Detection of Schistosoma mansoni Antibodies in a Low-Endemicity Area Using Indirect Immunofluorescence and Circumoval Precipitin Test

Espírito-Santo, Maria Cristina Carvalho do; Pintó, Pedro; Gargioni, Cybele; Alvarado-Mora, Mónica Viviana; Castilho, Vera Lúcia Pagliusi; Pinho, João Renato Rebello; Luna, Expedito José de Albuquerque; Gryschek, Ronaldo César Borges

doi:10.4269/ajtmh.13-0746

Cited by 12 publications

(7 citation statements)

References 30 publications

(35 reference statements)

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“…mansoni however, still heavily relies on the Kato-Katz thick stool smear. Several other detection tools have been proposed, including the circumoval precipitin test on serum samples [ 4 , 5 ], the FLOTAC technique on fecal samples [ 6 ], and the point-of-care circulating cathodic antigen assay (POC-CCA) for detection of Schistosoma antigen in urine samples [ 7 , 8 ]. In addition, DNA-based methods, such as real-time polymerase chain reaction (PCR)-based techniques, are increasingly being used for the detection of Schistosoma spp.…”

Section: Introductionmentioning

confidence: 99%

Is PCR the Next Reference Standard for the Diagnosis of Schistosoma in Stool? A Comparison with Microscopy in Senegal and Kenya

et al. 2015

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BackgroundThe current reference test for the detection of S. mansoni in endemic areas is stool microscopy based on one or more Kato-Katz stool smears. However, stool microscopy has several shortcomings that greatly affect the efficacy of current schistosomiasis control programs. A highly specific multiplex real-time polymerase chain reaction (PCR) targeting the Schistosoma internal transcriber-spacer-2 sequence (ITS2) was developed by our group a few years ago, but so far this PCR has been applied mostly on urine samples. Here, we performed more in-depth evaluation of the ITS2 PCR as an alternative method to standard microscopy for the detection and quantification of Schistosoma spp. in stool samples.Methodology/Principal findingsMicroscopy and PCR were performed in a Senegalese community (n = 197) in an area with high S. mansoni transmission and co-occurrence of S. haematobium, and in Kenyan schoolchildren (n = 760) from an area with comparatively low S. mansoni transmission. Despite the differences in Schistosoma endemicity the PCR performed very similarly in both areas; 13–15% more infections were detected by PCR when comparing to microscopy of a single stool sample. Even when 2–3 stool samples were used for microscopy, PCR on one stool sample detected more infections, especially in people with light-intensity infections and in children from low-risk schools. The low prevalence of soil-transmitted helminthiasis in both populations was confirmed by an additional multiplex PCR.Conclusions/SignificanceThe ITS2-based PCR was more sensitive than standard microscopy in detecting Schistosoma spp. This would be particularly useful for S. mansoni detection in low transmission areas, and post-control settings, and as such improve schistosomiasis control programs, epidemiological research, and quality control of microscopy. Moreover, it can be complemented with other (multiplex real-time) PCRs to detect a wider range of helminths and thus enhance effectiveness of current integrated control and elimination strategies for neglected tropical diseases.

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Section: Introductionmentioning

confidence: 99%

Is PCR the Next Reference Standard for the Diagnosis of Schistosoma in Stool? A Comparison with Microscopy in Senegal and Kenya

et al. 2015

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“…The test has a high sensitivity and specificity (108), and it has been used for diagnosis, mainly for S. japonicum infection in China, and as a reference for comparison with other procedures (109,110). It has also been combined with copro-microscopy to improve diagnostic accuracy (92,111). Major drawbacks associated with the COPT are its labor-intensiveness, its rather complex and lengthy procedure, and the long gap in seroconversion following treatment, which can result in the misdiagnosis of a cleared infection (45,92).…”

Section: Antibody Detectionmentioning

confidence: 99%

“…The reaction between parasite antigens and antischistosomal antibodies in patient serum or other bodily fluids is the concept behind the IFA, which is performed using adult worm paraffin sections, cercariae, and eggs (120)(121)(122). IFA detection of IgM and IgG antibodies in the acute and chronic stages of schistosomiasis has been used as a sensitive method of diagnosis, especially in low-prevalence areas (90,123,125), in some instances combined with other diagnostic procedures to increase the sensitivity and specificity (111,126). Some limitations of the test, including the need for relatively expensive microscopes and reagents, with appropriate laboratory facilities and technical expertise, hinder its application in community surveys (123,125).…”

