Feasibility of utilizing the SD BIOLINE Onchocerciasis IgG4 rapid test in onchocerciasis surveillance in Senegal

As effective onchocerciasis control efforts in Africa transition to elimination efforts, different diagnostic tools are required to support country programs. Senegal, with its long standing, successful control program, is transitioning to using the SD BIOLINE Onchocerciasis IgG4 (Ov16) rapid test over traditional skin snip microscopy. The aim of this study is to demonstrate the feasibility of integrating the Ov16 rapid test into onchocerciasis surveillance activities in Senegal, based on the following attributes of acceptability, usability, and cost. A cross-sectional study was conducted in 13 villages in southeastern Senegal in May 2016. Individuals 5 years and older were invited to participate in a demographic questionnaire, an Ov16 rapid test, a skin snip biopsy, and an acceptability interview. Rapid test technicians were interviewed and a costing analysis was conducted. Of 1,173 participants, 1,169 (99.7%) agreed to the rapid test while 383 (32.7%) agreed to skin snip microscopy. The sero-positivity rate of the rapid test among those tested was 2.6% with zero positives 10 years and younger. None of the 383 skin snips were positive for Ov microfilaria. Community members appreciated that the rapid test was performed quickly, was not painful, and provided reliable results. The total costs for this surveillance activity was $22,272.83, with a cost per test conducted at $3.14 for rapid test, $7.58 for skin snip microscopy, and $13.43 for shared costs. If no participants had refused skin snip microscopy, the total cost per method with shared costs would have been around $16 per person tested. In this area with low onchocerciasis sero-positivity, there was high acceptability and perceived value of the rapid test by community members and technicians. This study provides evidence of the feasibility of implementing the Ov16 rapid test in Senegal and may be informative to other country programs transitioning to Ov16 serologic tools.

[1]  Debrah I Boeras,et al.  Implementation science: the laboratory as a command centre , 2017, Current opinion in HIV and AIDS.

[2]  D. Ndiaye,et al.  Evaluation of Lymphatic Filariasis and Onchocerciasis in Three Senegalese Districts Treated for Onchocerciasis with Ivermectin , 2016, PLoS neglected tropical diseases.

[3]  Ashutosh Kumar Singh,et al.  Global, regional, and national disability-adjusted life-years (DALYs) for 315 diseases and injuries and healthy life expectancy (HALE), 1990–2015: a systematic analysis for the Global Burden of Disease Study 2015 , 2016, Lancet.

[4]  Margarete C. Kulik,et al.  Socioeconomic Inequalities in Neglected Tropical Diseases: A Systematic Review , 2016, PLoS neglected tropical diseases.

[5]  Eric Stevens,et al.  A Recombinant Positive Control for Serology Diagnostic Tests Supporting Elimination of Onchocerca volvulus , 2016, PLoS neglected tropical diseases.

[6]  G. Weil,et al.  Diagnostic Tools for Onchocerciasis Elimination Programs. , 2015, Trends in parasitology.

[7]  A. Hopkins From 'control to elimination': a strategic change to win the end game. , 2015, International health.

[8]  T. Unnasch,et al.  Onchocerciasis and lymphatic filariasis elimination in Africa: it's about time , 2015, The Lancet.

[9]  Eric Stevens,et al.  Rapid Point-of-Contact Tool for Mapping and Integrated Surveillance of Wuchereria bancrofti and Onchocerca volvulus Infection , 2015, Clinical and Vaccine Immunology.

[10]  D. Boakye,et al.  40 Years of the APOC Partnership , 2015, PLoS neglected tropical diseases.

[11]  S. Bush,et al.  From River Blindness to Neglected Tropical Diseases—Lessons Learned in Africa for Programme Implementation and Expansion by the Non-governmental Partners , 2015, PLoS neglected tropical diseases.

[12]  A. Onapa,et al.  Transmission of Onchocerca volvulus by Simulium neavei in Mount Elgon focus of Eastern Uganda has been interrupted. , 2014, The American journal of tropical medicine and hygiene.

[13]  C. Katholi,et al.  Serosurveillance to monitor onchocerciasis elimination: the Ugandan experience. , 2014, The American journal of tropical medicine and hygiene.

[14]  T. Nutman,et al.  Extended Result Reading Window in Lateral Flow Tests Detecting Exposure to Onchocerca volvulus: A New Technology to Improve Epidemiological Surveillance Tools , 2013, PloS one.

[15]  Gaetano Borriello,et al.  Open data kit 2.0: expanding and refining information services for developing regions , 2013, HotMobile '13.

[16]  L. Konaté,et al.  Proof-of-Principle of Onchocerciasis Elimination with Ivermectin Treatment in Endemic Foci in Africa: Final Results of a Study in Mali and Senegal , 2012, PLoS neglected tropical diseases.

[17]  Rosanna W. Peeling,et al.  Neglected Tropical Diseases : Rationale and Target Product Profiles , 2018 .

[18]  L. Konaté,et al.  Feasibility of Onchocerciasis Elimination with Ivermectin Treatment in Endemic Foci in Africa: First Evidence from Studies in Mali and Senegal , 2009, PLoS neglected tropical diseases.

[19]  Graham R. Gibbs,et al.  Analyzing Qualitative Data , 2014 .

[20]  T. Edejer,et al.  Generalized cost-effectiveness analysis for national-level priority-setting in the health sector , 2003, Cost effectiveness and resource allocation : C/E.

[21]  R. Baltussen,et al.  Generalised cost-effectiveness analysis: an aid to decision making in health. , 2002, Applied health economics and health policy.