Evaluation of Circulating Cathodic Antigen (CCA) Urine-Tests for Diagnosis of Schistosoma mansoni Infection in Cameroon

Tchuenté, Louis-Albert Tchuem; Fouodo, C.; Ngassam, Romuald Isaka Kamwa; Sumo, Laurentine; Noumedem, Calvine Dongmo; Kenfack, Christian Mérimé; Gipwe, Nestor Feussom; Nana, Esther Dankoni; Stothard, J. Russell; Rollinson, David

doi:10.1371/journal.pntd.0001758

Cited by 95 publications

(91 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This point-of-care urine CCA assay has been used in community studies to estimate the prevalence of schistosomiasis (177) and for successful assessments of PZQ treatment (177,183). Overall, compared to the KK test, this assay is a convenient and efficient method for screening and mapping schistosomiasis cases in communities with medium to high levels of endemicity (177,(183)(184)(185). However, day-to-day fluctuations in urine CCA dipstick test results have been observed, which has led to the suggestion that more than one urine sample collected on different days may be required for more accurate diagnosis.…”

Section: Antigen Detectionmentioning

confidence: 99%

“…However, day-to-day fluctuations in urine CCA dipstick test results have been observed, which has led to the suggestion that more than one urine sample collected on different days may be required for more accurate diagnosis. Also, it has been shown that the sensitivity of the CCA assay for diagnosing S. mansoni infection is reduced in areas of low endemicity and that CCA positivity is correlated strongly with infection intensity (178,184,186). Nevertheless, a recent study of patients from different areas in Uganda where S. mansoni is endemic reported that a single urine CCA assay had increased diagnostic accuracy compared to multiple KK tests and that the test sensitivity correlated with infection prevalence (187).…”

Section: Antigen Detectionmentioning

confidence: 99%

See 1 more Smart Citation

Advances in the Diagnosis of Human Schistosomiasis

et al. 2015

View full text Add to dashboard Cite

SUMMARY Schistosomiasis is a major neglected tropical disease that afflicts more than 240 million people, including many children and young adults, in the tropics and subtropics. The disease is characterized by chronic infections with significant residual morbidity and is of considerable public health importance, with substantial socioeconomic impacts on impoverished communities. Morbidity reduction and eventual elimination through integrated intervention measures are the focuses of current schistosomiasis control programs. Precise diagnosis of schistosome infections, in both mammalian and snail intermediate hosts, will play a pivotal role in achieving these goals. Nevertheless, despite extensive efforts over several decades, the search for sensitive and specific diagnostics for schistosomiasis is ongoing. Here we review the area, paying attention to earlier approaches but emphasizing recent developments in the search for new diagnostics for schistosomiasis with practical applications in the research laboratory, the clinic, and the field. Careful and rigorous validation of these assays and their cost-effectiveness will be needed, however, prior to their adoption in support of policy decisions for national public health programs aimed at the control and elimination of schistosomiasis.

show abstract

Section: Antigen Detectionmentioning

confidence: 99%

Section: Antigen Detectionmentioning

confidence: 99%

Advances in the Diagnosis of Human Schistosomiasis

et al. 2015

View full text Add to dashboard Cite

show abstract

“…Compared with microscopy, urine reagent strips used to detect microhaematuria or proteinuria as a proxy for S. haematobium infection are cheap, quick, and easy to use (Mott 1985; Brooker 2009); have no technical requirements; and are less influenced by the circadian production of schistosome eggs (Murare 1987; Lengeler 1991b). Furthermore, some studies have shown that the sensitivity of these strips is higher than that of urine filtration (French 2007; Robinson 2009), and that a single test with microhaematuria strips is more sensitive than a single test with urine filtration (Taylor 1990)—features that make these strips suitable for screening of urogenital schistosomiasis in the field. However, results should be interpreted against the background of risk for schistosomiasis, as well as any other signs and symptoms that could be indicative of other diseases.…”

Section: Introductionmentioning

confidence: 99%

Circulating antigen tests and urine reagent strips for diagnosis of active schistosomiasis in endemic areas

