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Effect of sampling and diagnostic effort on the assessment of schistosomiasis and soil-transmitted helminthiasis and drug efficacy: a meta-analysis of six drug efficacy trials and one epidemiological survey

Published online by Cambridge University Press:  14 April 2014

BRUNO LEVECKE ,
SIMON J. BROOKER ,
STEFANIE KNOPP ,
PETER STEINMANN ,
JOSE CARLOS SOUSA-FIGUEIREDO ,
J. RUSSELL STOTHARD ,
JÜRG UTZINGER  and
JOZEF VERCRUYSSE
BRUNO LEVECKE*
Affiliation:
Department of Virology, Parasitology and Immunology, Faculty of Veterinary Medicine, Ghent University, Salisburylaan 133, 9820 Merelbeke, Belgium
SIMON J. BROOKER
Affiliation:
Department of Disease Control, London School of Hygiene & Tropical Medicine, Keppel Street, London WC1E 7HT, UK
STEFANIE KNOPP
Affiliation:
Wolfson Wellcome Biomedical Laboratories, Department of Life Sciences, Natural History Museum, Cromwell Road, London SW7 5BD, UK Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Socinstrasse 57, CH-4002 Basel, Switzerland University of Basel, Petersplatz 1, CH-4003 Basel, Switzerland
PETER STEINMANN
Affiliation:
Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Socinstrasse 57, CH-4002 Basel, Switzerland University of Basel, Petersplatz 1, CH-4003 Basel, Switzerland
JOSE CARLOS SOUSA-FIGUEIREDO
Affiliation:
Department of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, Keppel Street, London WC1E 6HT, UK
J. RUSSELL STOTHARD
Affiliation:
Department of Parasitology, Liverpool School of Tropical Medicine, Liverpool L3 5QA, UK
JÜRG UTZINGER
Affiliation:
Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Socinstrasse 57, CH-4002 Basel, Switzerland University of Basel, Petersplatz 1, CH-4003 Basel, Switzerland
JOZEF VERCRUYSSE
Affiliation:
Department of Virology, Parasitology and Immunology, Faculty of Veterinary Medicine, Ghent University, Salisburylaan 133, 9820 Merelbeke, Belgium
*
*Corresponding author: Department of Virology, Parasitology and Immunology, Faculty of Veterinary Medicine, Ghent University, Salisburylaan 133, 9820 Merelbeke, Belgium. E-mail: [email protected]
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Summary

It is generally recommended to perform multiple stool examinations in order to improve the diagnostic accuracy when assessing the impact of mass drug administration programmes to control human intestinal worm infections and determining efficacy of the drugs administered. However, the collection and diagnostic work-up of multiple stool samples increases costs and workload. It has been hypothesized that these increased efforts provide more accurate results when infection and drug efficacy are summarized by prevalence (proportion of subjects infected) and cure rate (CR, proportion of infected subjects that become egg-negative after drug administration), respectively, but not when these indicators are expressed in terms of infection intensity and egg reduction rate (ERR). We performed a meta-analysis of six drug efficacy trials and one epidemiological survey. We compared prevalence and intensity of infection, CR and ERR based on collection of one or two stool samples that were processed with single or duplicate Kato-Katz thick smears. We found that the accuracy of prevalence estimates and CR was lowest with the minimal sampling effort, but that this was not the case for estimating infection intensity and ERR. Hence, a single Kato-Katz thick smear is sufficient for reporting infection intensity and ERR following drug treatment.

Keywords

Kato-Katz techniqueSchistosoma mansonisoil-transmitted helminthssampling effortdiagnostic effortprevalencefaecal egg countscure rateegg reduction rate
Type
Special Issue Article
Information
Parasitology , Volume 141 , Issue 14: Symposia of the British Society for Parasitology Volume 52 Advances in diagnostics for parasitic diseases , December 2014 , pp. 1826 - 1840
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Copyright
Copyright © Cambridge University Press 2014 

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