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Carvalho RGD, Pinheiro MCC, Damasceno Morais FJ, Galvão RLDF, Barbosa L, Souza Sá SLC, Scherr TF, Bezerra FSDM. Immunochromatographic POC-CCA Test for the diagnosis of intestinal schistosomiasis in a high endemic region in Brazil: Differences in the interpretation of results. Acta Trop 2024; 254:107181. [PMID: 38503365 DOI: 10.1016/j.actatropica.2024.107181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 03/05/2024] [Accepted: 03/07/2024] [Indexed: 03/21/2024]
Abstract
The POC-CCA test is subject to variations in reading interpretations depending on the intensity of its results, and trace test reading have implications for determining prevalence. The aim of this study was to assess whether the readings obtained from the POC-CCA tests, conducted using a semi-quantitative scale (the G-score classification for test determination), exhibited concurrence with the direct visual interpretation (positive, negative, or trace) performed by two distinct analysts, using photographs from previously performed POC-CCA test carried out in the municipality of Maruim, in the state of Sergipe-Brazil, a region of high endemicity. The devices used to read the photographs were smartphones, so as to simulate field usage, and a desktop, a tool with higher image quality that would help the researchers in the evaluation and establishment of the final result at a later. In direct visual interpretation of the POC-CCA photographs, the most discordant results occurred in the identification of the trace response (T). The Kappa index established for the direct visual interpretation between the two analysts, in which T is considered as positive, in the desktop was κ=0.826 and in the smartphone, κ=0.950. When we use the G-score as a reading standardization technique and classify the results according to the manufacturer, with trace being evaluated as positive, the highest level of agreement was obtained. Some disagreement remains between the direct visual interpretation and the G-score when performed on the desktop, with more individuals being classified as negative in the direct visual interpretation, by both analysts. However, this result was not statistically significant. The use of the G-score scale proved to be an excellent tool for standardizing the readings and classifying the results according to the semi-quantitative scale showed greater concordance of results both among analysts and among the different devices used to view the photographs.
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Affiliation(s)
- Roberta Gomes de Carvalho
- Laboratory of Parasitology and Mollusc Biology, Department of Clinical Analysis and Toxicology, Federal University of Ceará, Rua Pastor Samuel Munguba 1210, Fortaleza, Ceará 60.430-272, Brazil
| | - Marta Cristhiany Cunha Pinheiro
- Laboratory of Parasitology and Mollusc Biology, Department of Clinical Analysis and Toxicology, Federal University of Ceará, Rua Pastor Samuel Munguba 1210, Fortaleza, Ceará 60.430-272, Brazil
| | - Francisca Janaína Damasceno Morais
- Laboratory of Parasitology and Mollusc Biology, Department of Clinical Analysis and Toxicology, Federal University of Ceará, Rua Pastor Samuel Munguba 1210, Fortaleza, Ceará 60.430-272, Brazil; Pathology Postgraduate Program, Department of Pathology and Legal Medicine, School of Medicine, Universidade Federal do Ceará, Rua Monsenhor Furtado s/n, Fortaleza, Ceará, 60.441-750, Brazil
| | - Rosangela Lima de Freitas Galvão
- Laboratory of Parasitology and Mollusc Biology, Department of Clinical Analysis and Toxicology, Federal University of Ceará, Rua Pastor Samuel Munguba 1210, Fortaleza, Ceará 60.430-272, Brazil; Pathology Postgraduate Program, Department of Pathology and Legal Medicine, School of Medicine, Universidade Federal do Ceará, Rua Monsenhor Furtado s/n, Fortaleza, Ceará, 60.441-750, Brazil
| | - Luciene Barbosa
- Parasitology and Tropical Entomology Laboratory, Department of Morphology, Federal University of Sergipe, Avenida Marechal Rondon Jardim s/n, São Cristóvão, Sergipe, 49.100-000, Brazil
| | - Sidney Lourdes Cesar Souza Sá
- Epidemiological Monitoring. State's Office for Health of Sergipe. Avenida Augusto Franco 3150, Aracaju, Sergipe 49097-670, Brazil
| | - Thomas Foster Scherr
- Department of Chemistry, Vanderbilt University, 1234 Stevenson Center Lane, Nashville, Tennessee 37240, USA
| | - Fernando Schemelzer de Moraes Bezerra
- Laboratory of Parasitology and Mollusc Biology, Department of Clinical Analysis and Toxicology, Federal University of Ceará, Rua Pastor Samuel Munguba 1210, Fortaleza, Ceará 60.430-272, Brazil; Pathology Postgraduate Program, Department of Pathology and Legal Medicine, School of Medicine, Universidade Federal do Ceará, Rua Monsenhor Furtado s/n, Fortaleza, Ceará, 60.441-750, Brazil; Medical Sciences Postgraduate Program, Department of Internal Medicine, School of Medicine, Universidade Federal do Ceará, Rua Monsenhor Furtado s/n Fortaleza, Ceará, 60.441-75, Brazil.
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Mengsitu B, Liyew EF, Chernet M, Tasew G, Gomez SR, Maddren R, Collyer B, Anjulo U, Tamiru A, Forbes K, Mehari Z, Deribe K, Yadeta T, Salasibew M, Tollera G, Anderson R. Progress in controlling the transmission of schistosome parasites in Southern Ethiopia: the Geshiyaro Project in the Wolaita Zone. Parasit Vectors 2024; 17:113. [PMID: 38448997 PMCID: PMC10919034 DOI: 10.1186/s13071-024-06156-1] [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: 09/04/2023] [Accepted: 01/22/2024] [Indexed: 03/08/2024] Open
Abstract
BACKGROUND This paper describes changes in the prevalence and intensity of schistosome parasite infections in a project integrating mass drug administration (MDA), water, sanitation, and hygiene (WaSH), and behavioral change interventions. METHODS The Geshiyaro Project comprises three intervention arms. Arm 1 is subdivided into "Arm 1 pilot" (one district) and Arm 1 (four other districts), both receiving integrated community-wide MDA with intensive WaSH interventions. Arm 2 involves 17 districts with community-wide MDA interventions, while Arm 3 serves as a control with school-based MDA interventions in three districts. A total of 150 individuals, stratified by age group, were randomly selected from each of the 45 sentinel sites. Arm sizes were 584 (Arm 1 pilot), 1636 (Arm 1), 2203 (Arm 2), and 2238 (Arm 3). Statistical tests were employed to compare infection prevalence and intensity across the different arms. RESULTS The prevalence of schistosome parasite infection ranged from 0% to 2.6% and from 1.7% to 25.7% across districts, employing the Kato-Katz (KK) and point-of-care circulating cathodic antigen (POC-CCA) diagnostics, respectively. The mean infection intensity level showed no marked difference between baseline and follow-up surveys when measured by KK, except in Arm 2 (t = 6.89, P < 0.0001). Infection prevalence decreased significantly in Arm 1 (t = 8.62, P < 0.0001), Arm 2 (t = 6.94, P < 0.0001), and Arm 3 (t = 8.83, P < 0.0001), but not in Arm 1 pilot (t = 1.69, P = 0.09) by POC-CCA, when trace was considered positive. The decrease was significant only in Arm 1 (t = 3.28, P = 0.0001) and Arm 2 (t = 7.62, P < 0.0001) when the trace was considered negative in POC-CCA. Arm 2 demonstrated a significant difference in difference (DID) compared to the control group, Arm 3, regardless of whether trace in POC-CCA was considered positive (DID = 3.9%, df = 8780, P = 0.025) or negative (DID = -5.2, df = 8780, P = 0.0004). CONCLUSIONS The prevalence of schistosomiasis was low when employing the KK diagnostic but moderate in some locations by the POC-CCA diagnostic. The infection level had decreased across all arms of the Geshiyaro study at mid-term of the 7-year project, but further efforts are needed to reduce the rate of parasite transmission based on the POC-CCA diagnostic scores.
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Affiliation(s)
- Birhan Mengsitu
- London Centre for Neglected Tropical Disease Research, Department of Infectious Disease Epidemiology, Faculty of Medicine, St Marys Campus, Imperial College London, London, UK.
| | - Ewnetu Firdawek Liyew
- Bacterial, Parasitic and Zoonotic Disease Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Melkie Chernet
- Bacterial, Parasitic and Zoonotic Disease Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Geremew Tasew
- Bacterial, Parasitic and Zoonotic Disease Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Santiago Rayment Gomez
- London Centre for Neglected Tropical Disease Research, Department of Infectious Disease Epidemiology, Faculty of Medicine, St Marys Campus, Imperial College London, London, UK
| | - Rosie Maddren
- London Centre for Neglected Tropical Disease Research, Department of Infectious Disease Epidemiology, Faculty of Medicine, St Marys Campus, Imperial College London, London, UK
| | - Benjamin Collyer
- London Centre for Neglected Tropical Disease Research, Department of Infectious Disease Epidemiology, Faculty of Medicine, St Marys Campus, Imperial College London, London, UK
| | - Ufaysa Anjulo
- Disease Prevention and Health Promotion Core Process, Ministry of Health, Addis Ababa, Ethiopia
| | - Adugna Tamiru
- Disease Prevention and Health Promotion Core Process, Ministry of Health, Addis Ababa, Ethiopia
| | - Kathryn Forbes
- London Centre for Neglected Tropical Disease Research, Department of Infectious Disease Epidemiology, Faculty of Medicine, St Marys Campus, Imperial College London, London, UK
| | | | | | | | | | - Getachew Tollera
- Bacterial, Parasitic and Zoonotic Disease Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Roy Anderson
- London Centre for Neglected Tropical Disease Research, Department of Infectious Disease Epidemiology, Faculty of Medicine, St Marys Campus, Imperial College London, London, UK
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Phillips AE, Ower AK, Mekete K, Liyew EF, Maddren R, Mengistu B, Anjulo U, Chernet M, Dunn JC, Mohammed H, Belay H, Gidey B, Tasew G, Tadesse G, Salasibew M, Tollera G, Anderson R. Baseline soil-transmitted helminth and schistosome infection in the Geshiyaro project, Ethiopia: A unique transmission interruption project using biometric fingerprinting for longitudinal individual analysis. PLoS Negl Trop Dis 2023; 17:e0011589. [PMID: 37851666 PMCID: PMC10615263 DOI: 10.1371/journal.pntd.0011589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 10/30/2023] [Accepted: 09/07/2023] [Indexed: 10/20/2023] Open
Abstract
BACKGROUND The Geshiyaro project aims to assess the feasibility of interrupting transmission of soil-transmitted helminths (STH) and schistosome (SCH) infection in the Wolaita zone of southern Ethiopia through high coverage community-wide mass drug administration (MDA), in combination with improved water, sanitation, and hygiene services and behaviour change communication delivered through the existing health care infrastructure. To accurately measure treatment coverage a population census was conducted enrolling individuals with biometric fingerprinting and barcoded ID cards. This paper details the baseline census and parasitology surveys conducted before the start of any interventions. METHODS The census was conducted in five of the 15 Wolaita districts between October 2018 and December 2019, enrolling all consenting participants from every household. Simultaneously, a cross-sectional parasitology survey was conducted in 130 out of 361 randomly selected communities from all 15 districts, with 100 individuals across all age groups (infant to adult) per community providing stool and urine for analysis by duplicate Kato-Katz and a point-of-care circulating cathodic antigen (POC-CCA) to test for Schistosoma mansoni and STH, and microhaematuria and urine filtration for Schistosoma haematobium. Of the 130 communities, 30 were randomly selected for annual, longitudinal parasitological monitoring, with 150 randomly selected individuals from infant to adult providing two days of stool and urine samples for analysis by the same diagnostic tests per community. RESULTS In total 97,919 households participated in the baseline census enrolling 466,071 individuals, with parasitological data obtained from 10,785 people. At baseline, 15.5% were infected with at least one STH species, with Ascaris lumbricoides (9.5%), followed by hookworm (7.2%) and Trichuris trichiura (1.8%). Substantial heterogeneity in STH prevalence was observed between communities ranging from 0% to 61% where most infections were low intensity. Schistosoma mansoni infection was the dominant schistosome infection (0.85% by Kato-Katz and 13.3% by POC-CCA trace negative and 21.5% trace positive), with few Schistosoma haematobium infections identified (2.77% haematuria positive and 0.13% positive by urine filtration). CONCLUSIONS While the national control program in Ethiopia has made good progress in reducing prevalence of STH and SCH in Wolaita since it was launched in 2015, there remain areas of persistent infection suggesting the existence of environmental or behavioural risk factors that contribute to ongoing transmission. This project aims to identify the most efficient intervention strategies to reduce community burden and reach interruption of transmission.
