Morbidity of schistosomiasis mansoni in a low endemic setting in Ouro Preto, Minas Gerais, Brazil

Abstract

Introduction: Despite the advances of disease control programs, severe forms of schistosomiasis are prevalent. The prevalence of the disease in areas frequented by tourists urges for permanent prevention and control. The aim of this study was to describe the morbidity of schistosomiasis in the district of Antônio Pereira, Ouro Preto, Minas Gerais, Brazil. Methods: The proportion of positives was defined by Kato-Katz coproscopy and urinary POC-CCA rapid test. Hepatosplenic form was diagnosed using abdominal ultrasound. Results: Out of 180 participants,97 were examined by Kato-Katz, with 4 (4.1%) being positive. Thirtyfour (22.1%) out of 154 were positive by POC-CCA. Five (2.8%) of 177 examined by ultrasound had hepatosplenic form. One of them had undergone splenectomy. One (0.6%)participant had myeloradiculopathy. Conclusions: Severe forms of schistosomiasis are still prevalent in low endemic areas and should be thoroughly investigated.

Serological proteomic screening and evaluation of a recombinant egg antigen for the diagnosis of low-intensity infections in endemic area in Brazil Antigen target in schistosomiasis diagnosis

“…However, the studies conducted in Brazil were controversial. The issues about adopting POC-CCA ® in Brazil are related to inadequate interpretation of trace as positive following the manufacturer’s recommendation and the low sensitivity to detect low-intensity infections [11, 12, 20, 27-33]. The authors emphasized differences regarding the predominance of extreme low-intensity infections (1-25 epg) found in the Brazilian areas [10-12].…”

“…The majority of studies validating POC-CCA were conducted in Africa, whereas few (10) studies were conducted in Brazil, which has a significantly different prevalence and morbidity profile. In contrast to Africa, most of the low-intensity infections in Brazil are denoted as < 25 epg [11, 12, 20, 27-33].…”

Diagnosis of Schistosoma mansoni infections: what are the choices in Brazilian low-endemic areas?

“…There are 10 published studies that were conducted in Brazil. 25 , 26 , 33 , 36 , 39 , 47 , 48 , 49 , 50 , 51 The decision to adopt POC-CCA® for use in low-endemic areas of Brazil remains questionable for a number of reasons. Specifically, inadequate estimation of sensitivity and specificity of the POC-CCA® exists because of the absence of a highly sensitive reference method to evaluate its performance, interpretation of trace as either a positive or a negative reading can occur, and this test possesses low sensitivity for the detection of low-intensity infections.…”

“… 46 Only 10 studies were conducted in Brazil, which has a significantly different prevalence and morbidity profile, and these tests yielded controversial results regarding sensitivity and specificity. 25 , 26 , 33 , 36 , 39 , 47 , 48 , 49 , 50 , 51 …”

Serological proteomic screening and evaluation of a recombinant egg antigen for the diagnosis of low-intensity Schistosoma mansoni infections in endemic area in Brazil

“…Most studies validating POC-CCA were conducted in Africa, whereas few (10) studies were conducted in Brazil, which has a significantly different prevalence and morbidity profile. In contrast to Africa where low-intensity infections range from 1–100 EPG, most infections in Brazil are denoted as < 25 EPG [6, 7, 14, 22, 29, 31–35]. Furthermore, the KK method was used as a reference standard during the validation of POC-CCA in Africa.…”