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Soares FA, Suzuki CTN, Sabadini E, Falcão AX, de Oliveira Baccin A, de Melo LCV, Gomes JF. Laboratory validation of the automated diagnosis of intestinal parasites via fecal sample processing for the recovery of intestinal parasites through the dissolved air flotation technique. Parasit Vectors 2024; 17:368. [PMID: 39215369 PMCID: PMC11363502 DOI: 10.1186/s13071-024-06434-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2024] [Accepted: 08/05/2024] [Indexed: 09/04/2024] Open
Abstract
BACKGROUND Techniques for diagnosing intestinal parasites need technological advancements in the preanalytical (collection/processing) and analytical (detection) stages. The dissolved air flotation (DAF) technique effectively recovers parasites from processed feces for routine diagnosis. Artificial intelligence (AI) is a practical and affordable alternative to modernize the analysis stage of microscopy images and generates high efficiency in the parasitological examination of feces. METHODS The objective of this study was to standardize a laboratory protocol for stool processing using the DAF technique in conjunction with an automated diagnosis of intestinal parasites (DAPI) system. A total of 400 samples were obtained to perform the tests with the use of DAF to verify the recovery of the parasites as a function of the chemical reagent (polymer and surfactant), the volume of the flotation tube, and standardization of smear assembly on a microscopy slide, with automated analysis by DAPI. The DAF protocol that obtained the most satisfactory results in terms of parasite recovery (P < 0.05) and slide positivity was compared with the Three Fecal Test (TF-Test) protocol with manual (microscopists) and automated (DAPI) evaluation. We compared the sensitivity with the modified TF-Test technical protocol and the diagnostic agreement with the gold standard (Kappa) result. RESULTS There was no significant difference in the parasite recovery between the 10 ml and 50 ml tubes (P > 0.05). The surfactants showed a range of parasite recoveries between 41.9% and 91.2% in the float supernatant. We obtained a maximum positivity of 73% of the assembled slides when we applied DAF processing with 7% CTAB surfactant and 57% positivity with the modified TF-Test technique. Regarding diagnostic performance, the TF-Test-modified and DAF techniques used in fecal processing for subsequent computerized analysis by AI presented sensitivities of 86% and 94%, with kappa agreements of 0.62 and 0.80 (substantial), respectively. CONCLUSIONS The DAF protocol defined in this study and the DAPI system are innovative processes for parasite recovery and fecal debris elimination that are favorable for effectively detecting pathogenic structures in laboratory diagnosis.
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Affiliation(s)
- Felipe Augusto Soares
- School of Medical Sciences, Universidade Estadual de Campinas, Campinas, SP, Brazil.
- Laboratory of Image Data Science (LIDS), Institute of Computing (IC), Universidade Estadual de Campinas, Campinas, SP, Brazil.
| | | | - Edvaldo Sabadini
- Department of PhysicalChemistry, Institute of Chemistry, Universidade Estadual de Campinas, Campinas, SP, Brazil
| | - Alexandre Xavier Falcão
- Laboratory of Image Data Science (LIDS), Institute of Computing (IC), Universidade Estadual de Campinas, Campinas, SP, Brazil
| | | | | | - Jancarlo Ferreira Gomes
- School of Medical Sciences, Universidade Estadual de Campinas, Campinas, SP, Brazil
- Laboratory of Image Data Science (LIDS), Institute of Computing (IC), Universidade Estadual de Campinas, Campinas, SP, Brazil
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Ramos LMS, Pereira DSCA, Oliveira LOV, Graeff-Teixeira C. Accuracy of commercial ELISA and ICT for screening schistosomiasis infections at a low endemicity area in Brazil. Trans R Soc Trop Med Hyg 2024; 118:514-519. [PMID: 38401052 DOI: 10.1093/trstmh/trae005] [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: 09/28/2023] [Revised: 01/08/2024] [Accepted: 02/09/2024] [Indexed: 02/26/2024] Open
Abstract
BACKGROUND Control interventions recommended by the World Health Organization have successfully resulted in low-intensity schistosomiasis transmission areas. To achieve elimination of transmission, new diagnostic screening tools are needed to overcome less than adequate sensitivity of the currently used Kato-Katz faecal thick smear method. Ideally, in-house serological tests should be avoided due to not having a continuous supply of kits as would be necessary for large population studies. Quality assurance provided by manufacturers and proper performance evaluations are also needed. We evaluated the accuracy of two commercially available serology tests as screening methods for detecting light schistosomiasis infections. METHODS Serum samples were collected in 2015 from individuals living in a low-endemicity locality in northeastern Brazil and deposited in a biorepository. We evaluated immunoglobulin G (IgG) and IgM enzyme-linked immunosorbent assays (ELISAs) and an immunochromatographic test (ICT). The Helmintex method was used to define true-positive samples. RESULTS Overall sensitivity was close to 90% for both the IgG ELISA and ICT, yet specificity was 28% and 18%, respectively. For the IgM ELISA, the values were estimated to be 55% and 43%, respectively. CONCLUSIONS Poor specificity and positive predictive values prevent these tests from being recommended for screening populations in low-intensity schistosomiasis-endemic areas.
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Affiliation(s)
- Lida M S Ramos
- Núcleo de Doenças Infecciosas, Centro de Ciências da Saúde, Universidade Federal do Espírito Santo, Vitória 29043-910, Brazil
| | - Danielle S C A Pereira
- Núcleo de Doenças Infecciosas, Centro de Ciências da Saúde, Universidade Federal do Espírito Santo, Vitória 29043-910, Brazil
| | - Laila O V Oliveira
- Núcleo de Doenças Infecciosas, Centro de Ciências da Saúde, Universidade Federal do Espírito Santo, Vitória 29043-910, Brazil
| | - Carlos Graeff-Teixeira
- Núcleo de Doenças Infecciosas, Centro de Ciências da Saúde, Universidade Federal do Espírito Santo, Vitória 29043-910, Brazil
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Esteban JG, Muñoz-Antolí C, Toledo R, Ash LR. Diagnosis of Human Trematode Infections. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2024; 1454:541-582. [PMID: 39008275 DOI: 10.1007/978-3-031-60121-7_14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/16/2024]
Abstract
Digenetic trematodes form a major group of human parasites, affecting a large number of humans, especially in endemic foci. Over 100 species have been reported infecting humans, including blood, lung, liver and intestinal parasites. Traditionally, trematode infections have been diagnosed by parasitological methods based on the detection and the identification of eggs in different clinical samples. However, this is complicated due to the morphological similarity between eggs of different trematode species and other factors such as lack of sensitivity or ectopic locations of the parasites. Moreover, the problem is currently aggravated by migratory flows, international travel, international trade of foods and changes in alimentary habits. Although efforts have been made for the development of immunological and molecular techniques, the detection of eggs through parasitological techniques remains as the gold standard for the diagnosis of trematodiases. In the present chapter, we review the current status of knowledge on diagnostic techniques used when examining feces, urine, and sputum and also analyze the most relevant characteristics used to identify eggs with a quick key for the identification of eggs.
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Affiliation(s)
- J Guillermo Esteban
- Área de Parasitología, Departamento de Farmacia, Tecnología Farmacéutica y Parasitología, Facultad de Farmacia, Universidad de Valencia, Burjassot, Valencia, Spain.
| | - Carla Muñoz-Antolí
- Área de Parasitología, Departamento de Farmacia, Tecnología Farmacéutica y Parasitología, Facultad de Farmacia, Universidad de Valencia, Burjassot, Valencia, Spain
| | - Rafael Toledo
- Área de Parasitología, Departamento de Farmacia, Tecnología Farmacéutica y Parasitología, Facultad de Farmacia, Universidad de Valencia, Burjassot, Valencia, Spain
| | - Lawrence R Ash
- Infectious & Tropical Diseases, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, USA
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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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Menezes DL, Santos CTDJ, Oliveira YLDC, Campos VTC, Negrão-Corrêa DA, Geiger SM, Silva JRS, Jain S, Oliveira LM, Fujiwara RT, Graeff-Teixeira C, Dolabella SS. Accuracy Study of Kato-Katz and Helmintex Methods for Diagnosis of Schistosomiasis Mansoni in a Moderate Endemicity Area in Sergipe, Northeastern Brazil. Diagnostics (Basel) 2023; 13:527. [PMID: 36766631 PMCID: PMC9914664 DOI: 10.3390/diagnostics13030527] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 01/24/2023] [Accepted: 01/29/2023] [Indexed: 02/04/2023] Open
Abstract
Schistosomiasis is a neglected tropical disease (NTD) caused by blood flukes from the genus Schistosoma. Brazil hosts the main endemic area in the Americas, where Schistosoma mansoni is the only species causing the disease. Kato-Katz (KK) thick smear is the WHO recommended screening test for populational studies, but there is growing evidence for the sensitivity limitations associated with KK, especially in areas with low parasite loads. Helmintex (HTX) is another highly sensitive egg-detection method, based on the magnetic properties of S. mansoni eggs and their isolation in a magnetic field. The objective of this study is to evaluate both KK and HTX in a moderate endemic locality, Areia Branca, located in the municipality of Pacatuba, in the state of Sergipe in northeastern Brazil. From 234 individual fecal samples, two KK thick smears were prepared and evaluated for each sample. Similarly, 30 g of each fecal sample was processed by HTX protocol. Eggs were detected in 80 (34.18%) residents. Twenty-three (9.83%) samples were positive for eggs (only by KK), and 77 (32.91%) samples showed positive for eggs (only by HTX). Sensitivity, specificity, and accuracy estimates gave values of 28.75%, 100% and 75.64%, respectively, for KK, and 96.25%, 100% and 98.72% respectively, for HTX. The positive predictive value was 100% for both methods, while the negative predictive value was 72.99% for KK and 98.09% for HTX. Overall, HTX presented a superior performance compared to the one sample, two slides KK examination. The study confirms the role of HTX as a reference method for the definition of true-positive samples in comparative accuracy studies and its potential role in the late stages when the certification of schistosomiasis transmission interruption is required. Diagnostic tests are important tools for the elimination of this NTD, besides the effective implementation of safe water, basic sanitation, snail control, and the treatment of infected populations.
