Impact of Different Sampling Schemes for Decision Making in Soil-Transmitted Helminthiasis Control Programs.

Coffeng, LE; Malizia, V; Vegvari, C; Cools, P; Halliday, KEORCID logo; Levecke, B; Mekonnen, Z; Gichuki, PM; Sayasone, S; Sarkar, R; +4 more...Shaali, A; Vlaminck, J; Anderson, RM; de Vlas, SJ and (2019) Impact of Different Sampling Schemes for Decision Making in Soil-Transmitted Helminthiasis Control Programs. The Journal of infectious diseases, 221 (Suppl). S531-S538. ISSN 0022-1899 DOI: 10.1093/infdis/jiz535
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Starting and stopping preventive chemotherapy (PC) for soil-transmitted helminthiasis is typically based on the prevalence of infection as measured by Kato-Katz (KK) fecal smears. Kato-Katz-based egg counts can vary highly over repeated stool samples and smears. Consequentially, the sensitivity of KK-based surveys depends on the number of stool samples per person and the number of smears per sample. Given finite resources, collecting multiple samples and/or smears means screening fewer individuals, thereby lowering the statistical precision of prevalence estimates. Using population-level data from various epidemiological settings, we assessed the performance of different sampling schemes executed within the confines of the same budget. We recommend the use of single-slide KK for determining prevalence of moderate-to-heavy intensity infection and policy decisions for starting and continuing PC; more sensitive sampling schemes may be required for policy decisions involving stopping PC. Our findings highlight that guidelines should include specific guidance on sampling schemes.


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