Section: Antibody Detectionmentioning

confidence: 99%

Advances in the Diagnosis of Human Schistosomiasis

et al. 2015

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SUMMARY Schistosomiasis is a major neglected tropical disease that afflicts more than 240 million people, including many children and young adults, in the tropics and subtropics. The disease is characterized by chronic infections with significant residual morbidity and is of considerable public health importance, with substantial socioeconomic impacts on impoverished communities. Morbidity reduction and eventual elimination through integrated intervention measures are the focuses of current schistosomiasis control programs. Precise diagnosis of schistosome infections, in both mammalian and snail intermediate hosts, will play a pivotal role in achieving these goals. Nevertheless, despite extensive efforts over several decades, the search for sensitive and specific diagnostics for schistosomiasis is ongoing. Here we review the area, paying attention to earlier approaches but emphasizing recent developments in the search for new diagnostics for schistosomiasis with practical applications in the research laboratory, the clinic, and the field. Careful and rigorous validation of these assays and their cost-effectiveness will be needed, however, prior to their adoption in support of policy decisions for national public health programs aimed at the control and elimination of schistosomiasis.

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“…However, with the increasing widespread use of MDA and ongoing control programs, the diagnosis of schistosomiasis in low-endemic areas requires a test with high sensitivity and appropriate specificity. An immunodiagnostic test based on antibody detection has been shown to increase the detection efficiency of schistosomiasis especially in low-endemicity areas [27], and several countries such as China, Venezuela, and Brazil have introduced the antibody detectionbased test in their schistosomiasis elimination programs [28]. Although the differentiation of active from past infections has been challenging, the detection of specific antibody against SEA or SWAP has been used in laboratory and field settings to diagnose schistosome infection [29,30].…”

Section: Introductionmentioning

confidence: 99%

“…Although the differentiation of active from past infections has been challenging, the detection of specific antibody against SEA or SWAP has been used in laboratory and field settings to diagnose schistosome infection [29,30]. Immunodiagnostic tests provide increased detection efficiency of schistosome infection in low-endemicity areas and among patients from non-endemic areas [28]. Recombinant antigens have been used as alternatives to SEA and SWAP in order to increase the specificity of the test and overcome the cross-reactions that occur when crude antigens are used; importantly, recombinant antigens are amenable to large-scale production.…”

Section: Introductionmentioning

confidence: 99%

Tandem repeat recombinant proteins as potential antigens for the sero-diagnosis of Schistosoma mansoni infection

Kalenda

Kato

Goto

et al. 2015

Parasitology International

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The diagnosis of schistosome infection, followed by effective treatment and/or mass drug administration, is crucial to reduce the disease burden. Suitable diagnostic tests and field-applicable tools are required to sustain schistosomiasis control programs. We therefore assessed the potential of tandem repeat (TR) proteins for serodiagnosis of Schistosoma mansoni infection using an experimental mouse model. TR genes in the genome of S. mansoni were searched in silico and 7 candidates, named SmTR1, 3, 8, 9, 10, 11 and 15, were selected. Total RNA was extracted from S. mansoni adult worms and eggs. Target TR genes were amplified, cloned, and the proteins were expressed in Escherichia coli competent cells. Female BALB/c mice were infected with 100 S. mansoni cercariae and sera were collected each week post-infection for 18 weeks. The levels of IgG antibodies to SmTR antigens were compared to those to soluble egg antigen (SEA) and to soluble worm antigen preparation (SWAP). Sera of infected mice reacted to all the antigens whereas those of naïve mice did not. IgG responses to SmTR1, 3, 9 and 10 were detected at the early stage of infection. Interestingly, antibodies reacting to SmTR3, 9, 10 and 15 dramatically decreased 4 weeks after treatment with praziquantel, while those against SEA and SWAP remained elevated. Our study suggests that TR proteins, especially SmTR10, may be suitable antigens for sero-diagnosis of infection by S. mansoni and are potential markers for monitoring and surveillance of schistosomiasis, including re-infection after treatment with praziquantel.

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Detection of Schistosoma mansoni Antibodies in a Low-Endemicity Area Using Indirect Immunofluorescence and Circumoval Precipitin Test

Cited by 12 publications

References 30 publications

Is PCR the Next Reference Standard for the Diagnosis of Schistosoma in Stool? A Comparison with Microscopy in Senegal and Kenya

Is PCR the Next Reference Standard for the Diagnosis of Schistosoma in Stool? A Comparison with Microscopy in Senegal and Kenya

Advances in the Diagnosis of Human Schistosomiasis

Tandem repeat recombinant proteins as potential antigens for the sero-diagnosis of Schistosoma mansoni infection

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