Work

The role of diagnostic technologies to measure progress toward WHO 2030 targets for soil-transmitted helminth control programs

Year: 2021

Type: article

Abstract: ackgroundInfections with soil-transmitted helminths (STHs) occurs throughout the developing world and are caused by 5 main species commonly known as roundworms (Ascaris lumbricoides), whipworms (Trichuris trichiura), hookworms (Ancylostoma duodenale and Necator americanus), and threadworm (Strongyloides).Recently, the World Health Organization (WHO) published its 2030 roadmap for STH preventive chemotherapy (PC) control programs [1].In this roadmap, a total of 6 ambitious targets were identified, each with their corresponding milestones.The first 2 targets are to achieve and maintain elimination of STH-attributable (excluding Strongyloides) morbidity in pre-school age children (pre-SAC) and school-age children (SAC) by 2030 (Target #1) and to reduce the number of tablets needed in PC (Target #2).Target #3 aims increase domestic financial to support PC, whereas Targets #4 and #5 are aiming to establish an efficient control program specific for woman of reproductive age and strongyloidiasis in SAC, respectively.Finally, Target #6 aims to achieve universal access to basic sanitation and hygiene in STH-endemic areas.In the present viewpoint, we will reflect on the diagnostic technologies to measure progress toward Target #1 and Target #2 only.There, cost-effective diagnostics are a prerequisite to measure progress toward the set milestones.For Target #1, the milestone is the number of countries that have successfully reduced the prevalence of moderate and heavy intensity (M&HI) infections in children to less than 2% (2023: 70 countries; 2025: 90 countries; and 2030: 98 countries), whereas for Target #2, the milestone is the percentage reduction in number of anthelmintic tablets needed to deworm pre-SAC and SAC (2023: 20%; 2025: 30%; and 2030: 50%).For the latter target, a performant data reporting system feeds a decision tree to scale down the frequency of PC programs (and hence the number of anthelmintic tablets) based on prevalence of any STH infections.For the other targets, milestone indicators are in one way or another a coverage metric (Targets #4 to #6).In the 2030 WHO roadmap, the Kato-Katz (KK) thick stool smear remains the recommended diagnostic standard to detect and quantify the intensity of STH infections, although reference to other yet unspecified quantitative diagnostics is made.The KK method is not considered as the method of choice to detect Strongyloides infections; therefore, we will not further discuss strongyloidiosis in the context of achieving Targets #1 and #2.A recent diagnostic gap and priority assessment concluded that current diagnostic technologies are adequate-providing some minor modifications-for mapping STH infections and initiating PC programs, but

Source: PLoS neglected tropical diseases

DOI: 10.1371/journal.pntd.0009422

Authors: Lieven J. Stuyver, Bruno Levecke

Institutions: Janssen (Belgium), Ghent University

Language: English

Topic: Parasites and Host Interactions

Subfield: Parasitology

Field: Immunology and Microbiology

Domain: Life Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $2,420