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Affiliation(s)
- Daniel Lima Menezes
- Postgraduate Program in Pharmaceutical Sciences, Federal University of Sergipe, São Cristóvão 49100-000, SE, Brazil
| | | | | | | | | | - Stefan Michael Geiger
- Department of Parasitology, Federal University of Minas Gerais, Belo Horizonte 31270-901, MG, Brazil
| | - José Rodrigo Santos Silva
- Postgraduate Program in Parasite Biology, Federal University of Sergipe, São Cristóvão 49100-000, SE, Brazil
| | - Sona Jain
- Postgraduate Program in Industrial Biotechnology, Tiradentes University, Aracaju 49032-490, SE, Brazil
| | - Luciana Maria Oliveira
- Postgraduate Program in Parasite Biology, Federal University of Sergipe, São Cristóvão 49100-000, SE, Brazil
| | - Ricardo Toshio Fujiwara
- Postgraduate Program in Parasite Biology, Federal University of Sergipe, São Cristóvão 49100-000, SE, Brazil
- Department of Parasitology, Federal University of Minas Gerais, Belo Horizonte 31270-901, MG, Brazil
| | - Carlos Graeff-Teixeira
- Infectious Diseases Unit, Department of Pathology, Federal University of Espírito Santo, Vitória 29047-105, ES, Brazil
| | - Silvio Santana Dolabella
- Postgraduate Program in Pharmaceutical Sciences, Federal University of Sergipe, São Cristóvão 49100-000, SE, Brazil
- Postgraduate Program in Parasite Biology, Federal University of Sergipe, São Cristóvão 49100-000, SE, Brazil
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Ogongo P, Nyakundi RK, Chege GK, Ochola L. The Road to Elimination: Current State of Schistosomiasis Research and Progress Towards the End Game. Front Immunol 2022; 13:846108. [PMID: 35592327 PMCID: PMC9112563 DOI: 10.3389/fimmu.2022.846108] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Accepted: 03/21/2022] [Indexed: 12/14/2022] Open
Abstract
The new WHO Roadmap for Neglected Tropical Diseases targets the global elimination of schistosomiasis as a public health problem. To date, control strategies have focused on effective diagnostics, mass drug administration, complementary and integrative public health interventions. Non-mammalian intermediate hosts and other vertebrates promote transmission of schistosomiasis and have been utilized as experimental model systems. Experimental animal models that recapitulate schistosomiasis immunology, disease progression, and pathology observed in humans are important in testing and validation of control interventions. We discuss the pivotal value of these models in contributing to elimination of schistosomiasis. Treatment of schistosomiasis relies heavily on mass drug administration of praziquantel whose efficacy is comprised due to re-infections and experimental systems have revealed the inability to kill juvenile schistosomes. In terms of diagnosis, nonhuman primate models have demonstrated the low sensitivity of the gold standard Kato Katz smear technique. Antibody assays are valuable tools for evaluating efficacy of candidate vaccines, and sera from graded infection experiments are useful for evaluating diagnostic sensitivity of different targets. Lastly, the presence of Schistosomes can compromise the efficacy of vaccines to other infectious diseases and its elimination will benefit control programs of the other diseases. As the focus moves towards schistosomiasis elimination, it will be critical to integrate treatment, diagnostics, novel research tools such as sequencing, improved understanding of disease pathogenesis and utilization of experimental models to assist with evaluating performance of new approaches.
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Affiliation(s)
- Paul Ogongo
- Division of Experimental Medicine, Department of Medicine, University of California, San Francisco, San Francisco, CA, United States
- Department of Tropical and Infectious Diseases, Institute of Primate Research, Nairobi, Kenya
| | - Ruth K. Nyakundi
- Department of Tropical and Infectious Diseases, Institute of Primate Research, Nairobi, Kenya
| | - Gerald K. Chege
- Primate Unit & Delft Animal Centre, South African Medical Research Council, Cape Town, South Africa
- Department of Pathology, University of Cape Town, Cape Town, South Africa
| | - Lucy Ochola
- Department of Tropical and Infectious Diseases, Institute of Primate Research, Nairobi, Kenya
- Department of Environmental Health, School of Behavioural and Lifestyle Sciences, Faculty of Health Sciences, Nelson Mandela University, Gqeberha, South Africa
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Vilches TN, Graeff-Teixeira C, Yang HM. Assessing the effects of diagnostic sensitivity on schistosomiasis dynamics. J Theor Biol 2021; 523:110727. [PMID: 33887298 DOI: 10.1016/j.jtbi.2021.110727] [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: 06/29/2020] [Revised: 03/29/2021] [Accepted: 04/12/2021] [Indexed: 11/26/2022]
Abstract
Schistosomiasis is a parasite infection that affects millions of people around the world. It is endemic in 13 different states in Brazil and responsible for increasing morbidity in the population. One of its main characteristics is a heterogeneous distribution of worm burden in the human population, which makes the diagnosis difficult. We aimed to investigate how the sensitivity of the diagnostic method may contribute to successful control interventions against infections in a population. In order to do that, we present an ordinary differential equations model that considers three levels of worm burden in the human population, a snail population, and a miracidium reservoir. Through a steady-state analysis and its local stability, we show how this worm-burden heterogeneity can be responsible for the persistence of infection, especially due to reinfection in the highest level of worm burden. The analysis highlights sensitive diagnosis, besides treatment and sanitary improvements, as a key factor for schistosomiasis transmission control.
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Miranda GS, Resende SD, Cardoso DT, Camelo GMA, Silva JKAO, de Castro VN, Geiger SM, Carneiro M, Negrão-Corrêa D. Previous History of American Tegumentary Leishmaniasis Alters Susceptibility and Immune Response Against Schistosoma mansoni Infection in Humans. Front Immunol 2021; 12:630934. [PMID: 33777015 PMCID: PMC7990892 DOI: 10.3389/fimmu.2021.630934] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Accepted: 02/18/2021] [Indexed: 01/21/2023] Open
Abstract
Schistosomiasis and Leishmaniasis are chronic parasitic diseases with high prevalence in some tropical regions and, due to their wide distribution, a risk of co-infections is present in some areas. Nevertheless, the impact of this interaction on human populations is still poorly understood. Thus, the current study evaluated the effect of previous American Tegumentary Leishmaniasis (ATL) on the susceptibility and immune response to Schistosoma mansoni infection in residents from a rural community in Northern of Minas Gerais state, Brazil, an area endemic for both parasitic infections. The participants answered a socioeconomic questionnaire and provided stool and blood samples for parasitological and immunological evaluations. Stool samples were examined by a combination of parasitological techniques to identify helminth infections, especially S. mansoni eggs. Blood samples were used for hemograms and to measure the serum levels of cytokines and chemokines. Reports on previous ATL were obtained through interviews, clinical evaluation forms, and medical records. S. mansoni infection was the most prevalent parasitic infection in the study population (46%), and the majority of the infected individuals had a very low parasite burden. In the same population, 93 individuals (36.2%) reported previous ATL, and the prevalence of S. mansoni infection among these individuals was significantly higher than among individuals with no ATL history. A multiple logistic regression model revealed that S. mansoni infection was positively associated with higher levels of CCL3 and CCL17, and a higher frequency of IL-17 responders. Moreover, this model demonstrated that individuals with an ATL history had a 2-fold higher probability to be infected with S. mansoni (OR = 2.0; 95% CI 1.04–3.68). Among S. mansoni-infected individuals, the logistic regression demonstrated that a previous ATL history was negatively associated with the frequency of IL-17 responders and CXCL10 higher responders, but positively associated with higher IL-27 responders. Altogether, our data suggest that previous ATL may alter the susceptibility and the immune response in S. mansoni-infected individuals, which may likely affect the outcome of schistosomiasis and the severity of the disease in humans.
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Affiliation(s)
- Guilherme Silva Miranda
- Laboratory of Immunohelminthology and Schistosomiasis, Department of Parasitology, Institute of Biological Sciences, Federal University of Minas Gerais, Belo Horizonte, Brazil.,Laboratory of Biology, Department of Biology, Institute of Education, Science and Technology of Maranhão, São Raimundo das Mangabeiras, Brazil
| | - Samira Diniz Resende
- Laboratory of Immunohelminthology and Schistosomiasis, Department of Parasitology, Institute of Biological Sciences, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Diogo Tavares Cardoso
- Laboratory of Intestinal Helminthiasis, Department of Parasitology, Institute of Biological Sciences, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Genil Mororó Araújo Camelo
- Laboratory of Immunohelminthology and Schistosomiasis, Department of Parasitology, Institute of Biological Sciences, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Jeferson Kelvin Alves Oliveira Silva
- Laboratory of Immunohelminthology and Schistosomiasis, Department of Parasitology, Institute of Biological Sciences, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Vanessa Normandio de Castro
- Laboratory of Intestinal Helminthiasis, Department of Parasitology, Institute of Biological Sciences, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Stefan Michael Geiger
- Laboratory of Intestinal Helminthiasis, Department of Parasitology, Institute of Biological Sciences, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Mariângela Carneiro
- Laboratory of Epidemiology of Infectious and Parasitic Diseases, Department of Parasitology, Institute of Biological Sciences, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Deborah Negrão-Corrêa
- Laboratory of Immunohelminthology and Schistosomiasis, Department of Parasitology, Institute of Biological Sciences, Federal University of Minas Gerais, Belo Horizonte, Brazil
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Graeff-Teixeira C, Favero V, de Souza RP, Pascoal VF, Bittencourt HR, Fukushige M, Geiger SM, Negrão-Corrêa D. Use of Schistosoma mansoni soluble egg antigen (SEA) for antibody detection and diagnosis of schistosomiasis: The need for improved accuracy evaluations of diagnostic tools. Acta Trop 2021; 215:105800. [PMID: 33352167 DOI: 10.1016/j.actatropica.2020.105800] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 11/25/2020] [Accepted: 12/14/2020] [Indexed: 02/08/2023]
Abstract
Many antigens for use in antibody-detection systems for schistosomiasis have been investigated over the past 40 years. In particular, soluble egg antigens (SEA) are still widely used in enzyme-linked immunosorbent assays (ELISAs) for detection of immunoglobulin classes and subclasses. Here, we conducted a literature review to examine accuracy evaluations of SEA-Immunoglobulin G (IgG)-ELISAs performed to detect Schistosoma mansoni infections and published between 1979 and 2019. S. mansoni is the main causative agent for intestinal schistosomiasis in many countries in Africa and Central and South America. After retrieving 214 relevant abstracts from the PubMed database, we selected 15 publications to undergo a full review. Sensitivity and specificity values varied from 71 to 99%, and from 6 to 100%, respectively. In addition, 11/15 studies did not state confidence intervals. Therefore, the findings from this review indicate that after four decades, we still do not have consistent evaluation estimates of SEA-IgG-ELISAs. Antigen mass per well and dilution of test sera in these articles varied from 0.018 µg to 1.5 µg, and from 1:50 to 1:500, respectively. Most of the reported accuracy evaluations used control sera which were selected based on parasitological examinations for egg detection, although ill-defined criteria were also noted. The number and composition of control serum panels was considered not adequate in approximately half of the studies. It is also noteworthy that among more than 30 diagnostic antigen preparations under development since the 1970s, most were not validated in the field and they failed to reach populations in need. Thus, attention to guidelines for standardization, estimations of accuracy, and reporting of results is needed to facilitate coordinated efforts aimed at schistosomiasis control and elimination.
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Ramírez ADP, Favero V, Lindholz CG, Veríssimo CDM, Pascoal VF, Candido RRF, Morassutti AL, Graeff-Teixeira C. Schistosomiasis: an epidemiological update on Brazil's southernmost low endemic area in Esteio. Rev Soc Bras Med Trop 2020; 53:e20200411. [PMID: 33027417 PMCID: PMC7534964 DOI: 10.1590/0037-8682-0411-2020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Accepted: 07/31/2020] [Indexed: 12/31/2022] Open
Abstract
INTRODUCTION Brazil's southernmost state, Rio Grande do Sul (RGS), was considered schistosomiasis-free until 1998 when a low endemic focus was identified in Esteio, a city located next to the capital of RGS. In the last two decades, the control interventions applied in the region have been apparently successful, and the absence of new cases indicated the possibility of interrupted schistosomiasis transmission. The objective of this study was to update the clinical and epidemiological data of schistosomiasis in Esteio. METHODS We reviewed all 28 individuals diagnosed with the infection since 1997 and a survey was applied to a group of 29 school-aged children residing in Vila Pedreira, one of the most affected neighborhoods. RESULTS No eggs were detected in fecal samples using the Helmintex method, and all samples were negative for serum antibodies on examination by the western blot technique using the Schistosoma mansoni microsomal antigen (MAMA- WB). In contrast, 23 individuals (79%) tested positive for the cathodic circulating antigen with the point-of-care immunochromatographic test (POC-CCA) on urine samples. Of the 28 formerly infected individuals, only eight were located, of which four tested positive, and four tested negative for serum antibodies using the MAMA-WB technique. CONCLUSIONS Current adverse conditions for S. mansoni transmission in Esteio and the absence of a confirmed diagnosis suggests that there is (i) a lack of specificity of the POC-CCA test in low endemic settings, and (ii) a high probability that interruption of schistosomiasis has been achieved in Esteio.
