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Cardoso DT, Magalhães FDC, Enk MJ, Geiger SM, Barbosa DS. Challenges to Schistosomiasis Control Program in Brazil: setbacks in the control program and critical analysis of the disease notification. Rev Soc Bras Med Trop 2024; 57:e00409. [PMID: 39082519 PMCID: PMC11290847 DOI: 10.1590/0037-8682-0598-2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Accepted: 05/29/2024] [Indexed: 08/02/2024] Open
Abstract
BACKGROUND In 1970, Brazil implemented the Schistosomiasis Control Program (PCE, Portuguese acronym for Programa de Controle da Esquistossomose) was implemented in Brazil, where, through successive treatment interventions, the epidemiology and transmission of schistosomiasis have changed significantly over time. This study aimed to evaluate the PCE's effectiveness by critically analyzing the disease notification system. METHODS An ecological study was conducted using data on reported schistosomiasis cases in Brazil between 2007 and 2020. RESULTS The highest number of municipalities actively participating in the PCE was 750, recorded in 2007. Conversely, participation reached its lowest point in 2020, with only 259 municipalities involved. Over the past decade, there has been a drastic decline in the number of municipalities with active schistosomiasis control programs. During the same period, there was an observed increase in the number of deaths caused by schistosomiasis, while the number of reported cases decreased. This suggests an inverse correlation. CONCLUSIONS The present data suggest that schistosomiasis cases are not correctly diagnosed or reported, reflecting a twisted image of the magnitude of this public health problem in Brazil.
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Affiliation(s)
- Diogo Tavares Cardoso
- Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Departamento de Parasitologia, Belo Horizonte, MG, Brasil
| | - Fernanda do Carmo Magalhães
- Universidade Federal de Minas Gerais, Faculdade de Medicina Veterinária, Departamento de Medicina Veterinária Preventiva, Belo Horizonte, MG, Brasil
| | - Martin Johannes Enk
- Ministério da Saúde, Instituto Evandro Chagas, Secretaria de Vigilância em Saúde, Ananindeua, PA, Brasil
| | - Stefan Michael Geiger
- Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Departamento de Parasitologia, Belo Horizonte, MG, Brasil
| | - David Soeiro Barbosa
- Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Departamento de Parasitologia, Belo Horizonte, MG, Brasil
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Dias IHL, Fonseca ÁLS, de Sousa SRM, Gouveia MIM, Ribeiro LR, de Oliveira Goveia C, Nogueira JFC, Enk MJ, Souza E Guimarães RJDP, Lima KVB. Schistosoma mansoni infection in residents of a riverside community in Eastern Amazon. JOURNAL OF WATER AND HEALTH 2024; 22:835-841. [PMID: 38822463 DOI: 10.2166/wh.2024.300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Accepted: 04/05/2024] [Indexed: 06/03/2024]
Abstract
Schistosoma mansoni worms cause a waterborne parasitic disease called schistosomiasis. It commonly affects individuals in lack of sanitation structure. In Brazil, Pará state has Belém as one of the worst sanitation-ranking places in 2023, where schistosomiasis transmission was already documented. This study reports the occurrence of schistosomiasis in residents of Ilha das Onças, an island next to Belém. Stool samples were obtained from participants over 2 years old, all residents from Furo do Rio Grande, one of the rivers on the island. The Kato-Katz technique was performed for parasite investigation in the stool samples. Each participant responded to a sociodemographic and clinical questionnaire. The residences were georeferenced for map designing. Three out of 263 participants were S. mansoni positive, all men, ages ranging from 19 to 41 years old, with low parasitic load. Malacological surveys were carried out, but no Biomphalaria snails were found. Risk factors for schistosomiasis establishment are present on the island, and the lack of sanitation makes it a potential risk area. Malacological surveys are highly encouraged as preventive measures, as well as health surveillance for riverside populations, generating data that will help health authorities in the management and planning of preventive control actions.
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Affiliation(s)
- Isabelle Helena Lima Dias
- Programa de Pós-Graduação Strictu Sensu em Biologia Parasitária na Amazônia da Universidade do Estado do Pará (UEPA), Belém, Pará, Brazil E-mail: ;
| | - Álvaro Luan Santana Fonseca
- Programa de Pós-Graduação Strictu Sensu em Biologia Parasitária na Amazônia da Universidade do Estado do Pará (UEPA), Belém, Pará, Brazil
| | - Sergei Rodrigo Magalhães de Sousa
- Programa de Pós-Graduação Strictu Sensu em Biologia Parasitária na Amazônia da Universidade do Estado do Pará (UEPA), Belém, Pará, Brazil
| | | | - Layana Rufino Ribeiro
- Licenciatura plena em Ciências Biológicas, Universidade do Estado do Pará (UEPA), Belém, Pará, Brazil
| | - Christiane de Oliveira Goveia
- Laboratório de Malacologia (LABMAL), Seção de Parasitologia, Instituto Evandro Chagas/SVSA/MS, Ananindeua, Pará, Brazil
| | - Joyce Favacho Cardoso Nogueira
- Laboratório de Parasitoses Intestinais e Esquistossomose (LPIE), Seção de Parasitologia, Instituto Evandro Chagas/SVSA/MS, Ananindeua, Pará, Brazil
| | - Martin Johannes Enk
- Laboratório de Parasitoses Intestinais e Esquistossomose (LPIE), Seção de Parasitologia, Instituto Evandro Chagas/SVSA/MS, Ananindeua, Pará, Brazil
| | | | - Karla Valéria Batista Lima
- Laboratório de Biologia Molecular, Seção de Bacteriologia e Micologia, Instituto Evandro Chagas/SVSA/MS, Ananindeua, Pará, Brazil
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Magalhães FDC, Moreira JMP, de Rezende MC, Favero V, Graeff-Teixeira C, Coelho PMZ, Carneiro M, Geiger SM, Negrão-Corrêa D. Evaluation of isotype-based serology for diagnosis of Schistosoma mansoni infection in individuals living in endemic areas with low parasite burden. Acta Trop 2023; 248:107017. [PMID: 37774894 DOI: 10.1016/j.actatropica.2023.107017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Revised: 08/31/2023] [Accepted: 09/01/2023] [Indexed: 10/01/2023]
Abstract
Intestinal schistosomiasis is a chronic and debilitating disease that affects public health systems worldwide. Control interventions to reduce morbidity primarily involve the diagnosis and treatment of infected individuals. However, the recommended Kato-Katz (KK) parasitological method shows low sensitivity in individuals with low parasite loads and is not useful for monitoring elimination of parasite transmission at later stages. In the current study, we evaluated the accuracy of serum reactivity levels of different immunoglobulin isotypes in an enzyme-linked immunosorbent assay (ELISA), utilizing Schistosoma mansoni crude extracts, with the aim to improve the diagnosis of infected individuals with low parasite loads. The serum reactivity of IgM and IgG subclass antibodies (IgG1, IgG3, and IgG4) against soluble adult worm and egg antigen preparations was evaluated in residents from a schistosomiasis-endemic area in northern Minas Gerais, Brazil. The parasitological status of the study population was determined through fecal examination with multiple parasitological tests to create a consolidated reference standard (CRS) plus a fecal DNA detection test (q-PCR). Twelve months after praziquantel treatment, a second serum sample was obtained from the population for reexamination. A two-graph receiver operating characteristic curve (TG-ROC) analysis was performed using the serum reactivity of non-infected endemic controls and egg-positive individuals, and the cut-off value was established based on the intersection point of the sensibility and specificity curves in TG-ROC analyses. The diagnostic accuracy of each serological test was evaluated in relation to the parasitological CRS and to the combination of CRS plus qPCR results. The data revealed that serum reactivity of IgM and IgG3 against S. mansoni antigens did not allow identification of infected individuals from the endemic area. In contrast, serum IgG1 and IgG4-reactivity against schistosome antigens could distinguish between infected and non-infected individuals, with AUC values ranging between 0.728-0.925. The reactivity of IgG4 anti-soluble egg antigen - SEA (sensitivity 79 %, specificity 69 %, kappa = 0.49) had the best diagnostic accuracy, showing positive reactivity in more than 75 % of the infected individuals who eliminated less than 12 eggs per gram of feces. Moreover, serum IgG4 reactivity against SEA and against soluble worm antigen preparation (SWAP) was significantly reduced in the serum of infected individuals after 12 months of confirmed parasitological cure and in the absence of re-infection. These results reinforce that the described IgG4 anti-SEA ELISA assay is a sensitive alternative for the diagnosis of active intestinal schistosomiasis in individuals from endemic areas, including in those with a very low parasite load.
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Affiliation(s)
- Fernanda do Carmo Magalhães
- Departamento de Parasitologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - João Marcelo Peixoto Moreira
- Departamento de Parasitologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Michelle Carvalho de Rezende
- Departamento de Parasitologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Vivian Favero
- Laboratório de Biologia Parasitária, Escola de Ciências, Pontifícia Universidade Católica do Rio Grande do Sul, Brazil
| | - Carlos Graeff-Teixeira
- Centro de Ciências da Saúde, Núcleo de Doenças Infecciosas, Universidade Federal do Espírito Santo, Brazil
| | - Paulo Marcos Zech Coelho
- Laboratório de Esquistossomose, Centro de Pesquisas René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Brazil
| | - Mariângela Carneiro
- Departamento de Parasitologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Stefan Michael Geiger
- Departamento de Parasitologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Deborah Negrão-Corrêa
- Departamento de Parasitologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
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Lopes KF, Freire ML, Souza Lima DC, Enk MJ, Oliveira E, Geiger SM. Development and evaluation of an indirect ELISA using a multiepitope antigen for the diagnosis of intestinal schistosomiasis. Parasitology 2023; 150:683-692. [PMID: 37092694 PMCID: PMC10410369 DOI: 10.1017/s0031182023000409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 03/29/2023] [Accepted: 04/15/2023] [Indexed: 04/25/2023]
Abstract
The laboratory diagnosis of intestinal schistosomiasis, carried out by detecting parasite eggs in feces, has low sensitivity when applied to individuals with low parasitic load. Serological tests can be more sensitive for the diagnosis of the disease. Therefore, the objective of this work was to develop and evaluate an ELISA-based immunoenzymatic assay, using a Schistosoma mansoni multiepitope antigen (ELISA IgG anti-SmME). For this, the amino acid sequences of S. mansoni cathepsin B and asparaginyl endopeptidase were submitted to the prediction of B cell epitopes and, together with peptide sequences obtained from earlier works, were used in the construction of a minigene. The multiepitope protein was expressed in Escherichia coli and the performance of the ELISA IgG anti-SmME for schistosomiasis was evaluated using serum samples from 107 individuals either egg positive or negative. In addition, 11 samples from individuals with other helminth infections were included. The ELISA IgG anti-SmME showed a sensitivity of 81.1% and a specificity of 46.1%. Further analysis revealed a 77.2% sensitivity in diagnosis of individuals with egg counts of ≤12 epg (eggs per gram feces) and 87.5% for individuals with 13–99 epg. It is worth mentioning that, to our knowledge, this was the first study using a multiepitope recombinant antigen in an ELISA for diagnosis of intestinal schistosomiasis, which demonstrated promising results in the diagnosis of individuals with low parasitic loads.
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Affiliation(s)
- Karine Ferreira Lopes
- Department of Parasitology, Institute of Biological Sciences, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
- René Rachou Institute – Oswaldo Cruz Foundation, Belo Horizonte, Minas Gerais, Brazil
| | | | - Dayane Costa Souza Lima
- Department of Parasitology, Institute of Biological Sciences, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Martin Johannes Enk
- Evandro Chagas Institute – Secretary of Health Vigilance, Ministry of Health, Ananindeua, Pará, Brazil
| | - Edward Oliveira
- René Rachou Institute – Oswaldo Cruz Foundation, Belo Horizonte, Minas Gerais, Brazil
| | - Stefan Michael Geiger
- Department of Parasitology, Institute of Biological Sciences, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
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Mesquita SG, Caldeira RL, Favre TC, Massara CL, Beck LCNH, Simões TC, de Carvalho GBF, dos Santos Neves FG, de Oliveira G, de Souza Barbosa Lacerda L, de Almeida MA, dos Santos Carvalho O, Moraes Mourão M, Oliveira E, Silva-Pereira RA, Fonseca CT. Assessment of the accuracy of 11 different diagnostic tests for the detection of Schistosomiasis mansoni in individuals from a Brazilian area of low endemicity using latent class analysis. Front Microbiol 2022; 13:1048457. [PMID: 36590409 PMCID: PMC9797737 DOI: 10.3389/fmicb.2022.1048457] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 11/04/2022] [Indexed: 12/16/2022] Open
Abstract
Background Schistosomiasis is a parasitic disease associated with poverty. It is estimated that 7.1 million people are infected with Schistosoma mansoni in Latin America, with 95% of them living in Brazil. Accurate diagnosis and timely treatment are important measures to control and eliminate schistosomiasis, but diagnostic improvements are needed to detect infections, especially in areas of low endemicity. Methodology This research aimed to evaluate the performance of 11 diagnostic tests using latent class analysis (LCA). A cross-sectional survey was undertaken in a low endemicity area of the municipality of Malacacheta, Minas Gerais, Brazil. Feces, urine, and blood samples were collected from 400 residents older than 6 years of age, who had not been treated with praziquantel in the 12 months previous to the collection of their samples. The collected samples were examined using parasitological (Helm Test® kit Kato-Katz), nucleic acid amplification tests -NAATs (PCR, qPCR and LAMP on urine; PCR-ELISA, qPCR and LAMP on stool), and immunological (POC-CCA, the commercial anti-Schistosoma mansoni IgG ELISA kit from Euroimmun, and two in-house ELISA assays using either the recombinant antigen PPE or the synthetic peptide Smp150390.1) tests. Results The positivity rate of the 11 tests evaluated ranged from 5% (qPCR on urine) to 40.8% (commercial ELISA kit). The estimated prevalence of schistosomiasis was 12% (95% CI: 9-15%) according to the LCA. Among all tests assessed, the commercial ELISA kit had the highest estimated sensitivity (100%), while the Kato-Katz had the highest estimated specificity (99%). Based on the accuracy measures observed, we proposed three 2-step diagnostic approaches for the active search of infected people in endemic settings. The approaches proposed consist of combinations of commercial ELISA kit and NAATs tests performed on stool. All the approaches had higher sensitivity and specificity than the mean values observed for the 11 tests (70.4 and 89.5%, respectively). Conclusion We showed that it is possible to achieve high specificity and sensitivity rates with lower costs by combining serological and NAATs tests, which would assist in the decision-making process for appropriate allocation of public funding aiming to achieve the WHO target of eliminating schistosomiasis as a public health problem by 2030.
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Affiliation(s)
- Silvia Gonçalves Mesquita
- Grupo de Pesquisa em Helmintologia e Malacologia Médica, Instituto René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Minas Gerais, Brazil
| | - Roberta Lima Caldeira
- Grupo de Pesquisa em Helmintologia e Malacologia Médica, Instituto René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Minas Gerais, Brazil
| | - Tereza Cristina Favre
- Laboratório de Educação em Ambiente e Saúde, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Cristiano Lara Massara
- Grupo de Pesquisa em Helmintologia e Malacologia Médica, Instituto René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Minas Gerais, Brazil
| | | | - Taynãna César Simões
- Núcleo de Estudos em Saúde Pública e Envelhecimento, Instituto René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Minas Gerais, Brazil
| | - Gardênia Braz Figueiredo de Carvalho
- Grupo de Pesquisa em Biologia e Imunologia de Doenças Infecciosas e Parasitárias, Instituto René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Minas Gerais, Brazil
| | - Flória Gabriela dos Santos Neves
- Grupo de Pesquisa em Helmintologia e Malacologia Médica, Instituto René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Minas Gerais, Brazil
| | - Gabriela de Oliveira
- Grupo de Pesquisa em Biologia e Imunologia de Doenças Infecciosas e Parasitárias, Instituto René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Minas Gerais, Brazil
| | - Larisse de Souza Barbosa Lacerda
- Grupo de Pesquisa em Biologia e Imunologia de Doenças Infecciosas e Parasitárias, Instituto René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Minas Gerais, Brazil
| | - Matheus Alves de Almeida
- Grupo de Pesquisa em Genômica Funcional de Parasitos, Instituto René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Minas Gerais, Brazil
| | - Omar dos Santos Carvalho
- Grupo de Pesquisa em Helmintologia e Malacologia Médica, Instituto René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Minas Gerais, Brazil
| | - Marina Moraes Mourão
- Grupo de Pesquisa em Helmintologia e Malacologia Médica, Instituto René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Minas Gerais, Brazil
| | - Edward Oliveira
- Grupo de Pesquisa em Genômica Funcional de Parasitos, Instituto René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Minas Gerais, Brazil
| | - Rosiane A. Silva-Pereira
- Grupo de Pesquisa em Biologia e Imunologia de Doenças Infecciosas e Parasitárias, Instituto René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Minas Gerais, Brazil
| | - Cristina Toscano Fonseca
- Grupo de Pesquisa em Biologia e Imunologia de Doenças Infecciosas e Parasitárias, Instituto René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Minas Gerais, Brazil
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Mesquita SG, Lugli EB, Matera G, Fonseca CT, Caldeira RL, Webster B. Development of real-time and lateral flow recombinase polymerase amplification assays for rapid detection of Schistosoma mansoni. Front Microbiol 2022; 13:1043596. [PMID: 36466644 PMCID: PMC9716991 DOI: 10.3389/fmicb.2022.1043596] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 10/17/2022] [Indexed: 11/19/2022] Open
Abstract
Background Accurate diagnosis followed by timely treatment is an effective strategy for the prevention of complications together with reducing schistosomiasis transmission. Recombinase Polymerase Amplification (RPA) is a simple, rapid, sensitive, and specific isothermal method with low resource needs. This research aimed at the development and optimisation of a real-time (RT) and a lateral flow (LF) RPA assay for the detection of Schistosoma mansoni. Methodology Recombinase Polymerase Amplification reactions were performed at full- (as recommended) and half-volumes (to reduce costs), with RT or LF detection systems targeting the S. mansoni mitochondrial minisatellite region. The specificity was assessed using gDNA from other Schistosoma species, helminths co-endemic with S. mansoni, human stool, and urine, and Biomphalaria snail hosts. The analytical sensitivity was evaluated using serial dilutions of gDNA, synthetic copies of the target, and single eggs. The ability of both assays to detect the S. mansoni DNA in human urine and stool samples was also tested. The long-term stability of the RT-RPA reagents was evaluated by storing the reaction components in different temperature conditions for up to 3 weeks. Results The RT- and the LF-RPA (SmMIT- and SmMIT-LF-RPA, respectively) presented similar results when used full- and half-volumes, thus the latter was followed in all experiments. The SmMIT-RPA was 100% specific to S. mansoni, able to detect a single egg, with a limit of detection (LOD) of down to 1 fg of gDNA and one synthetic copy of the target. The assay was able to detect S. mansoni DNA from stool containing 1 egg/g and in spiked urine at a concentration of 10 fg/μl. SmMIT-RPA reagents were stable for up to 3 weeks when kept at 19°C, and 2 weeks when stored at 27°C. The SmMIT-LF-RPA cross-reacted with Clinostomidae, presented the LOD of 10 fg and one synthetic copy of the target, being able to detect a single egg and 1 egg/g in a stool sample. The LOD in spiked urine samples was 10 pg/μl. Conclusion The half-volume SmMIT-RPA is a promising method to be used in the field. It is specific, sensitive, robust, and tolerant to inhibitors, with a long-term stability of the reaction components and the real-time visualisation of results.
