Table 2. Matching current stool-based technologies with the diagnostic attributes to measure or make progress toward 2030 targets.
| KK (single) | Mini-FLOTAC | FECPAKG2 | qPCR | |
|---|---|---|---|---|
| Target-specific attributes | ||||
| Target 1 [2,12,27] | ||||
| Morbidity | FECs as a proxy | Amount of DNA of eggs or worms as a proxy | ||
| Infection intensity thresholds | WHO endorsed | Proposed, but not endorsed by WHO | ||
| Quantitative readout | Eggs per gram of stool | No consensus on a universal unit | ||
| Multiplex | All STH, excluding differentiation of hookworm spp. and Strongyloides | All STH including differentiation of hookworm spp. and Strongyloides | ||
| Clinical sensitivity | Reference method | Ascaris: 94.7% | Ascaris: 91.0% | Ascaris: 83.5% |
| Trichuris: 93.5% | Trichuris: 78.6% | Trichuris: 87.2% | ||
| Hookworms: 87.9% | Hookworms: 87.9% | Hookworms: 78.8% | ||
| Clinical specificity | Reference method | Ascaris: 92.0% | Ascaris: 84.1% | Ascaris: 87.8% |
| Trichuris: 90.6% | Trichuris: 79.6% | Trichuris: 75.0% | ||
| Hookworms: 90.8% | Hookworms: 86.4% | Hookworms: 88.5% | ||
| Target 2 [15,28] | ||||
| Clinical sensitivity: any intensity | Ascaris: 71.9% | Ascaris: 63.3% | Ascaris: 58.9% | Ascaris: 90.0% |
| Trichuris: 88.1% | Trichuris: 91.5% | Trichuris: 59.8% | Trichuris: 94.7% | |
| Hookworms: 72.6% | Hookworms: 73.9% | Hookworms: 52.4% | Hookworms: 91.9% | |
| Clinical sensitivity: low intensity | Ascaris: 55.6% | Ascaris: 42.1% | Ascaris: 36.8% | Ascaris: 86.2% |
| Trichuris: 79.6% | Trichuris: 85.6% | Trichuris: 37.5% | Trichuris: 91.0% | |
| Hookworms: 69.4% | Hookworms: 70.8% | Hookworms: 47.5% | Hookworms: 91.0% | |
| Clinical sensitivity: M&HI | ⩾95.0% for all STH | ⩾95.0% for all STH | ⩾95.0% for Ascaris only | ⩾95.0% for all STH |
| Clinical specificity | Assumed to be ⩾95.0% | Assumed to be 100% | ||
| General attributes | ||||
| ASSURED | ||||
| Time to result | 412 s | 620 s | 758 s | Not yet evaluated |
| Material cost | US$1.38 | US$1.52 | US$1.96 | To be determined |
| Supplier | Multiple | Single | Single | Multiple |
| Hardware | Microscope/power supply | Microscope/power supply/KUBIC | Computer, Micro-I/power supply | Extraction/amplification equipment; power supply |
| Reagents accessible in STH-endemic countries | Easily | Easily | Easily | Complicated, cold chain is needed |
| Integration into program decision-making | ||||
| Data entry, data analysis, and reporting | Manual | Automated, proof of principle in veterinary parasitology | Manual (depending on laboratory information management system) | |
FEC, fecal egg count; KK, Kato-Katz; M&HI, moderate and heavy intensity; qPCR, quantitative polymerase chain reaction; STH, soil-transmitted helminth; WHO, World Health Organization.