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Affiliation(s)
- Angélica da Paz Ramírez
- Pontifícia Universidade Católica do Rio Grande do Sul, Escola de Ciências, Departamento de Ecologia e Biodiversidade, Porto Alegre, RS, Brasil
| | - Vivian Favero
- Pontifícia Universidade Católica do Rio Grande do Sul, Escola de Ciências, Departamento de Ecologia e Biodiversidade, Porto Alegre, RS, Brasil
| | - Catieli Gobetti Lindholz
- Pontifícia Universidade Católica do Rio Grande do Sul, Escola de Ciências, Departamento de Ecologia e Biodiversidade, Porto Alegre, RS, Brasil
| | - Carolina de Marco Veríssimo
- Pontifícia Universidade Católica do Rio Grande do Sul, Escola de Ciências, Departamento de Ecologia e Biodiversidade, Porto Alegre, RS, Brasil
| | - Vanessa Fey Pascoal
- Pontifícia Universidade Católica do Rio Grande do Sul, Escola de Ciências, Departamento de Ecologia e Biodiversidade, Porto Alegre, RS, Brasil
| | - Renata Russo Frasca Candido
- Pontifícia Universidade Católica do Rio Grande do Sul, Escola de Ciências, Departamento de Ecologia e Biodiversidade, Porto Alegre, RS, Brasil.,University of Western Australia, Department of Physics, Perth, Australia
| | - Alessandra Loureiro Morassutti
- Pontifícia Universidade Católica do Rio Grande do Sul, Escola de Ciências, Departamento de Ecologia e Biodiversidade, Porto Alegre, RS, Brasil
| | - Carlos Graeff-Teixeira
- Pontifícia Universidade Católica do Rio Grande do Sul, Escola de Ciências, Departamento de Ecologia e Biodiversidade, Porto Alegre, RS, Brasil.,Universidade Federal do Espírito Santo, Centro de Ciências da Saúde, Departamento de Patologia e Núcleo de Doenças Infecciosas, Vitória, ES, Brasil
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11
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Favero V, Veríssimo CDM, Piovesan AR, Morassutti AL, Souto AA, Bittencourt HR, Pascoal VF, Lindholz CG, Jones MK, Souza RP, Rigo FDV, Carlini CR, Graeff-Teixeira C. A new diagnostic strategy which uses a luminol-H2O2 system to detect helminth eggs in fecal sediments processed by the Helmintex method. PLoS Negl Trop Dis 2020; 14:e0008500. [PMID: 32730339 PMCID: PMC7437924 DOI: 10.1371/journal.pntd.0008500] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Revised: 08/19/2020] [Accepted: 06/18/2020] [Indexed: 11/19/2022] Open
Abstract
Schistosomiasis remains a serious public health problem in tropical regions, affecting more than 250 million people. Sensitive diagnostic methods represent key tools for disease elimination, in particular in areas with low endemicity. Advances in the use of luminol-based chemiluminescent techniques have enabled greater sensitivity and speed in obtaining results in different diagnostic settings. In this study, we developed a luminol-H2O2 chemiluminescence (CL) method to detect Schistosoma mansoni eggs in human fecal sediments processed by the Helmintex (HTX) method. After S. mansoni eggs were incubated with a solution of luminol-H2O2 the light emission was detected and measured by spectrophotometry at 431 nm for 5 min, using detection and counts of eggs by bright field optical microscopy as a reference. CL intensity was found to correlate with different sources and numbers of eggs. Furthermore, our results showed that the CL method can distinguish positive from negative samples with 100% sensitivity and 71% specificity. To our knowledge, this is the first study to report the use of CL for the diagnosis of helminths from fecal samples. The combination of the HTX method with CL represents an important advance in providing a reference method with the highest standards of sensitivity. Schistosomiasis, the infection caused by parasites of the genus Schistosoma, is still a significant health problem in many countries, despite some successful control efforts. In areas where parasite load is low and few eggs are released in feces, most diagnostic tests fail to detect the infections. Helmintex is a very sensitive, but time consuming, egg-detection method, with most time being consumed in observations of samples at the microscope. Here we report standardization of an innovative luminol-H2O2 chemiluminescence reaction triggered by Schistosoma mansoni eggs that may improve their detection in feces. Improved diagnostic tests are urgently required as part of the schistosomiasis elimination efforts.
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Affiliation(s)
- Vivian Favero
- Research Group on Biomedical Parasitology, School of health and life sciences, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil
- Neurotoxins Laboratory (LaNeuroTox), School of Medicine, Brain Institute and School of Medicine, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil
- * E-mail:
| | - Carolina De Marco Veríssimo
- Research Group on Biomedical Parasitology, School of health and life sciences, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil
- Centre for One Health and Ryan Institute, School of Natural Sciences, National University of Ireland Galway, Galway, Ireland
| | - Angela R. Piovesan
- Neurotoxins Laboratory (LaNeuroTox), School of Medicine, Brain Institute and School of Medicine, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil
- Graduate Program in Cellular and Molecular Biology, Center of Biotechnology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Alessandra L. Morassutti
- Research Group on Biomedical Parasitology, School of health and life sciences, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil
| | - André A. Souto
- Polytechnic School, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil
| | - Hélio R. Bittencourt
- Polytechnic School, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil
| | - Vanessa F. Pascoal
- Research Group on Biomedical Parasitology, School of health and life sciences, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil
| | - Catieli G. Lindholz
- Research Group on Biomedical Parasitology, School of health and life sciences, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil
| | - Malcolm K. Jones
- School of Veterinary Science, The University of Queensland, Brisbane, Qld, Australia, 4072
| | - Renata P. Souza
- Research Group on Biomedical Parasitology, School of health and life sciences, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil
| | - Francine De Vargas Rigo
- Research Group on Biomedical Parasitology, School of health and life sciences, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil
| | - Célia R. Carlini
- Neurotoxins Laboratory (LaNeuroTox), School of Medicine, Brain Institute and School of Medicine, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil
| | - Carlos Graeff-Teixeira
- Research Group on Biomedical Parasitology, School of health and life sciences, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil
- Infectious Diseases Unit, Center for Health Sciences, Federal University of Espirito Santo, Vitoria, Brazil
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12
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Soares FA, Benitez ADN, dos Santos BM, Loiola SHN, Rosa SL, Nagata WB, Inácio SV, Suzuki CTN, Bresciani KDS, Falcão AX, Gomes JF. A historical review of the techniques of recovery of parasites for their detection in human stools. Rev Soc Bras Med Trop 2020; 53:e20190535. [PMID: 32491097 PMCID: PMC7269538 DOI: 10.1590/0037-8682-0535-2019] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Accepted: 04/30/2020] [Indexed: 11/22/2022] Open
Abstract
Since the early 20th century, the detection of intestinal parasites has improved with the development of several techniques for parasitic structures recovery and identification, which differ in sensitivity, specificity, practicality, cost, and infrastructure demand. This study aims to review, in chronological order, the stool examination techniques and discuss their advantages, limitations, and perspectives, and to provide professionals and specialists in this field with data that lays a foundation for critical analysis on the use of such procedures. The concentration procedures that constitute the main techniques applied in routine research and in parasitological kits are a) spontaneous sedimentation; b) centrifugation-sedimentation with formalin-ethyl acetate; and c) flotation with zinc sulfate solution. While selecting a technique, one should consider the purpose of its application and the technical-operational, biological, and physicochemical factors inherent in the procedures used in stool processing, which may restrict its use. These intrinsic limitations may have undergone procedural changes driven by scientific and technological development and by development of alternative methods, which now contribute to the improvement of diagnostic accuracy.
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Affiliation(s)
- Felipe Augusto Soares
- Universidade Estadual de Campinas, Faculdade de Ciências Médicas, Campinas, SP, Brasil
| | | | | | | | - Stefany Laryssa Rosa
- Universidade Estadual de Campinas, Faculdade de Ciências Médicas, Campinas, SP, Brasil
| | - Walter Bertequini Nagata
- Universidade Estadual Paulista, Faculdade de Medicina Veterinária, Departamento de Apoio, Produção e Saúde Animal, Araçatuba, SP, Brasil
| | - Sandra Valéria Inácio
- Universidade Estadual Paulista, Faculdade de Medicina Veterinária, Departamento de Apoio, Produção e Saúde Animal, Araçatuba, SP, Brasil
| | | | - Katia Denise Saraiva Bresciani
- Universidade Estadual Paulista, Faculdade de Medicina Veterinária, Departamento de Apoio, Produção e Saúde Animal, Araçatuba, SP, Brasil
| | | | - Jancarlo Ferreira Gomes
- Universidade Estadual de Campinas, Faculdade de Ciências Médicas, Campinas, SP, Brasil
- Universidade Estadual de Campinas, Instituto de Computação, Campinas, SP, Brasil
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13
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Esteban JG, Muñoz-Antoli C, Toledo R, Ash LR. Diagnosis of Human Trematode Infections. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2019; 1154:437-471. [PMID: 31297770 DOI: 10.1007/978-3-030-18616-6_14] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
Abstract
Digenetic trematodes form a major group of human parasites, affecting a large number of humans, especially in endemic foci. Over 100 species have been reported infecting humans, including blood, lung, liver, and intestinal parasites. Traditionally, trematode infections have been diagnosed by parasitological methods based on the detection and the identification of eggs in different clinical samples. However, this is complicated due to the morphological similarity between eggs of different trematode species and other factors such as lack of sensitivity or ectopic locations of the parasites. Moreover, the problem is currently aggravated by migratory flows, international travel, international trade of foods, and changes in alimentary habits. Although efforts have been made for the development of immunological and molecular techniques, the detection of eggs through parasitological techniques remains as the gold standard for the diagnosis of trematodiases. In this chapter, we review the current status of knowledge on diagnostic techniques used when examining feces, urine, and sputum and also analyze the most relevant characteristics used to identify eggs with a quick key for the identification of eggs.
