title: Sensitivities and specificities of diagnostic tests and infection prevalence of Schistosoma haematobium estimated from data on adults in villages northwest of Accra, Ghana.
abstract: Substantial uncertainties surround the sensitivities and specificities of diagnostic techniques for urinary schistosomiasis. We used latent class (LC) modeling to address this problem. In this study, 220 adults in three villages northwest of Accra, Ghana were examined using five Schistosoma haematobium diagnostic measures: microscopic examination of urine for detection of S. haematobium eggs, dipsticks for detection of hematuria, tests for circulating antigens, antibody tests, and ultrasound scans of the urinary system. Testing of the LC model indicated non-invariance of the performance of the diagnostic tests across different age groups, and measurement invariance held for males and females and for the three villages. We therefore recommend the use of LC models for comparison between and the identification of the most accurate schistosomiasis diagnostic tests. Furthermore, microscopy and hematuria dipsticks were indicated through these models as the most appropriate techniques for detection of S. haematobium infection.
authors.affiliation: Schistosomiasis Control Initiative, Department of Infectious Disease Epidemiology, Faculty of Medicine, Imperial College, London, United Kingdom. artemis.koukounari@imperial.ac.uk
authors.forename: Artemis
authors.initials: A
authors.lastname: Koukounari
authors.forename: Joanne P
authors.initials: JP
authors.lastname: Webster
authors.forename: Christl A
authors.initials: CA
authors.lastname: Donnelly
authors.forename: Bethany C
authors.initials: BC
authors.lastname: Bray
authors.forename: Jean
authors.initials: J
authors.lastname: Naples
authors.forename: Kwabena
authors.initials: K
authors.lastname: Bosompem
authors.forename: Clive
authors.initials: C
authors.lastname: Shiff
mesh_terms: D000328:Adult; D000818:Animals; D000913:Antibodies, Protozoan / Q000097:blood; D000953:Antigens, Protozoan / Q000652:urine; D005260:Female; D005869:Ghana / Q000453:epidemiology; D006417:Hematuria; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D016013:Likelihood Functions; D008297:Male; D008853:Microscopy; D008875:Middle Aged; D011237:Predictive Value of Tests; D012548:Schistosoma haematobium / Q000276:immunology / Q000302:isolation & purification; D012553:Schistosomiasis haematobia / Q000097:blood / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000453:epidemiology*; D012680:Sensitivity and Specificity; D014463:Ultrasonography; D055815:Young Adult
chemical_list: D000913:Antibodies, Protozoan; D000953:Antigens, Protozoan; D007074:Immunoglobulin G