The combination of three faecal parasitological methods to improve the diagnosis of schistosomiasis mansoni in a low endemic setting in the state of Ceará, Brazil

Pinheiro, Marta Cristhiany Cunha; Carneiro, Teiliane Rodrigues; Hanemann, Ana Lúcia de Paula; Oliveira, Sara Menezes de; Bezerra, Fernando Schemelzer de Moraes

doi:10.1590/s0074-02762012000700006

Cited by 23 publications

(33 citation statements)

References 13 publications

(10 reference statements)

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“…The present study considers only the reality of one of the PISF construction sites in Ceará, probably underestimating the real extent of schistosomiasis in this population. There was an increase in the positivity rate of S. mansoni-detection, among workers using the Kato-Katz method, with the growth in the number of slides read per individual, corroborating findings from other reports that rise in the number of assessed slides results in an increase in the positivity rate and a consequent increase in the prevalence of S. mansoni 38 . In fact, the reading of only one or two slides, as routinely performed in schistosomiasis control programs 39 , would have detected only one positive individual in our study.…”

Section: Discussionsupporting

confidence: 87%

“…In fact, the reading of only one or two slides, as routinely performed in schistosomiasis control programs 39 , would have detected only one positive individual in our study. As opposed to the World Health Organization (WHO) recommendation of assessing Kato-Katz smears of a single stool specimen in duplicate, our group sought to standardize the use of three smears per single stool-sample in order to improve the sensitivity of the method in this and other studies conducted by us 38 . Another alternative to improve the sensitivity of this method is to prepare and assess multiple smears of different samples from the same person; however, in epidemiological studies, repeated exams are economically unfeasible 40,41 .…”

Section: Discussionmentioning

confidence: 99%

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Detection of schistosomiasis in an area directly affected by the São Francisco River large-scale water transposition project in the Northeast of Brazil

Filho

Pinheiro

Sousa

et al. 2017

Rev. Soc. Bras. Med. Trop.

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Introduction: The development of the São Francisco River Integration Project [Projeto de Integração do Rio São Francisco (PISF)] in the State of Ceará, Brazil, has resulted in environmental and socioeconomic changes with potential risks to public health. We aimed to determine the presence of Schistosoma mansoni infections in schoolchildren (aged 7-14 years) and workers from the construction site in an area under the direct influence of the PISF in the municipality of Brejo Santo-CE, to aid in the prevention and control of schistosomiasis. Methods: We conducted a cross-sectional study using two S. mansoni-detection methods: detection of S. mansoni eggs by the Kato-Katz parasitological method in stool samples (assessed in triplicate for each sample) and S. mansoni circulating cathodic antigen by the point-of-care immunochromatographic rapid test (POC-CCA) in urine. Results: In general, the positivity rates for S. mansoni detection were 1.9% (2/106) among schoolchildren and 2.9% (4/138) among workers. No child had evidence of S. mansoni eggs in their stools; 1.9% tested positive by the POC-CCA method. Among workers, two (1.4%) tested positive by the Kato-Katz test and three (2.2%) by the POC-CCA test. If the POC-CCA test results that were scored as traces were considered negative, then the positivity rates dropped to 0.9% and 0.7% for schoolchildren and workers, respectively. Conclusions: The active transmission of schistosomiasis in a region covered by the PISF was recognized, reinforcing the necessity to consolidate surveillance and control actions, as well as structural sanitation measures to reverse the social determinants of the disease.

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Section: Discussionsupporting

confidence: 87%

Section: Discussionmentioning

confidence: 99%

Detection of schistosomiasis in an area directly affected by the São Francisco River large-scale water transposition project in the Northeast of Brazil

Filho

Pinheiro

Sousa

et al. 2017

Rev. Soc. Bras. Med. Trop.

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“…Based on the results of serological and parasitological techniques ( Carneiro et al 2012 , Pinheiro et al 2012 ), 56 stool samples were selected from individuals aged between four-72 years, with a mean age of 30.49 years [standard deviation (SD) 17.78] and a median age of 26 years. This sample was divided into the following five groups for PCR analysis: Group I - Ten stool samples from individuals with reactive ELISA results, but without parasitological confirmation of S. mansoni eggs by KK.…”

Section: Subjects Materials and Methodsmentioning

confidence: 99%

“…Parasitological methods - The KK Kit [Bio-Manguinhos, Oswaldo Cruz Foundation, Rio de Janeiro (RJ), Brazil] was used according to the manufacturer’s specifications and the saline gradient and Helmintex ® methods were performed as described in previous studies ( Pinheiro et al 2012 ). One stool sample was collected from each individual and the KK exams were performed by analysing three slides per sample.…”

