{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T11:13:58Z","timestamp":1789730038991,"version":"4.0.1"},"update-to":[{"DOI":"10.1371\/journal.pntd.0008927","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2021,1,5]],"date-time":"2021-01-05T00:00:00Z","timestamp":1609804800000}}],"reference-count":48,"publisher":"Public Library of Science (PLoS)","issue":"12","license":[{"start":{"date-parts":[[2020,12,21]],"date-time":"2020-12-21T00:00:00Z","timestamp":1608508800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000865","name":"Bill and Melinda Gates Foundation","doi-asserted-by":"publisher","award":["OPP1053230"],"award-info":[{"award-number":["OPP1053230"]}],"id":[{"id":"10.13039\/100000865","id-type":"DOI","asserted-by":"publisher"}]},{"name":"The Task Force for Global Health","award":["employment"],"award-info":[{"award-number":["employment"]}]},{"name":"Australian National Health and Medical Research Council Fellowship","award":["1109035"],"award-info":[{"award-number":["1109035"]}]}],"content-domain":{"domain":["www.plosntds.org"],"crossmark-restriction":false},"short-container-title":["PLoS Negl Trop Dis"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      Samoa conducted eight nationwide rounds of mass drug administration (MDA) for lymphatic filariasis (LF) between 1999 and 2011, and two targeted rounds in 2015 and 2017 in North West Upolu (NWU), one of three evaluation units (EUs). Transmission Assessment Surveys (TAS) were conducted in 2013 (failed in NWU) and 2017 (all three EUs failed). In 2018, Samoa was the first in the world to distribute nationwide triple-drug MDA using ivermectin, diethylcarbamazine, and albendazole.\n                      <jats:italic>Surveillance and Monitoring to Eliminate LF and Scabies from Samoa (SaMELFS Samoa)<\/jats:italic>\n                      is an operational research program designed to evaluate the effectiveness of triple-drug MDA on LF transmission and scabies prevalence in Samoa, and to compare the usefulness of different indicators of LF transmission. This paper reports results from the 2018 baseline survey and aims to i) investigate antigen (Ag) prevalence and spatial epidemiology, including geographic clustering; ii) compare Ag prevalence between two different age groups (5\u20139 years versus \u226510 years) as indicators of areas of ongoing transmission; and iii) assess the prevalence of limb lymphedema in those aged \u226515 years.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A community-based cluster survey was conducted in 30 randomly selected and five purposively selected clusters (primary sampling units, PSUs), each comprising one or two villages. Participants were recruited through household surveys (age \u22655 years) and convenience surveys (age 5\u20139 years). Alere Filariasis Test Strips (FTS) were used to detect Ag, and prevalence was adjusted for survey design and standardized for age and gender. Adjusted Ag prevalence was estimated for each age group (5\u20139, \u226510, and all ages \u22655 years) for random and purposive PSUs, and by region. Intraclass correlation (ICC) was used to quantify clustering at regions, PSUs, and households.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 3940 persons were included (1942 children aged 5\u20139 years, 1998 persons aged \u226510 years). Adjusted Ag prevalence in all ages \u22655 years in randomly and purposively selected PSUs were 4.0% (95% CI 2.8\u20135.6%) and 10.0% (95% CI 7.4\u201313.4%), respectively. In random PSUs, Ag prevalence was lower in those aged 5\u20139 years (1.3%, 95% CI 0.8\u20132.1%) than \u226510 years (4.7%, 95% CI 3.1\u20137.0%), and poorly correlated at the PSU level (R-square = 0.1459). Adjusted Ag prevalence in PSUs ranged from 0% to 10.3% (95% CI 5.9\u201317.6%) in randomly selected and 3.8% (95% CI 1.3\u201310.8%) to 20.0% (95% CI 15.3\u201325.8%) in purposively selected PSUs. ICC for Ag-positive individuals was higher at households (0.46) compared to PSUs (0.18) and regions (0.01).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Our study confirmed ongoing transmission of LF in Samoa, in accordance with the 2017 TAS results. Ag prevalence varied significantly between PSUs, and there was poor correlation between prevalence in 5\u20139 year-olds and older ages, who had threefold higher prevalence. Sampling older age groups would provide more accurate estimates of overall prevalence, and be more sensitive for identifying residual hotspots. Higher prevalence in purposively selected PSUs shows local knowledge can help identify at least some hotspots.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pntd.0008927","type":"journal-article","created":{"date-parts":[[2020,12,21]],"date-time":"2020-12-21T14:35:06Z","timestamp":1608561306000},"page":"e0008927","update-policy":"https:\/\/doi.org\/10.1371\/journal.pntd.corrections_policy","source":"Crossref","is-referenced-by-count":30,"title":["Lymphatic filariasis epidemiology in Samoa in 2018: Geographic clustering and higher antigen prevalence in older age groups"],"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\/0000-0002-8618-102X","authenticated-orcid":true,"given":"Kelley","family":"Meder","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3462-4324","authenticated-orcid":true,"given":"Helen J.","family":"Mayfield","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0862-7572","authenticated-orcid":true,"given":"Therese","family":"Kearns","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brady","family":"McPherson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Take","family":"Naseri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Thomsen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7499-7662","authenticated-orcid":true,"given":"Shannon M.","family":"Hedtke","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Sheridan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katherine","family":"Gass","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":[[2020,12,21]]},"reference":[{"issue":"41","key":"pntd.0008927.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"},{"issue":"9747","key":"pntd.0008927.ref002","doi-asserted-by":"crossref","first-page":"1175","DOI":"10.1016\/S0140-6736(10)60586-7","article-title":"Lymphatic Filariasis and Onchocerciasis","volume":"376","author":"MJ Taylor","year":"2010","journal-title":"Lancet"},{"key":"pntd.0008927.ref003","unstructured":"World Health Organization. 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