Diagnostic performance of two specific schistosoma japonicum immunological tests for screening schistosoma haematobium in school children in Zambia

Abstract Dipstick Dye Immunoassay (DDIA) and Indirect Haemagglutination Assay(IHA), are two commercially available kits which have been widely used for screening Schistosoma japonicum in P.R. China. Whether they can be used for screening of Schistosoma haematobium are not clear. In order to evaluate the diagnostic efficiency of DDIA and IHA for screening Schistosoma haematobium, serum samples were collected from pupils in endemic areas in Zambia, Southern Africa, and tested by DDIA and IHA by single-blind manner. Meanwhile, the pupils were microscopically examined by infection with Schistosoma and soil-transmitted helminths, visually observed for parasite eggs. Of the enrolled 148 pupils, 61% tested positive for S. haematobium infection, while 31% and 36% of pupils were infected with hookworm and Ascaris respectively. Regarding the parasitological tests as reference standard, for the diagnosis of S. haematobium infection, IHA performed higher sensitivity (74%, 95% CI: 65%-83%) than that of DDIA (60%, 95%CI: 49%-70%). The sensitivities of IHA and DDIA are significant higher in 10-14 years old students than those of 7-9 years old group. The specificity of DDIA and IHA were 61% (95%CI: 49%-74%) and 72% (95%CI: 60%-84%), respectively. The co-infection with STHs decreased the specificity of DDIA but had no impact on that of IHA. Our study indicated that IHA has more potential as an alternative diagnostic tool for identifying schistosomiasis haematobium but need further improvement.