%0 Journal Article
%9 ACL : Articles dans des revues avec comité de lecture répertoriées par l'AERES
%A D'Ambrosio, M. V.
%A Bakalar, M.
%A Bennuru, S.
%A Reber, C.
%A Skandarajah, A.
%A Nilsson, L.
%A Switz, N.
%A Kamgno, J.
%A Pion, Sébastien
%A Boussinesq, Michel
%A Nutman, T. B.
%A Fletcher, D. A.
%T Point-of-care quantification of blood-borne filarial parasites with a mobile phone microscope
%D 2015
%L fdi:010064223
%G ENG
%J Science Translational Medicine
%@ 1946-6234
%K AFRIQUE CENTRALE ; CAMEROUN
%M ISI:000354431600001
%N 286
%P 286re4
%R 10.1126/scitranslmed.aaa3480
%U https://www.documentation.ird.fr/hor/fdi:010064223
%> https://www.documentation.ird.fr/intranet/publi/2015/06/010064223.pdf
%V 7
%W Horizon (IRD)
%X Parasitic helminths cause debilitating diseases that affect millions of people in primarily low-resource settings. Efforts to eliminate onchocerciasis and lymphatic filariasis in Central Africa through mass drug administration have been suspended because of ivermectin-associated serious adverse events, including death, in patients infected with the filarial parasite Loa loa. To safely administer ivermectin for onchocerciasis or lymphatic filariasis in regions co-endemic with L. loa, a strategy termed "test and (not) treat" has been proposed whereby those with high levels of L. loa microfilariae (>30,000/ml) that put them at risk for life-threatening serious adverse events are identified and excluded from mass drug administration. To enable this, we developed a mobile phone-based video microscope that automatically quantifies L. loa microfilariae in whole blood loaded directly into a small glass capillary from a fingerprick without the need for conventional sample preparation or staining. This point-of-care device automatically captures and analyzes videos of microfilarial motion in whole blood using motorized sample scanning and onboard motion detection, minimizing input from health care workers and providing a quantification of microfilariae per milliliter of whole blood in under 2 min. To validate performance and usability of the mobile phone microscope, we tested 33 potentially Loa-infected patients in Cameroon and confirmed that automated counts correlated with manual thick smear counts (94% specificity; 100% sensitivity). Use of this technology to exclude patients from ivermectin-based treatment at the point of care in Loa-endemic regions would allow resumption/expansion of mass drug administration programs for onchocerciasis and lymphatic filariasis in Central Africa.
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