{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T03:31:24Z","timestamp":1782963084681,"version":"3.54.5"},"update-to":[{"DOI":"10.1371\/journal.pntd.0008916","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2021,2,9]],"date-time":"2021-02-09T00:00:00Z","timestamp":1612828800000}}],"reference-count":49,"publisher":"Public Library of Science (PLoS)","issue":"12","license":[{"start":{"date-parts":[[2020,12,28]],"date-time":"2020-12-28T00:00:00Z","timestamp":1609113600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/publicdomain\/zero\/1.0\/"}],"funder":[{"name":"Coalition for Operational Research on Neglected Tropical Diseases\/ Bill & Melinda Gates Foundation","award":["OPP1053230"],"award-info":[{"award-number":["OPP1053230"]}]},{"DOI":"10.13039\/100000200","name":"United States Agency for International Development","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000200","id-type":"DOI","asserted-by":"publisher"}]},{"name":"The Task Force for Global Health"},{"name":"Australian National Health and Medical Research Council","award":["1109035"],"award-info":[{"award-number":["1109035"]}]},{"DOI":"10.13039\/501100015972","name":"Westpac Scholars Trust","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100015972","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["www.plosntds.org"],"crossmark-restriction":false},"short-container-title":["PLoS Negl Trop Dis"],"abstract":"<jats:p>\n                    Under the Global Programme to Eliminate Lymphatic Filariasis (LF), American Samoa conducted mass drug administration (MDA) from 2000\u20132006. Despite passing Transmission Assessment Surveys (TAS) in 2011\/2012 and 2015, American Samoa failed TAS-3 in 2016, with antigen (Ag) prevalence of 0.7% (95%CI 0.3\u20131.8%) in 6\u20137 year-olds. A 2016 community survey (Ag prevalence 6.2% (95%CI 4.4\u20138.5%) in age \u22658 years) confirmed resurgence. Using data from the 2016 survey, this study aims to i) investigate antibody prevalence in TAS-3 and the community survey, ii) identify risk factors associated with being seropositive for Ag and anti-filarial antibodies, and iii) compare the efficiency of different sampling strategies for identifying seropositive persons in the post-MDA setting. Antibody prevalence in TAS-3 (n = 1143) were 1.6% for Bm14 (95%CI 0.9\u20132.9%), 7.9% for Wb123 (95%CI 6.4\u20139.6%), and 20.2% for Bm33 (95%CI 16.7\u201324.3%); and in the community survey (n = 2507), 13.9% for Bm14 (95%CI 11.2\u201317.2%), 27.9% for Wb123 (95%CI 24.6\u201331.4%), and 47.3% for Bm33 (95%CI 42.1\u201352.6%). Multivariable logistic regression was used to identify risk factors for being seropositive for Ag and antibodies. Higher Ag prevalence was found in males (adjusted odds ratio [aOR] 3.01), age \u226518 years (aOR 2.18), residents of Fagali\u2019i (aOR 15.81), and outdoor workers (aOR 2.61). Ag prevalence was 20.7% (95%CI 9.7\u201353.5%) in households of Ag-positive children identified in TAS-3. We used NNTest\n                    <jats:sup>av<\/jats:sup>\n                    (average number needed to test to identify one positive) to compare the efficiency of the following strategies for identifying persons who were seropositive for Ag and each antibody: i) TAS of 6\u20137 year-old children, ii) population representative surveys of older age groups, and iii) targeted surveillance of subpopulations at higher risk of being seropositive (older ages, householders of Ag-positive TAS children, and known hotspots). For Ag, NNTest\n                    <jats:sup>av<\/jats:sup>\n                    ranged from 142.5 for TAS, to &lt;5 for households of index children. NNTest\n                    <jats:sup>av<\/jats:sup>\n                    was lower in older ages, and highest for Ag, followed by Bm14, Wb123 and Bm33 antibodies. We propose a multi-stage surveillance strategy, starting with population-representative sampling (e.g. TAS or population representative survey of older ages), followed by strategies that target subpopulations and\/or locations with low NNTest\n                    <jats:sup>av<\/jats:sup>\n                    . This approach could potentially improve the efficiency of identifying remaining infected persons and residual hotspots. Surveillance programs should also explore the utility of antibodies as indicators of transmission.\n                  <\/jats:p>","DOI":"10.1371\/journal.pntd.0008916","type":"journal-article","created":{"date-parts":[[2020,12,28]],"date-time":"2020-12-28T15:20:37Z","timestamp":1609168837000},"page":"e0008916","update-policy":"https:\/\/doi.org\/10.1371\/journal.pntd.corrections_policy","source":"Crossref","is-referenced-by-count":24,"title":["Potential strategies for strengthening surveillance of lymphatic filariasis in American Samoa after mass drug administration: Reducing \u2018number needed to test\u2019 by targeting older age groups, hotspots, and household members of infected persons"],"prefix":"10.1371","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8288-4169","authenticated-orcid":true,"given":"Colleen L.","family":"Lau","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5453-070X","authenticated-orcid":true,"given":"Meru","family":"Sheel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2084-8039","authenticated-orcid":true,"given":"Katherine","family":"Gass","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saipale","family":"Fuimaono","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael C.","family":"David","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kimberly Y.","family":"Won","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Sheridan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5215-3901","authenticated-orcid":true,"given":"Patricia M.","family":"Graves","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2020,12,28]]},"reference":[{"key":"pntd.0008916.ref001","first-page":"457","article-title":"Global Programme to Eliminate Lymphatic Filariasis: Progress Report, 2018","volume":"94","author":"World Health Organization","year":"2019","journal-title":"Wkly Epidemiol Rec"},{"key":"pntd.0008916.ref002","article-title":"Monitoring and Epidemiological Assessment of Mass Drug Administration in the Global Programme to Eliminate Lymphatic Filariasis: A Manual for National Elimination 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