title: Performance of POC-CCA® in diagnosis of schistosomiasis mansoni in individuals with low parasite burden.
abstract: BACKGROUND
  Schistosomiasis, caused by Schistosoma mansoni, is a public health concern in Brazil. However, the most popular diagnostic method, the Kato-Katz technique, exhibits low sensitivity in low-endemicity areas. We aimed to compare the performance of an immunological assay, the point-of-care circulating cathodic antigen (POC-CCA®) test, with that of two parasitological techniques in a low-endemicity population.
  
  
  METHODS
  Our study included 141 individuals living in Estreito de Miralta, Minas Gerais, Brazil. Fecal samples were obtained from all participants and analyzed for schistosomiasis using two parasitological techniques: the Kato-Katz technique and the saline gradient technique. Additionally, POC-CCA® strips were utilized for testing urine samples. The results obtained by the different techniques were compared.
  
  
  RESULTS
  Analysis of two or 24 slides using the Kato-Katz technique resulted in a positivity rate of 10.6% (15/141) or 19.1% (27/141), respectively. The saline gradient technique yielded a positivity rate of 17.0% (24/141). The prevalence according to both parasitological techniques was 24.1% (34/141). The POC-CCA® test yielded a positivity rate of 22.7% (32/141); however, the positivity rate was merely 2.1% if trace results were considered negative. The agreements observed between POC-CCA® and the parasitological techniques were good (Kappa indexes > 0.64). The POC-CCA® test was more sensitive than the two-slide Kato-Katz technique (p < 0.05) in detecting cases of S. mansoni infection when trace results were considered positive.
  
  
  CONCLUSIONS
  These findings reinforce the importance of using multiple diagnostic techniques in low-endemicity areas for effective control of disease.
authors.affiliation: Laboratório de Esquistossomose, Centro de Pesquisas René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Minas Gerais, Brasil.
authors.forename: Liliane Maria Vidal
authors.initials: LM
authors.lastname: Siqueira
authors.affiliation: Laboratório de Esquistossomose, Centro de Pesquisas René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Minas Gerais, Brasil.
authors.forename: Flavia Fernanda Bubula
authors.initials: FF
authors.lastname: Couto
authors.affiliation: Laboratório de Esquistossomose, Centro de Pesquisas René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Minas Gerais, Brasil.
authors.forename: Diana
authors.initials: D
authors.lastname: Taboada
authors.affiliation: Laboratório de Esquistossomose, Centro de Pesquisas René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Minas Gerais, Brasil.
authors.forename: Áureo Almeida de
authors.initials: ÁA
authors.lastname: Oliveira
authors.affiliation: Centro de Controle de Zoonoses de Montes Claros, Montes Claros, Minas Gerais, Brasil.
authors.forename: Nidia Francisca de Figueiredo
authors.initials: NF
authors.lastname: Carneiro
authors.affiliation: Laboratório de Pesquisas Clínicas, Centro de Pesquisas René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Minas Gerais, Brasil.
authors.forename: Edward
authors.initials: E
authors.lastname: Oliveira
authors.affiliation: Laboratório de Esquistossomose, Centro de Pesquisas René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Minas Gerais, Brasil.
authors.forename: Paulo Marcos Zech
authors.initials: PM
authors.lastname: Coelho
authors.affiliation: Laboratório de Esquistossomose, Centro de Pesquisas René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Minas Gerais, Brasil.
authors.forename: Naftale
authors.initials: N
authors.lastname: Katz
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000818:Animals; D000947:Antigens, Helminth / Q000652:urine*; D002648:Child; D002675:Child, Preschool; D005243:Feces / Q000469:parasitology*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D010270:Parasite Egg Count; D019095:Point-of-Care Systems; D012550:Schistosoma mansoni / Q000276:immunology* / Q000302:isolation & purification*; D012555:Schistosomiasis mansoni / Q000175:diagnosis*; D012680:Sensitivity and Specificity; D055815:Young Adult
chemical_list: D000947:Antigens, Helminth