{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T06:50:51Z","timestamp":1791442251744,"version":"4.3.3"},"reference-count":25,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2020,6,2]],"date-time":"2020-06-02T00:00:00Z","timestamp":1591056000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000781","name":"European Research Council","doi-asserted-by":"publisher","award":["ERC 671055"],"award-info":[{"award-number":["ERC 671055"]}],"id":[{"id":"10.13039\/501100000781","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pathogens"],"abstract":"<jats:p>Onchocerciasis is diagnosed by detecting microfilariae in skin snips or by detecting OV16 IgG4 antibodies in blood by either enzyme linked immunosorbent assay (ELISA) or a rapid diagnostic test (RDT). Here, we compare the sensitivity and specificity of these three tests in persons with epilepsy living in an onchocerciasis endemic region in the Democratic Republic of Congo. Skin snips and blood samples were collected from 285 individuals for onchocerciasis diagnosis. Three tests were performed: the OV16 RDT (SD Bioline) and the OV16 ELISA both on serum samples, and microscopic detection of microfilariae in skin snips. The sensitivity and specificity of each test was calculated with the combined other tests as a reference. Microfilariae were present in 105 (36.8%) individuals, with a median of 18.5 (6.5\u201372.0) microfilariae\/skin snip. The OV16 RDT and OV16 ELISA were positive in, respectively, 112 (39.3%) and 143 (50.2%) individuals. The OV16 ELISA had the highest sensitivity among the three tests (83%), followed by the OV16 RDT (74.8%) and the skin snip (71.4%). The OV16 RDT had a higher specificity (98.6%) compared to the OV16 ELISA (84.8%). Our study confirms the need to develop more sensitive tests to ensure the accurate detection of ongoing transmission before stopping elimination efforts.<\/jats:p>","DOI":"10.3390\/pathogens9060435","type":"journal-article","created":{"date-parts":[[2020,6,2]],"date-time":"2020-06-02T09:19:27Z","timestamp":1591089567000},"page":"435","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":35,"title":["Comparison of Diagnostic Tests for Onchocerca volvulus in the Democratic Republic of Congo"],"prefix":"10.3390","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3356-4032","authenticated-orcid":false,"given":"An","family":"Hotterbeekx","sequence":"first","affiliation":[{"name":"Global Health Institute, University of Antwerp, 2000 Antwerp, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jolien","family":"Perneel","sequence":"additional","affiliation":[{"name":"Global Health Institute, University of Antwerp, 2000 Antwerp, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michel","family":"Mandro","sequence":"additional","affiliation":[{"name":"Provincial Health Division Ituri, Ministry of Health, Bunia 185 DRC 57, Democratic Republic of Congo"},{"name":"Centre de Recherche en Maladies Tropicales, Rethy Box 143, Democratic Republic of Congo"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Germain","family":"Abhafule","sequence":"additional","affiliation":[{"name":"Centre de Recherche en Maladies Tropicales, Rethy Box 143, Democratic Republic of Congo"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3544-1239","authenticated-orcid":false,"given":"Joseph Nelson","family":"Siewe Fodjo","sequence":"additional","affiliation":[{"name":"Global Health Institute, University of Antwerp, 2000 Antwerp, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2660-880X","authenticated-orcid":false,"given":"Alfred","family":"Dusabimana","sequence":"additional","affiliation":[{"name":"Global Health Institute, University of Antwerp, 2000 Antwerp, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7353-9304","authenticated-orcid":false,"given":"Steven","family":"Abrams","sequence":"additional","affiliation":[{"name":"Global Health Institute, University of Antwerp, 2000 Antwerp, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samir","family":"Kumar-Singh","sequence":"additional","affiliation":[{"name":"Molecular Pathology Group, Laboratory of Cell Biology &amp; Histology, Faculty of Medicine and Health Sciences, University of Antwerp, 2000 Antwerp, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1919-1340","authenticated-orcid":false,"given":"Robert","family":"Colebunders","sequence":"additional","affiliation":[{"name":"Global Health Institute, University of Antwerp, 2000 Antwerp, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2020,6,2]]},"reference":[{"key":"ref_1","unstructured":"World Health Organisation (1995). Onchocerciasis and Its Control, WHO. Technical report series no. 852."