03295nas a2200349   4500000000100000008004100001260003700042653002400079653005700103100001700160700001900177700001300196700001500209700001400224700001700238700001500255700002200270700001200292700002600304700001300330700001600343700001100359700001300370700001300383700001600396245017100412856009900583300001300682490000700695520222900702022001402931       2021                            d  bPublic Library of Science (PLoS)10aInfectious Diseases10aPublic Health, Environmental and Occupational Health1 aGrau-Pujol B1 aMartí-Soler H1 aEscola V1 aDemontis M1 aJamine JC1 aGandasegui J1 aMuchisse O1 aCambra-Pellejà M1 aCossa A1 aMartinez-Valladares M1 aSacoor C1 aLieshout LV1 aCano J1 aGiorgi E1 aMuñoz J1 aBeechler BR00aTowards soil-transmitted helminths transmission interruption: The impact of diagnostic tools on infection prediction in a low intensity setting in Southern Mozambique  uhttps://journals.plos.org/plosntds/article/file?id=10.1371/journal.pntd.0009803&type=printable  ae00098030 v153 a<jats:p>World Health Organization goals against soil-transmitted helminthiases (STH) are pointing towards seeking their elimination as a public health problem: reducing to less than 2% the proportion of moderate and heavy infections. Some regions are reaching WHO goals, but transmission could rebound if strategies are discontinued without an epidemiological evaluation. For that, sensitive diagnostic methods to detect low intensity infections and localization of ongoing transmission are crucial. In this work, we estimated and compared the STH infection as obtained by different diagnostic methods in a low intensity setting. We conducted a cross-sectional study enrolling 792 participants from a district in Mozambique. Two stool samples from two consecutive days were collected from each participant. Samples were analysed by Telemann, Kato-Katz and qPCR for STH detection. We evaluated diagnostic sensitivity using a composite reference standard. By geostatistical methods, we estimated neighbourhood prevalence of at least one STH infection for each diagnostic method. We used environmental, demographical and socioeconomical indicators to account for any existing spatial heterogeneity in infection. qPCR was the most sensitive technique compared to composite reference standard: 92% (CI: 83%– 97%) for <jats:italic>A</jats:italic>. <jats:italic>lumbricoides</jats:italic>, 95% (CI: 88%– 98%) for <jats:italic>T</jats:italic>. <jats:italic>trichiura</jats:italic> and 95% (CI: 91%– 97%) for hookworm. qPCR also estimated the highest neighbourhood prevalences for at least one STH infection in a low intensity setting. While 10% of the neighbourhoods showed a prevalence above 20% when estimating with single Kato-Katz from one stool and Telemann from one stool, 86% of the neighbourhoods had a prevalence above 20% when estimating with qPCR. In low intensity settings, STH estimated prevalence of infection may be underestimated if based on Kato-Katz. qPCR diagnosis outperformed the microscopy methods. Thus, implementation of qPCR based predictive maps at STH control and elimination programmes would disclose hidden transmission and facilitate targeted interventions for transmission interruption.</jats:p>  a1935-2735