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Affiliation(s)
- Anna E. Phillips
- MRC Centre for Global Infectious Disease Analysis, Imperial College London, St Mary’s Campus, London, United Kingdom
- London Centre for Neglected Tropical Disease Research, London, United Kingdom
| | - Alison K. Ower
- MRC Centre for Global Infectious Disease Analysis, Imperial College London, St Mary’s Campus, London, United Kingdom
- London Centre for Neglected Tropical Disease Research, London, United Kingdom
| | | | | | - Rosie Maddren
- MRC Centre for Global Infectious Disease Analysis, Imperial College London, St Mary’s Campus, London, United Kingdom
| | - Birhan Mengistu
- MRC Centre for Global Infectious Disease Analysis, Imperial College London, St Mary’s Campus, London, United Kingdom
- London Centre for Neglected Tropical Disease Research, London, United Kingdom
| | - Ufaysa Anjulo
- Children’s Investment Fund Foundation, London, United Kingdom
| | - Melkie Chernet
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Julia C. Dunn
- MRC Centre for Global Infectious Disease Analysis, Imperial College London, St Mary’s Campus, London, United Kingdom
- London Centre for Neglected Tropical Disease Research, London, United Kingdom
| | | | - Habtamu Belay
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | | | - Geremew Tasew
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | | | | | | | - Roy Anderson
- MRC Centre for Global Infectious Disease Analysis, Imperial College London, St Mary’s Campus, London, United Kingdom
- London Centre for Neglected Tropical Disease Research, London, United Kingdom
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Bartlett AW, Mendes EP, Dahmash L, Palmeirim MS, de Almeida MC, Peliganga LB, Lufunda LMM, Direito A, Ramirez J, Mwinzi PN, Lopes S, Vaz Nery S. School-based preventive chemotherapy program for schistosomiasis and soil-transmitted helminth control in Angola: 6-year impact assessment. PLoS Negl Trop Dis 2023; 17:e0010849. [PMID: 37196040 DOI: 10.1371/journal.pntd.0010849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 05/30/2023] [Accepted: 05/02/2023] [Indexed: 05/19/2023] Open
Abstract
BACKGROUND A school preventive chemotherapy (PC) program for soil-transmitted helminths (STHs) and schistosomiasis has operated in Huambo, Uige and Zaire provinces, Angola, since 2013 and 2014, respectively; complemented by a school water, sanitation and hygiene (WASH) program in a subset of schools from 2016. Conducted in 2021, this is the first impact assessment of the school program for the control of schistosomiasis and STHs. METHODOLOGY/PRINCIPAL FINDINGS A two-stage cluster design was used to select schools and schoolchildren for parasitological and WASH surveys. The rapid diagnostic tests (RDTs), point of care circulating cathodic antigen (POC-CCA) and Hemastix, were used to estimate Schistosoma mansoni and Schistosoma haematobium prevalence, respectively. Kato Katz was used to detect STHs, and quantify STH and S. mansoni infections. Urine filtration was used to quantify S. haematobium infections. Prevalence, infection intensity, relative prevalence reduction and egg reduction rates were calculated for schistosomiasis and STHs. Cohen's Kappa co-efficient was used to assess agreement between RDTs and microscopy. Chi-square or Fisher's exact test was used to compare WASH indicators in WASH-supported and WASH-unsupported schools. Overall, 17,880 schoolchildren (599 schools) and 6,461 schoolchildren (214 schools) participated in the schistosomiasis and STH surveys, respectively. Prevalence of any schistosomiasis in Huambo was 29.6%, Uige 35.4%, and Zaire 28.2%. Relative reduction in schistosomiasis prevalence from 2014 for Huambo was 18.8% (95% confidence interval (CI) 8.6, 29.0), Uige -92.3% (95%CI -162.2, -58.3), and Zaire -14.0% (95%CI -48.6, 20.6). Prevalence of any STH in Huambo was 16.3%, Uige 65.1%, and Zaire 28.2%. Relative reduction in STH prevalence for Huambo was -28.4% (95%CI -92.1, 35.2), Uige -10.7% (95%CI -30.2, 8.8), and Zaire -20.9% (95%CI -79.5, 37.8). A higher proportion of WASH-supported schools had improved water sources, and toilet and handwashing facilities compared to WASH-unsupported schools. CONCLUSIONS/SIGNIFICANCE The limited impact this school program has had in controlling schistosomiasis and STHs identifies the need for a comprehensive understanding of individual, community, and environmental factors associated with transmission, and consideration for a community-wide control program.
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Affiliation(s)
- Adam W Bartlett
- Kirby Institute, University of New South Wales, Sydney, Australia
| | - Elsa P Mendes
- National Directorate of Public Health, Ministry of Health, Luanda, Angola
| | | | - Marta S Palmeirim
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Maria C de Almeida
- National Directorate of Public Health, Ministry of Health, Luanda, Angola
| | - Luis B Peliganga
- National Directorate of Public Health, Ministry of Health, Luanda, Angola
| | | | | | | | - Pauline N Mwinzi
- Expanded Special Project for Elimination of Neglected Tropical Diseases, Brazzaville, Congo
| | | | - Susana Vaz Nery
- Kirby Institute, University of New South Wales, Sydney, Australia
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Elmehy DA, Elmansory BM, Gamea GA, Abdelhai DI, Abd-Elsalam SM, Salamah AM, Ata DS, Mahmoud EF, Ibrahim HA, Salama AM. Parasitic infections as potential risk factors for attention deficit hyperactivity disorder (ADHD) in children. J Parasit Dis 2023; 47:82-92. [PMID: 36910322 PMCID: PMC9998788 DOI: 10.1007/s12639-022-01542-x] [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: 08/21/2022] [Accepted: 10/12/2022] [Indexed: 11/27/2022] Open
Abstract
Attention deficit hyperactivity disorder (ADHD) represents a mysterious neuropsychiatric alarming concern due to indefinite etiopathogenesis among children. Notably, the studies which investigated the correlation between ADHD and parasitic infections are insufficient. Therefore, this research aimed to assess the correlation between ADHD and some tissue dwelling and intestinal parasitic infections in children. The study was conducted on 200 children, including 100 children suffering from ADHD (Group I) and 100 healthy children as a control group (Group II). All caregivers fulfilled predesigned sociodemographic form and Conners parent rating scale (CPRS-48) questionnaire. Blood samples were collected to determine hemoglobin level as well as relative eosinophilic count. The presence of anti-Toxoplasma IgG and anti-Toxocara IgG in serum by Enzyme-Linked Immunosorbent Assay (ELISA) was further investigated. Also, micronutrients as zinc, iron, and copper levels were measured. Schistosoma antigen was investigated in urine samples. Stool samples were subjected to direct wet smear, concentration technique and modified Ziehl-Neelsen (MZN) staining for coccidian parasites detection. Cryptosporidium parvum, Giardia lamblia and Entamoeba histolytica antigens were investigated in stool samples. Group I expressed more liability to sociodemographic risk factors, decreased levels of Hb, iron, zinc, and copper with statistically significant difference (P < 0.001). Comparison between Group I and Group II regarding the detected parasitic infections exhibited statistically significant difference except Schistosoma antigen positivity which expressed no statistical significance. The present study concluded that the parasitic infections with their consequences are potential risk factors in children with ADHD indicating that their early diagnosis and treatment may help in ADHD prevention.
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Affiliation(s)
- Dalia A. Elmehy
- Department of Medical Parasitology, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Basma M. Elmansory
- Department of Medical Parasitology, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Ghada A. Gamea
- Department of Medical Parasitology, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Dina I. Abdelhai
- Department of Clinical Pathology, Faculty of Medicine, Tanta University, Tanta, Egypt
| | | | - Abeer M. Salamah
- Department of Pediatrics, Faculty of Medicine, Kafr El Shiekh University, Kafr El Shiekh, Egypt
| | - Dina S. Ata
- Department of Pediatrics, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Eman F. Mahmoud
- Department of Physiology, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Hoda A. Ibrahim
- Department of Medical Biochemistry, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Amina M. Salama
- Department of Medical Parasitology, Faculty of Medicine, Tanta University, Tanta, Egypt
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Colley DG, Ramzy RMR, Maganga J, Kinung'hi S, Odiere MR, Musuva RM, Campbell CH. The POC-CCA assay for detection of Schistosoma mansoni infection needs standardization in production and proper quality control to be reliable. Acta Trop 2023; 238:106795. [PMID: 36539024 DOI: 10.1016/j.actatropica.2022.106795] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 12/07/2022] [Accepted: 12/11/2022] [Indexed: 12/23/2022]
Affiliation(s)
- Daniel G Colley
- Schistosomiasis Consortium for Operational Research and Evaluation (SCORE), Center for Tropical and Emerging Global Diseases, University of Georgia, Athens, Georgia; Department of Microbiology, University of Georgia, Athens, Georgia.
| | - Reda M R Ramzy
- National Nutrition Institute, General Organization for Teaching Hospitals and Institutes, Cairo, Egypt
| | - Jane Maganga
- National Institute for Medical Research (NIMR), Mwanza Centre, Mwanza, Tanzania
| | - Safari Kinung'hi
- National Institute for Medical Research (NIMR), Mwanza Centre, Mwanza, Tanzania
| | - Maurice R Odiere
- Kenya Medical Research Institute (KEMRI), Centre for Global Health Research (CGHR), Kisumu, Kenya
| | - Rosemary M Musuva
- Kenya Medical Research Institute (KEMRI), Centre for Global Health Research (CGHR), Kisumu, Kenya
| | - Carl H Campbell
- Schistosomiasis Consortium for Operational Research and Evaluation (SCORE), Center for Tropical and Emerging Global Diseases, University of Georgia, Athens, Georgia
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Mulindwa J, Namulondo J, Kitibwa A, Nassuuna J, Nyangiri OA, Kimuda MP, Boobo A, Nerima B, Busingye F, Candia R, Namukuta A, Ssenyonga R, Ukumu N, Ajal P, Adriko M, Noyes H, de Dood CJ, Corstjens PLAM, van Dam GJ, Elliott AM, Matovu E. High prevalence of Schistosoma mansoni infection and stunting among school age children in communities along the Albert-Nile, Northern Uganda: A cross sectional study. PLoS Negl Trop Dis 2022; 16:e0010570. [PMID: 35895705 PMCID: PMC9359559 DOI: 10.1371/journal.pntd.0010570] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 08/08/2022] [Accepted: 06/08/2022] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Knowing the prevalence of schistosomiasis is key to informing programmes to control and eliminate the disease as a public health problem. It is also important to understand the impact of infection on child growth and development in order to allocate appropriate resources and effort to the control of the disease. METHODS We conducted a survey to estimate the prevalence of schistosomiasis among school aged children in villages along the Albert-Nile shore line in the district of Pakwach, North Western Uganda. A total of 914 children aged between 10-15 years were screened for Schistosoma mansoni using the POC-CCA and Kato Katz (KK) techniques. The infection intensities were assessed by POC-CCA and KK as well as CAA tests. The KK intensities were also correlated with POC-CCA and with CAA intensity. Anthropometric measurements were also taken and multivariate analysis was carried out to investigate their association with infection status. RESULTS The prevalence of schistosomiasis using the POC-CCA diagnostic test was estimated at 85% (95% CI: 83-87), being highest amongst children living closer to the Albert-Nile shoreline. Visual scoring of the POC-CCA results was more sensitive than the Kato Katz test and was positively correlated with the quantified infection intensities by the CAA test. The majority of the children were underweight (BMI<18.5), and most notably, boys had significantly lower height for age (stunting) than girls in the same age range (p < 0.0001), but this was not directly associated with S. mansoni infection. CONCLUSION High prevalence of S. mansoni infection in the region calls for more frequent mass drug administration with praziquantel. We observed high levels of stunting which was not associated with schistosomiasis. There is a need for improved nutrition among the children in the area.