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"208","DOI":"10.1016\/j.pt.2017.11.009","article-title":"Onchocerciasis-Associated Epilepsy, an Additional Reason for Strengthening Onchocerciasis Elimination Programs","volume":"34","author":"Colebunders","year":"2018","journal-title":"Trends Parasitol."},{"key":"ref_3","unstructured":"WHO (2016). Progress report on the elimination of human onchocerciasis, 2015\u20132016. Wkly. Epidemiol. Rec., 91, 505\u2013514."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1186\/s40249-016-0160-7","article-title":"Progress towards onchocerciasis elimination in the participating countries of the African Programme for Onchocerciasis Control: Epidemiological evaluation results","volume":"5","author":"Tekle","year":"2016","journal-title":"Infect. Dis. Poverty"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1179\/136485908X337436","article-title":"The African Programme for Onchocerciasis Control (APOC)","volume":"102","author":"Amazigo","year":"2008","journal-title":"Ann. Trop. Med. Parasitol."},{"key":"ref_6","unstructured":"WHO (2016). Guidelines for Stopping Mass Drug Administration and Verifying Elimination of Human Onchocerciasis: Criteria and Procedures, WHO Press."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1796","DOI":"10.1086\/317629","article-title":"A Rapid-Format Antibody Card Test for Diagnosis of Onchocerciasis","volume":"182","author":"Weil","year":"2000","journal-title":"J. Infect. Dis."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"216","DOI":"10.1086\/505081","article-title":"Field Applicability of a Rapid-Format Anti\u2013Ov-16 Antibody Test for the Assessment of Onchocerciasis Control Measures in Regions of Endemicity","volume":"194","author":"Lipner","year":"2006","journal-title":"J. Infect. Dis."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1041","DOI":"10.4269\/ajtmh.18-0132","article-title":"Evaluation of an OV-16 IgG4 Enzyme-Linked Immunosorbent Assay in Humans and Its Application to Determine the Dynamics of Antibody Responses in a Non-Human Primate Model of Onchocerca volvulus Infection","volume":"99","author":"Cama","year":"2018","journal-title":"Am. J. Trop. Med. Hyg."},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Lont, Y.L., Coffeng, L.E., De Vlas, S.J., Golden, A., Santos, T.D.L., Domingo, G.J., and Stolk, W. (2017). Modelling Anti-Ov16 IgG4 Antibody Prevalence as an Indicator for Evaluation and Decision Making in Onchocerciasis Elimination Programmes. PLoS Negl. Trop. Dis., 11.","DOI":"10.1371\/journal.pntd.0005314"},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Dieye, Y., Storey, H.L., Barrett, K.L., Gerth-Guyette, E., Di Giorgio, L., Golden, A., Faulx, D., Kalnoky, M., Ndiaye, M.K.N., and Sy, N. (2017). Feasibility of utilizing the SD BIOLINE Onchocerciasis IgG4 rapid test in onchocerciasis surveillance in Senegal. PLoS Negl. Trop. Dis., 11.","DOI":"10.1371\/journal.pntd.0005884"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"338","DOI":"10.1186\/s13071-016-1623-1","article-title":"Analysis of age-dependent trends in Ov16 IgG4 seroprevalence to onchocerciasis","volume":"9","author":"Golden","year":"2016","journal-title":"Parasites Vectors"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"749","DOI":"10.4269\/ajtmh.18-0341","article-title":"Operational Performance of the Onchocerca volvulus \u201cOEPA\u201d Ov16 ELISA Serological Assay in Mapping, Guiding Decisions to Stop Mass Drug Administration, and Posttreatment Surveillance Surveys","volume":"99","author":"Richards","year":"2018","journal-title":"Am. J. Trop. Med. Hyg."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"e137","DOI":"10.2196\/resprot.7186","article-title":"Ivermectin Treatment in Patients With Onchocerciasis-Associated Epilepsy: Protocol of a Randomized Clinical Trial","volume":"6","author":"Colebunders","year":"2017","journal-title":"JMIR Res. Protoc."