the vector ecology. A survey of the breeding sites in Conakry revealed these to be heavily polluted and presenting ideal conditions for the breeding of <italic>Culex</italic>, compared to <italic>Anopheles</italic>, which prefer clean breeding sources.</p><p>The results from the LAMP and PCR assays may suggest that the LAMP has higher sensitivity as an epidemiological tool for detecting <italic>W. bancrofti</italic> infection compared to PCR, although previous reports have shown them to be substantially similar [<xref ref-type="bibr" rid="CR33">33</xref>]. The LAMP uses four primers (six distinct sequences) that are simultaneously used to initiate DNA synthesis from the original unamplified DNA to generate a stem-loop DNA for subsequent LAMP cycling. Thus, target selectivity is higher than in conventional PCR [<xref ref-type="bibr" rid="CR34">34</xref>, <xref ref-type="bibr" rid="CR35">35</xref>]. In addition to high sensitivity, the LAMP is also less prone to the presence of irrelevant DNA and inhibition compared to PCR and has the advantage of shorter reaction time, simple readout system and the use of cheaper technology tools [<xref ref-type="bibr" rid="CR34">34</xref>–<xref ref-type="bibr" rid="CR36">36</xref>]. As such, it enjoys increasing popularity for the diagnosis of a host of diseases [<xref ref-type="bibr" rid="CR22">22</xref>, <xref ref-type="bibr" rid="CR37">37</xref>, <xref ref-type="bibr" rid="CR38">38</xref>]. Indeed, LAMP represents a powerful tool that can be employed in the evaluation of LF control activities, especially in the end-game when interruption of LF transmission must be certified. However, the epidemiological usefulness of the LAMP assay must be determined in carefully thought out studies, with sufficiently high numbers of vector mosquitoes.</p><p>Various studies conducted in different localities in West Africa have identified <italic>An. gambiae</italic> as the main LF vector species [<xref ref-type="bibr" rid="CR39">39</xref>–<xref ref-type="bibr" rid="CR41">41</xref>]. However, in our collections, the proportion of <italic>An. gambiae</italic> among all the mosquitoes caught was low, and hence, the infection rate must be interpreted with caution. Indeed, very high numbers of mosquitoes should be analysed in settings characterised by low levels of infection in the human population, so that very low levels of infection in the vectors can be determined [<xref ref-type="bibr" rid="CR42">42</xref>]. Moreover, for parasitic diseases and more specifically LF whose infection is related to the parasite load and thus the frequency of infective bites [<xref ref-type="bibr" rid="CR43">43</xref>], infection in an urban system characterised by a low vector density may not lead to the transmission of <italic>W. bancrofti</italic>. Nonetheless, given that LAMP identified two <italic>An. gambiae</italic> mosquitoes in Conakry as positive, is it not possible to rule out transmission without further detailed entomological and parasitological studies, which calls for continuous, rigorous surveillance.</p><p>While <italic>Culex</italic> mosquitoes might not play a role in LF transmission in West Africa [<xref ref-type="bibr" rid="CR22">22</xref>, <xref ref-type="bibr" rid="CR40">40</xref>, <xref ref-type="bibr" rid="CR44">44</xref>], our results suggest that <italic>Culex</italic> mosquitoes are capable of ingesting parasite material while feeding on MF-positive individuals, demonstrating the potential of using non-vector species as a proxy for determining the presence of LF in human populations. Fischer and colleagues [<xref ref-type="bibr" rid="CR45">45</xref>] showed in laboratory experiments that parasite DNA can be detected in both vector and non-vector mosquitoes for 2 weeks or longer after they ingest MF-positive blood. Thus, the detection of <italic>W. bancrofti</italic> DNA in mosquitoes confirms that infected individuals are present in Conakry. This indicates that transmission from mosquitoes to humans may occur, albeit at very low levels. Outbreaks of <italic>Culex</italic> mosquitoes in urban cities in West Africa have coincided with the development of large cities, which has taken an extraordinary expansion in recent decades [<xref ref-type="bibr" rid="CR9">9</xref>, <xref ref-type="bibr" rid="CR46">46</xref>, <xref ref-type="bibr" rid="CR47">47</xref>]. Interestingly, in 1981, Fain reported that in West African regions, local strains of <italic>W. bancrofti</italic> have not yet fully adapted to <italic>Culex</italic> mosquitoes to facilitate transmission [<xref ref-type="bibr" rid="CR48">48</xref>], but this claim requires further scientific inquiry.