Determining seropositivity—a review of approaches to define population seroprevalence when using multiplex bead assays to assess burden of tropical diseases

Chan, Y., Fornace, K. , Wu, L., Arnold, B. F., Priest, J. W., Martin, D. L., Chang, M. A., Cook, J., Stresman, G. and Drakeley, C. (2021) Determining seropositivity—a review of approaches to define population seroprevalence when using multiplex bead assays to assess burden of tropical diseases. PLoS Neglected Tropical Diseases, 15(6), e0009457. (doi: 10.1371/journal.pntd.0009457) (PMID:34181665) (PMCID:PMC8270565)

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Abstract

Background: Serological surveys with multiplex bead assays can be used to assess seroprevalence to multiple pathogens simultaneously. However, multiple methods have been used to generate cut-off values for seropositivity and these may lead to inconsistent interpretation of results. A literature review was conducted to describe the methods used to determine cut-off values for data generated by multiplex bead assays. Methodology/Principal findings: A search was conducted in PubMed that included articles published from January 2010 to January 2020, and 308 relevant articles were identified that included the terms “serology”, “cut-offs”, and “multiplex bead assays”. After application of exclusion of articles not relevant to neglected tropical diseases (NTD), vaccine preventable diseases (VPD), or malaria, 55 articles were examined based on their relevance to NTD or VPD. The most frequently applied approaches to determine seropositivity included the use of presumed unexposed populations, mixture models, receiver operating curves (ROC), and international standards. Other methods included the use of quantiles, pre-exposed endemic cohorts, and visual inflection points. Conclusions/Significance: For disease control programmes, seropositivity is a practical and easily interpretable health metric but determining appropriate cut-offs for positivity can be challenging. Considerations for optimal cut-off approaches should include factors such as methods recommended by previous research, transmission dynamics, and the immunological backgrounds of the population. In the absence of international standards for estimating seropositivity in a population, the use of consistent methods that align with individual disease epidemiological data will improve comparability between settings and enable the assessment of changes over time.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Fornace, Dr Kimberly
Creator Roles:
Fornace, K.Methodology, Writing – review and editing
Authors: Chan, Y., Fornace, K., Wu, L., Arnold, B. F., Priest, J. W., Martin, D. L., Chang, M. A., Cook, J., Stresman, G., and Drakeley, C.
College/School:College of Medical Veterinary and Life Sciences > Institute of Biodiversity Animal Health and Comparative Medicine
College of Medical Veterinary and Life Sciences > School of Biodiversity, One Health & Veterinary Medicine
Journal Name:PLoS Neglected Tropical Diseases
Publisher:Public Library of Science
ISSN:1935-2727
ISSN (Online):1935-2735
Published Online:28 June 2021
Copyright Holders:This is an open access article, free of all copyright, and may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose
First Published:First published in PLoS Neglected Tropical Diseases 15(6): e0009457
Publisher Policy:Reproduced under a Creative Commons License

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