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Affiliation(s)
- J Guillermo Esteban
- Área de Parasitología, Departamento de Farmacia y Tecnología Farmacéutica y Parasitología, Facultad de Farmacia, Universidad de Valencia, Valencia, Spain.
| | - Carla Muñoz-Antoli
- Área de Parasitología, Departamento de Farmacia y Tecnología Farmacéutica y Parasitología, Facultad de Farmacia, Universidad de Valencia, Valencia, Spain
| | - Rafael Toledo
- Área de Parasitología, Departamento de Farmacia y Tecnología Farmacéutica y Parasitología, Facultad de Farmacia, Universidad de Valencia, Valencia, Spain
| | - Lawrence R Ash
- Infectious and Tropical Diseases, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, USA
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14
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de Souza RP, Favero V, Pascoal VF, Lindholz C, Bittencourt HR, Graeff-Teixeira C. Criteria for identification of Schistosoma mansoni eggs in faecal sediments prepared with the Helmintex method and stained by ninhydrin. Mem Inst Oswaldo Cruz 2019; 114:e180529. [PMID: 31166420 PMCID: PMC6543901 DOI: 10.1590/0074-02760180529] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Accepted: 04/24/2019] [Indexed: 11/22/2022] Open
Abstract
Helmintex is a sensitive method used for detecting Schistosoma mansoni eggs. Here, we describe the observed frequency of six proposed criteria associated with the identification of S. mansoni eggs prepared with the Helmintex method and stained with ninhydrin. The efficacy of these criteria in classifying S. mansoni eggs when applied in various combinations was also examined. Nine observers registered the presence or absence of 6 different criteria in 100 eggs using a microscope at 100x magnification. Ninhydrin purple, which was frequently observed, was the criterion associated with the lowest inter-observer variability. At least three criteria were associated with a significantly better performance in egg identification. In conclusion, ninhydrin staining and a combination of criteria are recommended for microscope examination of faecal sediments.
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Affiliation(s)
- Renata Perotto de Souza
- Pontifícia Universidade Católica do Rio Grande do Sul, Escola de Ciências, Porto Alegre, RS, Brasil
| | - Vivian Favero
- Pontifícia Universidade Católica do Rio Grande do Sul, Escola de Ciências, Porto Alegre, RS, Brasil
| | - Vanessa Fey Pascoal
- Pontifícia Universidade Católica do Rio Grande do Sul, Escola de Ciências, Porto Alegre, RS, Brasil
| | - Catieli Lindholz
- Pontifícia Universidade Católica do Rio Grande do Sul, Escola de Ciências, Porto Alegre, RS, Brasil
| | - Hélio Radke Bittencourt
- Pontifícia Universidade Católica do Rio Grande do Sul, Escola de Ciências, Porto Alegre, RS, Brasil
| | - Carlos Graeff-Teixeira
- Pontifícia Universidade Católica do Rio Grande do Sul, Escola de Ciências, Porto Alegre, RS, Brasil
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15
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Sousa MS, van Dam GJ, Pinheiro MCC, de Dood CJ, Peralta JM, Peralta RHS, Daher EDF, Corstjens PLAM, Bezerra FSM. Performance of an Ultra-Sensitive Assay Targeting the Circulating Anodic Antigen (CAA) for Detection of Schistosoma mansoni Infection in a Low Endemic Area in Brazil. Front Immunol 2019; 10:682. [PMID: 31019510 PMCID: PMC6458306 DOI: 10.3389/fimmu.2019.00682] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2018] [Accepted: 03/13/2019] [Indexed: 12/03/2022] Open
Abstract
Techniques with high sensitivity and specificity are required for an accurate diagnosis in low-transmission settings, where the conventional parasitological methods are insensitive. We determined the accuracy of an up-converting phosphor-lateral flow circulating anodic antigen (UCP-LF CAA) assay in urine and serum for Schistosoma mansoni diagnosis in low-prevalence settings in Ceará, Brazil, before and after praziquantel treatment. Clinical samples of a total of 258 individuals were investigated by UCP-LF CAA, point-of-care-circulating cathodic antigen (POC-CCA), soluble worm antigen preparation (SWAP)-ELISA and Kato-Katz (KK); a selection of 128 stools by real-time PCR technique. Three and 6-weeks after treatment, samples were collected and evaluated by detection Schistosoma circulating antigens (CAA and CCA). The UCP-LF CAA assays detected 80 positives (31%) with urine and 82 positives (31.8%) with serum. The urine POC-CCA and serum SWAP-ELISA assays detected 30 (11.6%) and 107 (40.7%) positives, respectively. The Kato-Katz technique revealed only 4 positive stool samples (1.6%). Among the 128 individuals with complete data records, 19 cases were identified by PCR (14.8%); Sensitivities and specificities of the UCP-LF CAA assays, determined versus a combined reference standard based on CCA/KK/PCR positivity, ranged from 60-68% to 68-77%, respectively. In addition only for comparative purposes, sensitivities of the different assays were determined vs. a comparative reference based on CAA/KK/PCR positivity, showing the highest sensitivity for the urine CAA assay (80%), followed by the serum CAA (70.9%), SWAP-ELISA (43.6%), PCR (34.5%), POC-CCA (29.1%), whilst triplicate Kato-Katz thick smears had a very low sensitivity (3.6%). CAA concentrations were higher in serum than in urine and were significantly correlated. There was a significant decrease in urine and serum CAA levels 3 and 6-weeks after treatment. The UCP-LF CAA assays revealed 33 and 28 S. mansoni-infected patients at the 3- and 6-week post-treatment follow-up, respectively. The UCP-LF CAA assays show high sensitivity for the diagnosis of S. mansoni in low-endemicity settings. It detects a considerably higher number of infections than microscopy, POC-CCA or PCR. Also it shows to be very useful for evaluating cure rates after treatment. Hence, the UCP-LF CAA assay is a robust and promising diagnostic approach in low-transmission settings.
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Affiliation(s)
- Mariana Silva Sousa
- Medical Sciences Post Graduate Program, Department of Internal Medicine, School of Medicine, Federal University of Ceará, Fortaleza, Brazil
- Parasitology and Mollusks Biology Research Laboratory, Department of Clinical Analysis and Toxicology, Federal University of Ceará, Fortaleza, Brazil
| | - Govert J. van Dam
- Department of Parasitology, Leiden University Medical Center, Leiden, Netherlands
| | - Marta Cristhiany Cunha Pinheiro
- Parasitology and Mollusks Biology Research Laboratory, Department of Clinical Analysis and Toxicology, Federal University of Ceará, Fortaleza, Brazil
| | - Claudia J. de Dood
- Department of Cell and Chemical Biology, Leiden University Medical Center, Leiden, Netherlands
| | - Jose Mauro Peralta
- Department of Immunology, Institute of Microbiology, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Elizabeth de Francesco Daher
- Medical Sciences Post Graduate Program, Department of Internal Medicine, School of Medicine, Federal University of Ceará, Fortaleza, Brazil
| | - Paul L. A. M. Corstjens
- Department of Cell and Chemical Biology, Leiden University Medical Center, Leiden, Netherlands
| | - Fernando Schemelzer Moraes Bezerra
- Medical Sciences Post Graduate Program, Department of Internal Medicine, School of Medicine, Federal University of Ceará, Fortaleza, Brazil
- Parasitology and Mollusks Biology Research Laboratory, Department of Clinical Analysis and Toxicology, Federal University of Ceará, Fortaleza, Brazil
- Pathology Post Graduate Program, Department of Pathology and Legal Medicine, Federal University of Ceará, Fortaleza, Brazil
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16
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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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17
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Markwalter C, Kantor AG, Moore CP, Richardson KA, Wright DW. Inorganic Complexes and Metal-Based Nanomaterials for Infectious Disease Diagnostics. Chem Rev 2019; 119:1456-1518. [PMID: 30511833 PMCID: PMC6348445 DOI: 10.1021/acs.chemrev.8b00136] [Citation(s) in RCA: 55] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Indexed: 12/12/2022]
Abstract
Infectious diseases claim millions of lives each year. Robust and accurate diagnostics are essential tools for identifying those who are at risk and in need of treatment in low-resource settings. Inorganic complexes and metal-based nanomaterials continue to drive the development of diagnostic platforms and strategies that enable infectious disease detection in low-resource settings. In this review, we highlight works from the past 20 years in which inorganic chemistry and nanotechnology were implemented in each of the core components that make up a diagnostic test. First, we present how inorganic biomarkers and their properties are leveraged for infectious disease detection. In the following section, we detail metal-based technologies that have been employed for sample preparation and biomarker isolation from sample matrices. We then describe how inorganic- and nanomaterial-based probes have been utilized in point-of-care diagnostics for signal generation. The following section discusses instrumentation for signal readout in resource-limited settings. Next, we highlight the detection of nucleic acids at the point of care as an emerging application of inorganic chemistry. Lastly, we consider the challenges that remain for translation of the aforementioned diagnostic platforms to low-resource settings.
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Affiliation(s)
| | | | | | | | - David W. Wright
- Department of Chemistry, Vanderbilt
University, Nashville, Tennessee 37235, United States
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18
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Resende SD, Magalhães FC, Rodrigues-Oliveira JL, Castro VN, Souza CSA, Oliveira EJ, Carneiro M, Geiger SM, Negrão-Corrêa DA. Modulation of Allergic Reactivity in Humans Is Dependent on Schistosoma mansoni Parasite Burden, Low Levels of IL-33 or TNF-α and High Levels of IL-10 in Serum. Front Immunol 2019; 9:3158. [PMID: 30713536 PMCID: PMC6345678 DOI: 10.3389/fimmu.2018.03158] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Accepted: 12/21/2018] [Indexed: 12/15/2022] Open
Abstract
Helminth infections and allergies are characterized by a predominant type-2 immune response. In schistosomiasis, the Th-2 response is usually accompanied by induction of immunoregulatory mechanisms that contribute to worm survival and less severe schistosomiasis. Although helminth-induced immunomodulatory mechanisms seem to affect atopy, epidemiological studies on the relationship between helminths and allergy have been inconsistent, and data suggest that the modulatory effects may be influenced by helminth species, chronicity of infection, and parasite burden. Here we performed a cross-sectional study to investigate the effects of Schistosoma mansoni parasite burden and immune response on allergic reactivity of individuals living in a schistosomiasis endemic area in Brazil. Fecal samples from the participants were collected for extensive parasitological examinations by spontaneous sedimentation, Kato-Katz, Helmintex and Saline Gradient tests and molecular detection of S. mansoni by qPCR. Additionally, the concentrations of cytokines and chemokines, total IgE and IgE-reactivity to common house dust allergens were quantified from serum samples. IgE reactivity to dust allergens was detected in 47 individuals (23.8%), and 140 individuals (54.4%) were diagnosed with S. mansoni infection. Most of the infected population (108 individuals) presented very low parasite burden (≤12 eggs/g of feces). The frequency and intensity (p ≤ 0.03) of allergic reactivity were lower in S. mansoni-infected compared with non-infected individuals. Multivariable logistic regression models adjusted by age revealed that allergic reactivity was positively associated with low IL-10 response (OR, 4.55, 95% CI, 0.56–7.36) and high concentration of the inflammatory mediators IL-33 (OR, 2.70, 95% CI, 1.02–7.15) or TNF-α (OR, 6.88, 95% CI, 0.32–143.39) in serum, and inversely associated with S. mansoni infection (OR, 0.38, 95% CI, 0.16–0.87). Most importantly, the logistic regression demonstrated that the modulatory effects of Schistosoma infection depend on parasite burden, with individuals infected with ≤12 eggs/g of feces showing allergic IgE-reactivity similar to non-infected individuals Altogether, our data show that immunomodulation of allergic reactivity depends on S. mansoni burden, low type-2 inflammatory response, and high level of IL-10.
