{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T10:26:21Z","timestamp":1767176781009,"version":"build-2238731810"},"update-to":[{"DOI":"10.1371\/journal.pntd.0013711","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2025,11,17]],"date-time":"2025-11-17T00:00:00Z","timestamp":1763337600000}}],"reference-count":31,"publisher":"Public Library of Science (PLoS)","issue":"11","license":[{"start":{"date-parts":[[2025,11,11]],"date-time":"2025-11-11T00:00:00Z","timestamp":1762819200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001713","name":"European and Developing Countries Clinical Trials Partnership","doi-asserted-by":"publisher","award":["RIA2017NCT-1845 -STOP"],"award-info":[{"award-number":["RIA2017NCT-1845 -STOP"]}],"id":[{"id":"10.13039\/501100001713","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosntds.org"],"crossmark-restriction":false},"short-container-title":["PLoS Negl Trop Dis"],"abstract":"\n Background<\/jats:title>\n \n Nucleic acid amplification tests have shown promising results for the diagnosis of soil-transmitted helminths (STH). The implementation of real-time PCR (qPCR) in low-resource settings is, however, still hampered by multiple logistical challenges. In this study, we assessed the diagnostic performance of a cartridge-based real-time PCR system (\n diaxxoPCR<\/jats:italic>\n ) for the detection of DNA of\n Trichuris trichiura<\/jats:italic>\n ,\n Ascaris lumbricoides,<\/jats:italic>\n and\n Strongyloides stercoralis<\/jats:italic>\n in clinical samples, using qPCR as the reference test.\n <\/jats:p>\n <\/jats:sec>\n \n Methodology<\/jats:title>\n \n Initially, a technical validation of the\n diaxxoPCR<\/jats:italic>\n system in a singleplex pod (cartridge) design was performed using 37 predefined DNA samples (Study A), followed by a diagnostic comparison between the\n diaxxoPCR<\/jats:italic>\n system (singleplex) and qPCR on DNA samples extracted from 325 stools collected in a clinical trial in a rural area of Mozambique (Study B). Finally, one negative and one positive DNA sample were used to demonstrate the technical performance of a multiplex pod design as a potential use-case for the\n diaxxoPCR<\/jats:italic>\n system (Study C).\n <\/jats:p>\n <\/jats:sec>\n \n Principal findings<\/jats:title>\n \n Study A demonstrated that the\n diaxxoPCR<\/jats:italic>\n system performed reliably for each of the three STH targets, with minimal intra- and inter-assay variation and sufficient output reproducibility. Study B, performed in Mozambique, showed a positive qPCR result in 57.5% (187), 15.4% (50), and 0.3% (1) of the 325 DNA trial samples for\n T. trichiura<\/jats:italic>\n ,\n A. lumbricoides,<\/jats:italic>\n and\n S. stercoralis<\/jats:italic>\n , respectively. The\n diaxxoPCR<\/jats:italic>\n system demonstrated sensitivities and specificities above 97% and 94% for each target, resulting in nearly perfect to perfect qualitative agreements with the reference test. Quantitatively, significant and positive associations were seen between the Ct-values (qPCR) and Cq-values (\n diaxxoPCR<\/jats:italic>\n ). In Study C, the\n diaxxoPCR<\/jats:italic>\n system correctly detected all 3 targets in the multiplex pod design.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n \n With refinements regarding faecal DNA extraction procedures, the\n diaxxoPCR<\/jats:italic>\n system has potential to provide accurate and easy-to-use real-time molecular diagnostics of STH in low resource laboratories.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1371\/journal.pntd.0013711","type":"journal-article","created":{"date-parts":[[2025,11,11]],"date-time":"2025-11-11T18:39:19Z","timestamp":1762886359000},"page":"e0013711","update-policy":"https:\/\/doi.org\/10.1371\/journal.pntd.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Performance evaluation of the diaxxoPCR system for rapid and user-friendly stool-based diagnosis of trichuriasis, ascariasis and strongyloidiasis in Mozambique"],"prefix":"10.1371","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1794-2462","authenticated-orcid":true,"given":"Augusto","family":"Messa","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michel","family":"Bengtson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pedro","family":"Fleitas","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luca","family":"Montemartini","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Valdemiro","family":"Novela","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"\u00c1uria","family":"de Jesus","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alejandro","family":"Krolewiecki","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tobias","family":"Schindler","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jose","family":"Mu\u00f1oz","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"In\u00e1cio","family":"Mandomando","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lisette","family":"van Lieshout","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2025,11,11]]},"reference":[{"issue":"10117","key":"pntd.0013711.ref001","doi-asserted-by":"crossref","first-page":"252","DOI":"10.1016\/S0140-6736(17)31930-X","article-title":"Soil-transmitted helminth infections","volume":"391","author":"PM Jourdan","year":"2018","journal-title":"Lancet"},{"key":"pntd.0013711.ref002","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1146\/annurev.nutr.22.120501.134539","article-title":"Nutritional impact of intestinal helminthiasis during the human life cycle","volume":"22","author":"DWT Crompton","year":"2002","journal-title":"Annu Rev Nutr"},{"issue":"10440","key":"pntd.0013711.ref003","doi-asserted-by":"crossref","first-page":"2133","DOI":"10.1016\/S0140-6736(24)00757-8","article-title":"Global incidence, prevalence, years lived with disability (YLDs), disability-adjusted life-years (DALYs), and healthy life expectancy (HALE) for 371 diseases and injuries in 204 countries and territories and 811 subnational locations, 1990-2021: a systematic analysis for the Global Burden of Disease Study 2021","volume":"403","author":"GBD 2021 Diseases and Injuries Collaborators","year":"2024","journal-title":"Lancet"},{"issue":"1","key":"pntd.0013711.ref004","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1016\/j.idc.2018.10.006","article-title":"Strongyloidiasis: A Neglected Tropical Disease","volume":"33","author":"A Krolewiecki","year":"2019","journal-title":"Infect Dis Clin North Am"},{"key":"pntd.0013711.ref005","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1371\/journal.pntd.0008184","article-title":"The strongyloides stercoralis-hookworms association as a path to the estimation of the global burden of strongyloidiasis: A systematic review","volume":"14","author":"PE Fleitas","year":"2020","journal-title":"PLoS Negl Trop Dis"},{"key":"pntd.0013711.ref006","unstructured":"World Health Organization. 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