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Detection of Onchocerca volvulus infection in low prevalence areas: a comparison of three diagnostic methods

Published online by Cambridge University Press:  11 February 2003

B. A. BOATIN ,
L. TOÉ ,
E. S. ALLEY ,
N. J. D. NAGELKERKE ,
G. BORSBOOM  and
J. D. F. HABBEMA
B. A. BOATIN
Affiliation:
Onchocerciasis Control Programme, World Health Organization, B.P. 549, Ouagadougou, Burkina Faso
L. TOÉ
Affiliation:
Onchocerciasis Control Programme, World Health Organization, B.P. 549, Ouagadougou, Burkina Faso
E. S. ALLEY
Affiliation:
Onchocerciasis Control Programme, World Health Organization, B.P. 549, Ouagadougou, Burkina Faso
N. J. D. NAGELKERKE
Affiliation:
Department of Public Health, Erasmus University, P.O. Box 1738, 3000 DR Rotterdam, The Netherlands
G. BORSBOOM
Affiliation:
Department of Public Health, Erasmus University, P.O. Box 1738, 3000 DR Rotterdam, The Netherlands
J. D. F. HABBEMA
Affiliation:
Department of Public Health, Erasmus University, P.O. Box 1738, 3000 DR Rotterdam, The Netherlands
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Abstract

The standard assay for onchocerciasis diagnosis is microscopical detection of microfilariae in skin snips. Skin snipping is painful, requires appropriate sterilization of equipment, and may fail to diagnose light infections. Two alternatives are a polymerase chain reaction (PCR) test which detects parasite DNA in pieces or scrapings of skin and a test based on allergic reactions to topical application of diethylcarbamazine (DEC). We compared these 2 diagnostics with standard skin snip microscopy in 313 individuals from 2 villages in Guinea, with low prevalence after over 10 years of control by the Onchocerciasis Control Programme. Lower and upper bounds on sensitivities and specificities of these 3 tests were estimated. In addition, these parameters were estimated using 5 different statistical models. Where prevalence was low, PCR and the DEC patch test appeared to be more sensitive than skin snipping which has low sensitivity. As the DEC test is non-invasive, simple and cheap, it may provide a good alternative to skin snipping alone for surveillance in low prevalence areas.

Keywords

onchocerciasisdiagnosticsPCRskin snippingdiethylcarbamazine patch test
Type
Research Article
Information
Parasitology , Volume 125 , Issue 6 , June 2002 , pp. 545 - 552
Copyright
© 2002 Cambridge University Press

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