Ochodo

Gopalakrishna

Spek

et al. 2015

Cochrane Database of Systematic Reviews

131

View full text Add to dashboard Cite

Background Point‐of‐care (POC) tests for diagnosing schistosomiasis include tests based on circulating antigen detection and urine reagent strip tests. If they had sufficient diagnostic accuracy they could replace conventional microscopy as they provide a quicker answer and are easier to use. Objectives To summarise the diagnostic accuracy of: a) urine reagent strip tests in detecting active Schistosoma haematobium infection, with microscopy as the reference standard; and b) circulating antigen tests for detecting active Schistosoma infection in geographical regions endemic for Schistosoma mansoni or S. haematobium or both , with microscopy as the reference standard. Search methods We searched the electronic databases MEDLINE, EMBASE, BIOSIS, MEDION, and Health Technology Assessment (HTA) without language restriction up to 30 June 2014. Selection criteria We included studies that used microscopy as the reference standard: for S. haematobium , microscopy of urine prepared by filtration, centrifugation, or sedimentation methods; and for S. mansoni , microscopy of stool by Kato‐Katz thick smear. We included studies on participants residing in endemic areas only. Data collection and analysis Two review authors independently extracted data, assessed quality of the data using QUADAS‐2, and performed meta‐analysis where appropriate. Using the variability of test thresholds, we used the hierarchical summary receiver operating characteristic (HSROC) model for all eligible tests (except the circulating cathodic antigen (CCA) POC for S. mansoni , where the bivariate random‐effects model was more appropriate). We investigated heterogeneity, and carried out indirect comparisons where data were sufficient. Results for sensitivity and specificity are presented as percentages with 95% confidence intervals (CI). Main results We included 90 studies; 88 from field settings in Africa. The median S. haematobium infection prevalence was 41% (range 1% to 89%) and 36% for S. mansoni (range 8% to 95%). Study design and conduct were poorly reported against current standards. Tests for S. haematobium Urine reagent test strips versus microscopy Compared to microscopy, the detection of microhaematuria on test strips had the highest sensitivity and specificity (sensitivity 75%, 95% CI 71% to 79%; specificity 87%, 95% CI 84% to 90%; 74 studies, 102,447 participants). For proteinuria, sensitivity was 61% and specificity was 82% (82,113 participants); and for leukocyturia, sensitivity was 58% and specificity 61% (1532 participants). Howeve...

show abstract

“…12,13 The POC-CCA assay is commercially available through Rapid Medical Diagnostics (Pretoria, South Africa), and has been evaluated for sensitivity, specificity, and ease of use in a number of settings. [14][15][16][17][18][19] However, there has been concern that the cost of the POC-CCA assay may be a barrier to widespread adoption of this technique for schistosomiasis control programs 14,16,17,20 ; therefore, there is a need for a comprehensive evaluation of the cost-effectiveness of the POC-CCA technique in relation to other available tests. 13 Although the cost of the materials and equipment are commonly cited as expenses, other cost contributions such as labor and transportation are rarely discussed.…”

Section: Introductionmentioning

confidence: 99%

Cost Analysis of Tests for the Detection of Schistosoma mansoni Infection in Children in Western Kenya

Worrell

Bartoces

Karanja

et al. 2015

The American Society of Tropical Medicine and Hygiene

View full text Add to dashboard Cite

Abstract. Financial resources tend to be limited in schistosomiasis endemic areas, forcing program managers to balance financial and scientific considerations when selecting detection assays. Therefore, we compared the costs of using single stool Kato-Katz, triplicate stool Kato-Katz, and point-of-contact circulating cathodic antigen (POC-CCA) assays for the detection of Schistosoma mansoni infection. Economic and financial costs were estimated from the viewpoint of a schistosomiasis control program using the ingredients approach. Costs related to specimen collection, sample processing and analysis, and treatment delivery were considered. Analysis inputs and assumptions were tested using one-way and two-way sensitivity analysis. The total per-person cost of performing the single Kato-Katz, triplicate Kato-Katz, and POC-CCA was US$6.89, US$17.54, and US$7.26, respectively. Major cost drivers included labor, transportation, and supplies. In addition, we provide a costing tool to guide program managers in evaluating detection costs in specific settings, as costs may vary temporally and spatially.

show abstract

Evaluation of Circulating Cathodic Antigen (CCA) Urine-Tests for Diagnosis of Schistosoma mansoni Infection in Cameroon

Cited by 95 publications

References 23 publications

Advances in the Diagnosis of Human Schistosomiasis

Advances in the Diagnosis of Human Schistosomiasis

Circulating antigen tests and urine reagent strips for diagnosis of active schistosomiasis in endemic areas

Cost Analysis of Tests for the Detection of Schistosoma mansoni Infection in Children in Western Kenya

Contact Info

Product

Resources

About