Diagnosis of schistosoma mansoni without the stool

Comparison of three diagnostic tests to detect schiostosoma mansoni infection from filtered urine in zambia

Nilanjan Lodh, James C L Mwansa, Mable M. Mutengo, Clive Julian Shiff

Research output: Contribution to journalArticle

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.

Original languageEnglish (US)
Pages (from-to)46-50
Number of pages5
JournalAmerican Journal of Tropical Medicine and Hygiene
Volume89
Issue number1
DOIs
StatePublished - Jul 2013

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Zambia
Schistosoma mansoni
Routine Diagnostic Tests
Urine
Polymerase Chain Reaction
Infection
Antigens
Schistosomiasis mansoni
Schistosomiasis
Age Groups
Sensitivity and Specificity
DNA

ASJC Scopus subject areas

  • Parasitology
  • Infectious Diseases
  • Virology

Cite this

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title = "Diagnosis of schistosoma mansoni without the stool: Comparison of three diagnostic tests to detect schiostosoma mansoni infection from filtered urine in zambia",
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.",
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