{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T04:42:09Z","timestamp":1788410529114,"version":"build-2803163510"},"reference-count":28,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2018,10,3]]},"abstract":"Appropriate diagnostic techniques are crucial to global soil-transmitted helminth (STH) control efforts. The recommended Kato\u2013Katz method has low sensitivity in low-transmission settings. Quantitative polymerase chain reaction (qPCR) is a highly sensitive alternative diagnostic option. However, little is known about the variability in qPCR results, and there are few published comparisons between qPCR and other microscopy-based techniques such as sodium nitrate flotation (SNF). Using 865 stool samples collected from 571 individuals, we compared SNF and qPCR in terms of diagnostic sensitivity and infection intensity measurements. In addition, we conducted repeated examinations on a single Necator americanus<\/jats:italic>\u2013positive stool sample over a 6-month period. Results showed good diagnostic agreement between SNF and qPCR for Ascaris<\/jats:italic> spp. (\u03ba = 0.69, P<\/jats:italic> < 0.001), and moderate agreement for hookworm (\u03ba = 0.55, P<\/jats:italic> < 0.001) and Trichuris<\/jats:italic> spp. (\u03ba = 0.50, P<\/jats:italic> < 0.001). Quantitative polymerase chain reaction demonstrated higher sensitivity than SNF for Ascaris<\/jats:italic> spp. (94.1% versus 68.1%) and hookworm (75.7% versus 66.9%) but not for Trichuris<\/jats:italic> spp. (53.1% versus 81.3%), which had very low prevalence. Sodium nitrate flotation and qPCR infection intensity measurements were strongly correlated for Ascaris<\/jats:italic> spp. (\u03c1 = 0.82, P<\/jats:italic> < 0.001) and moderately correlated for hookworm (\u03c1 = 0.58, P<\/jats:italic> < 0.001). Repeated examinations using qPCR showed that N. americanus<\/jats:italic> cycle threshold values decreased significantly at 1 month and remained stable thereafter. Results confirm the high diagnostic sensitivity of qPCR for Ascaris<\/jats:italic> spp. and hookworm, particularly for light-intensity infections, which is ideal for settings approaching transmission elimination. Results support the potential for qPCR to be used as a quantitative assay for STH. Further research is needed in settings where Trichuris trichiura<\/jats:italic> is endemic.<\/jats:p>","DOI":"10.4269\/ajtmh.18-0356","type":"journal-article","created":{"date-parts":[[2018,7,31]],"date-time":"2018-07-31T07:00:55Z","timestamp":1533020455000},"page":"1033-1040","source":"Crossref","is-referenced-by-count":19,"title":["Quantitative Polymerase Chain Reaction for Diagnosis of Soil-Transmitted Helminth Infections: A Comparison with a Flotation-Based Technique and an Investigation of Variability in DNA Detection"],"prefix":"10.4269","volume":"99","author":[{"given":"Naomi E.","family":"Clarke","sequence":"first","affiliation":[{"name":"Research School of Population Health, Australian National University, Canberra, Australia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stacey","family":"Llewellyn","sequence":"additional","affiliation":[{"name":"Clinical Tropical Medicine Laboratory, QIMR Berghofer Medical Research Institute, Brisbane, Australia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca J.","family":"Traub","sequence":"additional","affiliation":[{"name":"Faculty of Veterinary and Agricultural Sciences, University of Melbourne, Parkville, Australia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"McCarthy","sequence":"additional","affiliation":[{"name":"Clinical Tropical Medicine Laboratory, QIMR Berghofer Medical Research Institute, Brisbane, Australia;"},{"name":"School of Medicine, University of Queensland, Brisbane, Australia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alice","family":"Richardson","sequence":"additional","affiliation":[{"name":"Research School of Population Health, Australian National University, Canberra, Australia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susana V.","family":"Nery","sequence":"additional","affiliation":[{"name":"Research School of Population Health, Australian National University, Canberra, Australia;"},{"name":"Kirby Institute, University of New South Wales, Sydney, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2795","reference":[{"key":"b1","series-title":"Parasit Vectors","first-page":"37","article-title":"Global numbers of infection and disease burden of soil transmitted helminth infections in 