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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...

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Autores principales: Grau-Pujol, Berta, Martí-Soler, Helena, Escola, Valdemiro, Demontis, Maria, Jamine, Jose Carlos, Gandasegui, Javier, Muchisse, Osvaldo, Cambra-Pellejà, Maria, Cossa, Anelsio, Martinez-Valladares, Maria, Sacoor, Charfudin, Van Lieshout, Lisette, Cano, Jorge, Giorgi, Emanuele, Muñoz, Jose
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8568186/
https://www.ncbi.nlm.nih.gov/pubmed/34695108
http://dx.doi.org/10.1371/journal.pntd.0009803
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author Grau-Pujol, Berta
Martí-Soler, Helena
Escola, Valdemiro
Demontis, Maria
Jamine, Jose Carlos
Gandasegui, Javier
Muchisse, Osvaldo
Cambra-Pellejà, Maria
Cossa, Anelsio
Martinez-Valladares, Maria
Sacoor, Charfudin
Van Lieshout, Lisette
Cano, Jorge
Giorgi, Emanuele
Muñoz, Jose
author_facet Grau-Pujol, Berta
Martí-Soler, Helena
Escola, Valdemiro
Demontis, Maria
Jamine, Jose Carlos
Gandasegui, Javier
Muchisse, Osvaldo
Cambra-Pellejà, Maria
Cossa, Anelsio
Martinez-Valladares, Maria
Sacoor, Charfudin
Van Lieshout, Lisette
Cano, Jorge
Giorgi, Emanuele
Muñoz, Jose
author_sort Grau-Pujol, Berta
collection PubMed
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.
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spelling pubmed-85681862021-11-05 Towards soil-transmitted helminths transmission interruption: The impact of diagnostic tools on infection prediction in a low intensity setting in Southern Mozambique Grau-Pujol, Berta Martí-Soler, Helena Escola, Valdemiro Demontis, Maria Jamine, Jose Carlos Gandasegui, Javier Muchisse, Osvaldo Cambra-Pellejà, Maria Cossa, Anelsio Martinez-Valladares, Maria Sacoor, Charfudin Van Lieshout, Lisette Cano, Jorge Giorgi, Emanuele Muñoz, Jose PLoS Negl Trop Dis Research Article 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. Public Library of Science 2021-10-25 /pmc/articles/PMC8568186/ /pubmed/34695108 http://dx.doi.org/10.1371/journal.pntd.0009803 Text en © 2021 Grau-Pujol et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Grau-Pujol, Berta
Martí-Soler, Helena
Escola, Valdemiro
Demontis, Maria
Jamine, Jose Carlos
Gandasegui, Javier
Muchisse, Osvaldo
Cambra-Pellejà, Maria
Cossa, Anelsio
Martinez-Valladares, Maria
Sacoor, Charfudin
Van Lieshout, Lisette
Cano, Jorge
Giorgi, Emanuele
Muñoz, Jose
Towards soil-transmitted helminths transmission interruption: The impact of diagnostic tools on infection prediction in a low intensity setting in Southern Mozambique
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
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8568186/
https://www.ncbi.nlm.nih.gov/pubmed/34695108
http://dx.doi.org/10.1371/journal.pntd.0009803
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