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Open AccessArticle

Comparison of Diagnostic Tests for Onchocerca volvulus in the Democratic Republic of Congo

1
Global Health Institute, University of Antwerp, 2000 Antwerp, Belgium
2
Provincial Health Division Ituri, Ministry of Health, Bunia 185 DRC 57, Democratic Republic of Congo
3
Centre de Recherche en Maladies Tropicales, Rethy Box 143, Democratic Republic of Congo
4
Molecular Pathology Group, Laboratory of Cell Biology & Histology, Faculty of Medicine and Health Sciences, University of Antwerp, 2000 Antwerp, Belgium
*
Author to whom correspondence should be addressed.
Pathogens 2020, 9(6), 435; https://doi.org/10.3390/pathogens9060435
Received: 28 April 2020 / Revised: 20 May 2020 / Accepted: 1 June 2020 / Published: 2 June 2020
Onchocerciasis is diagnosed by detecting microfilariae in skin snips or by detecting OV16 IgG4 antibodies in blood by either enzyme linked immunosorbent assay (ELISA) or a rapid diagnostic test (RDT). Here, we compare the sensitivity and specificity of these three tests in persons with epilepsy living in an onchocerciasis endemic region in the Democratic Republic of Congo. Skin snips and blood samples were collected from 285 individuals for onchocerciasis diagnosis. Three tests were performed: the OV16 RDT (SD Bioline) and the OV16 ELISA both on serum samples, and microscopic detection of microfilariae in skin snips. The sensitivity and specificity of each test was calculated with the combined other tests as a reference. Microfilariae were present in 105 (36.8%) individuals, with a median of 18.5 (6.5–72.0) microfilariae/skin snip. The OV16 RDT and OV16 ELISA were positive in, respectively, 112 (39.3%) and 143 (50.2%) individuals. The OV16 ELISA had the highest sensitivity among the three tests (83%), followed by the OV16 RDT (74.8%) and the skin snip (71.4%). The OV16 RDT had a higher specificity (98.6%) compared to the OV16 ELISA (84.8%). Our study confirms the need to develop more sensitive tests to ensure the accurate detection of ongoing transmission before stopping elimination efforts. View Full-Text
Keywords: onchocerciasis; Onchocerca volvulus; antibodies; diagnosis; OV16 testing; microfilariae; epilepsy onchocerciasis; Onchocerca volvulus; antibodies; diagnosis; OV16 testing; microfilariae; epilepsy
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Hotterbeekx, A.; Perneel, J.; Mandro, M.; Abhafule, G.; Siewe Fodjo, J.N.; Dusabimana, A.; Abrams, S.; Kumar-Singh, S.; Colebunders, R. Comparison of Diagnostic Tests for Onchocerca volvulus in the Democratic Republic of Congo. Pathogens 2020, 9, 435.

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