Strengths and Limitations of Diagnostic Methods Sample Clauses

Strengths and Limitations of Diagnostic Methods. Evaluating the strengths and limitations of diagnostic methods helps to ensure the appropriate methods are used to monitor progress towards elimination of onchocerciasis. While nodule palpation is a rapid means of assessment, it is has low specificity which can result in misdiagnosis of other conditions including lipomas or cysticercosis, particularly in low prevalence settings [51]. Comparatively, skin snip microscopy and PCR are more specific and function well for pre-treatment evaluations. However, skin biopsies are invasive and may be painful for patients, and may also place individuals at risk for a secondary infection or transmission of blood-borne pathogens. Due to these concerns, community preference for these diagnostic methods is limited (discussed in [20, 21, 60]). Skin snips may result in false negatives for light infections or, given that MDA suppresses mf for up to one year, in areas with ongoing MDA [20, 21]. Serologic tests are not influenced be MDA and can be conducted at any time during program monitoring unlike skin snips that must occur one year following the last MDA. They can provide rapid results when card tests are used, but are more time and resource intensive when ELISA is used. Serologic tests cannot differentiate between past and active infections, unless seropositivity disappears rapidly after cure [20]. However, if used in a targeted manner such as restricting to particular age groups serologic tests can identify active infections (discussed in [20, 21]). Serologic tests would be most appropriate in when estimating burden in regions where MDA has not been occurring consistently or has had low coverage. They can also be used to determine if transmission has been interrupted by testing individuals who moved into the area or were born after it was believed transmission had been interrupted. Negative results in these populations indicate that there has been no recent infection.
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