</p><p>We were unable to demonstrate ongoing transmission of LF based on infection rates in humans and mosquitoes. Nevertheless, the presence of two infected <italic>An. gambiae</italic> vectors using a diagnostic method that is not stage-specific implies that people may be at risk of infection [<xref ref-type="bibr" rid="CR23">23</xref>]. However, the prevalence of parasite DNA in mosquitoes does not necessarily imply that LF transmission is ongoing in a given setting [<xref ref-type="bibr" rid="CR14">14</xref>]. Studies by Farid and colleagues showed that mosquitoes that fed on people with very low levels of MF sometimes ingested MF but rarely produced infective larvae [<xref ref-type="bibr" rid="CR49">49</xref>]. However, to ascertain the transmission of LF in areas where positive mosquitoes were detected, we recommend the use of gravid traps for the collection of mosquitoes [<xref ref-type="bibr" rid="CR50">50</xref>], followed by stage-specific molecular detection methods for <italic>W. bancrofti</italic> [<xref ref-type="bibr" rid="CR51">51</xref>]. This study further points to the focal nature of LF transmission, and the usefulness of xenomonitoring. As shown in the present investigation, analysing 611 individuals out of a population of over 1.5 million inhabitants (based on logistical, programmatic and ethical considerations) may be grossly inadequate to determine the presence of infection in areas with low infection levels in the population. As such, the widely used methodology in assessing the transmission of LF in areas with low infection rates requires critical review.</p></sec><sec id="Sec15" sec-type="conclusions"><title>Conclusions</title><p>Our study demonstrated the presence of <italic>W. bancrofti</italic> DNA in mosquitoes in Conakry, despite the apparent absence of circulating filarial antigen in the human population. The study also demonstrated the utility of the LAMP assay in xenomonitoring. Based on the findings reported here and on WHO recommendations to undertake MDA in implementation units with prevalence of 1 % or more, the city of Conakry does not qualify for MDA. However, rigorous surveillance through testing of a much larger human population sample size and entomological surveys, is required to monitor the epidemiological situation of LF in Conakry as well as inform future decisions.</p></sec></body><back><fn-group><fn><p><bold>Competing interests</bold></p><p>The authors declare that they have no competing interests.</p></fn><fn><p><bold>Authors’ contributions</bold></p><p>Conceived and designed the experiments: AG, MJB and BGK. Supervised the implementation of field works: AG and BGK. Performed the experiments: BLK BSM and LD. Analysed the data: BLK, DKdS and BGK. Processed mosquito samples: BLK, DKdS, CAN and SAK. Wrote the first draft of the manuscript: BLK DKdS and BGK. Revised the manuscript: SKD, DAB, JU, MJB and BGK. Provided conceptual advice and final editorial feedback prior to manuscript submission: JU, MJB and BGK. All authors read and approved the final version of the manuscript.</p></fn></fn-group><ack><title>Acknowledgements</title><p>We would like to address special thanks to the National Programme for Onchocerciasis, Blindness and Neglected Tropical Diseases (Conakry-Guinea). We are grateful to Dr. Oumar B Barry and the laboratory technicians (Arsène Sagno, Marie-Louise Niamy, Koné Raymond, Kéloi Jean, Kéita Mamy, Séssé Luc, Algassimou Bah, Barry A Oumar and Guoepogui Maoro) for their contribution to mosquito collection and dissection. Helen Keller International (HKI) Guinea provided logistic support. We thank the parasitology staff of the Noguchi Memorial Institute for Medical Research (Dr. Irene Ayi and Prof. Maxwell Appawu) for arranging the processing of mosquito samples in their institute. We acknowledge the cooperation of the communities of Conakry for smooth implementation of field activities. 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