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Rotejanaprasert C, Chuaicharoen P, Prada JM, Thantithaveewat T, Adisakwattana P, Pan-ngum W. Correction: 'Evaluation of Kato-Katz and multiplex quantitative polymerase chain reaction performance for clinical helminth infections in Thailand using a latent class analysis' (2023), by Rotejanaprasert et al.. Philos Trans R Soc Lond B Biol Sci 2024; 379:20230510. [PMID: 38310942 PMCID: PMC10838636 DOI: 10.1098/rstb.2023.0510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Accepted: 12/11/2023] [Indexed: 02/06/2024] Open
Affiliation(s)
- Chawarat Rotejanaprasert
- Department of Tropical Hygiene, Mahidol University, Bangkok, Thailand
- Mahidol-Oxford Tropical Medicine Research Unit (MORU), Mahidol University, Bangkok, Thailand
| | | | - Joaquin M. Prada
- Faculty of Health and Medical Sciences, School of Veterinary Medicine, University of Surrey, Guildford, UK
| | | | - Poom Adisakwattana
- Department of Helminthology, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Wirichada Pan-ngum
- Department of Tropical Hygiene, Mahidol University, Bangkok, Thailand
- Mahidol-Oxford Tropical Medicine Research Unit (MORU), Mahidol University, Bangkok, Thailand
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Rotejanaprasert C, Chuaicharoen P, Prada JM, Thantithaveewat T, Adisakwattana P, Pan-ngum W. Evaluation of Kato-Katz and multiplex quantitative polymerase chain reaction performance for clinical helminth infections in Thailand using a latent class analysis. Philos Trans R Soc Lond B Biol Sci 2023; 378:20220281. [PMID: 37598708 PMCID: PMC10440171 DOI: 10.1098/rstb.2022.0281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Accepted: 05/27/2023] [Indexed: 08/22/2023] Open
Abstract
Using an appropriate diagnostic tool is essential to soil-transmitted helminth control and elimination efforts. Kato-Katz (KK) is the most commonly used diagnostic, but recently other tools, such as real-time quantitative polymerase chain reaction (multiplex qPCR), are starting to be employed more. Here, we evaluated the performance of these two diagnostic tools for five helminth species in Thailand. In the absence of a gold standard, diagnostic performance can be evaluated using latent class analysis. Our results suggest that in moderate to high prevalence settings above 2% multiplex qPCR could be more sensitive than KK, this was particularly apparent for Opisthorchis viverrini in the northeastern provinces. However, for low prevalence, both diagnostics suffered from low sensitivity. Specificity of both diagnostics was estimated to be high (above 70%) across all settings. For some specific helminth infection such as O. viverrini, multiplex qPCR is still a preferable choice of diagnostic test. KK performed equally well in detecting Ascaris lumbricoides and Taenia solium when the prevalence is moderate to high (above 2%). Neither test performed well when the prevalence of infection is low (below 2%), and certainly in the case for hookworm and Trichuris trichiura. Combination of two or more diagnostic tests can improve the performance although the cost would be high. Development of new methods for helminth surveillance at the pre-elimination phase is therefore very important. This article is part of the theme issue 'Challenges and opportunities in the fight against neglected tropical diseases: a decade from the London Declaration on NTDs'.
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Affiliation(s)
- Chawarat Rotejanaprasert
- Department of Tropical Hygiene, Mahidol University, Bangkok, Thailand
- Mahidol-Oxford Tropical Medicine Research Unit (MORU), Mahidol University, Bangkok, Thailand
| | | | - Joaquin M. Prada
- Faculty of Health and Medical Sciences, School of Veterinary Medicine, University of Surrey, Guildford, UK
| | | | - Poom Adisakwattana
- Department of Helminthology, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Wirichada Pan-ngum
- Department of Tropical Hygiene, Mahidol University, Bangkok, Thailand
- Mahidol-Oxford Tropical Medicine Research Unit (MORU), Mahidol University, Bangkok, Thailand
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Ding X, Yang Y, Zhang Y, Zhang Q, Mao F, Dai Y. Establishment of a Simple and Rapid Nucleic Acid Detection Method for Hookworm Identification. Pathogens 2023; 12:pathogens12040630. [PMID: 37111516 PMCID: PMC10142964 DOI: 10.3390/pathogens12040630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 04/17/2023] [Accepted: 04/18/2023] [Indexed: 04/29/2023] Open
Abstract
Hookworm infection is one of the most common neglected tropical diseases and is mainly found in tropical and subtropical areas. Two species of human hookworm are distributed in China, i.e., Ancylostoma duodenale (AD) and Necator americanus (NA). BACKGROUND Traditional microscopic technology such as the Kato-Katz method is not suitable for hookworm diagnosis due to the rapid degeneration of fragile hookworm eggs or for species identification of hookworm infection. The aim of the present study was to establish and evaluate a novel nucleic acid detection method based on recombinase-aided isothermal amplification (RAA) for the detection of hookworm infections and species identification. METHODS Based on the specific target gene sequences of hookworms (5.8S rRNA for AD and ITS2 for NA, respectively), we designed and synthesized amplification primers and fluorescence probes referring to the principle of the fluorescence recombinase-aided amplification (RAA) technique. RESULTS Each assay provided specific amplification of larval DNA from AD and NA by fluorescence RAA, and the detection limits in plasmids reached 102 copies and 10 copies, respectively. Genomic DNA of two hookworm species was successfully detected at a concentration of 0.1 pg/μL, revealing a high detection sensitivity. No positive amplification occurred for genomic DNA from crossed hookworm species and genomic DNA from Cryptosporidium, Giardia lamblia, Strongyloides stercoralis, Schistosoma japonicum, Ascaris lumbricoides, and Clonorchis sinensis, revealing a satisfactory specificity. Fecal sample detection results demonstrated a similar efficacy to the Kato-Katz method; however, it had a greater sensitivity than the larvae culture method. CONCLUSION A simple and rapid nucleic acid method was successfully established based on RAA, which improved the detection efficacy and species identification for human hookworm infections.
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Affiliation(s)
- Xin Ding
- Key Laboratory of National Health Commission on Parasitic Disease Control and Prevention, Key Laboratory of Jiangsu Province on Parasite and Vector Control Technology, Jiangsu Institute of Parasitic Diseases, Wuxi 214064, China
| | - Yougui Yang
- School of Public Health, Nanjing Medical University, Nanjing 211166, China
| | - Yingshu Zhang
- School of Public Health, Nanjing Medical University, Nanjing 211166, China
| | - Qiang Zhang
- Key Laboratory of National Health Commission on Parasitic Disease Control and Prevention, Key Laboratory of Jiangsu Province on Parasite and Vector Control Technology, Jiangsu Institute of Parasitic Diseases, Wuxi 214064, China
| | - Fanzhen Mao
- Key Laboratory of National Health Commission on Parasitic Disease Control and Prevention, Key Laboratory of Jiangsu Province on Parasite and Vector Control Technology, Jiangsu Institute of Parasitic Diseases, Wuxi 214064, China
| | - Yang Dai
- Key Laboratory of National Health Commission on Parasitic Disease Control and Prevention, Key Laboratory of Jiangsu Province on Parasite and Vector Control Technology, Jiangsu Institute of Parasitic Diseases, Wuxi 214064, China
- School of Public Health, Nanjing Medical University, Nanjing 211166, China
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Alade T, Ta-Tang TH, Nassar SA, Akindele AA, Capote-Morales R, Omobami TB, Berzosa P. Prevalence of Schistosoma haematobium and Intestinal Helminth Infections among Nigerian School Children. Diagnostics (Basel) 2023; 13. [PMID: 36832247 DOI: 10.3390/diagnostics13040759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Revised: 02/03/2023] [Accepted: 02/14/2023] [Indexed: 02/19/2023] Open
Abstract
Schistosomiasis and soil-transmitted helminthiases (STH) are two parasitic diseases mainly affecting school children. The purpose of this study was to estimate the current prevalence and infection intensity, in addition to the associations of these infections with age and sex, in children aged 4-17 years living in Osun State, Nigeria. From each participant (250 children), one urine and one stool sample were taken for the study, for the microscopic detection of eggs or larvae in faeces by means of the Kato-Katz method and eggs in filtrated urine. The overall prevalence of urinary schistosomiasis was 15.20%, with light infection. The intestinal helminthic species identified (and their prevalence) were S. stercoralis (10.80%), S. mansoni (8%), A. lumbricoides (7.20%), hookworm (1.20%), and T. trichiura (0.4%), all of them being classified as light infections. Single infections (67.95%) are more frequent than multiple infections (32.05%). With this study, schistosomiasis and STH are still endemic in Osun State, but with a light to moderate prevalence and light infection intensity. Urinary infection was the most prevalent, with higher prevalence in children over 10 years. The >10 years age group had the highest prevalence for all of the intestinal helminths. There were no statistically significant associations between gender and age and urogenital or intestinal parasites.
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Menezes DL, Santos CTJ, Oliveira YLDC, Campos VTC, Negrão-Corrêa DA, Geiger SM, Silva JRS, Jain S, Oliveira LM, Fujiwara RT, Graeff-Teixeira C, Dolabella SS. Accuracy Study of Kato-Katz and Helmintex Methods for Diagnosis of Schistosomiasis Mansoni in a Moderate Endemicity Area in Sergipe, Northeastern Brazil. Diagnostics (Basel) 2023; 13. [PMID: 36766631 DOI: 10.3390/diagnostics13030527] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 01/24/2023] [Accepted: 01/29/2023] [Indexed: 02/04/2023] Open
Abstract
Schistosomiasis is a neglected tropical disease (NTD) caused by blood flukes from the genus Schistosoma. Brazil hosts the main endemic area in the Americas, where Schistosoma mansoni is the only species causing the disease. Kato-Katz (KK) thick smear is the WHO recommended screening test for populational studies, but there is growing evidence for the sensitivity limitations associated with KK, especially in areas with low parasite loads. Helmintex (HTX) is another highly sensitive egg-detection method, based on the magnetic properties of S. mansoni eggs and their isolation in a magnetic field. The objective of this study is to evaluate both KK and HTX in a moderate endemic locality, Areia Branca, located in the municipality of Pacatuba, in the state of Sergipe in northeastern Brazil. From 234 individual fecal samples, two KK thick smears were prepared and evaluated for each sample. Similarly, 30 g of each fecal sample was processed by HTX protocol. Eggs were detected in 80 (34.18%) residents. Twenty-three (9.83%) samples were positive for eggs (only by KK), and 77 (32.91%) samples showed positive for eggs (only by HTX). Sensitivity, specificity, and accuracy estimates gave values of 28.75%, 100% and 75.64%, respectively, for KK, and 96.25%, 100% and 98.72% respectively, for HTX. The positive predictive value was 100% for both methods, while the negative predictive value was 72.99% for KK and 98.09% for HTX. Overall, HTX presented a superior performance compared to the one sample, two slides KK examination. The study confirms the role of HTX as a reference method for the definition of true-positive samples in comparative accuracy studies and its potential role in the late stages when the certification of schistosomiasis transmission interruption is required. Diagnostic tests are important tools for the elimination of this NTD, besides the effective implementation of safe water, basic sanitation, snail control, and the treatment of infected populations.
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Machrumnizar M, Devita A, Yuliana Y, Tan S. Application of Ziehl Neelsen Staining Method for Taenia spp. Eggs Differentiation. Iran J Parasitol 2022; 17:332-338. [PMID: 36466028 PMCID: PMC9682374 DOI: 10.18502/ijpa.v17i3.10623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 04/11/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Three of Taenia species, named Taenia saginata, T. solium and T. asiatica can be found in Indonesia, but only T. solium can lead to neurocysticercosis. The morphology of those 3 Taenia spp. egg is indistinguishable by standard parasitology procedure. We aimed to use Ziehl Neelsen staining for differentiation of eggs of T. saginata and T. solium. METHODS As many as 40 containers of stool samples from the positive helminthiasis patients in Jakarta, Indonesia were collected during the year 2018. From each container, 10 slides prepared for staining with Kato-Katz technique as the preliminary examination. From those stool samples with positive taeniasis, we then once again made 10 slides/container for Ziehl Neelsen staining. RESULTS The first 400 slides stained with Kato-Katz technique as preliminary test were all positive for Taenia spp. The second 400 slides, we got 244 slides that gave good results as we could distinguished between the eggs of T. saginata and T. solium, meanwhile the remainder 156 slides gave unconfirmed results. From those 244 slides, 154 slides showed T. saginata eggs with magenta colored and 90 slides showed T. solium eggs with blue/purple colored. The eggs of T. solium slightly smaller if compared to Taenia saginata and had round shape, meanwhile T. saginata eggs were oval in shape. CONCLUSION Ziehl Neelsen staining method can be used as an alternative parasitological method to differentiate the eggs of T. saginata and T. solium.
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Affiliation(s)
| | - Arleen Devita
- Department of Microbiology, Faculty of Medicine, Trisakti University, Jakarta, Indonesia
| | - Yuliana Yuliana
- Department of Parasitology, Faculty of Medicine, Trisakti University, Jakarta, Indonesia
| | - Suriyani Tan
- Department of Parasitology, Faculty of Medicine, Trisakti University, Jakarta, Indonesia
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Kopolrat KY, Singthong S, Khuntikeo N, Loilome W, Worasith C, Homwong C, Wangboon C, Yasaka P, Eamudomkarn C, Pitaksakulrat O, Tonkhamhak K, Paeyo A, Crellen T, Sithithaworn J, Sithithaworn P. Performance of Mini Parasep ® SF stool concentrator kit, Kato-Katz, and formalin-ethyl acetate concentration methods for diagnosis of opisthorchiasis in Northeast Thailand. Parasit Vectors 2022; 15:234. [PMID: 35761311 PMCID: PMC9235228 DOI: 10.1186/s13071-022-05338-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 05/24/2022] [Indexed: 11/25/2022] Open
Abstract
Background Control and elimination of the liver fluke (Opisthorchis viverrini) is a primary preventive strategy against cholangiocarcinoma in Southeast Asia. A sensitive parasitological diagnostic method is required to facilitate a surveillance and control program. In this study, we evaluated the performance of Mini Parasep® SF stool concentrator kit (stool kit) compared with Kato-Katz (KK) and the quantitative formalin-ethyl acetate concentration technique (FECT) for detection of O. viverrini and co-endemic parasitic infections. Methods A cross-sectional survey for parasitic infection in residents aged > 15 years in a community in Kalasin province, Northeast Thailand, was conducted in 2018. Fecal samples were collected and screened by KK method, and a subset of samples was further examined by the stool kit and FECT methods. The results were analyzed for prevalence of parasitic infections in addition to the diagnostic performance of the methods for qualitative and quantitative detection of helminthiases. Results The initial survey of parasitic infection determined by the KK method (n = 567) showed the prevalence of O. viverrini was 32.63%, followed by Taenia 2.65%, echinostomes 1.76%, hookworms 1.41%, Trichuris trichiura 0.53% and Strongyloides stercoralis 0.53%. Within a subset of samples tested with multiple diagnostics (n = 150), the detection rates of O. viverrini by the stool kit, FECT and KK methods were 27.3%, 30.7% and 28.7%, respectively. The diagnostic sensitivity for opisthorchiasis was similar for FECT (75.5%), KK(66.0%) and the stool kit (67.3%). For other parasitic infections, FECT and stool kit methods performed better than KK, particularly in detecting minute intestinal flukes (MIF), S. stercoralis and coinfections. When measuring the intensity of O. viverrini infection (fecal egg counts), the stool kit results showed a significant positive correlation with KK and FECT (P < 0.05). Conclusions As the stool kit is simple to use and shows a comparable performance to FECT, it may serve as an alternative method of fecal examination for screening of helminthiasis including opisthorchiasis. Graphical abstract ![]()
Supplementary Information The online version contains supplementary material available at 10.1186/s13071-022-05338-z.
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Affiliation(s)
- Kulthida Y Kopolrat
- Faculty of Public Health, Kasetsart University Chalermphrakiat Sakon Nakhon Province Campus, Sakon Nakhon, Thailand.,Cholangiocarcinoma Research Institute and Department of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Seri Singthong
- The Office of Disease Prevention and Control 7 Khon Kaen, Department of Disease Control, Ministry of Public Health, Khon Kaen, Thailand
| | - Narong Khuntikeo
- Cholangiocarcinoma Research Institute and Department of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.,Department of Surgery, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Watcharin Loilome
- Cholangiocarcinoma Research Institute and Department of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.,Department of Biochemistry, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Chanika Worasith
- Cholangiocarcinoma Research Institute and Department of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.,Department of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Chutima Homwong
- Cholangiocarcinoma Research Institute and Department of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Chompunoot Wangboon
- School of Pre Clinic, Institute of Science, Suranaree University of Technology, Nakhon Ratchasima, Thailand
| | - Patiwat Yasaka
- Faculty of Management Technology, Rajamangala University of Technology Isan, Surin Campus, Surin, Thailand
| | - Chatanun Eamudomkarn
- Department of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Opal Pitaksakulrat
- Department of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Krisnakorn Tonkhamhak
- Cholangiocarcinoma Research Institute and Department of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Arunee Paeyo
- Cholangiocarcinoma Research Institute and Department of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Thomas Crellen
- Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow, Graham Kerr Building, Glasgow, G12 8QQ, UK.,Big Data Institute, Nuffield Department of Medicine, University of Oxford, Oxford, OX3 7LF, UK
| | | | - Paiboon Sithithaworn
- Cholangiocarcinoma Research Institute and Department of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand. .,Department of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.
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Clark J, Moses A, Nankasi A, Faust CL, Moses A, Ajambo D, Besigye F, Atuhaire A, Wamboko A, Carruthers LV, Francoeur R, Tukahebwa EM, Prada JM, Lamberton PHL. Reconciling Egg- and Antigen-Based Estimates of Schistosoma mansoni Clearance and Reinfection: A Modeling Study. Clin Infect Dis 2022; 74:1557-1563. [PMID: 34358299 PMCID: PMC9070857 DOI: 10.1093/cid/ciab679] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Despite decades of interventions, 240 million people have schistosomiasis. Infections cannot be directly observed, and egg-based Kato-Katz thick smears lack sensitivity, affected treatment efficacy and reinfection rate estimates. The point-of-care circulating cathodic antigen (referred to from here as POC-CCA+) test is advocated as an improvement on the Kato-Katz method, but improved estimates are limited by ambiguities in the interpretation of trace results. METHOD We collected repeated Kato-Katz egg counts from 210 school-aged children and scored POC-CCA tests according to the manufacturer's guidelines (referred to from here as POC-CCA+) and the externally developed G score. We used hidden Markov models parameterized with Kato-Katz; Kato-Katz and POC-CCA+; and Kato-Katz and G-Scores, inferring latent clearance and reinfection probabilities at four timepoints over six-months through a more formal statistical reconciliation of these diagnostics than previously conducted. Our approach required minimal but robust assumptions regarding trace interpretations. RESULTS Antigen-based models estimated higher infection prevalence across all timepoints compared with the Kato-Katz model, corresponding to lower clearance and higher reinfection estimates. Specifically, pre-treatment prevalence estimates were 85% (Kato-Katz; 95% CI: 79%-92%), 99% (POC-CCA+; 97%-100%) and 98% (G-Score; 95%-100%). Post-treatment, 93% (Kato-Katz; 88%-96%), 72% (POC-CCA+; 64%-79%) and 65% (G-Score; 57%-73%) of those infected were estimated to clear infection. Of those who cleared infection, 35% (Kato-Katz; 27%-42%), 51% (POC-CCA+; 41%-62%) and 44% (G-Score; 33%-55%) were estimated to have been reinfected by 9-weeks. CONCLUSIONS Treatment impact was shorter-lived than Kato-Katz-based estimates alone suggested, with lower clearance and rapid reinfection. At 3 weeks after treatment, longer-term clearance dynamics are captured. At 9 weeks after treatment, reinfection was captured, but failed clearance could not be distinguished from rapid reinfection. Therefore, frequent sampling is required to understand these important epidemiological dynamics.