Section: Subjects Materials and Methodsmentioning

confidence: 99%

“…PCR-based diagnoses have been shown to be highly sensitive and specific and should therefore be considered as alternative methods for the diagnosis of S. mansoni infections. Such methods have already been used to detect S. mansoni DNA in samples of stool ( Pontes et al 2002 , Espírito-Santo et al 2012 ), blood serum ( ten Hove et al 2008 , Haggag & Abdullah 2011 ), blood plasma ( Wichmann et al 2009 ) and urine ( Sandoval et al 2006 , Enk et al 2012 ). Real-time polymerase chain reaction (PCR) has also been used to diagnose schistosomiasis ( ten Hove et al 2008 ) and this technique can be used a potential therapeutic cure control method, as has been demonstrated in animal models of experimental infection ( Gentile et al 2011 ).…”

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A conventional polymerase chain reaction-based method for the diagnosis of human schistosomiasis in stool samples from individuals in a low-endemicity area

Carneiro

Peralta

Pinheiro

et al. 2013

Mem. Inst. Oswaldo Cruz

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The aim of this study was to evaluate the efficacy of a polymerase chain reaction (PCR)-based method to detect Schistosoma mansoni DNA in stool samples from individuals living in a low-endemicity area in Brazil. Of the 125 initial stool samples, 80 were ELISA reactive and eggs were identified in 19 of the samples by parasitological examination. For the PCR evaluations, 56 stool samples were selected and divided into five groups. Groups I-IV were scored negative for S. mansoni eggs by parasitological examination. Groups I and II were ELISA reactive, whereas Groups III and IV were ELISA nonreactive. Groups II and III were positive for other intestinal parasites. PCR testing scored eight samples as positive from these four groups. Group V represented the S. mansoni -positive group and it included ELISA-reactive samples that were scored positive for S. mansoni by one or more parasitological examinations (6/19 were positive by Kato-Katz method, 9/17 by saline gradient and 10/13 by Helmintex®). PCR scored 13 of these 19 samples as positive for S. mansoni . We conclude that while none of these methods yielded 100% sensitivity, a combination of techniques should be effective for improving the detection of S. mansoni infection in low-endemicity areas.

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Comparative analysis of the diagnostic performance of adult, cercarial and egg antigens assessed by ELISA, in the diagnosis of chronic human Schistosoma mansoni infection

2014

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Total IgG ELISA was assessed comparing soluble adult worm (SWA), cercarial (SCA), and egg antigens (SEA) using sera of chronic schistosomiasis patients in two different concentrations (1/50 and 1/100). This response showed reactivity against all antigens. Concerning 1/100 serum concentration the SWA gave the best sensitivity (100%) followed by SCA (86.6%) and SEA (80%). The best specificity was obtained from SCA (94.11%) with an equivalent result from the SWA and SEA (76.47%). Concerning the 1/50 serum concentration, the SWA gave the best sensitivity (100%) with an equivalent result from the SCA and SEA (80%). The best specificity was obtained from SEA (82.35%) followed by SCA (76.47%) then SWA (64.7%). The best AUC value (0.992) was that for SWA indicating its high ability to predict the disease in comparison to (0.914) for SCA and 0.871 for SEA in serum dilution 1/100. The highest AUC value (0.955) was that for SWA in comparison to (0.914) for SEA and (0.88) for SCA in serum dilution 1/50. Comparison between the AUCs from the three mentioned antigens revealed highly significant differences when the data were analyzed by ROC. Each antigen showed a highly statistically significant correlation within its optical density values at both concentrations; 1/100 and 1/50. Comparing the two concentrations in each antigen revealed a non significant correlation obtained from the SWA which signifies a near outcome from both concentrations while the SCA and SEA showed a highly significant difference between the two concentrations. In conclusion, for the diagnosis of chronic schistosomiasis mansoni, total IgG reactivity revealed the best sensitivity by SWA. There was a difference in the type of antigen showing best specificity results between SCA and SEA according to serum concentration used.

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The combination of three faecal parasitological methods to improve the diagnosis of schistosomiasis mansoni in a low endemic setting in the state of Ceará, Brazil

Cited by 23 publications

References 13 publications

Detection of schistosomiasis in an area directly affected by the São Francisco River large-scale water transposition project in the Northeast of Brazil

Detection of schistosomiasis in an area directly affected by the São Francisco River large-scale water transposition project in the Northeast of Brazil

A conventional polymerase chain reaction-based method for the diagnosis of human schistosomiasis in stool samples from individuals in a low-endemicity area

Comparative analysis of the diagnostic performance of adult, cercarial and egg antigens assessed by ELISA, in the diagnosis of chronic human Schistosoma mansoni infection

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