title: Accuracy of point-of-care testing for circulatory cathodic antigen in the detection of schistosome infection: systematic review and meta-analysis.
abstract: OBJECTIVE
  To assess the accuracy of point-of-care testing for circulatory cathodic antigen in the diagnosis of schistosome infection.
  
  
  METHODS
  We searched MEDLINE, EMBASE, LILACS and other bibliographic databases for studies published until 30 September 2015 that described circulatory cathodic antigen testing compared against one to three Kato-Katz tests per subject - for Schistosoma mansoni - or the filtration of one 10-ml urine sample per subject - for S. haematobium. We extracted the numbers of true positives, false positives, true negatives and false negatives for the antigen testing and performed meta-analyses using a bivariate hierarchical regression model.
  
  
  RESULTS
  Twenty-six studies published between 1994 and 2014 met the inclusion criteria. In the detection of S. mansoni, a single antigen test gave a pooled sensitivity of 0.90 (95% confidence interval, CI: 0.84-0.94) and a pooled specificity of 0.56 (95% CI: 0.39-0.71; n = 7) when compared against a single Kato-Katz test. The corresponding values from comparisons with two to three Kato-Katz tests per subject were 0.85 (95% CI: 0.80-0.88) and 0.66 (95% CI: 0.53-0.76; n = 14), respectively. There appeared to be no advantage in using three antigen tests per subject instead of one. When compared against the results of urine filtration, antigen testing for S. haematobium showed poor sensitivity and poor specificity. The performance of antigen testing was better in areas of high endemicity than in settings with low endemicity.
  
  
  CONCLUSIONS
  Antigen testing may represent an effective tool for monitoring programmes for the control of S. mansoni.
authors.affiliation: Department of Epidemiology and Disease Control, School of Public Health, University of Ghana, PO Box LG13, Legon, Ghana .
authors.forename: Anthony
authors.initials: A
authors.lastname: Danso-Appiah
authors.affiliation: School of Social and Political Sciences, University of Glasgow, Glasgow, Scotland .
authors.forename: Jonathan
authors.initials: J
authors.lastname: Minton
authors.affiliation: Department of Microbiology, Centre for Plant Medicine Research, Mampong, Ghana .
authors.forename: Daniel
authors.initials: D
authors.lastname: Boamah
authors.affiliation: Department of Parasitology, University of Ghana, Legon, Ghana .
authors.forename: Joseph
authors.initials: J
authors.lastname: Otchere
authors.affiliation: School of Biomedical and Allied Health Sciences, University of Ghana, Accra, Ghana .
authors.forename: Richard H
authors.initials: RH
authors.lastname: Asmah
authors.affiliation: Centre for Reviews and Dissemination, University of York, York, England .
authors.forename: Mark
authors.initials: M
authors.lastname: Rodgers
authors.affiliation: Department of Parasitology, University of Ghana, Legon, Ghana .
authors.forename: Kwabena M
authors.initials: KM
authors.lastname: Bosompem
authors.affiliation: Health Planning Service, Regional Health Authority of Umbria, Perugia, Italy .
authors.forename: Paolo
authors.initials: P
authors.lastname: Eusebi
authors.affiliation: Department of Public Health, Erasmus University Medical Centre Rotterdam, Rotterdam, Netherlands .
authors.forename: Sake J
authors.initials: SJ
authors.lastname: De Vlas
mesh_terms: D000947:Antigens, Helminth / Q000276:immunology* / Q000652:urine; D005243:Feces / Q000469:parasitology; D006801:Humans; D008403:Mass Screening / Q000379:methods* / Q000592:standards*; D019095:Point-of-Care Systems / Q000592:standards*; D012552:Schistosomiasis / Q000276:immunology* / Q000652:urine; D012680:Sensitivity and Specificity
chemical_list: D000947:Antigens, Helminth