Diagnosis of Schistosoma mansoni without the stool: comparison of three diagnostic tests to detect Schistosoma [corrected] mansoni infection from filtered urine in Zambia

Am J Trop Med Hyg. 2013 Jul;89(1):46-50. doi: 10.4269/ajtmh.13-0104. Epub 2013 May 28.

Abstract

Diagnosis for intestinal Schistosoma mansoni lacks sensitivity and is arduous to conduct. The standard diagnostic tests, Kato-Katz (KK) and circulating cathodic antigen (CCA) both lack sensitivity and with KK, require obtaining, transporting, and examining fresh stool. We compared diagnostic efficacy of KK, CCA, and polymerase chain reaction (PCR) to detect S. mansoni infection (species-specific DNA) from 89 filtered urine samples collected in Zambia. The PCR was the strongest indicator of positive cases with sensitivity and specificity of 100% in comparison to CCA (67% and 60%) and KK (50% and 100%). High positive and negative predictive values (100%) were also indicative of robustness of PCR. The same pattern was observed when stratified for sex and age group-specific analysis. Diagnosis of S. mansoni from filtered urine samples by PCR is an effective means to detect low intensity infection and would enhance the effectiveness of surveillance and control programs of schistosomiasis.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Animals
  • Antigens, Helminth / urine
  • Feces / parasitology
  • Female
  • Glycoproteins / urine
  • Helminth Proteins / urine
  • Humans
  • Male
  • Middle Aged
  • Parasite Egg Count
  • Polymerase Chain Reaction / methods
  • Reagent Strips
  • Schistosoma mansoni
  • Schistosomiasis mansoni / diagnosis*
  • Schistosomiasis mansoni / urine
  • Sensitivity and Specificity
  • Young Adult
  • Zambia

Substances

  • Antigens, Helminth
  • CCA protein, Schistosoma mansoni
  • Glycoproteins
  • Helminth Proteins
  • Reagent Strips