Diagnostic accuracy and cost-effectiveness of alternative methods for detection of soil-transmitted helminths in a post-treatment setting in western Kenya.
Diagnostic accuracy and cost-effectiveness of alternative methods for detection of soil-transmitted helminths in a post-treatment setting in western Kenya.
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DOI：
10.1371/journal.pntd.0002843
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发表时间：
2014-05
影响因子：
3.8
通讯作者：
Brooker SJ
中科院分区：
文献类型：
--
作者：
Assefa LM;Crellen T;Kepha S;Kihara JH;Njenga SM;Pullan RL;Brooker SJ
本研究评估的诊断准确性和成本效益的Kato-Katz和Mini-FLOTAC方法检测土壤传播的蠕虫（STH）在肯尼亚西部的治疗后设置。成本分析还探讨了与家庭调查相比，在学校调查期间收集样本所涉的成本问题。粪便样本收集儿童（n = 652）参加18所学校在Bungoma县和诊断的加藤Katz和迷你FLOTAC粪便学方法。 使用贝叶斯潜在类别建模分析灵敏度和其他诊断性能指标。计算了所有调查和诊断活动的财务和经济成本，并估计了每个儿童检测的成本，每个病例检测的成本和每个正确分类的STH感染的成本。进行了敏感性分析，以评估各种调查参数对费用估计数的影响。两种诊断方法在单日和连续一天采样中对任何STH物种的检测均表现出相当的灵敏度：单日Kato-Katz为52.0%;单日Mini-FLOTAC为49.1%;连续一天Kato-Katz为76.9%;连续一天Mini-FLOTAC为74.1%。不同STH物种的诊断性能在方法之间没有显著差异。就每个受测儿童的成本（10.14美元）和正确分类的每个病例的成本（12.84美元）而言，使用Kato-Katz和基于学校的抽样是成本最低的方案。Kato-Katz在社区抽样中发现的每例病例成本最低（128.24美元）。敏感性分析显示，任何STH的病例检测成本随着患病率的增加而非线性下降，并受到收集样本数量的影响。Kato-Katz方法的诊断灵敏度与Mini-FLOTAC方法相当，但具有更高的成本效益。未来的工作是需要评估的成本效益STH监测在不同的设置。准确的诊断方法和对人口进行抽样的最佳战略对于传染病的可靠绘图和监测至关重要。土壤传播蠕虫（STH）检测的现行标准需要使用Kato-Katz诊断方法。替代诊断方法，如浮选技术，如Mini-FLOTAC，已被开发，希望实现更高的灵敏度和易用性。在这里，我们评估的加藤-Katz方法和Mini-FLOTAC方法检测STH感染的诊断准确性。我们使用贝叶斯潜在类建模来计算诊断准确性的黄金标准的方法STH检测的情况下。采用以学校为基础和以社区为基础的抽样方法从学龄儿童中收集粪便样本。我们目前的成本估计使用加藤-卡茨和迷你FLOTAC诊断方法结合两种抽样方法，提供各种调查方案的成本数据。Kato-Katz和Mini-FLOTAC方法在一天内（Kato-Katz：52.0%，Mini-FLOTAC：49.1%）和连续几天（Kato-Katz：76.9%，Mini-FLOTAC：74.1%）检测任何STH物质的灵敏度相当。在使用Kato-Katz方法的情况下，成本最低;使用Kato-Katz诊断进行基于学校的抽样，每个儿童的测试成本和每个病例的正确分类成本分别为10.14美元和12.84美元。采用基于社区的抽样和使用Kato-Katz，发现的每个病例的最低成本为128.24美元。需要进一步开展工作，研究在各种环境下性病和艾滋病调查和其他被忽视的热带病监测的诊断和取样方法的成本效益。为此，我们提供了诊断分析中使用的模型代码和STH调查的成本计算模板。
This study evaluates the diagnostic accuracy and cost-effectiveness of the Kato-Katz and Mini-FLOTAC methods for detection of soil-transmitted helminths (STH) in a post-treatment setting in western Kenya. A cost analysis also explores the cost implications of collecting samples during school surveys when compared to household surveys. Stool samples were collected from children (n = 652) attending 18 schools in Bungoma County and diagnosed by the Kato-Katz and Mini-FLOTAC coprological methods. Sensitivity and additional diagnostic performance measures were analyzed using Bayesian latent class modeling. Financial and economic costs were calculated for all survey and diagnostic activities, and cost per child tested, cost per case detected and cost per STH infection correctly classified were estimated. A sensitivity analysis was conducted to assess the impact of various survey parameters on cost estimates. Both diagnostic methods exhibited comparable sensitivity for detection of any STH species over single and consecutive day sampling: 52.0% for single day Kato-Katz; 49.1% for single-day Mini-FLOTAC; 76.9% for consecutive day Kato-Katz; and 74.1% for consecutive day Mini-FLOTAC. Diagnostic performance did not differ significantly between methods for the