title: Accuracy of circulating cathodic antigen tests for rapid mapping of Schistosoma mansoni and S. haematobium infections in Southern Sudan.
abstract: OBJECTIVE
  To evaluate the diagnostic accuracy of a circulating cathodic antigen (CCA) urine dipstick test for detecting Schistosoma mansoni and S. haematobium alongside an integrated rapid mapping survey in Southern Sudan.
  
  
  RESULTS
  A total of 373 children aged 5-16 years were included in the study. Of these 26.0% were infected with S. haematobium and 24.5% were infected with S. mansoni, as identified by urine filtration or single Kato-Katz thick smear, respectively. The CCA performed moderately in detecting S. mansoni, with sensitivity of 89.1% and specificity of 74.2%, and poorly in detecting S. haematobium infections, with a sensitivity of 36.8% and specificity of 78.9%. This may be a slight underestimate of true CCA accuracy, since only single stool and urine samples were examined by microscopy. The true 'gold standard' for comparison would have been the collection of multiple stool samples over consecutive days.
  
  
  CONCLUSIONS
  The poor CCA accuracy for diagnosis of urinary schistosomiasis means that this test is currently not suitable for rapid mapping of schistosomiasis in areas where both S. mansoni and S. haematobium may be endemic.
authors.affiliation: Malaria Consortium-Africa Regional Office, Kampala, Uganda.
authors.forename: Ruth A
authors.initials: RA
authors.lastname: Ashton
authors.forename: Barclay T
authors.initials: BT
authors.lastname: Stewart
authors.forename: Nora
authors.initials: N
authors.lastname: Petty
authors.forename: Mounir
authors.initials: M
authors.lastname: Lado
authors.forename: Timothy
authors.initials: T
authors.lastname: Finn
authors.forename: Simon
authors.initials: S
authors.lastname: Brooker
authors.forename: Jan H
authors.initials: JH
authors.lastname: Kolaczinski
mesh_terms: D000293:Adolescent; D000818:Animals; D000947:Antigens, Helminth / Q000652:urine*; D002648:Child; D002675:Child, Preschool; D005243:Feces / Q000469:parasitology; D005260:Female; D006023:Glycoproteins / Q000652:urine*; D015801:Helminth Proteins / Q000652:urine*; D006801:Humans; D008297:Male; D058069:Neglected Diseases / Q000453:epidemiology; D010270:Parasite Egg Count; D011934:Reagent Strips / Q000592:standards*; D012548:Schistosoma haematobium / Q000276:immunology; D012550:Schistosoma mansoni / Q000276:immunology; D012553:Schistosomiasis haematobia / Q000453:epidemiology / Q000276:immunology / Q000652:urine*; D012555:Schistosomiasis mansoni / Q000453:epidemiology / Q000276:immunology / Q000652:urine*; D012680:Sensitivity and Specificity; D013397:Sudan / Q000453:epidemiology
chemical_list: D000947:Antigens, Helminth; C091532:CCA protein, Schistosoma mansoni; D006023:Glycoproteins; D015801:Helminth Proteins; D011934:Reagent Strips