The use of the circulating cathodic antigen (CCA) urine cassette assay for the diagnosis and assessment of cure of Schistosoma mansoni infections in an endemic area of the Amazon region

Abstract INTRODUCTION Schistosomiasis is a poverty-related disease that affects people in 78 countries worldwide. This study aimed to evaluate the point-of-care circulating cathodic antigen (POC-CCA) test performance using sensitive parasitological methods as a reference standard (RS) in individuals before and after treatment. METHODS The RS was established by combining the results of 16 Kato-Katz slides and the Helmintex® method. Positivity rates of the POC-CCA test and Kato-Katz and Helmintex® methods were calculated before treatment and 30 days afterward. Furthermore, the sensitivity, specificity, accuracy, and kappa coefficient before treatment were determined by comparing the methods. The cure rate was defined 30 days after treatment. RESULTS Among the 217 participants, the RS detected a total of 63 (29.0%) positive individuals. The POC-CCA test identified 79 (36.4%) infections. The evaluation of POC-CCA test performance in relation to the RS revealed a sensitivity of 61.9%, specificity of 74.0%, accuracy of 70.5%, and kappa coefficient of 0.33. Out of the 53 remaining participants after treatment, a total of 45 (81.1%) showed egg negative results, and 8 (18.9%) were egg positive according to the RS. A total of 5 (9.4%) egg-positive and 37 (69.8%) egg-negative individuals were positive by the POC-CCA test. CONCLUSIONS Our data show that the POC-CCA test has potential as an auxiliary tool for the diagnosis of Schistosoma mansoni infection, yielding better results than 16 Kato-Katz slides from three different stool samples. However, the immunochromatographic test lacks sufficient specificity and sensitivity for verifying the cure rate after treatment.

Detection of schistosomiasis in an area directly affected by the São Francisco River large-scale water transposition project in the Northeast of Brazil

Abstract INTRODUCTION: The development of the São Francisco River Integration Project [Projeto de Integração do Rio São Francisco (PISF)] in the State of Ceará, Brazil, has resulted in environmental and socioeconomic changes with potential risks to public health. We aimed to determine the presence of Schistosoma mansoni infections in schoolchildren (aged 7-14 years) and workers from the construction site in an area under the direct influence of the PISF in the municipality of Brejo Santo-CE, to aid in the prevention and control of schistosomiasis. METHODS: We conducted a cross-sectional study using two S. mansoni-detection methods: detection of S. mansoni eggs by the Kato-Katz parasitological method in stool samples (assessed in triplicate for each sample) and S. mansoni circulating cathodic antigen by the point-of-care immunochromatographic rapid test (POC-CCA) in urine. RESULTS In general, the positivity rates for S. mansoni detection were 1.9% (2/106) among schoolchildren and 2.9% (4/138) among workers. No child had evidence of S. mansoni eggs in their stools; 1.9% tested positive by the POC-CCA method. Among workers, two (1.4%) tested positive by the Kato-Katz test and three (2.2%) by the POC-CCA test. If the POC-CCA test results that were scored as traces were considered negative, then the positivity rates dropped to 0.9% and 0.7% for schoolchildren and workers, respectively. CONCLUSIONS: The active transmission of schistosomiasis in a region covered by the PISF was recognized, reinforcing the necessity to consolidate surveillance and control actions, as well as structural sanitation measures to reverse the social determinants of the disease.

Prevalence of Schistosomiasis among Primary School Children in Gadabuke District, Toto LGA, North Central Nigeria.

Aim: This study was aimed at determining the number of children infected in relation to study population. Study Design: Cross sectional Place and Duration of Study: This study was conducted among school children in Gadabuke and Garagwa LGEA Primary schools in Toto Local Government Area of Nasarawa State, Nigeria between October-December, 2012. Materials and Methods: A total of 250 samples were collected comprising 192 urine and 58 faecal samples. Samples were investigated using standard World Health Organisation guidelines for identification of parasites. Samples were analysed macroscopically and microscopically. Results: Out of the 192 children screened. Gadabuke LGED primary school had a prevalence of 58.1% while Garagwa LGED primary school had a prevalence of 22.7% and the overall prevalence of urinary schistosomiasis in the two schools is 44.3%. There was no significant difference in prevalence rate of urinary schistosomiasis between Gadabuke and Garagwa primary schools (P>0.05). On the other hand, Gadabuke had a prevalence of 5.3% for S.mansoni and 0% prevalence for Garagwa LGED. On the whole, the prevalence of S. mansoni was 3.4% in the study area. Children of age group (8 – 14) were more infected with urinary schistosomiasis. Male had higher prevalence of urinary schistosomiasis 50 (50%) than the female 35 (35%). Statistically there was significance difference in prevalence infection of Schistosoma haematobium among males and females investigated. Children whose parents are farmers and fishermen had the highest prevalence infections, followed by Artisan, civil servant and the businessmen. Conclusion: Urinary schistosomiasis in some selected primary schools in Gadabuke district of Toto LGA in Nasarawa State have been documented.

Fatores associados a alteraçöes urinárias em uma área hiperendêmica para esquistossomose mansônica: estudo clínico e ultrasonográfico / Factors associated on urinary alterations in one hyperendemic area for schistosomiasis mansoni: clinical and ultrasonographic study

Em Queixadinha, Caraí, MG, Brasil, 339 indivíduos com mais de 10 anos de idade (91,9 por cento da populaçäo nesta faixa etária) foram submetidos a dois exames parasitológicos de fezes pela técnica de Kato-Katz, exame clínico, ultrasom abdominal e um teste para elementos anormais na urina, por meio de fibra de elementos anormais (Comburtest 9 Boehring-Ingelheim). Os 48 pacientes que apresentaram proteinúria (+, ++ ou +++) na primeira visita à área foram examinados seis meses mais tarde e um novo teste para elementos anormais, complementado por sedimentoscopia, foi realizado. Nesta ocasiäo 25 pacientes apresentaram, de novo, testes positivos para proteinúria. Seis pacientes foram excluídos por causa de forte evidência de infecçäo urinária ou diabete. Os 19 pacientes restantes foram comparados à populaçäo com mais de 10 anos em relaçäo a: idade, sexo, raça, história de tratamento específico para esquistossomose, alteraçöes da palpaçäo hepática, presença de baço palpável, pressäo arterial, presença de ovos de S. mansoni nas fezes, carga parasitária e os seguintes parâmetros medidos pelo ultrasom: diâmetro longitudinal do baço, fibrose periportal, espessura dos ramos portais, espessura do tronco da veia porta, presença de colaterais portossistêmicas, calibre da veia porta, espessura da parede da vesícula biliar e diâmetro do lobo esquerdo do fígado. Após regressäo logística, a única variável associada à presença das referidas alteraçöes urinárias era a presença de fibrose hepática ao ultrasom.