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Affiliation(s)
- Julius Mulindwa
- Department of Biochemistry and Sports Sciences, College of Natural Sciences, Makerere University, Kampala, Uganda
| | - Joyce Namulondo
- Department of Biotechnical and Diagnostic Sciences, College of Veterinary Medicine Animal Resources and Biosecurity, Makerere University, Kampala, Uganda
| | - Anna Kitibwa
- Department of Biotechnical and Diagnostic Sciences, College of Veterinary Medicine Animal Resources and Biosecurity, Makerere University, Kampala, Uganda
| | - Jacent Nassuuna
- Medical Research Council/Uganda Virus Research Institute and London School of Hygiene & Tropical Medicine Uganda Research Unit, Entebbe, Uganda
| | - Oscar Asanya Nyangiri
- Department of Biotechnical and Diagnostic Sciences, College of Veterinary Medicine Animal Resources and Biosecurity, Makerere University, Kampala, Uganda
| | - Magambo Phillip Kimuda
- Department of Biotechnical and Diagnostic Sciences, College of Veterinary Medicine Animal Resources and Biosecurity, Makerere University, Kampala, Uganda
| | - Alex Boobo
- Department of Biotechnical and Diagnostic Sciences, College of Veterinary Medicine Animal Resources and Biosecurity, Makerere University, Kampala, Uganda
| | - Barbara Nerima
- Department of Biochemistry and Sports Sciences, College of Natural Sciences, Makerere University, Kampala, Uganda
| | - Fred Busingye
- Vector Borne & NTD Control Division, Ministry of Health, Kampala, Uganda
| | - Rowel Candia
- Vector Borne & NTD Control Division, Ministry of Health, Kampala, Uganda
| | - Annet Namukuta
- Vector Borne & NTD Control Division, Ministry of Health, Kampala, Uganda
| | - Ronald Ssenyonga
- Department of Epidemiology and Biostatistics, School of Public Health, Makerere University, Kampala, Uganda
| | - Noah Ukumu
- Pakwach District Local Government, District Health Office, Pakwach, Uganda
| | - Paul Ajal
- Pakwach District Local Government, District Health Office, Pakwach, Uganda
| | - Moses Adriko
- Vector Borne & NTD Control Division, Ministry of Health, Kampala, Uganda
| | - Harry Noyes
- Centre for Genomic Research, University of Liverpool, Liverpool, United Kingdom
| | - Claudia J. de Dood
- Department of Cell and Chemical Biology, Leiden University Medical Center, Leiden, the Netherlands
| | - Paul L. A. M. Corstjens
- Department of Cell and Chemical Biology, Leiden University Medical Center, Leiden, the Netherlands
| | - Govert J. van Dam
- Department of Parasitology, Leiden University Medical Center, Leiden, the Netherlands
| | - Alison M. Elliott
- Medical Research Council/Uganda Virus Research Institute and London School of Hygiene & Tropical Medicine Uganda Research Unit, Entebbe, Uganda
| | - Enock Matovu
- Department of Biotechnical and Diagnostic Sciences, College of Veterinary Medicine Animal Resources and Biosecurity, Makerere University, Kampala, Uganda
- * E-mail:
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Favre TC, Beck LCNH, Bezerra FSM, Graeff-Teixeira C, Coelho PMZ, Enk MJ, Katz N, Oliveira RR, Reis MGD, Pieri OS. Reliability of point-of-care circulating cathodic antigen assay for diagnosing schistosomiasis mansoni in urine samples from an endemic area of Brazil after one year of storage at -20 degrees Celsius. Rev Soc Bras Med Trop 2022; 55:e0389. [PMID: 35239906 PMCID: PMC8909435 DOI: 10.1590/0037-8682-0389-2021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 11/24/2021] [Indexed: 11/22/2022] Open
Abstract
Background The World Health Organization recommends reliable point-of-care (POC) diagnostic testing to eliminate schistosomiasis. Lateral flow immunoassay that detects schistosome circulating cathodic antigen (CCA) in urine to establish prevalence thresholds for intervention in endemic areas is recommended. Stored urine may be useful if surveying at-risk populations is delayed or interrupted by unforeseen circumstances, such as the current COVID-19 pandemic. This study evaluated the manufacturer’s claim that Schistosoma mansoni infection can be reliably diagnosed in urine samples stored at -20°C for one year. Methods Two-hundred-forty-two subjects from an endemic site in Brazil provided one urine sample each for testing with URINE CCA (SCHISTO) ECO TESTE® (POC-ECO) and one stool sample each for testing with Kato-Katz (KK) and Helmintex® (HTX) as a robust reference standard for infection status. At least 2 ml of urine from each participant was stored at -20°C; after one year, 76 samples were randomly selected for POC-ECO retesting. Results: The POC-ECO agreement between freshly collected and stored urine was inadequate considering trace results as positive (Cohen’s kappa coefficient κ = 0.08) and negative (κ = 0.36). POC-ECO accuracy was not significantly greater than that of routine KK (54%; 95% confidence interval: 42.1%-65.5%). Conclusions The precision and accuracy of POC-ECO have to be optimized in both freshly collected and stored urine before it can be recommended for use in control programs in Brazil.
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Affiliation(s)
| | | | | | - Carlos Graeff-Teixeira
- Universidade Federal do Espírito Santo, Brasil; Pontifícia Universidade Católica do Rio Grande do Sul, Brasil
| | | | | | | | | | - Mitermayer Galvão dos Reis
- Fundação Oswaldo Cruz, Brasil; Universidade Federal da Bahia, Brasil; Yale University, United States of America
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Bisetegn H, Eshetu T, Erkihun Y. Prevalence of Schistosoma mansoni infection among children in Ethiopia: a systematic review and meta-analysis. Trop Dis Travel Med Vaccines 2021; 7:30. [PMID: 34847958 PMCID: PMC8638414 DOI: 10.1186/s40794-021-00156-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Accepted: 09/07/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Schistosomiasis is a neglected tropical disease caused by mainly Schistosoma mansoni and Schistosoma hematobium. The disease is very common in Africa including Ethiopia. Schistosoma mansoni is a major public health problem in Ethiopia especially among children. This review is aimed to indicate the prevalence of Schistosoma mansoni among children at the national and regional levels. METHODS AND MATERIAL The PRISMA guidelines were followed. An electronic search of PubMed, Google Scholar, Web of Science, Scopus, MEDLINE, and Google search were carried out using key terms. Articles published from the proceeding of professional associations such as the Ethiopian medical laboratory association, the Ethiopian public health association, and annual national research conferences were also searched to find additional eligible studies. Data were extracted independently by two investigators, and cross-checked by a third reviewer. The quality of included studies was assessed using JBI quality assessment criteria. Data were extracted using Microsoft excel and finally analyzed using STATA version 12. The pooled prevalence was done using a random-effects model. RESULT Overall 49 studies involving 20,493 children (10,572 male and 9, 921 females) were included in this meta-analysis. The pooled prevalence of Schistosoma mansoni infection was 37.13% (95%CI:30.02-44.24). High heterogeneity was observed with I2 of 99.4%, P < 0.000. According to subgroup analysis, the pooled prevalence was high in the SNNPR (41.49%: 95%CI: 19.52-63.46) followed by the Amhara region (41.11%: 95%CI: 30.41-51.8), the Tigray region (31.40%: 95%CI:11.72-51.09), and the Oromia region (28.98%: 95%CI: 18.85-39.1). Year from 2011 to 2015 contributed to the highest prevalence of Schistosoma mansoni infection among children (46.31%: 95%:34.21-59.05). CONCLUSION This study revealed a 37.13% prevalence of Schistosoma mansoni infection among children. This is an alert to improve and implement appropriate control strategies such as mass drug administration in Ethiopia.