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Affiliation(s)
- Silvia Gonçalves Mesquita
- Grupo de Pesquisa em Helmintologia e Malacologia Médica, Instituto René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Brazil,Wolfson Wellcome Laboratories, Department of Science, Natural History Museum, London, United Kingdom
| | - Elena Birgitta Lugli
- Wolfson Wellcome Laboratories, Department of Science, Natural History Museum, London, United Kingdom
| | - Giovanni Matera
- Department of Health Sciences, Unit of Microbiology, University “Magna Graecia” of Catanzaro, Catanzaro, Italy
| | - Cristina Toscano Fonseca
- Grupo de Pesquisa em Biologia e Imunologia Parasitária, Instituto René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Brazil
| | - Roberta Lima Caldeira
- Grupo de Pesquisa em Helmintologia e Malacologia Médica, Instituto René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Brazil,*Correspondence: Bonnie Webster, ; Roberta Lima Caldeira,
| | - Bonnie Webster
- Wolfson Wellcome Laboratories, Department of Science, Natural History Museum, London, United Kingdom,*Correspondence: Bonnie Webster, ; Roberta Lima Caldeira,
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Zhang J, Pitol AK, Braun L, Hazell L, Templeton MR. The efficacy of soap against schistosome cercariae: A systematic review. PLoS Negl Trop Dis 2022; 16:e0010820. [PMID: 36191022 PMCID: PMC9560551 DOI: 10.1371/journal.pntd.0010820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 10/13/2022] [Accepted: 09/16/2022] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND Schistosomiasis is a parasitic disease that is endemic in 78 countries and affects almost 240 million people worldwide. It has been acknowledged that an integrated approach that goes beyond drug treatment is needed to achieve control and eventual elimination of the disease. Improving hygiene has been encouraged by World Health Organisation, and one aspect of good hygiene is using soap during water-contact activities, such as bathing and doing laundry. This hygiene practice might directly reduce the skin exposure to cercariae at transmission sites. A systematic review was carried out to investigate the efficacy of soap against schistosome cercariae and to identify the knowledge gaps surrounding this topic. METHODOLOGY Six online databases were searched between 5th and 8th July of 2021. Records returned from these databases were screened to remove duplicates, and the remaining records were classified by reading titles, abstracts, and full texts to identify the included studies. The results were categorised into two groups based on two different protective mechanisms of soap (namely, damage to cercariae and protection of skin). CONCLUSIONS Limited research has been conducted on the efficacy of soap against schistosome cercariae and only 11 studies met the criteria to be included in this review. The review demonstrates that soap has the potential of protecting people against schistosome cercariae and there are two protective aspects: (1) soap affects cercariae adversely; (2) soap on the skin prevents cercariae from penetrating the skin, developing into adult worms and producing eggs. Both aspects of protection were influenced by many factors, but the differences in the reported experimental conditions, such as the cercarial endpoint measurement used and the cercaria numbers used per water sample, lead to low comparability between the previous studies. This review indicates that more evidence is needed to inform hygiene advice for people living in schistosomiasis endemic areas.
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Affiliation(s)
- Jiaodi Zhang
- Department of Civil and Environmental Engineering, South Kensington Campus, Imperial College London, London, United Kingdom
| | - Ana K. Pitol
- Department of Vector Biology, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - Laura Braun
- Department of Disease Control, London School of Hygiene Tropical Medicine, London, United Kingdom
| | - Lucinda Hazell
- Department of Civil and Environmental Engineering, South Kensington Campus, Imperial College London, London, United Kingdom
| | - Michael R. Templeton
- Department of Civil and Environmental Engineering, South Kensington Campus, Imperial College London, London, United Kingdom
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Model MA, Williams PA, Marsh AE. Selective Visualization of Live Intestinal Parasites in Stool Specimens Without Purification. Acta Parasitol 2022; 67:1455-1459. [PMID: 35882825 DOI: 10.1007/s11686-022-00590-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Accepted: 07/01/2022] [Indexed: 11/01/2022]
Abstract
PURPOSE Microscopic observation of live parasites in the stool is an important diagnostic tool in human and veterinary medicine. Because of the presence of large amounts of contaminating organic matter, microscopic analysis must be preceded by time-consuming pre-purification steps. Transmission-through-dye (TTD) optical microscopy obviates this problem. The purpose of this study is to illustrate the use of TTD for the analysis of stool samples. METHODS TTD imaging is based on the exclusion of a strongly absorbing dye by living cells. A food colorant Acid Blue 9 (AB9) is added to a fecal suspension, and the sample is observed under transmitted illumination through a 630 nm bandpass filter. AB9 strongly absorbs red light, and it comes out of the sample significantly attenuated. However, if a viable cell of any origin is present in the sample, it excludes the dye and reduces the depth of the light-absorbing layer. RESULTS Live cells or eggs appear bright red on a dark background, while most of the organic contaminants remain dark. The method has been demonstrated on schistosomes, hookworms, giardia, yeast, and other organisms. CONCLUSION TTD dramatically increases the visibility of live parasites and permits their direct observation in a fecal suspension. TTD can be enabled on any microscope by simply adding a red filter.
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Affiliation(s)
- M A Model
- Department of Biological Sciences, Kent State University, Kent, OH, US.
| | | | - A E Marsh
- Department of Veterinary Preventive Medicine, The Ohio State University, Columbus, OH, US
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Automated diagnosis of schistosomiasis by using faster R-CNN for egg detection in microscopy images prepared by the Kato–Katz technique. Neural Comput Appl 2022. [DOI: 10.1007/s00521-022-06924-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Nigo MM, Odermatt P, Salieb–Beugelaar GB, Morozov O, Battegay M, Hunziker PR. Epidemiology of Schistosoma mansoni infection in Ituri Province, north-eastern Democratic Republic of the Congo. PLoS Negl Trop Dis 2021; 15:e0009486. [PMID: 34855748 PMCID: PMC8638996 DOI: 10.1371/journal.pntd.0009486] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Accepted: 05/14/2021] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Schistosomiasis, caused by Schistosoma mansoni, is of great significance to public health in sub-Saharan Africa. In the Democratic Republic of Congo (DRC), information on the burden of S. mansoni infection is scarce, which hinders the implementation of adequate control measures. We assessed the geographical distribution of S. mansoni infection across Ituri province in north-eastern DRC and determined the prevailing risk factors. METHODS/PRINCIPAL FINDINGS Two province-wide, community-based studies were conducted. In 2016, a geographical distribution study was carried out in 46 randomly selected villages across Ituri. In 2017, an in-depth study was conducted in 12 purposively-selected villages, across the province. Households were randomly selected, and members were enrolled. In 2016, one stool sample was collected per participant, while in 2017, several samples were collected per participant. S. mansoni eggs were detected using the Kato-Katz technique. In 2017, a point-of-care circulating cathodic S. mansoni antigen (POC-CCA) urine test was the second used diagnostic approach. Household and individual questionnaires were used to collect data on demographic, socioeconomic, environmental, behavioural and knowledge risk factors. Of the 2,131 participants in 2016, 40.0% were positive of S. mansoni infection. Infection prevalence in the villages ranged from 0 to 90.2%. Of the 707 participants in 2017, 73.1% were tested positive for S. mansoni. Prevalence ranged from 52.8 to 95.0% across the health districts visited. Infection prevalence increased from north to south and from west to east. Exposure to the waters of Lake Albert and the villages' altitude above sea level were associated with the distribution. Infection prevalence and intensity peaked in the age groups between 10 and 29 years. Preschool children were highly infected (62.3%). Key risk factors were poor housing structure (odds ratio [OR] 2.1, 95% 95% confidence interval [CI] 1.02-4.35), close proximity to water bodies (OR 1.72, 95% CI 1.1-2.49), long-term residence in a community (OR 1.41, 95% CI 1.11-1.79), lack of latrine in the household (OR 2.00, 95% CI 1.11-3.60), and swimming (OR 2.53, 95% CI 1.20-5.32) and washing (OR 1.75, 95% CI 1.10-2.78) in local water bodies. CONCLUSIONS/SIGNIFICANCE Our results show that S. mansoni is highly endemic and a major health concern in Ituri province, DRC. Infection prevalence and intensity, and the prevailing socioeconomic, environmental, and behavioural risk factors in Ituri reflect intense exposure and alarming transmission rates. A robust plan of action is urgently needed in the province.
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Affiliation(s)
- Maurice M. Nigo
- Nanomedicine Translation Group, Intensive Care Unit, University Hospital Basel, University of Basel, Basel, Switzerland
- CLINAM–European Foundation for Clinical Nanomedicine, Basel, Switzerland
- University of Basel, Basel, Switzerland
- Institut Supérieur des Techniques Médicales (ISTM) Nyankunde, Bunia, Democratic Republic of Congo
| | - Peter Odermatt
- University of Basel, Basel, Switzerland
- Swiss Tropical and Public Health Institute, Basel, Switzerland
| | - Georgette B. Salieb–Beugelaar
- Nanomedicine Translation Group, Intensive Care Unit, University Hospital Basel, University of Basel, Basel, Switzerland
- CLINAM–European Foundation for Clinical Nanomedicine, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Oleksii Morozov
- Nanomedicine Translation Group, Intensive Care Unit, University Hospital Basel, University of Basel, Basel, Switzerland
- CLINAM–European Foundation for Clinical Nanomedicine, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Manuel Battegay
- University of Basel, Basel, Switzerland
- Department of Infectiology & Hospital Hygiene, University Hospital Basel, Basel, Switzerland
| | - Patrick R. Hunziker
- Nanomedicine Translation Group, Intensive Care Unit, University Hospital Basel, University of Basel, Basel, Switzerland
- CLINAM–European Foundation for Clinical Nanomedicine, Basel, Switzerland
- University of Basel, Basel, Switzerland
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Francoeur R, Atuhaire A, Arinaitwe M, Adriko M, Ajambo D, Nankasi A, Babayan SA, Lamberton PHL. ABO Blood Groups Do Not Predict Schistosoma mansoni Infection Profiles in Highly Endemic Villages of Uganda. Microorganisms 2021; 9:microorganisms9122448. [PMID: 34946048 PMCID: PMC8705964 DOI: 10.3390/microorganisms9122448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 11/16/2021] [Accepted: 11/23/2021] [Indexed: 01/21/2023] Open
Abstract
Schistosoma mansoni is a parasite which causes significant public-health issues, with over 240 million people infected globally. In Uganda alone, approximately 11.6 million people are affected. Despite over a decade of mass drug administration in this country, hyper-endemic hotspots persist, and individuals who are repeatedly heavily and rapidly reinfected are observed. Human blood-type antigens are known to play a role in the risk of infection for a variety of diseases, due to cross-reactivity between host antibodies and pathogenic antigens. There have been conflicting results on the effect of blood type on schistosomiasis infection and pathology. Moreover, the effect of blood type as a potential intrinsic host factor on S. mansoni prevalence, intensity, clearance, and reinfection dynamics and on co-infection risk remains unknown. Therefore, the epidemiological link between host blood type and S. mansoni infection dynamics was assessed in three hyper-endemic communities in Uganda. Longitudinal data incorporating repeated pretreatment S. mansoni infection intensities and clearance rates were used to analyse associations between blood groups in school-aged children. Soil-transmitted helminth coinfection status and biometric parameters were incorporated in a generalised linear mixed regression model including age, gender, and body mass index (BMI), which have previously been established as significant factors influencing the prevalence and intensity of schistosomiasis. The analysis revealed no associations between blood type and S. mansoni prevalence, infection intensity, clearance, reinfection, or coinfection. Variations in infection profiles were significantly different between the villages, and egg burden significantly decreased with age. While blood type has proven to be a predictor of several diseases, the data collected in this study indicate that it does not play a significant role in S. mansoni infection burdens in these high-endemicity communities.
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Affiliation(s)
- Rachel Francoeur
- Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow, Glasgow G12 8QQ, UK;
- Welcome Centre for Integrative Parasitology, University of Glasgow, Glasgow G12 8QQ, UK
- Faculty of Science and Engineering, Department of Biological Sciences, University of Chester, Chester CH1 4BJ, UK
- Correspondence: (R.F.); (P.H.L.L.)
| | - Alon Atuhaire
- Vector Control Division, Ministry of Health, Kampala P.O. Box 1661, Uganda; (A.A.); (M.A.); (M.A.); (A.N.)
| | - Moses Arinaitwe
- Vector Control Division, Ministry of Health, Kampala P.O. Box 1661, Uganda; (A.A.); (M.A.); (M.A.); (A.N.)
| | - Moses Adriko
- Vector Control Division, Ministry of Health, Kampala P.O. Box 1661, Uganda; (A.A.); (M.A.); (M.A.); (A.N.)
| | - Diana Ajambo
- Vector Control Division, Ministry of Health, Kampala P.O. Box 1661, Uganda; (A.A.); (M.A.); (M.A.); (A.N.)
| | - Andrina Nankasi
- Vector Control Division, Ministry of Health, Kampala P.O. Box 1661, Uganda; (A.A.); (M.A.); (M.A.); (A.N.)
| | - Simon A. Babayan
- Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow, Glasgow G12 8QQ, UK;
| | - Poppy H. L. Lamberton
- Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow, Glasgow G12 8QQ, UK;
- Welcome Centre for Integrative Parasitology, University of Glasgow, Glasgow G12 8QQ, UK
- Correspondence: (R.F.); (P.H.L.L.)
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12
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Eltantawy M, Orsel K, Schroeder A, Morona D, Mazigo HD, Kutz S, Hatfield J, Manyama M, van der Meer F. Soil transmitted helminth infection in primary school children varies with ecozone in the Ngorongoro Conservation Area, Tanzania. Trop Med Health 2021; 49:22. [PMID: 33691800 PMCID: PMC7945338 DOI: 10.1186/s41182-021-00310-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Accepted: 02/22/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Soil-transmitted helminthiasis is a neglected tropical disease, thriving in environments of poverty and disadvantage. Our objective was to determine the prevalence and intensity of four soil transmitted helminths (STH) among primary school children in the Ngorongoro Conservation Area (NCA), Tanzania. METHODS A cross-sectional study was performed between May 15th and June 2nd, 2014. Six of 20 primary schools were chosen, based on elevation, designated low elevation ecozone (LEE) or high elevation ecozone (HEE). A total of 340 children from standards one to four were recruited. Height and weight of each child was determined and body mass index (BMI) was calculated. Stool samples were analyzed using the Kato-Katz, Wisconsin, and Baermann techniques to detect STH eggs and larvae. An interviewer-administered questionnaire on socio-demographic variables was used to capture information from the school's headmaster and a checklist was used to assess sanitation facilities. RESULTS STHs identified included Ascaris (presumably lumbricoides), Trichuris (presumably trichiura), hookworms (presumably Ancylostoma duodenale and/or Necator americanus), and Strongyloides (presumably stercoralis). The overall prevalence of STH infection was 29.0% in LEE and 34.0% in HEE. Prevalence was 34.3% and 28.2% in males versus females, respectively. Ascaris sp. were only identified in HEE, prevalence of Trichuris sp. and hookworms were significantly higher in HEE compared to LEE, and Strongyloides spp. prevalence was lower in HEE. Intensity of Trichuris sp. was significantly higher in HEE and lower for hookworms. We did not detect a significant relationship between BMI and helminth intensity; however, BMI was lower in lower elevations and in males vs. females. Sanitation practices are taught at the schools, but challenges were identified when implementing. Latrine facilities were available and latrine-cleaning routines were practiced; however, hand washing practices were challenging due to restricted water availability. CONCLUSIONS Significant differences in prevalence in HEE and LEE exist, and STH infections are still very common among school children suggesting that anthelminthic intervention and education may be necessary in this region. Based on this outcome, the study area in the NCA would be classified as a medium risk area, where periodic treatment recommendations should be based on prevalence estimations in the different ecozones. TRIAL REGISTRATION Ethics approval was obtained from the Catholic University of Health and Allied Sciences (CUHAS; Lake Zone Institutional Review Board MR/53/100/307)); the Conjoint Health Research Ethics Board (CHREB) at the University of Calgary in Canada (Study ID REB14-0127); the National Institute of Medical Research (NIMR) of Tanzania; and the Tanzania Commission for Science and Technology (COSTEC).