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Affiliation(s)
- Jessica Clark
- Wellcome Centre for Integrative Parasitology, Institute of Biodiversity, Animal Health & Comparative Medicine, University of Glasgow, Glasgow, United Kingdom
| | | | | | - Christina L Faust
- Wellcome Centre for Integrative Parasitology, Institute of Biodiversity, Animal Health & Comparative Medicine, University of Glasgow, Glasgow, United Kingdom
| | - Adriko Moses
- Vector Control Division, Ministry of Health, Uganda
| | - Diana Ajambo
- Vector Control Division, Ministry of Health, Uganda
| | - Fred Besigye
- Vector Control Division, Ministry of Health, Uganda
| | | | | | - Lauren V Carruthers
- Wellcome Centre for Integrative Parasitology, Institute of Biodiversity, Animal Health & Comparative Medicine, University of Glasgow, Glasgow, United Kingdom
| | - Rachel Francoeur
- Wellcome Centre for Integrative Parasitology, Institute of Biodiversity, Animal Health & Comparative Medicine, University of Glasgow, Glasgow, United Kingdom
- Faculty of Science & Engineering, University of Chester, Chester, United Kingdom
| | | | - Joaquin M Prada
- Faculty of Health & Medical Sciences, University of Surrey, Guildford, United Kingdom
| | - Poppy H L Lamberton
- Wellcome Centre for Integrative Parasitology, Institute of Biodiversity, Animal Health & Comparative Medicine, University of Glasgow, Glasgow, United Kingdom
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Chieng B, Okoyo C, Simiyu E, Gichuki P, Mwatele C, Kepha S, Njenga S, Mburu D. Comparison of quantitative polymerase chain reaction, Kato-Katz and circulating cathodic antigen rapid test for the diagnosis of Schistosoma mansoni infection: A cross-sectional study in Kirinyaga County, Kenya. Curr Res Parasitol Vector Borne Dis 2022; 1:100029. [PMID: 35284880 PMCID: PMC8906081 DOI: 10.1016/j.crpvbd.2021.100029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 05/11/2021] [Accepted: 05/14/2021] [Indexed: 01/11/2023]
Abstract
The current standard diagnostic tests for Schistosoma mansoni are the Kato-Katz and circulating cathodic antigen (CCA) techniques. However, these techniques have been documented to have several limitations that have a direct impact on schistosomiasis control programmes. Therefore, there is a need for more sensitive and specific tests for diagnosing schistosomiasis. This study compared the performance of quantitative polymerase chain reaction (qPCR), Kato-Katz, and point-of-care circulating cathodic antigen (POC-CCA) techniques in the diagnosis of S. mansoni infection in the Mwea irrigation scheme, Kirinyaga County in Central Kenya. We carried out a cross-sectional study on 357 individuals residing in four villages in the Mwea irrigation scheme. The participants provided urine and stool samples which were screened for S. mansoni infections using the three techniques. The prevalence of S. mansoni by each technique was calculated and 95% confidence intervals estimated using binomial regression model. Sensitivity and specificity were determined using 2 × 2 contingency tables and compared using the McNemar’s chi-square test. Positive and negative predictive values were also determined using the weighted generalized score chi-square test for paired data. The study showed that the prevalence of S. mansoni was 32.8%, 62.5% and 72.8% using Kato-Katz, POC-CCA and qPCR techniques, respectively. Further, when using Kato-Katz as a gold standard, POC-CCA sensitivity was 78.6% and specificity was 45.4%, while qPCR sensitivity was 97.4% and specificity was 39.2%. When using qPCR as the gold standard, Kato-Katz sensitivity was 43.8% and specificity was 96.9%, while POC-CCA sensitivity was 78.1% and specificity was 79.4%. Finally, when using the averaged results from the three techniques as the gold standard, the sensitivity was 41.6%, 79.4% and 92.5% for Kato-Katz, POC-CCA and qPCR, respectively, with a specificity of 100% for all techniques. Kato-Katz technique showed low sensitivity compared to the POC-CCA and qPCR despite it being the most commonly preferred method of choice to diagnose S. mansoni infections. qPCR showed superior sensitivity followed by POC-CCA, hence it can be used as an alternative or to confirm the results obtained by the Kato-Katz technique. Comparison of the performance of Kato-Katz, POC-CCA and qPCR for diagnosis of S. mansoni in Kirinyaga County, Kenya. A total of 357 urine and stool samples were tested for S. mansoni infection. qPCR estimated the highest prevalence followed by POC-CCA and Kato-Katz. qPCR showed a generally high sensitivity and specificity.
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Affiliation(s)
- Benard Chieng
- Eastern & Southern Africa Centre of International Parasite Control (ESACIPAC), Kenya Medical Research Institute (KEMRI), PO BOX 54840-00200, Nairobi, Kenya.,Department of Microbiology, Biotechnology and Biochemistry, Kenyatta University, Nairobi, Kenya
| | - Collins Okoyo
- Eastern & Southern Africa Centre of International Parasite Control (ESACIPAC), Kenya Medical Research Institute (KEMRI), PO BOX 54840-00200, Nairobi, Kenya
| | - Elses Simiyu
- Eastern & Southern Africa Centre of International Parasite Control (ESACIPAC), Kenya Medical Research Institute (KEMRI), PO BOX 54840-00200, Nairobi, Kenya
| | - Paul Gichuki
- Eastern & Southern Africa Centre of International Parasite Control (ESACIPAC), Kenya Medical Research Institute (KEMRI), PO BOX 54840-00200, Nairobi, Kenya
| | - Cassian Mwatele
- Eastern & Southern Africa Centre of International Parasite Control (ESACIPAC), Kenya Medical Research Institute (KEMRI), PO BOX 54840-00200, Nairobi, Kenya
| | - Stella Kepha
- Eastern & Southern Africa Centre of International Parasite Control (ESACIPAC), Kenya Medical Research Institute (KEMRI), PO BOX 54840-00200, Nairobi, Kenya
| | - Sammy Njenga
- Eastern & Southern Africa Centre of International Parasite Control (ESACIPAC), Kenya Medical Research Institute (KEMRI), PO BOX 54840-00200, Nairobi, Kenya
| | - David Mburu
- Department of Microbiology, Biotechnology and Biochemistry, Kenyatta University, Nairobi, Kenya
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Gordon CA, Williams GM, Gray DJ, Clements ACA, Zhou XN, Li Y, Utzinger J, Kurscheid J, Forsyth S, Addis Alene K, Zhou J, Li Z, Li G, Lin D, Lou Z, Li S, Ge J, Xu J, Yu X, Hu F, Xie S, Chen J, Shi T, Li C, Zheng H, McManus DP. Schistosomiasis in the People's Republic of China - down but not out. Parasitology 2022; 149:218-233. [PMID: 35234601 PMCID: PMC11010531 DOI: 10.1017/s0031182021001724] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 09/30/2021] [Accepted: 10/01/2021] [Indexed: 11/06/2022]
Abstract
Schistosomiasis has been subjected to extensive control efforts in the People's Republic of China (China) which aims to eliminate the disease by 2030. We describe baseline results of a longitudinal cohort study undertaken in the Dongting and Poyang lakes areas of central China designed to determine the prevalence of Schistosoma japonicum in humans, animals (goats and bovines) and Oncomelania snails utilizing molecular diagnostics procedures. Data from the Chinese National Schistosomiasis Control Programme (CNSCP) were compared with the molecular results obtained.Sixteen villages from Hunan and Jiangxi provinces were surveyed; animals were only found in Hunan. The prevalence of schistosomiasis in humans was 1.8% in Jiangxi and 8.0% in Hunan determined by real-time polymerase chain reaction (PCR), while 18.3% of animals were positive by digital droplet PCR. The CNSCP data indicated that all villages harboured S. japonicum-infected individuals, detected serologically by indirect haemagglutination assay (IHA), but very few, if any, of these were subsequently positive by Kato-Katz (KK).Based on the outcome of the IHA and KK results, the CNSCP incorporates targeted human praziquantel chemotherapy but this approach can miss some infections as evidenced by the results reported here. Sensitive molecular diagnostics can play a key role in the elimination of schistosomiasis in China and inform control measures allowing for a more systematic approach to treatment.
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Affiliation(s)
- Catherine A. Gordon
- Department of Immunology, Molecular Parasitology Laboratory, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Gail M. Williams
- School of Population Health, Discipline of Epidemiology and Biostatistics, University of Queensland, Brisbane, Australia
| | - Darren J. Gray
- Department of Global Health, Research School of Population Health, Australian National University, Canberra, Australia
| | | | - Xiao-Nong Zhou
- National Institute of Parasitic Diseases, Shanghai, People's Republic of China
| | - Yuesheng Li
- Department of Immunology, Molecular Parasitology Laboratory, QIMR Berghofer Medical Research Institute, Brisbane, Australia
- Hunan Institute of Schistosomiasis Control, Yueyang, Hunan, People's Republic of China
| | - Jürg Utzinger
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Johanna Kurscheid
- Department of Global Health, Research School of Population Health, Australian National University, Canberra, Australia
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Simon Forsyth
- School of Population Health, Discipline of Epidemiology and Biostatistics, University of Queensland, Brisbane, Australia
| | | | - Jie Zhou
- Hunan Institute of Schistosomiasis Control, Yueyang, Hunan, People's Republic of China
| | - Zhaojun Li
- Jiangxi Institute of Parasitic Diseases, Jiangxi, People's Republic of China
| | - Guangpin Li
- Hunan Institute of Schistosomiasis Control, Yueyang, Hunan, People's Republic of China
| | - Dandan Lin
- Jiangxi Institute of Parasitic Diseases, Jiangxi, People's Republic of China
| | - Zhihong Lou
- Hunan Institute of Schistosomiasis Control, Yueyang, Hunan, People's Republic of China
| | - Shengming Li
- Hunan Institute of Schistosomiasis Control, Yueyang, Hunan, People's Republic of China
| | - Jun Ge
- Jiangxi Institute of Parasitic Diseases, Jiangxi, People's Republic of China
| | - Jing Xu
- National Institute of Parasitic Diseases, Shanghai, People's Republic of China
| | - Xinling Yu
- Hunan Institute of Schistosomiasis Control, Yueyang, Hunan, People's Republic of China
| | - Fei Hu
- Jiangxi Institute of Parasitic Diseases, Jiangxi, People's Republic of China
| | - Shuying Xie
- Jiangxi Institute of Parasitic Diseases, Jiangxi, People's Republic of China
| | - Jie Chen
- Chinese National Human Genome Center, Shanghai, People's Republic of China
| | - Tao Shi
- Chinese National Human Genome Center, Shanghai, People's Republic of China
| | - Chong Li
- Chinese National Human Genome Center, Shanghai, People's Republic of China
| | - Huajun Zheng
- Chinese National Human Genome Center, Shanghai, People's Republic of China
| | - Donald P. McManus
- Department of Immunology, Molecular Parasitology Laboratory, QIMR Berghofer Medical Research Institute, Brisbane, Australia
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Kaliappan S, Ramanujam K, Manuel M, Farzana J, Janagaraj V, Laxmanan S, Muliyil J, Sarkar R, Kang G, Walson J, Ajjampur S. Soil-transmitted helminth infections after mass drug administration for lymphatic filariasis in rural southern India. Trop Med Int Health 2021; 27:81-91. [PMID: 34704320 DOI: 10.1111/tmi.13697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVES Targeted deworming is the current strategy for control of morbidity associated with soil-transmitted helminths (STH) among at-risk populations: preschool-aged children, school-aged children and women of childbearing age. We report the prevalence and intensity of STH in a district after lymphatic filariasis (LF) mass drug administration (MDA) in southern India where albendazole was co-administered from 2001. METHODS Children aged 2 to 15 years and adults (defined as ≥15 years) in a rural administrative block of Tamil Nadu were recruited using a probability proportional to size method. Stool samples were screened and eggs per gram (EPG) determined by Kato-Katz method. Multilevel logistic regression (MLR) and multilevel negative binomial regression (MNBR) analyses were used to identify factors associated with infection and intensity, respectively. RESULTS Of 862 participants who provided samples, 60 (7.0%; 95% confidence interval (CI): 5.3-8.7) were positive for STH with a predominance of hookworm infections (n = 57, 6.6%; 95% CI: 5.0-8.3). Increasing age (odds ratio (OR): 1.09; 95% CI: 1.04-1.15) and regular usage of the toilet (OR: 0.32; 95% CI: 0.12-0.88) were independently associated with hookworm infection and age was significantly associated with increasing intensity of hookworm infection (infection intensity ratio (IIR): 1.28; 95% CI: 1.19-1.37). A brief review of STH prevalence in endemic settings before and after the stoppage of LF MDA indicated that, in most settings, a substantial reduction in STH prevalence is seen. CONCLUSION Community-wide MDA in all age groups in these post-LF MDA districts with low prevalence and light intensity infections could result in transmission interruption of STH.
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Affiliation(s)
- Saravanakumar Kaliappan
- The Wellcome Trust Research Laboratory, Division of Gastrointestinal Sciences, Christian Medical College Vellore, Tamil Nadu, India
| | - Karthikeyan Ramanujam
- The Wellcome Trust Research Laboratory, Division of Gastrointestinal Sciences, Christian Medical College Vellore, Tamil Nadu, India
| | - Malathi Manuel
- The Wellcome Trust Research Laboratory, Division of Gastrointestinal Sciences, Christian Medical College Vellore, Tamil Nadu, India
| | - Jasmine Farzana
- The Wellcome Trust Research Laboratory, Division of Gastrointestinal Sciences, Christian Medical College Vellore, Tamil Nadu, India
| | - Venkateshprabhu Janagaraj
- The Wellcome Trust Research Laboratory, Division of Gastrointestinal Sciences, Christian Medical College Vellore, Tamil Nadu, India
| | - Selvi Laxmanan
- The Wellcome Trust Research Laboratory, Division of Gastrointestinal Sciences, Christian Medical College Vellore, Tamil Nadu, India
| | - Jayaprakash Muliyil
- The Wellcome Trust Research Laboratory, Division of Gastrointestinal Sciences, Christian Medical College Vellore, Tamil Nadu, India
| | - Rajiv Sarkar
- The Wellcome Trust Research Laboratory, Division of Gastrointestinal Sciences, Christian Medical College Vellore, Tamil Nadu, India
| | - Gagandeep Kang
- The Wellcome Trust Research Laboratory, Division of Gastrointestinal Sciences, Christian Medical College Vellore, Tamil Nadu, India
| | - Judd Walson
- Departments of Global Health, Medicine (Infectious Disease), Paediatrics & Epidemiology, University of Washington, Seattle, Washington, USA
| | - Sitara Ajjampur
- The Wellcome Trust Research Laboratory, Division of Gastrointestinal Sciences, Christian Medical College Vellore, Tamil Nadu, India
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12
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Cai P, Mu Y, Weerakoon KG, Olveda RM, Ross AG, McManus DP. Performance of the point-of-care circulating cathodic antigen test in the diagnosis of schistosomiasis japonica in a human cohort from Northern Samar, the Philippines. Infect Dis Poverty 2021; 10:121. [PMID: 34556183 PMCID: PMC8460201 DOI: 10.1186/s40249-021-00905-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Accepted: 09/09/2021] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Zoonotic schistosomiasis, caused by Schistosoma japonicum, remains a major public health problem in the Philippines. This study aimed to evaluate the commercially available rapid diagnostic point-of-care circulating cathodic antigen (POC-CCA) test in detecting individuals infected with S. japonicum in a human cohort from an endemic area for schistosomiasis japonica in the Philippines. METHODS Clinical samples were collectedin 18 barangays endemic for S. japonicum infection in Laoang and Palapag municipalities, Northern Samar, the Philippines, in 2015. The presence of CCA in filter-concentrated urine samples (n = 412) was evaluated using the commercial kits and the results were converted to images, which were further analyzed by ImageJ software to calculate R values. The diagnostic performance of the immunochromatographic POC-CCA test was compared using the Kato-Katz (KK) procedure, in-house enzyme-linked immunosorbent assays (ELISAs) and droplet digital (dd) PCR assays as reference. RESULTS The POC-CCA test was able to detect S. japonicum-infected individuals in the cohort with an eggs per gram of faeces (EPG) more than or equal to 10 with sensitivity/specificity values of 63.3%/93.3%. However, the assay showed an inability to diagnose schistosomiasis japonica infections in all cohort KK-positive individuals, of which the majority had an extremely low egg burden (EPG: 1-9). The prevalence of S. japonicum infection in the total cohort determined by the POC-CCA test was 12.4%, only half of that determined by the KK method (26.2%). When compared with the ELISAs and ddPCR assays as a reference, the POC-CCA assay was further shown to be a test with low sensitivity. Nevertheless, the assay exhibited significant positive correlations with egg burden determined by the KK technique and the target gene copy number index values determined by the ddPCR assays within the entire cohort. CONCLUSIONS By using in silico image analysis, the POC-CCA cassette test could be converted to a quantitative assay to avoid reader-variability. Because of its low sensitivity, the commercially available POC-CCA assay had limited potential for determining the status of a S. japonicum infection in the target cohort. The assay should be applied with caution in populations where schistosome parasites (especially S. japonicum) are present at low infection intensity.
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Affiliation(s)
- Pengfei Cai
- Molecular Parasitology Laboratory, Infectious Diseases Program, QIMR Berghofer Medical Research Institute, Brisbane, Australia.
| | - Yi Mu
- Molecular Parasitology Laboratory, Infectious Diseases Program, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Kosala G Weerakoon
- Molecular Parasitology Laboratory, Infectious Diseases Program, QIMR Berghofer Medical Research Institute, Brisbane, Australia
- Department of Parasitology, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Saliyapura, Sri Lanka
| | - Remigio M Olveda
- Department of Health, Research Institute for Tropical Medicine, Manila, Philippines
| | | | - Donald P McManus
- Molecular Parasitology Laboratory, Infectious Diseases Program, QIMR Berghofer Medical Research Institute, Brisbane, Australia
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Graeff-Teixeira C, Favero V, Pascoal VF, de Souza RP, Rigo FDV, Agnese LHD, Bezerra FSM, Coelho PMZ, Enk MJ, Favre TC, Katz N, Oliveira RR, Dos Reis MG, Pieri OS. Low specificity of point-of-care circulating cathodic antigen (POCCCA) diagnostic test in a non-endemic area for schistosomiasis mansoni in Brazil. Acta Trop 2021; 217:105863. [PMID: 33587944 DOI: 10.1016/j.actatropica.2021.105863] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 02/01/2021] [Accepted: 02/08/2021] [Indexed: 02/08/2023]
Abstract
A point-of-care test for detecting schistosome circulating cathodic antigen in urine (POCCCA) has been proposed for mapping infection and defining prevalence thresholds for mass drug administration (MDA). However, there is increasing evidence that POCCCA may yield false-positive results, which requires rigorous specificity evaluation in non-endemic areas. POCCCA was applied in an area known to be free from infection and devoid of any condition for schistosomiasis transmission as part of a multicentre study to evaluate the performance of POCCCA in Brazil's low or potentially endemic settings. Besides POCCCA detection in urine, a search for eggs in stool was performed by Kato-Katz (KK) and Helmintex (HTX) methods. One-hundred-and-seventy-four participants returned urine samples, 140 of which delivered stool samples. All these were HTX-negative for Schistosoma mansoni, and all 118 tested with KK were negative for both S. mansoni and soil-transmitted helminths. POCCCA results from freshly collected urine yielded a specificity of 62.1% (95% CI: 53.6% - 70.2%), taking trace outcomes as positive according to the manufacturer's instructions. Retesting urine from the 140 HTX-negatives after one-year storage at -20 °C with two new POCCCA batches simultaneously yielded significantly different specificities (34.3%; 95%CI: 26.5% - 42.8% and 75.0%; 95% CI: 67.0% - 81.9%). These two batches had a weak agreement (Cohen's kappa: 0.56; 95%CI: 0.44-0.68) among the 174 urine samples retested. At present, POCCCA cannot be recommended either as a cut-off point for MDA or a reliable diagnostic tool for treatment of the infection carriers (selective chemotherapy) in low endemic areas and at final stages of transmission interruption. Manufacturers should be required to optimize production standardization and to assure quality and reproducibility of the test. Extended rigorous performance evaluations by different users from different regions are needed before POCCCA is widely recommended.
