A general framework to support cost-efficient survey design choices for the control of soil-transmitted helminths when deploying Kato-Katz thick smear
To monitor and evaluate soil-transmitted helminth (STH) control programs, the World Health Organization (WHO) recommends screening stools from 250 children, deploying Kato-Katz thick smear (KK). However, it remains unclear whether these recommendations are sufficient to make adequate decisions about...
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| Veröffentlicht in: | PLoS neglected tropical diseases 2023-06, Vol.17 (6), p.e0011160-e0011160 |
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| creator | Kazienga, Adama Levecke, Bruno Leta, Gemechu Tadesse de Vlas, Sake J Coffeng, Luc E |
| description | To monitor and evaluate soil-transmitted helminth (STH) control programs, the World Health Organization (WHO) recommends screening stools from 250 children, deploying Kato-Katz thick smear (KK). However, it remains unclear whether these recommendations are sufficient to make adequate decisions about stopping preventive chemotherapy (PC) (prevalence of infection |
| doi_str_mv | 10.1371/journal.pntd.0011160 |
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We developed a simulation framework to determine the effectiveness and cost of survey designs for decision-making in STH control programs, capturing the operational resources to perform surveys, the variation in egg counts across STH species, across schools, between and within individuals, and between repeated smears. Using this framework and a lot quality assurance sampling approach, we determined the most cost-efficient survey designs (number of schools, subjects, stool samples per subject, and smears per stool sample) for decision-making.
For all species, employing duplicate KK (sampling 4 to 6 schools and 64 to 70 subjects per school) was the most cost-efficient survey design to assess whether prevalence of any infection intensity was above or under 2%. For prevalence of MHI infections, single KK was the most cost-efficient (sampling 11 to 25 schools and 52 to 84 children per school).
KK is valuable for monitoring and evaluation of STH control programs, though we recommend deploying a duplicate KK on a single stool sample to stop PC, and a single KK to declare the elimination of STHs as a public health problem.</description><identifier>ISSN: 1935-2735</identifier><identifier>ISSN: 1935-2727</identifier><identifier>EISSN: 1935-2735</identifier><identifier>DOI: 10.1371/journal.pntd.0011160</identifier><identifier>PMID: 37347783</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Analysis ; Biology and Life Sciences ; Chemotherapy ; Children ; Consent ; Control programs ; Costs ; Decision making ; Design ; Diagnosis ; Disease transmission ; Eggs ; Environmental DNA ; Frameworks ; Helminthiasis ; Infections ; Medicine and Health Sciences ; Polls & surveys ; Public health ; Quality assurance ; Quality control ; Risk factors ; Sampling ; Schools ; Simulation ; Social Sciences ; Soils ; Survey design ; Surveys ; Tropical diseases</subject><ispartof>PLoS neglected tropical diseases, 2023-06, Vol.17 (6), p.e0011160-e0011160</ispartof><rights>Copyright: © 2023 Kazienga et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.</rights><rights>COPYRIGHT 2023 Public Library of Science</rights><rights>2023 Kazienga et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2023 Kazienga et al 2023 Kazienga et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c625t-89b4d6ba646b0a9d72f784826694b3e9c7301407904d8d339e57eb88a3ec30693</citedby><cites>FETCH-LOGICAL-c625t-89b4d6ba646b0a9d72f784826694b3e9c7301407904d8d339e57eb88a3ec30693</cites><orcidid>0000-0002-6093-9648</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC10321644/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC10321644/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,315,729,782,786,866,887,2106,2932,23875,27933,27934,53800,53802</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37347783$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Cheng, Qu</contributor><creatorcontrib>Kazienga, Adama</creatorcontrib><creatorcontrib>Levecke, Bruno</creatorcontrib><creatorcontrib>Leta, Gemechu Tadesse</creatorcontrib><creatorcontrib>de Vlas, Sake J</creatorcontrib><creatorcontrib>Coffeng, Luc E</creatorcontrib><title>A general framework to support cost-efficient survey design choices for the control of soil-transmitted helminths when deploying Kato-Katz thick smear</title><title>PLoS neglected tropical diseases</title><addtitle>PLoS Negl Trop Dis</addtitle><description>To monitor and evaluate soil-transmitted helminth (STH) control programs, the World Health Organization (WHO) recommends screening stools from 250 children, deploying Kato-Katz thick smear (KK). However, it remains unclear whether these recommendations are sufficient to make adequate decisions about stopping preventive chemotherapy (PC) (prevalence of infection <2%) or declaring elimination of STHs as a public health problem (prevalence of moderate-to-heavy intensity (MHI) infections <2%).
