PMID- 15960703
OWN - NLM
STAT- MEDLINE
DCOM- 20050719
LR  - 20191008
IS  - 1360-2276 (Print)
IS  - 1365-3156 (Electronic)
IS  - 1360-2276 (Linking)
VI  - 10
IP  - 7
DP  - 2005 Jul
TI  - Rapid assessment of Schistosoma mansoni: the validity, applicability and 
      cost-effectiveness of the Lot Quality Assurance Sampling method in Uganda.
PG  - 647-58
AB  - Rapid and accurate identification of communities at highest risk of morbidity 
      from schistosomiasis is key for sustainable control. Although school 
      questionnaires can effectively and inexpensively identify communities with a high 
      prevalence of Schistosoma haematobium, parasitological screening remains the 
      preferred option for S. mansoni. To help reduce screening costs, we investigated 
      the validity of Lot Quality Assurance Sampling (LQAS) in classifying schools 
      according to categories of S. mansoni prevalence in Uganda, and explored its 
      applicability and cost-effectiveness. First, we evaluated several sampling plans 
      using computer simulation and then field tested one sampling plan in 34 schools 
      in Uganda. Finally, cost-effectiveness of different screening and control 
      strategies (including mass treatment without prior screening) was determined, and 
      sensitivity analysis undertaken to assess the effect of infection levels and 
      treatment costs. In identifying schools with prevalences > or =50%, computer 
      simulations showed that LQAS had high levels of sensitivity and specificity 
      (>90%) at sample sizes <20. The method also provides an ability to classify 
      communities into three prevalence categories. Field testing showed that LQAS 
      where 15 children were sampled had excellent diagnostic performance (sensitivity: 
      100%, specificity: 96.4%, positive predictive value: 85.7% and negative 
      predictive value: 92.3%). Screening using LQAS was more cost-effective than mass 
      treating all schools (US$218 vs. US$482/high prevalence school treated). 
      Threshold analysis indicated that parasitological screening and mass treatment 
      would become equivalent for settings where prevalence > or =50% in 75% of schools 
      and for treatment costs of US$0.19 per schoolchild. We conclude that, in Uganda, 
      LQAS provides a rapid, valid and cost-effective method for guiding decision 
      makers in allocating finite resources for the control of schistosomiasis.
FAU - Brooker, Simon
AU  - Brooker S
AD  - London School of Hygiene and Tropical Medicine, London, UK. 
      simon.brooker@lshtm.ac.uk
FAU - Kabatereine, Narcis B
AU  - Kabatereine NB
FAU - Myatt, Mark
AU  - Myatt M
FAU - Russell Stothard, J
AU  - Russell Stothard J
FAU - Fenwick, Alan
AU  - Fenwick A
LA  - eng
GR  - 073656/Wellcome Trust/United Kingdom
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - England
TA  - Trop Med Int Health
JT  - Tropical medicine & international health : TM & IH
JID - 9610576
SB  - IM
MH  - Adolescent
MH  - Animals
MH  - Child
MH  - Computer Simulation
MH  - Cost-Benefit Analysis/methods
MH  - Humans
MH  - Mass Screening/economics/methods
MH  - Prevalence
MH  - Quality Assurance, Health Care/economics/*methods
MH  - Quality Control
MH  - Sampling Studies
MH  - Schistosoma mansoni/isolation & purification
MH  - Schistosomiasis mansoni/*diagnosis/economics/prevention & control
MH  - Schools
MH  - Sensitivity and Specificity
MH  - Uganda/epidemiology
PMC - PMC1975759
MID - UKMS778
OID - NLM: UKMS778
EDAT- 2005/06/18 09:00
MHDA- 2005/07/20 09:00
PMCR- 2007/09/11
CRDT- 2005/06/18 09:00
PHST- 2005/06/18 09:00 [pubmed]
PHST- 2005/07/20 09:00 [medline]
PHST- 2005/06/18 09:00 [entrez]
PHST- 2007/09/11 00:00 [pmc-release]
AID - TMI1446 [pii]
AID - 10.1111/j.1365-3156.2005.01446.x [doi]
PST - ppublish
SO  - Trop Med Int Health. 2005 Jul;10(7):647-58. doi: 
      10.1111/j.1365-3156.2005.01446.x.