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Ponzo E, Midiri A, Manno A, Pastorello M, Biondo C, Mancuso G. Insights into the epidemiology, pathogenesis, and differential diagnosis of schistosomiasis. Eur J Microbiol Immunol (Bp) 2024; 14:86-96. [PMID: 38498078 PMCID: PMC11097794 DOI: 10.1556/1886.2024.00013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2024] [Accepted: 02/29/2024] [Indexed: 03/19/2024] Open
Abstract
Schistosomiasis is a neglected tropical disease that is prevalent in low- and middle-income countries. There are five human pathogenic species, of which Schistosoma haematobium, Schistosoma mansoni and Schistosoma japonicum are the most prevalent worldwide and cause the greatest burden of disease in terms of mortality and morbidity. In addition, hybrid schistosomes have been identified through molecular analysis. Human infection occurs when cercariae, the larval form of the parasite, penetrate the skin of people while bathing in contaminated waters such as lakes and rivers. Schistosomiasis can cause both urogenital and intestinal symptoms. Urogenital symptoms include haematuria, bladder fibrosis, kidney damage, and an increased risk of bladder cancer. Intestinal symptoms may include abdominal pain, sometimes accompanied by diarrhoea and blood in the stool. Schistosomiasis affects more than 250 million people and causes approximately 70 million Disability-Adjusted Life Years (DALYs), mainly in Africa, South America, and Asia. To control infection, it is essential to establish sensitive and specific diagnostic tests for epidemiological surveillance and morbidity reduction. This review provides an overview of schistosomiasis, with a focus on available diagnostic tools for Schistosoma spp. Current molecular detection methods and progress in the development of new diagnostics for schistosomiasis infection are also discussed.
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Affiliation(s)
- Elena Ponzo
- Department of Human Pathology, Laboratory of Parasitology, University of Messina, 98125Messina, Italy
| | - Angelina Midiri
- Department of Human Pathology, Laboratory of Parasitology, University of Messina, 98125Messina, Italy
| | - Andrea Manno
- Department of Human Pathology, Laboratory of Parasitology, University of Messina, 98125Messina, Italy
| | - Martina Pastorello
- Department of Human Pathology, Laboratory of Parasitology, University of Messina, 98125Messina, Italy
| | - Carmelo Biondo
- Department of Human Pathology, Laboratory of Parasitology, University of Messina, 98125Messina, Italy
| | - Giuseppe Mancuso
- Department of Human Pathology, Laboratory of Parasitology, University of Messina, 98125Messina, Italy
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Lima RRM, Pontes MSS, Silva MG, Ribeiro JFF, Nascimento GAF, Grenfell RFQ, Melo-Jr MR, de Paula AM, Pereira G, Cabral Filho PE, Carvalho LB, Fontes A. Fluorescent quantum dot-based nanotool for targeted identification and evaluation of the schistosomiasis circulating cathodic antigen in tissue samples. Micron 2024; 183:103658. [PMID: 38788484 DOI: 10.1016/j.micron.2024.103658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2024] [Revised: 05/09/2024] [Accepted: 05/09/2024] [Indexed: 05/26/2024]
Abstract
Schistosomiasis represents a serious public health problem, a disease for which the circulating cathodic antigen (CCA) is a relevant biomarker. Quantum dots (QDs) are advantageous fluorescent nanoparticles that can be used as specific nanoprobes. In this study, a nanotool based on QDs and anti-CCA antibodies was developed, which, in association with fluorescence microscopy, was applied to trace and evaluate the CCA profile in schistosomiasis-infected tissue samples. Kidney and liver tissues from mice at different disease phases were used as models. QDs and the conjugates were characterized by absorption and emission spectroscopies. Microscopy analyses were used to map and assess CCA accumulation in infected tissue slices in respect to non-infected control samples. The fluorescent microplate assay (FMA) and Zeta potential (ζ) analyses indicated an effective conjugation, which was corroborated by the absence of labeling in non-infected tissue slices (which lack CCA) after incubation with the nanoprobe. Infected liver and kidney tissues exhibited notable staining by the QDs-anti-CCA conjugate. The CCA accumulation increased as follows: 30 < 60 = 120 days post-infection, with 30, 60, and 120 days corresponding to the pre-patent, acute, and beginning of chronic disease phases, respectively. Therefore, this innovative approach, combining imaging acquisition with the sensitivity and specificity of the QDs-anti-CCA conjugate, demonstrated efficiency in locating and comparatively evaluating CCA deposition in biological samples, thereby opening new possibilities for schistosomiasis research.
