Abstract
Accurate diagnosis remains a cornerstone of onchocerciasis control and elimination, yet persistent gaps between field practices and WHO-recommended diagnostic procedures undermine progress toward elimination goals. In many endemic areas, skin snip microscopy is still performed using standard light microscopes rather than the WHO-recommended inverted microscopes, while rapid diagnostic tests (RDTs) are often interpreted under suboptimal field conditions. These discrepancies reduce diagnostic sensitivity and comparability across studies, potentially leading to misguided programmatic decisions. This project will: (1) Compare the diagnostic sensitivity of skin snip microscopy performed using light versus inverted microscopes against the O150 qPCR gold standard, using paired samples collected within the ERC-funded VILARIA project. Findings will inform a standardized, resource-adapted operating procedure (SOP) for skin snip microscopy suitable for field deployment; (2) Evaluate the performance of the Ov16 SD Bioline RDTs read in the field, using a standardized timer and camera-based read-out station compared to RDTs conducted in laboratory settings and validated against Ov16 ELISA results. The project will be implemented in Aketi, an onchocerciasis-endemic area in the Democratic Republic of Congo with ongoing high Onchocerca volvulus transmission. Beyond improving onchocerciasis diagnostics, this project will enhance local laboratory capacity, provide scalable tools (SOPs and training materials), and strengthen quality assurance frameworks applicable to other RDT-diagnosable diseases.
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