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Affiliation(s)
- Habtye Bisetegn
- College of Medicine and Health Sciences, Department of Medical Laboratory Sciences, Wollo University, Dessie, Ethiopia
| | - Tegegne Eshetu
- College of Medicine and Health Sciences, School of Biomedical and Laboratory Sciences, Department of Medical Parasitology, University of Gondar, Gondar, Ethiopia
| | - Yonas Erkihun
- College of Medicine and Health Sciences, Department of Medical Laboratory Sciences, Wollo University, Dessie, Ethiopia
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10
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Fusco D, Rakotozandrindrainy R, Rakotoarivelo RA, Andrianarivelo MR, Rakotozandrindrainy N, Rasamoelina T, Puradiredja DI, Klein P, Stahlberg K, Dechenaud M, Lorenz E, Jaeger A, Kreidenweiss A, Hoekstra PT, Adegnika AA, Sicuri E, Corstjens PLAM, van Dam GJ, May J, Schwarz NG. A cluster randomized controlled trial for assessing POC-CCA test based praziquantel treatment for schistosomiasis control in pregnant women and their young children: study protocol of the freeBILy clinical trial in Madagascar. Trials 2021; 22:822. [PMID: 34801082 PMCID: PMC8605548 DOI: 10.1186/s13063-021-05769-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 10/27/2021] [Indexed: 01/16/2023] Open
Abstract
Background Mass drug administration (MDA) of praziquantel is one of the main control measures against human schistosomiasis. Although there are claims for including pregnant women, infants and children under the age of 5 years in high-endemic regions in MDA campaigns, they are usually not treated without a diagnosis. Diagnostic tools identifying infections at the primary health care centre (PHCC) level could therefore help to integrate these vulnerable groups into control programmes. freeBILy (fast and reliable easy-to-use-diagnostics for eliminating bilharzia in young children and mothers) is an international consortium focused on implementing and evaluating new schistosomiasis diagnostic strategies. In Madagascar, the study aims to determine the effectiveness of a test-based schistosomiasis treatment (TBST) strategy for pregnant women and their infants and children up until the age of 2 years. Methods A two-armed, cluster-randomized, controlled phase III trial including 5200 women and their offspring assesses the impact of TBST on child growth and maternal haemoglobin in areas of medium to high endemicity of Schistosoma mansoni. The participants are being tested with the point of care-circulating cathodic antigen (POC-CCA) test, a commercially available urine-based non-invasive rapid diagnostic test for schistosomiasis. In the intervention arm, a POC-CCA-TBST strategy is offered to women during pregnancy and 9 months after delivery, for their infants at 9 months of age. In the control arm, study visit procedures are the same, but without the POC-CCA-TBST procedure. All participants are being offered the POC-CCA-TBST 24 months after delivery. This trial is being integrated into the routine maternal and child primary health care programmes at 40 different PHCC in Madagascar’s highlands. The purpose of the trial is to assess the effectiveness of the POC-CCA-TBST for controlling schistosomiasis in young children and mothers. Discussion This trial assesses a strategy to integrate pregnant women and their children under the age of 2 years into schistosomiasis control programmes using rapid diagnostic tests. It includes local capacity building for clinical trials and large-scale intervention research. Trial registration Pan-African Clinical Trial Register PACTR201905784271304. Retrospectively registered on 15 May 2019
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Affiliation(s)
- Daniela Fusco
- Department of Infectious Diseases Epidemiology, Bernhard Nocht Institute for Tropical Medicine (BNITM), Bernhard-Nocht-Strasse 74, D-20359, Hamburg, Germany.,German Center for Infection Research (DZIF), Hamburg-Borstel-, Lübeck, Riems, Germany
| | | | - Rivo Andry Rakotoarivelo
- Department of Infectious Diseases, University of Fianarantsoa Andrainjato, 301, Fianarantsoa, Madagascar
| | - Mala Rakoto Andrianarivelo
- Centre d'Infectiologie Charles Mérieux (CICM), University of Antananarivo, PO Box 4299, 101, Antananarivo, Madagascar
| | - Njary Rakotozandrindrainy
- Department of Microbiology and Parasitology, University of Antananarivo, 101, Antananarivo, Madagascar.,UPFR in Parasitology-Mycology of University Hospital Joseph Ravoahangy Andrianavalona Ampefiloha, 101, Antananarivo, Madagascar
| | - Tahinamandranto Rasamoelina
- Centre d'Infectiologie Charles Mérieux (CICM), University of Antananarivo, PO Box 4299, 101, Antananarivo, Madagascar
| | - Dewi Ismajani Puradiredja
- Department of Infectious Diseases Epidemiology, Bernhard Nocht Institute for Tropical Medicine (BNITM), Bernhard-Nocht-Strasse 74, D-20359, Hamburg, Germany
| | - Philipp Klein
- Department of Infectious Diseases Epidemiology, Bernhard Nocht Institute for Tropical Medicine (BNITM), Bernhard-Nocht-Strasse 74, D-20359, Hamburg, Germany
| | - Karl Stahlberg
- Department of Infectious Diseases Epidemiology, Bernhard Nocht Institute for Tropical Medicine (BNITM), Bernhard-Nocht-Strasse 74, D-20359, Hamburg, Germany
| | - Marie Dechenaud
- Department of Infectious Diseases Epidemiology, Bernhard Nocht Institute for Tropical Medicine (BNITM), Bernhard-Nocht-Strasse 74, D-20359, Hamburg, Germany
| | - Eva Lorenz
- Department of Infectious Diseases Epidemiology, Bernhard Nocht Institute for Tropical Medicine (BNITM), Bernhard-Nocht-Strasse 74, D-20359, Hamburg, Germany.,German Center for Infection Research (DZIF), Hamburg-Borstel-, Lübeck, Riems, Germany.,Institute of Medical Biostatistics, Epidemiology and Informatics, University Medical Centre of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Anna Jaeger
- Department of Infectious Diseases Epidemiology, Bernhard Nocht Institute for Tropical Medicine (BNITM), Bernhard-Nocht-Strasse 74, D-20359, Hamburg, Germany.,German Center for Infection Research (DZIF), Hamburg-Borstel-, Lübeck, Riems, Germany
| | - Andrea Kreidenweiss
- Institut für Tropenmedizin, Universität Tübingen, Wilhelmstrasse 27, D-72074, Tübingen, Germany.,German Center for Infection Research (DZIF), partner site Tübingen, Wilhelmstrasse 27, D-72074, Tübingen, Germany
| | - Pytsje T Hoekstra
- Department of Parasitology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, the Netherlands
| | - Akim Ayola Adegnika
- Institut für Tropenmedizin, Universität Tübingen, Wilhelmstrasse 27, D-72074, Tübingen, Germany.,German Center for Infection Research (DZIF), partner site Tübingen, Wilhelmstrasse 27, D-72074, Tübingen, Germany.,Department of Parasitology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, the Netherlands.,Centre de Recherches Médicales de Lambaréné, 242, Lambarene, BP, Gabon
| | - Elisa Sicuri
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Spain C/ Rosselló, 132, 5th 2nd, 08036, Barcelona, Spain
| | - Paul L A M Corstjens
- Department of Cell and Chemical Biology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, the Netherlands
| | - Govert J van Dam
- Department of Parasitology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, the Netherlands
| | - Jürgen May
- Department of Infectious Diseases Epidemiology, Bernhard Nocht Institute for Tropical Medicine (BNITM), Bernhard-Nocht-Strasse 74, D-20359, Hamburg, Germany.,German Center for Infection Research (DZIF), Hamburg-Borstel-, Lübeck, Riems, Germany
| | - Norbert Georg Schwarz
- Department of Infectious Diseases Epidemiology, Bernhard Nocht Institute for Tropical Medicine (BNITM), Bernhard-Nocht-Strasse 74, D-20359, Hamburg, Germany.,German Center for Infection Research (DZIF), Hamburg-Borstel-, Lübeck, Riems, Germany
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11
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Li HM, Qin ZQ, Bergquist R, Qian MB, Xia S, Lv S, Xiao N, Utzinger J, Zhou XN. Nucleic acid amplification techniques for the detection of Schistosoma mansoni infection in humans and the intermediate snail host: a structured review and meta-analysis of diagnostic accuracy. Int J Infect Dis 2021; 112:152-164. [PMID: 34474147 DOI: 10.1016/j.ijid.2021.08.061] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 08/18/2021] [Accepted: 08/25/2021] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Schistosomiasis is a parasitic disease caused by hematodes of genus Schistosoma. This review evaluated the available nucleic acid amplification techniques for diagnosing S. mansoni infections in humans, intermediate host snails, and presumed rodent reservoirs. METHODS Sensitivity, specificity, diagnostic odds ratio (DOR), and 95% CI were calculated based on available literature. The potential of PCR, nPCR, PCR-ELISA, qPCR, and LAMP was compared for diagnosing S. mansoni infections. RESULTS A total of 546 published records were identified. Quality assessment by QUADAS-2 revealed an uncertain risk in most studies, and 21 references were included in the final. For human samples, the four nucleic acid amplification techniques showed an overall sensitivity of 89.79% (95% CI: 83.92%-93.67%), specificity of 87.70% (95% CI: 72.60%-95.05%), and DOR of 37.73 (95% CI: 21.79-65.33). LAMP showed the highest sensitivity, followed by PCR-ELISA, PCR, and qPCR, while this order was almost reversed for specificity; qPCR had the highest AUC. For rodent samples, qPCR showed modest sensitivity (68.75%, 95% CI: 43.32%-86.36%) and high specificity (92.45%, 95% CI: 19.94%-99.83%). For snail samples, PCR and nPCR assays showed high sensitivity of 90.06% (95% CI: 84.39%-93.82%) and specificity of 85.51% (95% CI: 54.39%-96.69%). CONCLUSION Nucleic acid amplification techniques had high diagnostic potential for identifying S. mansoni infections in humans.
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Affiliation(s)
- Hong-Mei Li
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research), Shanghai, People's Republic of China; NHC Key Laboratory of Parasite and Vector Biology, Shanghai, People's Republic of China; WHO Collaborating Centre for Tropical Diseases, Shanghai, People's Republic of China; National Center for International Research on Tropical Diseases, Shanghai, People's Republic of China
| | - Zhi-Qiang Qin
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research), Shanghai, People's Republic of China; NHC Key Laboratory of Parasite and Vector Biology, Shanghai, People's Republic of China; WHO Collaborating Centre for Tropical Diseases, Shanghai, People's Republic of China; National Center for International Research on Tropical Diseases, Shanghai, People's Republic of China
| | | | - Men-Bao Qian
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research), Shanghai, People's Republic of China; NHC Key Laboratory of Parasite and Vector Biology, Shanghai, People's Republic of China; WHO Collaborating Centre for Tropical Diseases, Shanghai, People's Republic of China; National Center for International Research on Tropical Diseases, Shanghai, People's Republic of China; School of Global Health, Chinese Center for Tropical Diseases Research, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China
| | - Shang Xia
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research), Shanghai, People's Republic of China; NHC Key Laboratory of Parasite and Vector Biology, Shanghai, People's Republic of China; WHO Collaborating Centre for Tropical Diseases, Shanghai, People's Republic of China; National Center for International Research on Tropical Diseases, Shanghai, People's Republic of China; Ingerod, Brastad, Sweden (formerly with the UNICEF/UNDP/World Bank/WHO Special Programme for Research and Training in Tropical Diseases, World Health Organization, Geneva, Switzerland)
| | - Shan Lv
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research), Shanghai, People's Republic of China; NHC Key Laboratory of Parasite and Vector Biology, Shanghai, People's Republic of China; WHO Collaborating Centre for Tropical Diseases, Shanghai, People's Republic of China; National Center for International Research on Tropical Diseases, Shanghai, People's Republic of China; School of Global Health, Chinese Center for Tropical Diseases Research, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China
| | - Ning Xiao
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research), Shanghai, People's Republic of China; NHC Key Laboratory of Parasite and Vector Biology, Shanghai, People's Republic of China; WHO Collaborating Centre for Tropical Diseases, Shanghai, People's Republic of China; National Center for International Research on Tropical Diseases, Shanghai, People's Republic of China; School of Global Health, Chinese Center for Tropical Diseases Research, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China
| | - Jurg Utzinger
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Xiao-Nong Zhou
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research), Shanghai, People's Republic of China; NHC Key Laboratory of Parasite and Vector Biology, Shanghai, People's Republic of China; WHO Collaborating Centre for Tropical Diseases, Shanghai, People's Republic of China; National Center for International Research on Tropical Diseases, Shanghai, People's Republic of China; School of Global Health, Chinese Center for Tropical Diseases Research, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China.
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Hoekstra PT, van Dam GJ, van Lieshout L. Context-Specific Procedures for the Diagnosis of Human Schistosomiasis – A Mini Review. FRONTIERS IN TROPICAL DISEASES 2021. [DOI: 10.3389/fitd.2021.722438] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Schistosomiasis is a parasitic disease caused by trematode blood flukes of the genus Schistosoma, affecting over 250 million people mainly in the tropics. Clinically, the disease can present itself with acute symptoms, a stage which is relatively more common in naive travellers originating from non-endemic regions. It can also develop into chronic disease, with the outcome depending on the Schistosoma species involved, the duration and intensity of infection and several host-related factors. A range of diagnostic tests is available to determine Schistosoma infection, including microscopy, antibody detection, antigen detection using the Point-Of-Care Circulating Cathodic Antigen (POC-CCA) test and the Up-Converting Particle Lateral Flow Circulating Anodic Antigen (UCP-LF CAA) test, as well as Nucleic Acid Amplification Tests (NAATs) such as real-time PCR. In this mini review, we discuss these different diagnostic procedures and explore their most appropriate use in context-specific settings. With regard to endemic settings, diagnostic approaches are described based on their suitability for individual diagnosis, monitoring control programs, determining elimination as a public health problem and eventual interruption of transmission. For non-endemic settings, we summarize the most suitable diagnostic approaches for imported cases, either acute or chronic. Additionally, diagnostic options for disease-specific clinical presentations such as genital schistosomiasis and neuro-schistosomiasis are included. Finally, the specific role of diagnostic tests within research settings is described, including a controlled human schistosomiasis infection model and several clinical studies. In conclusion, context-specific settings have different requirements for a diagnostic test, stressing the importance of a well-considered decision of the most suitable diagnostic procedure.
