The ratio of the seroprevalence to the egg-positive prevalence of Schistosoma japonicum in China: a meta-analysis

Abstract

BackgroundSchistosomiasis, caused by Schistosoma japonicum, remains one of the most important parasitic diseases, and detection of S. japonicum infections in humans plays a crucial role in control and treatment. However, comparisons between the parasitological and the immunological examinations in the fields of China are lacking. Therefore we performed a meta-analysis to compare the seroprevalence of Schistosoma japonicum, as determined by IHA or ELISA, with coprological prevalence, as determined by Kato-Katz, and estimate the ratio of the serological to the egg-positive prevalence in order to evaluate the potential threat of egg-negative but worm-positive schistosomiasis.MethodsStudies published up to July 2018 on the parasitological and immunological examinations of schistosomiasis in the fields of China were searched in five databases including CNKI, WanFang, VIP, PubMed and Web of Science. The ratio of the serological to the egg-positive prevalence and its 95%CI for each study were calculated, and then point estimates and their 95%CIs of pooled prevalence ratio were meta-analyzed. Subgroup meta-analyses were also performed according to potential influential factors.ResultsA total of 23 articles were included. The prevalence ratio varied from 0.57 to 48.83 for IHA to Kato-Katz and ranged from 0.38 to 13.97 for ELISA to Kato-Katz. The pooled ratio was 4.72 (95%CI: 3.87~ 5.76) for IHA to KK and 4.65 (95%CI: 3.50~ 6.17) for ELISA to KK. Subgroup analyses implied that the ratio of the serological to the egg-positive prevalence may decrease with the endemic levels. The highest prevalence ratio was observed when Kato-Katz was performed with three slides per stool or in hilly and mountainous regions.ConclusionsThe worm-determined prevalence by IHA or ELISA is 4- to 5-fold higher than the egg-determined prevalence by Kato-Katz, which implied Kato-Katz may largely underestimate the prevalence of S. japonicum in China. The degree of underestimation was greater when Kato-Katz with three slides per stool was carried out, especially in low endemic areas or in hilly and mountainous regions. Therefore, more attention should be paid to those egg-negative but worm-positive patients with the aim of final elimination of S. japonicum in China.Electronic supplementary materialThe online version of this article (10.1186/s12879-018-3320-5) contains supplementary material, which is available to authorized users.

Comparison of point-of-care test and enzyme-linked immunosorbent assay for detection of immunoglobulin G antibodies in the diagnosis of human schistosomiasis japonica

“…A previous study in China revealed that the prevalence of schistosomiasis japonica determined by serological tests was Â4-5 times higher than that estimated by fecal examination (Deng et al, 2018). This finding implies that the prevalence of S. japonicum is underestimated by stool examination.…”

“…Schistosoma japonicum is the most prevalent species causing schistosomiasis japonica in Asia, especially in the People's Republic of China, the Philippines and Indonesia (Gordon et al, 2015;McManus et al, 2018;Moendeg et al, 2017;WHO, 2020). In 2015, the number of infected people in China was approximately 77 200, down from the 11.6 million estimated to have been infected when China first implemented its control program in the 1950s (Chen, 2014;Deng et al, 2018). However, a recent serological diagnostic study of approximately 7.2 million people in China found approximately 138 500 schistosomiasis infections (Chen et al, 2021;Zhang et al, 2019).…”

Prevalence of schistosomiasis and its association with anemia among pregnant women: a systematic review and meta-analysis

“…In Latin America and Southeast Asia, the identified reports addressed the pathophysiology rather than the epidemiology of schistosomiasis during pregnancy [ 4 , 47 ]. However, in these settings in which there are no published articles on schistosomiasis during pregnancy, there are meta-analyses on schistosomiasis available for other age groups [ 48 , 49 ]. Moreover, a previous study on S. japonicum during pregnancy assessed the pathophysiology rather than the prevalence of schistosomiasis during pregnancy [ 50 ].…”

NTD Diagnostics for Disease Elimination: A Review

“…Mature adult worms reside in the mesenteric (S. mansoni and S. japonicum) or pelvic (S. haematobium) veins, where female worms lay eggs that are later secreted in stools or urine. Eggs trapped in the surrounding tissues and organs cause inflammatory immune responses that result in intestinal, hepato-splenic, or urogenital disease [93]. Seventy-eight countries are endemic for schistosome infections, with different species of schistosomes affecting different regions.…”