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@article{Truscott:2019:10.1371/journal.pntd.0007196,
author = {Truscott, JE and Dunn, JC and Papaiakovou, M and Schaer, F and Werkman, M and Littlewood, DTJ and Walson, JL and Anderson, RM},
doi = {10.1371/journal.pntd.0007196},
journal = {PLoS Neglected Tropical Diseases},
title = {Calculating the prevalence of soil-transmitted helminth infection through pooling of stool samples: Choosing and optimizing the pooling strategy},
url = {http://dx.doi.org/10.1371/journal.pntd.0007196},
volume = {13},
year = {2019}
}

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TY  - JOUR
AB  - Prevalence is a common epidemiological measure for assessing soil-transmitted helminthburden and forms the basis for much public-health decision-making. Standard diagnostictechniques are based on egg detection in stool samples through microscopy and these techniques are known to have poor sensitivity for individuals with low infection intensity, leadingto poor sensitivity in low prevalence populations. PCR diagnostic techniques offer very highsensitivities even at low prevalence, but at a greater cost for each diagnostic test in terms ofequipment needed and technician time and training. Pooling of samples can allow prevalence to be estimated while minimizing the number of tests performed. We develop a modelof the relative cost of pooling to estimate prevalence, compared to the direct approach oftesting all samples individually. Analysis shows how expected relative cost depends on boththe underlying prevalence in the population and the size of the pools constructed. A criticalprevalence level (approx. 31%) above which pooling is never cost effective, independent ofpool size. When no prevalence information is available, there is no basis on which to choosebetween pooling and testing all samples individually. We recast our model of relative cost ina Bayesian framework in order to investigate how prior information about prevalence in agiven population can be used to inform the decision to choose either pooling or full testing.Results suggest that if prevalence is below 10%, a relatively small exploratory prevalencesurvey (10–15 samples) can be sufficient to give a high degree of certainty that pooling maybe relatively cost effective.
AU  - Truscott,JE
AU  - Dunn,JC
AU  - Papaiakovou,M
AU  - Schaer,F
AU  - Werkman,M
AU  - Littlewood,DTJ
AU  - Walson,JL
AU  - Anderson,RM
DO  - 10.1371/journal.pntd.0007196
PY  - 2019///
SN  - 1935-2727
TI  - Calculating the prevalence of soil-transmitted helminth infection through pooling of stool samples: Choosing and optimizing the pooling strategy
T2  - PLoS Neglected Tropical Diseases
UR  - http://dx.doi.org/10.1371/journal.pntd.0007196
UR  - http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000463799300024&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=1ba7043ffcc86c417c072aa74d649202
UR  - http://hdl.handle.net/10044/1/72081
VL  - 13
ER  -

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