RTI Envision

Adding Antibody Testing to Mini-TAS

To compare results from Brugia Rapid tests (in 3 districts) and FTS (in 2 districts) with Wb123 rapid tests and Wb123 and Bm14 ELISA testing.


Preliminary Findings

  • In March and April 2017, NIMPE had organized teams to go to the field to collect samples. In Duy Tien district, all of 20 primary schools were visited and 320 pupils were tested. In Quang Ninh district, all of 21 primary schools were visited and 323 students participated in the survey. In Le Thuy district, 35 of 38 primary schools were visited and 344 pupils had blood samples taken. 
  • In total, 987 serum samples were collected but one sample was ran out of serum after doing quick tests (Brugia rapid and FTS). Finally, 986 samples were collected for the antibodies test. The serum samples were kept in frieze (-20 0 C) until analysis. Base on the cut–off 0.096 that was calculated by CDC, no positive case was found by this technique.
  • Wb123 testing was applied in all three districts to detect W. bancrofti antibody. All 986 samples were tested, but no positive case was found. This result did not indicate that the Wb123 testing accuracy is equivalent to FTS but did show that no cross action with B. malayi and other parasites was found within the study. 
  • All 986 serum samples that collected from the three districts in the Mini TAS were tested by Bm14 to detect B.malayi antibody. No positive case was recorded and this result was comparable to the result from Brugia rapid test.
  • Following these data, the researchers supposed that the ELISA testing could be comparable to the quick testing with regards to accuracy. However, since no positive case was found and we could not conclude about the sensitivity and the specificity of the test. Therefore, a further study should be continued especially in endemic areas in which possibly can find some positive cases for assessment and conclusion.
Countries: Viet Nam

STH Diagnostic Comparison: PCR vs. Kato-Katz, Uganda

To determine if a standardized multi-parallel-PCR assay is a more sensitive diagnostic tool for detecting Hookworm (Ancylostoma duodenale and Necator americanus), Trichuris trichiura, Ascaris lumbricoides, Strongyloides stercoralis, and Schistosoma mansoni prevalence compared to the Kato-Katz stool test.

Countries: Cameroon

Field Validation of Wb123 monoplex, Haiti

To compare the performance of antigen (FTS) and antibody (Wb123 monoplex) tools in programmatic settings (TAS).

Preliminary Findings and Lessons Learned

The goal of this study is to compare the performance of antigen (FTS) and antibody (Wb123 monoplex, Wb123 ELISA, multiplex) tools in programmatic settings (TAS). In order to strengthen the existing TAS platform we need to better understand which diagnostic indicator(s) are best-suited for making programmatic decisions. The TAS was conducted in Trou de Nord and Plaisance EUs.  Both EUs passed the TAS, but positive FTS were identified (4 and 2, respectively). However the Wb123 RDT found ZERO positive children, of the over 2000 tested. While the Wb123 ELISA testing is still ongoing, this initial result agrees with findings from other studies, all of which suggest that the Wb123 RDT is too insensitive a tool to be of programmatic use.

Countries: Haiti

Assessment of LF status in Two Urban Settings of Benin (Cotonou and Porto-Novo)

To determine whether there is LF transmission in Cotonou and Porto-Novo, which are the two main urban locations of Benin where the LF status is undetermined. A study will be conducted to evaluate the prevalence of LF using antigenemia and antibody testing (FTS and Wb123). An entomological survey will be implemented to understand the dynamic of LF transmission and potential barriers to LF MDA in urban settings. 

Preliminary study findings:

  • While mass drug administration (MDA) in Benin is on track to eliminate LF in most endemic cities, 50 such cities – including the country’s largest cities, Cotonou and Porto Novo – never received treatements.
  • In 2016, more than 15 years after mapping, LF endemicity was re-evaluated in Cotonou and Porto Novo to put in place adequate strategies for LF elimination. This study constituted that re-mapping effort.
  • The various surveys, conducted in vectors and humans through collection of entomological and parasitological data, reveal an absence of LF transmission in Cotonou and Porto Novo.
  • The results demonstrate that the number of cities endemic for LF in Benin has dropped from 50 to 48.
  • However, the study revealed a lack of awareness of LF by residents and health workers, highlighting the need for more education and awareness raising on the disease.
Countries: Benin

Trachoma Post- MDA Surveillance Project

To validate thresholds for stopping MDA and improve confidence that elimination goals have been achieved through post-MDA surveillance.

