Evaluation of cathodic antigen urine tests for diagnosis of schistosoma mansoni infection in Sudan

Amin, Mutaz; Elsadig, A.; Osman, Hussam A.

doi:10.4103/1658-631x.194257

Cited by 3 publications

(2 citation statements)

References 14 publications

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“…Included studies were published between 2008 and 2021. Thirty studies were conducted in Africa [ 16 , 19 – 39 ] while 6 were from Brazil [ 40 – 45 ]. One study was conducted in Switzerland, but the study participants were newly arriving Eritrean refuges [ 46 ].…”

Section: Resultsmentioning

confidence: 99%

Evaluation of the Urine POC‐CCA Test Accuracy in the Detection of Schistosoma mansoni Infection: A Systematic Review and Meta‐Analysis

Alemu,

Nibret

2024

Journal of Tropical Medicine

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Background. Schistosomiasis is a common public health problem throughout the world and Schistosoma mansoni is the most prevalent species in Africa. Most endemic countries use the Kato–Katz (KK) stool smear examination for diagnosis, mapping, and monitoring of intervention programs. However, its poor sensitivity calls for an urgency to evaluate and use more accurate diagnostic tools, of which detection of circulating cathodic antigen (CCA) in urine seems promising. Methods. Studies published until May 2022 were searched from PubMed, Google Scholar, and grey literature for systematic review and meta‐analysis following the PRISMA guideline. Eligible studies were selected based on preset inclusion and exclusion criteria. Quality of included studies was assessed using the QUADAS‐2 tool. Heterogeneity between studies was assessed using Cochrane Q test and I2 test statistics. Data were analyzed using Review Manager 5.4.1 and Meta‐DiSc 1.4 software programs. Results. Thirty‐seven studies published in 29 papers and enrolling 21159 study participants were included for analysis. Overall analysis of Point‐of‐Care Circulating Cathodic Antigen (POC‐CCA) test against KK reference standard revealed a pooled sensitivity and specificity of 0.86 (95% CI: 0.85–0.87) and 0.66 (95% CI: 0.65–0.67), respectively. Subgroup analysis among 24 studies comparing single POC‐CCA with test single KK revealed a high sensitivity (0.88) but low specificity (0.66). Based on findings of 24 studies, the area under the curve (AUC) for the systematic receiver operating characteristic (SROC) curve was 0.7805, indicating that the POC‐CCA test effectively separates those with the disease from those who do not have it. Higher sensitivity estimates of 0.93 and 0.90 were reported when comparisons were made between test results of 2 urine and 1 stool samples, and 3 urine and 3 stool samples, respectively. Single POC‐CCA test resulted in a pooled sensitivity estimate of 0.81 (95% CI: 0.78–0.84) as evaluated by the polymerase chain reaction (PCR) reference test. Conclusions. The POC‐CCA test has higher sensitivity than KK and may serve as a routine diagnostic alternative for disease diagnosis, mapping, and monitoring of interventions. However, its accuracy should further be evaluated at different transmission settings and infection intensity.

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Section: Resultsmentioning

confidence: 99%

Evaluation of the Urine POC‐CCA Test Accuracy in the Detection of Schistosoma mansoni Infection: A Systematic Review and Meta‐Analysis

Alemu,

Nibret

2024

Journal of Tropical Medicine

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“…CCA therefore measures antigens in active worm infections that disappear from the body within 24 to 48 h of clearing the infection [ 14 ]. These assays are commercially available, and are now being used for countrywide mapping of the prevalence of schistosomiasis [ 15 – 17 ]. CCA has a higher sensitivity than KK, particularly at low intensity of infection, but there are some indications that specificity might not be 100% [ 5 , 13 , 18 , 19 ].…”

Section: Introductionmentioning

confidence: 99%

Understanding the relationship between egg- and antigen-based diagnostics of Schistosoma mansoni infection pre- and post-treatment in Uganda

et al. 2018

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BackgroundSchistosomiasis is a major socio-economic and public health problem in many sub-Saharan African countries. After large mass drug administration (MDA) campaigns, prevalence of infection rapidly returns to pre-treatment levels. The traditional egg-based diagnostic for schistosome infections, Kato-Katz, is being substituted in many settings by circulating antigen recognition-based diagnostics, usually the point-of-care circulating cathodic antigen test (CCA). The relationship between these diagnostics is poorly understood, particularly after treatment in both drug-efficacy studies and routine monitoring.ResultsWe created a model of schistosome infections to better understand and quantify the relationship between these two egg- and adult worm antigen-based diagnostics. We focused particularly on the interpretation of “trace” results after CCA testing. Our analyses suggest that CCA is generally a better predictor of prevalence, particularly after treatment, and that trace CCA results are typically associated with truly infected individuals.ConclusionsEven though prevalence rises to pre-treatment levels only six months after MDAs, our model suggests that the average intensity of infection is much lower, and is probably in part due to a small burden of surviving juveniles from when the treatment occurred. This work helps to better understand CCA diagnostics and the interpretation of post-treatment prevalence estimations.Electronic supplementary materialThe online version of this article (10.1186/s13071-017-2580-z) contains supplementary material, which is available to authorized users.

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Prevalence and Risk Factors of Schistosomiasis in Sudan: A Systematic Review and Meta-Analysis

Alsaafin,

Omer,

Felemban

et al. 2024

Cureus

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Schistosomiasis is considered the most widespread parasitic infection. Both Schistosoma haematobium and Schistosoma mansoni are present, and as waterborne infections, their epidemiology is closely associated with proximity and exposure to freshwater sources. The objective of the current study is to estimate the pooled prevalence of schistosomiasis among the Sudanese population and examine any associated sociocultural risk factors. A systematic review was conducted in December 2022. The review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Sixty-seven research articles were recruited representing a total sample size of 813,571 participants. Schistosoma haematobium pooled prevalence was 24.83% (95% confidence interval (CI): 22.75, 26.92) among 700,337 participants tested, while S. mansoni pooled prevalence of 19.13% (95% CI: 18.70, 19.56) among 685,133 participants was originated. Moreover, schistosomiasis prevalence among school-age children was assessed in 45 included studies; the pooled prevalence of S. haematobium was 22.37 (95% CI: 20.12, 24.63), while S. mansoni pooled prevalence was 18.62 (95% CI: 13.14, 24.11). Furthermore, the highest Schistosoma prevalence (overall pooled prevalence: 41% (95% CI: 26.72, 55,29), S. haematobium pooled prevalence: 38.59 (95% CI: 21.03, 56.14), S. mansoni pooled prevalence: 25.85 (95% CI: 5.07, 46.63)) was found among Gezira State participants, based on a sample size of 5,712 individuals. Farming, male gender, no presence of latrines, canal and stream water sources, and swimming, playing, or bathing in the Nile River and canals were found to be significantly associated with schistosomiasis infection. The current findings are believed to serve as a cornerstone for designing strategies and preventive measures.

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Evaluation of cathodic antigen urine tests for diagnosis of schistosoma mansoni infection in Sudan

Cited by 3 publications

References 14 publications

Evaluation of the Urine POC‐CCA Test Accuracy in the Detection of Schistosoma mansoni Infection: A Systematic Review and Meta‐Analysis

Evaluation of the Urine POC‐CCA Test Accuracy in the Detection of Schistosoma mansoni Infection: A Systematic Review and Meta‐Analysis

Understanding the relationship between egg- and antigen-based diagnostics of Schistosoma mansoni infection pre- and post-treatment in Uganda

Prevalence and Risk Factors of Schistosomiasis in Sudan: A Systematic Review and Meta-Analysis

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