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Affiliation(s)
- Manar Eltantawy
- Department. of Production Animal Health, Faculty of Veterinary Medicine, University of Calgary, Calgary, AB, Canada
| | - Karin Orsel
- Department. of Production Animal Health, Faculty of Veterinary Medicine, University of Calgary, Calgary, AB, Canada.,Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Ashley Schroeder
- Department of Ecosystem and Public Health, Faculty of Veterinary Medicine, University of Calgary, Calgary, AB, Canada
| | - Domenica Morona
- Department of Parasitology, Catholic University of Health and Allied Science, Mwanza, Tanzania
| | - Humphrey D Mazigo
- Department of Parasitology, Catholic University of Health and Allied Science, Mwanza, Tanzania
| | - Susan Kutz
- Department of Ecosystem and Public Health, Faculty of Veterinary Medicine, University of Calgary, Calgary, AB, Canada
| | - Jennifer Hatfield
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Mange Manyama
- Division of Medical Education, Weill Cornell Medicine - Qatar, Doha, Qatar
| | - Frank van der Meer
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada. .,Department of Ecosystem and Public Health, Faculty of Veterinary Medicine, University of Calgary, Calgary, AB, Canada.
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Elizondo-Luévano JH, Castro-Ríos R, Vicente B, Fernández-Soto P, López-Aban J, Muro A, Chávez-Montes A. In Vitro Antischistosomal Activity of the Argemone mexicana Methanolic Extract and Its Main Component Berberine. IRANIAN JOURNAL OF PARASITOLOGY 2021; 16:91-100. [PMID: 33786051 PMCID: PMC7988676 DOI: 10.18502/ijpa.v16i1.5518] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Background: Schistosomiasis has been identified as a major public health problem in tropical countries. The present study aimed to investigate the schistosomicidal effects of the methanolic extract of Argemone mexicana L. and its active component, berberine against Schistosoma mansoni on in-vitro experiments. Methods: S. mansoni adults were used. Various concentrations of the methanolic extract (10 – 200 μg/ml) and berberine (2.5 – 50 μM) were tested from 24 to 72 h. The viability of S. mansoni was confirmed with an invertoscope-microscope. Furthermore, cytotoxic (Hemolysis test), and antioxidant (DPPH radical scavenging assay) capacities were determined. Results: The viability tests on S. mansoni showed that A. mexicana at 50 μg/mL is lethal at 48 h and berberine at 10 μM is lethal at 24 h. The hemolytic activity at 1,000 μg/mL was 2.9% for A. mexicana and 90.2% for berberine. The antioxidant capacities shown by A. mexicana and berberine, were EC50 156.3 and 84.1 μg/mL, respectively. Conclusion: The extract of A. mexicana and berberine demonstrated high antischistosomal activities in low concentration and short exposure time on the in-vitro model.
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Affiliation(s)
- Joel H Elizondo-Luévano
- Department of Chemistry, School of Biological Sciences, Autonomous University of Nuevo León, Ciudad Universitaria, San Nicolás de los Garza, Nuevo León, México
| | - Rocío Castro-Ríos
- Department of Analytical Chemistry, School of Medicine, Autonomous University of Nuevo León, Monterrey, Nuevo León, México
| | - Belén Vicente
- Infectious and Tropical Diseases Group (e-INTRO), Biomedical Research Institute of Salamanca -Tropical Diseases Research Centre, Faculty of Pharmacy, University of Salamanca, Campus Miguel de Unamuno, Salamanca, Spain
| | - Pedro Fernández-Soto
- Infectious and Tropical Diseases Group (e-INTRO), Biomedical Research Institute of Salamanca -Tropical Diseases Research Centre, Faculty of Pharmacy, University of Salamanca, Campus Miguel de Unamuno, Salamanca, Spain
| | - Julio López-Aban
- Infectious and Tropical Diseases Group (e-INTRO), Biomedical Research Institute of Salamanca -Tropical Diseases Research Centre, Faculty of Pharmacy, University of Salamanca, Campus Miguel de Unamuno, Salamanca, Spain
| | - Antonio Muro
- Infectious and Tropical Diseases Group (e-INTRO), Biomedical Research Institute of Salamanca -Tropical Diseases Research Centre, Faculty of Pharmacy, University of Salamanca, Campus Miguel de Unamuno, Salamanca, Spain
| | - Abelardo Chávez-Montes
- Department of Chemistry, School of Biological Sciences, Autonomous University of Nuevo León, Ciudad Universitaria, San Nicolás de los Garza, Nuevo León, México
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14
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Santos IGDA, Bezerra LP, Cirilo TM, Silva LO, Machado JPV, Lima PD, Bispo MRS, Gomes SDC, da Silva GIL, Alencar VJB, Damasceno IA, de Carvalho MMV, Gomes DS, Ramos RES, Santos EG, Alves LC, Brayner FA. New epidemiological profile of schistosomiasis from an area of low prevalence in Brazil. Rev Soc Bras Med Trop 2020; 53:e20200335. [PMID: 33111913 PMCID: PMC7580273 DOI: 10.1590/0037-8682-0335-2020] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Accepted: 07/13/2020] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Schistosomiasis, caused by infection from Schistosoma mansoni, is a disease that represents an important public health problem for Brazil, especially for states in the Northeast region. Thus, the aim of this study is to present a new epidemiological profile for the disease in a municipality with low prevalence in the state of Alagoas, Brazil. METHODS A cross-sectional study was conducted through a coproparasitological and malacological survey. A structured questionnaire was applied to the study participants to survey possible risk factors and a spatial analysis (kernel density) was used to measure the risk of infection. RESULTS Of the 347 participants, 106 (30.5%) were infected by Schistosoma mansoni, most of them from the urban area of the municipality (68.9%; 73/106). A 3-fold risk of infection was found for individuals living in the urban area and a risk of 2.15 times for self-declared farmers. Biomphalaria glabrata and B. straminea were the species found in the municipality, but no animals were diagnosed as infected by the parasite. Spatial analysis showed a random distribution of vectors and human cases of the disease, and the formation of two clusters of human cases in the urban area was seen. CONCLUSIONS A new epidemiological profile for schistosomiasis from S. mansoni infection was presented in a municipality of low endemicity: a high proportion of positive individuals in the urban area; presence of snails without positive diagnosis for S. mansoni infection; random distribution of vectors and human cases; and absence of association between classical risk factors and human infection.
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Affiliation(s)
- Israel Gomes de Amorim Santos
- Fundação Oswaldo Cruz, Instituto Aggeu Magalhães, Programa de
Pós-Graduação Stricto Sensu em Biociência e Biotecnologia em Saúde, Recife, PE,
Brasil
- Universidade Estadual de Alagoas, Departamento de Biologia, Santana
do Ipanema, AL, Brasil
| | - Letícia Pereira Bezerra
- Universidade Federal de Sergipe, Programa de Pós-Graduação Stricto
Sensu em Biologia Parasitária, São Cristóvão, SE, Brasil
| | - Tatyane Martins Cirilo
- Universidade Federal de Sergipe, Programa de Pós-Graduação Stricto
Sensu em Biologia Parasitária, São Cristóvão, SE, Brasil
| | - Laryssa Oliveira Silva
- Universidade Estadual de Alagoas, Departamento de Biologia, Santana
do Ipanema, AL, Brasil
| | | | - Pedro Dantas Lima
- Universidade Estadual de Alagoas, Departamento de Biologia, Santana
do Ipanema, AL, Brasil
| | | | | | | | | | | | | | - Dharliton Soares Gomes
- Universidade Federal de Sergipe, Programa de Pós-Graduação Stricto
Sensu em Biologia Parasitária, São Cristóvão, SE, Brasil
| | - Rosália Elen Santos Ramos
- Universidade Federal de Sergipe, Programa de Pós-Graduação Stricto
Sensu em Biologia Parasitária, São Cristóvão, SE, Brasil
| | | | - Luiz Carlos Alves
- Fundação Oswaldo Cruz, Instituto Aggeu Magalhães, Programa de
Pós-Graduação Stricto Sensu em Biociência e Biotecnologia em Saúde, Recife, PE,
Brasil
- Universidade Federal de Pernambuco, Laboratório de Imunopatologia
Keizo Asami, Recife, PE, Brasil
| | - Fábio André Brayner
- Fundação Oswaldo Cruz, Instituto Aggeu Magalhães, Programa de
Pós-Graduação Stricto Sensu em Biociência e Biotecnologia em Saúde, Recife, PE,
Brasil
- Universidade Federal de Pernambuco, Laboratório de Imunopatologia
Keizo Asami, Recife, PE, Brasil
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Elbasheir MM, Karti IA, Elamin EM. Evaluation of a rapid diagnostic test for Schistosoma mansoni infection based on the detection of circulating cathodic antigen in urine in Central Sudan. PLoS Negl Trop Dis 2020; 14:e0008313. [PMID: 32559192 PMCID: PMC7360052 DOI: 10.1371/journal.pntd.0008313] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Revised: 07/14/2020] [Accepted: 04/20/2020] [Indexed: 11/24/2022] Open
Abstract
Background The Kato-Katz thick smear is the standard test for the diagnosis of Schistosoma mansoni infection, but the sensitivity of this technique is low. As an alternative, (CCA) strip test has been evaluated with the conclusion that it may replace the Kato-Katz method in areas where prevalences are moderate or high. Therefore, this study was undertaken to evaluate the performance of the CCA strip test in the diagnosis and monitoring of S. mansoni infection in Sudan. Methodology 489 stool and urine samples were collected from school children in endemic area of Sudan to determine the validity of CCA strip test based on duplicate Kato-Katz thick smear technique. Additional, 118 samples from known non schistosome-endemic area were collected to assess the CCA cross reactivity with other pathogens rather than schistosomiasis. The stability of CCA in urine samples was determined by consecutive examination of 40 positive CCA urine samples. 81 samples were used to evaluate the CCA strip test for the assessment of cure one week, three weeks and six weeks post Praziquantel treatment. Principal findings Assuming parasitological test results as the gold standard, the sensitivity, specificity, positive predictive and negative predictive values of the CCA test were 96%, 85.4%, 78.5% and 97.5% respectively. There was no cross reactivity with other pathogens. The CCA strip test showed high accuracy in monitoring of treatment 93.8% and 100% after three and six weeks of administration of Praziquantel respectively. The stability of the CCA for long time in the urine revealed a safety transportation and shipment of the samples whenever it demanded. Conclusion/Significance The uses of urine CCA strip test in the field would provide more accurate information on the epidemiology and monitoring of the Schistosoma mansoni infection in endemic areas of schistosomiasis than the conventional parasitological method. Moreover, The stability of CCA in urine samples confirms a safety transportation period of the samples whenever it required. A newly developed one-step reagent strip test for detection of S. mansoni circulating cathodic antigen (CCA) in urine was evaluated in different countries and claimed that it has high sensitivity as well as specificity for the epidemiological study of schistosomiasis. However, it is of practical importance to evaluate the effectiveness of such a new technique in several schistosomiasis-endemic areas prior to its application for routine diagnosis or epidemiological study of the disease. Therefore, the present study aimed to evaluate this new method in order to be adopted and applied in the Sudan to improve the diagnosis and to assist in the control of schistosomiasis. 489 school children in central Sudan were examined for stool and urine using Kato-Katz technique and CCA strip test for S. mansoni infection. The sensitivity, specificity, positive predictive and negative predictive values of the CCA test were 96%, 85.4%, 78.5% and 97.5% respectively. The CCA strip test also showed high accuracy in monitoring of treatment 93.8% and 100% after three and six weeks of administration of Praziquantel respectively. Therefore, the uses of urine CCA strip test in the field would provide more accurate information on the epidemiology and monitoring of the Schistosoma mansoni infection in endemic areas of schistosomiasis. Additional assessment is recommended in areas with lower schistosomiasis prevalence and intensity levels.
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Affiliation(s)
- Mohamed M. Elbasheir
- Department of Parasitology & Medical Entomology, Faculty of Medical Laboratory Sciences, Alzaiem Alazhari University, Khartoum State, Sudan
- * E-mail:
| | - Ibrahim A. Karti
- Department of Preventive Medicine, Omdurman Military Hospital, Khartoum State, Sudan
| | - Elwaleed M. Elamin
- Department of Histopathology & Cytology, Faculty of Medical Laboratory Sciences, Alzaiem Alazhari University, Khartoum State, Sudan
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Accuracy of real-time polymerase chain reaction to detect Schistosoma mansoni - infected individuals from an endemic area with low parasite loads. Parasitology 2020; 147:1140-1148. [PMID: 32484122 DOI: 10.1017/s003118202000089x] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Due to the efforts to control schistosomiasis transmission in tropical countries, a large proportion of individuals from endemic areas present low parasite loads, which hinders diagnosis of intestinal schistosomiasis by the Kato-Katz (KK) method. Therefore, the development of more sensitive diagnostic methods is essential for efficient control measures. The aim was to evaluate the accuracy of a real-time polymerase chain reaction (RT-PCR) to detect Schistosoma mansoni DNA in fecal samples of individuals with low parasite loads. A cross-sectional population-based study was conducted in a rural community (n = 257) in Brazil. POC-CCA® was performed in urine and feces were used for RT-PCR. In addition, fecal exams were completed by 18 KK slides, saline gradient and Helmintex techniques. The combined results of the three parasitological tests detected schistosome eggs in 118 participants (45.9%) and composed the consolidated reference standard (CRS). By RT-PCR, 117 out of 215 tested samples were positive, showing 91.4% sensitivity, 80.2% specificity and good concordance with the CRS (kappa = 0.71). RT-PCR identified 86.9% of the individuals eliminating less than 12 eggs/g of feces, demonstrating much better performance than POC-CCA® (50.8%). Our results showed that RT-PCR is a valuable alternative for the diagnosis of intestinal schistosomiasis in individuals with very low parasite loads.
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Tiruneh A, Kahase D, Zemene E, Tekalign E, Solomon A, Mekonnen Z. Identification of transmission foci of Schistosoma mansoni: narrowing the intervention target from district to transmission focus in Ethiopia. BMC Public Health 2020; 20:769. [PMID: 32448159 PMCID: PMC7245888 DOI: 10.1186/s12889-020-08904-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Accepted: 05/12/2020] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Schistosoma mansoni (S. mansoni) infection is a significant public health problem in Ethiopia, and has wide distribution in the country. The impact of the disease is particularly high on school-age children. Nationwide 385 endemic districts were identified, whereby control and elimination interventions are underway using school-based annual mass drug administration (MDA) with praziquantel. The national elimination program targets endemic districts as a whole. The aim of this study was to identify the transmission foci of Schistosoma mansoni and determine prevalence of soil-transmitted helminths (STHs) in Abeshge district. METHODS The study was conducted from April to May, 2019 among school-age children randomly selected from public elementary schools in Abeshge district, South-central Ethiopia. Demographic information and data on risk factors of S. mansoni infection were gathered using pre-tested questionnaire. Moreover, a stool sample was collected from each child and examined using Kato-Katz thick smear technique. The data were analyzed using STATA_MP version 12. RESULTS A total of 389 school-age children from five public elementary schools were included in the study. The overall prevalence of S. mansoni and STHs was 19.3% (75/389) and 35% (136/389), respectively. The prevalence of S. mansoni was 60.6% in Kulit Elementary school, while it was zero in Geraba. The prevalence of S. mansoni was significantly higher among males (AOR = 2.6, 95% CI 1.3-5.1), those with habit of swimming and/or bathing in rivers (AOR = 2.9, 95%CI 1.3-5.1) and involved in irrigation activities (AOR = 2.9, 95% CI 1.0-8.3). Overall, the prevalence of S. mansoni was significantly higher among school children attending Kulit Elementary School compared to those attending the remaining schools (AOR = 12.5, 95%CI 6.2-25.1). CONCLUSION A wide variation of S. mansoni prevalence was observed among the school children in the different schools. Control interventions better identify and target foci of S. mansoni transmission, instead of targeting the district homogenously.
