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Transrenal DNA-based diagnosis of Strongyloides stercoralis (Grassi, 1879) infection: Bayesian latent class modeling of test accuracy.

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Krolewiecki, Alejandro J, Koukounari, Artemis, Romano, Miryam, Caro, Nicolas N, Scott, Alan L, Fleitas, Pedro, Cimino, Rubin and Shiff, Clive J (2018) 'Transrenal DNA-based diagnosis of Strongyloides stercoralis (Grassi, 1879) infection: Bayesian latent class modeling of test accuracy.'. PLoS Neglected Tropical Diseases, Vol 12, Issue 6, e0006550.

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Abstract

For epidemiological work with soil transmitted helminths the recommended diagnostic approaches are to examine fecal samples for microscopic evidence of the parasite. In addition to several logistical and processing issues, traditional diagnostic approaches have been shown to lack the sensitivity required to reliably identify patients harboring low-level infections such as those associated with effective mass drug intervention programs. In this context, there is a need to rethink the approaches used for helminth diagnostics. Serological methods are now in use, however these tests are indirect and depend on individual immune responses, exposure patterns and the nature of the antigen. However, it has been demonstrated that cell-free DNA from pathogens and cancers can be readily detected in patient's urine which can be collected in the field, filtered in situ and processed later for analysis. In the work presented here, we employ three diagnostic procedures-stool examination, serology (NIE-ELISA) and PCR-based amplification of parasite transrenal DNA from urine-to determine their relative utility in the diagnosis of S. stercoralis infections from 359 field samples from an endemic area of Argentina. Bayesian Latent Class analysis was used to assess the relative performance of the three diagnostic procedures. The results underscore the low sensitivity of stool examination and support the idea that the use of serology combined with parasite transrenal DNA detection may be a useful strategy for sensitive and specific detection of low-level strongyloidiasis.

Item Type: Article
Subjects: QW Microbiology and Immunology > QW 51 Morphology and variability of microorganisms. Microbial genetics.
QX Parasitology > Helminths. Annelida > QX 200 Helminths
QX Parasitology > Helminths. Annelida > QX 203 Nematoda
Faculty: Department: Clinical Sciences & International Health > Clinical Sciences Department
Digital Object Identifer (DOI): https://doi.org/10.1371/journal.pntd.0006550
SWORD Depositor: JISC Pubrouter
Depositing User: Stacy Murtagh
Date Deposited: 12 Jun 2018 12:22
Last Modified: 12 Jun 2018 12:22
URI: https://archive.lstmed.ac.uk/id/eprint/8760

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