Field evaluation of a schistosome circulating cathodic antigen rapid test kit at point-of-care for mapping of schistosomiasis endemic districts in The Gambia

Sanneh, Bakary; Joof, Ebrima; Sanyang, Abdoulie M.; Renneker, Kristen; Camara, Yaya; Sey, Alhagie Papa; Jagne, Sheriffo; Baldeh, Ignatius; Ceesay, Serign J.; Sambou, Sana; Ogoussan, Kisito

doi:10.1371/journal.pone.0182003

Cited by 29 publications

(33 citation statements)

References 17 publications

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“…haematobium infections should be known. On the other hand, several studies indicated that POC-CCA test is not reliable in detecting S. haematobium infections [ 16 , 42 , 44 ].…”

Section: Discussionmentioning

confidence: 99%

Comparison of sensitivity and specificity of three diagnostic tests to detect Schistosoma mansoni infections in school children in Mwanza region, Tanzania

Fuss¹,

Mazigo²,

Tappe³

et al. 2018

PLoS ONE

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BackgroundSchistosomiasis remains one of the most prevalent parasitic infections in the world and has significant economic and public health consequences, particularly in poor communities. Reliable and accurate diagnosis plays a key role in surveillance, prevention and control of schistosomiasis. Currently, the microscopic Kato Katz (KK) stool thick smear technique is the most commonly used method to diagnose Schistosoma mansoni infections in epidemiological surveys. It is well-known that the sensitivity of this parasitological method decreases when infection intensities are moderate to low, however. The urine-based Point-of Care Circulating Cathodic Antigen (POC-CCA) test has been extensively evaluated as a further diagnostic tool. Several studies have shown that the POC-CCA test is more sensitive but less specific than the KK method. However, to clarify the meaning of inconsistent results between KK and POC-CCA tests in clinical routine, this study compares the accuracy of microscopy and POC-CCA versus real-time polymerase chain reaction (real-time PCR) results of urine and faecal samples from African school children participants.MethodologyThis was a school-based cross-sectional study conducted in 2015 among 305 school children aged 7–16 years from two primary schools located in Ilemela and Magu Districts, north-western Tanzania. Single stool and urine samples were collected from each participant and examined for the presence of Schistosoma mansoni eggs, parasite antigen, and parasite DNA using KK thick smears, POC-CCA tests, and real-time PCR, respectively.Principal findingsThe prevalence of S. mansoni infection, calculated by KK was 85.2%, by real-time PCR 92.9% and by POC-CCA 94.9%. In comparison to KK, the POC-CCA and real-time PCR tests had sensitivities of 89.7% and 99.5% and specificities of 22.73% and 29.55%, respectively. However, due to the known limitations of the KK assay, we also used latent class analysis (LCA) that included POC-CCA, KK, and schistosome-specific real-time PCR results to determine their sensitivities and specificities. The POC-CCA test had the highest sensitivity (99.5%) and a specificity of 63.4% by LCA and the real-time PCR test had a sensitivity of 98.7% and the highest specificity (81.2%).ConclusionIn moderate and high prevalence areas, the POC-CCA cassette test is more sensitive than the KK method and can be used for screening and geographical mapping of S. mansoni infections. Real-time PCR is highly sensitive and also shows the highest specificity among the 3 investigated diagnostic procedures. It can offer added value in diagnosing schistosomiasis.

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“…haematobium infections should be known. On the other hand, several studies indicated that POC-CCA test is not reliable in detecting S. haematobium infections [ 16 , 42 , 44 ].…”

Section: Discussionmentioning

confidence: 99%

Comparison of sensitivity and specificity of three diagnostic tests to detect Schistosoma mansoni infections in school children in Mwanza region, Tanzania

Fuss¹,

Mazigo²,

Tappe³

et al. 2018

PLoS ONE

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“…Unfortunately, the POC-CCA assay is inconsistent for the detection of infection with S. haematobium. [38][39][40][41] Thus, because the standard urine filtration assay for S. haematobium eggs is, like the KK, insensitive at low-to-moderate levels of infection intensity, 42,43 a tool is still needed for mapping S. haematobium in low prevalence areas.…”

Section: Additional Considerations In Using Poc-cca For Mappingmentioning

confidence: 99%

Evaluation, Validation, and Recognition of the Point-of-Care Circulating Cathodic Antigen, Urine-Based Assay for Mapping Schistosoma mansoni Infections

Colley

King

Kittur

et al. 2020

The American Journal of Tropical Medicine and Hygiene

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Efforts to control Schistosoma mansoni infection depend on the ability of programs to effectively detect and quantify infection levels and adjust programmatic approaches based on these levels and program goals. One of the three major objectives of the Schistosomiasis Consortium for Operational Research and Evaluation (SCORE) has been to develop and/or evaluate tools that would assist Neglected Tropical Disease program managers in accomplishing this fundamental task. The advent of a widely available point-of-care (POC) assay to detect schistosome circulating cathodic antigen (CCA) in urine with a rapid diagnostic test (the POC-CCA) in 2008 led SCORE and others to conduct multiple evaluations of this assay, comparing it with the Kato-Katz (KK) stool microscopy assay-the standard used for more than 45 years. This article describes multiple SCORE-funded studies comparing the POC-CCA and KK assays, the pros and cons of these assays, the use of the POC-CCA assay for mapping of S. mansoni infections in areas across the spectrum of prevalence levels, and the validation and recognition that the POC-CCA, although not infallible, is a highly useful tool to detect low-intensity infections in low-to-moderate prevalence areas. Such an assay is critical, as control programs succeed in driving down prevalence and intensity and seek to either maintain control or move to elimination of transmission of S. mansoni.

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“…Also, POC-CCA accuracy may be questionable in areas of S . haematobium mono infection or multiple Schistosoma infections [ 11 – 13 ]. But discussion becomes really intense when RTs are used in low parasite load and/or low endemic areas.…”

Section: Use Of Novel Approaches In the Diagnosis Of Schistosomiasis:mentioning

confidence: 99%

Is POC-CCA a truly reliable test for schistosomiasis diagnosis in low endemic areas? The trace results controversy

Peralta

Cavalcanti

2018

PLoS Negl Trop Dis

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Field evaluation of a schistosome circulating cathodic antigen rapid test kit at point-of-care for mapping of schistosomiasis endemic districts in The Gambia

Cited by 29 publications

References 17 publications

Comparison of sensitivity and specificity of three diagnostic tests to detect Schistosoma mansoni infections in school children in Mwanza region, Tanzania

Comparison of sensitivity and specificity of three diagnostic tests to detect Schistosoma mansoni infections in school children in Mwanza region, Tanzania

Evaluation, Validation, and Recognition of the Point-of-Care Circulating Cathodic Antigen, Urine-Based Assay for Mapping Schistosoma mansoni Infections

Is POC-CCA a truly reliable test for schistosomiasis diagnosis in low endemic areas? The trace results controversy

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