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Affiliation(s)
- Carlos Graeff-Teixeira
- Infectious Diseases Unit (NDI), Center for Health Sciences, Universidade Federal do Espírito Santo, Vitória, ES, Brazil; Research Group on Biomedical Parasitology, School of Sciences, Pontíficia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Vivian Favero
- Research Group on Biomedical Parasitology, School of Sciences, Pontíficia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Vanessa Fey Pascoal
- Research Group on Biomedical Parasitology, School of Sciences, Pontíficia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Renata Perotto de Souza
- Research Group on Biomedical Parasitology, School of Sciences, Pontíficia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil.
| | - Francine de Vargas Rigo
- Research Group on Biomedical Parasitology, School of Sciences, Pontíficia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Luize Hoffmann Dall Agnese
- Research Group on Biomedical Parasitology, School of Sciences, Pontíficia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | | | | | | | - Tereza Cristina Favre
- Oswaldo Cruz Institute, Fundação Oswaldo Cruz (FIOCRUZ), Rio de Janeiro, RJ, Brazil.
| | - Naftale Katz
- René Rachou Institute, Fundação Oswaldo Cruz (FIOCRUZ), Belo Horizonte, MG, Brazil
| | | | - Mitermayer Galvão Dos Reis
- Gonçalo Muniz Institute, Fundação Oswaldo Cruz (FIOCRUZ), Salvador, BA, Brazil; Faculty of Medicine of Bahia, Federal University of Bahia, Salvador, BA, Brazil; Department of Epidemiology of Microbial Diseases, School of Public Health, Yale University, New Haven, CT, United States of America.
| | - Otavio Sarmento Pieri
- Oswaldo Cruz Institute, Fundação Oswaldo Cruz (FIOCRUZ), Rio de Janeiro, RJ, Brazil.
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Bezerra DDF, Pinheiro MCC, Barbosa L, Viana AG, Fujiwara RT, Bezerra FSDM. Diagnostic comparison of stool exam and point-of-care circulating cathodic antigen (POC-CCA) test for schistosomiasis mansoni diagnosis in a high endemicity area in northeastern Brazil. Parasitology 2021; 148:420-426. [PMID: 33190646 PMCID: PMC11010182 DOI: 10.1017/s0031182020002164] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 11/03/2020] [Accepted: 11/05/2020] [Indexed: 12/15/2022]
Abstract
This study aimed to evaluate the performance of the point-of-care circulating cathodic antigen (POC-CCA) test in a highly endemic area in Brazil, comparing it to the Kato-Katz (KK) technique for sensitivity, specificity and the intensity of the reaction of the test in relation to the parasitic load. The community in Sergipe, Brazil, participated in the study, providing three stool samples, one of urine (POC-CCA) and fingers tick blood sample was tested by enzyme-linked immunosorbent assay (ELISA). Sensitivity, specificity, positive predictive value, negative predictive value, accuracy, kappa coefficient and Spearman's correlation were calculated for the POC-CCA test using the KK as the reference. The prevalence of schistosomiasis by KK testing was 48.82%; POC-CCA (t+) 66.14%; POC-CCA (t-) 45.24%. ELISA results showed 100% agreement in individuals with high and moderate eggs per gram (EPG). POC-CCA presented good diagnostic performance in individuals with medium and high EPG, but there were a high number of false negatives in individuals with low intensity infections. As observed, POC-CCA-filter test improves accuracy and sensitivity compared to a conventional test.
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Affiliation(s)
| | - Marta Cristhiany Cunha Pinheiro
- Laboratory of Parasitology and Mollusc Biology, Department of Clinical Analysis and Toxicology, Federal University of Ceará, Fortaleza, Brazil
| | - Luciene Barbosa
- Parasitology and Tropical Entomology Laboratory, Department of Morphology, Federal University of Sergipe, Aracajú, Brazil
| | | | - Ricardo Toshio Fujiwara
- Institute of Biological Sciences, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Fernando Schemelzer de Moraes Bezerra
- Post-Graduate Program in Pathology, School of Medicine, Federal University of Ceará, Fortaleza, Brazil
- Laboratory of Parasitology and Mollusc Biology, Department of Clinical Analysis and Toxicology, Federal University of Ceará, Fortaleza, Brazil
- Post-Graduate Program in Medical Sciences, School of Medicine, Federal University of Ceará, Fortaleza, Brazil
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15
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Allam AF, Salem A, Elsheredy A, Dewair MM, Ibrahim HS, Farag HF, Hagras NAE, Shehab AY. Intestinal schistosomiasis among preschool and school-aged children in a rural setting near Alexandria: initiative for elimination. Trop Med Int Health 2021; 26:632-639. [PMID: 33576107 DOI: 10.1111/tmi.13562] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To assess the status of intestinal schistosomiasis among preschool-aged (PSAC) and school-aged children (SAC) and to compare the efficacy of praziquantel (PZQ) in both groups. METHODS The study was conducted on 400 children; 103 PSAC and 297 SAC. Diagnosis of Schistosoma mansoni was based on triplicate Kato-Katz thick smears from a single stool sample. To identify the missed cases by Kato-Katz, 120 randomly selected negative cases (38 PSAC and 82 SAC) were screened by real-time PCR. All S. mansoni-positive cases by Kato-Katz were treated by crushed PZQ tablets. Four weeks after treatment, the cure rate was assessed by Kato-Katz smears and real-time PCR. RESULTS The prevalence of S. mansoni with Kato-Katz was 7.8% among PSAC and 7.4% among SAC. Most of children (63.3%) had light-intensity infection. The cure rate was 100% among PSAC by both techniques, and 91%, and 77.2% among SAC by Kato-Katz and real-time PCR, respectively. In the 120 stool samples screened by real-time PCR, S. mansoni prevalence was 25%; 15.8% and 29.3% were among PSAC and SAC respectively. Treated cases showed a lower range of Ct values than untreated cases. Two melting temperature ranges (Tm = 83-87°C and 89-93°C) were recognised among uncured cases which may point to S. mansoni genetic variability. CONCLUSION Continuous monitoring and inclusion of PSAC in schistosomiasis control programmes are crucial. Real-time PCR and other molecular tools are recommended for evaluation of the true prevalence, assessment of cure and further studies on genetic diversity.
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Affiliation(s)
- Amal Farahat Allam
- Department of Parasitology, Medical Research Institute, University of Alexandria, Alexandria, Egypt
| | - Aziza Salem
- Department of Parasitology, Medical Research Institute, University of Alexandria, Alexandria, Egypt
| | - Amel Elsheredy
- Department of Microbiology, Medical Research Institute, University of Alexandria, Alexandria, Egypt
| | - Musaad Mohammed Dewair
- Department of Medical Laboratory, Faculty of Allied Medical Science, Misr University for Science and Technology in Cairo, Cairo, Egypt
| | - Heba Said Ibrahim
- Department of Parasitology, Medical Research Institute, University of Alexandria, Alexandria, Egypt
| | - Hoda Fahmy Farag
- Department of Parasitology, Medical Research Institute, University of Alexandria, Alexandria, Egypt
| | - Nancy Abd-Elkader Hagras
- Department of Medical Laboratory, Faculty of Allied Medical Science, Pharos University in Alexandria, Alexandria, Egypt
| | - Amel Youssef Shehab
- Department of Parasitology, Medical Research Institute, University of Alexandria, Alexandria, Egypt
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16
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Allam AF, Farag HF, Lotfy W, Fawzy HH, Elhadad H, Shehab AY. Comparison among FLOTAC, Kato-Katz and formalin ether concentration techniques for diagnosis of intestinal parasitic infections in school children in an Egyptian rural setting. Parasitology 2021; 148:289-294. [PMID: 32907647 PMCID: PMC11010177 DOI: 10.1017/s0031182020001675] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
The study aimed to compare the diagnostic performance of the Kato-Katz, formalin ether concentration method (FECM) and FLOTAC using Sheather's sugar solution (FS1), saturated sodium chloride (FS2) and zinc sulfate (FS7) for the diagnosis of intestinal parasites among school children, focusing on Schistosoma mansoni. Ninety fecal samples were examined using the above mentioned techniques. The overall infection rate was 87.7%. Concerning protozoa, FLOTAC (FS1 and FS2) and FECM detected nearly equal infection rates (43.3% and 44.4%, respectively) with very good agreement. Kato-Katz diagnosed the highest helminthic infection rate (57.8%) followed by FLOTAC FS7 (44.4%) and FECM showed the lowest helminthic infection rate (27.7%). As for S. mansoni, Kato-Katz showed an infection rate of 38.8% vs FLOTAC (22.2%) and FECM (11.1%). The three techniques detected the same infection rate (11.1%) with egg counts more than 72 eggs/gram of feces. The FLOTAC sensitivity and accuracy for the diagnosis of protozoa were 97% and 99%, respectively. Regarding helminths diagnosis, FLOTAC technique showed higher sensitivity (77%) and accuracy (87%) compared to FECM (48% sensitivity and 70% accuracy). Therefore, FLOTAC can be used synchronously or in replacement to other diagnostic techniques. This can strategically impact future control programmes of intestinal parasitic infections in limited resources settings.
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Affiliation(s)
- Amal Farahat Allam
- Department of Parasitology, Medical Research Institute, University of Alexandria, Alexandria, Egypt
| | - Hoda Fahmy Farag
- Department of Parasitology, Medical Research Institute, University of Alexandria, Alexandria, Egypt
| | - Wael Lotfy
- Faculty of Nursing, Matrouh University, Matrouh, Egypt
| | - Hayam Hussien Fawzy
- Department of Parasitology, Medical Research Institute, University of Alexandria, Alexandria, Egypt
| | - Heba Elhadad
- Department of Parasitology, Medical Research Institute, University of Alexandria, Alexandria, Egypt
| | - Amel Youssef Shehab
- Department of Parasitology, Medical Research Institute, University of Alexandria, Alexandria, Egypt
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17
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Coffeng LE, Malizia V, Vegvari C, Cools P, Halliday KE, Levecke B, Mekonnen Z, Gichuki PM, Sayasone S, Sarkar R, Shaali A, Vlaminck J, Anderson RM, de Vlas SJ. Impact of Different Sampling Schemes for Decision Making in Soil-Transmitted Helminthiasis Control Programs. J Infect Dis 2021; 221:S531-S538. [PMID: 31829425 PMCID: PMC7289558 DOI: 10.1093/infdis/jiz535] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Starting and stopping preventive chemotherapy (PC) for soil-transmitted helminthiasis is typically based on the prevalence of infection as measured by Kato-Katz (KK) fecal smears. Kato-Katz-based egg counts can vary highly over repeated stool samples and smears. Consequentially, the sensitivity of KK-based surveys depends on the number of stool samples per person and the number of smears per sample. Given finite resources, collecting multiple samples and/or smears means screening fewer individuals, thereby lowering the statistical precision of prevalence estimates. Using population-level data from various epidemiological settings, we assessed the performance of different sampling schemes executed within the confines of the same budget. We recommend the use of single-slide KK for determining prevalence of moderate-to-heavy intensity infection and policy decisions for starting and continuing PC; more sensitive sampling schemes may be required for policy decisions involving stopping PC. Our findings highlight that guidelines should include specific guidance on sampling schemes.
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Affiliation(s)
- Luc E Coffeng
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Veronica Malizia
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Carolin Vegvari
- London Centre for Neglected Tropical Disease Research, Department of Infectious Disease Epidemiology, Imperial College London, London, United Kingdom
| | - Piet Cools
- Department of Virology, Parasitology and Immunology, Faculty of Veterinary Medicine, Ghent University, Belgium
| | - Katherine E Halliday
- Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Bruno Levecke
- Department of Virology, Parasitology and Immunology, Faculty of Veterinary Medicine, Ghent University, Belgium
| | - Zeleke Mekonnen
- Jimma University Institute of Health, Jimma University, Jimma, Ethiopia
| | - Paul M Gichuki
- Eastern and Southern Africa Centre of International Parasite Control, Kenya Medical Research Institute, Nairobi, Kenya
| | - Somphou Sayasone
- Lao Tropical and Public Health Institute, Ministry of Health, Vientiane, Lao People's Democratic Republic
| | - Rajiv Sarkar
- Division of Gastrointestinal Sciences, Christian Medical College, Vellore, Tamil Nadu, India
| | - Ame Shaali
- Laboratory Division, Public Health Laboratory-Ivo de Carneri, Chake Chake, United Republic of Tanzania
| | - Johnny Vlaminck
- Department of Virology, Parasitology and Immunology, Faculty of Veterinary Medicine, Ghent University, Belgium
| | - Roy M Anderson
- London Centre for Neglected Tropical Disease Research, Department of Infectious Disease Epidemiology, Imperial College London, London, United Kingdom
| | - Sake J de Vlas
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
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Keller L, Patel C, Welsche S, Schindler T, Hürlimann E, Keiser J. Performance of the Kato-Katz method and real time polymerase chain reaction for the diagnosis of soil-transmitted helminthiasis in the framework of a randomised controlled trial: treatment efficacy and day-to-day variation. Parasit Vectors 2020; 13:517. [PMID: 33059756 PMCID: PMC7558729 DOI: 10.1186/s13071-020-04401-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 10/09/2020] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Accurate, scalable and sensitive diagnostic tools are crucial in determining prevalence of soil-transmitted helminths (STH), assessing infection intensities and monitoring treatment efficacy. However, assessments on treatment efficacy comparing traditional microscopic to newly emerging molecular approaches such as quantitative Polymerase Chain Reaction (qPCR) are scarce and hampered partly by lack of an established diagnostic gold standard. METHODS We compared the performance of the copromicroscopic Kato-Katz method to qPCR in the framework of a randomized controlled trial on Pemba Island, Tanzania, evaluating treatment efficacy based on cure rates of albendazole monotherapy versus ivermectin-albendazole against Trichuris trichiura and concomitant STH infections. Day-to-day variability of both diagnostic methods was assessed to elucidate reproducibility of test results by analysing two stool samples before and two stool samples after treatment of 160 T. trichiura Kato-Katz positive participants, partially co-infected with Ascaris lumbricoides and hookworm, per treatment arm (n = 320). As negative controls, two faecal samples of 180 Kato-Katz helminth negative participants were analysed. RESULTS Fair to moderate correlation between microscopic egg count and DNA copy number for the different STH species was observed at baseline and follow-up. Results indicated higher sensitivity of qPCR for all three STH species across all time points; however, we found lower test result reproducibility compared to Kato-Katz. When assessed with two samples from consecutive days by qPCR, cure rates were significantly lower for T. trichiura (23.2 vs 46.8%), A. lumbricoides (75.3 vs 100%) and hookworm (52.4 vs 78.3%) in the ivermectin-albendazole treatment arm, when compared to Kato-Katz. CONCLUSIONS qPCR diagnosis showed lower reproducibility of test results compared to Kato-Katz, hence multiple samples per participant should be analysed to achieve a reliable diagnosis of STH infection. Our study confirms that cure rates are overestimated using Kato-Katz alone. Our findings emphasize that standardized and accurate molecular diagnostic tools are urgently needed for future monitoring within STH control and/or elimination programmes.
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Affiliation(s)
- Ladina Keller
- Swiss Tropical and Public Health Institute, Socinstrasse 57, 4051 Basel, Switzerland
- University of Basel, Petersplatz 1, 4051 Basel, Switzerland
| | - Chandni Patel
- Swiss Tropical and Public Health Institute, Socinstrasse 57, 4051 Basel, Switzerland
- University of Basel, Petersplatz 1, 4051 Basel, Switzerland
| | - Sophie Welsche
- Swiss Tropical and Public Health Institute, Socinstrasse 57, 4051 Basel, Switzerland
- University of Basel, Petersplatz 1, 4051 Basel, Switzerland
| | - Tobias Schindler
- Swiss Tropical and Public Health Institute, Socinstrasse 57, 4051 Basel, Switzerland
- University of Basel, Petersplatz 1, 4051 Basel, Switzerland
| | - Eveline Hürlimann
- Swiss Tropical and Public Health Institute, Socinstrasse 57, 4051 Basel, Switzerland
- University of Basel, Petersplatz 1, 4051 Basel, Switzerland
| | - Jennifer Keiser
- Swiss Tropical and Public Health Institute, Socinstrasse 57, 4051 Basel, Switzerland
- University of Basel, Petersplatz 1, 4051 Basel, Switzerland
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19
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Barda B, Schindler C, Wampfler R, Ame S, Ali SM, Keiser J. Comparison of real-time PCR and the Kato-Katz method for the diagnosis of soil-transmitted helminthiasis and assessment of cure in a randomized controlled trial. BMC Microbiol 2020; 20:298. [PMID: 33008301 PMCID: PMC7531123 DOI: 10.1186/s12866-020-01963-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Accepted: 09/01/2020] [Indexed: 02/05/2023] Open
Abstract
Background Diagnosis of soil-transmitted helminths (STHs) in developing countries is commonly based on microscopic detection of eggs in stool samples, using the Kato-Katz (KK) method, which has a poor sensitivity for detecting light intensity infections. We compared the performance of the KK method and real-time PCR in the framework of a randomized trial, which evaluated four novel treatments against Trichuris trichiura and concomitant STH infections. Results Two stool samples obtained from 320 participants were examined at baseline and follow-up with quadruplicate KK and PCR analyses of one of the two samples using “bead-beating” for DNA extraction. At follow-up, 80 samples were negative according to both PCR and KK and 173 were positive with both methods for any of the STHs. Relative to PCR, the calculated sensitivity of KK at follow-up was 83.6%, 43.0% and 53.8% for T. trichiura, for hookworm and for Ascaris lumbricoides, respectively. The sensitivity of PCR compared with KK at this time point was 89.1% for T. trichiura, 72.7% for hookworm and 87.5% for A. lumbricoides. Cure rates (CRs) for T. trichiura and A. lumbricoides were slightly lower with the PCR method. For hookworm CRs with KK were mostly significantly lower, namely 36.7%, 91.1%, 72.2% and 77.8% for moxidectin, moxidectin in combination with tribendimidine, moxidectin in combination with albendazole and albendazole in combination with oxantel pamoate, respectively, whereas with PCR the CRs were 8.3%, 82.6%, 37.1% and 57.1%, respectively. Conclusions In conclusion, a single real-time PCR is as sensitive as quadruplicate KK for T. trichiura and A. lumbricoides detection but more sensitive for hookworm, which has an influence on the estimated treatment efficacy. PCR method with DNA extraction using the “bead-beating protocol” should be further promoted in endemic areas and laboratories that can afford the needed equipment. The study is registered at ISRCTN (no. 20398469).
