Challenges encountered when evaluating an antibody-detecting point-of-care test for taeniosis in an endemic community in Zambia: a prospective diagnostic accuracy study

Chishimba Mubanga, Chiara Trevisan, Inge Van Damme, Veronika Schmidt, Isaac K Phiri, Gideon Zulu, John Noh, Sukwan Handali, Richard Mambo, Mwelwa Chembensofu, Maxwell Masuku, Dries Reynders, Famke Jansen, Emmanuel Bottieau, Pascal Magnussen, Andrea S Winkler, Pierre Dorny, Kabemba E Mwape, Sarah Gabriel

Research output: Contribution to journalA1: Web of Science-article

Abstract

Taenia solium taeniosis diagnosis is challenging because current tests perform sub-optimally and/or are expensive, require sophisticated equipment, infrastructure and trained manpower, and therefore are not community deployable. A recently-developed, multi-strip, T. solium point-of-care test (TS POC) for simultaneous detection of tapeworm (TS POC T) and cysticercus (TS POC CC) human antibodies was evaluated for diagnostic accuracy on consecutively recruited community participants in Sinda district, Zambia. All participants were tested using the TS POC test. All test-positives and 20% of the test-negative participants were invited to give a blood and stool sample for reference testing. Three different reference tests were used for taeniosis diagnosis: recombinant rES33 enzyme-linked immunoelectrotransfer blot (rES33 EITB), copro PCR and copro Ag ELISA. Bayesian analysis with probabilistic constraints was used to estimate sensitivity and specificity. In total, 1254 participants were tested with the TS POC test, of whom 13 tested positive using the TS POC T. Based on 161 participants with complete data, the estimated sensitivity and specificity for the TS POC T test were 38% (95% CI: 5-93%) and 99% (95% CI: 98-100%), respectively. The challenge of highly variable inter-assay performance is highlighted. We recommend either increasing the sensitivity or redesigning the test.

Original languageEnglish
JournalDiagnostics (Basel)
Volume11
Issue number11
ISSN2075-4418
DOIs
Publication statusPublished - 2021

Cite this