Parasitological diagnosis of schistosomiasis mansoni: fecal examination and rectal biopsy

Abstract

Even with all progress in the search of sensitive and specific methods for the immunological diagnosis of schistosomiasis, the microscopic detection of eggs of the parasite in the stool still remains the most widely used tool for the actual diagnosis of active infection. Among the coproscopic methods, Kato's technic modified by Katz et al (Kato/Katz) has the advantages of higher sensitivity, the possibility of egg quantification, its low operational cost and its feasibility in areas with minimal infra-structure. The oogram of the rectal mucosa is valuable in initial clinical trials of schistosomicides, when it is needed to observe egg morphology in tissue. It could be an alternative method for individual diagnosis, being more sensitive than a single stool exam in low intensity infection. However, the increased sensitivity of a higher number of fecal exams makes that invasive procedure unnecessary. In the assessment of cure of schistosomiasis, Kato/Katz method (three fecal samples in one, three and six months after treatment) and the rectal biopsy four months after treatment, are equally reliable.

Circulating antigen tests and urine reagent strips for diagnosis of active schistosomiasis in endemic areas

“…Of note, the urine CCA POC test was developed based on the performance of the ELISA format (Brooker 2009). The urine CCA ELISA was found to have the best diagnostic performance, followed by the serum CAA assay for S. mansoni (Polman 1995; van Lieshout 1995; van Lieshout 2000). Therefore, although they are not rapid tests, the accuracy measures of ELISA tests will be systematically assessed, as the summary measures obtained may guide the ongoing development of improved POC tests.…”

Directives for Schistosomiasis Control in Endemic Areas of Brazil

“…At present, KK kits are provided by the Immunobiological Technology Institute (Bio-Manguinhos/Fiocruz) at a cost of U$ 0.41 per exam. A single KK slide (one exam) is recommended for active-search surveys due to its operational cost-effectiveness, as increasing the number of slides or stool samples significantly increases the diagnosis sensitivity only in cases of light-intensity infections (less than 100 eggs per gram of faeces, or epg) (Rabello, 1992).…”

Endothelial Markers in Schistosomiasis Patients With or Without Portal Hypertension

“…Patients with the inactive forms of parasitosis [11] were eutrophic [20 kg/m 2 B body mass index (BMI) B 30 kg/m 2 ], nonalcoholic (i.e., abstaining from alcohol or drinking \160 g/week [12]), nonusers of hepatotoxic and/or cholestatic drugs, and had Hepatitis B surface antigen (HBsAg), Hepatitis B core antigen (anti-HBc), and Hepatitis C virus (anti-HCV) negative serum [5,6]. None of the patients had concomitant chronic systemic diseases, specifically autoimmune diseases, renal insufficiency (creatinine [106.8 lmol/l and creatinine clearance \50 ml/min), dysthyroidism, or known hepatocellular carcinoma.…”