We developed a simulation framework to determine the effectiveness and cost of survey designs for decision-making in STH control programs, capturing the operational resources to perform surveys, the variation in egg counts across STH species, across schools, between and within individuals, and between repeated smears. Using this framework and a lot quality assurance sampling approach, we determined the most cost-efficient survey designs (number of schools, subjects, stool samples per subject, and smears per stool sample) for decision-making.
For all species, employing duplicate KK (sampling 4 to 6 schools and 64 to 70 subjects per school) was the most cost-efficient survey design to assess whether prevalence of any infection intensity was above or under 2%. For prevalence of MHI infections, single KK was the most cost-efficient (sampling 11 to 25 schools and 52 to 84 children per school).
KK is valuable for monitoring and evaluation of STH control programs, though we recommend deploying a duplicate KK on a single stool sample to stop PC, and a single KK to declare the elimination of STHs as a public health problem.</description><subject>Analysis</subject><subject>Biology and Life Sciences</subject><subject>Chemotherapy</subject><subject>Children</subject><subject>Consent</subject><subject>Control programs</subject><subject>Costs</subject><subject>Decision making</subject><subject>Design</subject><subject>Diagnosis</subject><subject>Disease transmission</subject><subject>Eggs</subject><subject>Environmental DNA</subject><subject>Frameworks</subject><subject>Helminthiasis</subject><subject>Infections</subject><subject>Medicine and Health Sciences</subject><subject>Polls & surveys</subject><subject>Public health</subject><subject>Quality assurance</subject><subject>Quality control</subject><subject>Risk 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Dis</addtitle><date>2023-06-01</date><risdate>2023</risdate><volume>17</volume><issue>6</issue><spage>e0011160</spage><epage>e0011160</epage><pages>e0011160-e0011160</pages><issn>1935-2735</issn><issn>1935-2727</issn><eissn>1935-2735</eissn><abstract>To monitor and evaluate soil-transmitted helminth (STH) control programs, the World Health Organization (WHO) recommends screening stools from 250 children, deploying Kato-Katz thick smear (KK). However, it remains unclear whether these recommendations are sufficient to make adequate decisions about stopping preventive chemotherapy (PC) (prevalence of infection <2%) or declaring elimination of STHs as a public health problem (prevalence of moderate-to-heavy intensity (MHI) infections <2%).
We developed a simulation framework to determine the effectiveness and cost of survey designs for decision-making in STH control programs, capturing the operational resources to perform surveys, the variation in egg counts across STH species, across schools, between and within individuals, and between repeated smears. Using this framework and a lot quality assurance sampling approach, we determined the most cost-efficient survey designs (number of schools, subjects, stool samples per subject, and smears per stool sample) for decision-making.
For all species, employing duplicate KK (sampling 4 to 6 schools and 64 to 70 subjects per school) was the most cost-efficient survey design to assess whether prevalence of any infection intensity was above or under 2%. For prevalence of MHI infections, single KK was the most cost-efficient (sampling 11 to 25 schools and 52 to 84 children per school).
KK is valuable for monitoring and evaluation of STH control programs, though we recommend deploying a duplicate KK on a single stool sample to stop PC, and a single KK to declare the elimination of STHs as a public health problem.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>37347783</pmid><doi>10.1371/journal.pntd.0011160</doi><orcidid>https://orcid.org/0000-0002-6093-9648</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Analysis Biology and Life Sciences Chemotherapy Children Consent Control programs Costs Decision making Design Diagnosis Disease transmission Eggs Environmental DNA Frameworks Helminthiasis Infections Medicine and Health Sciences Polls & surveys Public health Quality assurance Quality control Risk factors Sampling Schools Simulation Social Sciences Soils Survey design Surveys Tropical diseases |
| title | A general framework to support cost-efficient survey design choices for the control of soil-transmitted helminths when deploying Kato-Katz thick smear |
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