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Affiliation(s)
- Rennan R M Lima
- Departamento de Biofísica e Radiobiologia, Universidade Federal de Pernambuco, Centro de Biociências, Recife, PE 50670-901, Brazil
| | - Maria S S Pontes
- Laboratório de Imunopatologia Keizo Asami, Universidade Federal de Pernambuco, Recife, PE 50670-901, Brazil
| | - Mychel G Silva
- Departamento de Física, Universidade Federal de Minas Gerais, Belo Horizonte, MG 31270-901, Brazil
| | - Jéssika F F Ribeiro
- Departamento de Biofísica e Radiobiologia, Universidade Federal de Pernambuco, Centro de Biociências, Recife, PE 50670-901, Brazil
| | - Gabriela A F Nascimento
- Laboratório de Imunopatologia Keizo Asami, Universidade Federal de Pernambuco, Recife, PE 50670-901, Brazil
| | | | - Mário R Melo-Jr
- Laboratório de Imunopatologia Keizo Asami, Universidade Federal de Pernambuco, Recife, PE 50670-901, Brazil
| | - Ana M de Paula
- Departamento de Física, Universidade Federal de Minas Gerais, Belo Horizonte, MG 31270-901, Brazil
| | - Goreti Pereira
- Departamento de Química Fundamental, Universidade Federal de Pernambuco, Recife, PE 50740-560, Brazil; Departamento de Química & CESAM, Universidade de Aveiro, Aveiro 3810-193, Portugal
| | - Paulo E Cabral Filho
- Departamento de Biofísica e Radiobiologia, Universidade Federal de Pernambuco, Centro de Biociências, Recife, PE 50670-901, Brazil.
| | - Luiz B Carvalho
- Laboratório de Imunopatologia Keizo Asami, Universidade Federal de Pernambuco, Recife, PE 50670-901, Brazil
| | - Adriana Fontes
- Departamento de Biofísica e Radiobiologia, Universidade Federal de Pernambuco, Centro de Biociências, Recife, PE 50670-901, Brazil.
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Makia CM, Fesuh NB, Amabo EN, Gamba VA, Oluwole AS, Stothard R. Urogenital schistosomiasis (UGS) and female genital schistosomiasis (FGS) in Cameroon: an observational assessment of key reproductive health determinants of girls and women in the Matta Health Area. BMJ Open 2023; 13:e063392. [PMID: 36787976 PMCID: PMC9930553 DOI: 10.1136/bmjopen-2022-063392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/16/2023] Open
Abstract
OBJECTIVES AND SETTING Across sub-Saharan Africa, urogenital schistosomiasis (UGS), in particular female genital schistosomiasis (FGS), is a significant waterborne parasitic disease, with its direct burden on the sexual and reproductive health (SRH) of sufferers infrequently measured. UGS has an established control plan, which in most endemic regions as in Cameroon, still excludes FGS considerations. Highlighting existent associations between UGS and FGS could increase the management of FGS within UGS interventions. This study seeks to identify current associations among FGS and UGS with some reproductive health indicators, to provide formative information for better integrated control. PARTICIPANTS 304 females aged 5-69 years were all examined for UGS by urine filtration and microscopy. Among these, 193 women and girls were eligible for clinical FGS assessment based on age (>13). After selective questioning for FGS symptoms, a subgroup of 67 women and girls consented for clinical examination for FGS using portable colposcopy, with observed sequelae classified according to the WHO FGS pocket atlas. OUTCOME Overall UGS and FGS prevalence was measured, with FGS-related/UGS-related reproductive health symptoms recorded. Associations between FGS and UGS were investigated by univariate and multivariate logistic regression analyses. RESULTS Overall UGS prevalence was 63.8% (194/304), where FGS prevalence (subgroup) was 50.7% (34/67). FGS manifestation increased significantly with increasing age, while a significant decrease with ascending age was observed for UGS. Lower abdominal pain (LAP) vaginal itches (VI) and coital pain (CP) were identified as the main significant shared symptoms of both FGS and UGS, while LAP with menstrual irregularity (MI) appeared a strong symptomatic indicator for FGS. CONCLUSION LAP, MI, CP and VI are the potential SRH indicators that could be exploited in future for targeting of praziquantel provision to FGS sufferers within primary care, complementary with existing praziquantel distribution for UGS sufferers in Schistosoma haematobium endemic areas.
