ArticlePLoS neglected tropical diseases2024
Analysis of diagnostic test outcomes in a large loiasis cohort from an endemic region: Serological tests are often false negative in hyper-microfilaremic infections.
Article in PLoS neglected tropical diseases, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 3 of them syntheses that pooled it.
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Who cites it
10 citing papers in PubMed, 3 syntheses or guidelines pooled it, 9 citations in OpenAlex.
- Laboratory diagnosis of loiasis to support individual patient management: A systematic review.PLoS neglected tropical diseases · 2026Pooled it
- Human Filariasis in Africa (2000-2025): Changing epidemiology, uneven diagnostic progress, and persistent neglect.PLoS neglected tropical diseases · 2026Pooled it
- Guideline
- Microfilaremic loiasis is associated with T cell hyporesponsiveness against SARS-CoV-2.PLoS neglected tropical diseases · 2026Article
- Development and application of a TaqMan probe-based pentaplex qPCR for the rapid detection and differential identification of five pathogens.Frontiers in microbiology · 2026Article
- A novel TaqMan probe-based pentaplex qPCR assay for the simultaneous detection of five pathogenic protozoans.Scientific reports · 2025Article
- Plasma Proteomics Reveals Distinct Signatures in Occult and Microfilaremic Loa loa Infections.The Journal of infectious diseases · 2025Article
- Association between Loa loa microfilaremia and anatomical hyposplenia in a rural area of the Republic of Congo: a population-based cross-sectional study.Infectious diseases of poverty · 2025Article
- Evaluation of a novel biplex rapid diagnostic test for antibody responses to Loa loa and Onchocerca volvulus infections.PLoS neglected tropical diseases · 2024Article
- A novel antigen biomarker for detection of high-level of Loa loa microfilaremia.PLoS neglected tropical diseases · 2024Article
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Authors and funding
18 authors at 6 institutions in 4 countries.
Funding
Abstract
backgroundThe parasitic disease loiasis is associated with significant morbidity and mortality. Individuals with hyper-microfilaremia (greater than 20,000 microfilariae per mL of blood) may suffer from serious treatment-related or spontaneous adverse events. Diagnosing loiasis remains complex and primarily relies on direct parasite detection. In this study, we analyzed the performance of various diagnostic tests and the influence of parasitological and clinical factors on test outcomes in samples from individuals living in an endemic region.
methodsData and samples were collected from rural Gabon. Loiasis was defined as either detectable microfilaremia, or a positive history of eyeworm as assessed by the RAPLOA questionnaire. Diagnostic testing included a quantitative PCR (qPCR) for detection of Loa loa DNA in blood samples, an in-house crude L. loa antigen IgG ELISA, and a rapid test for antibodies against the Ll-SXP-1 antigen (RDT). Sensitivity and specificity were determined for each test and factors potentially influencing outcomes were evaluated in an exploratory analysis.
resultsELISA, RDT and qPCR results were available for 99.8%, 78.5%, and 100% of the 1,232 participants, respectively. The ELISA and RDT had only modest diagnostic accuracy. qPCR was specific for L. loa microfilaremia and Cycle threshold values correlated with microfilarial density. Anti-L. loa IgG levels were highest in occult loiasis, and antibody levels correlated inversely with L. loa microfilarial density as did RDT line intensities. Only 84.6% and 16.7% of hyper-microfilaremic individuals tested positive by ELISA (11/13) and RDT (2/12), respectively.
conclusionNone of the tests demonstrated high sensitivity and specificity for loiasis. Indirect diagnostic assays were characterized by low specificity. Additionally, hyper-microfilaremic individuals often tested negative by RDT and ELISA, indicating that these tests are not suitable for individual case management in endemic populations.
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