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Affiliation(s)
- Samira D Resende
- Department of Parasitology, Federal University of Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Fernanda C Magalhães
- Department of Parasitology, Federal University of Minas Gerais (UFMG), Belo Horizonte, Brazil
| | | | - Vanessa N Castro
- Department of Parasitology, Federal University of Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Carolina S A Souza
- Schistosomiasis Laboratory, René Rachou Research Center, Oswaldo Cruz Foundation, Belo Horizonte, Brazil
| | - Edward J Oliveira
- Schistosomiasis Laboratory, René Rachou Research Center, Oswaldo Cruz Foundation, Belo Horizonte, Brazil
| | - Mariângela Carneiro
- Department of Parasitology, Federal University of Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Stefan M Geiger
- Department of Parasitology, Federal University of Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Deborah A Negrão-Corrêa
- Department of Parasitology, Federal University of Minas Gerais (UFMG), Belo Horizonte, Brazil
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19
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Castro VN, Rodrigues JL, Cardoso DT, Resende SD, Magalhães FC, Souza DC, Requeijo MH, Negrão-Corrêa D, Geiger SM. Systemic Cytokine and Chemokine Profiles in Individuals With Schistosoma mansoni Infection and Low Parasite Burden. Front Immunol 2018; 9:2975. [PMID: 30619332 PMCID: PMC6305627 DOI: 10.3389/fimmu.2018.02975] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2018] [Accepted: 12/04/2018] [Indexed: 11/13/2022] Open
Abstract
Intestinal schistosomiasis, caused by the parasitic trematode Schistosoma mansoni, is a chronic disease and the prolonged and continuous exposure to S. mansoni antigens results in a deviation of the host's immune response. For diagnosis, the Kato-Katz (KK) method is recommended, however, this method showed low accuracy in areas of low endemicity. This study aimed to characterize the cytokine and chemokine profile of individuals with an extremely low parasite load (<4 eggs per gram of feces), e.g., individuals who were detected by alternative parasitological methods, such as the saline gradient and/or Helmintex®. In order to search for immunological markers for infection, the immunological profile in serum samples of these individuals was then compared with patients detected with the KK method and with a higher parasite load and with individuals repetitively negative by extensive stool exams. The study was conducted in Northern Minas Gerais in a rural area of the Municipality of Januária. Serum samples of a total of 139 parasitologically well-characterized individuals were assessed for the following immunological markers by commercially available immunoassays: TNF-α, IL-1β, IL-6, IL-17A, IL-5, IL-10, IL-13, IL-33, IL-27, CCL3, CCL5, CXCL10, CCL11, and CCL17. As a result, there were no significant differences in concentrations or frequencies for immunological markers between egg-negative individuals or individuals with ultra-low (<4 epg) or low (4-99 epg) parasite loads. However, we found significant correlations between egg counts and eosinophil counts and between egg counts and IL-1β or TNF-α concentrations. The most striking alterations were found in individuals with the highest parasite load (≥100 epg). They had significantly higher TNF-α concentrations in serum when compared with individuals with a low parasite load (4-99 epg) and CCL17 concentrations were significantly elevated when compared with egg-negative individuals. Radar diagrams of frequencies for cytokine and chemokine responders in each infection group confirmed a distinct profile only in the infection group with highest parasite loads (≥100 epg).
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Affiliation(s)
- Vanessa N. Castro
- Department of Parasitology, Federal University of Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Jailza L. Rodrigues
- Department of Parasitology, Federal University of Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Diogo T. Cardoso
- Department of Parasitology, Federal University of Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Samira D. Resende
- Department of Parasitology, Federal University of Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Fernanda C. Magalhães
- Department of Parasitology, Federal University of Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Dayane C. Souza
- Department of Parasitology, Federal University of Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Maira H. Requeijo
- Faculdade da Saúde e Ecologia Humana (FASEH) Vespasiano, Belo Horizonte, Brazil
| | - Deborah Negrão-Corrêa
- Department of Parasitology, Federal University of Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Stefan M. Geiger
- Department of Parasitology, Federal University of Minas Gerais (UFMG), Belo Horizonte, Brazil
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Abd El-Aal NF, Abdelbary EH. Paeoniflorin in experimental BALB/c mansoniasis: A novel anti-angiogenic therapy. Exp Parasitol 2018; 197:85-92. [PMID: 30414842 DOI: 10.1016/j.exppara.2018.11.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Revised: 10/15/2018] [Accepted: 11/04/2018] [Indexed: 12/14/2022]
Abstract
Chronic hepatic schistosomiasis causes portal hypertension, fibrosis and lethal hepatosplenic complications. Previous studies focused mainly on schistosomicidal drugs and neglected the therapeutic approaches against the vascular complications after portal hypertension. Investigating a novel anti-angiogenic therapy is an urgent. The current study is to evaluate the performance of Paeoniflorin (PAE) as an anti-angiogenic therapy, being a powerful anti-fibrotic, compared to artemether (ART) and praziqantel (PZQ) in schistosomiasis mansoni BALB/c mice. Thirty two laboratory bred male BALB/c Swiss albino mice. The mice were classified into four groups (8 mice each), control infected (CI), PZQ (300 mg/kg/12 h), ART (0.1 ml/mg/d) and PAE (50 mg/kg/d) treated groups for one month. All mice groups were sacrificed 15 weeks post infection for assessment of the drugs' efficacy by parasitological, histopathological and immunohistochemical studies. Our results in PAE group showed marked reduction in the mean egg count/gram stool, worm burden, egg count/gram liver tissue, granuloma diameter and pro-angiogenic factors as vascular endothelial growth factor (VEGF), Proliferating cell nuclear antigen (PCNA), alpha-smooth muscle actin (α-SMA) and CD34; conversely, there was an augmentation of the tissue inhibitor metalloproteinases-2 (TIMP-2) as an anti-angiogenic expression that was exceeded ART and PZQ treated groups compared to CI group (p˂0.001). Conclusively, PAE has an anti-angiogenic impact with no vascular proliferative activity or recanalization, no micro-vessel density (MVD) changes, granuloma resolution and fibrosis regression. PAE is predicted to be a potential therapy for chronic hepatic diseases associated with fibrosis and angiogenesis, hopeful in protecting from advanced serious complications; cancer and metastasis.
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Eggs and Magnetism: New Approaches for Schistosomiasis Diagnosis. Trends Parasitol 2018; 34:267-271. [DOI: 10.1016/j.pt.2018.01.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2017] [Revised: 01/15/2018] [Accepted: 01/16/2018] [Indexed: 11/19/2022]
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Diagnosis of schistosomiasis mansoni: an evaluation of existing methods and research towards single worm pair detection. Parasitology 2018; 145:1355-1366. [PMID: 29506583 DOI: 10.1017/s0031182018000240] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
The inadequacy of current diagnostics for the detection of low worm burdens in humans means that schistosomiasis mansoni is more widespread than previously acknowledged. With the inception of mass drug treatment programmes aimed at disease elimination and the advent of human vaccine trials, the need for more sensitive diagnostics is evident. In this review, we evaluate the merits and limitations of the principal diagnostic methods, namely detection of eggs in faeces; anti-schistosome antibodies in serum; parasite-derived proteins and glycans in serum or urine; parasite DNA in blood, faeces or urine. Only in the baboon model, where actual worm burden is determined by portal perfusion, have faecal smear and circulating antigen methods been calibrated, and shown to have thresholds of detection of 10-19 worm pairs. There is scope for improvement in all the four methods of detection, e.g. the identification of single targets for host antibodies to improve the specificity of enzyme linked immunosorbent assay. Despite recent advances in the definition of the schistosome secretome, there have been no comprehensive biomarker investigations of parasite products in the urine of infected patients. Certainly, the admirable goal of eliminating schistosomiasis will not be achieved unless individuals with low worm burdens can be diagnosed.
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Lindholz CG, Favero V, Verissimo CDM, Candido RRF, de Souza RP, dos Santos RR, Morassutti AL, Bittencourt HR, Jones MK, St. Pierre TG, Graeff-Teixeira C. Study of diagnostic accuracy of Helmintex, Kato-Katz, and POC-CCA methods for diagnosing intestinal schistosomiasis in Candeal, a low intensity transmission area in northeastern Brazil. PLoS Negl Trop Dis 2018; 12:e0006274. [PMID: 29518081 PMCID: PMC5843168 DOI: 10.1371/journal.pntd.0006274] [Citation(s) in RCA: 54] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2017] [Accepted: 01/26/2018] [Indexed: 11/19/2022] Open
Abstract
Control initiatives have successfully reduced the prevalence and intensity of schistosomiasis transmission in several localities around the world. However, individuals that release low numbers of eggs in their feces may not be detected by classical methods that are limited by low sensitivity. Given that accurate estimates of prevalence are key to implementing planning control actions for the elimination of schistosomiasis, new diagnostic tools are needed to effectively monitor infections and confirm transmission interruption. The World Health Organization recommends the Kato-Katz (KK) thick smear as a parasitological test for epidemiological surveys, even though this method has been demonstrated to underestimate prevalence when egg burdens are low. The point-of-care immunodiagnostic for detecting schistosome cathodic circulating antigen (POC-CCA) method has been proposed as a more sensitive substitute for KK in prevalence estimations. An alternative diagnostic, the Helmintex (HTX) method, isolates eggs from fecal samples with the use of paramagnetic particles in a magnetic field. Here, a population-based study involving 461 individuals from Candeal, Sergipe State, Brazil, was conducted to evaluate these three methods comparatively by latent class analysis (LCA). The prevalence of schistosomiasis mansoni was determined to be 71% with POC-CCA, 40.% with HTX and 11% with KK. Most of the egg burdens of the individuals tested (70%) were < 1 epg, thereby revealing a dissociation between prevalence and intensity in this locality. Therefore, the present results confirm that the HTX method is a highly sensitive egg detection procedure and support its use as a reference method for diagnosing intestinal schistosomiasis and for comparative evaluation of other tests.
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Affiliation(s)
- Catieli Gobetti Lindholz
- Laboratório de Biologia Parasitária, School of Sciences, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil
| | - Vivian Favero
- Laboratório de Biologia Parasitária, School of Sciences, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil
| | - Carolina de Marco Verissimo
- Laboratório de Biologia Parasitária, School of Sciences, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil
- School of Biological Sciences, Queen’s University Belfast, Belfast, Northern Ireland
| | | | - Renata Perotto de Souza
- Laboratório de Biologia Parasitária, School of Sciences, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil
| | - Renata Rosa dos Santos
- Laboratório de Biologia Parasitária, School of Sciences, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil
| | - Alessandra Loureiro Morassutti
- Laboratório de Biologia Parasitária, School of Sciences, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil
| | - Helio Radke Bittencourt
- Polytechnic School, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil
| | - Malcolm K. Jones
- School of Veterinary Science, The University of Queensland, Queensland, Australia
| | - Timothy G. St. Pierre
- School of Physics, The University of Western Australia, Crawley, Western Australia, Australia
| | - Carlos Graeff-Teixeira
- Laboratório de Biologia Parasitária, School of Sciences, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, 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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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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26
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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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Gutiérrez L, Costo R, Grüttner C, Westphal F, Gehrke N, Heinke D, Fornara A, Pankhurst QA, Johansson C, Veintemillas-Verdaguer S, Morales MP. Synthesis methods to prepare single- and multi-core iron oxide nanoparticles for biomedical applications. Dalton Trans 2015; 44:2943-52. [DOI: 10.1039/c4dt03013c] [Citation(s) in RCA: 82] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
We review and classify synthetic routes to either single-core or multi-core iron oxide nanoparticles for biomedical applications.
