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Starting and stopping preventive chemotherapy (PC) for soil-transmitted helminthiasis is typically based on the prevalence of infection as measured by Kato-Katz (KK) fecal smears. Kato-Katz-based egg counts can vary highly over repeated stool samples and smears. Consequentially, the sensitivity of KK-based surveys depends on the number of stool samples per person and the number of smears per sample. Given finite resources, collecting multiple samples and/or smears means screening fewer individuals, thereby lowering the statistical precision of prevalence estimates. Using population-level data from various epidemiological settings, we assessed the performance of different sampling schemes executed within the confines of the same budget. We recommend the use of single-slide KK for determining prevalence of moderate-to-heavy intensity infection and policy decisions for starting and continuing PC; more sensitive sampling schemes may be required for policy decisions involving stopping PC. Our findings highlight that guidelines should include specific guidance on sampling schemes. © The Author(s) 2019. Published by Oxford University Press for the Infectious Diseases Society of America.


Luc E Coffeng, Veronica Malizia, Carolin Vegvari, Piet Cools, Katherine E Halliday, Bruno Levecke, Zeleke Mekonnen, Paul M Gichuki, Somphou Sayasone, Rajiv Sarkar, Ame Shaali, Johnny Vlaminck, Roy M Anderson, Sake J de Vlas. Impact of Different Sampling Schemes for Decision Making in Soil-Transmitted Helminthiasis Control Programs. The Journal of infectious diseases. 2020 Jun 11;221(Suppl 5):S531-S538

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PMID: 31829425

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