ArticlePLoS neglected tropical diseases2018
Comparison of individual and pooled diagnostic examination strategies during the national mapping of soil-transmitted helminths and Schistosoma mansoni in Ethiopia.
Article in PLoS neglected tropical diseases, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 2 of them syntheses that pooled it.
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Who cites it
13 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Prevalence of soil-transmitted helminths infections among preschool and school-age children in Ethiopia: a systematic review and meta-analysis.Global health research and policy · 2022Pooled it
- Epidemiology of intestinal parasitic infections in preschool and school-aged Ethiopian children: a systematic review and meta-analysis.BMC public health · 2020Pooled it
- A general framework to support cost-efficient fecal egg count methods and study design choices for large-scale STH deworming programs-monitoring of therapeutic drug efficacy as a case study.PLoS neglected tropical diseases · 2023Trial
- Diagnostic performance of a single and duplicate Kato-Katz, Mini-FLOTAC, FECPAKG2 and qPCR for the detection and quantification of soil-transmitted helminths in three endemic countries.PLoS neglected tropical diseases · 2019Trial
- Development, field-testing and optimization of tools to quantify soil-transmitted helminths in fecal sludge from school pit latrines in Ethiopia.PLoS neglected tropical diseases · 2026Article
- Factors affecting detection and quantification of Schistosoma haematobium eggs in pooled urine samples.PLoS neglected tropical diseases · 2026Article
- Clinical sensitivity and time-to-result of a cascaded pooled testing approach for assessing the prevalence and intensity of Schistosoma haematobium infection.PLoS neglected tropical diseases · 2024Article
- Prevalence of Schistosoma mansoni infection among children in Ethiopia: a systematic review and meta-analysis.Tropical diseases, travel medicine and vaccines · 2021Article
- Prevalence of Schistosoma mansoni infection in Ethiopia: a systematic review and meta-analysis.Tropical diseases, travel medicine and vaccines · 2021Review
- National mapping of soil-transmitted helminth and schistosome infections in Ethiopia.Parasites & vectors · 2020Article
- Currently Available Monitoring and Surveillance Systems forPathogens (Basel, Switzerland) · 2020Review
- Pooling as a strategy for the timely diagnosis of soil-transmitted helminths in stool: value and reproducibility.Parasites & vectors · 2019Article
- Calculating the prevalence of soil-transmitted helminth infection through pooling of stool samples: Choosing and optimizing the pooling strategy.PLoS neglected tropical diseases · 2019Article
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5 authors.
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Abstract
backgroundLaboratory-based studies have highlighted that pooling stool and urine samples can reduce costs and diagnostic burden without a negative impact on the ability to estimate the intensity of soil-transmitted helminth (STH, Ascaris lumbricoides, Trichuris trichiura and hookworms) and schistosome infections (Schistosoma mansoni and S. haematobium). In this study, we compare individual and pooled stool examination strategies in a programmatic setting.
methodsStool samples were collected from 2,650 children in 53 primary schools in Amhara Regional State, Ethiopia, during the national mapping of STHs and schistosome infections. Eggs of STHs and S. mansoni were quantified in both individual and pooled samples (pools were made from 10 individual samples) using a single Kato-Katz smear. PRINCIPAL
findingsA pooled diagnostic examination strategy provided comparable estimates of infection intensity with higher fecal egg count (expressed in eggs per gram of stool (EPG)) than those based on individual strategy (Ascaris: 45.1 EPG vs. 93.9, p = 0.03; Trichuris: 1.8 EPG vs. 2.1 EPG, p = 0.95; hookworms: 17.5 EPG vs. 28.5 EPG, p = 0.18; S. mansoni: 1.6 EPG vs. 3.4 EPG, p = 0.02), but had lower sensitivity (Ascaris: 90.0% vs. 55.0%; Trichuris: 91.7% vs. 16.7%; hookworms: 92.6% vs. 61.8%; S. mansoni: 100% vs. 51.7%, p < 0.001). A pooled approach resulted in a ~70% reduction in time required for sample testing, but reduced total operational costs by only ~11%. CONCLUSIONS/SIGNIFICANCE: A pooled approach holds promise for the rapid assessment of intensity of helminth infections in a programmatic setting, but it is not major cost-saving strategy. Further investigation is required to determine when and how pooling can be utilized. Such work should also include validation of statistical methods to estimate prevalence based on pooling samples. Finally, the comparison of operational costs across different scenarios of national program management will help determine whether pooling is indeed worthwhile considering.
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