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13
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Yin X, N’Goran EK, Ouattara M, Aka NAD, Diakité NR, Bassa FK, Kourany-Lefoll E, Tappert A, Yalkinoglu Ö, Huber E, Bezuidenhout D, Bagchus WM, Hayward B. Comparison of POC-CCA with Kato-Katz in Diagnosing Schistosoma mansoni Infection in a Pediatric L-Praziquantel Clinical Trial. FRONTIERS IN TROPICAL DISEASES 2021. [DOI: 10.3389/fitd.2021.686288] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
IntroductionTraditionally Schistosoma mansoni infection is diagnosed by the Kato-Katz method. Thick smears from each stool sample are prepared on slides and eggs are counted microscopically. Commercially available point-of-care circulating cathodic antigen (POC-CCA) cassette tests detect schistosomiasis antigens from urine samples in 20 minutes. POC-CCA results are qualitative or semi-quantitative: signal intensity is an indicator of the amount of worm antigens in the sample. Both methods were used in a phase II trial investigating the efficacy and safety of new pediatric formulations of praziquantel (PZQ) among children ≤6 years (NCT02806232). This secondary analysis evaluated the consistency of results between the Kato-Katz and POC-CCA methods.MethodsPOC-CCA was used to pre-screen for S. mansoni infection. Children with positive results were tested by the Kato-Katz method, and those with positive Kato-Katz results (>1 egg/1 occurrence) were enrolled. Participants (N=444) were treated with different formulations and doses of PZQ. POC-CCA and Kato-Katz were performed at 2–3 weeks after treatment to evaluate drug efficacy. Cure rate (CR) was defined as the proportion of participants with a negative result per POC-CCA, or no eggs in the stool samples per Kato-Katz. Kappa statistic was used to assess the agreement on cure status, and Spearman correlation between POC-CCA positivity and Kato-Katz egg counts was evaluated. Sensitivity and specificity of POC-CCA were calculated using Kato-Katz as a reference standard.ResultsCR per POC-CCA, measured 2–3 weeks after treatment, was 52% [95% confidence interval (CI): 48%, 57%] across all treatment arms except in infants aged 3–12 months. CR per Kato-Katz was 83% (95% CI: 79%, 87%). Kappa statistic was 0.16 (95% CI: 0.09, 0.23), indicating that the agreement was slightly better than by chance. Relative to Kato-Katz, POC-CCA’s sensitivity to detect infection was 70% and specificity was 57%. Spearman correlation coefficient between POC-CCA positivity and Kato-Katz egg counts was 0.26 (95% CI: 0.17, 0.34).ConclusionPOC-CCA is sensitive and rapid for diagnosing S. mansoni infection, but its performance and consistency with Kato-Katz requires further investigation among young children.
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Bharadwaj M, Bengtson M, Golverdingen M, Waling L, Dekker C. Diagnosing point-of-care diagnostics for neglected tropical diseases. PLoS Negl Trop Dis 2021; 15:e0009405. [PMID: 34138846 PMCID: PMC8211285 DOI: 10.1371/journal.pntd.0009405] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Inadequate and nonintegrated diagnostics are the Achilles' heel of global efforts to monitor, control, and eradicate neglected tropical diseases (NTDs). While treatment is often available, NTDs are endemic among marginalized populations, due to the unavailability or inadequacy of diagnostic tests that cause empirical misdiagnoses. The need of the hour is early diagnosis at the point-of-care (PoC) of NTD patients. Here, we review the status quo of PoC diagnostic tests and practices for all of the 24 NTDs identified in the World Health Organization's (WHO) 2021-2030 roadmap, based on their different diagnostic requirements. We discuss the capabilities and shortcomings of current diagnostic tests, identify diagnostic needs, and formulate prerequisites of relevant PoC tests. Next to technical requirements, we stress the importance of availability and awareness programs for establishing PoC tests that fit endemic resource-limited settings. Better understanding of NTD diagnostics will pave the path for setting realistic goals for healthcare in areas with minimal resources, thereby alleviating the global healthcare burden.
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Affiliation(s)
- Mitasha Bharadwaj
- Department of Bionanoscience, Kavli Institute of Nanoscience Delft, Delft University of Technology, Delft, The Netherlands
| | - Michel Bengtson
- Department of Bionanoscience, Kavli Institute of Nanoscience Delft, Delft University of Technology, Delft, The Netherlands
| | - Mirte Golverdingen
- Department of Bionanoscience, Kavli Institute of Nanoscience Delft, Delft University of Technology, Delft, The Netherlands
| | - Loulotte Waling
- Department of Bionanoscience, Kavli Institute of Nanoscience Delft, Delft University of Technology, Delft, The Netherlands
| | - Cees Dekker
- Department of Bionanoscience, Kavli Institute of Nanoscience Delft, Delft University of Technology, Delft, The Netherlands
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15
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Moore C, Scherr T, Matoba J, Sing'anga C, Lubinda M, Thuma P, Wright D. mHAT app for automated malaria rapid test result analysis and aggregation: a pilot study. Malar J 2021; 20:237. [PMID: 34039358 PMCID: PMC8153521 DOI: 10.1186/s12936-021-03772-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Accepted: 05/16/2021] [Indexed: 12/29/2022] Open
Abstract
Background There are a variety of approaches being used for malaria surveillance. While active and reactive case detection have been successful in localized areas of low transmission, concerns over scalability and sustainability keep the approaches from being widely accepted. Mobile health interventions are poised to address these shortcomings by automating and standardizing portions of the surveillance process. In this study, common challenges associated with current data aggregation methods have been quantified, and a web-based mobile phone application is presented to reduce the burden of reporting rapid diagnostic test (RDT) results in low-resource settings. Methods De-identified completed RDTs were collected at 14 rural health clinics as part of a malaria epidemiology study at Macha Research Trust, Macha, Zambia. Tests were imaged using the mHAT web application. Signal intensity was measured and a binary result was provided. App performance was validated by: (1) comparative limits of detection, investigated against currently used laboratory lateral flow assay readers; and, (2) receiver operating characteristic analysis comparing the application against visual inspection of RDTs by an expert. Secondary investigations included analysis of time-to-aggregation and data consistency within the existing surveillance structures established by Macha Research Trust. Results When compared to visual analysis, the mHAT app performed with 91.9% sensitivity (CI 78.7, 97.2) and specificity was 91.4% (CI 77.6, 97.0) regardless of device operating system. Additionally, an analysis of surveillance data from January 2017 through mid-February 2019 showed that while the majority of the data packets from satellite clinics contained correct data, 36% of data points required correction by verification teams. Between November 2018 and mid-February 2019, it was also found that 44.8% of data was received after the expected submission date, although most (65.1%) reports were received within 2 days. Conclusions Overall, the mHAT mobile app was observed to be sensitive and specific when compared to both currently available benchtop lateral flow readers and visual inspection. The additional benefit of automating and standardizing LFA data collection and aggregation poses a vital improvement for low-resource health facilities and could increase the accuracy and speed of data reporting in surveillance campaigns. Supplementary Information The online version contains supplementary material available at 10.1186/s12936-021-03772-5.
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Affiliation(s)
- Carson Moore
- Department of Chemistry, Vanderbilt University, 1234 Stevenson Center Lane, Nashville, TN, 37212, USA
| | - Thomas Scherr
- Department of Chemistry, Vanderbilt University, 1234 Stevenson Center Lane, Nashville, TN, 37212, USA.
| | | | | | | | - Phil Thuma
- Macha Research Trust, Choma District, Zambia
| | - David Wright
- Department of Chemistry, Vanderbilt University, 1234 Stevenson Center Lane, Nashville, TN, 37212, USA
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16
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Graeff-Teixeira C, Favero V, Pascoal VF, de Souza RP, Rigo FDV, Agnese LHD, Bezerra FSM, Coelho PMZ, Enk MJ, Favre TC, Katz N, Oliveira RR, Dos Reis MG, Pieri OS. Low specificity of point-of-care circulating cathodic antigen (POCCCA) diagnostic test in a non-endemic area for schistosomiasis mansoni in Brazil. Acta Trop 2021; 217:105863. [PMID: 33587944 DOI: 10.1016/j.actatropica.2021.105863] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 02/01/2021] [Accepted: 02/08/2021] [Indexed: 02/08/2023]
Abstract
A point-of-care test for detecting schistosome circulating cathodic antigen in urine (POCCCA) has been proposed for mapping infection and defining prevalence thresholds for mass drug administration (MDA). However, there is increasing evidence that POCCCA may yield false-positive results, which requires rigorous specificity evaluation in non-endemic areas. POCCCA was applied in an area known to be free from infection and devoid of any condition for schistosomiasis transmission as part of a multicentre study to evaluate the performance of POCCCA in Brazil's low or potentially endemic settings. Besides POCCCA detection in urine, a search for eggs in stool was performed by Kato-Katz (KK) and Helmintex (HTX) methods. One-hundred-and-seventy-four participants returned urine samples, 140 of which delivered stool samples. All these were HTX-negative for Schistosoma mansoni, and all 118 tested with KK were negative for both S. mansoni and soil-transmitted helminths. POCCCA results from freshly collected urine yielded a specificity of 62.1% (95% CI: 53.6% - 70.2%), taking trace outcomes as positive according to the manufacturer's instructions. Retesting urine from the 140 HTX-negatives after one-year storage at -20 °C with two new POCCCA batches simultaneously yielded significantly different specificities (34.3%; 95%CI: 26.5% - 42.8% and 75.0%; 95% CI: 67.0% - 81.9%). These two batches had a weak agreement (Cohen's kappa: 0.56; 95%CI: 0.44-0.68) among the 174 urine samples retested. At present, POCCCA cannot be recommended either as a cut-off point for MDA or a reliable diagnostic tool for treatment of the infection carriers (selective chemotherapy) in low endemic areas and at final stages of transmission interruption. Manufacturers should be required to optimize production standardization and to assure quality and reproducibility of the test. Extended rigorous performance evaluations by different users from different regions are needed before POCCCA is widely recommended.
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Affiliation(s)
- Carlos Graeff-Teixeira
- Infectious Diseases Unit (NDI), Center for Health Sciences, Universidade Federal do Espírito Santo, Vitória, ES, Brazil; Research Group on Biomedical Parasitology, School of Sciences, Pontíficia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Vivian Favero
- Research Group on Biomedical Parasitology, School of Sciences, Pontíficia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Vanessa Fey Pascoal
- Research Group on Biomedical Parasitology, School of Sciences, Pontíficia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Renata Perotto de Souza
- Research Group on Biomedical Parasitology, School of Sciences, Pontíficia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil.
| | - Francine de Vargas Rigo
- Research Group on Biomedical Parasitology, School of Sciences, Pontíficia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Luize Hoffmann Dall Agnese
- Research Group on Biomedical Parasitology, School of Sciences, Pontíficia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | | | | | | | - Tereza Cristina Favre
- Oswaldo Cruz Institute, Fundação Oswaldo Cruz (FIOCRUZ), Rio de Janeiro, RJ, Brazil.
| | - Naftale Katz
- René Rachou Institute, Fundação Oswaldo Cruz (FIOCRUZ), Belo Horizonte, MG, Brazil
| | | | - Mitermayer Galvão Dos Reis
- Gonçalo Muniz Institute, Fundação Oswaldo Cruz (FIOCRUZ), Salvador, BA, Brazil; Faculty of Medicine of Bahia, Federal University of Bahia, Salvador, BA, Brazil; Department of Epidemiology of Microbial Diseases, School of Public Health, Yale University, New Haven, CT, United States of America.
| | - Otavio Sarmento Pieri
- Oswaldo Cruz Institute, Fundação Oswaldo Cruz (FIOCRUZ), Rio de Janeiro, RJ, Brazil.
