Hotspot-based integrated serosurveillance of neglected tropical diseases, malaria, and vaccine-preventable diseases in urban Guyana

ABSTRACT Objectives. To assess exposure to lymphatic filariasis (LF), other neglected tropical diseases (NTDs), and malaria, as well as seroprotection against vaccine-preventable diseases (VPDs), using a hotspot-based integrated serosurveillance approach in urban areas of Guyana. Methods To monitor the impact of interventions on LF transmission, one historically elevated LF hotspot – defined as a previously identified urban community with focal transmission – was selected in each coastal region (Regions III, IV, V, and X). A total of 300 individuals aged ≥6 years were surveyed in each hotspot using convenience sampling. Dried blood spots were tested at the U.S. Centers for Disease Control and Prevention using multiplex bead assay to analyze antigens from 12 pathogens: Wuchereria bancrofti and Brugia malayi (Wb123, Bm14, Bm33), Plasmodium vivax and Plasmodium falciparum (pvMSP1-19, pfMSP1-19), Strongyloides stercoralis (NIE), Taenia solium (rES33, T24H), Chlamydia trachomatis (Pgp3, CT694), Treponema pallidum (rp17, TmpA), and measles, rubella, tetanus, and diphtheria. Results Reactivity to Wb123 and Bm14 was consistent with previous reports of elevated LF transmission in these regions. Seropositivity to P. falciparum and P. vivax was higher among adults. Seroprotection against measles and rubella was highest among children and older adults, with immunity gaps in young adults. Most participants showed minimal seroprotection against tetanus and diphtheria. Taeniasis and cysticercosis had low seropositivity across all sites. C. trachomatis and T. pallidum antigens showed age-related increases. Conclusions. Hotspot-based integrated serosurveillance using multiplex bead assay provides an efficient, targeted approach to monitor NTDs, malaria, and VPDs. Findings offer valuable insights for programmatic action, although interpretation should consider the hotspot-specific context when extrapolating results.