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Affiliation(s)
- L. Gutiérrez
- Instituto de Ciencia de Materiales de Madrid
- ICMM-CSIC
- Cantoblanco
- Spain
| | - R. Costo
- Instituto de Ciencia de Materiales de Madrid
- ICMM-CSIC
- Cantoblanco
- Spain
| | - C. Grüttner
- Micromod Partikeltechnologie GmbH
- D-18119 Rostock
- Germany
| | - F. Westphal
- Micromod Partikeltechnologie GmbH
- D-18119 Rostock
- Germany
| | - N. Gehrke
- NanoPET Pharma GmbH
- D-10115 Berlin
- Germany
| | - D. Heinke
- NanoPET Pharma GmbH
- D-10115 Berlin
- Germany
| | - A. Fornara
- SP Technical Research Institute of Sweden
- SE-114 86 Stockholm
- Sweden
| | - Q. A. Pankhurst
- Institute of Biomedical Engineering
- University College of London
- London WC1E 6BT
- UK
| | - C. Johansson
- Acreo Swedish ICT AB
- Arvid Hedvalls Backe 4
- SE-400 14 Göteborg
- Sweden
| | | | - M. P. Morales
- Instituto de Ciencia de Materiales de Madrid
- ICMM-CSIC
- Cantoblanco
- Spain
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Nie G, Wang T, Lu S, Liu W, Li Y, Lei J. Detection of Clonorchis sinensis circulating antigen in sera from Chinese patients by immunomagnetic bead ELISA based on IgY. PLoS One 2014; 9:e113208. [PMID: 25474577 PMCID: PMC4256281 DOI: 10.1371/journal.pone.0113208] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2014] [Accepted: 10/09/2014] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Clonorchiasis, caused by Clonorchis sinensis, is widely distributed in Southeast Asia including China. Clonorchiasis is included in control programs of neglected tropical diseases by World Health Organization (WHO) because it is one of the major health problems in most endemic areas. Diagnosis of clonorchiasis plays a key role in the control programs. However, so far, there is no satisfactory method for clonorchiasis because of low sensitivity, poor practicality and high false positivity of available diagnostic tools. METHODOLOGY/PRINCIPAL FINDINGS We developed an immunomagnetic bead enzyme-linked immunosorbent assay (ELISA) based on IgY (egg yolk immunoglobulin) against cysteine proteinase of C. sinensis for detection of circulating antigen in serum samples of patients infected with C. sinensis. The polyclonal IgY, coated with magnetic beads, was used as a capture antibody and a monoclonal IgG labeled with horseradish peroxidase as a detection antibody in the IgY-based immunomagnetic bead ELISA system (IgY-IMB-ELISA). The results showed that the sensitivity of IgY-IMB-ELISA was 93.3% (14 of 15) in cases of heavy infection (5000 to 9999 eggs per gram feces, i.e, EPG 5000-9999), 86.7% (13 of 15) in cases of moderate infection (EPG 1000-4999) and 75.0% (9 of 12) in cases of light infection (EPG <1000) of clonorchiasis. Together 36 of total 42 (85.7%) serum samples of human clonorchiasis gave a positive reaction. There was a significant correlation between ELISA optical density and egg counts (EPG) with a correlation coefficient of 0.83 in total 42 patients. There were no positive results in patients with trichinosis (n = 10) or cysticercosis (n = 10). Cross-reactivity was 6.7% (2 of 30) with schistosomiasis japonica and 10.0% (3 of 30) with paragonimiasis, respectively. No positive reaction was found in 20 healthy persons. CONCLUSIONS Our findings suggest that IgY-IMB-ELISA appears to be a sensitive and specific assay for detection of circulating antigen in human clonorchiasis.
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Affiliation(s)
- Ge Nie
- Department of Parasitology, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Ting Wang
- Department of Parasitology, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Shengjun Lu
- Department of Parasitology, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Wenqi Liu
- Department of Parasitology, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yonglong Li
- Department of Parasitology, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jiahui Lei
- Department of Parasitology, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Abstract
Schistosomiasis is one of the most prevalent, insidious and serious of the tropical parasitic diseases. Although the effective anthelmintic drug, praziquantel, is widely available and cheap, it does not protect against re-infection, drug-resistant schistosome may evolve and mass drug administration programmes based around praziquantel are probably unsustainable long term. Whereas protective anti-schistosome vaccines are not yet available, the zoonotic nature of Schistosoma japonicum provides a novel approach for developing a transmission-blocking veterinary vaccine in domestic animals, especially bovines, which are major reservoir hosts, being responsible for up to 90% of environmental egg contamination in China and the Philippines. However, a greater knowledge of schistosome immunology is required to understand the processes associated with anti-schistosome protective immunity and to reinforce the rationale for vaccine development against schistosomiasis japonica. Importantly as well, improved diagnostic tests, with high specificity and sensitivity, which are simple, rapid and able to diagnose light S. japonicum infections, are required to determine the extent of transmission interruption and the complete elimination of schistosomiasis following control efforts. This article discusses aspects of the host immune response in schistosomiasis, the current status of vaccine development against S. japonicum and reviews approaches for diagnosing and detecting schistosome infections in mammalian hosts.
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30
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Candido RRF, Favero V, Duke M, Karl S, Gutiérrez L, Woodward RC, Graeff-Teixeira C, Jones MK, St Pierre TG. The affinity of magnetic microspheres for Schistosoma eggs. Int J Parasitol 2014; 45:43-50. [PMID: 25305086 DOI: 10.1016/j.ijpara.2014.08.011] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2014] [Revised: 08/07/2014] [Accepted: 08/09/2014] [Indexed: 11/16/2022]
Abstract
Schistosomiasis is a chronic parasitic disease of humans, with two species primarily causing the intestinal infection: Schistosoma mansoni and Schistosoma japonicum. Traditionally, diagnosis of schistosomiasis is achieved through direct visualisation of eggs in faeces using techniques that lack the sensitivity required to detect all infections, especially in areas of low endemicity. A recently developed method termed Helmintex™ is a very sensitive technique for detection of Schistosoma eggs and exhibits 100% sensitivity at 1.3 eggs per gram of faeces, enough to detect even low-level infections. The Helminthex™ method is based on the interaction of magnetic microspheres and schistosome eggs. Further understanding the underlying egg-microsphere interactions would enable a targeted optimisation of egg-particle binding and may thus enable a significant improvement of the Helmintex™ method and diagnostic sensitivity in areas with low infection rates. We investigated the magnetic properties of S. mansoni and S. japonicum eggs and their interactions with microspheres with different magnetic properties and surface functionalization. Eggs of both species exhibited higher binding affinity to the magnetic microspheres than the non-magnetic microspheres. Binding efficiency was further enhanced if the particles were coated with streptavidin. Schistosoma japonicum eggs bound more microspheres compared with S. mansoni. However, distinct differences within eggs of each species were also observed when the distribution of the number of microspheres bound per egg was modelled with double Poisson distributions. Using this approach, both S. japonicum and S. mansoni eggs fell into two groups, one having greater affinity for magnetic microspheres than the other, indicating that not all eggs of a species exhibit the same binding affinity. Our observations suggest that interaction between the microspheres and eggs is more likely to be related to surface charge-based electrostatic interactions between eggs and magnetic iron oxide rather than through a direct magnetic interaction.
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Affiliation(s)
- Renata R F Candido
- Laboratório de Biologia Parasitária, Faculdade de Biociências e Laboratório de Parasitologia Molecular, Instituto de Pesquisas Biomédicas, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil; QIMR Berghofer Medical Research Institute, Herston, Queensland, Australia; School of Physics, The University of Western Australia, Crawley, Western Australia, Australia.
| | - Vivian Favero
- Laboratório de Biologia Parasitária, Faculdade de Biociências e Laboratório de Parasitologia Molecular, Instituto de Pesquisas Biomédicas, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil
| | - Mary Duke
- QIMR Berghofer Medical Research Institute, Herston, Queensland, Australia
| | - Stephan Karl
- School of Physics, The University of Western Australia, Crawley, Western Australia, Australia; Infection and Immunity Division, Walter and Eliza Hall Institute, Parkville, Victoria, Australia; Department of Medical Biology, The University of Melbourne, Melbourne, Victoria, Australia
| | - Lucía Gutiérrez
- School of Physics, The University of Western Australia, Crawley, Western Australia, Australia; Instituto de Ciencia de Materiales de Madrid (ICMM-CSIC), Consejo Superior de Investigaciones Científicas, Cantoblanco, Madrid, Spain
| | - Robert C Woodward
- School of Physics, The University of Western Australia, Crawley, Western Australia, Australia
| | - Carlos Graeff-Teixeira
- Laboratório de Biologia Parasitária, Faculdade de Biociências e Laboratório de Parasitologia Molecular, Instituto de Pesquisas Biomédicas, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil
| | - Malcolm K Jones
- School of Veterinary Sciences, The University of Queensland, Australia; QIMR Berghofer Medical Research Institute, Herston, Queensland, Australia
| | - Timothy G St Pierre
- School of Physics, The University of Western Australia, Crawley, Western Australia, Australia
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Evaluation of the sensitivity of IgG and IgM ELISA in detecting Schistosoma mansoni infections in a low endemicity setting. Eur J Clin Microbiol Infect Dis 2014; 33:2275-84. [DOI: 10.1007/s10096-014-2196-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2014] [Accepted: 06/23/2014] [Indexed: 10/25/2022]
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32
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Diagnosis of Human Trematode Infections. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2014; 766:293-327. [DOI: 10.1007/978-1-4939-0915-5_9] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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Karl S, Gutiérrez L, Lucyk-Maurer R, Kerr R, Candido RRF, Toh SQ, Saunders M, Shaw JA, Suvorova A, Hofmann A, House MJ, Woodward RC, Graeff-Teixera C, St Pierre TG, Jones MK. The iron distribution and magnetic properties of schistosome eggshells: implications for improved diagnostics. PLoS Negl Trop Dis 2013; 7:e2219. [PMID: 23696910 PMCID: PMC3656142 DOI: 10.1371/journal.pntd.0002219] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2013] [Accepted: 04/05/2013] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Schistosoma mansoni and Schistosoma japonicum are the most frequent causative agents of human intestinal schistosomiasis. Approximately 200 million people in the world are infected with schistosomes. Diagnosis of schistosomiasis is often difficult. High percentages of low level infections are missed in routine fecal smear analysis and current diagnostic methodologies are inadequate to monitor the progress of parasite control, especially in areas with low transmission. Improved diagnostic methods are urgently needed to evaluate the success of elimination programs. Recently, a magnetic fractionation method for isolation of parasite eggs from feces was described, which uses magnetic microspheres to form parasite egg - magnetic microsphere conjugates. This approach enables screening of larger sample volumes and thus increased diagnostic sensitivity. The mechanism of formation of the conjugates remains unexplained and may either be related to specific surface characteristics of eggs and microspheres or to their magnetic properties. METHODS/PRINCIPAL FINDINGS Here, we investigated iron localization in parasite eggs, specifically in the eggshells. We determined the magnetic properties of the eggs, studied the motion of eggs and egg-microsphere conjugates in magnetic fields and determined species specific affinity of parasite eggs to magnetic microspheres. Our study shows that iron is predominantly localized in pores in the eggshell. Parasite eggs showed distinct paramagnetic behaviour but they did not move in a magnetic field. Magnetic microspheres spontaneously bound to parasite eggs without the presence of a magnetic field. S. japonicum eggs had a significantly higher affinity to bind microspheres than S. mansoni eggs. CONCLUSIONS/SIGNIFICANCE Our results suggest that the interaction of magnetic microspheres and parasite eggs is unlikely to be magnetic in origin. Instead, the filamentous surface of the eggshells may be important in facilitating the binding. Modification of microsphere surface properties may therefore be a way to optimize magnetic fractionation of parasite eggs.
