Loss of sensitivity of immunochromatographic test (ICT) for lymphatic filariasis diagnosis in low prevalence settings: consequence in the monitoring and evaluation procedures
Identifieur interne : 000C61 ( Pmc/Curation ); précédent : 000C60; suivant : 000C62Loss of sensitivity of immunochromatographic test (ICT) for lymphatic filariasis diagnosis in low prevalence settings: consequence in the monitoring and evaluation procedures
Auteurs : Raceline Gounoue-Kamkumo [Cameroun] ; Hugues C. Nana-Djeunga [Cameroun] ; Jean Bopda [Cameroun] ; Julie Akame [Cameroun] ; Ann Tarini [Cameroun] ; Joseph Kamgno [Cameroun]Source :
- BMC Infectious Diseases [ 1471-2334 ] ; 2015.
Abstract
Diagnostic tools for lymphatic filariasis (LF) elimination programs are useful in mapping the distribution of the disease, delineating areas where mass drug administrations (MDA) are required, and determining when to stop MDA. The prevalence and burden of LF have been drastically reduced following mass treatments, and the evaluation of the performance of circulating filarial antigen (CFA)-based assays was acknowledged to be of high interest in areas with low residual LF endemicity rates after multiple rounds of MDA. The objective of this study was therefore to evaluate the immunochromatographic test (ICT) sensitivity in low endemicity settings and, specifically, in individuals with low intensity of lymphatic filariasis infection.
To perform this study, calibrated thick blood smears, ICT and Og4C3 enzyme-linked immunosorbent assay (ELISA) were carried out by night to identify
All individuals harbouring microfilariae (positive blood films) were detected by ICT and ELISA, but among individuals positive for ELISA, only 35.7 % of them were detected using ICT (Chi square: 4.57;
These findings suggest a loss of sensitivity for ICT in low endemicity settings, especially in people exhibiting low levels of circulating filarial antigen, raising serious concern regarding the monitoring and evaluation procedures in the framework of LF elimination program.
The online version of this article (doi:10.1186/s12879-015-1317-x) contains supplementary material, which is available to authorized users.
Url:
DOI: 10.1186/s12879-015-1317-x
PubMed: 26700472
PubMed Central: 4690254
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<affiliation wicri:level="1"><nlm:aff id="Aff2">Department of Animal Biology and Physiology, Laboratory of Animal Physiology, Faculty of Science, University of Yaounde 1, P.O. Box 812, Yaounde, Cameroon</nlm:aff>
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<author><name sortKey="Nana Djeunga, Hugues C" sort="Nana Djeunga, Hugues C" uniqKey="Nana Djeunga H" first="Hugues C." last="Nana-Djeunga">Hugues C. Nana-Djeunga</name>
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<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Loss of sensitivity of immunochromatographic test (ICT) for lymphatic filariasis diagnosis in low prevalence settings: consequence in the monitoring and evaluation procedures</title>
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<country xml:lang="fr">Cameroun</country>
<wicri:regionArea>Department of Animal Biology and Physiology, Laboratory of Animal Physiology, Faculty of Science, University of Yaounde 1, P.O. Box 812, Yaounde</wicri:regionArea>
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<author><name sortKey="Nana Djeunga, Hugues C" sort="Nana Djeunga, Hugues C" uniqKey="Nana Djeunga H" first="Hugues C." last="Nana-Djeunga">Hugues C. Nana-Djeunga</name>
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<author><name sortKey="Akame, Julie" sort="Akame, Julie" uniqKey="Akame J" first="Julie" last="Akame">Julie Akame</name>
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<author><name sortKey="Kamgno, Joseph" sort="Kamgno, Joseph" uniqKey="Kamgno J" first="Joseph" last="Kamgno">Joseph Kamgno</name>
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<series><title level="j">BMC Infectious Diseases</title>
<idno type="eISSN">1471-2334</idno>
<imprint><date when="2015">2015</date>
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<front><div type="abstract" xml:lang="en"><sec><title>Background</title>
<p>Diagnostic tools for lymphatic filariasis (LF) elimination programs are useful in mapping the distribution of the disease, delineating areas where mass drug administrations (MDA) are required, and determining when to stop MDA. The prevalence and burden of LF have been drastically reduced following mass treatments, and the evaluation of the performance of circulating filarial antigen (CFA)-based assays was acknowledged to be of high interest in areas with low residual LF endemicity rates after multiple rounds of MDA. The objective of this study was therefore to evaluate the immunochromatographic test (ICT) sensitivity in low endemicity settings and, specifically, in individuals with low intensity of lymphatic filariasis infection.</p>
