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Evaluation of a point-of-care test for the diagnosis of Taenia solium neurocysticercosis in rural southern Tanzania : a diagnostic accuracy study

(2024) LANCET INFECTIOUS DISEASES. 24(1). p.98-106
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Abstract
Background Neurocysticercosis is a common cause of epilepsy in Taenia solium-endemic areas in sub-Saharan Africa but is often undiagnosed because of an absence of affordable diagnostic tools. This study evaluated the diagnostic accuracy of a T solium cysticercosis antibody-detecting lateral-flow point-of-care assay (TS POC test) for the neuroimaging-based diagnosis of neurocysticercosis. Methods Patients with epileptic seizures or severe progressive headache were recruited consecutively from three hospitals in southern Tanzania. All patients were tested with the TS POC test. All patients positive for cysticercosis on the TS POC test and every tenth patient who was negative for cysticercosis received a brain CT examination and underwent reference testing for T solium cysticercosis (ie, rT24H-EITB, LLGP-EITB, and antigen ELISA). The primary outcome of the study was the sensitivity of the TS POC test for the diagnosis of neurocysticercosis. Findings Of the 601 recruited participants, 102 (17%) tested positive for cysticercosis with the TS POC test. Overall, 48 (62%) of the 77 patients positive for cysticercosis and five (17%) of the 29 patients negative for cysticercosis on the TS POC test had CT-confirmed neurocysticercosis. The TS POC test yielded a sensitivity of 49% (uncertainty interval [UI] 41-58) for neurocysticercosis. Sensitivity was similar to that of the rT24H-EITB (44%, UI 37-51) and the antigen ELISA (50%, 43-56). For the subset of neurocysticercosis cases with at least one active (ie, vesicular) lesion, sensitivity was above 98% for the TS POC test, the rT24H-ETIB, and the antigen ELISA. Interpretation The TS POC test showed promising results for the diagnosis of neurocysticercosis in patients with vesicular lesions, which need to be confirmed in a larger study. This test could be considered to support policies on screening patients with suspected neurocysticercosis in clinical settings, which would allow appropriate referral for neuroimaging and early treatment.
Keywords
Infectious Diseases, CRITERIA

