Sensitivity of the Point-of-Care Circulating Cathodic Antigen Urine Cassette Test for Diagnosis of Schistosoma mansoni in Low-Endemicity Settings in Côte d'Ivoire

Am J Trop Med Hyg. 2018 Dec;99(6):1567-1572. doi: 10.4269/ajtmh.18-0550.

Abstract

The sensitivity of a point-of-care circulating cathodic antigen (POC-CCA) urine cassette test for diagnosis of Schistosoma mansoni in low-endemicity settings is poorly understood. We conducted a cross-sectional survey in 14 villages in western Côte d'Ivoire and diagnosed children aged 9-12 years for schistosomiasis. Two stool samples were subjected to triplicate Kato-Katz thick smears each for diagnosis of S. mansoni, whereas a single urine sample was examined by POC-CCA for S. mansoni, filtration for Schistosoma haematobium, and reagent strip for microhematuria. According to the Kato-Katz technique, we found 45 out of 681 children positive for S. mansoni (6.6%) with a mean intensity among infected children of 72.2 eggs per gram of stool. Point-of-care circulating cathodic antigen revealed a prevalence of S. mansoni of 33.0% when trace results were considered positive and 12.5% when trace results were considered negative. Eggs of S. haematobium were found in eight participants (1.2%), whereas the prevalence of microhematuria was 13.5%. A single POC-CCA urine cassette test revealed a several-fold higher prevalence of S. mansoni than multiple Kato-Katz thick smears in this low-endemicity area. Our findings have important ramifications for choosing an appropriate diagnostic tool in low-endemic areas that might be targeted for elimination.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Animals
  • Anthelmintics / therapeutic use
  • Antigens, Helminth / urine*
  • Child
  • Cote d'Ivoire / epidemiology
  • Cross-Sectional Studies
  • Feces / parasitology
  • Female
  • Hematuria / diagnosis*
  • Hematuria / drug therapy
  • Hematuria / epidemiology*
  • Hematuria / parasitology
  • Humans
  • Male
  • Parasite Egg Count / statistics & numerical data
  • Point-of-Care Testing / standards*
  • Praziquantel / therapeutic use
  • Prevalence
  • Reagent Strips
  • Rural Population
  • Schistosoma haematobium / immunology
  • Schistosoma haematobium / isolation & purification
  • Schistosoma mansoni / immunology
  • Schistosoma mansoni / isolation & purification*
  • Schistosomiasis mansoni / diagnosis*
  • Schistosomiasis mansoni / drug therapy
  • Schistosomiasis mansoni / epidemiology*
  • Schistosomiasis mansoni / parasitology

Substances

  • Anthelmintics
  • Antigens, Helminth
  • Reagent Strips
  • Praziquantel