Circulating cathodic antigen cassette test versus haematuria strip test in diagnosis of urinary schistosomiasis

Abstract

Urinary schistosomiasis caused by Schistosoma haematobium constitutes a major public health problem in many tropical and sub-tropical countries. This study was conducted to evaluate circulating cathodic antigen cassette test and haematuria strip test for detection of S. haematobium in urine samples and to evaluate their screening performance among the study population. Microscopy was used as a gold standard. A total of 600 urine samples were examined by microscopy for detection of S. haematobium eggs, screened for microhaematuria using Self-Stik reagent strips and screened for circulating cathodic antigen (CCA) using the urine-CCA cassette test. The specificity of CCA, microhaematuria and macrohaematuria was 96.4, 40.6 and 31.2 % respectively while the sensitivity was 88.2, 99.3 and 100 % respectively which was statistically significant (P \ 0.001). These findings suggest that using of urine-CCA cassette test in diagnosis of urinary schistosomiasis is highly specific (96.4 %) compared with the highly sensitive haematuria strip test (100 %). The degree of agreement between microscopic examination and CCA detection was 99.3 % with highly statistically significant difference (P \ 0.001). The combination of two techniques could potentially use for screening and mapping of S. haematobium infection.

Imported schistosomiasis in Paris region of France: A multicenter study of prevalence and diagnostic methods

“…According to the current French guidelines, a diagnosis of schistosomiasis should be confirmed by combining serologic assays (screening by an ELISA and/or an indirect hemagglutination (IHA) assay and confirmation by a Western blot (WB) assay if one (or two) of the previous test is positive) and microscopic detection of eggs in urine or feces samples [12]. A urine rapid diagnostic test for the circulating cathodic antigen (CCA) produced by adult Schistosoma has been used in endemic areas for several years (Point of care (POC) -CCA) [13]. These POC-CCAs give immediate results, are inexpensive, and require little analytical material but their accuracy is very controversial depending on the studies, with a low specificity for IS [14], [15].…”

Tools for Detection of Schistosomiasis in Resource Limited Settings

“…POC-CCA also has the limitation of being a qualitative test; hence, its interpretation is based on individual analysis that could introduce some form of bias. Together with hematuria test strips, CCA cassette testing could have limited application in the screening and mapping of S. haematobium [ 46 ]. Despite the reliability of the POC-CCA, the inability to detect S. haematobium the most prevalent parasite in SSA is a major limitation.…”