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MLA
Stelzle, Dominik, et al. “Evaluation of a Point-of-Care Test for the Diagnosis of Taenia Solium Neurocysticercosis in Rural Southern Tanzania : A Diagnostic Accuracy Study.” LANCET INFECTIOUS DISEASES, vol. 24, no. 1, Elsevier, 2024, pp. 98–106, doi:10.1016/s1473-3099(23)00378-x.
APA
Stelzle, D., Makasi, C. E., Schmidt, V., Van Damme, I., Trevisan, C., Ruether, C., … Study group members, S. collaborators. (2024). Evaluation of a point-of-care test for the diagnosis of Taenia solium neurocysticercosis in rural southern Tanzania : a diagnostic accuracy study. LANCET INFECTIOUS DISEASES, 24(1), 98–106. https://doi.org/10.1016/s1473-3099(23)00378-x
Chicago author-date
Stelzle, Dominik, Charles E Makasi, Veronika Schmidt, Inge Van Damme, Chiara Trevisan, Charlotte Ruether, Agnès Fleury, et al. 2024. “Evaluation of a Point-of-Care Test for the Diagnosis of Taenia Solium Neurocysticercosis in Rural Southern Tanzania : A Diagnostic Accuracy Study.” LANCET INFECTIOUS DISEASES 24 (1): 98–106. https://doi.org/10.1016/s1473-3099(23)00378-x.
Chicago author-date (all authors)
Stelzle, Dominik, Charles E Makasi, Veronika Schmidt, Inge Van Damme, Chiara Trevisan, Charlotte Ruether, Agnès Fleury, John Noh, Sukwan Handali, Pierre Dorny, Pascal Magnussen, Gideon Zulu, Kabemba E Mwape, Emmanuel Bottieau, Sarah Gabriël, Bernard J Ngowi, Andrea S Winkler, Chishala Chabala, Chishimba Mubanga, Famke Jansen, Isaac K. Phiri, Richard Mambo, and SOLID collaborators Study group members. 2024. “Evaluation of a Point-of-Care Test for the Diagnosis of Taenia Solium Neurocysticercosis in Rural Southern Tanzania : A Diagnostic Accuracy Study.” LANCET INFECTIOUS DISEASES 24 (1): 98–106. doi:10.1016/s1473-3099(23)00378-x.
Vancouver
1.
Stelzle D, Makasi CE, Schmidt V, Van Damme I, Trevisan C, Ruether C, et al. Evaluation of a point-of-care test for the diagnosis of Taenia solium neurocysticercosis in rural southern Tanzania : a diagnostic accuracy study. LANCET INFECTIOUS DISEASES. 2024;24(1):98–106.
IEEE
[1]
D. Stelzle et al., “Evaluation of a point-of-care test for the diagnosis of Taenia solium neurocysticercosis in rural southern Tanzania : a diagnostic accuracy study,” LANCET INFECTIOUS DISEASES, vol. 24, no. 1, pp. 98–106, 2024.
@article{01HGAQ2W1DM923MQ6MJC4Z6RR5,
  abstract     = {{Background Neurocysticercosis is a common cause of epilepsy in Taenia solium-endemic areas in sub-Saharan Africa but is often undiagnosed because of an absence of affordable diagnostic tools. This study evaluated the diagnostic accuracy of a T solium cysticercosis antibody-detecting lateral-flow point-of-care assay (TS POC test) for the neuroimaging-based diagnosis of neurocysticercosis. Methods Patients with epileptic seizures or severe progressive headache were recruited consecutively from three hospitals in southern Tanzania. All patients were tested with the TS POC test. All patients positive for cysticercosis on the TS POC test and every tenth patient who was negative for cysticercosis received a brain CT examination and underwent reference testing for T solium cysticercosis (ie, rT24H-EITB, LLGP-EITB, and antigen ELISA). The primary outcome of the study was the sensitivity of the TS POC test for the diagnosis of neurocysticercosis. Findings Of the 601 recruited participants, 102 (17%) tested positive for cysticercosis with the TS POC test. Overall, 48 (62%) of the 77 patients positive for cysticercosis and five (17%) of the 29 patients negative for cysticercosis on the TS POC test had CT-confirmed neurocysticercosis. The TS POC test yielded a sensitivity of 49% (uncertainty interval [UI] 41-58) for neurocysticercosis. Sensitivity was similar to that of the rT24H-EITB (44%, UI 37-51) and the antigen ELISA (50%, 43-56). For the subset of neurocysticercosis cases with at least one active (ie, vesicular) lesion, sensitivity was above 98% for the TS POC test, the rT24H-ETIB, and the antigen ELISA. Interpretation The TS POC test showed promising results for the diagnosis of neurocysticercosis in patients with vesicular lesions, which need to be confirmed in a larger study. This test could be considered to support policies on screening patients with suspected neurocysticercosis in clinical settings, which would allow appropriate referral for neuroimaging and early treatment.}},
  author       = {{Stelzle, Dominik and Makasi, Charles E and Schmidt, Veronika and Van Damme, Inge and Trevisan, Chiara and Ruether, Charlotte and Fleury, Agnès and Noh, John and Handali, Sukwan and Dorny, Pierre and Magnussen, Pascal and Zulu, Gideon and Mwape, Kabemba E and Bottieau, Emmanuel and Gabriël, Sarah and Ngowi, Bernard J and Winkler, Andrea S and Chabala, Chishala and Mubanga, Chishimba and Jansen, Famke and Phiri, Isaac K. and Mambo, Richard and Study group members, SOLID collaborators}},
  issn         = {{1473-3099}},
  journal      = {{LANCET INFECTIOUS DISEASES}},
  keywords     = {{Infectious Diseases,CRITERIA}},
  language     = {{eng}},
  number       = {{1}},
  pages        = {{98--106}},
  publisher    = {{Elsevier}},
  title        = {{Evaluation of a point-of-care test for the diagnosis of Taenia solium neurocysticercosis in rural southern Tanzania : a diagnostic accuracy study}},
  url          = {{http://doi.org/10.1016/s1473-3099(23)00378-x}},
  volume       = {{24}},
  year         = {{2024}},
}

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