1. The increased sensitivity of qPCR in comparison to Kato-Katz is required for the accurate assessment of the prevalence of soil-transmitted helminth infection in settings that have received multiple rounds of mass drug administration
- Author
-
Nay Yee Wyine, Nay Soe Maung, D. T. J. Littlewood, Raju Misra, Kay Thwe Han, Darren Chooneea, Roy M. Anderson, Marina Papaiakovou, Julia C. Dunn, Alison A. Bettis, Aye Moe Moe Lwin, and GlaxoSmithKline Services Unlimited
- Subjects
0301 basic medicine ,Ancylostomatoidea ,Veterinary medicine ,Kato-Katz ,Necator americanus ,NECATOR-AMERICANUS ,Helminthiasis ,Mycology & Parasitology ,law.invention ,Feces ,Soil ,0302 clinical medicine ,law ,1108 Medical Microbiology ,Prevalence ,REAL-TIME PCR ,Monitoring and evaluation ,Diagnostics ,Eggs per gram ,Anthelmintics ,biology ,Soil-transmitted helminths ,qPCR ,Infectious Diseases ,Transmission (mechanics) ,Trichuris ,Mass Drug Administration ,Ascaris lumbricoides ,Life Sciences & Biomedicine ,ANCYLOSTOMA-CEYLANICUM ,Ancylostoma ,POLYMERASE-CHAIN-REACTION ,030231 tropical medicine ,DIAGNOSIS ,Real-Time Polymerase Chain Reaction ,Sensitivity and Specificity ,lcsh:Infectious and parasitic diseases ,1117 Public Health and Health Services ,03 medical and health sciences ,Hookworm Infections ,Dogs ,Tropical Medicine ,Helminths ,Animals ,Humans ,lcsh:RC109-216 ,Trichuriasis ,Mass drug administration ,Parasite Egg Count ,ELIMINATION ,Ancylostoma ceylanicum ,Science & Technology ,Diagnostic Tests, Routine ,Research ,DNA ,biology.organism_classification ,030104 developmental biology ,Parasitology ,COMMUNITIES - Abstract
Background The most commonly used diagnostic tool for soil-transmitted helminths (STH) is the Kato-Katz (KK) thick smear technique. However, numerous studies have suggested that the sensitivity of KK can be problematic, especially in low prevalence and low intensity settings. An emerging alternative is quantitative polymerase chain reaction (qPCR). Methods In this study, both KK and qPCR were conducted on stool samples from 648 participants in an STH epidemiology study conducted in the delta region of Myanmar in June 2016. Results Prevalence of any STH was 20.68% by KK and 45.06% by qPCR. Prevalence of each individual STH was also higher by qPCR than KK, the biggest difference was for hookworm with an approximately 4-fold increase between the two diagnostic techniques. Prevalence of Ancylostoma ceylanicum, a parasite predominately found in dogs, was 4.63%, indicating that there is the possibility of zoonotic transmission in the study setting. In individuals with moderate to high intensity infections there is evidence for a linear relationship between eggs per gram (EPG) of faeces, derived from KK, and DNA copy number, derived from qPCR which is particularly strong for Ascaris lumbricoides. Conclusions The use of qPCR in low prevalence settings is important to accurately assess the epidemiological situation and plan control strategies for the ‘end game’. However, more work is required to accurately assess STH intensity from qPCR results and to reduce the cost of qPCR so that is widely accessible in STH endemic countries.
- Published
- 2020