},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Mandro, M., Fodjo, J.N.S., Dusabimana, A., Mukendi, D., Haesendonckx, S., Lokonda, R., Nakato, S., Nyisi, F., Abhafule, G., and Wonya\u2019Rossi, D. (2020). Single versus Multiple Dose Ivermectin Regimen in Onchocerciasis-Infected Persons with Epilepsy Treated with Phenobarbital: A Randomized Clinical Trial in the Democratic Republic of Congo. Pathogens, 9.","DOI":"10.20944\/preprints202001.0259.v1"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1186\/s40249-018-0452-1","article-title":"High prevalence of epilepsy in onchocerciasis endemic health areas in Democratic Republic of the Congo","volume":"7","author":"Lenaerts","year":"2018","journal-title":"Infect. Dis. Poverty"},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Fodjo, J.N.S., Mandro, M., Mukendi, D., Tepage, F., Menon, S., Nakato, S., Nyisi, F., Abhafule, G., Wonya\u2019Rossi, D., and Anyolito, A. (2019). Onchocerciasis-associated epilepsy in the Democratic Republic of Congo: Clinical description and relationship with microfilarial density. PLoS Negl. Trop. Dis., 13.","DOI":"10.1371\/journal.pntd.0007300"},{"key":"ref_18","first-page":"519","article-title":"Parasitological diagnosis of onchocerciasis. A critical review of present methods (author\u2019s transl)","volume":"38","author":"Prost","year":"1978","journal-title":"Med. Trop. Rev. Corps Sante Colonial"},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Golden, A., Stevens, E.J., Yokobe, L., Faulx, D., Kalnoky, M., Peck, R., Valdez, M., Steel, C., Karabou, P., and Banla, M. (2016). A Recombinant Positive Control for Serology Diagnostic Tests Supporting Elimination of Onchocerca volvulus. PLoS Negl. Trop. Dis., 10.","DOI":"10.1371\/journal.pntd.0004292"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"14","DOI":"10.4269\/ajtmh.1993.48.14","article-title":"A Study of Onchocerciasis with Severe Skin and Eye Lesions in a Hyperendemic Zone in the Forest of Southwestern Cameroon: Clinical, Parasitologic, and Entomologic Findings","volume":"48","author":"Somo","year":"1993","journal-title":"Am. J. Trop. Med. Hyg."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1046\/j.1365-4362.1997.00007.x","article-title":"Onchocerciasis: Clinical presentation and host parasite interactions in patients of Southern Sudan","volume":"36","author":"Stingl","year":"1997","journal-title":"Int. J. Dermatol."},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Murdoch, M.E., Murdoch, I.E., Evans, J.R., Yahaya, H., Njepuome, N., Cousens, S., Jones, B.R., and Abiose, A. (2017). Pre-control relationship of onchocercal skin disease with onchocercal infection in Guinea Savanna, Northern Nigeria. PLoS Negl. Trop. Dis., 11.","DOI":"10.1371\/journal.pntd.0005489"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1603","DOI":"10.1126\/science.2011741","article-title":"An immunogenic Onchocerca volvulus antigen: A specific and early marker of infection","volume":"251","author":"Lobos","year":"1991","journal-title":"Science"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1805","DOI":"10.1093\/infdis\/jiz307","article-title":"Integrating Multiple Biomarkers to Increase Sensitivity for the Detection of Onchocerca volvulus Infection","volume":"221","author":"Bennuru","year":"2019","journal-title":"J. Infect. Dis."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"906","DOI":"10.4269\/ajtmh.15-0695","article-title":"Detection of Onchocerca volvulus in Skin Snips by Microscopy and Real-Time Polymerase Chain Reaction: Implications for Monitoring and Evaluation Activities","volume":"94","author":"Thiele","year":"2016","journal-title":"Am. J. Trop. Med. Hyg."}],"container-title":["Pathogens"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-0817\/9\/6\/435\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T09:34:54Z","timestamp":1760175294000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-0817\/9\/6\/435"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,6,2]]},"references-count":25,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2020,6]]}},"alternative-id":["pathogens9060435"],"URL":"https:\/\/doi.org\/10.3390\/pathogens9060435","relation":{},"ISSN":["2076-0817"],"issn-type":[{"value":"2076-0817","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,6,2]]}}}