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Affiliation(s)
- Christine Masong Makia
- Social Sciences and Management, Catholic University of Central Africa, Yaounde, Centre, Cameroon
| | - Nono Betrand Fesuh
- Department of Mathematics and Physical Sciences, National Advanced School of Engineering, University of Yaoundé 1, Yaoundé, Centre, Cameroon
| | | | - Victoria A Gamba
- Department of Obstetrics and Gynecology, University of Nairobi, Nairobi, Nairobi, Kenya
| | - Akinola Stephen Oluwole
- Department of Pure and Applied Zoology, Federal University of Agriculture Abeokuta, Abeokuta, Ogun, Nigeria
| | - Russell Stothard
- Department of Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool, UK
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Mei Z, Lv S, Tian L, Wang W, Jia T. The Efficiency of Commercial Immunodiagnostic Assays for the Field Detection of Schistosoma japonicum Human Infections: A Meta-Analysis. Pathogens 2022; 11:pathogens11070791. [PMID: 35890035 PMCID: PMC9318282 DOI: 10.3390/pathogens11070791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Revised: 07/10/2022] [Accepted: 07/11/2022] [Indexed: 11/16/2022] Open
Abstract
Although great strides have been achieved, schistosomiasis japonica remains a major public health concern in China. Immunodiagnostics have been widely accepted as the first choice in large-scale screening of Schistosoma japonicum human infections, and indirect hemagglutination test (IHA), enzyme-linked immunosorbent assay (ELISA), and dipstick dye immunoassay (DDIA) are currently the three most common immunological tests for the diagnosis of S. japonicum human infections in China. This meta-analysis aimed to comprehensively assess the performance of IHA, ELISA, and DDIA for the field diagnosis of S. japonicum human infections. A total of 37 eligible publications were enrolled in the final analysis, including 29 Chinese publications and 8 English publications. No significant heterogeneities were detected among the studies reporting ELISA (I2 = 88%, p < 0.05), IHA (I2 = 95%, p < 0.05), or DDIA (I2 = 84%, p < 0.05). DDIA showed the highest pooled sensitivity (90.8%, 95% CI: 84.6% to 94.7%) and IHA presented the highest pooled specificity for detection of S. japonicum human infections (71.6%, 95% CI: 65.9% to 76.7%). Summary receiver operating characteristic (SROC) curve analysis showed that IHA exhibited the highest area under the SROC curve (AUC) (0.88, 95% CI: 0.85 to 0.9), and ELISA presented the lowest AUC (0.85, 95% CI: 0.82 to 0.88). Deeks’ funnel plots indicated no publication bias. IHA presented the highest sensitivity in medium-endemicity regions and the highest specificity for diagnosis of S. japonicum human infections in low-endemicity regions, and ELISA showed the highest diagnostic sensitivity in high-endemicity regions and the highest specificity in medium-endemicity regions, while DDIA exhibited the highest diagnostic sensitivity in high-endemicity regions and the highest specificity in low-endemicity regions. IHA and DDIA presented a higher efficiency for the diagnosis of S. japonicum human infections in marshland and lake regions than in hilly and mountainous regions, while ELISA showed a comparable diagnostic sensitivity between in marshland and lake regions and hilly and mountainous regions (88.3% vs. 88.6%), and a higher specificity in marshland and lake regions than in hilly and mountainous regions (60% vs. 48%). Our meta-analysis demonstrates a comparable diagnostic accuracy of IHA, ELISA, and DDIA for S. japonicum human infections, and the diagnostic sensitivity and specificity of IHA, ELISA, and DDIA vary in types and infection prevalence of endemic regions. DDIA combined with IHA is recommended as a tool for screening chemotherapy targets and seroepidemiological surveys during the stage moving towards schistosomiasis elimination in China. Further studies to examine the effectiveness of combinations of two or three immunological tests for diagnosis of S. japonicum human infections are warranted.
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Affiliation(s)
- Zhongqiu Mei
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Key Laboratory of National Health Commission on Parasite and Vector Biology, WHO Collaborating Center for Tropical Diseases, Shanghai 200025, China; (Z.M.); (S.L.); (L.T.)
| | - Shan Lv
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Key Laboratory of National Health Commission on Parasite and Vector Biology, WHO Collaborating Center for Tropical Diseases, Shanghai 200025, China; (Z.M.); (S.L.); (L.T.)
| | - Liguang Tian
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Key Laboratory of National Health Commission on Parasite and Vector Biology, WHO Collaborating Center for Tropical Diseases, Shanghai 200025, China; (Z.M.); (S.L.); (L.T.)
| | - Wei Wang
- Key Laboratory of National Health Commission on Parasitic Disease Prevention and Control, Jiangsu Provincial Key Laboratory on Parasites and Vector Control Technology, Jiangsu Institute of Parasitic Diseases, Wuxi 214064, China
- Correspondence: (W.W.); (T.J.)
| | - Tiewu Jia
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Key Laboratory of National Health Commission on Parasite and Vector Biology, WHO Collaborating Center for Tropical Diseases, Shanghai 200025, China; (Z.M.); (S.L.); (L.T.)
- Correspondence: (W.W.); (T.J.)
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