McLure Angus, Alamnia Tilahun, Xu Zhiwei, Lau Colleen L, Mayfield Helen J
National Centre for Epidemiology and Population Health, The Australian National University, Canberra, Australia.
College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia.
Trop Med Int Health. 2025 Sep;30(9):893-907. doi: 10.1111/tmi.70017. Epub 2025 Aug 5.
Molecular xenomonitoring is a surveillance method for vector-borne diseases where vectors are tested for molecular pathogen markers. Testing is typically on pools (groups) of vectors. Molecular xenomonitoring is a sensitive and efficient complement to human-based surveillance. However, existing statistical guidance for the appropriate design and analysis of molecular xenomonitoring surveys has key gaps. We reviewed the literature to understand the common objectives, survey designs, and analysis methods for molecular xenomonitoring surveys for two vector-borne neglected tropical diseases: lymphatic filariasis and onchocerciasis.
We searched peer-reviewed literature for studies published between 1999 and 2022 that presented the results of surveys that collected vectors in field surveys and used a molecular test for the presence of the causative pathogens for lymphatic filariasis and onchocerciasis.
Out of 1225 works identified in the database search, a total of 76 studies (lymphatic filariasis: 45; onchocerciasis: 31) across 30 countries were included in the review. The five most common objectives were determination of elimination status after mass drug administration, comparison of vector and human infection indicators, evaluation of an intervention, comparison of vector collection methods and comparison of laboratory techniques. Nearly all studies used a cluster or hierarchical sampling framework to collect vectors (72/76), but very few studies accounted for this in their designs (2/76) or analysis (1/76). While few studies justified the number of vectors included in each pool (5/76), nearly all studies accounted for pooled testing when calculating pathogen prevalence from results (69/76). Few studies justified the number or selection of collection sites or total sample size (16/76).
Published molecular xenomonitoring surveys for lymphatic filariasis and onchocerciasis had varied objectives, study designs and analysis methods, but proper consideration of survey design was frequently missing from the analysis. There is a need for statistical tools and guidance to enable appropriate design and analysis of molecular xenomonitoring surveys while accounting for disease, objective and context-specific considerations.
分子外来监测是一种针对媒介传播疾病的监测方法，即对媒介进行分子病原体标志物检测。检测通常针对媒介群体进行。分子外来监测是基于人群监测的一种敏感且高效的补充手段。然而，现有的关于分子外来监测调查的适当设计和分析的统计指南存在关键空白。我们回顾了相关文献，以了解针对两种被忽视的媒介传播热带疾病——淋巴丝虫病和盘尾丝虫病的分子外来监测调查的常见目标、调查设计和分析方法。
我们在同行评审文献中搜索了1999年至2022年间发表的研究，这些研究展示了在实地调查中收集媒介并使用分子检测方法检测淋巴丝虫病和盘尾丝虫病致病病原体的调查结果。
在数据库搜索中识别出的1225篇文献中，共有来自30个国家的76项研究（淋巴丝虫病：45项；盘尾丝虫病：31项）被纳入综述。五个最常见的目标是确定大规模药物给药后的消除状态、比较媒介和人类感染指标、评估一项干预措施、比较媒介采集方法以及比较实验室技术。几乎所有研究都采用整群或分层抽样框架来收集媒介（72/76），但很少有研究在设计（2/76）或分析（1/76）中考虑到这一点。虽然很少有研究说明每个群体中包含的媒介数量的合理性（5/76），但几乎所有研究在根据结果计算病原体流行率时都考虑了混合检测（69/76）。很少有研究说明采集地点的数量或选择或总样本量的合理性（16/76）。
已发表的关于淋巴丝虫病和盘尾丝虫病的分子外来监测调查有不同的目标、研究设计和分析方法，但分析中经常缺少对调查设计的适当考虑。需要统计工具和指南，以便在考虑疾病、目标和特定背景因素的同时，对分子外来监测调查进行适当的设计和分析。
