title: A five-country evaluation of a point-of-care circulating cathodic antigen urine assay for the prevalence of Schistosoma mansoni.
abstract: We evaluated a commercial point-of-care circulating cathodic antigen (POC-CCA) test for assessing Schistosoma mansoni infection prevalence in areas at risk. Overall, 4,405 school-age children in Cameroon, Côte d'Ivoire, Ethiopia, Kenya, and Uganda provided urine for POC-CCA testing and stool for Kato-Katz assays. By latent class analysis, one POC-CCA test was more sensitive (86% versus 62%) but less specific (72% versus ~100%) than multiple Kato-Katz smears from one stool. However, only 1% of POC-CCA tests in a non-endemic area were false positives, suggesting the latent class analysis underestimated the POC-CCA specificity. Multivariable modeling estimated POC-CCA as significantly more sensitive than Kato-Katz at low infection intensities (< 100 eggs/gram stool). By linear regression, 72% prevalence among 9-12 year olds by POC-CCA corresponded to 50% prevalence by Kato-Katz, whereas 46% POC-CCA prevalence corresponded to 10% Kato-Katz prevalence. We conclude that one urine POC-CCA test can replace Kato-Katz testing for community-level S. mansoni prevalence mapping.
authors: Daniel G
authors: DG
authors: Colley
authors: Sue
authors: S
authors: Binder
authors: Carl
authors: C
authors: Campbell
authors: Charles H
authors: CH
authors: King
authors: Louis-Albert
authors: LA
authors: Tchuem Tchuenté
authors: Eliézer K
authors: EK
authors: N'Goran
authors: Berhanu
authors: B
authors: Erko
authors: Diana M S
authors: DMS
authors: Karanja
authors: Narcis B
authors: NB
authors: Kabatereine
authors: Lisette
authors: L
authors: van Lieshout
authors: Stephen
authors: S
authors: Rathbun
mesh_terms: D000349:Africa / Q000453:epidemiology; D000818:Animals; D000947:Antigens, Helminth / Q000652:urine*; D002648:Child; D005188:False Negative Reactions; D005189:False Positive Reactions; D005243:Feces / Q000469:parasitology; D006801:Humans; D019095:Point-of-Care Systems; D015995:Prevalence; D012550:Schistosoma mansoni / Q000276:immunology*; D012555:Schistosomiasis mansoni / Q000175:diagnosis* / Q000453:epidemiology / Q000652:urine*; D012680:Sensitivity and Specificity
chemical_list: D000947:Antigens, Helminth