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Affiliation(s)
- Abebaw Tiruneh
- School of Medical Laboratory Sciences, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Daniel Kahase
- Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Wolkite University, Wolkite, Ethiopia
| | - Endalew Zemene
- School of Medical Laboratory Sciences, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Eyob Tekalign
- Department of Medical Laboratory Sciences, College of Health Sciences, Mizan-Tepi University, Mizan-Tepi, Ethiopia
| | - Absra Solomon
- Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Wolkite University, Wolkite, Ethiopia
| | - Zeleke Mekonnen
- School of Medical Laboratory Sciences, Institute of Health, Jimma University, Jimma, Ethiopia
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18
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Marinho CC, Nicolato AJPG, Reis VW, Dos Santos RC, Silva JC, Faria HP, Machado-Coelho GLL. Ultrasound evaluation of schistosomiasis-related morbidity among the Xakriabá people in the state of Minas Gerais, Brazil. Radiol Bras 2020; 53:7-13. [PMID: 32313330 PMCID: PMC7159047 DOI: 10.1590/0100-3984.2019.0047] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Objective To use ultrasound to investigate the morbidity related to schistosomiasis in the Xakriabá indigenous population. Materials and Methods This was a field-based census study conducted in the territory of the Xakriabá people. A total of 166 individuals were invited, and 148 (≤ 77 years of age) agreed to participate. Most participants underwent abdominal ultrasound, physical examination, and stool examination. Mann-Whitney U and chi-square tests were used for comparisons. We determined risk by calculating odds ratio (OR) and performed logistic regression analysis. Results Schistosoma mansoni eggs were found in 31 (26.7%) of the 116 stool samples examined, 22 (70.9%) of the 31 being from individuals 4-16 years of age. The median count was 144 eggs/g of feces (interquartile range, 264). Of the 105 participants examined with ultrasound, 68 (64.8%) had hepatomegaly (left lobe), 6 (5.7%) had splenomegaly, and 4 (3.8%) had portal hypertension. Egg-positive stool samples were more common in those with an enlarged left lobe (OR = 3.4; 95% confidence interval (CI): 1.1-11.2; p = 0.043). Periportal fibrosis was found in 30 participants (28.6%), of whom 9 (30%) had pattern C, 10 (33.3%) had pattern D, and 11 (36.7%) had pattern Dc. Age was the only independent risk factor for fibrosis (p = 0.007). Fibrosis was up to nine-fold more common in alcohol drinkers than in nondrinkers (OR = 9.28; 95% CI: 2.60-33.06; p < 0.001). Among the 138 participants in whom the clinical form was classified, the chronic hepatic form was identified in 54 (39.1%), of whom 32 (59.2%) were under 30 years of age and one (1.8%) was hepatosplenic. Conclusion Schistosomiasis in the Xakriabá population is characterized by a high frequency of egg-positive stool samples, predominantly in children/adolescents, and by chronic hepatic form in the young, especially among alcohol drinkers.
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Affiliation(s)
| | | | | | | | - Jaime Costa Silva
- Ministério da Saúde, Fundação Nacional de Saúde (Funasa), Brasília, DF, Brazil
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Carneiro NFDF, Caldeira AP, Katz N, de Oliveira ÁA, Siqueira LMV, Oliveira E, Silveira MF, Enk MJ, Coelho PMZ. Transmission control of schistosomiasis mansoni in a low endemicity area through a single intervention with rigorous prospection of infected cases treated with praziquantel: evaluation after 7 years of intervention. Rev Inst Med Trop Sao Paulo 2019; 61:e64. [PMID: 31859841 PMCID: PMC6907418 DOI: 10.1590/s1678-9946201961064] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Accepted: 10/22/2019] [Indexed: 11/22/2022] Open
Abstract
A prospective cohort study with rigorous searching for schistosomiasis cases was conducted among residents of Pedra Preta, Montes Claros, Minas Gerais State, Brazil, seven years after an intervention. Kato-Katz (KK), Saline Gradient, Miracidia Hatch and Polymerase Chain Reaction (PCR) were used as the diagnostic methods in 2008. In the period of 2013-2016, 175 patients remaining in the area were examined using the diagnostic methods Kato-Katz (24 slides, 1 g of feces) and Saline Gradient (2 procedures, 1 g of feces). Sixty-eight out of the 69 infected and treated individuals in 2008 tested negative. The percentage of new cases was 2.29% (4/175), and the 4 infected individuals presented low parasitic load [1, 6, 7 and 19 eggs per gram (EPG)]. All the participants answered epidemiological questionnaires on risky behavior. All residences had pit latrines and domiciliary water supply. The primary transmission focus (lake) was dry for several months. Malacological surveys showed a few non-infected specimens of Biomphalaria glabrata . A clear dominance of Biomphalaria straminea was observed. It can be inferred that a significant decrease in the disease transmission occurred after a single action through an intense search for infected and treated cases under the ecoepidemiological conditions of this area.
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Affiliation(s)
| | | | - Naftale Katz
- Fundação Oswaldo Cruz, Instituto René Rachou, Laboratório de Esquistossomose, Belo Horizonte, Minas Gerais, Brazil
| | - Áureo Almeida de Oliveira
- Fundação Oswaldo Cruz, Instituto René Rachou, Laboratório de Esquistossomose, Belo Horizonte, Minas Gerais, Brazil
| | - Liliane Maria Vidal Siqueira
- Fundação Oswaldo Cruz, Instituto René Rachou, Laboratório de Esquistossomose, Belo Horizonte, Minas Gerais, Brazil
| | - Edward Oliveira
- Fundação Oswaldo Cruz, Instituto René Rachou, Laboratório de Pesquisa Clínica, Belo Horizonte, Minas Gerais, Brazil
| | | | | | - Paulo Marcos Zech Coelho
- Fundação Oswaldo Cruz, Instituto René Rachou, Laboratório de Esquistossomose, Belo Horizonte, Minas Gerais, Brazil
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Nigo MM, Salieb-Beugelaar G, Battegay M, Odermatt P, Hunziker P. Schistosomiasis: from established diagnostic assays to emerging micro/nanotechnology-based rapid field testing for clinical management and epidemiology. PRECISION NANOMEDICINE 2019. [DOI: 10.33218/prnano3(1).191205.1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Schistosomiasis is a neglected invasive worm disease with a huge disease burden in developing countries, particularly in children, and is seen increasingly in non-endemic regions through transfer by travellers, expatriates, and refugees. Undetected and untreated infections may be responsible for the persistence of transmission. Rapid and accurate diagnosis is the key to treatment and control. So far, parasitological detection methods remain the cornerstone of Schistosoma infection diagnosis in endemic regions, but conventional tests have limited sensitivity, in particular in low-grade infection. Recent advances contribute to improved detection in clinical and field settings. The recent progress in micro- and nanotechnologies opens a road by enabling the design of new miniaturized point-of-care devices and analytical platforms, which can be used for the rapid detection of these infections. This review starts with an overview of currently available laboratory tests and their performance and then discusses emerging rapid and micro/nanotechnologies-based tools. The epidemiological and clinical setting of testing is then discussed as an important determinant for the selection of the best analytical strategy in patients suspected to suffer from Schistosoma infection. Finally, it discusses the potential role of advanced technologies in the setting near to disease eradication is examined.
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Affiliation(s)
| | | | | | - Peter Odermatt
- Swiss Tropical and Public Health Institute, Basel, Switzerland
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21
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Brauer AMNW, Gradella DBT, Souza AAD, Souza MAAD. Socioeconomic and parasitological aspects in Quilombola communities in two of the oldest municipalities in Brazil. Rev Salud Publica (Bogota) 2019. [DOI: 10.15446/rsap.v21n6.76110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Objective To carry out a socioeconomic, demographic and parasitological evaluation of quilombola communities in two of the oldest municipalities in Brazil.Material and Methods Between December 2015 and June 2016, of the total of 231 residents of the communities, socioeconomic questionnaires were applied and fecal samples collected from 150 individuals were analyzed by spontaneous sedimentation method and the Kato-Katz method.Results It was observed that 95.3% (n=143) of the interviewees had piped water at their residence, and 76% (n=114) came from wells or springs; 85.3% (n=128) reported that the toilet drain was made in a rudimentary septic tank and 59.3% (n=89) reported having litter buried or burned, showing precarious conditions in basic sanitation. Still on socioeconomic aspects, 80.7% (n=121) of the individuals reported having access to the public health service. Parasitological tests were positive for 48% (n=72) of the analyzed samples, and 25% (n=18) had two or more parasites. The most frequent organism in the study population was the commensal Entamoeba coli (55.6%, n=40), followed by Ascaris lumbricoides (19.4%, n=14) and the commensal Endolimax nana (16.7%, n=12). The Poisson regression showed an increase of 1.59 in the prevalence of parasites for individuals who do not have access to the public health service, when compared to those who have access to these services.Conclusions The results indicate the need to implement public health measures in order to reduce, prevent and treat the parasitological condition of the population to obtain better conditions and quality of life.
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22
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Grenfell RFQ, Pedrosa ML, Couto FFB, Almeida A, Coelho PMZ, Katz N. Suitability of commercially available POC-CCA tests for schistosomiasis: Considerations for efficiency, reproducibility and decision making criteria for field application in areas of low endemicity. J Immunol Methods 2019; 472:1-6. [PMID: 31194970 DOI: 10.1016/j.jim.2019.06.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Revised: 06/03/2019] [Accepted: 06/04/2019] [Indexed: 11/17/2022]
Abstract
BACKGROUND Point of care tests would be valuable for field diagnosis. However, high sensitivity will likely be required in low endemicity sets where individuals with low schistosome burden are hard to diagnose. METHODS Commercially available POC tests (POC-CCA® and Urine CCA (Schisto) ECO Teste®) were evaluated to evidence their potential in low endemicity areas. Individuals with 0-76 eggs per gram of feces were selected, and comparison was performed between Kato-Katz, Saline Gradient and POC-CCA® after urine concentration (POC FLT) methods. RESULTS Both POC-CCA had poor performances, showing low identification of less than half of positive individuals and several undiagnosed cases, revealing an accuracy of 0.44 and 0.46, and a Kappa Index of 0.308 and 0, respectively. Positivity rates of POC-CCA tests were below the one found for a single Kato-Katz slide. POC FLT had a Kappa Index of 0.617, an accuracy of 0.81, 67% of reproducibility, and was shown to have the same sensitivity of 21 Kato-Katz slides when two tests were performed. CONCLUSIONS POC-CCA® and POC Eco presented exactly the same inadequacy in low endemicity areas. POC FLT significantly improved the performance of POC-CCA®. More accurate methods must be evaluated in low endemicity areas.
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Affiliation(s)
- Rafaella F Q Grenfell
- Schistosomiasis Laboratory, Rene Rachou Institute, Oswaldo Cruz Foundation (FIOCRUZ), Belo Horizonte, Minas Gerais, Brazil; National Excellence Centre for Schistosomiasis Diagnosis, Oswaldo Cruz Foundation (FIOCRUZ), Belo Horizonte, Minas Gerais, Brazil; College of Veterinary Medicine, Department of Infectious Diseases, University of Georgia, Athens, GA, USA.
| | - Maria Luysa Pedrosa
- Schistosomiasis Laboratory, Rene Rachou Institute, Oswaldo Cruz Foundation (FIOCRUZ), Belo Horizonte, Minas Gerais, Brazil; National Excellence Centre for Schistosomiasis Diagnosis, Oswaldo Cruz Foundation (FIOCRUZ), Belo Horizonte, Minas Gerais, Brazil
| | - Flavia F B Couto
- Schistosomiasis Laboratory, Rene Rachou Institute, Oswaldo Cruz Foundation (FIOCRUZ), Belo Horizonte, Minas Gerais, Brazil
| | - Aureo Almeida
- Schistosomiasis Laboratory, Rene Rachou Institute, Oswaldo Cruz Foundation (FIOCRUZ), Belo Horizonte, Minas Gerais, Brazil
| | - Paulo Marcos Z Coelho
- Schistosomiasis Laboratory, Rene Rachou Institute, Oswaldo Cruz Foundation (FIOCRUZ), Belo Horizonte, Minas Gerais, Brazil
| | - Naftale Katz
- Schistosomiasis Laboratory, Rene Rachou Institute, Oswaldo Cruz Foundation (FIOCRUZ), Belo Horizonte, Minas Gerais, Brazil
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Cavalcanti MG, Cunha AFA, Peralta JM. The Advances in Molecular and New Point-of-Care (POC) Diagnosis of Schistosomiasis Pre- and Post-praziquantel Use: In the Pursuit of More Reliable Approaches for Low Endemic and Non-endemic Areas. Front Immunol 2019; 10:858. [PMID: 31191512 PMCID: PMC6546849 DOI: 10.3389/fimmu.2019.00858] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2018] [Accepted: 04/03/2019] [Indexed: 12/22/2022] Open
Abstract
Like soil-transmitted helminth infections, schistosomiasis is an important neglected tropical disease (NTD) related to poverty with a major impact on public health in developing countries. Diagnosis of active infection is crucial for surveillance of controlled or post-elimination schistosomiasis areas. In addition, the use of conventional diagnostic tools in non-exposed populations (such as travelers) results in misdiagnoses in the prepatent period of infection. Also, the accuracy of standard tests applied in low-endemicity areas (LEAs) decreases after several rounds of treatment. We aimed to determine whether it would be necessary to replace schistosomiasis conventional diagnostic tests such as parasitological methods in LEAs. Also, we evaluate the use of new tools in non-endemic areas. Reliable, cheap and easy-to-use diagnostic tools are needed to respond to the demands of a new era of elimination and eradication of schistosomiasis. To this end, molecular diagnosis-including nucleic acid-based assays (loop-mediated isothermal amplification, polymerase chain reaction) and circulating cathodic and anodic antigen detection tests have become promising strategies. In this review, we attempt to address the use of alternative diagnostic tests for active infection detection and drug-monitoring after specific schistosomiasis treatment.
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Affiliation(s)
- Marta G Cavalcanti
- Serviço de Doenças Infecciosas e Parasitárias, Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil.,Departmento de Imunologia, Instituto de Microbiologia Paulo de Góes, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Aline Fernandes Araujo Cunha
- Departmento de Imunologia, Instituto de Microbiologia Paulo de Góes, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - José Mauro Peralta
- Departmento de Imunologia, Instituto de Microbiologia Paulo de Góes, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
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Silva-Moraes V, Shollenberger LM, Siqueira LMV, Castro-Borges W, Harn DA, Grenfell RFQE, Rabello ALT, Coelho PMZ. Diagnosis of Schistosoma mansoni infections: what are the choices in Brazilian low-endemic areas? Mem Inst Oswaldo Cruz 2019; 114:e180478. [PMID: 30942278 PMCID: PMC6440364 DOI: 10.1590/0074-02760180478] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Accepted: 02/21/2019] [Indexed: 12/25/2022] Open
Abstract
The population of Brazil is currently characterised by many individuals harbouring low-intensity Schistosoma mansoni infections. The Kato-Katz technique is the diagnostic method recommended by the World Health Organization (WHO) to assess these infections, but this method is not sensitive enough in the context of low egg excretion. In this regard, potential alternatives are being employed to overcome the limits of the Kato-Katz technique. In the present review, we evaluated the performance of parasitological and immunological approaches adopted in Brazilian areas. Currently, the diagnostic choices involve a combination of strategies, including the utilisation of antibody methods to screen individuals and then subsequent confirmation of positive cases by intensive parasitological investigations.
