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Understanding the relationship between egg- and antigen-based diagnostics of Schistosoma mansoni infection pre- and post-treatment in Uganda

Prada, Joaquin, Touloupou, Panayiota, Adriko, Moses, Tukahebwa, Edridah M., Lamberton, Poppy H. L. and Hollingsworth, T. Déirdre (2018) Understanding the relationship between egg- and antigen-based diagnostics of Schistosoma mansoni infection pre- and post-treatment in Uganda Parasites & Vectors, 11 (21). pp. 1-8.

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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.

Item Type: Article
Divisions : Faculty of Health and Medical Sciences > School of Veterinary Medicine
Authors :
NameEmailORCID
Prada, Joaquinj.prada@surrey.ac.uk
Touloupou, Panayiota
Adriko, Moses
Tukahebwa, Edridah M.
Lamberton, Poppy H. L.
Hollingsworth, T. Déirdre
Date : 8 January 2018
Funders : Medical Research Council (MRC)
Identification Number : 10.1186/s13071-017-2580-z
Copyright Disclaimer : © The Author(s) 2018. Open Access. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver(http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
Uncontrolled Keywords : Schistosomes; Kato-Katz; CCA; Mathematical models; Diagnostics; Trace readings
Depositing User : Clive Harris
Date Deposited : 05 Mar 2018 14:22
Last Modified : 14 Mar 2018 08:32
URI: http://epubs.surrey.ac.uk/id/eprint/845942

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