PMID- 24367250
OWN - NLM
STAT- MEDLINE
DCOM- 20140819
LR  - 20220129
IS  - 1553-7358 (Electronic)
IS  - 1553-734X (Print)
IS  - 1553-734X (Linking)
VI  - 9
IP  - 12
DP  - 2013
TI  - A latent Markov modelling approach to the evaluation of circulating cathodic 
      antigen strips for schistosomiasis diagnosis pre- and post-praziquantel treatment 
      in Uganda.
PG  - e1003402
LID - 10.1371/journal.pcbi.1003402 [doi]
LID - e1003402
AB  - Regular treatment with praziquantel (PZQ) is the strategy for human 
      schistosomiasis control aiming to prevent morbidity in later life. With the 
      recent resolution on schistosomiasis elimination by the 65th World Health 
      Assembly, appropriate diagnostic tools to inform interventions are keys to their 
      success. We present a discrete Markov chains modelling framework that deals with 
      the longitudinal study design and the measurement error in the diagnostic methods 
      under study. A longitudinal detailed dataset from Uganda, in which one or two 
      doses of PZQ treatment were provided, was analyzed through Latent Markov Models 
      (LMMs). The aim was to evaluate the diagnostic accuracy of Circulating Cathodic 
      Antigen (CCA) and of double Kato-Katz (KK) faecal slides over three consecutive 
      days for Schistosoma mansoni infection simultaneously by age group at baseline 
      and at two follow-up times post treatment. Diagnostic test sensitivities and 
      specificities and the true underlying infection prevalence over time as well as 
      the probabilities of transitions between infected and uninfected states are 
      provided. The estimated transition probability matrices provide parsimonious yet 
      important insights into the re-infection and cure rates in the two age groups. We 
      show that the CCA diagnostic performance remained constant after PZQ treatment 
      and that this test was overall more sensitive but less specific than single-day 
      double KK for the diagnosis of S. mansoni infection. The probability of clearing 
      infection from baseline to 9 weeks was higher among those who received two PZQ 
      doses compared to one PZQ dose for both age groups, with much higher re-infection 
      rates among children compared to adolescents and adults. We recommend LMMs as a 
      useful methodology for monitoring and evaluation and treatment decision research 
      as well as CCA for mapping surveys of S. mansoni infection, although additional 
      diagnostic tools should be incorporated in schistosomiasis elimination programs.
FAU - Koukounari, Artemis
AU  - Koukounari A
AD  - MRC Centre for Outbreak Analysis and Modelling, Department of Infectious Disease 
      Epidemiology, Imperial College London, London, United Kingdom ; Department of 
      Statistics, London School of Economics and Political Science, London, United 
      Kingdom.
FAU - Donnelly, Christl A
AU  - Donnelly CA
AD  - MRC Centre for Outbreak Analysis and Modelling, Department of Infectious Disease 
      Epidemiology, Imperial College London, London, United Kingdom.
FAU - Moustaki, Irini
AU  - Moustaki I
AD  - Department of Statistics, London School of Economics and Political Science, 
      London, United Kingdom.
FAU - Tukahebwa, Edridah M
AU  - Tukahebwa EM
AD  - Schistosomiasis Control Initiative at Vector Control Division - Ministry of 
      Health, Kampala, Uganda.
FAU - Kabatereine, Narcis B
AU  - Kabatereine NB
AD  - Schistosomiasis Control Initiative at Vector Control Division - Ministry of 
      Health, Kampala, Uganda.
FAU - Wilson, Shona
AU  - Wilson S
AD  - Department of Pathology, University of Cambridge, Cambridge, United Kingdom.
FAU - Webster, Joanne P
AU  - Webster JP
AD  - Department of Infectious Disease Epidemiology, Imperial College London, London, 
      United Kingdom.
FAU - Deelder, Andre M
AU  - Deelder AM
AD  - Department of Parasitology, Leiden University Medical Center, Leiden, The 
      Netherlands.
FAU - Vennervald, Birgitte J
AU  - Vennervald BJ
AD  - Section for Parasitology and Aquatic Diseases, University of Copenhagen, 
      Copenhagen, Denmark.
FAU - van Dam, Govert J
AU  - van Dam GJ
AD  - Department of Parasitology, Leiden University Medical Center, Leiden, The 
      Netherlands.
LA  - eng
GR  - G0902130/MRC_/Medical Research Council/United Kingdom
GR  - MR/K010174/1/MRC_/Medical Research Council/United Kingdom
GR  - G0902130/1/MRC_/Medical Research Council/United Kingdom
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20131219
PL  - United States
TA  - PLoS Comput Biol
JT  - PLoS computational biology
JID - 101238922
RN  - 0 (Anthelmintics)
RN  - 0 (Antigens, Protozoan)
RN  - 6490C9U457 (Praziquantel)
SB  - IM
MH  - Anthelmintics/*therapeutic use
MH  - Antigens, Protozoan/*blood
MH  - Humans
MH  - *Markov Chains
MH  - Praziquantel/*therapeutic use
MH  - Schistosomiasis/*diagnosis/*drug therapy
MH  - Sensitivity and Specificity
MH  - Uganda
PMC - PMC3868541
COIS- The authors have declared that no competing interests exist.
EDAT- 2013/12/25 06:00
MHDA- 2014/08/20 06:00
PMCR- 2013/12/01
CRDT- 2013/12/25 06:00
PHST- 2013/05/06 00:00 [received]
PHST- 2013/10/28 00:00 [accepted]
PHST- 2013/12/25 06:00 [entrez]
PHST- 2013/12/25 06:00 [pubmed]
PHST- 2014/08/20 06:00 [medline]
PHST- 2013/12/01 00:00 [pmc-release]
AID - PCOMPBIOL-D-13-00783 [pii]
AID - 10.1371/journal.pcbi.1003402 [doi]
PST - ppublish
SO  - PLoS Comput Biol. 2013;9(12):e1003402. doi: 10.1371/journal.pcbi.1003402. Epub 
      2013 Dec 19.