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Affiliation(s)
- Vanessa Silva-Moraes
- Fundação Oswaldo Cruz-Fiocruz, Instituto René Rachou, Biologia do Schistosoma mansoni e sua interação com o hospedeiro, Belo Horizonte, MG, Brasil
- University of Georgia, College of Veterinary Medicine, Department of Infectious Diseases, Athens, GA, United States of America
| | - Lisa M Shollenberger
- Fundação Oswaldo Cruz-Fiocruz, Instituto René Rachou, Biologia do Schistosoma mansoni e sua interação com o hospedeiro, Belo Horizonte, MG, Brasil
- Old Dominion University, Department of Biological Sciences, Norfolk, VA, United States of America
| | - Liliane Maria Vidal Siqueira
- Fundação Oswaldo Cruz-Fiocruz, Instituto René Rachou, Biologia do Schistosoma mansoni e sua interação com o hospedeiro, Belo Horizonte, MG, Brasil
| | - William Castro-Borges
- Universidade Federal de Ouro Preto, Laboratório de Enzimologia e Proteômica, Ouro Preto, MG, Brasil
| | - Donald A Harn
- University of Georgia, College of Veterinary Medicine, Department of Infectious Diseases, Athens, GA, United States of America
| | - Rafaella Fortini Queiroz e Grenfell
- Fundação Oswaldo Cruz-Fiocruz, Instituto René Rachou, Biologia do Schistosoma mansoni e sua interação com o hospedeiro, Belo Horizonte, MG, Brasil
- University of Georgia, College of Veterinary Medicine, Department of Infectious Diseases, Athens, GA, United States of America
| | - Ana Lucia Teles Rabello
- Fundação Oswaldo Cruz-Fiocruz, Instituto René Rachou, Grupo de Pesquisas Clínicas e Políticas Públicas em Doenças Infecciosas e Parasitárias, Belo Horizonte, MG, Brasil
| | - Paulo Marcos Zech Coelho
- Fundação Oswaldo Cruz-Fiocruz, Instituto René Rachou, Biologia do Schistosoma mansoni e sua interação com o hospedeiro, Belo Horizonte, MG, Brasil
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25
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Grenfell RFQ, Taboada D, Coutinho LA, Pedrosa MLC, Assis JV, Oliveira MSP, Cruz RR, Almeida A, Silva-Moraes V, Katz N, Coelho PMZ. Innovative methodology for point-of-care circulating cathodic antigen with rapid urine concentration for use in the field for detecting low Schistosoma mansoni infection and for control of cure with high accuracy. Trans R Soc Trop Med Hyg 2019. [PMID: 29522211 DOI: 10.1093/trstmh/try014] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Background Prior to eliminating schistosomiasis, efforts must address accurate and fast individual diagnosis. Diagnosis is still inaccurate by parasitological and point-of-care circulating cathodic antigen (POC-CCA) in areas of low endemicity. Methods Our group has optimized POC-CCA with a 30 min urine concentration step with no need for specialized technicians or equipment and with high accuracy. We evaluated this new method, called POC-CCA filter (FLT), in two Brazilian endemic areas with distinct profiles. Results At baseline, POC-CCA had a poor performance with several false results and undefined trace readings, revealing a prevalence rate of 10% against a rate of 23% for POC-CCA FLT, which was similar to the parasitological rates. Accuracy increased from as low as 0.36 to 0.96 after urine concentration in one area. POC-CCA properly diagnosed only half of the cases at three post-treatment time points, while POC-CCA FLT was able to diagnose 96, 83 and 100%, respectively. Conclusions The improvement of conventional POC methodology by a fast and simple urine concentration step provided not only an increase in its accuracy before and after praziquantel treatment, but also preserved its applicability in low-prevalence endemic areas, allowing the definition of trace readings as negative cases.
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Affiliation(s)
- Rafaella F Q Grenfell
- Schistosomiasis Laboratory, Rene Rachou Research Center, Oswaldo Cruz Foundation (Fiocruz), Belo Horizonte, Minas Gerais, 30190-002, Brazil.,Department of Infectious Diseases, College of Veterinary Medicine, University of Georgia, Athens, Georgia 30602-7387, USA
| | - Diana Taboada
- Schistosomiasis Laboratory, Rene Rachou Research Center, Oswaldo Cruz Foundation (Fiocruz), Belo Horizonte, Minas Gerais, 30190-002, Brazil
| | - Lucélia A Coutinho
- Schistosomiasis Laboratory, Rene Rachou Research Center, Oswaldo Cruz Foundation (Fiocruz), Belo Horizonte, Minas Gerais, 30190-002, Brazil
| | - Maria Luysa C Pedrosa
- Schistosomiasis Laboratory, Rene Rachou Research Center, Oswaldo Cruz Foundation (Fiocruz), Belo Horizonte, Minas Gerais, 30190-002, Brazil
| | - Jéssica V Assis
- Schistosomiasis Laboratory, Rene Rachou Research Center, Oswaldo Cruz Foundation (Fiocruz), Belo Horizonte, Minas Gerais, 30190-002, Brazil
| | - Matheus S P Oliveira
- Schistosomiasis Laboratory, Rene Rachou Research Center, Oswaldo Cruz Foundation (Fiocruz), Belo Horizonte, Minas Gerais, 30190-002, Brazil
| | - Renata R Cruz
- Schistosomiasis Laboratory, Rene Rachou Research Center, Oswaldo Cruz Foundation (Fiocruz), Belo Horizonte, Minas Gerais, 30190-002, Brazil
| | - Aureo Almeida
- Schistosomiasis Laboratory, Rene Rachou Research Center, Oswaldo Cruz Foundation (Fiocruz), Belo Horizonte, Minas Gerais, 30190-002, Brazil
| | - Vanessa Silva-Moraes
- Schistosomiasis Laboratory, Rene Rachou Research Center, Oswaldo Cruz Foundation (Fiocruz), Belo Horizonte, Minas Gerais, 30190-002, Brazil
| | - Naftale Katz
- Schistosomiasis Laboratory, Rene Rachou Research Center, Oswaldo Cruz Foundation (Fiocruz), Belo Horizonte, Minas Gerais, 30190-002, Brazil
| | - Paulo Marcos Z Coelho
- Schistosomiasis Laboratory, Rene Rachou Research Center, Oswaldo Cruz Foundation (Fiocruz), Belo Horizonte, Minas Gerais, 30190-002, Brazil
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Santos BM, Soares FA, Rosa SL, Gomes DDCF, Oliveira BCM, Peixinho AZ, Suzuki CTN, Bresciani KDS, Falcão AX, Gomes JF. TF‐Test Quantified
: a new technique for diagnosis of
Schistosoma mansoni
eggs. Trop Med Int Health 2019; 24:586-595. [DOI: 10.1111/tmi.13215] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Bianca Martins Santos
- School of Medical Sciences University of Campinas São Paulo Brazil
- Laboratory of Image Data Science Institute of Computing University of Campinas São Paulo Brazil
| | - Felipe Augusto Soares
- School of Medical Sciences University of Campinas São Paulo Brazil
- Laboratory of Image Data Science Institute of Computing University of Campinas São Paulo Brazil
| | - Stefany Laryssa Rosa
- School of Medical Sciences University of Campinas São Paulo Brazil
- Laboratory of Image Data Science Institute of Computing University of Campinas São Paulo Brazil
| | | | | | - Alan Zanoni Peixinho
- Laboratory of Image Data Science Institute of Computing University of Campinas São Paulo Brazil
| | | | - Katia Denise Saraiva Bresciani
- Laboratory of Image Data Science Institute of Computing University of Campinas São Paulo Brazil
- School of Veterinary Medicine São Paulo State University Araçatuba São Paulo Brazil
| | - Alexandre Xavier Falcão
- Laboratory of Image Data Science Institute of Computing University of Campinas São Paulo Brazil
| | - Jancarlo Ferreira Gomes
- School of Medical Sciences University of Campinas São Paulo Brazil
- Laboratory of Image Data Science Institute of Computing University of Campinas São Paulo Brazil
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Nacife MBPESL, Siqueira LMV, Martins R, Vianna VN, Barbosa KF, Masioli CZ, Silva JCD, Machado-Coelho GLL. Prevalence of schistosomiasis mansoni in indigenous Maxakali villages, Minas Gerais, Brazil. Rev Inst Med Trop Sao Paulo 2018; 60:e26. [PMID: 29972467 PMCID: PMC6029851 DOI: 10.1590/s1678-9946201860026] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Accepted: 04/26/2018] [Indexed: 11/21/2022] Open
Abstract
Intestinal parasitic infections are a common health problem among Amerindian populations and schistosomiasis represents one of the most prevalent diseases in Maxakali people. The Kato-Katz is the diagnostic method recommended by WHO for epidemiological studies; however, one of the technique's limitations is the failure to detect parasites in individuals with low parasite load. The aim of this study was to establish the prevalence of Schistosoma mansoni in indigenous Maxakali villages, evaluating the TF-Test® performance for diagnosis compared to the Kato-Katz technique. Stool samples from 545 individuals were processed by the TF-Test® (1 sample) and Kato-Katz (1 slide). The positivity rate for S. mansoni by Kato-Katz was 45.7%. The rate by the TF-Test® was 33.2%, and 51.9% by the combined parasitological techniques. The amplitude of parasite load was 24 to 4,056 eggs per gram of feces (epg), with a geometric mean of 139 epg. The co-positivity, co-negativity, and accuracy values by TF-Test® in relation to Kato-Katz were 59.0%, 88.5%, and 75.0%, respectively. The agreement between these techniques was moderate (k=0.486) as determined by the kappa index. Thus, the results of this study demonstrated that the performance of Kato-Katz was superior (p <0.05) to that of TF-Test® in the detection of S. mansoni. The combination of TF-Test® and Kato-Katz resulted in an increased positivity rate of S. mansoni, demonstrating the high risk of infection to which indigenous populations are exposed and the importance of the implementation of control strategies in Maxakali villages.
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Affiliation(s)
| | - Liliane Maria Vidal Siqueira
- Laboratório de Esquistossomose, Instituto de Pesquisas René Rachou, Fundação Oswaldo Cruz, Belo Horizonte, Minas Gerais, Brazil
| | - Rafael Martins
- Laboratório de Epidemiologia, Escola de Medicina, Universidade Federal de Ouro Preto, Ouro Preto, Minas Gerais, Brazil
| | - Valeska Natiely Vianna
- Laboratório de Epidemiologia, Escola de Medicina, Universidade Federal de Ouro Preto, Ouro Preto, Minas Gerais, Brazil
| | - Keila Furbino Barbosa
- Laboratório de Epidemiologia, Escola de Medicina, Universidade Federal de Ouro Preto, Ouro Preto, Minas Gerais, Brazil
| | - Cássio Zumerle Masioli
- Laboratório de Epidemiologia, Escola de Medicina, Universidade Federal de Ouro Preto, Ouro Preto, Minas Gerais, Brazil
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Evaluating a point-of-care circulating cathodic antigen test (POC-CCA) to detect Schistosoma mansoni infections in a low endemic area in north-eastern Brazil. Acta Trop 2018. [PMID: 29526480 DOI: 10.1016/j.actatropica.2018.03.002] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Schistosomiasis is still a public health problem in Brazil. The Kato-Katz test is the most frequently used diagnostic method for Schistosoma mansoni infection. However, it lacks sensitivity in areas of low prevalence. We have assessed the positivity rate of S. mansoni infection in Bananeiras, a village on Capistrano, Ceara, Brazil by performing a point-of-care test in urine to determine the circulating cathodic antigens (POC-CCA), and we compared the findings with those of the Kato-Katz technique for egg detection in stool and an enzyme-linked immunosorbent assay for specific antibodies against adult worms (SWAP-ELISA) in serum before treatment (baseline). Additionally, the POC-CCA and Kato-Katz test results were compared at one and two years post-treatment, and only POC-CCA strips were utilised for follow-up testing on urine samples at 3-6 weeks. Only one sample of stool and urine was collected per event. Overall, 258 individuals were investigated at the baseline. The POC-CCA test detected 10 (3.9%) positive cases; however, this amount increased to 30 (11.6%) when considering trace readings as positive (t + ), whereas the Kato-Katz method found only 4 (1.6%) positive cases and the SWAP-ELISA detected 105 (40.7%) positive cases. The consistency observed between a single POC-CCA (t + ) or (t-) and the Kato-Katz (three slides) was poor (Kappa indexes <0.20). The highest positivity rate as determined by CCA and Kato-Katz was found in adults. At the baseline, a praziquantel treatment was administered to all individuals regardless of their infection status. According to the POC-CCA test, 93% of the previous positive cases became negative by the third week after the treatment; this rate reached 100% at the sixth week assessment. The follow-up showed that of the 175 individuals evaluated at one year post-treatment, only one (0.6%) showed 'trace' results, and all the individuals were negative for eggs in the stool. At two years, all 185 examined individuals were negative by the Kato-Katz method, and 11 (5.9%) presented traces by POC-CCA. Our results indicate that a single POC-CCA test reveals a significantly higher number of positive cases than the Kato-Katz technique for diagnosing S. mansoni in a low endemic setting, when trace results are considered as positive cases. Nevertheless, the true significance of the trace is not clear. These findings reinforce the need to associate different tools for improved schistosomiasis diagnosis in individuals with low parasite burdens.
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Gandasegui J, Fernández-Soto P, Muro A, Simões Barbosa C, Lopes de Melo F, Loyo R, de Souza Gomes EC. A field survey using LAMP assay for detection of Schistosoma mansoni in a low-transmission area of schistosomiasis in Umbuzeiro, Brazil: Assessment in human and snail samples. PLoS Negl Trop Dis 2018. [PMID: 29534072 PMCID: PMC5849311 DOI: 10.1371/journal.pntd.0006314] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Background In Brazil, schistosomiasis is a parasitic disease of public health relevance, mainly in poor areas where Schistosoma mansoni is the only human species encountered and Biomphalaria straminea is one of the intermediate host snails. A nested-PCR based on a specific mitochondrial S. mansoni minisatellite DNA region has been successfully developed and applied as a reference method in Brazil for S. mansoni detection, mainly in host snails for epidemiological studies. The amplification efficiency of LAMP is known to be higher than PCR. The present work aimed to assess the utility of our previously described SmMIT-LAMP assay for S. mansoni detection in human stool and snail samples in a low-transmission area of schistosomiasis in the municipality of Umbuzeiro, Paraíba State, Northeast Region of Brazil. Methodology/Principal findings A total of 427 human stool samples were collected during June-July 2016 in the municipality of Umbuzeiro and an overall prevalence of 3.04% (13/427) resulted positive by duplicate Kato-Katz thick smear. A total of 1,175 snails identified as Biomphalaria straminea were collected from 14 breeding sites along the Paraíba riverbank and distributed in 46 pools. DNA from human stool samples and pooled snails was extracted using the phenol/chloroform method. When performing the SmMIT-LAMP assay a total of 49/162 (30.24%) stool samples resulted positive, including 12/13 (92.31%) that were Kato-Katz positive and 37/149 (24.83%) previously Kato-Katz negative. By nested-PCR, only 1/46 pooled DNA snail samples was positive. By SmMIT-LAMP assay, the same sample also resulted positive and an additional one was positive from a different breeding site. Data of human and snail surveys were used to build risk maps of schistosomiasis incidence using kernel density analysis. Conclusions/Significance This is the first study in which a LAMP assay was evaluated in both human stool and snail samples from a low-transmission schistosomiasis-endemic area. Our SmMIT-LAMP proved to be much more efficient in detection of S. mansoni in comparison to the 'gold standard' Kato-Katz method in human stool samples and the reference molecular nested-PCR in snails. The SmMIT-LAMP has demonstrated to be a useful molecular tool to identify potential foci of transmission in order to build risk maps of schistosomiasis. In Brazil, around 1.8 million people, mostly in the northeastern region of the country, are thought to be infected with Schistosoma mansoni. Snails of the genus Biomphalaria serve as intermediate hosts of the S. mansoni. A special program for schistosomiasis control was implemented more than 40 years ago in Brazil, decreasing prevalence, morbidity, and mortality over the past years. PCR-based diagnostic methods have been successfully applied in a few endemic areas of schistosomiasis in Brazil, although they are not still widely used due to the highly technical requirements making them unviable for routine application in field conditions. Loop-mediated isothermal amplification (LAMP) technology could be a powerful tool to apply for point-of-care testing in resource-poor settings. In previous work, a LAMP-based method to detect S. mansoni DNA, called SmMIT-LAMP, was developed by our research group to detect S. mansoni DNA testing stool samples from experimentally infected mice. Here, with the aim to apply SmMIT-LAMP as a cost-effective molecular tool for the detection of S. mansoni in field applicable conditions, we assess SmMIT-LAMP in human and snail samples collected in an endemic area of Brazil. The results obtained by Kato-Katz analysis of human stool samples and nested-PCR performed in snails were compared with the SmMIT-LAMP assay. It is the first time that a LAMP-based method has been used to identify potential transmission foci and to evaluate the epidemiological risk of acquiring schistosomiasis.