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Affiliation(s)
- Beatrice Barda
- Swiss Tropical and Public Health Institute, Socinstrasse 57, 4002, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | - Christian Schindler
- Swiss Tropical and Public Health Institute, Socinstrasse 57, 4002, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | - Rahel Wampfler
- Swiss Tropical and Public Health Institute, Socinstrasse 57, 4002, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | - Shaali Ame
- Laboratory Division, Public Health Laboratory-Ivo de Carneri, Chake-Chake, Tanzania
| | - Said M Ali
- Laboratory Division, Public Health Laboratory-Ivo de Carneri, Chake-Chake, Tanzania
| | - Jennifer Keiser
- Swiss Tropical and Public Health Institute, Socinstrasse 57, 4002, Basel, Switzerland. .,University of Basel, Basel, Switzerland.
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20
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Valero MA, Gironès N, Reguera-Gomez M, Pérez-Crespo I, López-García MP, Quesada C, Bargues MD, Fresno M, Mas-Coma S. Impact of fascioliasis reinfection on Fasciola hepatica egg shedding: relationship with the immune-regulatory response. Acta Trop 2020; 209:105518. [PMID: 32371223 DOI: 10.1016/j.actatropica.2020.105518] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 04/07/2020] [Accepted: 04/24/2020] [Indexed: 11/29/2022]
Abstract
Fascioliasis is a disease caused by liver flukes. In human fascioliasis hyperendemic areas, reinfection and chronicity are the norm. Control strategies in humans require the use of egg count techniques to calculate the appropriate treatment dose for colic risk prevention. The present study investigates how fascioliasis reinfection affects liver fluke egg shedding and its relationship with the immune-regulatory response. The experimental design reproduced the usual reinfection/chronicity conditions in human fascioliasis endemic areas and included Fasciola hepatica primo-infected Wistar rats (PI) and rats reinfected at 4 weeks (R4), 8 weeks (R8), 12 weeks (R12), and negative control rats. In a longitudinal study (0-20 weeks post-infection, p.i.), serical IgG1 levels and eggs per gram of faeces (epg) were analyzed. In a cross-sectional study, the expression of the genes associated with Th1 (Ifng, Il12a, Il12b, Nos2), Th2 (Il4, Arg1), Treg (Foxp3, Il10, Tgfb, Ebi3), and Th17 (Il17) in the spleen and thymus was analyzed. In R8 and R12, transiently higher averages of epg and epg/worm in reinfected groups vs PI group were detected at least in the weeks following reinfection. The kinetics of IgG1 levels shows that reinfected groups followed a pattern similar to the one in the PI group, but transiently higher averages of IgG1 levels in reinfected groups vs the PI group were detected in the weeks following reinfection. Epg correlated with IgG1 levels and also with systemic Il10 and thymic Ifng, and Il10 expression levels. These results suggest that epg depends on the Th1 and Treg phenotype and that the determination of the fluke burden by epg is likely to be an overestimation in cases of recent reinfection in low burden situations. A strategy to facilitate the implementation of epg count techniques and the subsequent decision on the appropriate treatment dose for each patient to prevent colic risk is required.
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Affiliation(s)
- M Adela Valero
- Departamento de Parasitología, Facultad de Farmacia, Universidad de Valencia, Av. Vicent Andrés Estellés s/n, 46100 Burjassot, Valencia, Spain.
| | - Nuria Gironès
- Centro de Biología Molecular "Severo Ochoa", Consejo Superior de Investigaciones Científicas (CSIC)-Universidad Autónoma de Madrid (UAM), Cantoblanco, 28049 Madrid, Spain.
| | - Marta Reguera-Gomez
- Departamento de Parasitología, Facultad de Farmacia, Universidad de Valencia, Av. Vicent Andrés Estellés s/n, 46100 Burjassot, Valencia, Spain.
| | - Ignacio Pérez-Crespo
- Departamento de Parasitología, Facultad de Farmacia, Universidad de Valencia, Av. Vicent Andrés Estellés s/n, 46100 Burjassot, Valencia, Spain
| | - M Pilar López-García
- Departamento de Bioquímica y Biología Molecular, Facultad de Farmacia, Universidad de Valencia, Av. Vicent Andrés Estellés s/n, 46100 Burjassot, Valencia, Spain
| | - Carla Quesada
- Departamento de Parasitología, Facultad de Farmacia, Universidad de Valencia, Av. Vicent Andrés Estellés s/n, 46100 Burjassot, Valencia, Spain
| | - M Dolores Bargues
- Departamento de Parasitología, Facultad de Farmacia, Universidad de Valencia, Av. Vicent Andrés Estellés s/n, 46100 Burjassot, Valencia, Spain.
| | - Manuel Fresno
- Centro de Biología Molecular "Severo Ochoa", Consejo Superior de Investigaciones Científicas (CSIC)-Universidad Autónoma de Madrid (UAM), Cantoblanco, 28049 Madrid, Spain
| | - Santiago Mas-Coma
- Departamento de Parasitología, Facultad de Farmacia, Universidad de Valencia, Av. Vicent Andrés Estellés s/n, 46100 Burjassot, Valencia, Spain.
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21
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Adisakwattana P, Yoonuan T, Phuphisut O, Poodeepiyasawat A, Homsuwan N, Gordon CA, McManus DP, Atkinson LE, Mousley A, Gobert GN. Clinical helminthiases in Thailand border regions show elevated prevalence levels using qPCR diagnostics combined with traditional microscopic methods. Parasit Vectors 2020; 13:416. [PMID: 32787935 PMCID: PMC7425172 DOI: 10.1186/s13071-020-04290-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Accepted: 08/05/2020] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Under-regulated national borders in Southeast Asia represent potential regions for enhanced parasitic helminth transmission and present barriers to helminthiasis disease control. METHODS Three Thailand border regions close to Myanmar, Laos and Cambodia were surveyed for clinical parasitic helminth disease. In-field microscopy was performed on stools from 567 individuals. Sub-samples were transported to Bangkok for molecular analysis comprising three multiplex qPCR assays. RESULTS The overall helminth infection prevalence was 17.99% as assessed by Kato-Katz and 24.51% by qPCR. The combined prevalence of the two methods was 28.57%; the most predominant species detected were Opisthorchis viverrini (18.34%), hookworm (6.88%; Ancylostoma spp. and Necator americanus), Ascaris lumbricoides (2.29%) and Trichuris trichiura (1.76%). CONCLUSIONS These data demonstrate the value of molecular diagnostics for determining more precise prevalence levels of helminthiases in Southeast Asia. Availability of such accurate prevalence information will help guide future public health initiatives and highlights the need for more rigorous surveillance and timely intervention in these regions.
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Affiliation(s)
- Poom Adisakwattana
- Department of Helminthology, Faculty of Tropical Medicine, Mahidol University, Bangkok, 10400, Thailand.
| | - Tippayarat Yoonuan
- Department of Helminthology, Faculty of Tropical Medicine, Mahidol University, Bangkok, 10400, Thailand
| | - Orawan Phuphisut
- Department of Helminthology, Faculty of Tropical Medicine, Mahidol University, Bangkok, 10400, Thailand
| | - Akkarin Poodeepiyasawat
- Department of Helminthology, Faculty of Tropical Medicine, Mahidol University, Bangkok, 10400, Thailand
| | - Nirundorn Homsuwan
- Department of Helminthology, Faculty of Tropical Medicine, Mahidol University, Bangkok, 10400, Thailand
| | - Catherine A Gordon
- Molecular Parasitology Laboratory, Infectious Diseases Division, QIMR Berghofer Medical Research Institute, Brisbane, 4006, Australia
| | - Donald P McManus
- Molecular Parasitology Laboratory, Infectious Diseases Division, QIMR Berghofer Medical Research Institute, Brisbane, 4006, Australia
| | - Louise E Atkinson
- School of Biological Sciences, Queen's University Belfast, Belfast, BT9 5DL, UK
| | - Angela Mousley
- School of Biological Sciences, Queen's University Belfast, Belfast, BT9 5DL, UK
| | - Geoffrey N Gobert
- School of Biological Sciences, Queen's University Belfast, Belfast, BT9 5DL, UK.
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22
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Homsana A, Odermatt P, Southisavath P, Yajima A, Sayasone S. Cross-reaction of POC-CCA urine test for detection of Schistosoma mekongi in Lao PDR: a cross-sectional study. Infect Dis Poverty 2020; 9:114. [PMID: 32787912 PMCID: PMC7424653 DOI: 10.1186/s40249-020-00733-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Accepted: 07/29/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The point-of-care circulating cathodic antigen (POC-CCA) test is increasingly used as a rapid diagnostic method for Schistosoma mansoni infection. The test has good sensitivity, although false positive results have been reported among pregnant women and patients with urine infections and hematuria. We validated the POC-CCA test's ability to diagnose Schistosoma mekongi infection in Lao People's Democratic Republic (Lao PDR), where S. mekongi is endemic. Of particular interest was the test's specificity and possible cross-reactivity with other helminth infections. METHODS We conducted a cross-sectional study of children and adults in the provinces of Champasack (Schistosoma mekongi and Opisthorchis viverrini endemic), Savannakhet (O. viverrini endemic) and Luang Prabang (soil-transmitted helminths endemic) between October 2018 and April 2019. POC-CCA and urine dipstick tests were administered to all study participants, while an additional pregnancy test was offered to women. Two stool samples were collected from participants and examined with a Kato-Katz test (two smears per stool). Logistic regression was used to associate potential confounding factors (predictors) with POC-CCA test results (outcome). RESULTS In S. mekongi-endemic Champasack, 11.5% (n = 366) and 0.5% (n = 2) of study participants had positive POC-CCA and Kato-Katz test results, respectively. Only one of the two Kato-Katz positive patients was also POC-CCA positive. In Champasack and Luang Prabang, where S. mekongi is not endemic, the POC-CCA test yielded (presumably) false positive results for 6.0% (n = 22) and 2.5% (n = 9) of study participants, respectively, while all of the Kato-Katz tests were negative. POC-CCA positive test results were significantly associated with O. viverrini infection (1.69, 95% confidence interval (CI): 1.02-2.77, P = 0.042), increased leukocytes (adjusted Odds Ratio (aOR) = 1.58, 95% CI: 1.15-2.17, P = 0.005) and hematuria (aOR = 1.50, 95% CI: 1.07-2.10, P = 0.019) if the observed trace was counted as a positive test result. Two pregnant women from Champasack province had POC-CCA positive tests. CONCLUSIONS We observed a cross-reaction between the POC-CCA test and O. viverrini infection. To some extent, we can confirm previous observations asserting that POC-CCA provides false positive results among patients with urinary tract infections and hematuria. In S. mekongi-endemic areas, POC-CCA can be applied cautiously for surveillance purposes, keeping in mind the considerable risk of false positive results and its unknown sensitivity.
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Affiliation(s)
- Anousin Homsana
- Lao Tropical and Public Health Institute, Ministry of Health, Vientiane Capital, Lao People's Democratic Republic
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, P.O. Box, CH-4002, Basel, Switzerland
- University of Basel, P.O. Box, CH-4003, Basel, Switzerland
| | - Peter Odermatt
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, P.O. Box, CH-4002, Basel, Switzerland
- University of Basel, P.O. Box, CH-4003, Basel, Switzerland
| | - Phonesavanh Southisavath
- Lao Tropical and Public Health Institute, Ministry of Health, Vientiane Capital, Lao People's Democratic Republic
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, P.O. Box, CH-4002, Basel, Switzerland
- University of Basel, P.O. Box, CH-4003, Basel, Switzerland
- Department of Radiology, Mahosot Hospital, Ministry of Health, Vientiane Capital, Lao People's Democratic Republic
| | - Aya Yajima
- World Health Organization, Western Pacific Regional Office, Manila, Philippines
| | - Somphou Sayasone
- Lao Tropical and Public Health Institute, Ministry of Health, Vientiane Capital, Lao People's Democratic Republic.
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23
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Dana D, Vlaminck J, Mekonnen Z, Ayana M, Vogt F, Verdonck K, Tweya H, Timire C, Geldhof P, Levecke B. Diagnostic sensitivity of direct wet mount microscopy for soil-transmitted helminth infections in Jimma Town, Ethiopia. J Infect Dev Ctries 2020; 14:66S-71S. [PMID: 32614799 DOI: 10.3855/jidc.11733] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Accepted: 01/17/2020] [Indexed: 10/31/2022] Open
Abstract
INTRODUCTION Soil-transmitted helminthiasis (STH) remains a major public health problem in school children in Ethiopia. Although direct wet mount microscopy (DWMM) is the means to diagnose parasitic diseases in health care facilities in Ethiopia, it remains unclear what its diagnostic performance is for STH. METHODOLOGY A cross-sectional study was performed in Jimma Town (Ethiopia) and included 600 children from 10 primary schools. The diagnostic sensitivity of DWMM was compared to a composite reference standard (CRS) consisting of Kato-Katz, McMaster and Mini-FLOTAC. We also explored the impact of intensity of infection (the highest faecal egg counts (FECs; expressed as eggs per gram of stool (EPG)) across the CRS) on the diagnostic sensitivity of DWMM. RESULTS Based on the CRS, there were 210 Ascaris (35.0%), 312 Trichuris (52.0%) and 102 hookworm cases (17.0%). The median intensity of infections equalled 2,057 EPG for Ascaris, 200 EPG for Trichuris and 110 EPG for hookworms. The sensitivity of DWMM was 73.8% for Ascaris, but was around 17% for both Trichuris and hookworms. The sensitivity significantly increased with intensity of STH. For Ascaris, the odds for detecting an infection intensity of 1,000 EPG was 6.2 times higher than detecting an infection of 100 EPG. For Trichuris and hookworms, these odds ratios were 7.1 and 14. CONCLUSIONS The diagnostic sensitivity of DWMM is low for STH, but it is able to detect those subjects that are in the highest need of treatment, and hence contributes to the global goal to eliminate STH as a public health problem.
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Affiliation(s)
- Daniel Dana
- School of Medical Laboratory Science, Faculty of Health Science, Institute of Health, Jimma University, Jimma, Ethiopia.
| | - Johnny Vlaminck
- Department of Virology, Parasitology and Immunology, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium.
| | - Zeleke Mekonnen
- School of Medical Laboratory Science, Faculty of Health Science, Institute of Health, Jimma University, Jimma, Ethiopia.
| | - Mio Ayana
- School of Medical Laboratory Science, Faculty of Health Science, Institute of Health, Jimma University, Jimma, Ethiopia.
| | - Florian Vogt
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium.
| | - Kristien Verdonck
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium.
| | - Hannock Tweya
- The International Union against Tuberculosis and Lung Disease, Paris, France.
| | - Collins Timire
- The International Union against Tuberculosis and Lung Disease, Paris, France.
| | - Peter Geldhof
- Department of Virology, Parasitology and Immunology, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium.
| | - Bruno Levecke
- Department of Virology, Parasitology and Immunology, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium.
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Dunn JC, Papaiakovou M, Han KT, Chooneea D, Bettis AA, Wyine NY, Lwin AMM, Maung NS, Misra R, Littlewood DTJ, Anderson RM. The increased sensitivity of qPCR in comparison to Kato-Katz is required for the accurate assessment of the prevalence of soil-transmitted helminth infection in settings that have received multiple rounds of mass drug administration. Parasit Vectors 2020; 13:324. [PMID: 32580759 PMCID: PMC7315547 DOI: 10.1186/s13071-020-04197-w] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Accepted: 06/17/2020] [Indexed: 12/13/2022] Open
Abstract
Background The most commonly used diagnostic tool for soil-transmitted helminths (STH) is the Kato-Katz (KK) thick smear technique. However, numerous studies have suggested that the sensitivity of KK can be problematic, especially in low prevalence and low intensity settings. An emerging alternative is quantitative polymerase chain reaction (qPCR). Methods In this study, both KK and qPCR were conducted on stool samples from 648 participants in an STH epidemiology study conducted in the delta region of Myanmar in June 2016. Results Prevalence of any STH was 20.68% by KK and 45.06% by qPCR. Prevalence of each individual STH was also higher by qPCR than KK, the biggest difference was for hookworm with an approximately 4-fold increase between the two diagnostic techniques. Prevalence of Ancylostoma ceylanicum, a parasite predominately found in dogs, was 4.63%, indicating that there is the possibility of zoonotic transmission in the study setting. In individuals with moderate to high intensity infections there is evidence for a linear relationship between eggs per gram (EPG) of faeces, derived from KK, and DNA copy number, derived from qPCR which is particularly strong for Ascaris lumbricoides. Conclusions The use of qPCR in low prevalence settings is important to accurately assess the epidemiological situation and plan control strategies for the ‘end game’. However, more work is required to accurately assess STH intensity from qPCR results and to reduce the cost of qPCR so that is widely accessible in STH endemic countries.![]()
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Affiliation(s)
- Julia C Dunn
- Department of Infectious Disease Epidemiology, School of Public Health, Faculty of Medicine, Imperial College London, London, W2 1PG, UK. .,London Centre for Neglected Tropical Disease Research, London, UK.
| | - Marina Papaiakovou
- Department of Infectious Disease Epidemiology, School of Public Health, Faculty of Medicine, Imperial College London, London, W2 1PG, UK.,London Centre for Neglected Tropical Disease Research, London, UK.,Department of Life Sciences, Natural History Museum, London, UK
| | - Kay Thwe Han
- Department of Medical Research, Ministry of Health and Sports, Nyapyitaw, Myanmar
| | - Darren Chooneea
- Core Research Laboratories, Natural History Museum, London, UK
| | - Alison A Bettis
- Department of Infectious Disease Epidemiology, School of Public Health, Faculty of Medicine, Imperial College London, London, W2 1PG, UK.,London Centre for Neglected Tropical Disease Research, London, UK
| | - Nay Yee Wyine
- London Centre for Neglected Tropical Disease Research, London, UK
| | - Aye Moe Moe Lwin
- University of Public Health, Myorma Kyaung Street, Yangon, 11131, Myanmar
| | - Nay Soe Maung
- University of Public Health, Myorma Kyaung Street, Yangon, 11131, Myanmar
| | - Raju Misra
- Core Research Laboratories, Natural History Museum, London, UK
| | | | - Roy M Anderson
- Department of Infectious Disease Epidemiology, School of Public Health, Faculty of Medicine, Imperial College London, London, W2 1PG, UK.,London Centre for Neglected Tropical Disease Research, London, UK
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25
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Armoo S, Cunningham LJ, Campbell SJ, Aboagye FT, Boampong FK, Hamidu BA, Osei-Atweneboana MY, Stothard JR, Adams ER. Detecting Schistosoma mansoni infections among pre-school-aged children in southern Ghana: a diagnostic comparison of urine-CCA, real-time PCR and Kato-Katz assays. BMC Infect Dis 2020; 20:301. [PMID: 32321418 DOI: 10.1186/s12879-020-05034-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Accepted: 04/15/2020] [Indexed: 11/16/2022] Open
Abstract
Background In Ghana, pre-school-aged children (PSAC) are at risk of intestinal schistosomiasis and are living in need of praziquantel treatment. To better assess the infection burden within this vulnerable demographic group, we have provided a comparative assessment of the prevalence of Schistosoma mansoni in pre-school-aged children by urine circulating cathodic antigen (CCA) dipsticks, real-time PCR Taqman® faecal assays and Kato-Katz coproscopy. Methods In all, 190 pre-school-aged children were sampled from three endemic communities (viz. Tomefa, Torgahkope/Adakope, and Manheam) around Weija dam, Southern Ghana. Fresh stool and urine samples were collected from all participants for diagnosis. Results Among all the three communities, the urine-CCA assay recorded the highest prevalence values of 90.5% (95% CI 80.4–96.4), 87.9% (95% CI 76.7–95), and 81.2% (95% CI 69.9–89.6) in Tomefa, Torgahkope/Adakope, and Manheam respectively. Prevalence by real-time PCR was 50% (95% CI 35.5–64.5), 8% (95% CI 2.2–19.2) and 16.7% (95% CI 8.3–28.5), while by Kato-Katz was 55.6% (95% CI 42.5–68.1), 8.6% (95% CI 2.9–19) and 11.6% (95% CI 5.1–21.6) respectively. Children aged 1 year and over were found to be positive with the urine-CCA assay; by the ages of 3–4, over 50% were urine-CCA patent. The sensitivity and specificity of the POC-CCA dipsticks, when compared against the combined results of Kato-Katz/TaqMan results was found to be 84.1% (95% CI = 72.7–92.1) and 12.9% (95% CI = 6.6–22) respectively. Conclusions We propose that the urine-CCA dipstick may be a useful rapid diagnostic tool to estimate the prevalence of intestinal schistosomiasis in PSAC, particularly in rapid identification of at-risk areas. However, our assessment has shown that it possible to record false positives when compared to combined Kato-Katz and qPCR results. To guide PSAC praziquantel treatment needs, we propose the urine CCA assay should be included in routine surveillance of intestinal schistosomiasis alongside other diagnostics such as Kato-Katz and urine filtration.