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17
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Mehta SD, Okal D, Otieno F, Green SJ, Nordgren RK, Huibner S, Bailey RC, Bhaumik DK, Landay A, Kaul R. Schistosomiasis is associated with rectal mucosal inflammation among Kenyan men who have sex with men. Int J STD AIDS 2021; 32:694-703. [PMID: 33533314 DOI: 10.1177/0956462420985973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background: Schistosoma mansoni infection is hyperendemic in Lake Victoria communities and associated with cervicovaginal immune alterations and HIV acquisition. We assessed the hypothesis that schistosomiasis correlates with greater rectal inflammation in men who have sex with men (MSM) in Kisumu, Kenya. Methods: In this cross-sectional study of 38 HIV-negative MSM aged 18-35 years, schistosomiasis was diagnosed by urine circulating cathodic antigen (CCA). Microbiome was assessed in rectal swabs by 16S rRNA gene amplicon sequencing, and rectal inflammation by quartile normalized summative score of inflammatory cytokines (IL-1α, IL-1β, IL-8, and TNF-α). Elastic net (EN) regression identified taxa associated with inflammation. Multivariable linear regression estimated the association between inflammation score and schistosomiasis and bacteria identified in EN. Results: Most men were CCA positive (24/38; 63%), and median rectal inflammation score was significantly higher in these participants (11 vs. 8, p = 0.04). In multivariable regression, CCA-positive men had 2.85-point greater inflammation score (p = 0.009). The relative abundance of Succinivibrio (coefficient = -1.13, p = 0.002) and Pseudomonas (coefficient = -1.04, p = 0.001) were negatively associated with inflammation. Discussion: CCA positivity was associated with rectal mucosal inflammation, controlling for rectal microbiome composition. Given its high prevalence and contribution to inflammation, schistosomiasis may have important implications for HIV transmission in this vulnerable population.
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Affiliation(s)
- Supriya D Mehta
- Division of Epidemiology & Biostatistics, 14681University of Illinois at Chicago School of Public Health, Chicago, USA
| | - Duncan Okal
- Nyanza Reproductive Health Society, Kisumu, Kenya
| | | | - Stefan J Green
- Sequencing Core, Research Resources Center, 14681University of Illinois at Chicago, Chicago, USA
| | - Rachel K Nordgren
- Division of Epidemiology & Biostatistics, 14681University of Illinois at Chicago School of Public Health, Chicago, USA
| | - Sanja Huibner
- Division of Infectious Diseases, University of Toronto School of Medicine, Toronto, Canada
| | - Robert C Bailey
- Division of Epidemiology & Biostatistics, 14681University of Illinois at Chicago School of Public Health, Chicago, USA
| | - Dulal K Bhaumik
- Division of Epidemiology & Biostatistics, 14681University of Illinois at Chicago School of Public Health, Chicago, USA
| | - Alan Landay
- Department of Internal Medicine, 2468Rush University, Chicago, USA
| | - Rupert Kaul
- Division of Infectious Diseases, University of Toronto School of Medicine, Toronto, Canada
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18
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Nyangiri OA, Edwige SA, Koffi M, Mewamba E, Simo G, Namulondo J, Mulindwa J, Nassuuna J, Elliott A, Karume K, Mumba D, Corstjens P, Casacuberta-Partal M, van Dam G, Bucheton B, Noyes H, Matovu E. Candidate gene family-based and case-control studies of susceptibility to high Schistosoma mansoni worm burden in African children: a protocol. AAS Open Res 2021; 4:36. [PMID: 35252746 PMCID: PMC8861467 DOI: 10.12688/aasopenres.13203.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/04/2021] [Indexed: 11/20/2022] Open
Abstract
Background: Approximately 25% of the risk of Schistosoma mansoni is associated with host genetic variation. We will test 24 candidate genes, mainly in the T h2 and T h17 pathways, for association with S. mansoni infection intensity in four African countries, using family based and case-control approaches. Methods: Children aged 5-15 years will be recruited in S. mansoni endemic areas of Ivory Coast, Cameroon, Uganda and the Democratic Republic of Congo (DRC). We will use family based (study 1) and case-control (study 2) designs. Study 1 will take place in Ivory Coast, Cameroon, Uganda and the DRC. We aim to recruit 100 high worm burden families from each country except Uganda, where a previous study recruited at least 40 families. For phenotyping, cases will be defined as the 20% of children in each community with heaviest worm burdens as measured by the circulating cathodic antigen (CCA) assay. Study 2 will take place in Uganda. We will recruit 500 children in a highly endemic community. For phenotyping, cases will be defined as the 20% of children with heaviest worm burdens as measured by the CAA assay, while controls will be the 20% of infected children with the lightest worm burdens. Deoxyribonucleic acid (DNA) will be genotyped on the Illumina H3Africa SNP (single nucleotide polymorphisms) chip and genotypes will be converted to sets of haplotypes that span the gene region for analysis. We have selected 24 genes for genotyping that are mainly in the Th2 and Th17 pathways and that have variants that have been demonstrated to be or could be associated with Schistosoma infection intensity. Analysis: In the family-based design, we will identify SNP haplotypes disproportionately transmitted to children with high worm burden. Case-control analysis will detect overrepresentation of haplotypes in extreme phenotypes with correction for relatedness by using whole genome principal components.
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Affiliation(s)
- Oscar A. Nyangiri
- College of Veterinary Medicine, Animal Resources and Biosecurity, Makerere University, Kampala, Uganda
| | - Sokouri A. Edwige
- Université Jean Lorougnon Guédé (UJLoG) de Daloa, Daloa, Cote d'Ivoire
| | - Mathurin Koffi
- Université Jean Lorougnon Guédé (UJLoG) de Daloa, Daloa, Cote d'Ivoire
| | - Estelle Mewamba
- Faculty of Science, University of Dschang, Dschang, Cameroon
| | - Gustave Simo
- Faculty of Science, University of Dschang, Dschang, Cameroon
| | - Joyce Namulondo
- College of Veterinary Medicine, Animal Resources and Biosecurity, Makerere University, Kampala, Uganda
| | - Julius Mulindwa
- College of Veterinary Medicine, Animal Resources and Biosecurity, Makerere University, Kampala, Uganda
| | - Jacent Nassuuna
- Medical Research Council/Uganda Virus Research Institute and London School of Hygiene & Tropical Medicine Uganda Research Unit, Entebbe, Uganda
| | - Alison Elliott
- Medical Research Council/Uganda Virus Research Institute and London School of Hygiene & Tropical Medicine Uganda Research Unit, Entebbe, Uganda
- London School of Hygiene and Tropical Medicine, London, WC1E, UK
| | - Kévin Karume
- Institut National de Recherche Biomedicale, Kinshasa, Democratic Republic of the Congo
| | - Dieudonne Mumba
- Institut National de Recherche Biomedicale, Kinshasa, Democratic Republic of the Congo
| | - P.L.A.M Corstjens
- Dept. of Cell and Chemical Biology, Leiden University Medical Center, Leiden, The Netherlands
| | | | - G.J. van Dam
- Dept. of Parasitology, Leiden University Medical Center, Leiden, The Netherlands
| | - Bruno Bucheton
- Institut de Recherche pour le Développement (IRD), IRD-CIRAD, Montpellier, France
| | - Harry Noyes
- Centre for Genomic Research, University of Liverpool, Liverpool, UK
| | - Enock Matovu
- College of Veterinary Medicine, Animal Resources and Biosecurity, Makerere University, Kampala, Uganda
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19
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Nyangiri OA, Edwige SA, Koffi M, Mewamba E, Simo G, Namulondo J, Mulindwa J, Nassuuna J, Elliott A, Karume K, Mumba D, Corstjens P, Casacuberta-Partal M, van Dam G, Bucheton B, Noyes H, Matovu E. Candidate gene family-based and case-control studies of susceptibility to high Schistosoma mansoni worm burden in African children: a protocol. AAS Open Res 2021; 4:36. [PMID: 35252746 PMCID: PMC8861467 DOI: 10.12688/aasopenres.13203.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/15/2021] [Indexed: 11/20/2022] Open
Abstract
Background: Approximately 25% of the risk of Schistosoma mansoni is associated with host genetic variation. We will test 24 candidate genes, mainly in the T h2 and T h17 pathways, for association with S. mansoni infection intensity in four African countries, using family based and case-control approaches. Methods: Children aged 5-15 years will be recruited in S. mansoni endemic areas of Ivory Coast, Cameroon, Uganda and the Democratic Republic of Congo (DRC). We will use family based (study 1) and case-control (study 2) designs. Study 1 will take place in Ivory Coast, Cameroon, Uganda and the DRC. We aim to recruit 100 high worm burden families from each country except Uganda, where a previous study recruited at least 40 families. For phenotyping, cases will be defined as the 20% of children in each community with heaviest worm burdens as measured by the circulating cathodic antigen (CCA) assay. Study 2 will take place in Uganda. We will recruit 500 children in a highly endemic community. For phenotyping, cases will be defined as the 20% of children with heaviest worm burdens as measured by the CAA assay, while controls will be the 20% of infected children with the lightest worm burdens. Deoxyribonucleic acid (DNA) will be genotyped on the Illumina H3Africa SNP (single nucleotide polymorphisms) chip and genotypes will be converted to sets of haplotypes that span the gene region for analysis. We have selected 24 genes for genotyping that are mainly in the Th2 and Th17 pathways and that have variants that have been demonstrated to be or could be associated with Schistosoma infection intensity. Analysis: In the family-based design, we will identify SNP haplotypes disproportionately transmitted to children with high worm burden. Case-control analysis will detect overrepresentation of haplotypes in extreme phenotypes with correction for relatedness by using whole genome principal components.
