Towards soil-transmitted helminths transmission interruption: The impact of diagnostic tools on infection prediction in a low intensity setting in Southern Mozambique.
World Health Organization goals against soil-transmitted helminthiases (STH) are pointing towards seeking their elimination as a public health problem: reducing to less than 2% the proportion of moderate and heavy infections. Some regions are reaching WHO goals, but transmission could rebound if str...
Saved in:
| Main Authors: | , , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Public Library of Science (PLoS)
2021-10-01
|
| Series: | PLoS Neglected Tropical Diseases |
| Online Access: | https://doi.org/10.1371/journal.pntd.0009803 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849337591900405760 |
|---|---|
| author | Berta Grau-Pujol Helena Martí-Soler Valdemiro Escola Maria Demontis Jose Carlos Jamine Javier Gandasegui Osvaldo Muchisse Maria Cambra-Pellejà Anelsio Cossa Maria Martinez-Valladares Charfudin Sacoor Lisette Van Lieshout Jorge Cano Emanuele Giorgi Jose Muñoz |
| author_facet | Berta Grau-Pujol Helena Martí-Soler Valdemiro Escola Maria Demontis Jose Carlos Jamine Javier Gandasegui Osvaldo Muchisse Maria Cambra-Pellejà Anelsio Cossa Maria Martinez-Valladares Charfudin Sacoor Lisette Van Lieshout Jorge Cano Emanuele Giorgi Jose Muñoz |
| author_sort | Berta Grau-Pujol |
| collection | DOAJ |
| description | World Health Organization goals against soil-transmitted helminthiases (STH) are pointing towards seeking their elimination as a public health problem: reducing to less than 2% the proportion of moderate and heavy infections. Some regions are reaching WHO goals, but transmission could rebound if strategies are discontinued without an epidemiological evaluation. For that, sensitive diagnostic methods to detect low intensity infections and localization of ongoing transmission are crucial. In this work, we estimated and compared the STH infection as obtained by different diagnostic methods in a low intensity setting. We conducted a cross-sectional study enrolling 792 participants from a district in Mozambique. Two stool samples from two consecutive days were collected from each participant. Samples were analysed by Telemann, Kato-Katz and qPCR for STH detection. We evaluated diagnostic sensitivity using a composite reference standard. By geostatistical methods, we estimated neighbourhood prevalence of at least one STH infection for each diagnostic method. We used environmental, demographical and socioeconomical indicators to account for any existing spatial heterogeneity in infection. qPCR was the most sensitive technique compared to composite reference standard: 92% (CI: 83%- 97%) for A. lumbricoides, 95% (CI: 88%- 98%) for T. trichiura and 95% (CI: 91%- 97%) for hookworm. qPCR also estimated the highest neighbourhood prevalences for at least one STH infection in a low intensity setting. While 10% of the neighbourhoods showed a prevalence above 20% when estimating with single Kato-Katz from one stool and Telemann from one stool, 86% of the neighbourhoods had a prevalence above 20% when estimating with qPCR. In low intensity settings, STH estimated prevalence of infection may be underestimated if based on Kato-Katz. qPCR diagnosis outperformed the microscopy methods. Thus, implementation of qPCR based predictive maps at STH control and elimination programmes would disclose hidden transmission and facilitate targeted interventions for transmission interruption. |
| format | Article |
| id | doaj-art-152b933e7c234cd5baa286a7395c1dbe |
| institution | Kabale University |
| issn | 1935-2727 1935-2735 |
| language | English |
| publishDate | 2021-10-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS Neglected Tropical Diseases |
| spelling | doaj-art-152b933e7c234cd5baa286a7395c1dbe2025-08-20T03:44:39ZengPublic Library of Science (PLoS)PLoS Neglected Tropical Diseases1935-27271935-27352021-10-011510e000980310.1371/journal.pntd.0009803Towards soil-transmitted helminths transmission interruption: The impact of diagnostic tools on infection prediction in a low intensity setting in Southern Mozambique.Berta Grau-PujolHelena Martí-SolerValdemiro EscolaMaria DemontisJose Carlos JamineJavier GandaseguiOsvaldo MuchisseMaria Cambra-PellejàAnelsio CossaMaria Martinez-ValladaresCharfudin SacoorLisette Van LieshoutJorge CanoEmanuele GiorgiJose MuñozWorld Health Organization goals against soil-transmitted helminthiases (STH) are pointing towards seeking their elimination as a public health problem: reducing to less than 2% the proportion of moderate and heavy infections. Some regions are reaching WHO goals, but transmission could rebound if strategies are discontinued without an epidemiological evaluation. For that, sensitive diagnostic methods to detect low intensity infections and localization of ongoing transmission are crucial. In this work, we estimated and compared the STH infection as obtained by different diagnostic methods in a low intensity setting. We conducted a cross-sectional study enrolling 792 participants from a district in Mozambique. Two stool samples from two consecutive days were collected from each participant. Samples were analysed by Telemann, Kato-Katz and qPCR for STH detection. We evaluated diagnostic sensitivity using a composite reference