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Affiliation(s)
- Javier Gandasegui
- Infectious and Tropical Diseases Research Group (e-INTRO), Biomedical Research Institute of Salamanca-Research Centre for Tropical Diseases at the University of Salamanca (IBSAL-CIETUS), Faculty of Pharmacy, University of Salamanca, Salamanca, Spain
| | - Pedro Fernández-Soto
- Infectious and Tropical Diseases Research Group (e-INTRO), Biomedical Research Institute of Salamanca-Research Centre for Tropical Diseases at the University of Salamanca (IBSAL-CIETUS), Faculty of Pharmacy, University of Salamanca, Salamanca, Spain
- * E-mail: (PFS); (AM)
| | - Antonio Muro
- Infectious and Tropical Diseases Research Group (e-INTRO), Biomedical Research Institute of Salamanca-Research Centre for Tropical Diseases at the University of Salamanca (IBSAL-CIETUS), Faculty of Pharmacy, University of Salamanca, Salamanca, Spain
- * E-mail: (PFS); (AM)
| | - Constança Simões Barbosa
- Schistosomiasis Laboratory and Reference Service, Department of Parasitology, Aggeu Magalhães Institute, Fiocruz - Ministry of Health (MoH), Recife, Pernambuco, Brazil
| | - Fabio Lopes de Melo
- Schistosomiasis Laboratory and Reference Service, Department of Parasitology, Aggeu Magalhães Institute, Fiocruz - Ministry of Health (MoH), Recife, Pernambuco, Brazil
| | - Rodrigo Loyo
- Schistosomiasis Laboratory and Reference Service, Department of Parasitology, Aggeu Magalhães Institute, Fiocruz - Ministry of Health (MoH), Recife, Pernambuco, Brazil
| | - Elainne Christine de Souza Gomes
- Schistosomiasis Laboratory and Reference Service, Department of Parasitology, Aggeu Magalhães Institute, Fiocruz - Ministry of Health (MoH), Recife, Pernambuco, Brazil
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Evaluation of diagnostic methods for the detection of intestinal schistosomiasis in endemic areas with low parasite loads: Saline gradient, Helmintex, Kato-Katz and rapid urine test. PLoS Negl Trop Dis 2018; 12:e0006232. [PMID: 29470516 PMCID: PMC5823366 DOI: 10.1371/journal.pntd.0006232] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Accepted: 01/11/2018] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND In some tropical countries, such as Brazil, schistosomiasis control programs have led to a significant reduction in the prevalence and parasite burden of endemic populations. In this setting, the Kato-Katz technique, as the standard diagnostic method for the diagnosis of Schistosoma mansoni infections, which involves the analysis of two slides from one fecal sample, loses its sensitivity. As a result, a significant number of infected individuals are not detected. The objective of this study was to perform extensive parasitological testing of up to three fecal samples and include a rapid urine test (POC-CCA) in a moderate prevalence area in Northern Minas Gerais, Brazil, and evaluate the performance of each test separately and in combination. METHODS AND FINDINGS A total of 254 individuals were examined with variants of the standard Kato-Katz technique (up to18 Kato-Katz slides prepared from three fecal samples), a modified Helmintex (30 g of feces), the saline gradient (500 mg of feces), and the POC-CCA methods. We established a reference standard taking into consideration all the positive results in any of the parasitological exams. Evaluation of the parasite burden by two Kato-Katz slides confirmed that most of the individuals harbored a light infection. When additional slides and different parasitological methods were included, the estimated prevalence rose 2.3 times, from 20.4% to 45.9%. The best sensitivity was obtained with the Helmintex method (84%). All parasitological methods readily detected a high or moderate intensity of infection; however, all lost their high sensitivity in the case of low or very low intensity infections. The overall sensitivity of POC-CCA (64.9%) was similar to the six Kato-Katz slides from three fecal samples. However, POC-CCA showed low concordance (κ = 0.34) when compared with the reference standard. CONCLUSIONS The recommended Kato-Katz method largely underestimated the prevalence of S. mansoni infection. Because the best performance was achieved with a modified Helmintex method, this technique might serve as a more precise reference standard. An extended number of Kato-Katz slides in combination with other parasitological methods or with POC-CCA was able to detect more than 80% of egg-positive individuals; however, the rapid urine test (POC-CCA) produced a considerable percentage of false positive results.
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Systematic review and meta-analysis on Schistosoma mansoni infection prevalence, and associated risk factors in Brazil. Parasitology 2018; 145:1000-1014. [PMID: 29295718 DOI: 10.1017/s0031182017002268] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
We performed a systematic review and meta-analysis on the prevalence and factors associated with Schistosoma mansoni infection in Brazil. We searched the PubMed, Web of Science and Latin-American and Caribbean System on Health Sciences Information (LILACS) databases, scientific publications articles, according to The PRISMA Statement, from 2000 to 2016. A total of 27 studies were included according to the established criteria. The prevalence of S. mansoni infection varied widely, from 0·1 to 73·1%, based on Kato-Katz technique. Of the identified studies, 42·9% were performed in the state of Minas Gerais, and 33·3% were performed in the northeast region of Brazil. We identified sex, age, education level, family income, contact with water and the presence of the intermediate host snail as major risk factors associated with infection. The meta-analysis summarized a high prevalence rate pooled for Schistosoma mansoni. On the other hand, the analysis of the subgroup showed a highly significant reduction of the prevalence rate after control measures. The epidemiological factors evidenced in the studies show the influence of environmental and social conditions on the occurrence of schistosomiasis.
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Silva JDD, Pinheiro MCC, Sousa MS, Gomes VDS, Castro IMND, Ramos AN, Bezerra FSDM. Detection of schistosomiasis in an area directly affected by the São Francisco River large-scale water transposition project in the Northeast of Brazil. Rev Soc Bras Med Trop 2017; 50:658-665. [PMID: 29160513 DOI: 10.1590/0037-8682-0299-2017] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2017] [Accepted: 10/05/2017] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION The development of the São Francisco River Integration Project [Projeto de Integração do Rio São Francisco (PISF)] in the State of Ceará, Brazil, has resulted in environmental and socioeconomic changes with potential risks to public health. We aimed to determine the presence of Schistosoma mansoni infections in schoolchildren (aged 7-14 years) and workers from the construction site in an area under the direct influence of the PISF in the municipality of Brejo Santo-CE, to aid in the prevention and control of schistosomiasis. METHODS We conducted a cross-sectional study using two S. mansoni-detection methods: detection of S. mansoni eggs by the Kato-Katz parasitological method in stool samples (assessed in triplicate for each sample) and S. mansoni circulating cathodic antigen by the point-of-care immunochromatographic rapid test (POC-CCA) in urine. RESULTS In general, the positivity rates for S. mansoni detection were 1.9% (2/106) among schoolchildren and 2.9% (4/138) among workers. No child had evidence of S. mansoni eggs in their stools; 1.9% tested positive by the POC-CCA method. Among workers, two (1.4%) tested positive by the Kato-Katz test and three (2.2%) by the POC-CCA test. If the POC-CCA test results that were scored as traces were considered negative, then the positivity rates dropped to 0.9% and 0.7% for schoolchildren and workers, respectively. CONCLUSIONS The active transmission of schistosomiasis in a region covered by the PISF was recognized, reinforcing the necessity to consolidate surveillance and control actions, as well as structural sanitation measures to reverse the social determinants of the disease.
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Affiliation(s)
- José Damião da Silva
- Programa de Pós-Graduação em Patologia, Faculdade de Medicina, Universidade Federal do Ceará, Fortaleza, CE, Brazil.,Laboratório de Parasitologia e Biologia de Moluscos, Faculdade de Farmácia, Odontologia e Enfermagem, Universidade Federal do Ceará, Fortaleza, CE, Brazil
| | - Marta Cristhiany Cunha Pinheiro
- Laboratório de Parasitologia e Biologia de Moluscos, Faculdade de Farmácia, Odontologia e Enfermagem, Universidade Federal do Ceará, Fortaleza, CE, Brazil.,Programa de Pós-Graduação em Saúde Coletiva, Faculdade de Medicina, Universidade Federal do Ceará, Fortaleza, CE, Brazil
| | - Mariana Silva Sousa
- Laboratório de Parasitologia e Biologia de Moluscos, Faculdade de Farmácia, Odontologia e Enfermagem, Universidade Federal do Ceará, Fortaleza, CE, Brazil.,Programa de Pós-Graduação em Ciências Médicas, Faculdade de Medicina, Universidade Federal do Ceará, Fortaleza, CE, Brazil
| | - Vivian da Silva Gomes
- Núcleo de Controle de Vetores, Secretaria de Saúde do Estado do Ceará, Fortaleza, CE, Brazil
| | - Issis Maria Nogueira de Castro
- Programa de Pós-Graduação em Patologia, Faculdade de Medicina, Universidade Federal do Ceará, Fortaleza, CE, Brazil.,Laboratório de Parasitologia e Biologia de Moluscos, Faculdade de Farmácia, Odontologia e Enfermagem, Universidade Federal do Ceará, Fortaleza, CE, Brazil
| | - Alberto Novaes Ramos
- Programa de Pós-Graduação em Saúde Coletiva, Faculdade de Medicina, Universidade Federal do Ceará, Fortaleza, CE, Brazil
| | - Fernando Schemelzer de Moraes Bezerra
- Programa de Pós-Graduação em Patologia, Faculdade de Medicina, Universidade Federal do Ceará, Fortaleza, CE, Brazil.,Laboratório de Parasitologia e Biologia de Moluscos, Faculdade de Farmácia, Odontologia e Enfermagem, Universidade Federal do Ceará, Fortaleza, CE, Brazil.,Programa de Pós-Graduação em Ciências Médicas, Faculdade de Medicina, Universidade Federal do Ceará, Fortaleza, CE, Brazil
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Sousa SRMD, Carvalho ADQ, Cardoso JFN, Coelho PMZ, Geiger SM, Enk MJ. Schistosomiasis in the Amazon region: is the current diagnostic strategy still appropriate? Rev Soc Bras Med Trop 2017; 50:848-852. [DOI: 10.1590/0037-8682-0097-2017] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Accepted: 08/24/2017] [Indexed: 11/21/2022] Open
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Bakuza JS, Denwood MJ, Nkwengulila G, Mable BK. Estimating the prevalence and intensity of Schistosoma mansoni infection among rural communities in Western Tanzania: The influence of sampling strategy and statistical approach. PLoS Negl Trop Dis 2017; 11:e0005937. [PMID: 28934206 PMCID: PMC5626504 DOI: 10.1371/journal.pntd.0005937] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Revised: 10/03/2017] [Accepted: 09/06/2017] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Schistosoma mansoni is a parasite of major public health importance in developing countries, where it causes a neglected tropical disease known as intestinal schistosomiasis. However, the distribution of the parasite within many endemic regions is currently unknown, which hinders effective control. The purpose of this study was to characterize the prevalence and intensity of infection of S. mansoni in a remote area of western Tanzania. METHODOLOGY/PRINCIPAL FINDINGS Stool samples were collected from 192 children and 147 adults residing in Gombe National Park and four nearby villages. Children were actively sampled in local schools, and adults were sampled passively by voluntary presentation at the local health clinics. The two datasets were therefore analysed separately. Faecal worm egg count (FWEC) data were analysed using negative binomial and zero-inflated negative binomial (ZINB) models with explanatory variables of site, sex, and age. The ZINB models indicated that a substantial proportion of the observed zero FWEC reflected a failure to detect eggs in truly infected individuals, meaning that the estimated true prevalence was much higher than the apparent prevalence as calculated based on the simple proportion of non-zero FWEC. For the passively sampled data from adults, the data were consistent with close to 100% true prevalence of infection. Both the prevalence and intensity of infection differed significantly between sites, but there were no significant associations with sex or age. CONCLUSIONS/SIGNIFICANCE Overall, our data suggest a more widespread distribution of S. mansoni in this part of Tanzania than was previously thought. The apparent prevalence estimates substantially under-estimated the true prevalence as determined by the ZINB models, and the two types of sampling strategies also resulted in differing conclusions regarding prevalence of infection. We therefore recommend that future surveillance programmes designed to assess risk factors should use active sampling whenever possible, in order to avoid the self-selection bias associated with passive sampling.
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Affiliation(s)
- Jared S. Bakuza
- Institute of Biodiversity Animal Health and Comparative Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom
- Department of Biological Sciences, Faculty of Science, Dar es Salaam University, College of Education, Dar es Salaam, Tanzania
| | - Matthew J. Denwood
- School of Veterinary Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom
- Department of Veterinary and Animal Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Gamba Nkwengulila
- Department of Zoology and Wildlife Conservation, College of Natural and Applied Sciences, University of Dar es Salaam, Dar es Salaam, Tanzania
| | - Barbara K. Mable
- Institute of Biodiversity Animal Health and Comparative Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom
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Ferreira FT, Fidelis TA, Pereira TA, Otoni A, Queiroz LC, Amâncio FF, Antunes CM, Lambertucci JR. Sensitivity and specificity of the circulating cathodic antigen rapid urine test in the diagnosis of Schistosomiasis mansoni infection and evaluation of morbidity in a low- endemic area in Brazil. Rev Soc Bras Med Trop 2017; 50:358-364. [PMID: 28700054 DOI: 10.1590/0037-8682-0423-2016] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2016] [Accepted: 05/16/2017] [Indexed: 12/28/2022] Open
Abstract
INTRODUCTION: The Kato-Katz technique is the standard diagnostic test for Schistosoma mansoni infection in rural areas. However, the utility of this method is severely limited by the day-to-day variability in host egg excretion in the stool. In high-transmission areas, the point-of-care circulating cathodic antigen (POC-CCA) urine assay has proven to be a reliable test. However, investigations of the reliability of the POC-CCA assay in low-transmission regions are under way. This study aimed to evaluate the sensitivity and specificity of the POC-CCA assay and the morbidity of schistosomiasis in a low-endemic area in Brazil. METHODS: Pains City is a low-transmission zone for schistosomiasis. A total of 300 subjects aged 7-76 years were randomly selected for the POC-CCA cassette test. For S. mansoni diagnosis, three stool samples on six slides were compared with one urine sample for each subject. The sensitivity and specificity in the absence of a gold standard were calculated using latent class analysis. Clinical examinations and abdominal ultrasounds were performed in 181 volunteers to evaluate morbidity associated with schistosomiasis. RESULTS: The sensitivity and specificity of the Kato-Katz technique were 25.6% and 94.6%, respectively. By contrast, the sensitivity and specificity of the POC-CCA assay were 68.1% and 72.8%, respectively. Hepatosplenic schistosomiasis was diagnosed in two patients (1.1%). CONCLUSIONS: Overall, the POC-CCA urine assay proved to be a useful test for diagnosing S. mansoni in a low-endemic area in Brazil. Severe clinical forms of schistosomiasis can be present even in such low-endemic areas.
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Affiliation(s)
- Fernanda Teixeira Ferreira
- Serviço de Doenças Infecciosas e Parasitárias, Departamento de Clínica Médica, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil
| | - Thiago André Fidelis
- Serviço de Doenças Infecciosas e Parasitárias, Departamento de Clínica Médica, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil
| | - Thiago Almeida Pereira
- Serviço de Doenças Infecciosas e Parasitárias, Departamento de Clínica Médica, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil.,Immunopathogenesis section, Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Alba Otoni
- Serviço de Doenças Infecciosas e Parasitárias, Departamento de Clínica Médica, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil.,Núcleo de Pesquisas em Epidemiologia e Saúde Coletiva, Universidade Federal de São João del-Rei , Divinópolis, MG, Brasil
| | - Leonardo Campos Queiroz
- Serviço de Doenças Infecciosas e Parasitárias, Departamento de Clínica Médica, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil
| | - Frederico Figueiredo Amâncio
- Serviço de Doenças Infecciosas e Parasitárias, Departamento de Clínica Médica, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil
| | - Carlos Maurício Antunes
- Instituto de Ensino e Pesquisa, Santa Casa de Misericórdia de Belo Horizonte, Belo Horizonte, MG, Brasil
| | - José Roberto Lambertucci
- Serviço de Doenças Infecciosas e Parasitárias, Departamento de Clínica Médica, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil
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Favero V, Frasca Candido RR, De Marco Verissimo C, Jones MK, St. Pierre TG, Lindholz CG, Da Silva VD, Morassutti AL, Graeff-Teixeira C. Optimization of the Helmintex method for schistosomiasis diagnosis. Exp Parasitol 2017; 177:28-34. [DOI: 10.1016/j.exppara.2017.04.001] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2016] [Revised: 03/30/2017] [Accepted: 04/18/2017] [Indexed: 11/26/2022]
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Cabello RKS, Beck LC, Massara CL, Murta FL, Guimarães RJ, Pieri OS, Schall VT, Favre TC. Schistosoma mansoni infection and related knowledge among schoolchildren in an endemic area of Minas Gerais, Brazil, prior to educational actions. Acta Trop 2016; 164:208-215. [PMID: 27647573 DOI: 10.1016/j.actatropica.2016.09.015] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2016] [Revised: 07/13/2016] [Accepted: 09/15/2016] [Indexed: 11/25/2022]
Abstract
As a signatory to World Health Assembly Resolution WHA65.21 on eliminating schistosomiasis, the Brazilian Ministry of Health (MoH) recommends early identification and timely treatment of the infection carriers for morbidity control, plus complementary preventive measures, such as health education, for transmission control. This study reports infection and awareness of schistosomiasis among schoolchildren before the implementation of school-based educational actions in an endemic municipality with persisting moderate prevalence levels despite successive control campaigns since the late 1990s. A questionnaire was applied in April 2013 to schoolchildren in the middle years of schooling (6th to 8th year) of Malacacheta municipality to assess baseline knowledge and risk behaviour related to schistosomiasis. A stool survey was conducted in May/June 2013 in 2519 schoolchildren from all years of fundamental education (first to 9th year) to identify the infection carriers, as well as to assess baseline prevalence and intensity of infection using the Kato-Katz method (one sample, two slides). The infected schoolchildren were treated promptly with single-dose praziquantel 60mg/kg and followed up after 45days for treatment efficacy. Relevant outcomes from baseline stool survey, treatment and follow-up were statistically evaluated in relation to area of residence (rural/urban), gender, age group (<11/≥years) and infection. Adherence to baseline survey was 81.2%, and prevalence of infection was 21.4%. Of the 539 positives, 60 (11.1%) had ≥400 eggs per gram of faeces (heavy-intensity infection). Prevalence of infection was significantly higher among rural residents and≥11year olds, whereas intensity of infection was higher among rural residents,≥11year olds and boys. Adherence by the positives to treatment was 93.3% and adherence by the treated children to 45-day follow-up was 72.2%. At 45days after treatment, 97.0% of the 363 children surveyed were egg-negative; the egg reduction rate was 99.4%. Of the 924 children who responded to the questionnaire, 95.5% showed awareness of schistosomiasis, although 76.2% reported contact with natural, unsafe bodies of water. Reported contact with water was significantly more frequent among infected than non-infected, and boys than girls. The results show persisting infection and risk behaviour among schoolchildren, regardless of their basic knowledge about schistosomiasis. These are grounds for implementing specific educational actions to improve awareness and behavioural change, jointly with other control measures, to attain the MoH goals.
