title: Accuracy of urine circulating cathodic antigen test for the diagnosis of Schistosoma mansoni in preschool-aged children before and after treatment.
abstract: BACKGROUND
  The Kato-Katz technique is widely used for the diagnosis of Schistosoma mansoni, but shows low sensitivity in light-intensity infections. We assessed the accuracy of a commercially available point-of-care circulating cathodic antigen (POC-CCA) cassette test for the diagnosis of S. mansoni in preschool-aged children before and after praziquantel administration.
  
  
  METHODS
  A 3-week longitudinal survey with a treatment intervention was conducted in Azaguié, south Côte d'Ivoire. Overall, 242 preschoolers (age range: 2 months to 5.5 years) submitted two stool and two urine samples before praziquantel administration, and 86 individuals were followed-up posttreatment. Stool samples were examined with duplicate Kato-Katz thick smears for S. mansoni. Urine samples were subjected to POC-CCA cassette test for S. mansoni, and a filtration method for S. haematobium diagnosis.
  
  
  RESULTS
  Before treatment, the prevalence of S. mansoni, as determined by quadruplicate Kato-Katz, single CCA considering 'trace' as negative (t-), and single CCA with 'trace' as positive (t+), was 23.1%, 34.3% and 64.5%, respectively. Using the combined results (i.e., four Kato-Katz and duplicate CCA(t-)) as diagnostic 'gold' standard, the sensitivity of a single Kato-Katz, a single CCA(t-) or CCA(t+) was 28.3%, 69.7% and 89.1%, respectively. Three weeks posttreatment, the sensitivity of a single Kato-Katz, single CCA(t-) and CCA(t+) was 4.0%, 80.0% and 84.0%, respectively. The intensity of the POC-CCA test band reaction was correlated with S. mansoni egg burden (odds ratio = 1.2, p = 0.04).
  