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de Sousa SRM, Dias IHL, Fonseca ÁLS, Contente BR, Nogueira JFC, da Costa Oliveira TN, Geiger SM, Enk MJ. Concordance of the point-of-care circulating cathodic antigen test for the diagnosis of intestinal schistosomiasis in a low endemicity area. Infect Dis Poverty 2019; 8:37. [PMID: 31142379 PMCID: PMC6542115 DOI: 10.1186/s40249-019-0551-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Accepted: 05/16/2019] [Indexed: 11/25/2022] Open
Abstract
Background The Kato-Katz technique is recommended worldwide for the diagnosis of intestinal schistosomiasis, detecting parasite eggs in feces of infected people. However, new tests have been developed in order to facilitate diagnosis, e.g. by detection of specific antigens secreted by schistosomes, such as the circulating cathodic antigen (CCA). The aim of this study was to evaluate the performance of the point-of-care circulating cathodic antigen test (POC-CCA) compared to the Kato-Katz technique in a low prevalence area in the Amazon Region, located in the municipality of Primavera, State of Pará, Brazil. Methods Positivity rates of the POC-CCA test and the Kato-Katz technique were calculated. The sensitivity, specificity, accuracy and kappa coefficient were determined by comparing both methods. The reference standard was established using 16 Kato-Katz slides, 12 of the first fecal sample, two of the second and two of the third one. The study also included the concordance between POC-CCA results and different numbers and combinations of Kato-Katz slides. Results The prevalence of schistosomiasis according to the reference standard or POC-CCA test reached a rate of 9.4% or 23.9%, respectively, among a total of 372 participants. The positivity rates by the Kato-Katz technique increased from 2.4 to 9.4%, according to the increase in the number of slides examined and fecal samples collected. A sensitivity of 55.6%, specificity 76.9%, accuracy 76% and κ coefficient of 0.06 was observed by comparing one slide of the first sample and POC-CCA. Comparing 6 slides from three different samples, two slides of each, with POC-CCA resulted in a sensitivity of 58.3%, specificity 78.4%, accuracy 77% and κ coefficient of 0.16. Finally, the comparison of 16 slides from three different samples with POC-CCA revealed a sensitivity of 65.7%, specificity 80.4%, accuracy 79%, and κ coefficient of 0.27. Conclusions The immunochromatographic test has the potential to be an important tool to combat schistosomiasis because of its practicality and applicability but should be applied with caution in low prevalence areas and in programs that aim to eliminate this disease. Trial registration CAAE#21824513.9.0000.5091. January 31st, 2014. Electronic supplementary material The online version of this article (10.1186/s40249-019-0551-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Sergei Rodrigo Magalhães de Sousa
- Programa de Pós-Graduação Strictu Sensu em Biologia Parasitária na Amazônia da Universidade do Estado do Pará, Tv. Perebebuí, 2623 - Marco, Belém, PA, 66087, Brazil. .,Laboratório de Parasitoses Intestinais, Esquistossomose e Malacologia (LPIEM), Secção de Parasitologia, Instituto Evandro Chagas/SVS/MS, Ananindeua, Pará, Brazil.
| | - Isabelle Helena Lima Dias
- Programa de Pós-Graduação Strictu Sensu em Biologia Parasitária na Amazônia da Universidade do Estado do Pará, Tv. Perebebuí, 2623 - Marco, Belém, PA, 66087, Brazil.,Laboratório de Parasitoses Intestinais, Esquistossomose e Malacologia (LPIEM), Secção de Parasitologia, Instituto Evandro Chagas/SVS/MS, Ananindeua, Pará, Brazil
| | - Álvaro Luan Santana Fonseca
- Programa de Pós-Graduação Strictu Sensu em Biologia Parasitária na Amazônia da Universidade do Estado do Pará, Tv. Perebebuí, 2623 - Marco, Belém, PA, 66087, Brazil.,Laboratório de Parasitoses Intestinais, Esquistossomose e Malacologia (LPIEM), Secção de Parasitologia, Instituto Evandro Chagas/SVS/MS, Ananindeua, Pará, Brazil
| | - Bianca Rodrigues Contente
- Programa de Pós-Graduação Strictu Sensu em Biologia Parasitária na Amazônia da Universidade do Estado do Pará, Tv. Perebebuí, 2623 - Marco, Belém, PA, 66087, Brazil.,Laboratório de Parasitoses Intestinais, Esquistossomose e Malacologia (LPIEM), Secção de Parasitologia, Instituto Evandro Chagas/SVS/MS, Ananindeua, Pará, Brazil
| | - Joyce Favacho Cardoso Nogueira
- Programa de Pós-Graduação Strictu Sensu em Biologia Parasitária na Amazônia da Universidade do Estado do Pará, Tv. Perebebuí, 2623 - Marco, Belém, PA, 66087, Brazil.,Laboratório de Parasitoses Intestinais, Esquistossomose e Malacologia (LPIEM), Secção de Parasitologia, Instituto Evandro Chagas/SVS/MS, Ananindeua, Pará, Brazil
| | - Tatyellen Natasha da Costa Oliveira
- Programa de Pós-Graduação Strictu Sensu em Biologia Parasitária na Amazônia da Universidade do Estado do Pará, Tv. Perebebuí, 2623 - Marco, Belém, PA, 66087, Brazil
| | - Stefan Michael Geiger
- Departamento de Parasitologia, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Martin Johannes Enk
- Programa de Pós-Graduação Strictu Sensu em Biologia Parasitária na Amazônia da Universidade do Estado do Pará, Tv. Perebebuí, 2623 - Marco, Belém, PA, 66087, Brazil.,Laboratório de Parasitoses Intestinais, Esquistossomose e Malacologia (LPIEM), Secção de Parasitologia, Instituto Evandro Chagas/SVS/MS, Ananindeua, Pará, Brazil
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Alharbi MH, Condemine C, Christiansen R, LaCourse EJ, Makaula P, Stanton MC, Juziwelo L, Kayuni S, Stothard JR. Biomphalaria pfeifferi Snails and Intestinal Schistosomiasis, Lake Malawi, Africa, 2017-2018. Emerg Infect Dis 2019; 25:613-615. [PMID: 30602122 PMCID: PMC6390747 DOI: 10.3201/eid2503.181601] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Two surveys conducted in 2017 and 2018 demonstrated Biomphalaria pfeifferi snails in Lake Malawi in Africa. Epidemiologic examination of 175 local children at 3 primary schools confirmed emergence of intestinal schistosomiasis. These findings highlight autochthonous transmission of Schistosoma mansoni flukes in Lake Malawi and the need to revise international travel advice.
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Diab RG, Mady RF, Tolba MM, Ghazala RA. Urinary circulating DNA and circulating antigen for diagnosis of schistosomiasis mansoni: a field study. Trop Med Int Health 2019; 24:371-378. [PMID: 30549391 DOI: 10.1111/tmi.13193] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
OBJECTIVE To evaluate three non-invasive assays for the diagnosis of schistosomiasis mansoni in an Egyptian village. METHODS Urine was collected for the detection of circulating cathodic antigen (CCA) and cell-free parasite DNA (cfpd) by Point-of-contact (POC)-cassette assay and PCR, respectively. These tests were compared to Kato-Katz (KK) faecal thick smear for detection of Schistosoma mansoni eggs. RESULTS Disease prevalence by POC-CCA assay was 86%; by PCR it was 39% vs. 27% by KK. Compared to KK, the sensitivity of POC-CCA reached 100%, but its specificity was only 19.2% with 41% accuracy. Sensitivity of the PCR assay for cfpd was 55.56%, and specificity was 67.12% with 64% accuracy. A new end point was calculated for combined analysis of KK, POC-CCA assay and PCR. Sensitivity for the three tests was 52.94%, 90.2% and 76.47%; specificity was 100% for KK and PCR and 18.37% for POC-CCA. The accuracy calculated for the three tests at the end point was 76% for KK, 55% for POC-CCA assay and 88% for PCR. CONCLUSION Conventional PCR assay for detection of cfpd provides a potential screening tool for intestinal schistosomiasis with reliable specificity, reasonable accuracy and affordable financial and technical cost.
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Affiliation(s)
- Radwa Galal Diab
- Medical Parasitology Department, Faculty of Medicine, University of Alexandria, Alexandria, Egypt
| | - Rasha Fadly Mady
- Medical Parasitology Department, Faculty of Medicine, University of Alexandria, Alexandria, Egypt
| | - Mona Mohamed Tolba
- Parasitology Department, Medical Research Institute, University of Alexandria, Alexandria, Egypt
| | - Rasha Abdelmawla Ghazala
- Medical Biochemistry Department, Faculty of Medicine, University of Alexandria, Alexandria, Egypt
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Hoekstra PT, Casacuberta Partal M, Amoah AS, van Lieshout L, Corstjens PLAM, Tsonaka S, Assaré RK, Silué KD, Meité A, N'Goran EK, N'Gbesso YK, Roestenberg M, Knopp S, Utzinger J, Coulibaly JT, van Dam GJ. Repeated doses of Praziquantel in Schistosomiasis Treatment (RePST) - single versus multiple praziquantel treatments in school-aged children in Côte d'Ivoire: a study protocol for an open-label, randomised controlled trial. BMC Infect Dis 2018; 18:662. [PMID: 30547750 DOI: 10.1186/s12879-018-3554-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Accepted: 11/23/2018] [Indexed: 11/30/2022] Open
Abstract
Background Large scale administration of the anthelminthic drug praziquantel (PZQ) to at-risk populations is the cornerstone of schistosomiasis control, although persisting high prevalence of infections in some areas and growing concerns of PZQ resistance have revealed the limitations of this strategy. Most studies assessing PZQ efficacy have used relatively insensitive parasitological diagnostics, such as the Kato-Katz (KK) and urine-filtration methods, thereby overestimating cure rates (CRs). This study aims to determine the efficacy of repeated PZQ treatments against Schistosoma mansoni infection in school-aged children in Côte d’Ivoire using the traditional KK technique, as well as more sensitive antigen- and DNA-detection methods. Methods An open-label, randomised controlled trial will be conducted in school-aged children (5 to 18 years) from the region of Taabo, Côte d’Ivoire, an area endemic for S. mansoni. This 8-week trial includes four two-weekly standard doses of PZQ in the “intense treatment” intervention group and one standard dose of PZQ in the “standard treatment” control group. The efficacy of PZQ will be evaluated in stool samples using the KK technique and real-time PCR as well as in urine using the point-of-care circulating cathodic antigen test and the up-converting phosphor, lateral flow, circulating anodic antigen assay. The primary outcome of the study will be the difference in CR of intense versus standard treatment with PZQ on individuals with a confirmed S. mansoni infection measured by KK. Secondary outcomes include the difference in CR and intensity reduction rate between the intense and standard treatment groups as measured by the other diagnostic tests, as well as the accuracy of the different diagnostic tests, and the safety of PZQ. Discussion This study will provide data on the efficacy of repeated PZQ treatment on the clearance of S. mansoni as measured by several diagnostic techniques. These findings will inform future mass drug administration policy and shed light on position of novel diagnostic tools to evaluate schistosomiasis control strategies. Trial registration The study is registered at EudraCT (2016–003017-10, date of registration: 22 July 2016) and (NCT02868385, date of registration: 16 August 2016). Electronic supplementary material The online version of this article (10.1186/s12879-018-3554-2) contains supplementary material, which is available to authorized users.
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Korir HK, Riner DK, Kavere E, Omondi A, Landry J, Kittur N, Ndombi EM, Ondigo BN, Secor WE, Karanja DMS, Colley DG. Young Adults in Endemic Areas: An Untreated Group in Need of School-Based Preventive Chemotherapy for Schistosomiasis Control and Elimination. Trop Med Infect Dis 2018; 3:E100. [PMID: 30274496 DOI: 10.3390/tropicalmed3030100] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Revised: 08/16/2018] [Accepted: 08/31/2018] [Indexed: 11/30/2022] Open
Abstract
Parasitologic surveys of young adults in college and university settings are not commonly done, even in areas known to be endemic for schistosomiasis and soil-transmitted helminths. We have done a survey of 291 students and staff at the Kisumu National Polytechnic in Kisumu, Kenya, using the stool microscopy Kato-Katz (KK) method and the urine point-of-care circulating cathodic antigen (POC-CCA) test. Based on three stools/two KK slides each, in the 208 participants for whom three consecutive stools were obtained, Schistosoma mansoni prevalence was 17.8%. When all 291 individuals were analyzed based on the first stool, as done by the national neglected tropical disease (NTD) program, and one urine POC-CCA assay (n = 276), the prevalence was 13.7% by KK and 23.2% by POC-CCA. Based on three stools, 2.5% of 208 participants had heavy S. mansoni infections (≥400 eggs/gram feces), with heavy S. mansoni infections making up 13.5% of the S. mansoni cases. The prevalence of the soil-transmitted helminths (STH: Ascaris lumbricoides, Trichuris trichiura and hookworm) by three stools was 1.4%, 3.1%, and 4.1%, respectively, and by the first stool was 1.4%, 2.4% and 1.4%, respectively. This prevalence and intensity of infection with S. mansoni in a college setting warrants mass drug administration with praziquantel. This population of young adults is ‘in school’ and is both approachable and worthy of inclusion in national schistosomiasis control and elimination programs.
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Deng Y, Qiu C, Ding H, Lu DB. The ratio of the seroprevalence to the egg-positive prevalence of Schistosoma japonicum in China: a meta-analysis. BMC Infect Dis 2018; 18:404. [PMID: 30111280 PMCID: PMC6094899 DOI: 10.1186/s12879-018-3320-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Accepted: 08/09/2018] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Schistosomiasis, caused by Schistosoma japonicum, remains one of the most important parasitic diseases, and detection of S. japonicum infections in humans plays a crucial role in control and treatment. However, comparisons between the parasitological and the immunological examinations in the fields of China are lacking. Therefore we performed a meta-analysis to compare the seroprevalence of Schistosoma japonicum, as determined by IHA or ELISA, with coprological prevalence, as determined by Kato-Katz, and estimate the ratio of the serological to the egg-positive prevalence in order to evaluate the potential threat of egg-negative but worm-positive schistosomiasis. METHODS Studies published up to July 2018 on the parasitological and immunological examinations of schistosomiasis in the fields of China were searched in five databases including CNKI, WanFang, VIP, PubMed and Web of Science. The ratio of the serological to the egg-positive prevalence and its 95%CI for each study were calculated, and then point estimates and their 95%CIs of pooled prevalence ratio were meta-analyzed. Subgroup meta-analyses were also performed according to potential influential factors. RESULTS A total of 23 articles were included. The prevalence ratio varied from 0.57 to 48.83 for IHA to Kato-Katz and ranged from 0.38 to 13.97 for ELISA to Kato-Katz. The pooled ratio was 4.72 (95%CI: 3.87~ 5.76) for IHA to KK and 4.65 (95%CI: 3.50~ 6.17) for ELISA to KK. Subgroup analyses implied that the ratio of the serological to the egg-positive prevalence may decrease with the endemic levels. The highest prevalence ratio was observed when Kato-Katz was performed with three slides per stool or in hilly and mountainous regions. CONCLUSIONS The worm-determined prevalence by IHA or ELISA is 4- to 5-fold higher than the egg-determined prevalence by Kato-Katz, which implied Kato-Katz may largely underestimate the prevalence of S. japonicum in China. The degree of underestimation was greater when Kato-Katz with three slides per stool was carried out, especially in low endemic areas or in hilly and mountainous regions. Therefore, more attention should be paid to those egg-negative but worm-positive patients with the aim of final elimination of S. japonicum in China.
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Affiliation(s)
- Yao Deng
- Department of Epidemiology and Statistics, School of Public Health, Soochow University, Suzhou, China
- Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, School of Public Health, Soochow University, Suzhou, People's Republic of China
- Key Laboratory of National Health and Family Planning Commission on Parasitic Disease Control and Prevention, Jiangsu Provincial Key Laboratory on Parasite and Vector Control Technology, Jiangsu Institute of Parasitic Diseases, Wuxi, Jiangsu Province, China
| | - Chen Qiu
- Department of Epidemiology and Statistics, School of Public Health, Soochow University, Suzhou, China
- Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, School of Public Health, Soochow University, Suzhou, People's Republic of China
- Key Laboratory of National Health and Family Planning Commission on Parasitic Disease Control and Prevention, Jiangsu Provincial Key Laboratory on Parasite and Vector Control Technology, Jiangsu Institute of Parasitic Diseases, Wuxi, Jiangsu Province, China
| | - Huan Ding
- Department of Epidemiology and Statistics, School of Public Health, Soochow University, Suzhou, China
- Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, School of Public Health, Soochow University, Suzhou, People's Republic of China
- Key Laboratory of National Health and Family Planning Commission on Parasitic Disease Control and Prevention, Jiangsu Provincial Key Laboratory on Parasite and Vector Control Technology, Jiangsu Institute of Parasitic Diseases, Wuxi, Jiangsu Province, China
| | - Da-Bing Lu
- Department of Epidemiology and Statistics, School of Public Health, Soochow University, Suzhou, China.
- Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, School of Public Health, Soochow University, Suzhou, People's Republic of China.
- Key Laboratory of National Health and Family Planning Commission on Parasitic Disease Control and Prevention, Jiangsu Provincial Key Laboratory on Parasite and Vector Control Technology, Jiangsu Institute of Parasitic Diseases, Wuxi, Jiangsu Province, China.