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Affiliation(s)
- Oscar A. Nyangiri
- College of Veterinary Medicine, Animal Resources and Biosecurity, Makerere University, Kampala, Uganda
| | - Sokouri A. Edwige
- Université Jean Lorougnon Guédé (UJLoG) de Daloa, Daloa, Cote d'Ivoire
| | - Mathurin Koffi
- Université Jean Lorougnon Guédé (UJLoG) de Daloa, Daloa, Cote d'Ivoire
| | - Estelle Mewamba
- Faculty of Science, University of Dschang, Dschang, Cameroon
| | - Gustave Simo
- Faculty of Science, University of Dschang, Dschang, Cameroon
| | - Joyce Namulondo
- College of Veterinary Medicine, Animal Resources and Biosecurity, Makerere University, Kampala, Uganda
| | - Julius Mulindwa
- College of Veterinary Medicine, Animal Resources and Biosecurity, Makerere University, Kampala, Uganda
| | - Jacent Nassuuna
- Medical Research Council/Uganda Virus Research Institute and London School of Hygiene & Tropical Medicine Uganda Research Unit, Entebbe, Uganda
| | - Alison Elliott
- Medical Research Council/Uganda Virus Research Institute and London School of Hygiene & Tropical Medicine Uganda Research Unit, Entebbe, Uganda
- London School of Hygiene and Tropical Medicine, London, WC1E, UK
| | - Kévin Karume
- Institut National de Recherche Biomedicale, Kinshasa, Democratic Republic of the Congo
| | - Dieudonne Mumba
- Institut National de Recherche Biomedicale, Kinshasa, Democratic Republic of the Congo
| | - P.L.A.M Corstjens
- Dept. of Cell and Chemical Biology, Leiden University Medical Center, Leiden, The Netherlands
| | | | - G.J. van Dam
- Dept. of Parasitology, Leiden University Medical Center, Leiden, The Netherlands
| | - Bruno Bucheton
- Institut de Recherche pour le Développement (IRD), IRD-CIRAD, Montpellier, France
| | - Harry Noyes
- Centre for Genomic Research, University of Liverpool, Liverpool, UK
| | - Enock Matovu
- College of Veterinary Medicine, Animal Resources and Biosecurity, Makerere University, Kampala, Uganda
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20
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Campbell CH, Binder S, King CH, Knopp S, Rollinson D, Person B, Webster B, Allan F, Utzinger J, Ame SM, Ali SM, Kabole F, N'Goran EK, Tediosi F, Salari P, Ouattara M, Diakité NR, Hattendorf J, S Andros T, Kittur N, Colley DG. SCORE Operational Research on Moving toward Interruption of Schistosomiasis Transmission. Am J Trop Med Hyg 2020; 103:58-65. [PMID: 32400354 PMCID: PMC7351301 DOI: 10.4269/ajtmh.19-0825] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
As part of its diverse portfolio, the Schistosomiasis Consortium for Operational Research and Evaluation (SCORE) included two cluster-randomized trials evaluating interventions that could potentially lead to interruption of schistosomiasis transmission (elimination) in areas of Africa with low prevalence and intensity of infection. These studies, conducted in Zanzibar and Côte d’Ivoire, demonstrated that multiyear mass drug administration (MDA) with praziquantel failed to interrupt the transmission of urogenital schistosomiasis, even when provided biannually and/or supplemented by small-scale implementation of additional interventions. Other SCORE activities related to elimination included a feasibility and acceptability assessment of test–treat–track–test–treat (T5) strategies and mathematical modeling. Future evaluations of interventions to eliminate schistosomiasis should recognize the difficulties inherent in conducting randomized controlled trials on elimination and in measuring small changes where baseline prevalence is low. Highly sensitive and specific diagnostic tests for use in very low–prevalence areas for schistosomiasis are not routinely available, which complicates accurate measurement of infection rates and assessment of changes resulting from interventions in these settings. Although not encountered in these two studies, as prevalence and intensity decrease, political and community commitment to population-wide MDA may decrease. Because of this potential problem, SCORE developed and funded the T5 strategy implemented in Egypt, Kenya, and Tanzania. It is likely that focal MDA campaigns, along with more targeted approaches, including a T5 strategy and snail control, will need to be supplemented with the provision of clean water and sanitation and behavior change communications to achieve interruption of schistosome transmission.
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Affiliation(s)
- Carl H Campbell
- Schistosomiasis Consortium for Operational Research and Evaluation, Center for Tropical and Emerging Global Diseases, University of Georgia, Athens, Georgia
| | - Sue Binder
- Schistosomiasis Consortium for Operational Research and Evaluation, Center for Tropical and Emerging Global Diseases, University of Georgia, Athens, Georgia
| | - Charles H King
- Center for Global Health and Diseases, Case Western Reserve University, Cleveland, Ohio.,Schistosomiasis Consortium for Operational Research and Evaluation, Center for Tropical and Emerging Global Diseases, University of Georgia, Athens, Georgia
| | - Stefanie Knopp
- Department of Life Sciences, Wolfson Wellcome Biomedical Laboratories, Natural History Museum, London, United Kingdom.,University of Basel, Basel, Switzerland.,Swiss Tropical and Public Health Institute, Basel, Switzerland
| | - David Rollinson
- London Centre for Neglected Tropical Disease Research, Imperial College Faculty of Medicine, London, United Kingdom.,Department of Life Sciences, Wolfson Wellcome Biomedical Laboratories, Natural History Museum, London, United Kingdom
| | - Bobbie Person
- Schistosomiasis Consortium for Operational Research and Evaluation, Center for Tropical and Emerging Global Diseases, University of Georgia, Athens, Georgia
| | - Bonnie Webster
- London Centre for Neglected Tropical Disease Research, Imperial College Faculty of Medicine, London, United Kingdom.,Department of Life Sciences, Wolfson Wellcome Biomedical Laboratories, Natural History Museum, London, United Kingdom
| | - Fiona Allan
- London Centre for Neglected Tropical Disease Research, Imperial College Faculty of Medicine, London, United Kingdom.,Department of Life Sciences, Wolfson Wellcome Biomedical Laboratories, Natural History Museum, London, United Kingdom
| | - Jürg Utzinger
- University of Basel, Basel, Switzerland.,Swiss Tropical and Public Health Institute, Basel, Switzerland
| | - Shaali M Ame
- Public Health Laboratory - Ivo de Carneri, Pemba, United Republic of Tanzania
| | - Said M Ali
- Public Health Laboratory - Ivo de Carneri, Pemba, United Republic of Tanzania
| | - Fatma Kabole
- Neglected Tropical Diseases Unit, Ministry of Health Zanzibar, Unguja, United Republic of Tanzania
| | - Eliézer K N'Goran
- Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, Abidjan, Côte d'Ivoire.,Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire
| | - Fabrizio Tediosi
- University of Basel, Basel, Switzerland.,Swiss Tropical and Public Health Institute, Basel, Switzerland
| | - Paola Salari
- University of Basel, Basel, Switzerland.,Swiss Tropical and Public Health Institute, Basel, Switzerland
| | - Mamadou Ouattara
- Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, Abidjan, Côte d'Ivoire.,Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire
| | - Nana R Diakité
- Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, Abidjan, Côte d'Ivoire.,Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire
| | - Jan Hattendorf
- University of Basel, Basel, Switzerland.,Swiss Tropical and Public Health Institute, Basel, Switzerland
| | - Tamara S Andros
- Schistosomiasis Consortium for Operational Research and Evaluation, Center for Tropical and Emerging Global Diseases, University of Georgia, Athens, Georgia
| | - Nupur Kittur
- Schistosomiasis Consortium for Operational Research and Evaluation, Center for Tropical and Emerging Global Diseases, University of Georgia, Athens, Georgia
| | - Daniel G Colley
- Department of Microbiology, University of Georgia, Athens, Georgia.,Schistosomiasis Consortium for Operational Research and Evaluation, Center for Tropical and Emerging Global Diseases, University of Georgia, Athens, Georgia
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21
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Corstjens PLAM, de Dood CJ, Knopp S, Clements MN, Ortu G, Umulisa I, Ruberanziza E, Wittmann U, Kariuki T, LoVerde P, Secor WE, Atkins L, Kinung'hi S, Binder S, Campbell CH, Colley DG, van Dam GJ. Circulating Anodic Antigen (CAA): A Highly Sensitive Diagnostic Biomarker to Detect Active Schistosoma Infections-Improvement and Use during SCORE. Am J Trop Med Hyg 2020; 103:50-57. [PMID: 32400344 PMCID: PMC7351307 DOI: 10.4269/ajtmh.19-0819] [Citation(s) in RCA: 57] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
The Schistosomiasis Consortium for Operational Research and Evaluation (SCORE) was funded in 2008 to conduct research that would support country schistosomiasis control programs. As schistosomiasis prevalence decreases in many places and elimination is increasingly within reach, a sensitive and specific test to detect infection with Schistosoma mansoni and Schistosoma haematobium has become a pressing need. After obtaining broad input, SCORE supported Leiden University Medical Center (LUMC) to modify the serum-based antigen assay for use with urine, simplify the assay, and improve its sensitivity. The urine assay eventually contributed to several of the larger SCORE studies. For example, in Zanzibar, we demonstrated that urine filtration, the standard parasite egg detection diagnostic test for S. haematobium, greatly underestimated prevalence in low-prevalence settings. In Burundi and Rwanda, the circulating anodic antigen (CAA) assay provided critical information about the limitations of the stool-based Kato–Katz parasite egg-detection assay for S. mansoni in low-prevalence settings. Other SCORE-supported CAA work demonstrated that frozen, banked urine specimens yielded similar results to fresh ones; pooling of specimens may be a useful, cost-effective approach for surveillance in some settings; and the assay can be performed in local laboratories equipped with adequate centrifuge capacity. These improvements in the assay continue to be of use to researchers around the world. However, additional work will be needed if widespread dissemination of the CAA assay is to occur, for example, by building capacity in places besides LUMC and commercialization of the assay. Here, we review the evolution of the CAA assay format during the SCORE period with emphasis on urine-based applications.
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Affiliation(s)
- Paul L A M Corstjens
- Department of Cell and Chemical Biology, Leiden University Medical Center, Leiden, Netherlands
| | - Claudia J de Dood
- Department of Cell and Chemical Biology, Leiden University Medical Center, Leiden, Netherlands
| | - Stefanie Knopp
- University of Basel, Basel, Switzerland.,Swiss Tropical and Public Health Institute, Basel, Switzerland
| | - Michelle N Clements
- MRC Clinical Trials Unit, University College London, London, United Kingdom.,SCI Foundation, London, United Kingdom
| | | | - Irenee Umulisa
- African Leaders Malaria Alliance, Dar-es-Salam, Tanzania.,Malaria and Other Parasitic Diseases Division, Neglected Tropical Diseases and Other Parasitic Diseases Unit, Rwanda Biomedical Center, Ministry of Health, Kigali, Rwanda
| | - Eugene Ruberanziza
- Malaria and Other Parasitic Diseases Division, Neglected Tropical Diseases and Other Parasitic Diseases Unit, Rwanda Biomedical Center, Ministry of Health, Kigali, Rwanda
| | - Udo Wittmann
- Consult AG Statistical Services, Zurich, Switzerland.,SCI Foundation, London, United Kingdom
| | - Thomas Kariuki
- African Academy of Sciences, Alliance for Accelerating Excellence in Science in Africa, Nairobi, Kenya.,Institute of Primate Research, National Museums of Kenya, Nairobi, Kenya
| | - Philip LoVerde
- Department of Biochemistry and Structural Biology, University of Texas Health, San Antonio, Texas
| | - William Evan Secor
- Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Lydia Atkins
- Ministry of Health and Wellness, Castries, St. Lucia
| | - Safari Kinung'hi
- Mwanza Research Centre, National Institute for Medical Research, Mwanza, Tanzania
| | - Sue Binder
- Schistosomiasis Consortium for Operational Research and Evaluation, Center for Tropical and Emerging Global Diseases, University of Georgia, Athens, Georgia
| | - Carl H Campbell
- Schistosomiasis Consortium for Operational Research and Evaluation, Center for Tropical and Emerging Global Diseases, University of Georgia, Athens, Georgia
| | - Daniel G Colley
- Department of Microbiology, University of Georgia, Athens, Georgia.,Schistosomiasis Consortium for Operational Research and Evaluation, Center for Tropical and Emerging Global Diseases, University of Georgia, Athens, Georgia
| | - Govert J van Dam
- Department of Parasitology, Leiden University Medical Center, Leiden, Netherlands
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22
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Colley DG, Jacobson JA, Binder S. Schistosomiasis Consortium for Operational Research and Evaluation (SCORE): Its Foundations, Development, and Evolution. Am J Trop Med Hyg 2020; 103:5-13. [PMID: 32400343 PMCID: PMC7351300 DOI: 10.4269/ajtmh.19-0785] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
The Schistosomiasis Consortium for Operational Research and Evaluation (SCORE) was established in late 2008 to conduct operational research that would inform practices related to the control and elimination of schistosomiasis. This article traces SCORE’s beginnings and underpinnings. These include an emphasis on openness and contributing to the development of a cohesive schistosomiasis control community, building linkages between researchers and national programs, and focusing on answering questions that will help Neglected Tropical Disease program managers to better control and eliminate schistosomiasis. It describes the development and implementation of SCORE’s multiple projects. SCORE began by drawing on advice from a broad range of experts by holding wide-ranging meetings that informed the priorities and protocols for SCORE research. SCORE’s major efforts included large, multicountry field studies comparing multiple strategies for mass drug administration with praziquantel, assessment of approaches to elimination, evaluation of a point-of-care assay for field mapping Schistosoma mansoni, and increasing the sensitivity of a laboratory-based diagnostic. SCORE also supported studies on morbidity due to schistosomiasis, quantification of vector snails and the detection of schistosome infections in snails, and changes in schistosome population genetics under praziquantel drug pressure. SCORE data and specimens are archived and will remain available for future research. Although much remains to be carried out, our hope is that through the already published articles and SCORE results described in this supplement, we will have provided a body of evidence to assist policy makers in the development of judicious guidelines for the control and elimination of schistosomiasis.
