{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T07:01:07Z","timestamp":1789542067616,"version":"build-2803163510"},"update-to":[{"DOI":"10.1371\/journal.pntd.0011160","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2023,7,5]],"date-time":"2023-07-05T00:00:00Z","timestamp":1688515200000}}],"reference-count":30,"publisher":"Public Library of Science (PLoS)","issue":"6","license":[{"start":{"date-parts":[[2023,6,22]],"date-time":"2023-06-22T00:00:00Z","timestamp":1687392000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Ghent University"},{"DOI":"10.13039\/501100003246","name":"Dutch Research Council","doi-asserted-by":"crossref","award":["NWO, grant 016.Veni.178.023"],"award-info":[{"award-number":["NWO, grant 016.Veni.178.023"]}],"id":[{"id":"10.13039\/501100003246","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Schistosomiasis Control Initiative"},{"name":"Partnership for Child Development"},{"DOI":"10.13039\/100010409","name":"Children's Investment Fund Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100010409","id-type":"DOI","asserted-by":"publisher"}]},{"name":"End Neglected Tropical Diseases Fund"},{"name":"UKAID-DFI"}],"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>To monitor and evaluate soil-transmitted helminth (STH) control programs, the World Health Organization (WHO) recommends screening stools from 250 children, deploying Kato-Katz thick smear (KK). However, it remains unclear whether these recommendations are sufficient to make adequate decisions about stopping preventive chemotherapy (PC) (prevalence of infection &lt;2%) or declaring elimination of STHs as a public health problem (prevalence of moderate-to-heavy intensity (MHI) infections &lt;2%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methodology<\/jats:title>\n                    <jats:p>We developed a simulation framework to determine the effectiveness and cost of survey designs for decision-making in STH control programs, capturing the operational resources to perform surveys, the variation in egg counts across STH species, across schools, between and within individuals, and between repeated smears. Using this framework and a lot quality assurance sampling approach, we determined the most cost-efficient survey designs (number of schools, subjects, stool samples per subject, and smears per stool sample) for decision-making.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Principal findings<\/jats:title>\n                    <jats:p>For all species, employing duplicate KK (sampling 4 to 6 schools and 64 to 70 subjects per school) was the most cost-efficient survey design to assess whether prevalence of any infection intensity was above or under 2%. For prevalence of MHI infections, single KK was the most cost-efficient (sampling 11 to 25 schools and 52 to 84 children per school).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusions\/Significance<\/jats:title>\n                    <jats:p>KK is valuable for monitoring and evaluation of STH control programs, though we recommend deploying a duplicate KK on a single stool sample to stop PC, and a single KK to declare the elimination of STHs as a public health problem.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pntd.0011160","type":"journal-article","created":{"date-parts":[[2023,6,23]],"date-time":"2023-06-23T13:20:10Z","timestamp":1687526410000},"page":"e0011160","update-policy":"https:\/\/doi.org\/10.1371\/journal.pntd.corrections_policy","source":"Crossref","is-referenced-by-count":10,"title":["A general framework to support cost-efficient survey design choices for the control of soil-transmitted helminths when deploying Kato-Katz thick smear"],"prefix":"10.1371","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6093-9648","authenticated-orcid":true,"given":"Adama","family":"Kazienga","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruno","family":"Levecke","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gemechu Tadesse","family":"Leta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sake J.","family":"de Vlas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luc E.","family":"Coffeng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2023,6,22]]},"reference":[{"key":"pntd.0011160.ref001","volume-title":"Ending the neglect to attain the Sustainable Development Goals: A road map for neglected tropical diseases 2021\u20132030","author":"World Health Organization"},{"key":"pntd.0011160.ref002","volume-title":"2030 targets for soil-transmitted helminthiases control programmes","author":"World Health Organization","year":"2020"},{"key":"pntd.0011160.ref003","unstructured":"World Health Organization. Helminth control in school-age children: a guide for managers of control programmes \/ A. Montresor\u2026 [et al.]. 2002 [cited 26 Apr 2023]. Available: https:\/\/apps.who.int\/iris\/handle\/10665\/42473"},{"key":"pntd.0011160.ref004","unstructured":"World Health Organization. Preventive chemotherapy in human helminthiasis: coordinated use of anthelminthic drugs in control interventions: a manual for health professionals and programme managers. 2006 [cited 26 Apr 2023]. Available: https:\/\/apps.who.int\/iris\/handle\/10665\/43545"},{"key":"pntd.0011160.ref005","unstructured":"World Health Organization. Helminth control in school-age children: a guide for managers of control programmes. 2011 [cited 26 Apr 2023]. Available: https:\/\/apps.who.int\/iris\/handle\/10665\/44671"},{"key":"pntd.0011160.ref006","article-title":"A general framework to support cost-efficient fecal egg count method and study design choices for large-scale STH deworming programs\u2013monitoring of therapeutic drug efficacy as a case study","author":"LE Coffeng","year":"2023","journal-title":"PLoS Negl Trop Dis"},{"key":"pntd.0011160.ref007","doi-asserted-by":"crossref","first-page":"e0010353","DOI":"10.1371\/journal.pntd.0010353","article-title":"Two-stage lot quality assurance sampling framework for monitoring and evaluation of neglected tropical diseases, allowing for imperfect diagnostics and spatial heterogeneity","volume":"16","author":"A Kazienga","year":"2022","journal-title":"PLoS Negl Trop Dis"},{"key":"pntd.0011160.ref008","doi-asserted-by":"crossref","first-page":"e0007446","DOI":"10.1371\/journal.pntd.0007446","article-title":"Diagnostic performance of a single and duplicate Kato-Katz, Mini-FLOTAC, FECPAKG2 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