</sec>
<sec><title>Methods</title>
<p>To perform this study, calibrated thick blood smears, ICT and Og4C3 enzyme-linked immunosorbent assay (ELISA) were carried out by night to identify <italic>Wuchereria bancrofti</italic>
microfilarial and circulating filarial antigen carriers. A threshold determination assay regarding ICT and ELISA was performed using serial plasma dilutions from individuals with positive microfilarial counts.</p>
</sec>
<sec><title>Results</title>
<p>All individuals harbouring microfilariae (positive blood films) were detected by ICT and ELISA, but among individuals positive for ELISA, only 35.7 % of them were detected using ICT (Chi square: 4.57; <italic>p</italic>
-value = 0.03), indicating a moderate agreement between both tests (kappa statistics = 0.49). Threshold determination analyses showed that ELISA was still positive at the last plasma dilution with negative ICT result.</p>
</sec>
<sec><title>Conclusions</title>
<p>These findings suggest a loss of sensitivity for ICT in low endemicity settings, especially in people exhibiting low levels of circulating filarial antigen, raising serious concern regarding the monitoring and evaluation procedures in the framework of LF elimination program.</p>
</sec>
<sec><title>Electronic supplementary material</title>
<p>The online version of this article (doi:10.1186/s12879-015-1317-x) contains supplementary material, which is available to authorized users.</p>
</sec>
</div>
</front>
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<pmc article-type="research-article"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">BMC Infect Dis</journal-id>
<journal-id journal-id-type="iso-abbrev">BMC Infect. Dis</journal-id>
<journal-title-group><journal-title>BMC Infectious Diseases</journal-title>
</journal-title-group>
<issn pub-type="epub">1471-2334</issn>
<publisher><publisher-name>BioMed Central</publisher-name>
<publisher-loc>London</publisher-loc>
</publisher>
</journal-meta>
<article-meta><article-id pub-id-type="pmid">26700472</article-id>
<article-id pub-id-type="pmc">4690254</article-id>
<article-id pub-id-type="publisher-id">1317</article-id>
<article-id pub-id-type="doi">10.1186/s12879-015-1317-x</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject>
</subj-group>
</article-categories>
<title-group><article-title>Loss of sensitivity of immunochromatographic test (ICT) for lymphatic filariasis diagnosis in low prevalence settings: consequence in the monitoring and evaluation procedures</article-title>
</title-group>
<contrib-group><contrib contrib-type="author" corresp="yes"><name><surname>Gounoue-Kamkumo</surname>
<given-names>Raceline</given-names>
</name>
<address><phone>+00237-699-598-493</phone>
<email>gounoue@crfilmt.org</email>
</address>
<xref ref-type="aff" rid="Aff1"></xref>
<xref ref-type="aff" rid="Aff2"></xref>
</contrib>
<contrib contrib-type="author"><name><surname>Nana-Djeunga</surname>
<given-names>Hugues C.</given-names>
</name>
<address><email>nanadjeunga@crfilmt.org</email>
</address>
<xref ref-type="aff" rid="Aff1"></xref>
<xref ref-type="aff" rid="Aff3"></xref>
</contrib>
<contrib contrib-type="author"><name><surname>Bopda</surname>
<given-names>Jean</given-names>
</name>
<address><email>bopda@crfilmt.org</email>
</address>
<xref ref-type="aff" rid="Aff1"></xref>
</contrib>
<contrib contrib-type="author"><name><surname>Akame</surname>
<given-names>Julie</given-names>
</name>
<address><email>jakame@hki.org</email>
</address>
<xref ref-type="aff" rid="Aff4"></xref>
</contrib>
<contrib contrib-type="author"><name><surname>Tarini</surname>
<given-names>Ann</given-names>
</name>
<address><email>tariniann@gmail.com</email>
</address>
<xref ref-type="aff" rid="Aff4"></xref>
</contrib>
<contrib contrib-type="author"><name><surname>Kamgno</surname>
<given-names>Joseph</given-names>
</name>
<address><email>kamgno@crfilmt.org</email>
</address>
<xref ref-type="aff" rid="Aff1"></xref>
<xref ref-type="aff" rid="Aff5"></xref>
</contrib>
<aff id="Aff1"><label></label>
Centre for Research on Filariasis and other Tropical Diseases (CRFilMT), P.O. Box 5797, Yaounde, Cameroon</aff>
<aff id="Aff2"><label></label>
Department of Animal Biology and Physiology, Laboratory of Animal Physiology, Faculty of Science, University of Yaounde 1, P.O. Box 812, Yaounde, Cameroon</aff>
