title: Real-time polymerase chain reaction for detection of low-intensity Schistosoma japonicum infections in China.
abstract: More sensitive methods for diagnosing infection with Schistosoma japonicum are needed as control becomes more effective. We compared a real-time polymerase chain reaction (PCR) for stool samples with conventional diagnostic methods in a study of 1,727 persons from Anhui Province, China. Seroprevalence determined by using an indirect hemagglutination assay (IHA) was much higher (26.1%) than the prevalence in stool-based tests, which were 5.3%, 3.2%, and 3.0% for PCR, hatching test, and Kato-Katz thick smear, respectively. A large proportion of the positive stool samples were only positive in one or two tests. The PCR showed better agreement with IHA than the other two stool-based tests. A commonly used diagnostic algorithm with initial screening for antibodies and subsequent testing with the Kato-Katz thick smear of the seropositive results would have resulted in treatment of 22 people compared with 50 people if the PCR replaced the Kato-Katz thick smear. As prevalence and intensity decrease, the benefit of increased sensitivity using the PCR must be weighed against additional costs.
authors.affiliation: Department of Microbiology and Infection Control, University Hospital of North Norway, Tromsø, Norway. tore.lier@unn.no
authors.forename: Tore
authors.initials: T
authors.lastname: Lier
authors.forename: Gunnar S
authors.initials: GS
authors.lastname: Simonsen
authors.forename: Tianping
authors.initials: T
authors.lastname: Wang
authors.forename: Dabing
authors.initials: D
authors.lastname: Lu
authors.forename: Hanne H
authors.initials: HH
authors.lastname: Haukland
authors.forename: Birgitte J
authors.initials: BJ
authors.lastname: Vennervald
authors.forename: Joachim
authors.initials: J
authors.lastname: Hegstad
authors.forename: Maria V
authors.initials: MV
authors.lastname: Johansen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D002648:Child; D002681:China / Q000453:epidemiology; D005243:Feces / Q000469:parasitology; D005260:Female; D006386:Hemagglutination Tests; D006801:Humans; D008297:Male; D008875:Middle Aged; D010270:Parasite Egg Count; D016133:Polymerase Chain Reaction / Q000379:methods*; D012554:Schistosomiasis japonica / Q000175:diagnosis* / Q000453:epidemiology*; D012680:Sensitivity and Specificity; D055815:Young Adult