  
  CONCLUSIONS
  A single POC-CCA cassette test appears to be more sensitive than multiple Kato-Katz thick smears for the diagnosis of S. mansoni in preschool-aged children before and after praziquantel administration. The POC-CCA cassette test can be recommended for the rapid identification of S. mansoni infections before treatment. Additional studies are warranted to determine the usefulness of POC-CCA for assessing drug efficacy and monitoring the impact of control interventions.
authors.affiliation: Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland.
authors.forename: Jean T
authors.initials: JT
authors.lastname: Coulibaly
authors.forename: Yves K
authors.initials: YK
authors.lastname: N'Gbesso
authors.forename: Stefanie
authors.initials: S
authors.lastname: Knopp
authors.forename: Nicaise A
authors.initials: NA
authors.lastname: N'Guessan
authors.forename: Kigbafori D
authors.initials: KD
authors.lastname: Silué
authors.forename: Govert J
authors.initials: GJ
authors.lastname: van Dam
authors.forename: Eliézer K
authors.initials: EK
authors.lastname: N'Goran
authors.forename: Jürg
authors.initials: J
authors.lastname: Utzinger
mesh_terms: D000818:Animals; D000871:Anthelmintics / Q000627:therapeutic use; D000947:Antigens, Helminth / Q000652:urine*; D002675:Child, Preschool; D019411:Clinical Laboratory Techniques / Q000379:methods*; D007560:Cote d'Ivoire; D016903:Drug Monitoring / Q000379:methods*; D005243:Feces / Q000469:parasitology; D005260:Female; D006801:Humans; D007223:Infant; D008137:Longitudinal Studies; D008297:Male; D010274:Parasitology / Q000379:methods*; D019095:Point-of-Care Systems; D011223:Praziquantel / Q000627:therapeutic use; D012550:Schistosoma mansoni / Q000302:isolation & purification*; D012555:Schistosomiasis mansoni / Q000175:diagnosis* / Q000188:drug therapy; D012680:Sensitivity and Specificity
chemical_list: D000871:Anthelmintics; D000947:Antigens, Helminth; D011223:Praziquantel
references.citation: Infection. 2008 Dec;36(6):585-9
references.pmid: 18998054
references.citation: Trans R Soc Trop Med Hyg. 2006 Nov;100(11):1039-48
references.pmid: 16765394
references.citation: Trends Parasitol. 2009 Apr;25(4):151-6
references.pmid: 19269899
references.citation: Am J Trop Med Hyg. 2009 Dec;81(6):1071-8
references.pmid: 19996439
references.citation: Parasit Vectors. 2011 Feb 21;4:21
references.pmid: 21338486
references.citation: Am J Trop Med Hyg. 2013 Mar;88(3):426-432
references.pmid: 23339198
references.citation: Parasitology. 1986 Feb;92 ( Pt 1):209-17
references.pmid: 3960592
references.citation: Parasite Immunol. 2009 Nov;31(11):656-63
references.pmid: 19825105
references.citation: Int J Parasitol. 2006 Oct;36(12):1241-4
references.pmid: 16930605
references.citation: Parasitology. 1994 Jun;108 ( Pt 5):519-26
references.pmid: 8052507
references.citation: Rev Inst Med Trop Sao Paulo. 1972 Nov-Dec;14(6):397-400
references.pmid: 4675644
references.citation: J Parasitol. 1996 Aug;82(4):557-64
references.pmid: 8691363
references.citation: Trans R Soc Trop Med Hyg. 1993 May-Jun;87(3):311-2
references.pmid: 8236404
references.citation: PLoS Negl Trop Dis. 2013;7(1):e2008
references.pmid: 23359826
references.citation: Trans R Soc Trop Med Hyg. 2009 Jan;103(1):45-51
references.pmid: 18951599
references.citation: Trop Med Int Health. 2012 Mar;17(3):402-3
references.pmid: 22129037
references.citation: Trans R Soc Trop Med Hyg. 1985;79(3):369-73
references.pmid: 4035739
references.citation: BMC Infect Dis. 2013 Jan 24;13:37
references.pmid: 23347408
references.citation: J Clin Microbiol. 2008 Jan;46(1):171-6
references.pmid: 17942645
references.citation: Parasitol Today. 1998 Oct;14(10):428-34
references.pmid: 17040835
references.citation: BMC Med. 2007 Sep 03;5:27
references.pmid: 17767713
references.citation: Acta Trop. 2010 Sep;115(3):212-9
references.pmid: 20303925
references.citation: Acta Trop. 2006 Feb;97(2):219-28
references.pmid: 16386231
references.citation: Trans R Soc Trop Med Hyg. 2006 Mar;100(3):208-15
references.pmid: 16378628
references.citation: Adv Parasitol. 1985;24:1-101
references.pmid: 3904343
references.citation: Am J Trop Med Hyg. 2011 May;84(5):787-91
references.pmid: 21540390
references.citation: Z Parasitenkd. 1986;72(5):635-46
references.pmid: 3535287
references.citation: Acta Trop. 2004 Nov-Dec;92(3):205-12
references.pmid: 15533288
references.citation: Parasitology. 2009 Nov;136(13):1677-81
references.pmid: 19765347
references.citation: PLoS Negl Trop Dis. 2012;6(12):e1917
references.pmid: 23236526
references.citation: PLoS Negl Trop Dis. 2008 Mar 26;2(3):e126
references.pmid: 18365031
references.citation: Acta Trop. 2013 Nov;128(2):423-40
references.pmid: 22580511
references.citation: PLoS Negl Trop Dis. 2008;2(11):e331
references.pmid: 18982057
references.citation: N Engl J Med. 2003 Apr 17;348(16):1565-73
references.pmid: 12700377
references.citation: Acta Trop. 2013 Nov;128(2):412-22
references.pmid: 21586268
references.citation: Parasitology. 2009 Nov;136(13):1719-30
references.pmid: 19631008
references.citation: Am J Trop Med Hyg. 2002 Feb;66(2):157-62
references.pmid: 12135287
references.citation: PLoS Negl Trop Dis. 2011 Nov;5(11):e1384
references.pmid: 22132246
references.citation: Lancet. 2004 Feb 21;363(9409):641-53
references.pmid: 14987892
references.citation: Parasitology. 2012 Jun;139(7):835-41
references.pmid: 22313588
references.citation: Parasitol Int. 2008 Sep;57(3):281-6
references.pmid: 18485807
references.citation: PLoS Negl Trop Dis. 2011 Jan 04;5(1):e938
references.pmid: 21245910
references.citation: Trends Parasitol. 2007 Mar;23(3):83-6
references.pmid: 17241815
references.citation: Parasitology. 2011 Oct;138(12):1620-32
references.pmid: 21349223
references.citation: Parasit Vectors. 2013 Jan 29;6:29
references.pmid: 23360734
references.citation: PLoS Negl Trop Dis. 2011 Apr 12;5(4):e1036
references.pmid: 21532740
references.citation: Bull World Health Organ. 2008 Oct;86(10):780-7, A
references.pmid: 18949215
references.citation: Trans R Soc Trop Med Hyg. 2007 Jul;101(7):668-73
references.pmid: 17368699
references.citation: Biometrics. 1977 Mar;33(1):159-74
references.pmid: 843571
references.citation: PLoS Negl Trop Dis. 2011 Jan 25;5(1):e951
references.pmid: 21283613
references.citation: Am J Trop Med Hyg. 2007 Apr;76(4):725-31
references.pmid: 17426179
references.citation: World Health Organ Tech Rep Ser. 2002;912:i-vi, 1-57, back cover
references.pmid: 12592987
references.citation: Trans R Soc Trop Med Hyg. 1998 Nov-Dec;92(6):675-7
references.pmid: 10326120
references.citation: Ann Trop Med Parasitol. 2006 Jun;100(4):315-26
references.pmid: 16762112
references.citation: Parasit Vectors. 2011 Oct 07;4:194
references.pmid: 21981948
references.citation: Parasit Vectors. 2010 Aug 14;3:71
references.pmid: 20707931
references.citation: J Infect Dis. 2007 Sep 1;196(5):659-69
references.pmid: 17674306
references.citation: Int Health. 2010 Jun;2(2):103-13
references.pmid: 20640034