<aff id="Aff3"><label></label>
Department of Animal Biology and Physiology, Parasitology and Ecology Laboratory, Faculty of Science, University of Yaounde 1, P.O. Box 812, Yaounde, Cameroon</aff>
<aff id="Aff4"><label></label>
Helen Keller International, P.O. Box 14227, Yaounde, Cameroon</aff>
<aff id="Aff5"><label></label>
Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, P.O. Box 1364, Yaounde, Cameroon</aff>
</contrib-group>
<pub-date pub-type="epub"><day>23</day>
<month>12</month>
<year>2015</year>
</pub-date>
<pub-date pub-type="pmc-release"><day>23</day>
<month>12</month>
<year>2015</year>
</pub-date>
<pub-date pub-type="collection"><year>2015</year>
</pub-date>
<volume>15</volume>
<elocation-id>579</elocation-id>
<history><date date-type="received"><day>8</day>
<month>8</month>
<year>2015</year>
</date>
<date date-type="accepted"><day>10</day>
<month>12</month>
<year>2015</year>
</date>
</history>
<permissions><copyright-statement>© Gounoue-Kamkumo et al. 2015</copyright-statement>
<license license-type="OpenAccess"><license-p><bold>Open Access</bold>
This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by/4.0/">http://creativecommons.org/licenses/by/4.0/</ext-link>
), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/publicdomain/zero/1.0/">http://creativecommons.org/publicdomain/zero/1.0/</ext-link>
) applies to the data made available in this article, unless otherwise stated.</license-p>
</license>
</permissions>
<abstract id="Abs1"><sec><title>Background</title>
<p>Diagnostic tools for lymphatic filariasis (LF) elimination programs are useful in mapping the distribution of the disease, delineating areas where mass drug administrations (MDA) are required, and determining when to stop MDA. The prevalence and burden of LF have been drastically reduced following mass treatments, and the evaluation of the performance of circulating filarial antigen (CFA)-based assays was acknowledged to be of high interest in areas with low residual LF endemicity rates after multiple rounds of MDA. The objective of this study was therefore to evaluate the immunochromatographic test (ICT) sensitivity in low endemicity settings and, specifically, in individuals with low intensity of lymphatic filariasis infection.</p>
</sec>
<sec><title>Methods</title>
<p>To perform this study, calibrated thick blood smears, ICT and Og4C3 enzyme-linked immunosorbent assay (ELISA) were carried out by night to identify <italic>Wuchereria bancrofti</italic>
microfilarial and circulating filarial antigen carriers. A threshold determination assay regarding ICT and ELISA was performed using serial plasma dilutions from individuals with positive microfilarial counts.</p>
</sec>
<sec><title>Results</title>
<p>All individuals harbouring microfilariae (positive blood films) were detected by ICT and ELISA, but among individuals positive for ELISA, only 35.7 % of them were detected using ICT (Chi square: 4.57; <italic>p</italic>
-value = 0.03), indicating a moderate agreement between both tests (kappa statistics = 0.49). Threshold determination analyses showed that ELISA was still positive at the last plasma dilution with negative ICT result.</p>
</sec>
<sec><title>Conclusions</title>
<p>These findings suggest a loss of sensitivity for ICT in low endemicity settings, especially in people exhibiting low levels of circulating filarial antigen, raising serious concern regarding the monitoring and evaluation procedures in the framework of LF elimination program.</p>
</sec>
<sec><title>Electronic supplementary material</title>
<p>The online version of this article (doi:10.1186/s12879-015-1317-x) contains supplementary material, which is available to authorized users.</p>
</sec>
</abstract>
<kwd-group xml:lang="en"><title>Keywords</title>
<kwd>Diagnostic tests</kwd>
<kwd>Enzyme-linked immunosorbent assay</kwd>
<kwd>Immunochromatographic test</kwd>
<kwd>Lymphatic filariasis</kwd>
<kwd>Sensitivity</kwd>
</kwd-group>
<funding-group><award-group><funding-source><institution>USAID/ENVISION</institution>
</funding-source>
<award-id>AID-OAA-A-11-00048</award-id>
<principal-award-recipient><name><surname>Kamgno</surname>
<given-names>Joseph</given-names>
</name>
</principal-award-recipient>
</award-group>
<award-group><funding-source><institution>Mectizan Donation Program</institution>
</funding-source>
</award-group>
</funding-group>
<custom-meta-group><custom-meta><meta-name>issue-copyright-statement</meta-name>
<meta-value>© The Author(s) 2015</meta-value>
</custom-meta>
</custom-meta-group>
</article-meta>
</front>
</pmc>
</record>
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