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Identifying thresholds for classifying moderate-to-heavy soil-transmitted helminth intensity infections for FECPAKG2, McMaster, Mini-FLOTAC and qPCR.

  • Levecke B Department of Virology, Parasitology and Immunology, Ghent University, Merelbeke, Belgium.
  • Cools P Department of Virology, Parasitology and Immunology, Ghent University, Merelbeke, Belgium.
  • Albonico M Center for Tropical Diseases, Sacro Cuore Don Calabria Hospital, Negrar, Italy.
  • Ame S Public Health Laboratory-Ivo de Carneri, Chake Chake, United Republic of Tanzania.
  • Angebault C Clinical Laboratory, Institut Pasteur, Phnom Penh, Cambodia.
  • Ayana M Jimma University Institute of Health, Jimma University, Jimma, Ethiopia.
  • Behnke JM School of Life Sciences, University of Nottingham, Nottingham, United Kingdom.
  • Bethony JM Microbiology, Immunology, and Tropical Medicine, George Washington University Medical Center, Washington D.C., United States of America.
  • Cringoli G Department of Veterinary Medicine and Animal Production, University of Naples Federico II, Naples, Italy.
  • Dana D Jimma University Institute of Health, Jimma University, Jimma, Ethiopia.
  • Guillard B Clinical Laboratory, Institut Pasteur, Phnom Penh, Cambodia.
  • Viet Hoa NT Department of Parasitology, National Institute of Malariology, Parasitology and Entomology, Ha Noi, Vietnam.
  • Kang G Department of Gastrointestinal Sciences, Christian Medical College, Vellore, India.
  • Kattula D Department of Gastrointestinal Sciences, Christian Medical College, Vellore, India.
  • Keiser J Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Basel, Switzerland & University of Basel, Basel, Switzerland.
  • Kotze AC Division of Agriculture and Food, Commonwealth Scientific and Industrial Research Organization, St. Lucia, Australia.
  • Matoso LF Laboratory of Molecular and Cellular Immunology, Research Center René Rachou - FIOCRUZ, Belo Horizonte, Brazil.
  • Maurelli MP Department of Veterinary Medicine and Animal Production, University of Naples Federico II, Naples, Italy.
  • McCarthy JS QIMR Berghofer Medical Research Institute, University of Queensland, Brisbane, Australia.
  • Mekonnen Z Jimma University Institute of Health, Jimma University, Jimma, Ethiopia.
  • Mirams G Techion Group Ltd, Dunedin, New Zealand.
  • Montresor A Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland.
  • Oliveira RC Laboratory of Molecular and Cellular Immunology, Research Center René Rachou - FIOCRUZ, Belo Horizonte, Brazil.
  • Periago MV Laboratory of Molecular and Cellular Immunology, Research Center René Rachou - FIOCRUZ, Belo Horizonte, Brazil.
  • Pinto SA Laboratory of Molecular and Cellular Immunology, Research Center René Rachou - FIOCRUZ, Belo Horizonte, Brazil.
  • Rinaldi L Department of Veterinary Medicine and Animal Production, University of Naples Federico II, Naples, Italy.
  • Sayasone S Lao Tropical and Public Health Institute, Ministry of Health, Vientiane Capital, Lao People's Democratic Republic.
  • Sumo L Centre for Schistosomiasis and Parasitology, University of Yaoundé I, Yaoundé, Cameroon.
  • Tchuem-Tchuenté LA Centre for Schistosomiasis and Parasitology, University of Yaoundé I, Yaoundé, Cameroon.
  • Cam Thach DT Department of Parasitology, National Institute of Malariology, Parasitology and Entomology, Ha Noi, Vietnam.
  • Thomas E Techion Group Ltd, Aberystwyth, United Kingdom.
  • Zeynudin A Jimma University Institute of Health, Jimma University, Jimma, Ethiopia.
  • Verweij JJ Laboratory for Medical Microbiology and Immunology, Elisabeth-Tweesteden Hospital, Tilburg, The Netherlands.
  • Vlaminck J Department of Virology, Parasitology and Immunology, Ghent University, Merelbeke, Belgium.
  • Vercruysse J Department of Virology, Parasitology and Immunology, Ghent University, Merelbeke, Belgium.
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  • 2020-07-03
Published in:
  • PLoS neglected tropical diseases. - 2020
Helminthiasis
Humans
Microscopy
Real-Time Polymerase Chain Reaction
Soil
World Health Organization
English The World Health Organization (WHO) has defined moderate-to-heavy intensity (M&HI) infections with soil-transmitted helminths (Ascaris lumbricoides, Trichuris trichiura and the two hookworms, Ancylostoma duodenale and Necator americanus) based on specific values of eggs per gram of stool, as measured by the Kato-Katz method. There are a variety of novel microscopy and DNA-based methods but it remains unclear whether applying current WHO thresholds on to these methods allows for a reliable classification of M&HI infections. We evaluated both WHO and method-specific thresholds for classifying the M&HI infections for novel microscopic (FECPAKG2, McMaster and Mini-FLOTAC) and DNA-based (qPCR) diagnostic methods. For this, we determined method-specific thresholds that best classified M&HI infections (defined by Kato-Katz and WHO thresholds; reference method) in two multi-country drug efficacy studies. Subsequently, we verified whether applying these method-specific thresholds improved the agreement in classifying M&HI infections compared to the reference method. When we applied the WHO thresholds, the new microscopic methods mainly misclassified M&HI as low intensity, and to a lesser extent low intensity infection as M&HI. For FECPAKG2, applying the method-specific thresholds significantly improved the agreement for Ascaris (moderate → substantial), Trichuris and hookworms (fair → moderate). For Mini-FLOTAC, a significantly improved agreement was observed for hookworms only (fair → moderate). For the other STHs, the agreement was almost perfect and remained unchanged. For McMaster, the method-specific thresholds revealed a fair to a substantial agreement but did not significantly improve the agreement. For qPCR, the method-specific thresholds based on genome equivalents per ml of DNA moderately agreed with the reference method for hookworm and Trichuris infections. For Ascaris, there was a substantial agreement. We defined method-specific thresholds that improved the classification of M&HI infections. Validation studies are required before they can be recommended for general use in assessing M&HI infections in programmatic settings.
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  • English
Open access status
gold
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https://sonar.ch/global/documents/232638
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