Utility and costs of reactive case detection using molecular detection and genotyping in Thailand, a near-elimination setting with predominantly Plasmodium vivax transmission

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Utility and costs of reactive case detection using molecular detection and genotyping in Thailand, a near-elimination setting with predominantly Plasmodium vivax transmission

Cotter, Chris (författare): Uppsala universitet,Institutionen för kvinnors och barns hälsa,University of California San Francisco

(creator_code:org_t)

Engelska.

Relaterad länk:: https://urn.kb.se/re...

Annan publikation (övrigt vetenskapligt/konstnärligt)

Abstract Ämnesord

Stäng

In Thailand, progress toward malaria elimination has slowed, largely due to the challenge of residual Plasmodium vivax transmission. Screening and testing for malaria in the vicinity of recent passively-identified index cases, also called reactive case detection (RACD), is commonly used in near-elimination settings, but standard diagnostics such as microscopy miss low-level infections. We assessed the utility, costs, and cost-effectiveness of RACD using loop-mediated isothermal amplification (LAMP) versus standard RACD using microscopy to detect infections in RACD. We also assessed the utility of microsatellite genotyping to determine relatedness of index and RACD-identified infections. Each of 27 microscopy-positive index cases reported through passive surveillance (20 Plasmodium vivax, 5 P. falciparum, and 2 mixed P. falciparum/ P. vivax infections) triggered RACD, whereby 1,973 index case household members or surrounding neighbors received malaria testing. Of these, no infections were detected in RACD by microscopy, but 12 (0.6%) confirmed or probable infections were detected in RACD by molecular testing using LAMP, out of which four infections were confirmed by PCR. Among these four, one (25%) was genetically related to the index case suggesting low levels of local transmission. The average cost per individual screened for RACD using microscopy and RACD using LAMP was $15 and $22, respectively, and the incremental cost effectiveness ratio to detect infections was $1,191 per additional infection detected. In this near elimination setting, RACD using molecular detection and genotyping can make RACD a more effective strategy by identifying additional infections and transmission foci to facilitate a better understanding regarding local patterns of transmission.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP -- Hälsovetenskap -- Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi (hsv//swe)
MEDICAL AND HEALTH SCIENCES -- Health Sciences -- Public Health, Global Health, Social Medicine and Epidemiology (hsv//eng)

Nyckelord

malaria
surveillance
genetic surveillance
reactive case detection
LAMP
Plasmodium vivax
cost
cost-effectiveness

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Av författaren/redakt...: Cotter, Chris

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MEDICIN OCH HÄLSOVETENSKAP: MEDICIN OCH HÄLS ...; och Hälsovetenskap; och Folkhälsovetensk ...

Av lärosätet: Uppsala universitet

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