Comparative Study of the Accuracy of Different Techniques for the Laboratory Diagnosis of Schistosomiasis Mansoni in Areas of Low Endemicity in Barra Mansa City, Rio de Janeiro State, Brazil.
Schistosomiasis constitutes a major public health problem, with an estimated 200 million people infected worldwide. Many areas of Brazil show low endemicity of schistosomiasis, and the current standard parasitological techniques are not sufficiently sensitive to detect the low-level helminth infections common in areas of low endemicity (ALEs). This study compared the Kato-Katz (KK); Hoffman, Pons, and Janer (HH); enzyme-linked immunosorbent assay- (ELISA-) IgG and ELISA-IgM; indirect immunofluorescence technique (IFT-IgM); and qPCR techniques for schistosomiasis detection in serum and fecal samples, using the circumoval precipitin test (COPT) as reference. An epidemiological survey was conducted in a randomized sample of residents from five neighborhoods of Barra Mansa, RJ, with 610 fecal and 612 serum samples. ELISA-IgM (21.4%) showed the highest positivity and HH and KK techniques were the least sensitive (0.8%). All techniques except qPCR-serum showed high accuracy (82-95.5%), differed significantly from COPT in positivity (P < 0.05), and showed poor agreement with COPT. Medium agreement was seen with ELISA-IgG (Kappa = 0.377) and IFA (Kappa = 0.347). Parasitological techniques showed much lower positivity rates than those by other techniques. We suggest the possibility of using a combination of laboratory tools for the diagnosis of schistosomiasis in ALEs.
Department of Infectious and Parasitic Diseases and Laboratory of Immunopathology of Schistosomiasis (LIM-06), School of Medicine, University of São Paulo, 05403-000 São Paulo, SP, Brazil ; University Center of Volta Redonda, 27240-560 Volta Redonda, RJ, Brazil.
Maria Cristina Carvalho
MC
Espírito-Santo
Department of Gastroenterology and Laboratory of Tropical Gastroenterology and Hepatology, School of Medicine, University of São Paulo, 05403-000 São Paulo, SP, Brazil.
Mónica Viviana
MV
Alvarado-Mora
Department of Enteroparasites at the Parasitology and Mycology Service from the Adolfo Lutz Institute, 01246-902 São Paulo, SP, Brazil.
Pedro Luiz Silva
PL
Pinto
Laboratory of Seroepidemiology and Immunobiology, Institute of Tropical Medicine, University of São Paulo, 05403-000 São Paulo, SP, Brazil.
Maria Carmen Arroyo
MC
Sanchez
Laboratory of Medical Genomics, AC Camargo Cancer Center, 01509-010 São Paulo, SP, Brazil ; Institute of Psychiatry (LIM-27), São Paulo Medical School, University of São Paulo, 01246-903 São Paulo, SP, Brazil.
Emmanuel
E
Dias-Neto
Section of Parasitology, Central Laboratory Division of Hospital das Clínicas, School of Medicine, University of São Paulo, 05403-000 São Paulo, SP, Brazil.
Vera Lúcia Pagliusi
VL
Castilho
Section of Parasitology, Central Laboratory Division of Hospital das Clínicas, School of Medicine, University of São Paulo, 05403-000 São Paulo, SP, Brazil.
Elenice Messias do Nascimento
EM
Gonçalves
Santa Casa Medical School, 01221-020 São Paulo, SP, Brazil ; Institute of Tropical Medicine, University of São Paulo, 05403-000 São Paulo, SP, Brazil.
Pedro Paulo
PP
Chieffi
Institute of Tropical Medicine, University of São Paulo, 05403-000 São Paulo, SP, Brazil.
Expedito José de Albuquerque
EJ
Luna
Department of Gastroenterology and Laboratory of Tropical Gastroenterology and Hepatology, School of Medicine, University of São Paulo, 05403-000 São Paulo, SP, Brazil.
João Renato Rebello
JR
Pinho
Department of Infectious and Parasitic Diseases and Laboratory of Immunopathology of Schistosomiasis (LIM-06), School of Medicine, University of São Paulo, 05403-000 São Paulo, SP, Brazil.
Flair José
FJ
Carrilho
Department of Infectious and Parasitic Diseases and Laboratory of Immunopathology of Schistosomiasis (LIM-06), School of Medicine, University of São Paulo, 05403-000 São Paulo, SP, Brazil.
Ronaldo Cesar Borges
RC
Gryschek
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001938:Brazil / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D019411:Clinical Laboratory Techniques / Q000379:methods* / Q000706:statistics & numerical data*; D019353:Endemic Diseases / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007118:Immunoassay / Q000379:methods* / Q000706:statistics & numerical data; D007223:Infant; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance / Q000379:methods; D011233:Precipitin Tests / Q000379:methods / Q000706:statistics & numerical data; D015995:Prevalence; D015203:Reproducibility of Results; D018570:Risk Assessment / Q000379:methods; D012555:Schistosomiasis mansoni / Q000175:diagnosis* / Q000453:epidemiology* / Q000469:parasitology; D012680:Sensitivity and Specificity; D055815:Young Adult