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Coelho P, Caldeira RL. Critical analysis of molluscicide application in schistosomiasis control programs in Brazil. Infect Dis Poverty 2016; 5:57. [PMID: 27374126 PMCID: PMC4931695 DOI: 10.1186/s40249-016-0153-6] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2015] [Accepted: 05/24/2016] [Indexed: 11/17/2022] Open
Abstract
In Brazil, Biomphalaria glabrata, B. tenagophila, and B. straminea are naturally infected by the trematode Schistosoma mansoni, the causative agent of schistosomiasis. Despite decades of governmental efforts through official control programs, schistosomiasis remains an important public health problem in the country: thousands of people are infected with the trematode each year and millions live in endemic areas. The World Health Organization recommends using a combination of molluscicide (niclosamide) and mass chemotherapy to control the transmission of schistosomiasis, with this treatment successfully reducing the morbidity of the disease. In the past, niclosamide has been used in official schistosomiasis control programs in Brazil. However, as B. glabrata recolonizes even after molluscicide application, the use of molluscicides has gradually decreased in the country until they were discontinued in 2002, mainly due to the rising global pressure to preserve the environment and the difficulties of obtaining licenses from the Brazilian Ministry of Environment to use toxic substances in aquatic ecosystems. Therefore, the discovery of new molluscicides, which could be more selective to Biomphalaria species and less harmful to the aquatic ecosystem, is necessary. In addition, political efforts to sensitize funders to provide grants for this field of research are required. In this context, this article aims to make a critical analysis of molluscicide application in schistosomiasis control programs in Brazil.
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Affiliation(s)
- Pmz Coelho
- Research group of Schistosoma mansoni Biology and Its Interaction with the Host, René Rachou Institute, Oswaldo Cruz Foundation-Minas Gerais, 30190-002, Belo Horizonte, MG, Brazil
| | - R L Caldeira
- Research group of Medical Helminthology and Malacology, René Rachou Institute, Oswaldo Cruz Foundation-Minas Gerais, 30190-002, Belo Horizonte, MG, Brazil.
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Coelho PMZ, Siqueira LMV, Grenfell RFQ, Almeida NBF, Katz N, Almeida Á, Carneiro NFDF, Oliveira E. Improvement of POC-CCA Interpretation by Using Lyophilization of Urine from Patients with Schistosoma mansoni Low Worm Burden: Towards an Elimination of Doubts about the Concept of Trace. PLoS Negl Trop Dis 2016; 10:e0004778. [PMID: 27326453 PMCID: PMC4915691 DOI: 10.1371/journal.pntd.0004778] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2015] [Accepted: 05/23/2016] [Indexed: 12/05/2022] Open
Abstract
Background Accurate diagnostic techniques for schistosomiasis are essential for prevalence determination and identification of positive patients. A point-of-care test for detecting schistosome circulating cathodic antigen (POC-CCA) has been evaluated for its accuracy in different endemic regions. This reagent strip/dipstick based assay has showed high sensitivity for individuals with high or moderate worm burden, but the interpretation of light infections is less clear, especially for trace readings. Methodology/Principal Findings We introduced a urine lyophilization step to the POC-CCA assay to improve its sensitivity and clarify the interpretation of traces. We evaluated POC-CCA sensitivity and specificity within individuals with low parasite burdens in a Brazilian endemic area where a high number of traces were detected. Patients that were positive for other helminths were also evaluated for cross reactions. In all cases, a combined parasitological diagnosis using Kato-Katz (24 slides) and Saline Gradient (1 g of feces) were used as reference. At baseline, diagnosis by POC-CCA (1–2 cassettes) showed 6% sensitivity, inaccurately predicting a low prevalence of Schistosoma mansoni infections (2 POC-CCA positives/32 egg positives). After urine lyophilization, the sensitivity was increased significantly (p < 0.05). Prevalence rates changed from 2% to 32% (27 POC-CCA positives/32 egg positives), equivalent to parasitological techniques. Most of the trace readings changed to positive after lyophilization while some negatives turned into traces. Cross reaction analysis confirmed the specificity of POC-CCA. Conclusions/Significance Trace readings cannot be primarily defined as positive or negative cases. It is critical to verify case-by-case by concentrating urine 10 fold by lyophilization for the diagnosis. Following lyophilization, persistent trace readings should be read as negatives. No trained technician is needed and cost is restricted to the cost of a lyophilizer and the electricity to run it. Schistosomiasis mansoni is a relevant disease affecting millions of individuals in different countries, in particular countries in Africa, and Brazil. Diagnosis performed by Kato-Katz technique for the detection of eggs in stool and a point-of-care test for circulating cathodic antigen detection in urine (POC-CCA) has been evaluated. Both methods have decreased sensitivity when diagnosing patients with low parasite burdens, which can lead to infected individuals not receiving treatment. Here, we focused on interpretation of POC-CCA results in persons with low parasite burdens. We noted a high number (49%) of indeterminate results, including false negatives and trace readings. A urine concentration step was included to improve the test’s sensitivity. Important differences on sensitivity and prevalence rates were noted when comparing diagnosis by POC-CCA before and after urine concentration. Notably, indeterminate results were easily defined after introduction of this step. Cross reaction analysis confirmed the specificity of POC-CCA, with exceptions noted for individuals with hookworm infection. In conclusion, trace readings cannot be primarily defined as positive or negative cases. It is imperative to analyze each case individually by concentrating urine prior to the introduction of treatment, instead of relying on a point-of-care test with indeterminate results.
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Affiliation(s)
- Paulo Marcos Zech Coelho
- Schistosomiasis Laboratory, Rene Rachou Research Center, Oswaldo Cruz Foundation (Fiocruz), Belo Horizonte, Minas Gerais, Brazil
- * E-mail:
| | - Liliane Maria Vidal Siqueira
- Schistosomiasis Laboratory, Rene Rachou Research Center, Oswaldo Cruz Foundation (Fiocruz), Belo Horizonte, Minas Gerais, Brazil
| | - Rafaella Fortini Queiroz Grenfell
- Schistosomiasis Laboratory, Rene Rachou Research Center, Oswaldo Cruz Foundation (Fiocruz), Belo Horizonte, Minas Gerais, Brazil
- Department of Infectious Diseases, College of Veterinary Medicine, University of Georgia, Athens, Georgia, United States of America
| | - Nathalie Bonatti Franco Almeida
- Schistosomiasis Laboratory, Rene Rachou Research Center, Oswaldo Cruz Foundation (Fiocruz), Belo Horizonte, Minas Gerais, Brazil
| | - Naftale Katz
- Schistosomiasis Laboratory, Rene Rachou Research Center, Oswaldo Cruz Foundation (Fiocruz), Belo Horizonte, Minas Gerais, Brazil
| | - Áureo Almeida
- Schistosomiasis Laboratory, Rene Rachou Research Center, Oswaldo Cruz Foundation (Fiocruz), Belo Horizonte, Minas Gerais, Brazil
| | | | - Edward Oliveira
- Clinical Research Laboratory, Rene Rachou Research Center, Oswaldo Cruz Foundation (Fiocruz), Belo Horizonte, Minas Gerais, Brazil
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Siqueira LMV, Couto FFB, Taboada D, Oliveira ÁAD, Carneiro NFDF, Oliveira E, Coelho PMZ, Katz N. Performance of POC-CCA® in diagnosis of schistosomiasis mansoni in individuals with low parasite burden. Rev Soc Bras Med Trop 2016; 49:341-7. [DOI: 10.1590/0037-8682-0070-2016] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2016] [Accepted: 05/13/2016] [Indexed: 01/19/2023] Open
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Zoni AC, Catalá L, Ault SK. Schistosomiasis Prevalence and Intensity of Infection in Latin America and the Caribbean Countries, 1942-2014: A Systematic Review in the Context of a Regional Elimination Goal. PLoS Negl Trop Dis 2016; 10:e0004493. [PMID: 27007193 PMCID: PMC4805296 DOI: 10.1371/journal.pntd.0004493] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2015] [Accepted: 02/04/2016] [Indexed: 12/11/2022] Open
Abstract
Background In 2012 the World Health Assembly adopted resolution WHA65.21 on elimination of schistosomiasis, calling for increased investment in schistosomiasis control and support for countries to initiate elimination programs. This study aims to analyze prevalence and intensity of Schistosoma mansoni infection in children in Latin America and the Caribbean countries and territories (LAC), at the second administrative level or lower. Methodology A systematic review of schistosomiasis prevalence and intensity of infection was conducted by searching at PubMed, LILACS and EMBASE. Experts on the topic were informally consulted and institutional web pages were reviewed (PAHO/WHO, Ministries of Health). Only SCH infection among children was registered because it can be a ‘proxi-indicator’ of recent transmission by the time the study is conducted. Principal Findings One hundred thirty two full-text articles met the inclusion criteria and provided 1,242 prevalence and 199 intensity of infection data points. Most of them were from Brazil (69.7%). Only Brazil published studies after 2001, showing several 'hot spots' with high prevalence. Brazil, Venezuela, Suriname and Saint Lucia need to update the epidemiological status of schistosomiasis to re-design their national programs and target the elimination of Schistosoma mansoni transmission by 2020. In Antigua and Barbuda, Dominican Republic, Guadeloupe, Martinique, Montserrat and Puerto Rico schistosomiasis transmission may be interrupted. However the compilation of an elimination dossier and follow-up surveys, per WHO recommendations, are needed to verify that status. Hence, the burden of subtle SCH chronic infection may be still present and even high in countries that may have eliminated transmission. Heterogeneity in the methodologies used for monitoring and evaluating the progress of the schistosomiasis programs was found, making cross-national and chronological comparisons difficult. Conclusions There is a need for updating the schistosomiasis status in the historically endemic countries and territories in LAC to address the required public health interventions for control and elimination programs or to verify the elimination of transmission of Schistosoma mansoni. Improved reporting and standardization of the monitoring and evaluation methodologies used are recommended, while using available WHO guidelines. Meeting a regional elimination goal will require additional and improved epidemiological data by age group and sex. Schistosomiasis (Schistosoma spp) is an intestinal parasitic infection that causes anaemia, stunted growth, impaired cognition, and decreased physical fitness among other pathological effects. Currently, the control of schistosomiasis relies principally on mass drug administration of praziquantel. In addition, the implementation of further interventions such as snail (intermediate host) control, improving access to safe water and sanitation are required to achieve elimination of transmission in humans. An updated epidemiological situation will help countries to design tailor-made interventions enabling a step-up in prevention and control measures with the goal of elimination of transmission of this disease by 2020. In the region of the Americas, Schistosoma mansoni is the only species present that infect humans. This systematic review shows that in this region there is a need for re-mapping the schistosomiasis epidemiological situation in certain areas and countries in order to implement and optimize the best public health interventions needed to interrupt transmission or verify elimination of transmission. The methodology for monitoring and evaluating schistosomiasis control programs are well defined by current WHO guidelines. However, further investigations and guidelines on suitable tools for monitoring and evaluating schistosomiasis elimination programs and criteria and procedures for validating the elimination are required, and are currently being undertaken by WHO.
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Affiliation(s)
| | - Laura Catalá
- Pan American Health Organization/World Health Organization, Washington, D.C., United States of America
- * E-mail: ;
| | - Steven K. Ault
- Pan American Health Organization/World Health Organization, Washington, D.C., United States of America
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Ng'etich AI, Rawago FO, Jura WGZO, Mwinzi PN, Won KY, Odiere MR. A cross-sectional study on schistosomiasis and soil-transmitted helminths in Mbita district, western Kenya using different copromicroscopic techniques. Parasit Vectors 2016; 9:87. [PMID: 26883744 PMCID: PMC4756404 DOI: 10.1186/s13071-016-1368-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2015] [Accepted: 02/06/2016] [Indexed: 11/10/2022] Open
Abstract
Background Identification of populations to be targeted for individual treatment and broad-spectrum therapy in schistosomiasis-endemic areas, assessment of therapy efficacy, morbidity, and evaluation of control strategies need to be based on reliable diagnostic tools. Kato-Katz is routinely used and remains the standard diagnostic technique for schistosomiasis, despite its many challenges. This study was conducted in Nyamanga village, Mbita, western Kenya, and evaluated the diagnostic performance of Kato-Katz, Mini-Parasep and modified Mini-FLOTAC techniques in detection of Schistosoma mansoni and soil-transmitted helminths (Ascaris lumbricoides, Trichuris trichiura and hookworm) ova. Methods Stool samples from 132 individuals were screened for eggs of S. mansoni by the 3 techniques. Mini-Parasep® faecal parasite concentrator (Apacor Ltd, England), a single-use diagnostic device with a built-in filter for faecal concentration of helminth eggs by sedimentation was employed on stool samples fixed in 10 % formalin. A modified Mini-FLOTAC (University of Naples, Italy) was based on floatation of helminths eggs with two different solutions (FS2 and FS7) using a closed system (Fill-FLOTAC) with 5 % formalin. Kato-Katz was performed following WHO recommendation. Prevalence of S. mansoni and STH, sensitivity and degree of agreement among the 3 techniques were determined. Results Prevalence of S. mansoni was 47.0 %, 34.1 % and 20.5 % by Mini-Parasep, Kato-Katz and modified Mini-FLOTAC FS7 techniques, respectively. Prevalence of any STH infection was 6.1 %, 3.0 %, 6.1 % and 6.8 % by Mini-Parasep, Kato-Katz, modified Mini-FLOTAC FS2 and modified Mini-FLOTAC FS7 techniques, respectively. Considering the pooled results of the three methods (Mini-Parasep, Kato-Katz and modified Mini-FLOTAC FS7) as diagnostic ‘gold’ standard, the sensitivity of Mini-Parasep, Kato-Katz and modified Mini-FLOTAC FS7 for S. mansoni was 77.5 %, 56.1 %, and 33.8 %, respectively. Mini-Parasep and modified Mini-FLOTAC FS7 techniques had moderate (κ = 0.46) and fairly good (κ = 0.25) agreements with Kato-Katz for S. mansoni, respectively. Mini-Parasep detected a higher proportion of light intensity S. mansoni infections compared to Kato-Katz, which detected high proportions of heavy infections. Mini-Parasep detected a similar mean number of S. mansoni eggs per gram (EPG) of stool compared to the standard Kato-Katz (62.9 vs 97.3; t (131) = -0.49, P = 0.6265) and significantly higher EPG compared to the modified Mini-FLOTAC FS7 (62.9 vs 34.6; t (131) = 5.39, P < 0.0001). Conclusions The high sensitivity of Mini-Parasep suggests its promising potential as an alternative tool in enhancing diagnosis and in monitoring schistosomiasis transmission and determining endpoint of intervention programs, especially in low endemicity areas. Mini-Parasep is also easy to operate, safe and also permits work with fresh stool.
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Affiliation(s)
- Annette I Ng'etich
- Neglected Tropical Diseases Branch, Centre for Global Health Research, Kenya Medical Research Institute, P. O. Box 1578-40100, Kisumu, Kenya. .,Department of Zoology, Maseno University, PRIVATE BAG, Maseno, Kenya.
| | - Fredrick O Rawago
- Neglected Tropical Diseases Branch, Centre for Global Health Research, Kenya Medical Research Institute, P. O. Box 1578-40100, Kisumu, Kenya.
| | - Walter G Z O Jura
- Department of Zoology, Maseno University, PRIVATE BAG, Maseno, Kenya.
| | - Pauline N Mwinzi
- Neglected Tropical Diseases Branch, Centre for Global Health Research, Kenya Medical Research Institute, P. O. Box 1578-40100, Kisumu, Kenya.
| | - Kimberly Y Won
- Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Maurice R Odiere
- Neglected Tropical Diseases Branch, Centre for Global Health Research, Kenya Medical Research Institute, P. O. Box 1578-40100, Kisumu, Kenya.
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Hosking CG, McWilliam HEG, Driguez P, Piedrafita D, Li Y, McManus DP, Ilag LL, Meeusen ENT, de Veer MJ. Generation of a Novel Bacteriophage Library Displaying scFv Antibody Fragments from the Natural Buffalo Host to Identify Antigens from Adult Schistosoma japonicum for Diagnostic Development. PLoS Negl Trop Dis 2015; 9:e0004280. [PMID: 26684756 PMCID: PMC4686158 DOI: 10.1371/journal.pntd.0004280] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2015] [Accepted: 11/13/2015] [Indexed: 12/27/2022] Open
Abstract
The development of effective diagnostic tools will be essential in the continuing fight to reduce schistosome infection; however, the diagnostic tests available to date are generally laborious and difficult to implement in current parasite control strategies. We generated a series of single-chain antibody Fv domain (scFv) phage display libraries from the portal lymph node of field exposed water buffaloes, Bubalus bubalis, 11–12 days post challenge with Schistosoma japonicum cercariae. The selected scFv-phages showed clear enrichment towards adult schistosomes and excretory-secretory (ES) proteins by immunofluorescence, ELISA and western blot analysis. The enriched libraries were used to probe a schistosome specific protein microarray resulting in the recognition of a number of proteins, five of which were specific to schistosomes, with RNA expression predominantly in the adult life-stage based on interrogation of schistosome expressed sequence tags (EST). As the libraries were enriched by panning against ES products, these antigens may be excreted or secreted into the host vasculature and hence may make good targets for a diagnostic assay. Further selection of the scFv library against infected mouse sera identified five soluble scFv clones that could selectively recognise soluble whole adult preparations (SWAP) relative to an irrelevant protein control (ovalbumin). Furthermore, two of the identified scFv clones also selectively recognised SWAP proteins when spiked into naïve mouse sera. These host B-cell derived scFvs that specifically bind to schistosome protein preparations will be valuable reagents for further development of a cost effective point-of-care diagnostic test. Mass drug administration using the highly effective drug praziquantel (PZQ) is currently the method of choice to combat schistosomiasis. However, this treatment regime has limitations; in particular, it does not prevent re-infection and sporadic parasite resistance against PZQ is a continuing threat. The path to the successful control of schistosomiasis is highly challenging and must consider, not only the complex nature of the host-parasite interaction, but also the capacity to assess disease burden and parasite re-emergence in communities where successful control has been achieved. Furthermore, control programs must be economically sustainable in endemic countries and despite significant recent advancements the elimination of schistosomiasis may still be some time away. Accordingly, there is a definitive need to formulate innovative approaches for the development of improved diagnostic tools to accurately assess the disease burden associated with active schistosome infections. Here we describe the usefulness of a phage display library to mature antibody fragments derived from lymph node RNA of the natural buffalo host of the Asian schistosome, Schistosoma japonicum, following an experimental infection. These mature antibody fragments were able to bind native parasite proteins and could thus be used to develop a low cost and accurate point-of-care diagnostic test.