standard. By geostatistical methods, we estimated neighbourhood prevalence of at least one STH infection for each diagnostic method. We used environmental, demographical and socioeconomical indicators to account for any existing spatial heterogeneity in infection. qPCR was the most sensitive technique compared to composite reference standard: 92% (CI: 83%- 97%) for A. lumbricoides, 95% (CI: 88%- 98%) for T. trichiura and 95% (CI: 91%- 97%) for hookworm. qPCR also estimated the highest neighbourhood prevalences for at least one STH infection in a low intensity setting. While 10% of the neighbourhoods showed a prevalence above 20% when estimating with single Kato-Katz from one stool and Telemann from one stool, 86% of the neighbourhoods had a prevalence above 20% when estimating with qPCR. In low intensity settings, STH estimated prevalence of infection may be underestimated if based on Kato-Katz. qPCR diagnosis outperformed the microscopy methods. Thus, implementation of qPCR based predictive maps at STH control and elimination programmes would disclose hidden transmission and facilitate targeted interventions for transmission interruption.https://doi.org/10.1371/journal.pntd.0009803 |
| spellingShingle | Berta Grau-Pujol Helena Martí-Soler Valdemiro Escola Maria Demontis Jose Carlos Jamine Javier Gandasegui Osvaldo Muchisse Maria Cambra-Pellejà Anelsio Cossa Maria Martinez-Valladares Charfudin Sacoor Lisette Van Lieshout Jorge Cano Emanuele Giorgi Jose Muñoz Towards soil-transmitted helminths transmission interruption: The impact of diagnostic tools on infection prediction in a low intensity setting in Southern Mozambique. PLoS Neglected Tropical Diseases |
| title | Towards soil-transmitted helminths transmission interruption: The impact of diagnostic tools on infection prediction in a low intensity setting in Southern Mozambique. |
| title_full | Towards soil-transmitted helminths transmission interruption: The impact of diagnostic tools on infection prediction in a low intensity setting in Southern Mozambique. |
| title_fullStr | Towards soil-transmitted helminths transmission interruption: The impact of diagnostic tools on infection prediction in a low intensity setting in Southern Mozambique. |
| title_full_unstemmed | Towards soil-transmitted helminths transmission interruption: The impact of diagnostic tools on infection prediction in a low intensity setting in Southern Mozambique. |
| title_short | Towards soil-transmitted helminths transmission interruption: The impact of diagnostic tools on infection prediction in a low intensity setting in Southern Mozambique. |
| title_sort | towards soil transmitted helminths transmission interruption the impact of diagnostic tools on infection prediction in a low intensity setting in southern mozambique |
| url | https://doi.org/10.1371/journal.pntd.0009803 |
| work_keys_str_mv | AT bertagraupujol towardssoiltransmittedhelminthstransmissioninterruptiontheimpactofdiagnostictoolsoninfectionpredictioninalowintensitysettinginsouthernmozambique AT helenamartisoler towardssoiltransmittedhelminthstransmissioninterruptiontheimpactofdiagnostictoolsoninfectionpredictioninalowintensitysettinginsouthernmozambique AT valdemiroescola towardssoiltransmittedhelminthstransmissioninterruptiontheimpactofdiagnostictoolsoninfectionpredictioninalowintensitysettinginsouthernmozambique AT mariademontis towardssoiltransmittedhelminthstransmissioninterruptiontheimpactofdiagnostictoolsoninfectionpredictioninalowintensitysettinginsouthernmozambique AT josecarlosjamine towardssoiltransmittedhelminthstransmissioninterruptiontheimpactofdiagnostictoolsoninfectionpredictioninalowintensitysettinginsouthernmozambique AT javiergandasegui towardssoiltransmittedhelminthstransmissioninterruptiontheimpactofdiagnostictoolsoninfectionpredictioninalowintensitysettinginsouthernmozambique AT osvaldomuchisse towardssoiltransmittedhelminthstransmissioninterruptiontheimpactofdiagnostictoolsoninfectionpredictioninalowintensitysettinginsouthernmozambique AT mariacambrapelleja towardssoiltransmittedhelminthstransmissioninterruptiontheimpactofdiagnostictoolsoninfectionpredictioninalowintensitysettinginsouthernmozambique AT anelsiocossa towardssoiltransmittedhelminthstransmissioninterruptiontheimpactofdiagnostictoolsoninfectionpredictioninalowintensitysettinginsouthernmozambique AT mariamartinezvalladares towardssoiltransmittedhelminthstransmissioninterruptiontheimpactofdiagnostictoolsoninfectionpredictioninalowintensitysettinginsouthernmozambique AT charfudinsacoor towardssoiltransmittedhelminthstransmissioninterruptiontheimpactofdiagnostictoolsoninfectionpredictioninalowintensitysettinginsouthernmozambique AT lisettevanlieshout towardssoiltransmittedhelminthstransmissioninterruptiontheimpactofdiagnostictoolsoninfectionpredictioninalowintensitysettinginsouthernmozambique AT jorgecano towardssoiltransmittedhelminthstransmissioninterruptiontheimpactofdiagnostictoolsoninfectionpredictioninalowintensitysettinginsouthernmozambique AT emanuelegiorgi towardssoiltransmittedhelminthstransmissioninterruptiontheimpactofdiagnostictoolsoninfectionpredictioninalowintensitysettinginsouthernmozambique AT josemunoz towardssoiltransmittedhelminthstransmissioninterruptiontheimpactofdiagnostictoolsoninfectionpredictioninalowintensitysettinginsouthernmozambique |