title: Use of Occult Blood Detection Cards for Real-Time PCR-Based Diagnosis of Schistosoma Mansoni Infection.
abstract: BACKGROUND
  In Schistosoma mansoni infection, diagnosis and control after treatment mainly rely on parasitological stool investigations which are laborious and have limited sensitivity. PCR methods have shown equal or superior sensitivity but preservation and storage methods limit their use in the field. Therefore, the use of occult blood detection cards (fecal cards) for easy sampling and storage of fecal samples for further PCR testing was evaluated in a pilot study.
  
  
  METHODS
  Stool specimens were collected in a highly endemic area for S. mansoni in Ethiopia and submitted in an investigator-blinded fashion to microscopic examination by Kato-Katz thick smear as well as to real-time PCR using either fresh frozen stool samples or stool smears on fecal cards which have been stored at ambient temperature for up to ten months.
  
  
  RESULTS
  Out of 55 stool samples, 35 were positive by microscopy, 33 and 32 were positive by PCR of frozen samples and of fecal card samples, respectively. When microscopy was used as diagnostic "gold standard", the sensitivity of PCR on fresh stool was 94.3% (95%-CI: 86.6; 100) and on fecal cards 91.4% (95%-CI: 82.2; 100).
  
  
  CONCLUSIONS
  The use of fecal cards proved to be a simple and useful method for stool collection and prolonged storage prior to PCR based diagnosis of S. mansoni infection. This technique may be a valuable approach for large scale surveillance and post treatment assessments.
authors.affiliation: Department of Infectious Diseases and Tropical Medicine (DITM), Ludwig-Maximilians University of Munich, Munich, Germany.
authors.forename: Mirjam
authors.initials: M
authors.lastname: Schunk
authors.affiliation: Department of Medical Laboratory Sciences and Pathology, Jimma University, Jimma, Ethiopia.
authors.forename: Seleshi
authors.initials: S
authors.lastname: Kebede Mekonnen
authors.affiliation: Department of Medical Laboratory Sciences and Pathology, Jimma University, Jimma, Ethiopia.
authors.forename: Beyene
authors.initials: B
authors.lastname: Wondafrash
authors.affiliation: Department of Infectious Diseases and Tropical Medicine (DITM), Ludwig-Maximilians University of Munich, Munich, Germany.
authors.forename: Carolin
authors.initials: C
authors.lastname: Mengele
authors.affiliation: Department of Infectious Diseases and Tropical Medicine (DITM), Ludwig-Maximilians University of Munich, Munich, Germany; Bundeswehr Institute of Microbiology, Munich, Germany.
authors.forename: Erna
authors.initials: E
authors.lastname: Fleischmann
authors.affiliation: Department of Infectious Diseases and Tropical Medicine (DITM), Ludwig-Maximilians University of Munich, Munich, Germany.
authors.forename: Karl-Heinz
authors.initials: KH
authors.lastname: Herbinger
authors.affiliation: Laboratory of Medical Microbiology and Immunology, St. Elisabeth Hospital, Tilsburg, the Netherlands.
authors.forename: Jaco J
authors.initials: JJ
authors.lastname: Verweij
authors.affiliation: Department of Infectious Diseases and Tropical Medicine (DITM), Ludwig-Maximilians University of Munich, Munich, Germany.
authors.forename: Christof
authors.initials: C
authors.lastname: Geldmacher
authors.affiliation: Department of Infectious Diseases and Tropical Medicine (DITM), Ludwig-Maximilians University of Munich, Munich, Germany.
authors.forename: Gisela
authors.initials: G
authors.lastname: Bretzel
authors.affiliation: Department of Infectious Diseases and Tropical Medicine (DITM), Ludwig-Maximilians University of Munich, Munich, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Löscher
authors.affiliation: Department of Medical Laboratory Sciences and Pathology, Jimma University, Jimma, Ethiopia.
authors.forename: Ahmed
authors.initials: A
authors.lastname: Zeynudin
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000818:Animals; D002648:Child; D002675:Child, Preschool; D005243:Feces / Q000737:chemistry / Q000469:parasitology; D005260:Female; D006801:Humans; D008297:Male; D008853:Microscopy; D008875:Middle Aged; D009780:Occult Blood; D060888:Real-Time Polymerase Chain Reaction / Q000379:methods; D015203:Reproducibility of Results; D012550:Schistosoma mansoni / Q000235:genetics*; D012555:Schistosomiasis mansoni / Q000175:diagnosis* / Q000469:parasitology*; D012680:Sensitivity and Specificity; D055815:Young Adult