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Affiliation(s)
| | - Hamish E. G. McWilliam
- Department of Microbiology and Immunology, The University of Melbourne, the Peter Doherty Institute for Infection and Immunity, Parkville, Victoria, Australia
| | - Patrick Driguez
- QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | - David Piedrafita
- School of Applied Sciences and Engineering, Federation University, Churchill, Victoria, Australia
| | - Yuesheng Li
- QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | - Donald P. McManus
- QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | - Leodevico L. Ilag
- Bio21 Molecular Sciences and Biotechnology Institute, University of Melbourne, Parkville, Victoria, Australia
| | - Els N. T. Meeusen
- Department of Microbiology, Monash University, Clayton, Victoria, Australia
| | - Michael J. de Veer
- Department of Physiology, Monash University, Clayton, Victoria, Australia
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Assaré RK, Hürlimann E, Ouattara M, N'Guessan NA, Tian-Bi YNT, Yapi A, Yao PK, Coulibaly JT, Knopp S, N'Goran EK, Utzinger J. Sustaining the Control of Schistosoma mansoni in Western Côte d'Ivoire: Baseline Findings Before the Implementation of a Randomized Trial. Am J Trop Med Hyg 2015; 94:352-60. [PMID: 26598571 DOI: 10.4269/ajtmh.15-0530] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2015] [Accepted: 10/19/2015] [Indexed: 12/22/2022] Open
Abstract
We report baseline findings before the implementation of a 4-year intervention trial designed to assess the impact of three different school-based treatment schedules with praziquantel to sustain the control of intestinal schistosomiasis. The baseline survey was conducted in 75 schools of western Côte d'Ivoire previously identified with moderate Schistosoma mansoni endemicity (prevalence: 10-24% in children aged 13-14 years). Three stool samples collected over consecutive days were subjected to duplicate Kato-Katz thick smears each. A questionnaire was administered to collect village-specific information that is relevant for schistosomiasis transmission. Overall, 4,953 first graders (aged 5-8 years) and 7,011 school children (aged 9-12 years) had complete parasitologic data. The overall prevalence of S. mansoni was 5.4% among first graders and 22.1% in 9- to 12-year-old children. Open defecation was practiced in all villages. The current baseline findings will be important to better understand the dynamics of S. mansoni prevalence and intensity over the course of this trial that might be governed by village characteristics and specific treatment interventions.
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Affiliation(s)
- Rufin K Assaré
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland; Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, Abidjan, Côte d'Ivoire; Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire; Wolfson Wellcome Biomedical Laboratories, Department of Life Sciences, Natural History Museum, London, United Kingdom
| | - Eveline Hürlimann
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland; Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, Abidjan, Côte d'Ivoire; Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire; Wolfson Wellcome Biomedical Laboratories, Department of Life Sciences, Natural History Museum, London, United Kingdom
| | - Mamadou Ouattara
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland; Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, Abidjan, Côte d'Ivoire; Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire; Wolfson Wellcome Biomedical Laboratories, Department of Life Sciences, Natural History Museum, London, United Kingdom
| | - Nicaise A N'Guessan
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland; Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, Abidjan, Côte d'Ivoire; Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire; Wolfson Wellcome Biomedical Laboratories, Department of Life Sciences, Natural History Museum, London, United Kingdom
| | - Yves-Nathan T Tian-Bi
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland; Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, Abidjan, Côte d'Ivoire; Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire; Wolfson Wellcome Biomedical Laboratories, Department of Life Sciences, Natural History Museum, London, United Kingdom
| | - Ahoua Yapi
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland; Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, Abidjan, Côte d'Ivoire; Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire; Wolfson Wellcome Biomedical Laboratories, Department of Life Sciences, Natural History Museum, London, United Kingdom
| | - Patrick K Yao
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland; Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, Abidjan, Côte d'Ivoire; Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire; Wolfson Wellcome Biomedical Laboratories, Department of Life Sciences, Natural History Museum, London, United Kingdom
| | - Jean T Coulibaly
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland; Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, Abidjan, Côte d'Ivoire; Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire; Wolfson Wellcome Biomedical Laboratories, Department of Life Sciences, Natural History Museum, London, United Kingdom
| | - Stefanie Knopp
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland; Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, Abidjan, Côte d'Ivoire; Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire; Wolfson Wellcome Biomedical Laboratories, Department of Life Sciences, Natural History Museum, London, United Kingdom
| | - Eliézer K N'Goran
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland; Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, Abidjan, Côte d'Ivoire; Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire; Wolfson Wellcome Biomedical Laboratories, Department of Life Sciences, Natural History Museum, London, United Kingdom
| | - Jürg Utzinger
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland; Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, Abidjan, Côte d'Ivoire; Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire; Wolfson Wellcome Biomedical Laboratories, Department of Life Sciences, Natural History Museum, London, United Kingdom
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Siqueira LMV, Gomes LI, Oliveira E, Oliveira ERD, Oliveira ÁAD, Enk MJ, Carneiro NF, Rabello A, Coelho PMZ. Evaluation of parasitological and molecular techniques for the diagnosis and assessment of cure of schistosomiasis mansoni in a low transmission area. Mem Inst Oswaldo Cruz 2015; 110:209-14. [PMID: 25946244 PMCID: PMC4489451 DOI: 10.1590/0074-02760140375] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2014] [Accepted: 01/26/2015] [Indexed: 11/22/2022] Open
Abstract
This study evaluated parasitological and molecular techniques for the diagnosis and
assessment of cure of schistosomiasis mansoni. A population-based study was performed
in 201 inhabitants from a low transmission locality named Pedra Preta, municipality
of Montes Claros, state of Minas Gerais, Brazil. Four stool samples were analysed
using two techniques, the Kato-Katz® (KK) technique (18 slides) and the
TF-Test®, to establish the infection rate. The positivity rate of 18 KK
slides of four stool samples was 28.9% (58/201) and the combined parasitological
techniques (KK+TF-Test®) produced a 35.8% positivity rate (72/201).
Furthermore, a polymerase chain reaction (PCR)-ELISA assay produced a positivity rate
of 23.4% (47/201) using the first sample. All 72 patients with positive
parasitological exams were treated with a single dose of Praziquantel® and
these patients were followed-up 30, 90 and 180 days after treatment to establish the
cure rate. Cure rates obtained by the analysis of 12 KK slides were 100%, 100% and
98.4% at 30, 90 and 180 days after treatment, respectively. PCR-ELISA revealed cure
rates of 98.5%, 95.5% and 96.5%, respectively. The diagnostic and assessment of cure
for schistosomiasis may require an increased number of KK slides or a test with
higher sensitivity, such as PCR-ELISA, in situations of very low parasite load, such
as after therapeutic interventions.
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Affiliation(s)
| | - Luciana Inácia Gomes
- Laboratório de Pesquisas Clínicas, Centro de Pesquisas René Rachou, Fiocruz, Belo Horizonte, MG, Brasil
| | - Edward Oliveira
- Laboratório de Pesquisas Clínicas, Centro de Pesquisas René Rachou, Fiocruz, Belo Horizonte, MG, Brasil
| | | | | | | | | | - Ana Rabello
- Laboratório de Pesquisas Clínicas, Centro de Pesquisas René Rachou, Fiocruz, Belo Horizonte, MG, Brasil
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Comparative Study of the Accuracy of Different Techniques for the Laboratory Diagnosis of Schistosomiasis Mansoni in Areas of Low Endemicity in Barra Mansa City, Rio de Janeiro State, Brazil. BIOMED RESEARCH INTERNATIONAL 2015; 2015:135689. [PMID: 26504777 PMCID: PMC4609343 DOI: 10.1155/2015/135689] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/02/2015] [Revised: 05/06/2015] [Accepted: 05/10/2015] [Indexed: 11/17/2022]
Abstract
Schistosomiasis constitutes a major public health problem, with an estimated 200 million people infected worldwide. Many areas of Brazil show low endemicity of schistosomiasis, and the current standard parasitological techniques are not sufficiently sensitive to detect the low-level helminth infections common in areas of low endemicity (ALEs). This study compared the Kato-Katz (KK); Hoffman, Pons, and Janer (HH); enzyme-linked immunosorbent assay- (ELISA-) IgG and ELISA-IgM; indirect immunofluorescence technique (IFT-IgM); and qPCR techniques for schistosomiasis detection in serum and fecal samples, using the circumoval precipitin test (COPT) as reference. An epidemiological survey was conducted in a randomized sample of residents from five neighborhoods of Barra Mansa, RJ, with 610 fecal and 612 serum samples. ELISA-IgM (21.4%) showed the highest positivity and HH and KK techniques were the least sensitive (0.8%). All techniques except qPCR-serum showed high accuracy (82–95.5%), differed significantly from COPT in positivity (P < 0.05), and showed poor agreement with COPT. Medium agreement was seen with ELISA-IgG (Kappa = 0.377) and IFA (Kappa = 0.347). Parasitological techniques showed much lower positivity rates than those by other techniques. We suggest the possibility of using a combination of laboratory tools for the diagnosis of schistosomiasis in ALEs.
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Worrell CM, Bartoces M, Karanja DMS, Ochola EA, Matete DO, Mwinzi PNM, Montgomery SP, Secor WE. Cost analysis of tests for the detection of Schistosoma mansoni infection in children in western Kenya. Am J Trop Med Hyg 2015; 92:1233-9. [PMID: 25870422 DOI: 10.4269/ajtmh.14-0644] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2014] [Accepted: 02/27/2015] [Indexed: 12/25/2022] Open
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.
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Affiliation(s)
- Caitlin M Worrell
- Parasitic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, Georgia; Data Management Activity, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia; Centre for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya
| | - Monina Bartoces
- Parasitic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, Georgia; Data Management Activity, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia; Centre for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya
| | - Diana M S Karanja
- Parasitic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, Georgia; Data Management Activity, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia; Centre for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya
| | - Elizabeth A Ochola
- Parasitic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, Georgia; Data Management Activity, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia; Centre for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya
| | - Daniel O Matete
- Parasitic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, Georgia; Data Management Activity, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia; Centre for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya
| | - Pauline N M Mwinzi
- Parasitic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, Georgia; Data Management Activity, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia; Centre for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya
| | - Susan P Montgomery
- Parasitic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, Georgia; Data Management Activity, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia; Centre for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya
| | - W Evan Secor
- Parasitic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, Georgia; Data Management Activity, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia; Centre for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya
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48
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Mwinzi PNM, Kittur N, Ochola E, Cooper PJ, Campbell CH, King CH, Colley DG. Additional Evaluation of the Point-of-Contact Circulating Cathodic Antigen Assay for Schistosoma mansoni Infection. Front Public Health 2015; 3:48. [PMID: 25853117 PMCID: PMC4365547 DOI: 10.3389/fpubh.2015.00048] [Citation(s) in RCA: 59] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2015] [Accepted: 03/04/2015] [Indexed: 01/02/2023] Open
Abstract
Studies of the urine-based point-of-contact cathodic circulating antigen test (POC-CCA) in Schistosoma mansoni-endemic settings in Africa indicate it has good sensitivity in detecting infections, but in areas of low prevalence, the POC-CCA can be positive for persons who are egg-negative by Kato-Katz stool assays. We examined the POC-CCA assay for: (a) batch-to-batch stability; (b) intra-reader and inter-reader variability; (c) day-to-day variability compared to Kato-Katz stool assays, and (d) to see if praziquantel (PZQ) treatment converted Kato-Katz-negative/POC-CCA positive individuals to POC-CCA negativity. We found essentially no batch-to-batch variation, negligible intra-reader variability (2%), and substantial agreement for inter-reader reliability. Some day-to-day variation was observed over 5 days of urine collection, but less than the variation in Kato-Katz stool assays over 3 days. To evaluate the effect of treatment on Kato-Katz(-)/POC-CCA(+) children, 149 children in an area of 10-15% prevalence who were Kato-Katz(-) based on 3 stool samples but POC-CCA(+) were enrolled. Seven days after treatment (PZQ 40 mg/kg) samples were again collected and tested. Almost half (47%) POC-CCA positive children turned negative. Those still POC-CCA positive received a second treatment, and 34% of them turned POC-CCA negative upon this second treatment. Most who remained POC-CCA positive shifted each time to a "lesser" POC-CCA "level of positivity." The data suggest that most Kato-Katz-negative/POC-CCA positive individuals harbor low-intensity infections, and each treatment kills all or some of their adult worms. The data also suggest that when evaluated by a more sensitive assay, the effective cure rates for PZQ are significantly less than those inferred from fecal testing. These findings have public health significance for the mapping and monitoring of Schistosoma infections and in planning the transition from schistosomiasis morbidity control to elimination of transmission.
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Affiliation(s)
- Pauline N M Mwinzi
- Neglected Tropical Diseases Research Unit, Center for Global Health Research, Kenya Medical Research Institute , Kisumu , Kenya
| | - Nupur Kittur
- Center for Tropical and Emerging Global Diseases, University of Georgia , Athens, GA , USA
| | - Elizabeth Ochola
- Neglected Tropical Diseases Research Unit, Center for Global Health Research, Kenya Medical Research Institute , Kisumu , Kenya
| | - Philip J Cooper
- Institute of Infection and Immunity, St George's University of London , London , UK ; Centro de Investigación en Enfermedades Infecciosas y Crónicas, Pontificia Universidad Católica del Ecuador , Quito , Ecuador
| | - Carl H Campbell
- Center for Tropical and Emerging Global Diseases, University of Georgia , Athens, GA , USA
| | - Charles H King
- Center for Global Health and Diseases, Case Western Reserve University School of Medicine , Cleveland, OH , USA
| | - Daniel G Colley
- Center for Tropical and Emerging Global Diseases, University of Georgia , Athens, GA , USA ; Department of Microbiology, University of Georgia , Athens, GA , USA
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49
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Carneiro TR, Peralta RHS, Pinheiro MCC, Oliveira SMD, Peralta JM, Bezerra FSM. A conventional polymerase chain reaction-based method for the diagnosis of human schistosomiasis in stool samples from individuals in a low-endemicity area. Mem Inst Oswaldo Cruz 2015; 108:1037-44. [PMID: 24402156 PMCID: PMC4005555 DOI: 10.1590/0074-0276130202] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2013] [Accepted: 10/07/2013] [Indexed: 01/17/2023] Open
Abstract
The aim of this study was to evaluate the efficacy of a polymerase chain reaction
(PCR)-based method to detect Schistosoma mansoni DNA in stool
samples from individuals living in a low-endemicity area in Brazil. Of the 125
initial stool samples, 80 were ELISA reactive and eggs were identified in 19 of the
samples by parasitological examination. For the PCR evaluations, 56 stool samples
were selected and divided into five groups. Groups I-IV were scored negative for
S. mansoni eggs by parasitological examination. Groups I and II
were ELISA reactive, whereas Groups III and IV were ELISA nonreactive. Groups II and
III were positive for other intestinal parasites. PCR testing scored eight samples as
positive from these four groups. Group V represented the S. mansoni
-positive group and it included ELISA-reactive samples that were scored positive for
S. mansoni by one or more parasitological examinations (6/19 were
positive by Kato-Katz method, 9/17 by saline gradient and 10/13 by Helmintex®). PCR
scored 13 of these 19 samples as positive for S. mansoni . We
conclude that while none of these methods yielded 100% sensitivity, a combination of
techniques should be effective for improving the detection of S.
mansoni infection in low-endemicity areas.
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Affiliation(s)
| | | | | | | | - José Mauro Peralta
- Departamento de Imunologia, Instituto de Microbiologia Paulo de Goes, Universidade Federal do Rio de Janeiro, Brasil, Rio de JaneiroRJ
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50
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Noya O, Katz N, Pointier JP, Theron A, de Noya BA. Schistosomiasis in America. NEGLECTED TROPICAL DISEASES 2015. [DOI: 10.1007/978-3-7091-1422-3_2] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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