title: A multicenter evaluation of diagnostic tools to define endpoints for programs to eliminate bancroftian filariasis.
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.
authors.affiliation: Lymphatic Filariasis Support Center, The Task Force for Global Health, Decatur, Georgia, United States of America.
authors.forename: Katherine
authors.initials: K
authors.lastname: Gass
authors.forename: Madsen V E
authors.initials: MV
authors.lastname: Beau de Rochars
authors.forename: Daniel
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authors.lastname: Boakye
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authors.lastname: Bradley
authors.forename: Peter U
authors.initials: PU
authors.lastname: Fischer
authors.forename: John
authors.initials: J
authors.lastname: Gyapong
authors.forename: Makoto
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authors.lastname: Itoh
authors.forename: Nese
authors.initials: N
authors.lastname: Ituaso-Conway
authors.forename: Hayley
authors.initials: H
authors.lastname: Joseph
authors.forename: Dominique
authors.initials: D
authors.lastname: Kyelem
authors.forename: Sandra J
authors.initials: SJ
authors.lastname: Laney
authors.forename: Anne-Marie
authors.initials: AM
authors.lastname: Legrand
authors.forename: Tilaka S
authors.initials: TS
authors.lastname: Liyanage
authors.forename: Wayne
authors.initials: W
authors.lastname: Melrose
authors.forename: Khalfan
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authors.lastname: Mohammed
authors.forename: Nils
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authors.lastname: Pilotte
authors.forename: Eric A
authors.initials: EA
authors.lastname: Ottesen
authors.forename: Catherine
authors.initials: C
authors.lastname: Plichart
authors.forename: Kapa
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authors.lastname: Ramaiah
authors.forename: Ramakrishna U
authors.initials: RU
authors.lastname: Rao
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Talbot
authors.forename: Gary J
authors.initials: GJ
authors.lastname: Weil
authors.forename: Steven A
authors.initials: SA
authors.lastname: Williams
authors.forename: Kimberly Y
authors.initials: KY
authors.lastname: Won
authors.forename: Patrick
authors.initials: P
authors.lastname: Lammie
mesh_terms: D000293:Adolescent; D000328:Adult; D000818:Animals; D000871:Anthelmintics / Q000627:therapeutic use*; D000909:Antibodies, Helminth / Q000097:blood / Q000652:urine; D002648:Child; D002675:Child, Preschool; D004605:Elephantiasis, Filarial / Q000188:drug therapy* / Q000453:epidemiology / Q000469:parasitology; D005260:Female; D014943:Global Health; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D015995:Prevalence; D012680:Sensitivity and Specificity; D014958:Wuchereria bancrofti; D055815:Young Adult
chemical_list: D000871:Anthelmintics; D000909:Antibodies, Helminth