- Ministry of Health Cambodia
- MINISTRY OF HEALTH Iceland
- James Cook University Australia
- Gobierno de Chile Chile
- Ministry of Health Peru
- Ministry of Health Indonesia
- Ministry of Health Saudi Arabia
- Ministry of Health Ukraine
- GlaxoSmithKline United Kingdom
- Ministry of Health Oman
- Ministry of Health Uganda
- Ministry of Health
- Ministry of Health Angola
- Ministry of Health
- UNIVERSITY OF GHANA Ghana
- Washington University in St. Louis United States
- Ministry of Health El Salvador
- Ministry of Health Zambia
- Ministry of Health Turkey
- Ministry of Health Swaziland
- Ministry of Health (PHLTA)
- Ministry of Health Seychelles
- GlaxoSmithKline (United Kingdom) United Kingdom
- Ministry of Health (Guatemala)
- Ministry of Health
- Ministry of Health Mongolia
- MINISTRY OF HEALTH Greece
- Ministry of Health Myanmar
- Ministry of Health Lesotho
- Ministry of Health Malaysia
- Centers for Disease Control and Prevention United States
- Ministry of Health Bahamas
- Ministry of Health Kuwait
- Ministry of Health
- James Cook University Australia
- Ministry of Health Bahrain
- Ministry of Health Croatia
- Ministry of Health (Mexico)
- MINISTRY OF HEALTH Ethiopia
- Vector Control Research Centre India
- Ministry of Health Spain
- Government of Portugal Portugal
- Ghana Health Service Ghana
- Ministry of Health
- Ministry of Health Botswana
- MINISTRY OF HEALTH Israel
- Ministry of Health United Arab Emirates
- Ministry of Health Slovenia
- Ministry of Health Cyprus
- Ministry of Health Rwanda
- Ministry of Health Brunei Darussalam
- MINISTRY OF HEALTH LESOTHO Lesotho
- Ministry of Health Portugal
- Ministry of Health Kenya
- INSTITUT LOUIS MALARDE
- Institut Louis Malardé French Polynesia
- Ministry of Health
- Ministry of Health Bhutan
- Ministry of Health Hungary
- Ministry of Health
- Ministry of Health Czech Republic
- Washington University in St. Louis School of Medicine United States
- Ministry of Health Russian Federation
- Ministry of Health Trinidad and Tobago
- Smith College United States
- Indian Council of Medical Research India
- Ministry of Health Montenegro
- Ministry of Health Ghana
- Ministry of Health Barbados
- Ministry of Health Lao (People's Democratic Republic)
- Ministry of Health Belarus
- Ministry of Health Singapore
- Ministry of Health Tonga
- Ministry of Health Canada
- Division of Parasitic Diseases and Malaria United States
- Ministry of Health Brazil
- The Task Force for Global Health United States
- Ministry of Health New Zealand
- Aichi Medical University Japan
- Ministry of Health Malawi
- Ministry of Health
- Ministry of Health Viet Nam
- Ministry of Health
- Ministry of Health Poland
- University of Ghana Ghana
- MINISTRY OF HEALTH Lao (People's Democratic Republic)
- Ministry of Health Chile
- MINISTRY OF HEALTH Ethiopia
- Ministry of Health (MoHCDGEC)
- Ministry of Health Iraq
- MINISTRY OF HEALTH Lao (People's Democratic Republic)
- Ministry of Health
- Ministry of Health Jordan
- Ministry of Health Mozambique
- Anti Filariasis Campaign Sri Lanka
- Ministry Of Health Fiji
- Noguchi Memorial Institute for Medical Research Ghana
- GlaxoSmithKline United Kingdom
- Ministry of Health Jamaica
- MINISTRY OF HEALTH Cambodia
- Ministry of Health Greece
Successful mass drug administration (MDA) campaigns have brought several countries near the point of Lymphatic Filariasis (LF) elimination. A diagnostic tool is needed to determine when the prevalence levels have decreased to a point that MDA campaigns can be discontinued without the threat of recrudescence. A six-country study was conducted assessing the performance of seven diagnostic tests, including tests for microfilariae (blood smear, PCR), parasite antigen (ICT, Og4C3) and antifilarial antibody (Bm14, PanLF, Urine SXP). One community survey and one school survey were performed in each country. A total of 8,513 people from the six countries participated in the study, 6,443 through community surveys and 2,070 through school surveys. Specimens from these participants were used to conduct 49,585 diagnostic tests. Each test was seen to have both positive and negative attributes, but overall, the ICT test was found to be 76% sensitive at detecting microfilaremia and 93% specific at identifying individuals negative for both microfilariae and antifilarial antibody; the Og4C3 test was 87% sensitive and 95% specific. We conclude, however, that the ICT should be the primary tool recommended for decision-making about stopping MDAs. As a point-of-care diagnostic, the ICT is relatively inexpensive, requires no laboratory equipment, has satisfactory sensitivity and specificity and can be processed in 10 minutes—qualities consistent with programmatic use. Og4C3 provides a satisfactory laboratory-based diagnostic alternative.
Author Summary Lymphatic filariasis (LF), a mosquito-borne parasitic disease, is a candidate for elimination largely because of the success of mass drug administration (MDA) campaigns, in which entire at-risk populations are given a once-yearly regimen of single-dose treatment with two medications. As a result, a diagnostic tool is needed to determine when the prevalence of LF has fallen below the threshold for sustained transmission so that MDA programs can be stopped. To determine the best diagnostic tool available, a multi-country study was conducted to assess the performance of seven diagnostic tests on a panel of patient specimens. The selection of the most effective diagnostic test was based on an evaluation of each test's accuracy, technical requirements, programmatic feasibility and reliability, as well as confidence in test performance. This study found advantages and disadvantages to each test. Based on the data and experiences it was determined that the ICT test, a point-of-care rapid card test, is the preferred diagnostic tool for use in defining the end-point of MDA, although the Og4C3 test provides a suitable laboratory-based alternative.