title: Factors associated with the performance and cost-effectiveness of using lymphatic filariasis transmission assessment surveys for monitoring soil-transmitted helminths: a case study in Kenya.
abstract: Transmission assessment surveys (TAS) for lymphatic filariasis have been proposed as a platform to assess the impact of mass drug administration (MDA) on soil-transmitted helminths (STHs). This study used computer simulation and field data from pre- and post-MDA settings across Kenya to evaluate the performance and cost-effectiveness of the TAS design for STH assessment compared with alternative survey designs. Variations in the TAS design and different sample sizes and diagnostic methods were also evaluated. The district-level TAS design correctly classified more districts compared with standard STH designs in pre-MDA settings. Aggregating districts into larger evaluation units in a TAS design decreased performance, whereas age group sampled and sample size had minimal impact. The low diagnostic sensitivity of Kato-Katz and mini-FLOTAC methods was found to increase misclassification. We recommend using a district-level TAS among children 8-10 years of age to assess STH but suggest that key consideration is given to evaluation unit size.
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Smith
authors.forename: Hugh J W
authors.initials: HJW
authors.lastname: Sturrock
authors.forename: Liya
authors.initials: L
authors.lastname: Assefa
authors.forename: Birgit
authors.initials: B
authors.lastname: Nikolay
authors.forename: Sammy M
authors.initials: SM
authors.lastname: Njenga
authors.forename: Jimmy
authors.initials: J
authors.lastname: Kihara
authors.forename: Charles S
authors.initials: CS
authors.lastname: Mwandawiro
authors.forename: Simon J
authors.initials: SJ
authors.lastname: Brooker
mesh_terms: D000293:Adolescent; D000367:Age Factors; D000723:Ancylostomatoidea; D000818:Animals; D001196:Ascariasis / Q000453:epidemiology; D017164:Ascaris lumbricoides; D002648:Child; D002675:Child, Preschool; D003362:Cost-Benefit Analysis; D003625:Data Collection; D004605:Elephantiasis, Filarial / Q000453:epidemiology* / Q000469:parasitology / Q000635:transmission; D006376:Helminths / Q000502:physiology; D006725:Hookworm Infections / Q000453:epidemiology; D006801:Humans; D007630:Kenya / Q000453:epidemiology; D019982:Organizational Case Studies / Q000191:economics; D011159:Population Surveillance / Q000379:methods; D015995:Prevalence; D018401:Sample Size; D012680:Sensitivity and Specificity; D012987:Soil / Q000469:parasitology; D014257:Trichuriasis / Q000453:epidemiology; D014258:Trichuris
chemical_list: D012987:Soil