Accuracy of urine circulating cathodic antigen (CCA) test for Schistosoma mansoni diagnosis in different settings of Côte d'Ivoire
JournalArticle (Originalarbeit in einer wissenschaftlichen Zeitschrift)
ID 1022808
Author(s) Coulibaly, J. T.; Knopp, S.; N'Guessan N. A.,; Silué, K. D.; Fürst, T.; Lohourignon, L. K.; Brou, J. K.; N'gbesso Y. K.,; Vounatsou, P.; N'Goran E. K.,; Utzinger, J.
Author(s) at UniBasel Fürst, Thomas
Vounatsou, Penelope
Utzinger, Jürg
Year 2011
Title Accuracy of urine circulating cathodic antigen (CCA) test for Schistosoma mansoni diagnosis in different settings of Côte d'Ivoire
Journal PLoS neglected tropical diseases
Volume 5
Number 11
Pages / Article-Number e1384
Mesh terms Animals; Antigens, Helminth, urine; Child; Clinical Laboratory Techniques, methods; Cote d'Ivoire; Cross-Sectional Studies; Feces, chemistry; Female; Glycoproteins, urine; Helminth Proteins, urine; Humans; Immunoassay, methods; Male; Parasitology, methods; Prevalence; Schistosomiasis mansoni, diagnosis; Sensitivity and Specificity; Urine, chemistry
Abstract BACKGROUND: Promising results have been reported for a urine circulating cathodic antigen (CCA) test for the diagnosis of Schistosoma mansoni. We assessed the accuracy of a commercially available CCA cassette test (designated CCA-A) and an experimental formulation (CCA-B) for S. mansoni diagnosis. METHODOLOGY: We conducted a cross-sectional survey in three settings of Cote d'Ivoire: settings A and B are endemic for S. mansoni, whereas S. haematobium co-exists in setting C. Overall, 446 children, aged 8-12 years, submitted multiple stool and urine samples. For S. mansoni diagnosis, stool samples were examined with triplicate Kato-Katz, whereas urine samples were tested with CCA-A. The first stool and urine samples were additionally subjected to an ether-concentration technique and CCA-B, respectively. Urine samples were examined for S. haematobium using a filtration method, and for microhematuria using Hemastix dipsticks. PRINCIPAL FINDINGS: Considering nine Kato-Katz as diagnostic 'gold' standard, the prevalence of S. mansoni in setting A, B and C was 32.9%, 53.1% and 91.8%, respectively. The sensitivity of triplicate Kato-Katz from the first stool and a single CCA-A test was 47.9% and 56.3% (setting A), 73.9% and 69.6% (setting B), and 94.2% and 89.6% (setting C). The respective sensitivity of a single CCA-B was 10.4%, 29.9% and 75.0%. The ether-concentration technique showed a low sensitivity for S. mansoni diagnosis (8.3-41.0%). The specificity of CCA-A was moderate (76.9-84.2%); CCA-B was high (96.7-100%). The likelihood of a CCA-A color reaction increased with higher S. mansoni fecal egg counts (odds ratio: 1.07, p>0.001). A concurrent S. haematobium infection or the presence of microhematuria did not influence the CCA-A test results for S. mansoni diagnosis. CONCLUSION/SIGNIFICANCE: CCA-A showed similar sensitivity than triplicate Kato-Katz for S. mansoni diagnosis with no cross-reactivity to S. haematobium and microhematuria. The low sensitivity of CCA in our study area precludes its use for S. mansoni diagnosis
Publisher Library of Science
ISSN/ISBN 1935-2727
Full Text on edoc No
Digital Object Identifier DOI 10.1371/journal.pntd.0001384
PubMed ID
ISI-Number WOS:000298134000017
Document type (ISI) Journal Article

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