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Affiliation(s)
- Stephan Karl
- School of Physics, The University of Western Australia, Crawley, Western Australia, Australia.
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Cavalcanti MG, Silva LF, Peralta RHS, Barreto MGM, Peralta JM. Schistosomiasis in areas of low endemicity: a new era in diagnosis. Trends Parasitol 2013; 29:75-82. [PMID: 23290589 DOI: 10.1016/j.pt.2012.11.003] [Citation(s) in RCA: 78] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2012] [Revised: 11/13/2012] [Accepted: 11/26/2012] [Indexed: 01/02/2023]
Abstract
Parasitological detection of Schistosoma is the cornerstone of schistosomiasis diagnosis in areas of transmission worldwide. However, a steep decrease of sensitivity in low-endemicity areas (LEAs) compromises estimation of schistosomiasis. Despite the restricted utilization of molecular and immunodiagnostic techniques, recent improvements and advances have been contributing to change this scenario, especially in LEAs. Nonetheless, the main issue in a new era of diagnosis overcomes technical advances per se and relates to the loss of 'gold standards' in schistosomiasis diagnosis in LEAs. Here, we review and discuss the current role of molecular and immunodiagnostic methods in schistosomiasis management.
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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, RJ 21941-913, Brazil
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Yu Q, Yang H, Feng Y, Yang X, Zhu Y. Magnetic affinity enzyme-linked immunoassay based on recombinant 26 kDa glutathione-S-transferase for serological diagnosis of schistosomiasis japonica. Acta Trop 2012; 124:199-202. [PMID: 22940100 DOI: 10.1016/j.actatropica.2012.08.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2012] [Revised: 08/04/2012] [Accepted: 08/09/2012] [Indexed: 11/19/2022]
Abstract
Schistosomiasis remains a serious worldwide public health problem. Improving the diagnostic assay for surveillance and monitoring will contribute to hastening the possible elimination of the disease in endemic regions. Therefore, this study aims to develop magnetic affinity enzyme-linked immunoassay (MEIA) for serological diagnosis of schistosomiasis based on recombinant 26kDa glutathione-S-transferase of Schistosoma japonicum (rSj26GST). BALB/c mice infected with S. japonicum cercariae (40 per mouse) were used. After infecting for 6 weeks, the antibody was detected by MEIA. All of the infected mouse sera were effectively determined by MEIA. Compared with the enzyme-linked immunosorbent assay (ELISA), MEIA has a higher ratio of the mean positive value to the mean negative value (P/N) at the same dilution ratio (3.92 versus 2.66). MEIA was further applied for diagnosis of human schistosomiasis. Sera from 28 schistosomiasis-confirmed patients with low-intensity infection, 15 treated patients, and 20 non-endemic negative controls, were used to assess the assay. The results showed that MEIA and ELISA had similarity in positive detection rates. However, the higher P/N of MEIA was observed at the same dilution ratio. MEIA had high negative rate in detection of specific IgG in the treated patients. Moreover, there was no cross reaction with the sera of paragonimiasis patients. These results suggested that MEIA based on rSj26GST is a simple, rapid, convenient assay for the diagnosis of schistosomiasis.
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Affiliation(s)
- Qin Yu
- Department of Biochemistry and Molecular Biology, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China
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Xu B, Gordon CA, Hu W, McManus DP, Chen HG, Gray DJ, Ju C, Zeng XJ, Gobert GN, Ge J, Lan WM, Xie SY, Jiang WS, Ross AG, Acosta LP, Olveda R, Feng Z. A novel procedure for precise quantification of Schistosoma japonicum eggs in bovine feces. PLoS Negl Trop Dis 2012; 6:e1885. [PMID: 23166847 PMCID: PMC3499414 DOI: 10.1371/journal.pntd.0001885] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2012] [Accepted: 09/14/2012] [Indexed: 11/19/2022] Open
Abstract
Schistosomiasis japonica is a zoonosis with a number of mammalian species acting as reservoir hosts, including water buffaloes which can contribute up to 75% to human transmission in the People's Republic of China. Determining prevalence and intensity of Schistosoma japonicum in mammalian hosts is important for calculating transmission rates and determining environmental contamination. A new procedure, the formalin–ethyl acetate sedimentation-digestion (FEA–SD) technique, for increased visualization of S. japonicum eggs in bovine feces, is described that is an effective technique for identifying and quantifying S. japonicum eggs in fecal samples from naturally infected Chinese water buffaloes and from carabao (water buffalo) in the Philippines. The procedure involves filtration, sedimentation, potassium hydroxide digestion and centrifugation steps prior to microscopy. Bulk debris, including the dense cellulosic material present in bovine feces, often obscures schistosome eggs with the result that prevalence and infection intensity based on direct visualization cannot be made accurately. This technique removes nearly 70% of debris from the fecal samples and renders the remaining debris translucent. It allows improved microscopic visualization of S. japonicum eggs and provides an accurate quantitative method for the estimation of infection in bovines and other ruminant reservoir hosts. We show that the FEA-SD technique could be of considerable value if applied as a surveillance tool for animal reservoirs of S. japonicum, particularly in areas with low to high infection intensity, or where, following control efforts, there is suspected elimination of schistosomiasis japonica. Schistosomiasis japonica, a chronic human parasitic disease in the People's Republic of China, the Philippines and areas of Indonesia, is a zoonosis with over 40 different mammals, including a number of ruminants, that can act as reservoir hosts for the infection. Precise identification of the major infection reservoirs is important for the control of Schistosoma japonicum as their targeted treatment can prevent environmental contamination and transmission of the parasite, thus reducing the risk to humans. Current copro-parasitological techniques are generally unsatisfactory for identifying and quantifying S. japonicum eggs in ruminant feces due to the large volume of cellulosic debris present. The new approach we describe here, the FEA–SD technique, removes much of this material by sieving and centrifugation with ethyl actate and renders any remaining debris transparent by use of a potassium hydroxide (KOH) digestion, providing much improved visualization of eggs, enabling the collection of more accurate data on S. japonicum infection in ruminants. This new tool will be of particular value for monitoring schistosome prevalence and intensity in animal reservoirs in areas of the People's Republic of China that are heading toward schistosomiasis elimination.
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Affiliation(s)
- Bin Xu
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, People's Republic of China
| | - Catherine A. Gordon
- Molecular Parasitology Laboratory, Queensland Institute of Medical Research, Brisbane, Australia
- Infectious Disease Epidemiology Unit, School of Population Health, University of Queensland, Brisbane, Australia
- * E-mail: (CAG); (ZF)
| | - Wei Hu
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, People's Republic of China
| | - Donald P. McManus
- Molecular Parasitology Laboratory, Queensland Institute of Medical Research, Brisbane, Australia
| | - Hong-Gen Chen
- Jiangxi Provincial Institute of Parasitic Diseases Control, Nanchang, People's Republic of China
| | - Darren J. Gray
- Molecular Parasitology Laboratory, Queensland Institute of Medical Research, Brisbane, Australia
- Infectious Disease Epidemiology Unit, School of Population Health, University of Queensland, Brisbane, Australia
| | - Chuan Ju
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, People's Republic of China
| | - Xiao-Jun Zeng
- Jiangxi Provincial Institute of Parasitic Diseases Control, Nanchang, People's Republic of China
| | - Geoffrey N. Gobert
- Molecular Parasitology Laboratory, Queensland Institute of Medical Research, Brisbane, Australia
| | - Jun Ge
- Jiangxi Provincial Institute of Parasitic Diseases Control, Nanchang, People's Republic of China
| | - Wei-Ming Lan
- Jiangxi Provincial Institute of Parasitic Diseases Control, Nanchang, People's Republic of China
| | - Shu-Ying Xie
- Jiangxi Provincial Institute of Parasitic Diseases Control, Nanchang, People's Republic of China
| | - Wei-Sheng Jiang
- Jiangxi Provincial Institute of Parasitic Diseases Control, Nanchang, People's Republic of China
| | - Allen G. Ross
- Griffith Health Institute, Griffith University, Gold Coast, Australia
| | - Luz P. Acosta
- Research Institute of Tropical Medicine, Department of Immunology, Manila, Philippines
| | - Remigio Olveda
- Research Institute of Tropical Medicine, Department of Immunology, Manila, Philippines
| | - Zheng Feng
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Shanghai, People's Republic of China
- * E-mail: (CAG); (ZF)
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Pinheiro MCC, Carneiro TR, Hanemann ALDP, Oliveira SMD, Bezerra FSM. The combination of three faecal parasitological methods to improve the diagnosis of schistosomiasis mansoni in a low endemic setting in the state of Ceará, Brazil. Mem Inst Oswaldo Cruz 2012; 107:873-6. [DOI: 10.1590/s0074-02762012000700006] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2012] [Accepted: 06/01/2012] [Indexed: 11/21/2022] Open
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Zhao GH, Li J, Blair D, Li XY, Elsheikha HM, Lin RQ, Zou FC, Zhu XQ. Biotechnological advances in the diagnosis, species differentiation and phylogenetic analysis of Schistosoma spp. Biotechnol Adv 2012; 30:1381-9. [DOI: 10.1016/j.biotechadv.2012.02.008] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2011] [Revised: 01/08/2012] [Accepted: 02/08/2012] [Indexed: 11/26/2022]
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Yu Q, Yang H, Feng Y, Zhu Y, Yang X. Magnetic affinity enzyme-linked immunoassay for diagnosis of Schistosomiasis japonicum in persons with low-intensity infection. Am J Trop Med Hyg 2012; 87:689-93. [PMID: 22869635 DOI: 10.4269/ajtmh.2012.11-0716] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Most schistosome-endemic areas in China are characterized by low-intensity infections that are independent of prevalence. To establish an effective diagnostic method, we developed a magnetic affinity enzyme-linked immunoassay based on soluble egg antigens (SEA-MEIA) for diagnosing schistosomiasis in persons with low-intensity infection with Schistosoma japonicum by comparing it with a conventional enzyme-linked immunosorbent assay (ELISA). Our results showed that the SEA-MEIA had a higher sensitivity and greater precision in the diagnosis of low-intensity S. japonicum infections than the ELISA. In addition, when we used Pearson's correlation in associating SEA-MEIA with ELISA, a significant correlation existed between the two assays (r = 0.845, P < 0.001). Our data indicated that SEA-MEIA, with a higher sensitivity and greater ease of performance, would be valuable for diagnosis of schistosomiasis japonicum in persons with low-intensity infections.
