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Fecal occult blood and fecal calprotectin as point-of-care markers of intestinal morbidity in Ugandan children with Schistosoma mansoni infection.

Bustinduy, AL, Sousa-Figueiredo, JC, Adriko, M, Betson, M, Fenwick, A, Kabatereine, N and Stothard, JR (2013) Fecal occult blood and fecal calprotectin as point-of-care markers of intestinal morbidity in Ugandan children with Schistosoma mansoni infection. PLoS neglected tropical diseases, 7 (11).

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Abstract

BACKGROUND: Calprotectin is a calcium-binding cytoplasmic protein found in neutrophils and increasingly used as a marker of bowel inflammation. Fecal occult blood (FOB) is also a dependable indicator of bowel morbidity. The objective of our study was to determine the applicability of these tests as surrogate markers of Schistosoma mansoni intestinal morbidity before and after treatment with praziquantel (PZQ). METHODS: 216 children (ages 3-9 years old) from Buliisa District in Lake Albert, Uganda were examined and treated with PZQ at baseline in October 2012 with 211 of them re-examined 24 days later for S. mansoni and other soil transmitted helminths (STH). POC calprotectin and FOB assays were performed at both time points on a subset of children. Associations between the test results and infection were analysed by logistic regression. RESULTS: Fecal calprotectin concentrations of 150-300 µg/g were associated with S. mansoni egg patent infection both at baseline and follow up (OR: 12.5 P = 0.05; OR: 6.8 P = 0.02). FOB had a very strong association with baseline anemia (OR: 9.2 P = 0.03) and medium and high egg intensity schistosomiasis at follow up (OR: 6.6 P = 0.03; OR: 51.3 P = 0.003). Both tests were strongly associated with heavy intensity S. mansoni infections. There was a significant decrease in FOB and calprotectin test positivity after PZQ treatment in those children who had egg patent schistosomiasis at baseline. CONCLUSIONS: Both FOB and calprotectin rapid assays were found to correlate positively and strongly with egg patent S. mansoni infection with a positive ameloriation response after PZQ treatment indicative of short term reversion of morbidity. Both tests were appropriate for use in the field with excellent operational performance and reliability. Due to its lower-cost which makes its scale-up of use affordable, FOB could be immediately adopted as a monitoring tool for PC campaigns for efficacy evaluation before and after treatment.

Item Type: Article
Divisions : Faculty of Health and Medical Sciences
Authors :
AuthorsEmailORCID
Bustinduy, ALUNSPECIFIEDUNSPECIFIED
Sousa-Figueiredo, JCUNSPECIFIEDUNSPECIFIED
Adriko, MUNSPECIFIEDUNSPECIFIED
Betson, MUNSPECIFIEDUNSPECIFIED
Fenwick, AUNSPECIFIEDUNSPECIFIED
Kabatereine, NUNSPECIFIEDUNSPECIFIED
Stothard, JRUNSPECIFIEDUNSPECIFIED
Date : 14 November 2013
Identification Number : 10.1371/journal.pntd.0002542
Uncontrolled Keywords : Animals, Child, Child, Preschool, Feces, Female, Humans, Intestines, Leukocyte L1 Antigen Complex, Male, Occult Blood, Schistosoma mansoni, Schistosomiasis mansoni
Related URLs :
Additional Information : Copyright: 2013 Bustinduy 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 14:40
Last Modified : 11 Aug 2015 14:40
URI: http://epubs.surrey.ac.uk/id/eprint/808132

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