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dc.contributor.authorAssefa, Liya M.
dc.contributor.authorCrellen, Thomas
dc.contributor.authorKepha, Stella
dc.contributor.authorKihara, Jimmy H.
dc.contributor.authorNjenga, Sammy M.
dc.contributor.authorPullan, Rachel L.
dc.contributor.authorBrooker, Simon J.
dc.date.accessioned2015-05-07T06:31:26Z
dc.date.available2015-05-07T06:31:26Z
dc.date.issued2014
dc.identifier.citationAssefa L. M, et al. (2014). Diagnostic accuracy and cost-effectiveness of alternative methods for detection of soil-transmitted Helminths in a post-treatment setting in Western Kenya. PLoS Neglected Tropical Diseases, 8(5): 1-9.en_US
dc.identifier.otherdoi:10.1371/journal.pntd.0002843
dc.identifier.urihttp://hdl.handle.net/10570/4405
dc.description.abstractObjectives: This study evaluates the diagnostic accuracy and cost-effectiveness of the Kato-Katz and Mini-FLOTAC methods for detection of soil-transmitted helminths (STH) in a post-treatment setting in western Kenya. A cost analysis also explores the cost implications of collecting samples during school surveys when compared to household surveys. Methods: Stool samples were collected from children (n = 652) attending 18 schools in Bungoma County and diagnosed by the Kato-Katz and Mini-FLOTAC coprological methods. Sensitivity and additional diagnostic performance measures were analyzed using Bayesian latent class modeling. Financial and economic costs were calculated for all survey and diagnostic activities, and cost per child tested, cost per case detected and cost per STH infection correctly classified were estimated. A sensitivity analysis was conducted to assess the impact of various survey parameters on cost estimates. Results: Both diagnostic methods exhibited comparable sensitivity for detection of any STH species over single and consecutive day sampling: 52.0% for single day Kato-Katz; 49.1% for single-day Mini-FLOTAC; 76.9% for consecutive day Kato-Katz; and 74.1% for consecutive day Mini-FLOTAC. Diagnostic performance did not differ significantly between methods for the different STH species. Use of Kato-Katz with school-based sampling was the lowest cost scenario for cost per child tested ($10.14) and cost per case correctly classified ($12.84). Cost per case detected was lowest for Kato-Katz used in community-based sampling ($128.24). Sensitivity analysis revealed the cost of case detection for any STH decreased nonlinearly as prevalence rates increased and was influenced by the number of samples collected. Conclusions: The Kato-Katz method was comparable in diagnostic sensitivity to the Mini-FLOTAC method, but afforded greater cost-effectiveness. Future work is required to evaluate the cost-effectiveness of STH surveillance in different settings.en_US
dc.description.sponsorshipThe main trial in which the study was nested is supported by the Dissecting the Immunological Interplay between Poverty Related Diseases and Helminth Infections: An African-European Research Initiative (IDEA) consortium, which is funded by the European Union through its FP7-HEALTH-2009 programme. Wellcome Trust.en_US
dc.language.isoenen_US
dc.publisherPLOSen_US
dc.subjectSoil-transmitted Helminthsen_US
dc.subjectWestern Kenyaen_US
dc.titleDiagnostic Accuracy and Cost-Effectiveness of Alternative Methods for Detection of Soil-Transmitted Helminths in a Post-Treatment Setting in Western Kenyaen_US
dc.typeJournal articleen_US


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