Development and Accuracy Evaluation of Lateral Flow Immunoassay for Rapid Diagnosis of Schistosomiasis Mekongi in Humans.
Rutchanee RodpaiLakkhana SadaowOranuch SanpoolPatcharaporn BoonroumkaewTongjit ThanchomnangSakhone LaymanivongPenchom JanwanYanin LimpanontPhiraphol ChusongsangHiroshi OhmaeHiroshi YamasakiZhiyue LvPewpan M. IntapanWanchai Maleewong
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Schistosoma mekongi infection is endemic in countries along the Mekong River and certain of its tributaries in the lower Mekong basin, especially in Lao People's Democratic Republic and Cambodia. Diagnosis of schistosomiasis is crucial before treatment and epidemiological surveys before and/or after an intervention, such as a mass drug administration. A newly developed immunochromatographic test (ICT) for the diagnosis of schistosomiasis mekongi, based on antiparasite antibody detection in human sera, was evaluated. The schistosomiasis mekongi-ICT (Smk-ICT) strip was developed using somatic antigen from adult S. mekongi. In total, 209 serum samples were examined, including 14 from parasitologically proven schistosomiasis mekongi patients, 30 from schistosomiasis japonica patients, other parasitosis (n = 135), and healthy volunteers (n = 30) from areas not endemic for S. mekongi. Eleven schistosomiasis mekongi samples were positive according to the Smk-ICT, whereas all healthy control samples were negative. Cross-reactions with paragonimiasis heterotremus, sparganosis, trichinellosis, and taeniasis saginata samples were observed at 2.4% (4/165). The diagnostic sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were 78.6% (95% confidence interval [CI] 49.2-95.3), 97.6% (95% CI 93.9-99.3), 73.3% (95% CI 44.9-92.2), 98.2% (95% CI 94.7-99.6), and 96.1% (95% CI 92.1-98.4), respectively. The Smk-ICT kit might be useful to assess the prevalence of disease before establishing transmission control and mass deworming campaigns in countries in the Mekong River subregion.Kappa
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Various immunodiagnostic methods have been employed for the demonstration of specific antischistosomal antibodies. Serological assays are generally less sensitive, less specific and less reproducible than parasitological tests. Positive serological results do not indicate the intensity of infection or differentiate active or chronic infection. If their limitations are recognized and taken into account are serological tests of use in human schistosomiasis control. The diagnosis schistosomiasis should be based on a combination of clinical symptoms, history of residence in endemic or non-endemic areas, parasitological examinations, and serological findings.
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ABSTRACT The diagnosis of schistosomiasis in individuals from countries where the disease is not endemic is challenging, and few data are available on the accuracy of serological diagnosis in those patients. We evaluated the performance of eight serological assays, including four commercial kits, in the diagnosis of imported schistosomiasis in individuals from areas where the disease is not endemic, including six enzyme-linked immunosorbent assays using three different antigens, an indirect hemagglutination assay, and an indirect immunofluorescent-antibody test. To analyze the assays, we used a total of 141 serum samples, with 121 derived from patients with various parasitic infections (among which were 37 cases of schistosomiasis) and 20 taken from healthy volunteers. The sensitivity values for detection of schistosomiasis cases ranged from 41% to 78% and were higher for Schistosoma mansoni than for S. haematobium infections. Specificity values ranged from 76% to 100%; false-positive results were most frequent for samples from patients with cestode infections. By combining two or more tests, sensitivity improved markedly and specificity decreased only moderately. Serological tests are useful instruments for diagnosing imported schistosomiasis in countries where the disease is not endemic, but due to limitations in test sensitivities, we recommend the use of two or more assays in parallel.
