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- Title
Latent-Class Methods to Evaluate Diagnostics Tests for Echinococcus Infections in Dogs.
- Authors
Hartnack, Sonja; Budke, Christine M.; Craig, Philip S.; Qiu Jiamin; Boufana, Belgees; Ponce, Maiza Campos; Torgerson, Paul R.
- Abstract
Background: The diagnosis of canine echinococcosis can be a challenge in surveillance studies because there is no perfect gold standard that can be used routinely. However, unknown test specificities and sensitivities can be overcome using latent-class analysis with appropriate data. Methodology: We utilised a set of faecal and purge samples used previously to explore the epidemiology of canine echinococcosis on the Tibetan plateau. Previously only the purge results were reported and analysed in a largely deterministic way. In the present study, additional diagnostic tests of copro-PCR and copro-antigen ELISA were undertaken on the faecal samples. This enabled a Bayesian analysis in a latent-class model to examine the diagnostic performance of a genus specific copro-antigen ELISA, species-specific copro-PCR and arecoline purgation. Potential covariates including co- infection with Taenia, age and sex of the dog were also explored. The dependence structure of these diagnostic tests could also be analysed. Principle findings: The most parsimonious result, indicated by deviance-information criteria, suggested that co-infection with Taenia spp. was a significant covariate with the Echinococcus infection. The copro-PCRs had estimated sensitivities of 89% and 84% respectively for the diagnoses of Echinococcus multilocularis and E. granulosus. The specificities for the copro- PCR were estimated at 93 and 83% respectively. Copro-antigen ELISA had sensitivities of 55 and 57% for the diagnosis of E. multilocularis and E. granulosus and specificities of 71 and 69% respectively. Arecoline purgation with an assumed specificity of 100% had estimated sensitivities of 76% and 85% respectively. Significance: This study also shows that incorporating diagnostic uncertainty, in other words assuming no perfect gold standard, and including potential covariates like sex or Taenia co-infection into the epidemiological analysis may give different results than if the diagnosis of infection status is assumed to be deterministic and this approach should therefore be used whenever possible.
- Subjects
ECHINOCOCCUS multilocularis; ECHINOCOCCUS granulosus; EPIDEMIOLOGICAL research; TAENIASIS; ARECOLINE; TAENIA
- Publication
PLoS Neglected Tropical Diseases, 2013, Vol 7, Issue 2, p1
- ISSN
1935-2727
- Publication type
Article
- DOI
10.1371/journal.pntd.0002068