title: Field comparison of circulating antibody assays versus circulating antigen assays for the detection of schistosomiasis japonica in endemic areas of China.
abstract: BACKGROUND
  Schistosomiasis remains a serious public health problem in affected countries, and routine, highly sensitive and cost-effective diagnostic methods are lacking. We evaluated two immunodiagnostic techniques for the detection of Schistosoma japonicum infections: circulating antibody and circulating antigen assays.
  
  
  METHODS
  A total of 1864 individuals (between 6 and 72 years old) residing in five administrative villages in Hubei province were screened by serum examination with an indirect hemagglutination assay (IHA). The positive individuals (titer ≥20 in IHA) were reconfirmed by stool examination with the Kato-Katz method (three slides from a single stool specimen). Samples of good serum quality and a volume above 0.5 ml were selected for further testing with two immunodiagnostic antibody (DDIA and ELISA) and two antigen (ELISA) assays.
  
  
  RESULTS
  The average antibody positive rate in the five villages was 12.7%, while the average parasitological prevalence was 1.50%; 25 of the 28 egg-positive samples were also circulating antigen-positive. Significant differences were observed between the prevalence according to the Kato-Katz method and all three immunodiagnostic antibody assays (P-value <0.0001). Similar differences were observed between the Kato-Katz method and the two immunodiagnostic antigen assays (P-value <0.0001) and between the antigen and antibody assays (P-value <0.0001).
  
  
  CONCLUSIONS
  Both circulating antibody and circulating antigen assays had acceptable performance characteristics. Immunodiagnostic techniques to detect circulating antigens have potential to be deployed for schistosomiasis japonica screening in the endemic areas.
authors.forename: Yu-Chun
authors.initials: YC
authors.lastname: Cai
authors.forename: Jun-Fang
authors.initials: JF
authors.lastname: Xu
authors.forename: Peter
authors.initials: P
authors.lastname: Steinmann
authors.forename: Shao-Hong
authors.initials: SH
authors.lastname: Chen
authors.forename: Yan-Hong
authors.initials: YH
authors.lastname: Chu
authors.forename: Li-Guang
authors.initials: LG
authors.lastname: Tian
authors.forename: Mu-Xin
authors.initials: MX
authors.lastname: Chen
authors.forename: Hao
authors.initials: H
authors.lastname: Li
authors.forename: Yan
authors.initials: Y
authors.lastname: Lu
authors.forename: Ling-Ling
authors.initials: LL
authors.lastname: Zhang
authors.forename: Yang
authors.initials: Y
authors.lastname: Zhou
authors.affiliation: National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai 200025, People's Republic of China. chenjiaxu1962@163.com.
authors.forename: Jia-Xu
authors.initials: JX
authors.lastname: Chen
mesh_terms: D000328:Adult; D000368:Aged; D000818:Animals; D000909:Antibodies, Helminth / Q000097:blood*; D000947:Antigens, Helminth / Q000097:blood*; D005243:Feces / Q000469:parasitology; D005260:Female; D006801:Humans; D007118:Immunoassay / Q000379:methods*; D008297:Male; D008875:Middle Aged; D012549:Schistosoma japonicum / Q000276:immunology*; D012554:Schistosomiasis japonica / Q000175:diagnosis* / Q000453:epidemiology / Q000276:immunology
chemical_list: D000909:Antibodies, Helminth; D000947:Antigens, Helminth