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The urine circulating cathodic antigen (CCA) dipstick: a valid substitute for microscopy for mapping and point-of-care diagnosis of intestinal schistosomiasis.

Sousa-Figueiredo, JC, Betson, M, Kabatereine, NB and Stothard, JR (2013) The urine circulating cathodic antigen (CCA) dipstick: a valid substitute for microscopy for mapping and point-of-care diagnosis of intestinal schistosomiasis. PLoS neglected tropical diseases, 7 (1).

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Abstract

BACKGROUND: The World Health Organization now recommends the provision of praziquantel treatment to preschool-aged children infected with schistosomiasis. For intestinal schistosomiasis the current operational field diagnostic standard is examination of a thick Kato-Katz smear by microscopy prepared from a single stool specimen, and although pragmatic, this methodology has well-known shortcomings. Here, as a potential alternative, the performance of the urine circulating cathodic antigen (CCA) dipstick test was assessed in terms of disease-mapping and point-of-care diagnosis for intestinal schistosomiasis in preschool-aged children. Our manuscript reports on findings at baseline and at the end of a one-year longitudinal treatment study. METHODOLOGY/PRINCIPAL FINDINGS: A total of 925 children (mean age 2.8 years) were initially recruited from six lakeshore villages representative of high, moderate and low levels of disease transmission. At baseline, all children were tested for intestinal schistosomiasis by microscopic examination of duplicate Kato-Katz smears prepared from a single stool faecal, by antigen detection with the urine CCA dipstick test and by serology with a commercially available ELISA test (as 'gold-standard') that measures host antibody titres to soluble egg antigens. As a point-of-care diagnosis, the urine CCA dipstick test achieved sensitivity and specificity values ranging from 52.5-63.2% and 57.7-75.6%, respectively, with faecal microscopy achieving very high specificities (>87%) but sensitivities as low as 16.7% in the low transmission setting. CONCLUSION/SIGNIFICANCE: The urine CCA test was shown to be more effective than faecal microscopy especially in lower transmission settings. The diagnostic performance of this test was not significantly impacted by treatment history or co-infections with other intestinal helminths.

Item Type: Article
Divisions : Faculty of Health and Medical Sciences
Authors :
AuthorsEmailORCID
Sousa-Figueiredo, JCUNSPECIFIEDUNSPECIFIED
Betson, MUNSPECIFIEDUNSPECIFIED
Kabatereine, NBUNSPECIFIEDUNSPECIFIED
Stothard, JRUNSPECIFIEDUNSPECIFIED
Date : 24 January 2013
Identification Number : 10.1371/journal.pntd.0002008
Uncontrolled Keywords : Antibodies, Helminth, Antigens, Helminth, Child, Child, Preschool, Clinical Laboratory Techniques, Enzyme-Linked Immunosorbent Assay, Feces, Female, Glycoproteins, Helminth Proteins, Humans, Immunoassay, Infant, Male, Microscopy, Parasitology, Point-of-Care Systems, Schistosomiasis mansoni, Sensitivity and Specificity
Related URLs :
Additional Information : Copyright: 2013 Sousa-Figueiredo et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Depositing User : Symplectic Elements
Date Deposited : 11 Aug 2015 14:49
Last Modified : 11 Aug 2015 14:49
URI: http://epubs.surrey.ac.uk/id/eprint/808129

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