Clinical Infectious Diseases
Volume 65, Issue 4, 2017, Pages 568-574

Accuracy of Diagnostic Tests for Schistosoma mansoni Infection in Asymptomatic Eritrean Refugees: Serology and Point-of-Care Circulating Cathodic Antigen Against Stool Microscopy (Article) (Open Access)

Chernet A. , Kling K. , Sydow V. , Kuenzli E. , Hatz C. , Utzinger J. , Van Lieshout L. , Marti H. , Nickel B. , Labhardt N.D. , Neumayr A.*
  • a Swiss Tropical and Public Health Institute, PO Box, Socinstrasse 57, Basel, 4002, Switzerland, University of Basel, Switzerland
  • b Swiss Tropical and Public Health Institute, PO Box, Socinstrasse 57, Basel, 4002, Switzerland, University of Basel, Switzerland
  • c Swiss Tropical and Public Health Institute, PO Box, Socinstrasse 57, Basel, 4002, Switzerland, University of Basel, Switzerland
  • d Swiss Tropical and Public Health Institute, PO Box, Socinstrasse 57, Basel, 4002, Switzerland, University of Basel, Switzerland
  • e Swiss Tropical and Public Health Institute, PO Box, Socinstrasse 57, Basel, 4002, Switzerland, University of Basel, Switzerland
  • f Swiss Tropical and Public Health Institute, PO Box, Socinstrasse 57, Basel, 4002, Switzerland, University of Basel, Switzerland
  • g Department of Parasitology, Leiden University Medical Center, Netherlands
  • h Swiss Tropical and Public Health Institute, PO Box, Socinstrasse 57, Basel, 4002, Switzerland, University of Basel, Switzerland
  • i Swiss Tropical and Public Health Institute, PO Box, Socinstrasse 57, Basel, 4002, Switzerland, University of Basel, Switzerland
  • j Swiss Tropical and Public Health Institute, PO Box, Socinstrasse 57, Basel, 4002, Switzerland, University of Basel, Switzerland
  • k Swiss Tropical and Public Health Institute, PO Box, Socinstrasse 57, Basel, 4002, Switzerland, University of Basel, Switzerland

Abstract

Background The unprecedented increase in number of African refugees arriving in Europe is confronting clinicians and general practitioners with the question of whether or not and how to screen migrants from endemic regions for Schistosoma mansoni infection. Methods We assessed the accuracy of 3 different diagnostic tests for S. mansoni infection (stool microscopy [samples prepared by sedimentation technique], serology, and point-of-care circulating cathodic antigen [POC-CCA] urine cassette test) in 107 newly arrived asymptomatic Eritrean refugees in Switzerland. Result Sixty-three study participants (59%) tested positive by at least 1 of the 3 methods. Thirty-seven participants (35%) were considered to have active schistosomiasis, either due to the detection of parasite eggs in stool and/or the presence of a concordant positive serology and urine POC-CCA test, which we consider to be a suitable surrogate marker of active infection. Of 23 microscopy-positive participants, 22 were positive by serology (95.7% sensitivity) and 21 were positive by the urine POC-CCA test (91.3% sensitivity). The combination of serology and urine POC-CCA testing detected all 23 microscopy-positive study participants (100% sensitivity). Conclusions With a sensitivity of 100% (95% confidence interval, 82.2%-100%), the combination of serology plus urine POC-CCA testing appears to be the most sensitive screening option for asymptomatic S. mansoni infection in Eritrean refugees, compared with stool sedimentation microscopy. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved.

Author Keywords

Screening POC-CCA Refugees Eritrea Schistosomiasis

Index Keywords

parasitology Antibodies, Helminth Eosinophilia Eritrea refugee predictive value human Refugees feces analysis diagnostic accuracy priority journal Animals procedures animal Cross-Sectional Studies Young Adult cross-sectional study point of care system Humans Point-of-Care Systems male Schistosoma mansoni female schistosomiasis mansoni diagnostic test asymptomatic infection Asymptomatic Infections immunology sensitivity and specificity helminth antibody Article blood Antigens, Helminth Eritrean parasite antigen adult major clinical study Feces serology microscopy point of care testing Urinalysis disease marker urine
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85026873312&doi=10.1093%2fcid%2fcix366&partnerID=40&md5=49baf3df9be9ae1239161787d6bad966
DOI: 10.1093/cid/cix366
ISSN: 10584838
Cited by: 15
Original Language: English