title: Evaluation of a novel rapid diagnostic test for Schistosoma haematobium based on the detection of human immunoglobulins bound to filtered Schistosoma haematobium eggs.
abstract: OBJECTIVE
  To determine whether the detection of human IgG bound to Schistosoma haematobium eggs from filtered urine could be used as a rapid diagnostic test (RDT-Sh).
  
  
  METHODS
  We filtered 160 urine samples from children in the Kwale District of Kenya to isolate S. haematobium eggs and used anti-human IgG antibody conjugated to horseradish peroxidase to bind to the human IgG attached to the eggs. We then added 3,3'5,5'-tetramethylbenzidine base (TMB), which turns blue in the presence of horseradish peroxidase to detect the S. haematobium eggs. The RDT-Sh was compared in a blinded manner to urine microscopy.
  
  
  RESULTS
  The RDT-Sh was positive in 89% of urine samples containing >1 egg/10 ml (58/65 samples) and 97% of urine samples containing >11 eggs/10 ml urine (35/36 samples) seen by microscopy. The RDT-Sh was negative 79% of the time when no eggs were seen on urine microscopy, but because up to three times more urine was used for the RDT-Sh, there were likely cases in which eggs were on the RDT-Sh filter but not detected by microscopy. We used latent class analysis incorporating urine microscopy, haematuria, proteinuria and RDT-Sh results to determine an overall 97% sensitivity and 78% specificity for RDT-Sh, 96% and 81% for urine microscopy, 71% and 98% for microscopic haematuria and 46% and 89% for proteinuria, respectively.
  
  
  CONCLUSIONS
  The RDT-Sh is quick, inexpensive and easy to perform in the field for the diagnosis of S. haematobium.
authors: Department of Emergency Medicine, Eastern Virginia Medical School, Norfolk, VA 23507, USA. jsheele@gmail.com
authors: Johnathan M
authors: JM
authors: Sheele
authors: Jimmy H
authors: JH
authors: Kihara
authors: Sarah
authors: S
authors: Baddorf
authors: Jonathan
authors: J
authors: Byrne
authors: Bhaskara
authors: B
authors: Ravi
mesh_terms: D000293:Adolescent; D000818:Animals; D000871:Anthelmintics / Q000627:therapeutic use; D000909:Antibodies, Helminth / Q000276:immunology; D002648:Child; D006801:Humans; D007136:Immunoglobulins / Q000032:analysis*; D010270:Parasite Egg Count / Q000379:methods; D011223:Praziquantel / Q000627:therapeutic use; D011237:Predictive Value of Tests; D012548:Schistosoma haematobium / Q000276:immunology* / Q000302:isolation & purification; D012553:Schistosomiasis haematobia / Q000175:diagnosis* / Q000188:drug therapy / Q000652:urine; D012680:Sensitivity and Specificity; D014556:Urine / Q000469:parasitology*
chemical_list: D000871:Anthelmintics; D000909:Antibodies, Helminth; D007136:Immunoglobulins; D011223:Praziquantel