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Bezerra FSM, Leal JKF, Sousa MS, Pinheiro MCC, Ramos AN Jr, Silva-Moraes V, Katz N. Evaluating a point-of-care circulating cathodic antigen test (POC-CCA) to detect Schistosoma mansoni infections in a low endemic area in north-eastern Brazil. Acta Trop 2018; 182:264-70. [PMID: 29526480 DOI: 10.1016/j.actatropica.2018.03.002] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Schistosomiasis is still a public health problem in Brazil. The Kato-Katz test is the most frequently used diagnostic method for Schistosoma mansoni infection. However, it lacks sensitivity in areas of low prevalence. We have assessed the positivity rate of S. mansoni infection in Bananeiras, a village on Capistrano, Ceara, Brazil by performing a point-of-care test in urine to determine the circulating cathodic antigens (POC-CCA), and we compared the findings with those of the Kato-Katz technique for egg detection in stool and an enzyme-linked immunosorbent assay for specific antibodies against adult worms (SWAP-ELISA) in serum before treatment (baseline). Additionally, the POC-CCA and Kato-Katz test results were compared at one and two years post-treatment, and only POC-CCA strips were utilised for follow-up testing on urine samples at 3-6 weeks. Only one sample of stool and urine was collected per event. Overall, 258 individuals were investigated at the baseline. The POC-CCA test detected 10 (3.9%) positive cases; however, this amount increased to 30 (11.6%) when considering trace readings as positive (t + ), whereas the Kato-Katz method found only 4 (1.6%) positive cases and the SWAP-ELISA detected 105 (40.7%) positive cases. The consistency observed between a single POC-CCA (t + ) or (t-) and the Kato-Katz (three slides) was poor (Kappa indexes <0.20). The highest positivity rate as determined by CCA and Kato-Katz was found in adults. At the baseline, a praziquantel treatment was administered to all individuals regardless of their infection status. According to the POC-CCA test, 93% of the previous positive cases became negative by the third week after the treatment; this rate reached 100% at the sixth week assessment. The follow-up showed that of the 175 individuals evaluated at one year post-treatment, only one (0.6%) showed 'trace' results, and all the individuals were negative for eggs in the stool. At two years, all 185 examined individuals were negative by the Kato-Katz method, and 11 (5.9%) presented traces by POC-CCA. Our results indicate that a single POC-CCA test reveals a significantly higher number of positive cases than the Kato-Katz technique for diagnosing S. mansoni in a low endemic setting, when trace results are considered as positive cases. Nevertheless, the true significance of the trace is not clear. These findings reinforce the need to associate different tools for improved schistosomiasis diagnosis in individuals with low parasite burdens.
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Alemu M, Zigta E, Derbie A. Under diagnosis of intestinal schistosomiasis in a referral hospital, North Ethiopia. BMC Res Notes 2018; 11:245. [PMID: 29661251 PMCID: PMC5902945 DOI: 10.1186/s13104-018-3355-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Accepted: 04/11/2018] [Indexed: 11/27/2022] Open
Abstract
Objective The present cross-sectional study was aimed at determining the magnitude of under diagnosis of intestinal schistosomiasis among patients requested for routine ova/parasite examination at Ayder referral hospital. Results A total of 280 stool samples were collected and only 5% of the patients were positive for ova of Schistosoma mansoni in the routine direct wet mount microscopy. On the other hand, 12.5% of the patients were positive for ova Schistosoma mansoni when the stool samples were processed by either Kato Kat or formol ether concentration techniques. Moderate test agreement (κ = 0.48) was recorded for wet mount. Formol-ether concentration (κ = 0.89) and Kato-Katz (κ = 0.92) showed excellent agreements with the ‘Gold’ standard. Direct wet mount technique exhibited the poorest sensitivity (35%) of detection of ova of Schistosoma mansoni. Hence, the Kato-Katz technique should be implemented in parallel with the direct wet mount microscopy for Schistosoma mansoni presumptive patients.
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Affiliation(s)
- Megbaru Alemu
- Department of Microbiology, Immunology and Parasitology, Bahir Dar University, Po. Box 79, Bahir Dar, Ethiopia.
| | - Eyob Zigta
- Department of Medical Parasitology and Vector Biology, Mekelle University, Mekelle, Ethiopia
| | - Awoke Derbie
- Department of Microbiology, Immunology and Parasitology, Bahir Dar University, Po. Box 79, Bahir Dar, Ethiopia
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Okoyo C, Simiyu E, Njenga SM, Mwandawiro C. Comparing the performance of circulating cathodic antigen and Kato-Katz techniques in evaluating Schistosoma mansoni infection in areas with low prevalence in selected counties of Kenya: a cross-sectional study. BMC Public Health 2018; 18:478. [PMID: 29642875 PMCID: PMC5896080 DOI: 10.1186/s12889-018-5414-9] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Accepted: 04/05/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Kato-Katz technique has been the mainstay test in Schistosoma mansoni diagnosis in endemic areas. However, recent studies have documented its poor sensitivity in evaluating Schistosoma mansoni infection especially in areas with lower rates of transmission. It's the primary diagnostic tool in monitoring impact of the Kenya national school based deworming program on infection transmission, but there is need to consider a more sensitive technique as the prevalence reduces. Therefore, this study explored the relationship between results of the stool-based Kato-Katz technique with urine-based point-of-care circulating cathodic antigen (POC-CCA) test in view to inform decision-making by the program in changing from Kato-Katz to POC-CCA test. METHODS We used two cross-sectional surveys conducted pre- and post- mass drug administration (MDA) using praziquantel in a representative random sample of children from 18 schools across 11 counties. A total of 1944 children were randomly sampled for the study. Stool and urine samples were tested for S. mansoni infection using Kato-Katz and POC-CCA methods, respectively. S. mansoni prevalence using each technique was calculated and 95% confidence intervals obtained using binomial regression model. Specificity (Sp) and sensitivity (Sn) were determined using 2 × 2 contingency tables and compared using the McNemar's chi-square test. RESULTS A total of 1899 and 1878 children were surveyed at pre- and post-treatment respectively. S. mansoni infection prevalence was 26.5 and 21.4% during pre- and post-treatment respectively using POC-CCA test, and 4.9 and 1.5% for pre- and post-treatment respectively using Kato-Katz technique. Taking POC-CCA as the gold standard, Kato-Katz was found to have significantly lower sensitivity both at pre- and post-treatment, Sn = 12.5% and Sn = 5.2% respectively, McNemar test χ2m = 782.0, p < 0.001. In overall, the results showed a slight/poor agreement between the two methods, kappa index (k) = 0.11, p < 0.001, inter-rater agreement = 77.1%. CONCLUSIONS Results showed POC-CCA technique as an effective, sensitive and accurate screening tool for Schistosoma mansoni infection in areas of low prevalence. It was up to 14-fold accurate than Kato-Katz which had extremely inadequate sensitivity. We recommend usage of POC-CCA alongside Kato-Katz examinations by Schistosomiasis control programs in low prevalence areas.
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Affiliation(s)
- Collins Okoyo
- Eastern and Southern Africa Centre of International Parasite Control, Kenya Medical Research Institute (KEMRI), P.O. Box 54840 - 00200, Nairobi, Kenya.
| | - Elses Simiyu
- Eastern and Southern Africa Centre of International Parasite Control, Kenya Medical Research Institute (KEMRI), P.O. Box 54840 - 00200, Nairobi, Kenya
| | - Sammy M Njenga
- Eastern and Southern Africa Centre of International Parasite Control, Kenya Medical Research Institute (KEMRI), P.O. Box 54840 - 00200, Nairobi, Kenya
| | - Charles Mwandawiro
- Eastern and Southern Africa Centre of International Parasite Control, Kenya Medical Research Institute (KEMRI), P.O. Box 54840 - 00200, Nairobi, Kenya
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Al-Shehri H, Koukounari A, Stanton MC, Adriko M, Arinaitwe M, Atuhaire A, Kabatereine NB, Stothard JR. Surveillance of intestinal schistosomiasis during control: a comparison of four diagnostic tests across five Ugandan primary schools in the Lake Albert region. Parasitology 2018; 145:1715-22. [PMID: 29560841 DOI: 10.1017/S003118201800029X] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Programmatic surveillance of intestinal schistosomiasis during control can typically use four diagnostic tests, either singularly or in combination, but these have yet to be cross-compared directly. Our study assembled a complete diagnostic dataset, inclusive of infection intensities, from 258 children from five Ugandan primary schools. The schools were purposely selected as typical of the endemic landscape near Lake Albert and reflective of high- and low-transmission settings. Overall prevalence was: 44.1% (95% CI 38.0–50.2) by microscopy of duplicate Kato-Katz smears from two consecutive stools, 56.9% (95% CI 50.8–63.0) by urine-circulating cathodic antigen (CCA) dipstick, 67.4% (95% CI 61.6–73.1) by DNA-TaqMan® and 75.1% (95% CI 69.8–80.4) by soluble egg antigen enzyme-linked immunosorbent assay (SEA-ELISA). A cross-comparison of diagnostic sensitivities, specificities, positive and negative predictive values was undertaken, inclusive of a latent class analysis (LCA) with a LCA-model estimate of prevalence by each school. The latter ranged from 9.6% to 100.0%, and prevalence by school for each diagnostic test followed a static ascending order or monotonic series of Kato-Katz, urine-CCA dipstick, DNA-TaqMan® and SEA-ELISA. We confirm that Kato-Katz remains a satisfactory diagnostic standalone in high-transmission settings but in low-transmission settings should be augmented or replaced by urine-CCA dipsticks. DNA-TaqMan® appears suitable in both endemic settings though is only implementable if resources permit. In low-transmission settings, SEA-ELISA remains the method of choice to evidence an absence infection. We discuss the pros and cons of each method concluding that future surveillance of intestinal schistosomiasis would benefit from a flexible, context-specific approach both in choice and application of each diagnostic method, rather than a single one-size fits all approach.
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Clements MN, Corstjens PLAM, Binder S, Campbell CH, de Dood CJ, Fenwick A, Harrison W, Kayugi D, King CH, Kornelis D, Ndayishimiye O, Ortu G, Lamine MS, Zivieri A, Colley DG, van Dam GJ. Latent class analysis to evaluate performance of point-of-care CCA for low-intensity Schistosoma mansoni infections in Burundi. Parasit Vectors 2018; 11:111. [PMID: 29475457 PMCID: PMC5824563 DOI: 10.1186/s13071-018-2700-4] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2017] [Accepted: 02/06/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Kato-Katz examination of stool smears is the field-standard method for detecting Schistosoma mansoni infection. However, Kato-Katz misses many active infections, especially of light intensity. Point-of-care circulating cathodic antigen (CCA) is an alternative field diagnostic that is more sensitive than Kato-Katz when intensity is low, but interpretation of CCA-trace results is unclear. To evaluate trace results, we tested urine and stool specimens from 398 pupils from eight schools in Burundi using four approaches: two in Burundi and two in a laboratory in Leiden, the Netherlands. In Burundi, we used Kato-Katz and point-of-care CCA (CCAB). In Leiden, we repeated the CCA (CCAL) and also used Up-Converting Phosphor Circulating Anodic Antigen (CAA). METHODS We applied Bayesian latent class analyses (LCA), first considering CCA traces as negative and then as positive. We used the LCA output to estimate validity of the prevalence estimates of each test in comparison to the population-level infection prevalence and estimated the proportion of trace results that were likely true positives. RESULTS Kato-Katz yielded the lowest prevalence (6.8%), and CCAB with trace considered positive yielded the highest (53.5%). There were many more trace results recorded by CCA in Burundi (32.4%) than in Leiden (2.3%). Estimated prevalence with CAA was 46.5%. LCA indicated that Kato-Katz had the lowest sensitivity: 15.9% [Bayesian Credible Interval (BCI): 9.2-23.5%] with CCA-trace considered negative and 15.0% with trace as positive (BCI: 9.6-21.4%), implying that Kato-Katz missed approximately 85% of infections. CCAB underestimated disease prevalence when trace was considered negative and overestimated disease prevalence when trace was considered positive, by approximately 12 percentage points each way, and CAA overestimated prevalence in both models. Our results suggest that approximately 52.2% (BCI: 37.8-5.8%) of the CCAB trace readings were true infections. CONCLUSIONS Whether measured in the laboratory or the field, CCA outperformed Kato-Katz at the low infection intensities in Burundi. CCA with trace as negative likely missed many infections, whereas CCA with trace as positive overestimated prevalence. In the absence of a field-friendly gold standard diagnostic, the use of a variety of diagnostics with differing properties will become increasingly important as programs move towards elimination of schistosomiasis. It is clear that CCA is a valuable tool for the detection and mapping of S. mansoni infection in the field and CAA may be a valuable field tool in the future.
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Affiliation(s)
- Michelle N. Clements
- Schistosomiasis Control Initiative (SCI), Department of Infectious Disease Epidemiology, Imperial College London, London, UK
| | - Paul L. A. M. Corstjens
- Department of Molecular Cell Biology, Leiden University Medical Center, Leiden, the Netherlands
| | - Sue Binder
- Center for Tropical and Emerging Global Diseases, University of Georgia, Athens, GA USA
| | - Carl H. Campbell
- Center for Tropical and Emerging Global Diseases, University of Georgia, Athens, GA USA
| | - Claudia J. de Dood
- Department of Molecular Cell Biology, Leiden University Medical Center, Leiden, the Netherlands
| | - Alan Fenwick
- Schistosomiasis Control Initiative (SCI), Department of Infectious Disease Epidemiology, Imperial College London, London, UK
| | - Wendy Harrison
- Schistosomiasis Control Initiative (SCI), Department of Infectious Disease Epidemiology, Imperial College London, London, UK
| | - Donatien Kayugi
- Programme National Intégré de lutte contre les Maladies Tropicales Négligées et la Cécité (PNIMTNC), Ministère de la Santé Publique et de la Lutte contre le SIDA, Bujumbura, Burundi
| | - Charles H. King
- Center for Global Health and Diseases, Case Western Reserve University School of Medicine, Cleveland, OH USA
| | - Dieuwke Kornelis
- Department of Molecular Cell Biology, Leiden University Medical Center, Leiden, the Netherlands
| | - Onesime Ndayishimiye
- Programme National Intégré de lutte contre les Maladies Tropicales Négligées et la Cécité (PNIMTNC), Ministère de la Santé Publique et de la Lutte contre le SIDA, Bujumbura, Burundi
| | - Giuseppina Ortu
- Schistosomiasis Control Initiative (SCI), Department of Infectious Disease Epidemiology, Imperial College London, London, UK
| | - Mariama Sani Lamine
- Schistosomiasis Control Initiative (SCI), Department of Infectious Disease Epidemiology, Imperial College London, London, UK
| | - Antonio Zivieri
- Schistosomiasis Control Initiative (SCI), Department of Infectious Disease Epidemiology, Imperial College London, London, UK
| | - Daniel G. Colley
- Center for Tropical and Emerging Global Diseases, University of Georgia, Athens, GA USA
| | - Govert J. van Dam
- Department of Molecular Cell Biology, Leiden University Medical Center, Leiden, the Netherlands
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He P, Gordon CA, Williams GM, Li Y, Wang Y, Hu J, Gray DJ, Ross AG, Harn D, McManus DP. Real-time PCR diagnosis of Schistosoma japonicum in low transmission areas of China. Infect Dis Poverty 2018; 7:8. [PMID: 29394958 PMCID: PMC5796516 DOI: 10.1186/s40249-018-0390-y] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2017] [Accepted: 01/17/2018] [Indexed: 01/22/2023] Open
Abstract
Background Schistosomiasis in the People’s Republic of China (PRC) can be traced back to antiquity. In the past 60 years, the Chinese government has made great efforts to control this persistent disease with elimination slated by 2020 through the implementation of a comprehensive control strategy. This strategy aims to reduce the role of bovines and humans as sources of infection as a pre-requisite for elimination through transmission interruption. The goal of elimination will be achievable only by the implementation of a sustainable surveillance and control system, with sensitive diagnosis a key feature so that the true disease burden is not underestimated. Currently used diagnostics lack the necessary sensitivity to accurately determine the prevalence of Schistosoma japonicum infection in areas with low infection intensities. It is of critical importance to find and treat people and to identify animals with low-level infections if the National Control Programme for China is to achieve schistosomiasis elimination. Methods We evaluated a real-time polymerase chain reaction (qPCR) assay using 633 human stool samples collected from five villages in Hunan, Anhui, Hubei, and Jiangxi provinces, and 182 bovine (70 cattle and 112 buffalo) stool samples obtained from four villages in Hunan, Anhui, and Jiangxi provinces in the PRC. All stool samples were subjected to the miracidium hatching test (MHT, a diagnostic procedure used in the National Schistosomiasis Control Programme) and the qPCR assay. Samples positive by MHT were subjected to either the Kato-Katz technique for humans, or the formalin-ethyl acetate sedimentation-digestion (FEA-SD) procedure for bovines, to determine infection intensities. Results The qPCR assay exhibited a high level of sensitivity in the detection of S. japonicum infections. With both the human and bovine samples, a significantly higher prevalence was determined using the qPCR assay (11.06% humans, 24.73% bovines) than with the MHT (0.93% humans, 7.69% bovines). The animal contamination index (calculated using data obtained with the qPCR technique) for all positive bovines was 27 618 000 eggs per day, indicating a considerable amount of environmental egg contamination that would be underestimated using less sensitive diagnostic procedures. Conclusions The qPCR assay we have evaluated will be applicable as a future field diagnostic and surveillance tool in low-transmission zones where schistosomiasis elimination is targeted and for monitoring post-intervention areas to verify that elimination has been maintained. Electronic supplementary material The online version of this article (10.1186/s40249-018-0390-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Pei He
- Hunan Institute of Parasitic Diseases, Yueyang, People's Republic of China
| | - Catherine A Gordon
- Molecular Parasitology Laboratory, Infectious Diseases Division, QIMR Berghofer Medical Research Institute, Brisbane, Australia.
| | - Gail M Williams
- Discipline of Epidemiology and Biostatistics, School of Population Health, University of Queensland, Brisbane, Australia
| | - Yuesheng Li
- Hunan Institute of Parasitic Diseases, Yueyang, People's Republic of China.,Molecular Parasitology Laboratory, Infectious Diseases Division, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Yuanyuan Wang
- Hunan Institute of Parasitic Diseases, Yueyang, People's Republic of China
| | - Junjian Hu
- Hunan Institute of Parasitic Diseases, Yueyang, People's Republic of China
| | - Darren J Gray
- Molecular Parasitology Laboratory, Infectious Diseases Division, QIMR Berghofer Medical Research Institute, Brisbane, Australia.,Discipline of Epidemiology and Biostatistics, School of Population Health, University of Queensland, Brisbane, Australia.,Research School of Population Health, The Australian National University, Canberra, Australia
| | - Allen G Ross
- Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD, Australia
| | - Donald Harn
- University of Georgia, College of Veterinary Medicine, Athens, GA, USA
| | - Donald P McManus
- Molecular Parasitology Laboratory, Infectious Diseases Division, QIMR Berghofer Medical Research Institute, Brisbane, Australia.
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Prada JM, Touloupou P, Adriko M, Tukahebwa EM, Lamberton PHL, Hollingsworth TD. Understanding the relationship between egg- and antigen-based diagnostics of Schistosoma mansoni infection pre- and post-treatment in Uganda. Parasit Vectors 2018; 11:21. [PMID: 29310695 PMCID: PMC5759883 DOI: 10.1186/s13071-017-2580-z] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2017] [Accepted: 12/06/2017] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Schistosomiasis is a major socio-economic and public health problem in many sub-Saharan African countries. After large mass drug administration (MDA) campaigns, prevalence of infection rapidly returns to pre-treatment levels. The traditional egg-based diagnostic for schistosome infections, Kato-Katz, is being substituted in many settings by circulating antigen recognition-based diagnostics, usually the point-of-care circulating cathodic antigen test (CCA). The relationship between these diagnostics is poorly understood, particularly after treatment in both drug-efficacy studies and routine monitoring. RESULTS We created a model of schistosome infections to better understand and quantify the relationship between these two egg- and adult worm antigen-based diagnostics. We focused particularly on the interpretation of "trace" results after CCA testing. Our analyses suggest that CCA is generally a better predictor of prevalence, particularly after treatment, and that trace CCA results are typically associated with truly infected individuals. CONCLUSIONS Even though prevalence rises to pre-treatment levels only six months after MDAs, our model suggests that the average intensity of infection is much lower, and is probably in part due to a small burden of surviving juveniles from when the treatment occurred. This work helps to better understand CCA diagnostics and the interpretation of post-treatment prevalence estimations.
