Katherine Gass, The Task Force for Global Health, Decatur, Georgia
Madsen V.E. Beau de Rochars, Hopital Ste. Croix, Leogane, Haiti
Daniel Boakye, University of Ghana
Mark Bradley, Global Community Partnerships
Peter U. Fischer, Washington University School of Medicine
John Gyapong, Research and Development Division, Ghana Health Service
Makoto Itoh, Aichi Medical University School of Medicine
Nese Ituaso-Conway, National Program for Elimination of Lymphatic Filariasis, Ministry of Health, Funafuti, Tuvalu
Hayley Joseph, James Cook University
Dominique Kyelem, The Task Force for Global Health, Decatur, Georgia
Sandra J. Laney, Smith College
Anne-Marie Legrand, Institut Louis Malarde ́
Tilaka S. Liyanage, Sri Lanka Ministry of Health and Nutrition
Wayne Melrose, James Cook University
Khalfan Mohammed, Neglected Tropical Disease Control Program, Ministry of Health, Zanzibar, United Republic of Tanzania
Nils Pilotte, Smith College
Eric A. Ottesen, The Task Force for Global Health, Decatur, Georgia
Catherine Plichart, Institut Louis Malarde ́
Kapa Ramaiah, Vector Control Research Centre, Indian Council of Medical Research, Pondicherry, India
Ramakrishna U. Rao, Washington University School of Medicine
Jeffrey Talbot, The Task Force for Global Health, Decatur, Georgia
Gary J. Weil, Washington University School of Medicine
Steven A. Williams, Smith CollegeFollow
Kimberly Y. Won, Centers for Disease Control and Prevention, Atlanta, Georgia
Patrick J. Lammie, Centers for Disease Control and Prevention, Atlanta, Georgia

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PLOS Neglected Tropical Diseases


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.







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


©2012 Gass et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


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