Evaluating the diagnostic test accuracy of molecular xenomonitoring methods for characterising community burden of lymphatic filariasis

评估分子异种监测方法的诊断测试准确性，以表征淋巴丝虫病的社区负担

• 批准号: 1964928
• 金额: --
• 依托单位: Liverpool School of Tropical Medicine
• 依托单位国家: 英国
• 项目类别: Studentship
• 财政年份: 2017
• 资助国家: 英国
• 起止时间: 2017 至 无数据
• 项目状态: 已结题
• 来源: https://gtr.ukri.org/projects?ref=studentship-1964928
• 关键词: Evaluating; diagnostic; test; accuracy; molecular

BackgroundMolecular xenomonitoring (MX), the detection of pathogen DNA in mosquitoes, is a recommended approach to support lymphatic filariasis (LF) elimination efforts. Potential roles of MX include detecting presence of LF in communities and quantifying progress towards elimination of the disease. However, the relationship between MX results and human prevalence is poorly understood.MethodsWe conducted a systematic review and meta-analysis from all previously conducted studies that reported the prevalence of filarial DNA in wild-caught mosquitoes (MX rate) and the corresponding prevalence of microfilaria (mf) in humans. We calculated a pooled estimate of MX sensitivity for detecting positive communities at a range of mf prevalence values and mosquito sample sizes. We conducted a linear regression to evaluate the relationship between mf prevalence and MX rate.ResultsWe identified 24 studies comprising 144 study communities. MX had an overall sensitivity of 98.3% (95% CI 41.5, 99.9%) and identified 28 positive communities that were negative in the mf survey. Low sensitivity in some studies was attributed to small mosquito sample sizes (<1,000) and very low mf prevalence (<0.25%). Human mf prevalence and mass drug administration status accounted for approximately half of the variation in MX rate (R2 = 0.49, p<0.001). Data from longitudinal studies showed that, within a given study area, there is a strong linear relationship between MX rate and mf prevalence (R2 = 0.78, p < 0.001).ConclusionMX shows clear potential as a tool for detecting communities where LF is present and as a predictor of human mf prevalence.

背景分子异种监测(MX)，即在蚊子中检测病原体DNA，是支持消除淋巴丝虫病(LF)努力的推荐方法。MX的潜在作用包括检测社区中LF的存在和量化消除该疾病的进展情况。然而，MX结果与人类感染率之间的关系还不是很清楚。方法我们对所有报道野生捕获蚊体丝虫DNA流行率(MX率)和相应的人类微丝虫病流行率(MF)的研究进行了系统的回顾和荟萃分析。我们计算了在一定范围的MF流行值和蚊子样本大小下用于检测阳性社区的MX敏感性的综合估计。我们进行了线性回归来评估MF患病率和MX率之间的关系。MX的总体敏感度为98.3%(95%可信区间41.5，99.9%)，并在MF调查中确定了28个阳性社区。在一些研究中，敏感度低归因于蚊子样本量小(&lt；1000)和MF患病率非常低(&lt；0.25%)。人类MF患病率和大众用药状况约占MX率变化的一半(R2=0.49p&lt；0.001)。来自纵向研究的数据表明，在给定的研究区域内，MX率与MF患病率之间存在很强的线性关系(R2=0.78，p&lt；0.001)。结论MX作为检测存在LF的社区和预测人类MF患病率的工具具有明显的潜力。