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Affiliation(s)
- Joaquín M. Prada
- Department of Mathematics, University of Warwick, Coventry, UK
- School of Veterinary Medicine, Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK
| | | | - Moses Adriko
- Vector Control Division, Ministry of Health, Uganda, Kampala, Uganda
| | | | - Poppy H. L. Lamberton
- Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow, Glasgow, UK
- Wellcome Centre for Molecular Parasitology, University of Glasgow, Glasgow, UK
| | - T. Déirdre Hollingsworth
- Department of Mathematics, University of Warwick, Coventry, UK
- Big Data Institute, University of Oxford, Oxford, UK
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Vonghachack Y, Sayasone S, Khieu V, Bergquist R, van Dam GJ, Hoekstra PT, Corstjens PLAM, Nickel B, Marti H, Utzinger J, Muth S, Odermatt P. Comparison of novel and standard diagnostic tools for the detection of Schistosoma mekongi infection in Lao People's Democratic Republic and Cambodia. Infect Dis Poverty 2017; 6:127. [PMID: 28793922 PMCID: PMC5550959 DOI: 10.1186/s40249-017-0335-x] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Accepted: 07/12/2017] [Indexed: 12/29/2022] Open
Abstract
Background Given the restricted distribution of Schistosoma mekongi in one province in Lao People’s Democratic Republic (Lao PDR) and two provinces in Cambodia, together with progress of the national control programmes aimed at reducing morbidity and infection prevalence, the elimination of schistosomiasis mekongi seems feasible. However, sensitive diagnostic tools will be required to determine whether elimination has been achieved. We compared several standard and novel diagnostic tools in S. mekongi-endemic areas. Methods The prevalence and infection intensity of S. mekongi were evaluated in 377 study participants from four villages in the endemic areas in Lao PDR and Cambodia using Kato-Katz stool examination, antibody detection based on an enzyme-linked immunosorbent assay (ELISA) and schistosome circulating antigen detection by lateral-flow tests. Two highly sensitive test systems for the detection of cathodic and anodic circulating antigens (CCA, CAA) in urine and serum were utilized. Results Stool microscopy revealed an overall prevalence of S. mekongi of 6.4% (one case in Cambodia and 23 cases in Lao PDR), while that of Opisthorchis viverrini, hookworm, Trichuris trichiura, Ascaris lumbricoides and Taenia spp. were 50.4%, 28.1%, 3.5%, 0.3% and 1.9%, respectively. In the urine samples, the tests for CCA and CAA detected S. mekongi infections in 21.0% and 38.7% of the study participants, respectively. In the serum samples, the CAA assay revealed a prevalence of 32.4%, while a combination of the CAA assay in serum and in urine revealed a prevalence of 43.2%. There was a difference between the two study locations with a higher prevalence reached in the samples from Lao PDR. Conclusions The CCA, CAA and ELISA results showed substantially higher prevalence estimates for S. mekongi compared to Kato-Katz thick smears. Active schistosomiasis mekongi in Lao PDR and Cambodia might thus have been considerably underestimated previously. Hence, sustained control efforts are still needed to break transmission of S. mekongi. The pivotal role of highly sensitive diagnostic assays in areas targeting elimination cannot be overemphasised. Electronic supplementary material The online version of this article (doi:10.1186/s40249-017-0335-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Youthanavanh Vonghachack
- Faculty of Basic Sciences, University of Health Sciences, Ministry of Health, Vientiane, Lao People's Democratic Republic.,Swiss Tropical and Public Health Institute, P.O. Box, CH-4002, Basel, Switzerland.,University of Basel, P.O. Box, CH-4003, Basel, Switzerland
| | - Somphou Sayasone
- National Institute of Public Health, Ministry of Health, Vientiane, Lao People's Democratic Republic
| | - Virak Khieu
- National Centre for Parasitology, Entomology and Malaria Control, Ministry of Health, Phnom Penh, Cambodia
| | | | - Govert J van Dam
- Department of Parasitology, Leiden University Medical Center, Leiden, The Netherlands
| | - Pytsje T Hoekstra
- Department of Parasitology, Leiden University Medical Center, Leiden, The Netherlands
| | - Paul L A M Corstjens
- Department of Molecular Cell Biology, Leiden University Medical Center, Leiden, The Netherlands
| | - Beatrice Nickel
- Swiss Tropical and Public Health Institute, P.O. Box, CH-4002, Basel, Switzerland.,University of Basel, P.O. Box, CH-4003, Basel, Switzerland
| | - Hanspeter Marti
- Swiss Tropical and Public Health Institute, P.O. Box, CH-4002, Basel, Switzerland.,University of Basel, P.O. Box, CH-4003, Basel, Switzerland
| | - Jürg Utzinger
- Swiss Tropical and Public Health Institute, P.O. Box, CH-4002, Basel, Switzerland.,University of Basel, P.O. Box, CH-4003, Basel, Switzerland
| | - Sinuon Muth
- National Centre for Parasitology, Entomology and Malaria Control, Ministry of Health, Phnom Penh, Cambodia
| | - Peter Odermatt
- Swiss Tropical and Public Health Institute, P.O. Box, CH-4002, Basel, Switzerland. .,University of Basel, P.O. Box, CH-4003, Basel, Switzerland.
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Easton AV, Oliveira RG, Walker M, O'Connell EM, Njenga SM, Mwandawiro CS, Webster JP, Nutman TB, Anderson RM. Sources of variability in the measurement of Ascaris lumbricoides infection intensity by Kato-Katz and qPCR. Parasit Vectors 2017; 10:256. [PMID: 28545561 PMCID: PMC5445470 DOI: 10.1186/s13071-017-2164-y] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Accepted: 05/01/2017] [Indexed: 12/20/2022] Open
Abstract
Background Understanding and quantifying the sources and implications of error in the measurement of helminth egg intensity using Kato-Katz (KK) and the newly emerging “gold standard” quantitative polymerase chain reaction (qPCR) technique is necessary for the appropriate design of epidemiological studies, including impact assessments for deworming programs. Methods Repeated measurements of Ascaris lumbricoides infection intensity were made from samples collected in western Kenya using the qPCR and KK techniques. These data were combined with data on post-treatment worm expulsions. Random effects regression models were used to quantify the variability associated with different technical and biological factors for qPCR and KK diagnosis. The relative precision of these methods was compared, as was the precision of multiple qPCR replicates. Results For both KK and qPCR, intensity measurements were largely determined by the identity of the stool donor. Stool donor explained 92.4% of variability in qPCR measurements and 54.5% of observed measurement variance for KK. An additional 39.1% of variance in KK measurements was attributable to having expelled adult A. lumbricoides worms following anthelmintic treatment. For qPCR, the remaining 7.6% of variability was explained by the efficiency of the DNA extraction (2.4%), plate-to-plate variability (0.2%) and other residual factors (5%). Differences in replicate measurements by qPCR were comparatively small. In addition to KK variability based on stool donor infection levels, the slide reader was highly statistically significant, although it only explained 1.4% of the total variation. In a comparison of qPCR and KK variance to mean ratios under ideal conditions, the coefficient of variation was on average 3.6 times larger for KK highlighting increased precision of qPCR. Conclusions Person-to-person differences explain the majority of variability in egg intensity measurements by qPCR and KK, with very little additional variability explained by the technical factors associated with the practical implementation of these techniques. qPCR provides approximately 3.6 times more precision in estimating A. lumbricoides egg intensity than KK, and could potentially be made more cost-effective by testing each sample only once without diminishing the power of a study to assess population-level intensity and prevalence. Electronic supplementary material The online version of this article (doi:10.1186/s13071-017-2164-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Alice V Easton
- Helminth Immunology Section, Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Disease, National Institutes of Health, Bethesda, MD, 20814, USA. .,Department of Infectious Disease Epidemiology and London Centre for Neglected Tropical Disease Research (LCNTDR), Faculty of Medicine, Imperial College London St Mary's Campus, London, W2 1PG, UK.
| | - Rita G Oliveira
- Department of Infectious Disease Epidemiology and London Centre for Neglected Tropical Disease Research (LCNTDR), Faculty of Medicine, Imperial College London St Mary's Campus, London, W2 1PG, UK
| | - Martin Walker
- Department of Infectious Disease Epidemiology and London Centre for Neglected Tropical Disease Research (LCNTDR), Faculty of Medicine, Imperial College London St Mary's Campus, London, W2 1PG, UK.,Department of Pathobiology and Population Science and London Centre for Neglected Tropical Disease Research (LCNTDR), The Royal Veterinary College, Hawkshead Lane, Hatfield, Hertfordshire, AL97TA, UK
| | - Elise M O'Connell
- Helminth Immunology Section, Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Disease, National Institutes of Health, Bethesda, MD, 20814, USA
| | - Sammy M Njenga
- The Eastern and Southern Africa Centre of International Parasite Control (ESACIPAC), Kenya Medical Research Institute, Nairobi, Kenya
| | - Charles S Mwandawiro
- The Eastern and Southern Africa Centre of International Parasite Control (ESACIPAC), Kenya Medical Research Institute, Nairobi, Kenya
| | - Joanne P Webster
- Department of Infectious Disease Epidemiology and London Centre for Neglected Tropical Disease Research (LCNTDR), Faculty of Medicine, Imperial College London St Mary's Campus, London, W2 1PG, UK.,Department of Pathobiology and Population Science and London Centre for Neglected Tropical Disease Research (LCNTDR), The Royal Veterinary College, Hawkshead Lane, Hatfield, Hertfordshire, AL97TA, UK
| | - Thomas B Nutman
- Helminth Immunology Section, Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Disease, National Institutes of Health, Bethesda, MD, 20814, USA
| | - Roy M Anderson
- Department of Infectious Disease Epidemiology and London Centre for Neglected Tropical Disease Research (LCNTDR), Faculty of Medicine, Imperial College London St Mary's Campus, London, W2 1PG, UK
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41
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Colley DG, Andros TS, Campbell CH. Schistosomiasis is more prevalent than previously thought: what does it mean for public health goals, policies, strategies, guidelines and intervention programs? Infect Dis Poverty 2017; 6:63. [PMID: 28327187 PMCID: PMC5361841 DOI: 10.1186/s40249-017-0275-5] [Citation(s) in RCA: 95] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2017] [Accepted: 03/06/2017] [Indexed: 01/08/2023] Open
Abstract
Mapping and diagnosis of infections by the three major schistosome species (Schistosoma haematobium, S. mansoni and S. japonicum) has been done with assays that are known to be specific but increasingly insensitive as prevalence declines or in areas with already low prevalence of infection. This becomes a true challenge to achieving the goal of elimination of schistosomiasis because the multiplicative portion of the life-cycle of schistosomes, in the snail vector, favors continued transmission as long as even a few people maintain low numbers of worms that pass eggs in their excreta. New mapping tools based on detection of worm antigens (circulating cathodic antigen – CCA; circulating anodic antigen – CAA) in urine of those infected are highly sensitive and the CAA assay is reported to be highly specific. Using these tools in areas of low prevalence of all three of these species of schistosomes has demonstrated that more people harbor adult worms than are regularly excreting eggs at a level detectable by the usual stool assay (Kato-Katz) or by urine filtration. In very low prevalence areas this is sometimes 6- to10-fold more. Faced with what appears to be a sizable population of “egg-negative/worm-positive schistosomiasis” especially in areas of very low prevalence, national NTD programs are confounded about what guidelines and strategies they should enact if they are to proceed toward a goal of elimination. There is a critical need for continued evaluation of the assays involved and to understand the contribution of this “egg-negative/worm-positive schistosomiasis” condition to both individual morbidity and community transmission. There is also a critical need for new guidelines based on the use of these more sensitive assays for those national NTD programs that wish to move forward to strategies designed for elimination.
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Affiliation(s)
- Daniel G Colley
- Schistosomiasis Consortium for Operational Research and Evaluation (SCORE), Center for Tropical and Emerging Global Diseases (CTEGD), University of Georgia, 500 DW Brooks Drive, Room 330B Coverdell Center, Athens, Georgia, 30602, USA. .,Department of Microbiology, University of Georgia, Athens, Georgia, 30602, USA.
| | - Tamara S Andros
- Schistosomiasis Consortium for Operational Research and Evaluation (SCORE), Center for Tropical and Emerging Global Diseases (CTEGD), University of Georgia, 500 DW Brooks Drive, Room 330B Coverdell Center, Athens, Georgia, 30602, USA
| | - Carl H Campbell
- Schistosomiasis Consortium for Operational Research and Evaluation (SCORE), Center for Tropical and Emerging Global Diseases (CTEGD), University of Georgia, 500 DW Brooks Drive, Room 330B Coverdell Center, Athens, Georgia, 30602, USA
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Haggag AA, Rabiee A, Abd Elaziz KM, Gabrielli AF, Abdel Hay R, Ramzy RM. Mapping of Schistosoma mansoni in the Nile Delta, Egypt: Assessment of the prevalence by the circulating cathodic antigen urine assay. Acta Trop 2017; 167:9-17. [PMID: 27965144 DOI: 10.1016/j.actatropica.2016.11.038] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2016] [Revised: 11/18/2016] [Accepted: 11/27/2016] [Indexed: 11/24/2022]
Abstract
In line with WHO recommendations on elimination of schistosomiasis, accurate identification of all areas of residual transmission is a key step to design and implement measures aimed at interrupting transmission in low-endemic settings. To this purpose, we assessed the prevalence of active S. mansoni infection in five pilot governorates in the Nile Delta of Egypt by examining schoolchildren (6-15 years) using the Urine-Circulating Cathodic Antigen (Urine-CCA) cassette test; we also carried out the standard Kato-Katz (KK) thick smear, the monitoring and evaluation tool employed by Egypt's national schistosomiasis control programme. Prevalence rates determined by the Urine-CCA test for all governorates were higher than those determined by KK (p<0.01). Of 35 districts surveyed in the five governorates, S. mansoni infection was detected in 19 districts (54.3%) using KK, and in 31 districts (88.6%) by Urine-CCA (χ2=9.94; P=0.0016). S. mansoni infections were detected by Urine-CCA, but not by KK in 12 districts (34.3%), and infection was not detected by either of the two diagnostic methods in four districts in Qalyubia governorate. Males and higher age-groups have significantly higher Urine-CCA prevalence rates. Based on the findings of the current S. mansoni mapping exercise, authorities of the Ministry of Health and Population (MoHP) adopted a new elimination strategy by readjusting thresholds for mass treatment with praziquantel and targeting all transmission areas. MoHP is now planning to remap in all other endemic governorates using Urine-CCA with the aim of identifying all areas of transmission where the elimination strategy should be applied.
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Stanton MC, Adriko M, Arinaitwe M, Howell A, Davies J, Allison G, LaCourse EJ, Muheki E, Kabatereine NB, Stothard JR. Intestinal schistosomiasis in Uganda at high altitude (>1400 m): malacological and epidemiological surveys on Mount Elgon and in Fort Portal crater lakes reveal extra preventive chemotherapy needs. Infect Dis Poverty 2017; 6:34. [PMID: 28162096 PMCID: PMC5292801 DOI: 10.1186/s40249-017-0248-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2016] [Accepted: 01/19/2017] [Indexed: 01/24/2023] Open
Abstract
Background Intestinal schistosomiasis is of public health importance in Uganda but communities living above 1400 m are not targeted for control as natural transmission is thought unlikely. To assess altitudinal boundaries and at-risk populations, conjoint malacological and epidemiological surveys were undertaken on Mount Elgon (1139 m–3937 m), in Fort Portal crater lakes and in the Rwenzori Mountains (1123 m–4050 m). Methods Seventy freshwater habitats [Mount Elgon (37), Fort Portal crater lakes (23), Rwenzori Mountains (8) and Lake Albert (2)] were inspected for Biomphalaria species. Water temperature, pH and conductivity were recorded. A parasitological examination of 756 schoolchildren [Mount Elgon (300), Fort Portal crater lakes (456)] by faecal microscopy of duplicate Kato-Katz smears from two consecutive stool samples was bolstered by antigen (urine-CCA dipstick) and antibody (SEA-ELISA) diagnostic assays. Results Biomphalaria spp. was found up to 1951 m on Mount Elgon and 1567 m in the Fort Portal crater lakes. Although no snail from Mount Elgon shed cercariae, molecular analysis judged 7.1% of snails sampled at altitudes above 1400 m as having DNA of Schistosoma mansoni; in Fort Portal crater lakes three snails shed schistosome cercariae. Prevalence of intestinal schistosomiasis as measured in schoolchildren by Kato-Katz (Mount Elgon = 5.3% v. Fort Portal crater lakes = 10.7%), CCA urine-dipsticks (18.3% v. 34.4%) and SEA-ELISA (42.3% v. 63.7%) showed negative associations with increasing altitude with some evidence of infection up to 2000 m. Conclusions Contrary to expectations, these surveys clearly show that natural transmission of intestinal schistosomiasis occurs above 1400 m, possibly extending up to 2000 m. Using spatial epidemiological predictions, this now places some extra six million people at-risk, denoting an expansion of preventive chemotherapy needs in Uganda. Electronic supplementary material The online version of this article (doi:10.1186/s40249-017-0248-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Michelle C Stanton
- Department of Parasitology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK
| | - Moses Adriko
- Vector Control Division, Ministry of Health, Kampala, P.O. Box 1661, Uganda
| | - Moses Arinaitwe
- Vector Control Division, Ministry of Health, Kampala, P.O. Box 1661, Uganda
| | - Alison Howell
- Department of Parasitology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK
| | - Juliet Davies
- Department of Parasitology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK
| | - Gillian Allison
- Department of Parasitology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK
| | - E James LaCourse
- Department of Parasitology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK
| | - Edridah Muheki
- Vector Control Division, Ministry of Health, Kampala, P.O. Box 1661, Uganda
| | - Narcis B Kabatereine
- Vector Control Division, Ministry of Health, Kampala, P.O. Box 1661, Uganda.,Schistosomiasis Control Initiative, Imperial College London, London, W2 1PG, UK
| | - J Russell Stothard
- Department of Parasitology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK.
