Comparison of Multi-Parallel qPCR and Double-Slide Kato-Katz for Detection of Soil-Transmitted Helminth Infection Among Children in Rural Bangladesh

Authors

Jade Benjamin-Chung, University of California, Berkeley
Nils Pilotte, Smith College
Ayse Ercumen, University of California, Berkeley
Jessica R. Grant, Smith College
Jacqueline R.M.A. Maasch, Smith College
Andrew M. Gonzalez, Smith College
Ashanta C. Ester, Smith College
Benjamin F. Arnold, University of California, Berkeley
Mahbubur Rahman, International Centre for Diarrhoeal Disease Research Bangladesh
Rashidul Haque, International Centre for Diarrhoeal Disease Research Bangladesh
Alan E. Hubbard, University of California, Berkeley
Stephen P. Luby, Stanford University
Steven A. Williams, Smith CollegeFollow
John M. Colford, University of California, Berkeley

Document Type

Article

Publication Date

4-1-2020

Publication Title

PLoS Neglected Tropical Diseases

Abstract

There is growing interest in local elimination of soil-transmitted helminth (STH) infection in endemic settings. In such settings, highly sensitive diagnostics are needed to detect STH infection. We compared double-slide Kato-Katz, the most commonly used copromicroscopic detection method, to multi-parallel quantitative polymerase chain reaction (qPCR) in 2,799 stool samples from children aged 2–12 years in a setting in rural Bangladesh with predominantly low STH infection intensity. We estimated the sensitivity and specificity of each diagnostic using Bayesian latent class analysis. Compared to double-slide Kato-Katz, STH prevalence using qPCR was almost 3-fold higher for hookworm species and nearly 2-fold higher for Trichuris trichiura. Ascaris lumbricoides prevalence was lower using qPCR, and 26% of samples classified as A. lumbricoides positive by Kato-Katz were negative by qPCR. Amplicon sequencing of the 18S rDNA from 10 samples confirmed that A. lumbricoides was absent in samples classified as positive by Kato-Katz and negative by qPCR. The sensitivity of Kato-Katz was 49% for A. lumbricoides, 32% for hookworm, and 52% for T. trichiura; the sensitivity of qPCR was 79% for A. lumbricoides, 93% for hookworm, and 90% for T. tri-chiura. Specificity was ≥97% for both tests for all STH except for Kato-Katz for A. lumbri-coides (specificity = 68%). There were moderate negative, monotonic correlations between qPCR cycle quantification values and eggs per gram quantified by Kato-Katz. While it is widely assumed that double-slide Kato-Katz has few false positives, our results indicate otherwise and highlight inherent limitations of the Kato-Katz technique. qPCR had higher sensitivity than Kato-Katz in this low intensity infection setting.

Volume

14

Issue

4

First Page

1

Last Page

23

DOI

10.1371/journal.pntd.0008087

ISSN

19352727

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

Rights

© 2020 Benjamin-Chung et al.

Comments

Archived as published. Open access paper.

Recommended Citation

Benjamin-Chung, Jade; Pilotte, Nils; Ercumen, Ayse; Grant, Jessica R.; Maasch, Jacqueline R.M.A.; Gonzalez, Andrew M.; Ester, Ashanta C.; Arnold, Benjamin F.; Rahman, Mahbubur; Haque, Rashidul; Hubbard, Alan E.; Luby, Stephen P.; Williams, Steven A.; and Colford, John M., "Comparison of Multi-Parallel qPCR and Double-Slide Kato-Katz for Detection of Soil-Transmitted Helminth Infection Among Children in Rural Bangladesh" (2020). Biological Sciences: Faculty Publications, Smith College, Northampton, MA.
https://scholarworks.smith.edu/bio_facpubs/155