Countries: Nepal
Diseases: Trachoma

Alternative approaches to coverage surveys (Uganda)

To compare coverage evaluation methods to identify a method that is statistically rigorous and feasible for programs. This study will focus on assessing MDA coverage for lymphatic filariasis by comparing the cost, time and feasibility of 3 different methods: the EPI approach (n=1768), LQAS design (n=95) and probability sampling alternatives (n=1768).

Primary Findings and Lessons Learned

Coverage surveys are an important tool for programs to evaluate their reporting systems and to determine whether effective MDA coverage has been achieved. However, for various reasons coverage surveys are seldom implemented.  Some key challenges are: perceived technical difficulty, lack of resources, and lack of standardized guidance on how to conduct coverage surveys.  This protocol seeks to address the 1st and 3rd points by comparing the feasibility of three different coverage survey methods (EPI approach, LQAS, and segmentation).     This study was completed in 3 districts in Burkina Faso.  All 3 districts found that their survey coverage was above the WHO target threshold (65% for LF).  Furthermore, in all 3 cases the survey coverage validated (or nearly validated) the reported coverage. Taken together this suggests that the Burkina Faso program is working well.   The feasibility results found all 3 methods to be very similar with regards to time, cost and perceived difficulty.  Because only the segmentation approach results in a probability sample, this method was recommended by the M&E Working Group and ultimately approved by the STAG.  Since the approval, significant work has been underway to create guidelines for conducting coverage surveys for preventive chemotherapy.  An excel tool was created to improve the usability of the tool and online learning modules are currently in the works.

Countries: Uganda

Piloting the Supervisor's Coverage Tool in Ethiopia: an in-process monitoring tool for MDA at the district-level

This study is piloting the Supervisor's Coverage Tool (formerly the Coverage Supervision Tool, or CST) approach that is meant to provide a platform for district- and sub-district-level supervisors to monitor the success of the last MDA. It is meant to be conducted at the sub-district level two weeks following MDA and provides a pass/fail result regarding whether the target coverage threshold was met. It is designed as a quick and inexpensive in-process monitoring tool for use by sub-national level NTD management teams/supervisors to help improve or maintain the success of future MDA rounds.

Preliminary Findings and Lessons Learned

A recurring request from the national neglected tropical disease (NTD) programme teams is for a quick, inexpensive and simple tool that the programmes can use to assess preventive chemotherapy (PC) coverage. Consequently, the WHO, in collaboration with partners, has developed a Supervisor’s Coverage Tool (SCT) that can be used to improve the coverage of PC delivered through mass drug administration (MDA). The SCT gives supervisors a supportive supervision tool with which to strengthen the performance of the community drug distributors (CDDs) and their first-level supervisors, providing an opportunity to identify and solve problems related to low MDA coverage.
This tool was first piloted in the Benishangul-Gumuz region in western Ethiopia in close collaboration with RTI and the regional health bureau. The results suggested that the tool was both feasible for district-level staff to implement and resulted in programmatically useful information.
The methodology behind this tool was presented at the WHO Working Group on Monitoring and Evaluation of Preventive Chemotherapy (WG M&E) in 2015 and 2016. Evidence from four field studies in Ethiopia, Nigeria (two separate occasions) and the Philippines confirms the value and feasibility of using the Supervisor’s Coverage Tool (SCT) by sub-district health supervisors.
Consequently, the Scientific and Technical Advisory Group for Neglected Tropical Diseases has recommended that the SCT be made available to national programmes for immediate use. Information from SCT should be used to take appropriate data-driven, corrective action at sub-district levels. Additional evidence will be gathered about the tool’s use and applications in other treatment settings such as school-based platforms and urban settings.

Countries: Ethiopia

Correlating Ov16 Serology with Skin Snip Assessments (Mali)

To compare different diagnostic tools during onchocerciasis epidemiological assessments, including Ov16 ELISA, OV16 rapid diagnostic test (RDT) and skin snip test.

Countries: Mali
Diseases: Onchocerciasis

Correlating Ov16 Serology with Skin Snip Assessments (DRC)

To compare different diagnostic tools during onchocerciasis mapping, including Ov16 ELISA, OV16 rapid diagnostic test (RDT) and skin snip test.

Countries: Dem. Rep. of Congo