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Bajiro M, Dana D, Ayana M, Emana D, Mekonnen Z, Zawdie B, Garbi A, Kure A, Zeynudin A. Prevalence of Schistosoma mansoni infection and the therapeutic efficacy of praziquantel among school children in Manna District, Jimma Zone, southwest Ethiopia. Parasit Vectors 2016; 9:560. [PMID: 27772528 PMCID: PMC5075754 DOI: 10.1186/s13071-016-1833-6] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2016] [Accepted: 10/05/2016] [Indexed: 01/17/2023] Open
Abstract
Background Intestinal schistosomiasis is one of the neglected tropical parasitic diseases caused by Schistosoma mansoni. Currently, the control measures for the disease are mainly based on mass drug administration (MDA) with praziquantel (PZQ) targeting the school-age children. In Ethiopia, the potential foci for schistosomiasis and therapeutic efficacy of PZQ among school-age children remain poorly explored. Therefore, we determined both the prevalence and intensity of S. mansoni infection and the therapeutic efficacy of PZQ among school children in the Manna District (new foci for S. mansoni), Jimma Zone, southwest Ethiopia. Methods A cross-sectional study was conducted among the school children aged between 6 and 18 years in three primary schools in Manna district from March to April 2014. For diagnosis of S. mansoni, a single stool sample was obtained from each child and processed using single Kato Katz and examined under light microscopy. A questionnaire was used to collect demographic information of the school children participated in the study. School children excreting eggs of S. mansoni were administered with 40 mg/kg of PZQ and re-examined after three weeks post-treatment. The therapeutic efficacy of PZQ against S. mansoni was evaluated by means of cure rate and egg reduction rate. Results The overall prevalence of S. mansoni among the school children in the three primary schools in Manna District was 24.0 %. Higher prevalence was recorded for males 25.6 % (61/238) than for females 22.5 % (59/262). Majority (27.5 %) of infection intensity was light with mean faecal egg count (FEC) of 202 eggs per gram (EPG). The therapeutic efficacy of PZQ at a dose of 40 mg/kg was highly efficient (cure rate of 99.1 % and egg reduction rate of 99.9 %) among the school children in the three primary schools in Manna District. Conclusions The school children in the three primary schools of Manna District, Jimma Zone were at moderate risk of the morbidity caused by S. mansoni (prevalence > 10 % and < 50 % according to WHO threshold), and hence a biannual MDA with PZQ is required. PZQ available on the local market was found efficient and can be recommended for individual treatment in absence of MDA. The therapeutic efficacy of PZQ at 40 mg/kg against S. mansoni was high in the study area. Electronic supplementary material The online version of this article (doi:10.1186/s13071-016-1833-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Mitiku Bajiro
- Department of Medical Laboratory Sciences and Pathology, Jimma University, Jimma, Ethiopia.
| | - Daniel Dana
- Department of Medical Laboratory Sciences and Pathology, Jimma University, Jimma, Ethiopia
| | - Mio Ayana
- Department of Medical Laboratory Sciences and Pathology, Jimma University, Jimma, Ethiopia
| | - Daniel Emana
- Department of Medical Laboratory Sciences and Pathology, Jimma University, Jimma, Ethiopia
| | - Zeleke Mekonnen
- Department of Medical Laboratory Sciences and Pathology, Jimma University, Jimma, Ethiopia
| | - Belay Zawdie
- Departement of Biomedical Sciences, Jimma University, Jimma, Ethiopia
| | - Asfaw Garbi
- Departement of Biomedical Sciences, Jimma University, Jimma, Ethiopia
| | - Ashenafi Kure
- Public Health Laboratory, South Nations Nationalities and People's Regional State Health Bureau, Hawassa, Ethiopia
| | - Ahmed Zeynudin
- Department of Medical Laboratory Sciences and Pathology, Jimma University, Jimma, Ethiopia
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Lopez M, Morales ML, Konana M, Hoyer P, Pineda-Reyes R, White AC, Garcia HH, Lescano AG, Gotuzzo E, Cabada MM. Kato-Katz and Lumbreras rapid sedimentation test to evaluate helminth prevalence in the setting of a school-based deworming program. Pathog Glob Health 2016; 110:130-4. [PMID: 27376503 PMCID: PMC4984960 DOI: 10.1080/20477724.2016.1187361] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
The sensitivity of the Kato-Katz test is suboptimal for the evaluation of intestinal helminth prevalence. Moreover, during mass deworming, as helminth egg burden decreases, the sensitivity is likely to decrease. The Lumbreras rapid sedimentation (Lumbreras) is a low-cost non-quantitative test, but may provide useful information in low burden areas. We compared the prevalence of intestinal helminth infections assessed by the Kato-Katz and the Lumbreras rapid sedimentation test on 3 stool specimens from each of 1083 children. The sensitivities were compared using the McNemar paired test. Using the combined outcome of the 3 different stool tests as the standard, Kato-Katz had lower sensitivity than Lumbreras rapid sedimentation tests for Ascaris lumbricoides (85.1% vs. 95.1%, p = 0.03), Hymenolepis nana (77.7% vs. 97.9%, p < 0.01), Trichuris trichura (41.7% vs. 100%, p = 0.01), hookworm (0% vs. 100%, p = 0.01), and Strongyloides stercoralis (0% vs. 88%, p < 0.01). Kato-Katz demonstrated significantly lower sensitivity, missing most T. trichiura, hookworm, and S. stercoralis infections. The combination of Kato-Katz and Lumbreras rapid sedimentation tests enables the detection of more intestinal helminths infections in post-deworming low prevalence areas.
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Affiliation(s)
- Martha Lopez
- Universidad Peruana Cayetano Heredia and University of Texas Medical Branch Collaborative Research Center, Cusco, Peru
| | - Maria Luisa Morales
- Universidad Peruana Cayetano Heredia and University of Texas Medical Branch Collaborative Research Center, Cusco, Peru
| | - Monisha Konana
- School of Medicine, University of Texas Medical Branch, Galveston, TX, USA
| | - Paige Hoyer
- School of Medicine, University of Texas Medical Branch, Galveston, TX, USA
| | - Roberto Pineda-Reyes
- Universidad Peruana Cayetano Heredia and University of Texas Medical Branch Collaborative Research Center, Cusco, Peru
| | - Arthur Clinton White
- Universidad Peruana Cayetano Heredia and University of Texas Medical Branch Collaborative Research Center, Cusco, Peru
- Infectious Disease Division, Department of Internal Medicine, University of Texas Medical Branch, Galveston, TX, USA
| | - Hector Hugo Garcia
- Cysticercosis Working Group in Peru, Lima, Peru
- Faculty of Science and Philosophy, Infectious Diseases Laboratory Research-LID, Alberto Cazorla Talleri, Universidad Peruana Cayetano Heredia, Lima, Peru
- Cysticercosis Unit, Instituto de Ciencias Neurologicas, Lima, Peru
| | - Andres Guillermo Lescano
- School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru
- US Naval Medical Research Unit No. 6 (NAMRU-6), Lima, Peru
| | - Eduardo Gotuzzo
- Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Miguel Mauricio Cabada
- Universidad Peruana Cayetano Heredia and University of Texas Medical Branch Collaborative Research Center, Cusco, Peru
- Infectious Disease Division, Department of Internal Medicine, University of Texas Medical Branch, Galveston, TX, USA
- Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru
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Bopda J, Nana-Djeunga H, Tenaguem J, Kamtchum-Tatuene J, Gounoue-Kamkumo R, Assob-Nguedia C, Kamgno J. Prevalence and intensity of human soil transmitted helminth infections in the Akonolinga health district (Centre Region, Cameroon): Are adult hosts contributing in the persistence of the transmission? Parasite Epidemiol Control 2016; 1:199-204. [PMID: 29988185 PMCID: PMC5991827 DOI: 10.1016/j.parepi.2016.03.001] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2015] [Revised: 03/01/2016] [Accepted: 03/02/2016] [Indexed: 12/24/2022] Open
Abstract
Background Soil-transmitted helminthiases (STHs) are among the most prevalent afflictions of the developing world, with approximately 2 billion people infected worldwide. Heavily infected individuals suffer from severe morbidity that can result in death. These parasitic diseases also impair physical and mental growth in childhood, thwart educational advancement, and hinder economic development. Periodic deworming with Albendazole or Mebendazole of high-risk groups (school-age children, preschool children, and pregnant women) can significantly lower the levels of infections below the threshold associated with morbidity. However, an important proportion of the population (adults) is excluded from this high-risk group treatment based-strategy, and might lead to the persistence of these diseases in endemic areas despite the repeated treatments. The main objective of this study was to evaluate the contribution of this neglected at-risk group in the spread and persistence of STH in Cameroon. Methods A cross sectional survey was conducted in the Akonolinga health district (Centre Region, Cameroon) to assess the prevalence and intensity of these helminth infections. Stool samples were collected from males and females, aged 18 years and over, and analyzed using the Kato-Katz technique. Results A total of 334 patients, among which 181 (54.2%) females and 153 (45.8%) males, were examined. The STH of major concern was found in this group of individuals, with overall prevalence equal to 18.0% (95% CI: 14.2–22.4) for Ascaris lumbricoides, 43.7% (95% CI: 38.5–49.1) for Trichuris trichiura, and 7.5% (95% CI: 5.1–10.8) for Necator americanus. Conclusion This study reveals that STH infections are prevalent in adults in the Akonolinga health district, with moderate to high risk and light intensity of infection. These infected adults might constitute a potential parasite reservoir and a source of dissemination and persistence of these infections, highlighting the need to really take into account this neglected group of individuals in the mass treatment policy.
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Affiliation(s)
- Jean Bopda
- Centre for Research on Filariasis and other Tropical Diseases (CRFilMT), P.O. Box 5797, Yaounde, Cameroon
| | - Hugues Nana-Djeunga
- Centre for Research on Filariasis and other Tropical Diseases (CRFilMT), P.O. Box 5797, Yaounde, Cameroon.,Parasitology and Ecology Laboratory, Department of Animal Biology and Physiology, Faculty of Science, P.O. Box 812, University of Yaounde 1, Yaounde, Cameroon
| | - Jean Tenaguem
- Centre for Research on Filariasis and other Tropical Diseases (CRFilMT), P.O. Box 5797, Yaounde, Cameroon
| | - Joseph Kamtchum-Tatuene
- Centre for Research on Filariasis and other Tropical Diseases (CRFilMT), P.O. Box 5797, Yaounde, Cameroon
| | - Raceline Gounoue-Kamkumo
- Centre for Research on Filariasis and other Tropical Diseases (CRFilMT), P.O. Box 5797, Yaounde, Cameroon.,Laboratory of Animal Physiology, Department of Animal Biology and Physiology, Faculty of Science, P.O. Box 812, University of Yaounde 1, Yaounde, Cameroon
| | - Clément Assob-Nguedia
- INSAM, Department of Medicine and Biomedical Sciences, University of Buea, P.O. Box 63, Buea, Cameroon
| | - Joseph Kamgno
- Centre for Research on Filariasis and other Tropical Diseases (CRFilMT), P.O. Box 5797, Yaounde, Cameroon.,Department of Public Health, Faculty of Medicine and Biomedical Sciences, P.O. Box 1364, University of Yaounde 1, Yaounde, Cameroon
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Mwinzi PNM, Kittur N, Ochola E, Cooper PJ, Campbell CH, King CH, Colley DG. Additional Evaluation of the Point-of-Contact Circulating Cathodic Antigen Assay for Schistosoma mansoni Infection. Front Public Health 2015; 3:48. [PMID: 25853117 PMCID: PMC4365547 DOI: 10.3389/fpubh.2015.00048] [Citation(s) in RCA: 59] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2015] [Accepted: 03/04/2015] [Indexed: 01/02/2023] Open
Abstract
Studies of the urine-based point-of-contact cathodic circulating antigen test (POC-CCA) in Schistosoma mansoni-endemic settings in Africa indicate it has good sensitivity in detecting infections, but in areas of low prevalence, the POC-CCA can be positive for persons who are egg-negative by Kato-Katz stool assays. We examined the POC-CCA assay for: (a) batch-to-batch stability; (b) intra-reader and inter-reader variability; (c) day-to-day variability compared to Kato-Katz stool assays, and (d) to see if praziquantel (PZQ) treatment converted Kato-Katz-negative/POC-CCA positive individuals to POC-CCA negativity. We found essentially no batch-to-batch variation, negligible intra-reader variability (2%), and substantial agreement for inter-reader reliability. Some day-to-day variation was observed over 5 days of urine collection, but less than the variation in Kato-Katz stool assays over 3 days. To evaluate the effect of treatment on Kato-Katz(-)/POC-CCA(+) children, 149 children in an area of 10-15% prevalence who were Kato-Katz(-) based on 3 stool samples but POC-CCA(+) were enrolled. Seven days after treatment (PZQ 40 mg/kg) samples were again collected and tested. Almost half (47%) POC-CCA positive children turned negative. Those still POC-CCA positive received a second treatment, and 34% of them turned POC-CCA negative upon this second treatment. Most who remained POC-CCA positive shifted each time to a "lesser" POC-CCA "level of positivity." The data suggest that most Kato-Katz-negative/POC-CCA positive individuals harbor low-intensity infections, and each treatment kills all or some of their adult worms. The data also suggest that when evaluated by a more sensitive assay, the effective cure rates for PZQ are significantly less than those inferred from fecal testing. These findings have public health significance for the mapping and monitoring of Schistosoma infections and in planning the transition from schistosomiasis morbidity control to elimination of transmission.
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Affiliation(s)
- Pauline N M Mwinzi
- Neglected Tropical Diseases Research Unit, Center for Global Health Research, Kenya Medical Research Institute , Kisumu , Kenya
| | - Nupur Kittur
- Center for Tropical and Emerging Global Diseases, University of Georgia , Athens, GA , USA
| | - Elizabeth Ochola
- Neglected Tropical Diseases Research Unit, Center for Global Health Research, Kenya Medical Research Institute , Kisumu , Kenya
| | - Philip J Cooper
- Institute of Infection and Immunity, St George's University of London , London , UK ; Centro de Investigación en Enfermedades Infecciosas y Crónicas, Pontificia Universidad Católica del Ecuador , Quito , Ecuador
| | - Carl H Campbell
- Center for Tropical and Emerging Global Diseases, University of Georgia , Athens, GA , USA
| | - Charles H King
- Center for Global Health and Diseases, Case Western Reserve University School of Medicine , Cleveland, OH , USA
| | - Daniel G Colley
- Center for Tropical and Emerging Global Diseases, University of Georgia , Athens, GA , USA ; Department of Microbiology, University of Georgia , Athens, GA , USA
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Nickel B, Sayasone S, Vonghachack Y, Odermatt P, Marti H. Schistosoma mansoni antigen detects Schistosoma mekongi infection. Acta Trop 2015; 141:310-4. [PMID: 25116398 DOI: 10.1016/j.actatropica.2014.08.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2014] [Revised: 07/20/2014] [Accepted: 08/02/2014] [Indexed: 12/28/2022]
Abstract
Northern Cambodia and Southern Laos are highly endemic for Schistosoma mekongi. However, there is currently no immunological assay available that is specific for this form of schistosomiasis. We have validated Schistosoma mansoni antigens to detect S. mekongi-directed antibodies in human sera collected from a highly S. mekongi endemic region in Laos. On two consecutive days stool samples of 234 individuals were analyzed by Kato-Katz for presence of S. mekongi eggs and the results were correlated with serology. A sensitivity of 94.5% was calculated for a combination of ELISA and indirect fluorescence assay (IFA) as compared to the detection of S. mekongi eggs in stool samples as gold standard. The results demonstrate that S. mansoni antigens can be used for the diagnosis of S. mekongi infections.
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Couto LD, Tibiriça SHC, Pinheiro IO, Mitterofhe A, Lima AC, Castro MF, Gonçalves M, Silva MR, Guimarães RJPS, Rosa FM, Coimbra ES. Neglected tropical diseases: prevalence and risk factors for schistosomiasis and soil-transmitted helminthiasis in a region of Minas Gerais State, Brazil. Trans R Soc Trop Med Hyg 2014; 108:363-71. [PMID: 24781377 DOI: 10.1093/trstmh/tru054] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Among the neglected tropical diseases (NTDs), schistosomiasis and the three main soil-transmitted helminthiases (STHs), i.e., ascariasis, trichuriasis and hookworm infection, represent the most common infections in developing countries. In Brazil, there is a lack of epidemiological data in many parts of the country, which favors the unawareness of the real situation concerning these diseases. Due to this, we investigated the occurrence of schistosomiasis and STHs in a region of Minas Gerais State, Brazil. METHODS One stool sample was collected from 503 individuals, whose ages ranged from 0.1 to 91.2 years, and screened using both the Kato-Katz and the Formol-Ether methods. In parallel, a malacological survey was carried out in the main water bodies of the district, and Biomphalaria susceptibility assays and kernel-based techniques were also performed. RESULTS No individual was found infected with Ascaris lumbricoides or hookworm. Schistosoma mansoni was the most common parasite found (1.6%). The prevalence was higher in males and the chance of acquiring the disease increased by 43.35 times with contact with a body of water. None of the Biomphalaria tenagophila and B. glabrata specimens were found naturally infected, but B. glabrata was highly susceptible to infection with Schistosoma mansoni. Using kernel-based techniques, clusters of Biomphalaria were found near the households where the infected individuals lived. CONCLUSIONS Schistosomiasis was the most prevalent parasitic infection found. Our findings show that the occurrence of this disease has been underestimated by the local health care service, and highlight the importance of epidemiological surveillance in areas of low prevalence for schistosomiasis.
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Affiliation(s)
- Luzivalda D Couto
- Programa de Pós-graduação em Saúde Brasileira, Universidade Federal de Juiz de Fora, Juiz de Fora, MG, Brasil
| | - Sandra H C Tibiriça
- Departamento de Clínica médica, Faculdade de Medicina, Universidade Federal de Juiz de Fora, Juiz de Fora, MG, Brasil
| | - Izabella O Pinheiro
- Superintendência Regional de Saúde de Juiz de Fora, Secretaria de Estado da Saúde de Minas Gerais, Juiz de Fora, MG, Brasil
| | - Adalberto Mitterofhe
- Superintendência Regional de Saúde de Juiz de Fora, Secretaria de Estado da Saúde de Minas Gerais, Juiz de Fora, MG, Brasil
| | - Adilson C Lima
- Superintendência Regional de Saúde de Juiz de Fora, Secretaria de Estado da Saúde de Minas Gerais, Juiz de Fora, MG, Brasil
| | - Milton F Castro
- Superintendência Regional de Saúde de Juiz de Fora, Secretaria de Estado da Saúde de Minas Gerais, Juiz de Fora, MG, Brasil
| | - Murilo Gonçalves
- Superintendência Regional de Saúde de Juiz de Fora, Secretaria de Estado da Saúde de Minas Gerais, Juiz de Fora, MG, Brasil
| | | | | | - Florence M Rosa
- Departamento de Parasitologia, Microbiologia e Imunologia, Instituto de Ciências Biológicas, Universidade Federal de Juiz de Fora, Juiz de Fora, MG, Brasil
| | - Elaine S Coimbra
- Departamento de Parasitologia, Microbiologia e Imunologia, Instituto de Ciências Biológicas, Universidade Federal de Juiz de Fora, Juiz de Fora, MG, Brasil
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Idris MA, Al-Jabri AM. Usefulness of Kato-Katz and trichrome staining as diagnostic methods for parasitic infections in clinical laboratories. J Sci Res Med Sci 2001; 3:65-8. [PMID: 24019710 PMCID: PMC3174709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
OBJECTIVES To assess the efficacy of the Kato-Katz technique and to re-evaluate other routine procedures conducted in the Microbiology Clinical Laboratory at Sultan Qaboos University Hospital (SQUH) and to throw light on the prevalence of intestinal parasitic infections among a small group of food handlers in Muscat. METHOD Faecal samples collected from food handlers were examined using five parasitological techniques. RESULTS Out of 100 faecal samples, 53 were positive for one or more of 11 intestinal parasites. The Kato-Katz and trichrome stain methods were found superior to the other techniques in detecting helminthic and protozoan infections, respectively. The auramine stain was useful only in detecting Cryptosporidium parvum oocysts. CONCLUSION A combination of trichrome stain and Kato-Katz techniques for stool examination is sufficient and recommended for busy laboratories; auramine stain should be applied only to samples with suspected cryptosporidal infections.
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Affiliation(s)
- M A Idris
- Department of Microbiology and Immunology, College of Medicine, Sultan Qaboos University, P.O. Box: 35, Al-Khod 123, Muscat, Sultanate of Oman
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