Abstract
Background: Point-of-care diagnostic tests are essential for confirming Onchocerca volvulus transmission in remote, resource-limited, onchocerciasis-endemic communities. In Maridi, South Sudan, we field-tested a novel "biplex A" rapid diagnostic test (RDT) developed by Drugs & Diagnostics for Tropical Diseases (DDTD), San Diego, California. Methods: In February 2023, children aged 3-9 years were recruited from study sites at different distances from the Maridi Dam, a known blackfly breeding site. O. volvulus antibodies were detected using the DDTD biplex A RDT, which detects antibodies to Ov16 and OvOC3261 at test line 1 and to Ov33.3 and OvOC10469 at test line 2, along with the commercially available Ov16 SD Bioline RDT. Both tests were performed on whole blood obtained via finger prick. The feasibility and acceptability of the DDTD biplex A RDT were assessed, and its results were compared with those of the Ov16 SD Bioline RDT. Results: A total of 239 children participated in the study. The anti-Ov16 seroprevalence detected by the Ov16 SD Bioline RDT was 30.2% (72/239), with the highest prevalence observed in children living closest to the Maridi Dam (p < 0.001). Testing with the DDTD biplex A RDT was determined to be feasible, acceptable, and easy to use in a field setting. The DDTD biplex A RDT test line 1 (anti-Ov16 and anti-OvOC3261) was positive in 35.1% (84/239) of children, while test line 2 (anti-Ov33.3 and anti-OvOC10469) was positive in 18.4% (44/239). Both lines were simultaneously visible in 15.5% (37/239). Conclusions: The DDTD biplex A RDT prototype was user-friendly and practical for field deployment. However, additional research is needed to evaluate its performance relative to the commercially available Ov16 SD Bioline RDT. The high anti-Ov16 seroprevalence that was observed underscores the ongoing O. volvulus transmission near the Maridi Dam. Strengthening the onchocerciasis elimination program in Maridi should be prioritized as a critical public health intervention.