title: Evaluation of diagnostic tests for Wuchereria bancrofti infection in Brazilian schoolchildren.
abstract: BACKGROUND
  Since the launch of the Global Programme to Eliminate Lymphatic Filariasis, more than 70% of the endemic countries have implemented mass drug administration (MDA) to interrupt disease transmission. The monitoring of filarial infection in sentinel populations, particularly schoolchildren, is recommended to assess the impact of MDA. A key issue is choosing the appropriate tools for these initial assessments (to define the best intervention) and for monitoring transmission.
  
  
  METHODS
  This study compared the pre-MDA performance of five diagnostic methods, namely, thick film test, Knott's technique, filtration, Og4C3-ELISA, and the AD12-ICT card test, in schoolchildren from Brazil. Venous and capillary blood samples were collected between 11 pm and 1 am. The microfilarial loads were analyzed with a negative binomial regression, and the prevalence and associated 95% confidence intervals were estimated for all methods. The accuracies of the AD12-ICT card and Og4C3-ELISA tests were assessed against the combination of parasitological test results.
  
  
  RESULTS
  A total of 805 schoolchildren were examined. The overall and stratified prevalence by age group and gender detected by Og4C3-ELISA and AD12-ICT were markedly higher than the prevalence estimated by the parasitological methods. The sensitivity of the AD12-ICT card and Og4C3-ELISA tests was approximately 100%, and the positive likelihood ratios were above 6. The specificity of the Og4C3-ELISA was higher than that of the AD12-ICT at different prevalence levels.
  
  
  CONCLUSIONS
  The ICT card test should be the recommended tool for monitoring school-age populations living in areas with ongoing or completed MDA.
authors: Serviço de Referência Nacional em Filarioses, Centro de Pesquisas Aggeu Magalhães, Fundação Oswaldo Cruz, Recife, PE, Brasil.
authors: Paula
authors: P
authors: Oliveira
authors: Departamento de Parasitologia, Centro de Pesquisas Aggeu Magalhães, Fundação Oswaldo Cruz, Recife, PE, Brasil.
authors: Cynthia
authors: C
authors: Braga
authors: Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK.
authors: Neal
authors: N
authors: Alexander
authors: Serviço de Referência Nacional em Filarioses, Centro de Pesquisas Aggeu Magalhães, Fundação Oswaldo Cruz, Recife, PE, Brasil.
authors: Eduardo
authors: E
authors: Brandão
authors: Departamento de Parasitologia, Centro de Pesquisas Aggeu Magalhães, Fundação Oswaldo Cruz, Recife, PE, Brasil.
authors: Almerice
authors: A
authors: Silva
authors: Departamento de Parasitologia, Centro de Pesquisas Aggeu Magalhães, Fundação Oswaldo Cruz, Recife, PE, Brasil.
authors: Leandro
authors: L
authors: Wanderley
authors: Serviço de Referência Nacional em Filarioses, Centro de Pesquisas Aggeu Magalhães, Fundação Oswaldo Cruz, Recife, PE, Brasil.
authors: Ana Maria
authors: AM
authors: Aguiar
authors: Departamento de Saúde Coletiva, Centro de Pesquisas Aggeu Magalhães, Fundação Oswaldo Cruz, Recife, PE, Brasil.
authors: George
authors: G
authors: Diniz
authors: Serviço de Referência Nacional em Filarioses, Centro de Pesquisas Aggeu Magalhães, Fundação Oswaldo Cruz, Recife, PE, Brasil.
authors: Zulma
authors: Z
authors: Medeiros
authors: Serviço de Referência Nacional em Filarioses, Centro de Pesquisas Aggeu Magalhães, Fundação Oswaldo Cruz, Recife, PE, Brasil.
authors: Abraham
authors: A
authors: Rocha
mesh_terms: D000818:Animals; D000947:Antigens, Helminth / Q000097:blood*; D001938:Brazil; D002648:Child; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005368:Filariasis / Q000175:diagnosis*; D006801:Humans; D008297:Male; D011933:Reagent Kits, Diagnostic; D012680:Sensitivity and Specificity; D014958:Wuchereria bancrofti / Q000276:immunology*
chemical_list: D000947:Antigens, Helminth; D011933:Reagent Kits, Diagnostic