Rapid, inexpensive, fingerstick, whole-blood, sensitive, specific, point-of-care test for anti-Toxoplasma antibodies

Lykins, Joseph; Xuan, Ling; Levigne, Pauline; Zhou, Ying; Bissati, Kamal El; Clouser, Fatima; Wallon, Martine; Morel, Florence; Leahy, Karen; Mansouri, Bouchra El; Siddiqui, Maryam; Leong, Nicole; Michalowski, Morgan; Irwin, Erin; Goodall, Perpetua; Ismail, Mahmoud; Christmas, Monica; Adlaoui, El Bachir; Roubal, M.; Barkat, Amina; Cong, Hua; Begeman, Ian J.; Lai, Bo Shiun; Contopoulos‐Ioannidis, Despina G.; Montoya, José G.; Maldonado, Yvonne; Ramirez, Raymund; Press, Cindy; Peyron, François; McLeod, Rima

doi:10.1371/journal.pntd.0006536

Cited by 24 publications

(46 citation statements)

References 10 publications

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“…Reducing costs and constraints of screening is another significant line of research. The impact of using new diagnostic tests to be integrated into existing strategy at the laboratories or as Point-of-Care tests [60], including individual rapid fingerprick [61] or saliva tests [62], is currently being investigated. Being able to rely on a prenatal screening program is key to investigating, in real life conditions without selection bias, such new diagnostic strategies, or for performing additional clinical research.…”

Section: Discussionmentioning

confidence: 99%

The cost-effectiveness of neonatal versus prenatal screening for congenital toxoplasmosis

et al. 2019

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BackgroundCongenital Toxoplasmosis (CT) can have severe consequences. France, Austria, and Slovenia have prenatal screening programs whereas some other countries are considering universal screening to reduce congenital transmission and severity of infection in children. The efficiency of such programs is debated increasingly as seroprevalence among pregnant women and incidence of congenital toxoplasmosis show a steady decrease. In addition, uncertainty remains regarding the effectiveness of pre- and postnatal treatments.MethodTo identify cost-effective strategies, prenatal and neonatal screenings were compared using a decision-analytic model based on French guidelines and current knowledge of long-term evolution of the disease in treated children. Epidemiological data were extracted from the scientific literature and clinical data from the French Lyon cohort. Strategies were compared at one year of age, when infection can be definitively evaluated, and at 15 years of age, after which validated outcome data become scarce. The analysis was performed from the French Health Insurance System perspective and included direct medical costs for pregnant women and their children.ResultsThe 1-year Incremental Cost-Effectiveness Ratio showed that prenatal screening would require investing €14,826 to avoid one adverse event (liveborn with CT, fetal loss, neonatal death or pregnancy termination) compared to neonatal screening. Extra investment increased up to €21,472 when considering the 15-year endpoint.ConclusionsPrenatal screening is cost-effective as compared to neonatal screening in moderate prevalence areas with predominant Type II strains. In addition, prenatal screening, by providing closer follow-up of women at risk increases the number of occasions for education avoiding toxoplasmosis.

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Section: Discussionmentioning

confidence: 99%

The cost-effectiveness of neonatal versus prenatal screening for congenital toxoplasmosis

et al. 2019

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“…In many countries, researchers have tested different types of ICT as a potential alternative screening tool to the most commonly used diagnostic methods that require special settings with promising results (Wang et al 2011;Terkawi et al 2013;Mahinc et al 2017;Begeman et al 2017;Chapey et al 2017). A very recent study showed that another modified ICT testing for Toxoplasma infection using finger pricks has an excellent performance with high sensitivity (100%) and specificity (100%) (Lykins et al 2018).…”

Section: Introductionmentioning

confidence: 99%

Validity of a new immunochromatographic test in detection of Toxoplasma gondii in cancer patients

Wassef

Abdel-Malek

2018

J Parasit Dis

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Screening of toxoplasmosis in cancer patients is mandatory especially before starting treatment to guard against life-threatening disseminated disease. Diagnosis of toxoplasmosis rely mainly on serology. The most widely used method for detection of anti-Toxoplasma gondii (T. gondii) antibodies is the enzyme linked immunosorbent assay (ELISA), being available and reliable. Immunochromatographic tests (ICT) attracted a lot of attention recently being one of the high quality, rapid and easy to perform tests. Available data comparing the performance of ICT versus ELISA techniques have yielded inconsistent results and none compared their performance among the immunocompromised cancer patients. Therefore, we designed this study to compare the performance of a new ICT (the OnSite Toxo IgG/IgM Combo Rapid test) and ELISA techniques for the detection of anti-T. gondii antibody as a tool for screening for toxoplasmosis among cancer patients in Cairo-Egypt. Among 180 cancer patients, a total of 110 patients (61.1%) were positive for anti-T. gondii antibodies by one or both methods. Agreement between both methods was found in 78.8% of the samples. By using ELISA technique as a gold standard test for the detection of anti-T. gondii antibodies, our results showed 87.5% specificity and 74% sensitivity of ICT technique. Moreover, our results proved that ICT is more sensitive in detecting lower level of antibodies than ELISA, that makes it preferable as a screening test for the immunocompromised patients.

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“…With effective antenatal prophylaxis and therapy, a prenatal screening program has been found to be cost-effective, even when the incidence of CT is under 1/10 000. 9,83 The cost of testing can be strongly reduced, 84 making it even more attractive.…”

Section: Maternal Safetymentioning

confidence: 99%

Congenital toxoplasmosis: What is the evidence for chemoprophylaxis to prevent fetal infection?

Mandelbrot

2020

Prenatal Diagnosis

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Although prenatal diagnosis and prenatal and neonatal therapy of congenital toxoplasmosis are available, there is controversy concerning the effectiveness of prophylaxis to prevent placental transmission. Experimental, parasitological, and clinical data suggest a "window of opportunity" following maternal infection. Among medications active against Toxoplasma gondii, mainly spiramycin (Spy) and pyrimethamine + sulfonamide combinations (P-S) have been evaluated. Results from observational studies suffered treatment bias, since prescriptions differed according to the gestational age at seroconversion, which is the major risk factor for transmission, and many lacked precise timing. Some large retrospective studies found no difference in transmission according to prophylactic treatment, but transmission was lower when treatment started promptly after maternal seroconversion. A few recent studies adjusting for timing of infection observed lower transmission in case of P-S than other or no prophylaxis. In the only randomized controlled trial, transmission was lower with P-S than S (18.5% vs 30%, P = .147); this association was strengthened when the treatment was started within 3 weeks of seroconversion, and the incidence of fetal cerebral ultrasound signs was significantly reduced in the P-S group. Rapid initiation of prophylactic therapy following maternal infection, which is usually asymptomatic, requires systematic screening for maternal seroconversion during pregnancy.

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Rapid, inexpensive, fingerstick, whole-blood, sensitive, specific, point-of-care test for anti-Toxoplasma antibodies

Cited by 24 publications

References 10 publications

The cost-effectiveness of neonatal versus prenatal screening for congenital toxoplasmosis

The cost-effectiveness of neonatal versus prenatal screening for congenital toxoplasmosis

Validity of a new immunochromatographic test in detection of Toxoplasma gondii in cancer patients

Congenital toxoplasmosis: What is the evidence for chemoprophylaxis to prevent fetal infection?

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