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Three symptomatic and 3 asymptomatic patients with acute schistosomiasis mansoni are described. The index case presented with fever and eosinophilia 4–6 weeks after swimming in the Pipi River of the Central African Republic, suggesting acute schistosomiasis (Katayama fever). A fortunate early diagnosis led to early treatment of these schistosomiasis patients. Diagnosis was obtained based on the finding of one Schistosoma mansoni egg in the index case and positive serology in all cases. A commercially available passive haemagglutination test for serum bilharzia antibodies was negative in all cases prior to, and 2 weeks after treatment. However, antibodies against gut-associated antigens (GAA) of adult S. mansoni worms could be demonstrated using the indirect immunofluorescence technique. These cases illustrate the importance of using appropriate diagnostic assays for the early demonstration of infection by schistosomes in previously unexposed “nonimmune” patients with atypical symptoms and in asymptomatic individuals at risk even after brief exposure to schistosome-containing water in endemic countries. Careful (and repeated) stool examination and appropriate serological tests are the keys to prompt diagnosis of S. mansoni infection.
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Journal Article Schistosomiasis in Somalia a parasitological and serological survey in Giohar Get access Kevin M. Cahill, Kevin M. Cahill Tropical Disease Center, St. Clare's Hospital, N.Y.C., and New York Medical College, USA Search for other works by this author on: Oxford Academic PubMed Google Scholar Irving Kagan Irving Kagan National Communicable Disease Center, Atlanta, USA Search for other works by this author on: Oxford Academic PubMed Google Scholar Transactions of The Royal Society of Tropical Medicine and Hygiene, Volume 62, Issue 2, 1968, Pages 227–230, https://doi.org/10.1016/0035-9203(68)90161-2 Published: 01 January 1968
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The prevalence of schistosomiasis serologically based on detection of anti-soluble egg antigen (SEA)--IgM and/or IgG by ELISA technique was 68% of 380 cases, and 52.7% of 148 cases by stool examination. The serological technique seems to be more sensitive and able to detect early infection as well as detection of ectopic infection.
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Abstract Identifying populations with active transmission and monitoring changes in transmission is centrally important in guiding schistosomiasis control programs. Traditionally, human Schistosoma mansoni infections have been detected in stool using microscopy, which is logistically difficult at program scale and has low sensitivity when people have low infection burdens. We compared serological measures of transmission based on antibody response to schistosomiasis soluble egg antigen (SEA) with stool-based measures of infection among 3,663 preschool-age children in an area endemic for S. mansoni in western Kenya. Serological measures of transmission closely aligned with stool-based measures of infection, and serological measures provided better resolution for between-community differences at lower levels of infection. Serology enabled fine- scale measures of heterogeneity in force of infection both geographically and by age. Our results show that serologic surveillance platforms represent an important new opportunity to guide and monitor schistosomiasis control programs.
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Between 2002 and 2006 in the Department of Tropical and Parasitic Diseases of the
Medical University of Gdansk 40 hospitalized patients were suspected of
schistosomiasis on the basis of clinical manifestations, epidemiological data and
positive serology tests (ELISA IgG).
In spite of multiple tests, schistosoma eggs were not identified neither in stool nor
in urine of the patients.
Histopathological examinations of liver and colon or bladder mucosal biopsy have
not revealed schistosoma eggs in chosen patients.
Diagnosis confirmation in case of negative parasitic tests requires serologic tests for
schistosomiasis. ELISA serology tests for antibodies class G were performed in all 40
patients. In some cases the results were dubious – index in the upper limit or only
slightly elevated. In those cases, cross reactions with Plasmodium spp. were taken into
account. In 10 patients, serologic index for schistosomiasis was elevated during or a few
weeks after treatment for malaria. In control tests, 4-8 weeks after the first examination, serologic indexes for schistosomiasis were significantly lower or normal without
specific treatment with praziquantel (Biltricide, Cesol). Seven patients were lost from
follow up.
Because of diagnostic difficulties confirmation tests with Immuno-Blot IgG were
introduced to verify ELISA. After final clinical and serologic analysis, human
schistosomiasis was diagnosed in 23 patients who were treated with success.
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Stool and urine samples from children living in an area in the Western Transvaal in which human schistosomiasis was not endemic were examined for parasites and the indirect fluorescent antibody test was performed on their sera. Since none of these children passed any schistosome ova in their excreta but approximately half of them had a positive serological reaction they must have been infected with either Schistosoma mattheei, which is common in snails and cattle in the area, or avian schistosomes. In view of the occurrence of such 'false-positive' results, general practitioners are advised not to rely too heavily on serological tests in the diagnosis of schistosomiasis.
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