Combining different diagnostic studies of lymphatic filariasis for risk mapping in Papua New Guinea: a predictive model from microfilaraemia and antigenaemia prevalence surveys

Berg Soto, Alvaro, Xu, Zhijing, Wood, Peter, Sanuku, Nelly, Robinson, Leanne J., King, Christopher L., Tisch, Daniel, Susapu, Melinda, and Graves, Patricia M. (2018) Combining different diagnostic studies of lymphatic filariasis for risk mapping in Papua New Guinea: a predictive model from microfilaraemia and antigenaemia prevalence surveys. Tropical Medicine and Health, 46. 41.

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Background: The Global Programme to Eliminate Lymphatic Filariasis has encouraged countries to follow a set of guidelines to help them assess the need for mass drug administration and evaluate its progress. Papua New Guinea (PNG) is one of the highest priority countries in the Western Pacific for lymphatic filariasis and the site of extensive research on lymphatic filariasis and surveys of its prevalence. However, different diagnostic tests have been used and thresholds for each test are unclear.

Methods: We reviewed the prevalence of lymphatic filariasis reported in 295 surveys conducted in PNG between 1990 and 2014, of which 65 used more than one test. Results from different diagnostics were standardised using a set of criteria that included a model to predict antigen prevalence from microfilariae prevalence. We mapped the point location of each of these surveys and categorised their standardised prevalence estimates.

Results: Several predictive models were produced and investigated, including the effect of any mass drug administration and number of rounds prior to the surveys. One model was chosen based on goodness of fit parameters and used to predict antigen prevalence for surveys that tested only for microfilariae. Standardised prevalence values show that 72% of all surveys reported a prevalence above 0.05. High prevalence was situated on the coastal north, south and island regions, while the central highland area of Papua New Guinea shows low levels of prevalence.

Conclusions: Our study is the first to provide an explicit predictive relationship between the prevalence values based on empirical results from antigen and microfilaria tests, taking into account the occurrence of mass drug administration. This is a crucial step to combine studies to develop risk maps of lymphatic filariasis for programme planning and evaluation, as shown in the case of Papua New Guinea.

Item ID: 56532
Item Type: Article (Research - C1)
ISSN: 1349-4147
Keywords: lymphatic filariasis, Papua New Guinea, prevalence, predictive model, diagnostic tests, risk map
Copyright Information: © The Author(s) 2018. Open Access: This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (, 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 ( applies to the data made available in this article, unless otherwise stated.
Funders: National Institute of Health (NIH), USA
Projects and Grants: NIH NIAID RO1 AI097262
Date Deposited: 07 Dec 2018 00:07
FoR Codes: 32 BIOMEDICAL AND CLINICAL SCIENCES > 3202 Clinical sciences > 320211 Infectious diseases @ 20%
32 BIOMEDICAL AND CLINICAL SCIENCES > 3207 Medical microbiology > 320704 Medical parasitology @ 20%
42 HEALTH SCIENCES > 4202 Epidemiology > 420202 Disease surveillance @ 60%
SEO Codes: 92 HEALTH > 9201 Clinical Health (Organs, Diseases and Abnormal Conditions) > 920109 Infectious Diseases @ 30%
92 HEALTH > 9203 Indigenous Health > 920308 Pacific Peoples Health - Health Status and Outcomes @ 40%
92 HEALTH > 9204 Public Health (excl. Specific Population Health) > 920499 Public Health (excl. Specific Population Health) not elsewhere classified @ 30%
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