2010","volume":"7","author":"Pullan","year":"2014"},{"key":"b2","series-title":"Lancet","first-page":"1603","article-title":"Global, regional, and national disability-adjusted life-years (DALYs) for 315 diseases and injuries and healthy life expectancy (HALE), 1990\u20132015: a systematic analysis for the Global Burden of Disease Study 2015","volume":"388","author":"GBD 2015 DALYs and HALE Collaborators","year":"2016"},{"key":"b3","author":"Uniting to Combat NTDs","year":"2016"},{"key":"b4","author":"WHO","year":"2012"},{"key":"b5","author":"WHO","year":"2017"},{"key":"b6","series-title":"PLoS Negl Trop Dis","first-page":"e0003897","article-title":"Should the goal for the treatment of soil-transmitted helminth (STH) infections be changed from morbidity control in children to community-wide transmission elimination?","volume":"9","author":"Anderson","year":"2015"},{"key":"b7","series-title":"Parasit Vectors","first-page":"266","article-title":"Can chemotherapy alone eliminate the transmission of soil transmitted helminths","volume":"7","author":"Truscott","year":"2014"},{"key":"b8","series-title":"PLoS Negl Trop Dis","first-page":"e1601","article-title":"A research agenda for helminth diseases of humans: diagnostics for control and elimination programmes","volume":"6","author":"McCarthy","year":"2012"},{"key":"b9","author":"WHO","year":"2011"},{"key":"b10","author":"WHO","year":"1991"},{"key":"b11","series-title":"Parasitology","first-page":"525","article-title":"The influence of sampling effort and the performance of the Kato\u2013Katz technique in diagnosing Schistosoma mansoni and hookworm co-infections in rural C\u00f4te d\u2019Ivoire","volume":"127","author":"Booth","year":"2003"},{"key":"b12","series-title":"Int J Parasitol","first-page":"765","article-title":"Sensitivity of diagnostic tests for human soil-transmitted helminth infections: a meta-analysis in the absence of a true gold standard","volume":"44","author":"Nikolay","year":"2014"},{"key":"b13","series-title":"Trans R Soc Trop Med Hyg","first-page":"140","article-title":"Time delays between patient and laboratory selectively affect accuracy of helminth diagnosis","volume":"101","author":"Dacombe","year":"2007"},{"key":"b14","series-title":"Am J Trop Med Hyg","first-page":"338","article-title":"A pentaplex real-time polymerase chain reaction assay for detection of four species of soil-transmitted helminths","volume":"84","author":"Basuni","year":"2011"},{"key":"b15","series-title":"Parasit Vectors","first-page":"38","article-title":"Multi-parallel qPCR provides increased sensitivity and diagnostic breadth for gastrointestinal parasites of humans: field-based inferences on the impact of mass deworming","volume":"9","author":"Easton","year":"2016"},{"key":"b16","series-title":"PLoS Negl Trop Dis","first-page":"e3313","article-title":"Simple fecal flotation is a superior alternative to quadruple Kato Katz smear examination for the detection of hookworm eggs in human stool","volume":"8","author":"Inpankaew","year":"2014"},{"key":"b17","series-title":"PLoS Negl Trop Dis","first-page":"e0006022","article-title":"Status of soil-transmitted helminth infections in schoolchildren in Laguna Province, the Philippines: determined by parasitological and molecular diagnostic techniques","volume":"11","author":"Mationg","year":"2017"},{"key":"b18","series-title":"Am J Trop Med Hyg","first-page":"1041","article-title":"A novel, multi-parallel, real-time polymerase chain reaction approach for eight gastrointestinal parasites provides improved diagnostic capabilities to resource-limited at-risk populations","volume":"88","author":"Mejia","year":"2013"},{"key":"b19","series-title":"Am J Trop Med Hyg","first-page":"685","article-title":"Simultaneous detection and quantification of Ancylostoma duodenale, Necator americanus, and Oesophagostomum bifurcum in fecal samples using multiplex real-time PCR","volume":"77","author":"Verweij","year":"2007"},{"key":"b20","series-title":"PLoS Negl Trop Dis","first-page":"e0004380","article-title":"Application of a multiplex quantitative PCR to assess prevalence and intensity of intestinal parasite infections in a controlled clinical trial","volume":"10","author":"Llewellyn","year":"2016"},{"key":"b21","series-title":"Am J Trop Med Hyg","first-page":"535","article-title":"Diagnostic accuracy of Kato-Katz, FLOTAC, Baermann, and PCR methods for the detection of light-intensity hookworm and Strongyloides stercoralis infections in Tanzania","volume":"90","author":"Knopp","year":"2014"},{"key":"b22","series-title":"PLoS Negl Trop 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