A multicenter evaluation of diagnostic tools to define endpoints for programs to eliminate bancroftian filariasis

Gass, Katherine, Beau de Rochars, Madsen V.E., Boakye, Daniel, Bradley, Mark, Fischer, Peter U., Gyapong, John, Itoh, Makoto, Ituaso-Conway, Nese, Joseph, Hayley, Kyelem, Dominique, Laney, Sandra J., Legrand, Anne-Marie, Liyanage, Tilaka S., Melrose, Wayne, Mohammed, Khalfan, Pilotte, Nils, Ottesen, Eric A., Plichart, Catherine, Ramaiah, Kapa, Rao, Ramakrishna U., Talbot, Jeffrey, Weil, Gary J., Williams, Steven A., Won, Kimberly Y., and Lammie, Patrick (2012) A multicenter evaluation of diagnostic tools to define endpoints for programs to eliminate bancroftian filariasis. PLoS Neglected Tropical Diseases, 6 (1). pp. 1-12.

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Abstract

Successful mass drug administration (MDA) campaigns have brought several countries near the point of Lymphatic Filariasis (LF) elimination. A diagnostic tool is needed to determine when the prevalence levels have decreased to a point that MDA campaigns can be discontinued without the threat of recrudescence. A six-country study was conducted assessing the performance of seven diagnostic tests, including tests for microfilariae (blood smear, PCR), parasite antigen (ICT, Og4C3) and antifilarial antibody (Bm14, PanLF, Urine SXP). One community survey and one school survey were performed in each country. A total of 8,513 people from the six countries participated in the study, 6,443 through community surveys and 2,070 through school surveys. Specimens from these participants were used to conduct 49,585 diagnostic tests. Each test was seen to have both positive and negative attributes, but overall, the ICT test was found to be 76% sensitive at detecting microfilaremia and 93% specific at identifying individuals negative for both microfilariae and antifilarial antibody; the Og4C3 test was 87% sensitive and 95% specific. We conclude, however, that the ICT should be the primary tool recommended for decision-making about stopping MDAs. As a point-of-care diagnostic, the ICT is relatively inexpensive, requires no laboratory equipment, has satisfactory sensitivity and specificity and can be processed in 10 minutes—qualities consistent with programmatic use. Og4C3 provides a satisfactory laboratory-based diagnostic alternative.

Item ID: 20004
Item Type: Article (Refereed Research - C1)
Additional Information:

© 2012 Gass et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

ISSN: 1935-2735
Date Deposited: 30 Mar 2012 06:41
FoR Codes: 11 MEDICAL AND HEALTH SCIENCES > 1117 Public Health and Health Services > 111711 Health Information Systems (incl Surveillance) @ 100%
SEO Codes: 92 HEALTH > 9204 Public Health (excl. Specific Population Health) > 920404 Disease Distribution and Transmission (incl. Surveillance and Response) @ 100%
Citation Count from Web of Science Web of Science 2
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