District Level Management NTD Training Course

Module 9 Diagnostic of PC NTDs

Session 1: Overview of diagnostics for M&E

5th June 2015

District Level Management NTD Training Course Meeting NTD STAG, 29-30 April 2013, Geneva, Switzerland 2

District Level Management NTD Training Course

Module 9 – Laboratory and Diagnostic tools

Purpose of the Module: The purpose of this module is to district level NTD managers, M&E personnel and laboratory personnel with knowledge to understand the basic diagnostic and laboratory tools and techniques to support mapping and M&E activities for PC NTDs

Units: 1. Overview of diagnostics for PC NTDs 2. Good laboratory practice of NTD diagnostic tests 3. Laboratory and diagnostic tools for filarial worms, intestinal

and urinary parasites (detailed)

District Level Management NTD Training Course Meeting NTD STAG, 29-30 April 2013, Geneva, Switzerland 3

District Level Management NTD Training Course

Session 1 – Overview of diagnostic tests for M&E

Purpose of the unit: This unit provides a brief overview of diagnostics for NTD M&E activities for district-level NTD managers, M&E personnel and laboratory personnel

Objectives: • Participants gain broad knowledge of the procedures for

sample collection for mapping and M&E activities

• Note for more detailed information on diagnostics

including SOPs see Unit 9.3

District Level Management NTD Training Course Meeting NTD STAG, 29-30 April 2013, Geneva, Switzerland 4

District Level Management NTD Training Course

Preparations for diagnostics of NTDs for M&E

• Identify the target population

• Mobilise the concerned communities for sample collection

• Inform concerned communities about sample collection procedures

• Ensure consent is received where necessary (prepare consent forms)

• Identify diagnostic tools for the diseases to be targeted in the district

• Ensure diagnostic teams have basic knowledge for the sampling and diagnostic methods

• Diagnostic tests may be carried out on blood samples, skin biopsies, fecal and urine samples

District Level Management NTD Training Course Meeting NTD STAG, 29-30 April 2013, Geneva, Switzerland 5

District Level Management NTD Training Course

Diagnostics for filarial worms

• Who will samples be collected from?

– community based survey

• What samples will be taken?

– blood samples and skin biopsy

• Why?

– Results provide baseline prevalence of targeted diseases at district level to determine whether PCT is needed

District Level Management NTD Training Course Meeting NTD STAG, 29-30 April 2013, Geneva, Switzerland 6

District Level Management NTD Training Course

LF ICT card

• It is highly sensitive and specific for W. bancrofti

• Performed with 100 µl of blood

• Results can be read after 10 minutes

• Card has longer shelf-life if cold storage is available

District Level Management NTD Training Course Meeting NTD STAG, 29-30 April 2013, Geneva, Switzerland 7

District Level Management NTD Training Course

A new LF Strip test

A new, highly sensitive tool to replace the existing ICT to detect the presence of W. bancrofti has been developed and is in use in some countries. This test is more sensitive than the old ICT cards and does not require a cold chain.

District Level Management NTD Training Course Meeting NTD STAG, 29-30 April 2013, Geneva, Switzerland 8

District Level Management NTD Training Course

Brugia Rapid test

RDT card which detects the presence of B. malayi or B. timori. Results can be read after 15-25 minutes

District Level Management NTD Training Course Meeting NTD STAG, 29-30 April 2013, Geneva, Switzerland 9

District Level Management NTD Training Course

Skin snip biopsy for diagnosis of onchocerciasis

• Detection of Onchocerca volvulus parasite which causes onchocerciasis (river blindness)

• Uses small tissue samples and microscopy

District Level Management NTD Training Course Meeting NTD STAG, 29-30 April 2013, Geneva, Switzerland 10

District Level Management NTD Training Course

Diagnosis of Intestinal and Urinary Parasites

• Who will samples be collected from?

– school-aged children (where school enrolment is high) or community-based (low enrolment)

• What samples will be taken?

– urine and faecal samples

• Why?

– Results provide baseline prevalence of targeted diseases at district level to determine whether PCT is needed

District Level Management NTD Training Course Meeting NTD STAG, 29-30 April 2013, Geneva, Switzerland 11

District Level Management NTD Training Course

Kato Katz thick smear

• This technique is used in field surveys for the detection of STH and SCH ova in stool samples

District Level Management NTD Training Course Meeting NTD STAG, 29-30 April 2013, Geneva, Switzerland 12

District Level Management NTD Training Course

Tools for diagnosis of Urinary Parasites

• Questionnaire: used for rapid assessment through self-reporting of blood in urine using a standardised WHO questionnaire

• Hemastix: Used to detect the presence of blood in urine which can be a result of S. haematobium infection. It does not detect the presence of S. haematobium ova

• Urine Filtration: Use to detect S. haematobium ova in urine

District Level Management NTD Training Course Meeting NTD STAG, 29-30 April 2013, Geneva, Switzerland 13

District Level Management NTD Training Course

Session 1 activity

Participants divide into groups of 4-6 individuals to discuss their experiences with making preparations for mapping and/or M&E activities. Each group should highlight the following: • The main preparations they made • Any difficulties faced in making preparations • How these difficulties can be overcome After 10 minutes each group will present the key points that they have highlighted with the facilitators and other participants