different STH species. Use of Kato-Katz with school-based sampling was the lowest cost scenario for cost per child tested ($10.14) and cost per case correctly classified ($12.84). Cost per case detected was lowest for Kato-Katz used in community-based sampling ($128.24). Sensitivity analysis revealed the cost of case detection for any STH decreased non-linearly as prevalence rates increased and was influenced by the number of samples collected. The Kato-Katz method was comparable in diagnostic sensitivity to the Mini-FLOTAC method, but afforded greater cost-effectiveness. Future work is required to evaluate the cost-effectiveness of STH surveillance in different settings. Accurate methods of diagnosis and optimal strategies to sample the population are essential for the reliable mapping and surveillance of infectious diseases. The current standard for detection of soil-transmitted helminths (STH) entails use of the Kato-Katz diagnostic method. Alternative diagnostic methods, such as flotation techniques like the Mini-FLOTAC, have been developed with hopes of achieving greater sensitivity and ease of use. Here, we evaluate the diagnostic accuracy of the Kato-Katz method and the Mini-FLOTAC method for detecting STH infection. We use Bayesian latent class modeling to calculate the diagnostic accuracy in the absence of a gold-standard method for STH detection. Stool samples were collected from school-age children using school-based and community-based sampling. We present cost estimates for use of the Kato-Katz and Mini-FLOTAC diagnostic methods in combination with both sampling methods, providing cost data for the various survey scenarios. Sensitivity was comparable between the Kato-Katz and Mini-FLOTAC methods for detection of any STH species over a single day (Kato Katz: 52.0%, Mini-FLOTAC: 49.1%) and consecutive days (Kato-Katz: 76.9%, Mini-FLOTAC: 74.1%). Costs were lowest in scenarios using the Kato-Katz method; cost per child tested and cost per case correctly classified for school-based sampling with the Kato-Katz diagnostic were $10.14 and $12.84 respectively. The lowest cost per case detected was $128.24 with community-based sampling and use of Kato-Katz. Further work is required on the cost-effectiveness of diagnostic and sampling methods for STH surveys and surveillance of other neglected tropical diseases (NTDs) in various settings. To this end, we provide the model code used in the diagnostic analysis and a costing template for STH surveys.
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比较Kato-Katz，Koga琼脂板，以太浓度和FLOTAC的诊断精度，用于曼森和土壤传播的蠕虫。
影响因子：
3.8
作者：
Glinz, Dominik;Silue, Kigbafori D.;Knopp, Stefanie;Lohourignon, Laurent K.;Yao, Kouassi P.;Steinmann, Peter;Rinaldi, Laura;Cringoli, Giuseppe;N'Goran, Eliezer K.;Utzinger, Juerg
通讯作者：
Utzinger, Juerg
影响因子：
3.8
作者：
Krauth SJ;Coulibaly JT;Knopp S;Traoré M;N'Goran EK;Utzinger J
通讯作者：
Utzinger J
影响因子：
1.9
作者：
Habtamu, Kassahun;Degarege, Abraham;Erko, Berhanu
通讯作者：
Erko, Berhanu
影响因子：
1.9
作者：
Dendukuri, N;Joseph, L
通讯作者：
Joseph, L
影响因子：
4.9
作者：
Brooker, Simon;Kabatereine, Narcis B.;Snow, Robert W.
通讯作者：
Snow, Robert W.