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Affiliation(s)
- Qin Yu
- Department of Biochemistry and Molecular Biology, Tongji Medical College, Wuhan, People's Republic of China.
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40
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Caldeira K, Teixeira CF, Silveira MBD, Fries LCCD, Romanzini J, Bittencourt HR, Graeff-Teixeira C. Comparison of the Kato-Katz and Helmintex methods for the diagnosis of schistosomiasis in a low-intensity transmission focus in Bandeirantes, Paraná, southern Brazil. Mem Inst Oswaldo Cruz 2012; 107:690-2. [DOI: 10.1590/s0074-02762012000500019] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2011] [Accepted: 02/29/2012] [Indexed: 11/22/2022] Open
Affiliation(s)
- Kerlen Caldeira
- Pontifícia Universidade Católica do Rio Grande do Sul, Brasil; Pontifícia Universidade Católica do Rio Grande do Sul, Brasil
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Risk factors for helminth infections in a rural and a peri-urban setting of the Dongting Lake area, People's Republic of China. Int J Parasitol 2011; 41:1165-73. [PMID: 21854780 DOI: 10.1016/j.ijpara.2011.07.006] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2010] [Revised: 07/01/2011] [Accepted: 07/04/2011] [Indexed: 12/20/2022]
Abstract
Schistosomiasis japonica and soil-transmitted helminthiasis are endemic parasitic diseases in the People's Republic of China (PR China). As very few studies have reported on the distribution and interaction of multiple species helminth infections, we carried out a comparative study of households in a rural village and a peri-urban setting in the Dongting Lake area of Hunan province in November and December 2006 to determine the extent of single and multiple species infections, the underlying risk factors for infection, and the relationships with clinical manifestations and self-reported morbidity. In each household, stool samples were collected and subjected to the Kato-Katz method for identifying Schistosoma japonicum, Ascaris lumbricoides, hookworm and Trichuris trichiura infections. Clinical examinations were performed and questionnaire surveys conducted at both household and individual subject levels. Complete parasitological, clinical and questionnaire data were obtained for 1,298 inhabitants of the two settings. The overall prevalences of single infections of S. japonicum, A. lumbricoides, hookworm and T. trichiura were 6.5%, 5.5%, 3.0% and 0.8%, respectively; the majority of the infections were of light intensity. We found significant negative associations between wealth and infections with S. japonicum and A. lumbricoides. Clinical manifestations of splenomegaly, hepatomegaly and anaemia were prevalent (9.0%, 3.7% and 10.9%, respectively), the latter two being significantly (P<0.05) associated with schistosomiasis. Self-reported symptoms were more common among females but there was considerable under-reporting in both sexes when relying only on spontaneous recall. Our findings may guide the design and targeting of a more equitable, comprehensive and integrated parasitic disease control programme in Hunan province and in other areas of PR China.
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Ross AG, McManus DP, Farrar J, Hunstman RJ, Gray DJ, Li YS. Neuroschistosomiasis. J Neurol 2011; 259:22-32. [PMID: 21674195 DOI: 10.1007/s00415-011-6133-7] [Citation(s) in RCA: 62] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2011] [Revised: 05/29/2011] [Accepted: 05/30/2011] [Indexed: 01/06/2023]
Abstract
Schistosomiasis (bilharzia) is a neglected tropical disease caused by digenetic trematode platyhelminths of the genus Schistosoma. Neuroschistosomiasis is one of the most severe clinical outcomes associated with schistosome infection. Neurological complications early during the course of infection are thought to occur through in situ egg deposition following aberrant migration of adult worms to the brain or spinal cord. The presence of eggs in the CNS induces a cell-mediated Th2-driven periovular granulomatous reaction. The mass effect of thousands of eggs and the large granulomas concentrated within the brain or spinal cord explain the signs and symptoms of increased intracranial pressure, myelopathy, radiculopathy and subsequent clinical sequelae. Myelopathy (acute transverse myelitis and subacute myeloradiculopathy) of the lumbosacral region is the most common neurological manifestation of S. mansoni or S. haematobium infection, whereas acute encephalitis of the cortex, subcortical white matter, basal ganglia or internal capsule is typical of S. japonicum infection. Cerebral complications include encephalopathy with headache, visual impairment, delirium, seizures, motor deficits and ataxia, whereas spinal symptoms include lumbar pain, lower limb radicular pain, muscle weakness, sensory loss and bladder dysfunction. The finding of eggs in the stool or a positive serology, provides supportive but not direct evidence of neuroschistosomiasis. A definitive diagnosis can only be made with histopathological study showing Schistosoma eggs and granulomas. Schistosomicidal drugs (notably praziquantel), steroids and surgery are currently used for the treatment of neuroschistosomiasis. During the 'acute phase' of the disease, neuroschistosomiasis is treated with corticosteroids which are augmented with a course of praziquantel once female worm ovipositioning commences. Surgery should be reserved for special cases such as in those with evidence of medullary compression and in those who deteriorate despite clinical management.
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Affiliation(s)
- Allen G Ross
- School of Public Health, Griffith University, Meadowbrook, QLD, Australia.
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Schistosomiasis in the People's Republic of China: the era of the Three Gorges Dam. Clin Microbiol Rev 2010; 23:442-66. [PMID: 20375361 DOI: 10.1128/cmr.00044-09] [Citation(s) in RCA: 166] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The potential impact of the Three Gorges Dam (TGD) on schistosomiasis transmission in China has invoked considerable global concern. The TGD will result in changes in the water level and silt deposition downstream, favoring the reproduction of Oncomelania snails. Combined with blockages of the Yangtze River's tributaries, these changes will increase the schistosomiasis transmission season within the marshlands along the middle and lower reaches of the Yangtze River. The changing schistosome transmission dynamics necessitate a comprehensive strategy to control schistosomiasis. This review discusses aspects of the epidemiology and transmission of Schistosoma japonicum in China and considers the pathology, clinical outcomes, diagnosis, treatment, immunobiology, and genetics of schistosomiasis japonica together with an overview of current progress in vaccine development, all of which will have an impact on future control efforts. The use of synchronous praziquantel (PZQ) chemotherapy for humans and domestic animals is only temporarily effective, as schistosome reinfection occurs rapidly. Drug delivery requires a substantial infrastructure to regularly cover all parts of an area of endemicity. This makes chemotherapy expensive and, as compliance is often low, a less than satisfactory control option. There is increasing disquiet about the possibility that PZQ-resistant schistosomes will develop. Consequently, as mathematical modeling predicts, vaccine strategies represent an essential component in the future control of schistosomiasis in China. With the inclusion of focal mollusciciding, improvements in sanitation, and health education into the control scenario, China's target of reducing the level of schistosome infection to less than 1% by 2015 may be achievable.
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Schmidt PJ, Emelko MB, Reilly PM. Quantification of analytical recovery in particle and microorganism enumeration methods. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2010; 44:1705-1712. [PMID: 20108894 DOI: 10.1021/es902237f] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Enumeration-based methods that are often used to quantify microorganisms and microscopic discrete particles in aqueous systems may include losses during sample processing or errors in counting. Analytical recovery (the capacity of the analyst to successfully count each microorganism or particle of interest in a sample using a specific enumeration method) is frequently assessed by enumerating samples that are seeded with known quantities of the microorganisms or particles. Probabilistic models were developed to account for the impacts of seeding and analytical error on recovery data, and probability intervals, obtained by Monte Carlo simulation, were used to evaluate recovery experiment design (i.e., seeding method, number of seeded particles, and number of samples). The method of moments, maximum likelihood estimation, and credible intervals were used to statistically analyze recovery experiment results. Low or uncertain numbers of seeded particles were found to result in variability in recovery data that was not due to analytical recovery, and should be avoided if possible. This additional variability was found to reduce the reproducibility of experimental results and necessitated the use of statistical analysis techniques, such as maximum likelihood estimation using probabilistic models that account for the impacts of sampling and analytical error in recovery data.
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Affiliation(s)
- Philip J Schmidt
- Department of Civil and Environmental Engineering and Department of Chemical Engineering, University of Waterloo, Waterloo, Ontario N2L 3G1, Canada
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Emelko MB, Schmidt PJ, Reilly PM. Particle and microorganism enumeration data: enabling quantitative rigor and judicious interpretation. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2010; 44:1720-1727. [PMID: 20121082 DOI: 10.1021/es902382a] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Many of the methods routinely used to quantify microscopic discrete particles and microorganisms are based on enumeration, yet these methods are often known to yield highly variable results. This variability arises from sampling error and variations in analytical recovery (i.e., losses during sample processing and errors in counting), and leads to considerable uncertainty in particle concentration or log(10)-reduction estimates. Conventional statistical analysis techniques based on the t-distribution are often inappropriate, however, because the data must be corrected for mean analytical recovery and may not be normally distributed with equal variance. Furthermore, these statistical approaches do not include subjective knowledge about the stochastic processes involved in enumeration. Here we develop two probabilistic models to account for the random errors in enumeration data, with emphasis on sampling error assumptions, nonconstant analytical recovery, and discussion of counting errors. These models are implemented using Bayes' theorem to yield posterior distributions (by numerical integration or Gibbs sampling) that completely quantify the uncertainty in particle concentration or log(10)-reduction given the experimental data and parameters that describe variability in analytical recovery. The presented approach can easily be implemented to correctly and rigorously analyze single or replicate (bio)particle enumeration data.
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Affiliation(s)
- Monica B Emelko
- Department of Civil and Environmental Engineering and Department of Chemical Engineering, University of Waterloo, Waterloo, Ontario N2L 3G1, Canada.
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46
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Coelho PMZ, Jurberg AD, Oliveira AA, Katz N. Use of a saline gradient for the diagnosis of schistosomiasis. Mem Inst Oswaldo Cruz 2010; 104:720-3. [PMID: 19820832 DOI: 10.1590/s0074-02762009000500010] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2009] [Accepted: 06/04/2009] [Indexed: 11/22/2022] Open
Abstract
The development of novel methods for parasitological diagnosis that are both highly sensitive and low in cost has been strongly recommended by the World Health Organization. In this study, a new technique for diagnosis of schistosomiasis mansoni is proposed based on the differential sedimentation of eggs when subjected to a slow continuous flux of 3% saline solution through a porous plaque. This influx suspends low-density faecal material, effectively cleaning the sample. The remaining sediment covering the porous plaque surface is then transferred to a glass slide and examined under a bright field microscope. Twelve Kato-Katz slides were used for comparison in the present study. Our results suggest that the saline gradient method detects a significantly higher number of eggs than the 12 Kato-Katz slides (p < 0.0001). We also found microscopic inspection to be quicker and easier with our newly described method. After cleaning the sample, the obtained sediment can also be conserved in a 10% formaldehyde solution and examined for at least 45 days later without statistically significant egg count differences.
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Affiliation(s)
- Paulo Marcos Z Coelho
- Laboratório de Esquistossomose, Centro de Pesquisas René Rachou-Fiocruz, Av. Augusto de Lima 1715, Belo Horizonte, MG, Brazil.
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Affiliation(s)
- Malcolm K Jones
- Australian Centre for International and Tropical Health, Queensland Institute of Medical Research, Herston, Queensland, Australia.
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