Accuracy of Two Circulating Antigen Tests for the Diagnosis and Surveillance of Schistosoma mansoni Infection in Low-Endemicity Settings of Côte d’Ivoire

Assaré, Rufin K.; Tra-Bi, Mathieu I; Coulibaly, Jean T.; Corstjens, Paul L. A. M.; Ouattara, Mamadou; Hürlimann, Eveline; Dam, Govert J. van; Utzinger, Jürg; N’Goran, Eliézer K.

doi:10.4269/ajtmh.21-0031

Cited by 10 publications

(8 citation statements)

References 37 publications

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“…A fair to moderate agreement was found between the diagnostic methods. Intensity categories of each diagnostic method were either pragmatic (POC-CCA, UCP-LF CAA) or arbitrary (PCR) and therefore difficult to compare, but when looking at an individual level, a positive correlation was observed between the increasing intensity of the POC-CCA visual score and CAA-levels in urine, which corresponds to previous findings [ 39 , 40 ]. Also, a strong correlation was observed between POC-CCA visual scores and Ct values.…”

Section: Discussionsupporting

confidence: 80%

Diagnosis of Schistosomiasis without a Microscope: Evaluating Circulating Antigen (CCA, CAA) and DNA Detection Methods on Banked Samples of a Community-Based Survey from DR Congo

et al. 2022

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Detection of Schistosoma eggs in stool or urine is known for its low sensitivity in diagnosing light infections. Alternative diagnostics with better sensitivity while remaining highly specific, such as real-time PCR and circulating antigen detection, are progressively used as complementary diagnostic procedures but have not yet replaced microscopy. This study evaluates these alternative methods for the detection of Schistosoma infections in the absence of microscopy. Schistosomiasis presence was determined retrospectively in 314 banked stool and urine samples, available from a previous survey on the prevalence of taeniasis in a community in the Democratic Republic of the Congo, using real-time PCR, the point-of-care circulating cathodic antigen (POC-CCA) test, as well as the up-converting particle lateral flow circulating anodic antigen (UCP-LF CAA) test. Schistosoma DNA was present in urine (3%) and stool (28%) samples, while CCA (28%) and CAA (69%) were detected in urine. Further analysis of the generated data indicated stool-based PCR and the POC-CCA test to be suitable diagnostics for screening of S. mansoni infections, even in the absence of microscopy. A substantial proportion (60%) of the 215 CAA-positive cases showed low antigen concentrations, suggesting that even PCR and POC-CCA underestimated the “true” number of schistosome positives.

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Section: Discussionsupporting

confidence: 80%

Diagnosis of Schistosomiasis without a Microscope: Evaluating Circulating Antigen (CCA, CAA) and DNA Detection Methods on Banked Samples of a Community-Based Survey from DR Congo

et al. 2022

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“…13 Still others are finding the tests reliable, and there are emerging urine-based tests that show promise as well (e.g., the up-converting phosphor lateral flow circulating anodic antigen assay). 14 POC CCA validity will require close follow-up should these tests be integrated into future screening programs. Incremental modifications to the engineering and design of mobile phone microscopes over the past few years have improved the diagnostic operating characteristics for infections of global health significance.…”

Section: Discussionmentioning

confidence: 99%

High Sensitivity of Mobile Phone Microscopy Screening for Schistosoma haematobium in Azaguié, Côte d’Ivoire

Coulibaly

Silué

Armstrong

et al. 2023

The American Journal of Tropical Medicine and Hygiene

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Schistosomiasis infections continue to impact African settings disproportionately, and there is an urgent need for novel tools to evaluate infection control and elimination strategies at the community level. Mobile phone microscopes are portable and semiautomated devices with multiple applications for screening neglected tropical diseases. In a community-based schistosomiasis screening program in Azaguié, Côte d’Ivoire, mobile phone microscopy demonstrated a sensitivity of 85.7% (95% CI: 69.7–95.2%) and specificity of 93.3% (95% CI: 87.7–96.9%) for Schistosoma haematobium identification compared with conventional light microscopy, and 95% sensitivity (95% CI: 74.1–99.8%) with egg concentrations of five or more per 10 mL of urine. Mobile phone microscopy is a promising tool for schistosomiasis control and elimination efforts.

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“…The second assay was the lateral flow cassette-based designed as a point-of-care CCA assay (POC-CCA) ( 115 ), the introduction of which had a great impact in schistosome diagnostics. Consequently, the POC-CCA has been widely used in mass treatment programs in several African countries, where it has outperformed the fecal smear as a diagnostic tool ( 175 – 178 ).…”

Section: Diagnosis Of Schistosoma Species Infectionsmentioning

confidence: 99%

“…Additional improvement of these tests has been the combination with various quantitative lateral flow (LF)-based assays utilizing up-converting phosphor (UCP) reporters ( 168 , 178 – 180 ). Importantly, the UCP-LF assay for CAA detection has been adapted to a dry reagent format that is stable at ambient temperature and worldwide shipping without the need for a cold chain ( 181 ).…”

Section: Diagnosis Of Schistosoma Species Infectionsmentioning

confidence: 99%

The Road to Elimination: Current State of Schistosomiasis Research and Progress Towards the End Game

et al. 2022

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The new WHO Roadmap for Neglected Tropical Diseases targets the global elimination of schistosomiasis as a public health problem. To date, control strategies have focused on effective diagnostics, mass drug administration, complementary and integrative public health interventions. Non-mammalian intermediate hosts and other vertebrates promote transmission of schistosomiasis and have been utilized as experimental model systems. Experimental animal models that recapitulate schistosomiasis immunology, disease progression, and pathology observed in humans are important in testing and validation of control interventions. We discuss the pivotal value of these models in contributing to elimination of schistosomiasis. Treatment of schistosomiasis relies heavily on mass drug administration of praziquantel whose efficacy is comprised due to re-infections and experimental systems have revealed the inability to kill juvenile schistosomes. In terms of diagnosis, nonhuman primate models have demonstrated the low sensitivity of the gold standard Kato Katz smear technique. Antibody assays are valuable tools for evaluating efficacy of candidate vaccines, and sera from graded infection experiments are useful for evaluating diagnostic sensitivity of different targets. Lastly, the presence of Schistosomes can compromise the efficacy of vaccines to other infectious diseases and its elimination will benefit control programs of the other diseases. As the focus moves towards schistosomiasis elimination, it will be critical to integrate treatment, diagnostics, novel research tools such as sequencing, improved understanding of disease pathogenesis and utilization of experimental models to assist with evaluating performance of new approaches.

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Accuracy of Two Circulating Antigen Tests for the Diagnosis and Surveillance of Schistosoma mansoni Infection in Low-Endemicity Settings of Côte d’Ivoire

Cited by 10 publications

References 37 publications

Diagnosis of Schistosomiasis without a Microscope: Evaluating Circulating Antigen (CCA, CAA) and DNA Detection Methods on Banked Samples of a Community-Based Survey from DR Congo

Diagnosis of Schistosomiasis without a Microscope: Evaluating Circulating Antigen (CCA, CAA) and DNA Detection Methods on Banked Samples of a Community-Based Survey from DR Congo

High Sensitivity of Mobile Phone Microscopy Screening for Schistosoma haematobium in Azaguié, Côte d’Ivoire

The Road to Elimination: Current State of Schistosomiasis Research and Progress Towards the End Game

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