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Affiliation(s)
- Daniel G Colley
- Schistosomiasis Consortium for Operational Research and Evaluation, Center for Tropical and Emerging Global Diseases, University of Georgia, Athens, Georgia.,Department of Microbiology, University of Georgia, Athens, Georgia
| | | | - Sue Binder
- Schistosomiasis Consortium for Operational Research and Evaluation, Center for Tropical and Emerging Global Diseases, University of Georgia, Athens, Georgia
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23
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Webster JP, Neves MI, Webster BL, Pennance T, Rabone M, Gouvras AN, Allan F, Walker M, Rollinson D. Parasite Population Genetic Contributions to the Schistosomiasis Consortium for Operational Research and Evaluation within Sub-Saharan Africa. Am J Trop Med Hyg 2020; 103:80-91. [PMID: 32400355 PMCID: PMC7351308 DOI: 10.4269/ajtmh.19-0827] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Analyses of the population genetic structure of schistosomes under the "Schistosomiasis Consortium for Operational Research and Evaluation" (SCORE) contrasting treatment pressure scenarios in Tanzania, Niger, and Zanzibar were performed to provide supplementary critical information with which to evaluate the impact of these large-scale control activities and guide how activities could be adjusted. We predicted that population genetic analyses would reveal information on a range of important parameters including, but not exclusive to, recruitment and transmission of genotypes, occurrence of hybridization events, differences in reproductive mode, and degrees of inbreeding, and hence, the evolutionary potential, and responses of parasite populations under contrasting treatment pressures. Key findings revealed that naturally high levels of gene flow and mixing of the parasite populations between neighboring sites were likely to dilute any effects imposed by the SCORE treatment arms. Furthermore, significant inherent differences in parasite fecundity were observed, independent of current treatment arm, but potentially of major impact in terms of maintaining high levels of ongoing transmission in persistent "biological hotspot" sites. Within Niger, naturally occurring Schistosoma haematobium/Schistosoma bovis viable hybrids were found to be abundant, often occurring in significantly higher proportions than that of single-species S. haematobium infections. By examining parasite population genetic structures across hosts, treatment regimens, and the spatial landscape, our results to date illustrate key transmission processes over and above that which could be achieved through standard parasitological monitoring of prevalence and intensity alone, as well as adding to our understanding of Schistosoma spp. life history strategies in general.
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Affiliation(s)
- Joanne P Webster
- London Centre for Neglected Tropical Disease Research (LCNTDR), Imperial College Faculty of Medicine, London, United Kingdom.,Department of Pathobiology and Population Sciences, Centre for Emerging, Endemic and Exotic Diseases (CEEED), Royal Veterinary College, University of London, Hawkshead Campus, Herts, United Kingdom
| | - Maria Inês Neves
- London Centre for Neglected Tropical Disease Research (LCNTDR), Imperial College Faculty of Medicine, London, United Kingdom.,Department of Pathobiology and Population Sciences, Centre for Emerging, Endemic and Exotic Diseases (CEEED), Royal Veterinary College, University of London, Hawkshead Campus, Herts, United Kingdom
| | - Bonnie L Webster
- Department of Life Sciences, Wolfson Wellcome Biomedical Laboratories, The Natural History Museum, London, United Kingdom.,London Centre for Neglected Tropical Disease Research (LCNTDR), Imperial College Faculty of Medicine, London, United Kingdom
| | - Tom Pennance
- School of Biosciences, Cardiff University, Cardiff, United Kingdom.,Department of Life Sciences, Wolfson Wellcome Biomedical Laboratories, The Natural History Museum, London, United Kingdom.,London Centre for Neglected Tropical Disease Research (LCNTDR), Imperial College Faculty of Medicine, London, United Kingdom
| | - Muriel Rabone
- Department of Life Sciences, Wolfson Wellcome Biomedical Laboratories, The Natural History Museum, London, United Kingdom.,London Centre for Neglected Tropical Disease Research (LCNTDR), Imperial College Faculty of Medicine, London, United Kingdom
| | - Anouk N Gouvras
- Department of Life Sciences, Wolfson Wellcome Biomedical Laboratories, The Natural History Museum, London, United Kingdom.,London Centre for Neglected Tropical Disease Research (LCNTDR), Imperial College Faculty of Medicine, London, United Kingdom
| | - Fiona Allan
- Department of Life Sciences, Wolfson Wellcome Biomedical Laboratories, The Natural History Museum, London, United Kingdom.,London Centre for Neglected Tropical Disease Research (LCNTDR), Imperial College Faculty of Medicine, London, United Kingdom
| | - Martin Walker
- London Centre for Neglected Tropical Disease Research (LCNTDR), Imperial College Faculty of Medicine, London, United Kingdom.,Department of Pathobiology and Population Sciences, Centre for Emerging, Endemic and Exotic Diseases (CEEED), Royal Veterinary College, University of London, Hawkshead Campus, Herts, United Kingdom
| | - David Rollinson
- Department of Life Sciences, Wolfson Wellcome Biomedical Laboratories, The Natural History Museum, London, United Kingdom.,London Centre for Neglected Tropical Disease Research (LCNTDR), Imperial College Faculty of Medicine, London, United Kingdom
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24
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Colley DG, Fleming FM, Matendechero SH, Knopp S, Rollinson D, Utzinger J, Castleman JD, Kittur N, King CH, Campbell CH, Kabole FM, Kinung'hi S, Ramzy RMR, Binder S. Contributions of the Schistosomiasis Consortium for Operational Research and Evaluation (SCORE) to Schistosomiasis Control and Elimination: Key Findings and Messages for Future Goals, Thresholds, and Operational Research. Am J Trop Med Hyg 2020; 103:125-134. [PMID: 32400345 PMCID: PMC7351304 DOI: 10.4269/ajtmh.19-0787] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Herein, we summarize what we consider are major contributions resulting from the Schistosomiasis Consortium for Operational Research and Evaluation (SCORE) program, including its key findings and key messages from those findings. Briefly, SCORE's key findings are as follows: i) biennial mass drug administration (MDA) with praziquantel can control schistosomiasis to moderate levels of prevalence; ii) MDA alone will not achieve elimination; iii) to attain and sustain control throughout endemic areas, persistent hotspots need to be identified following a minimal number of years of annual MDA and controlled through adaptive strategies; iv) annual MDA is more effective than biennial MDA in high-prevalence areas; v) the current World Health Organization thresholds for decision-making based on the prevalence of heavy infections should be redefined; and vi) point-of-care circulating cathodic antigen urine assays are useful for Schistosoma mansoni mapping in low-to-moderate prevalence areas. The data and specimens collected and curated through SCORE efforts will continue to be critical resource for future research. Besides providing useful information for program managers and revision of guidelines for schistosomiasis control and elimination, SCORE research and outcomes have identified additional questions that need to be answered as the schistosomiasis community continues to implement effective, evidence-based programs. An overarching contribution of SCORE has been increased cohesiveness within the schistosomiasis field-oriented community, thereby fostering new and productive collaborations. Based on SCORE's findings and experiences, we propose new approaches, thresholds, targets, and goals for control and elimination of schistosomiasis, and recommend research and evaluation activities to achieve these targets and goals.
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Affiliation(s)
- Daniel G Colley
- Department of Microbiology, University of Georgia, Athens, Georgia.,Schistosomiasis Consortium for Operational Research and Evaluation (SCORE), Center for Tropical and Emerging Global Diseases, University of Georgia, Athens, Georgia
| | - Fiona M Fleming
- Department of Infectious Disease Epidemiology, Schistosomiasis Control Initiative, London, United Kingdom
| | - Sultani H Matendechero
- Division of Communicable Disease Prevention and Control, Neglected Tropical Diseases Unit, Ministry of Health, Nairobi, Kenya
| | - Stefanie Knopp
- University of Basel, Basel, Switzerland.,Swiss Tropical and Public Health Institute, Basel, Switzerland.,Department of Life Sciences, Wolfson Wellcome Biomedical Laboratories, Natural History Museum, London, United Kingdom
| | - David Rollinson
- Department of Life Sciences, Wolfson Wellcome Biomedical Laboratories, Natural History Museum, London, United Kingdom
| | - Jürg Utzinger
- University of Basel, Basel, Switzerland.,Swiss Tropical and Public Health Institute, Basel, Switzerland
| | - Jennifer D Castleman
- Schistosomiasis Consortium for Operational Research and Evaluation (SCORE), Center for Tropical and Emerging Global Diseases, University of Georgia, Athens, Georgia
| | - Nupur Kittur
- Schistosomiasis Consortium for Operational Research and Evaluation (SCORE), Center for Tropical and Emerging Global Diseases, University of Georgia, Athens, Georgia
| | - Charles H King
- Center for Global Health and Diseases, Case Western Reserve University, Cleveland, Ohio.,Schistosomiasis Consortium for Operational Research and Evaluation (SCORE), Center for Tropical and Emerging Global Diseases, University of Georgia, Athens, Georgia
| | - Carl H Campbell
- Schistosomiasis Consortium for Operational Research and Evaluation (SCORE), Center for Tropical and Emerging Global Diseases, University of Georgia, Athens, Georgia
| | - Fatma M Kabole
- Neglected Diseases Programme, Ministry of Health of Zanzibar, Zanzibar, United Republic of Tanzania
| | - Safari Kinung'hi
- National Institute for Medical Research (NIMR), Mwanza Centre, Mwanza, United Republic of Tanzania
| | - Reda M R Ramzy
- National Nutrition Institute, General Organization for Teaching Hospitals and Institutes, Cairo, Egypt
| | - Sue Binder
- Schistosomiasis Consortium for Operational Research and Evaluation (SCORE), Center for Tropical and Emerging Global Diseases, University of Georgia, Athens, Georgia
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25
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Urine-Based Antigen (Protein) Detection Test for the Diagnosis of Visceral Leishmaniasis. Microorganisms 2020; 8:microorganisms8111676. [PMID: 33126760 PMCID: PMC7693408 DOI: 10.3390/microorganisms8111676] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 10/22/2020] [Accepted: 10/23/2020] [Indexed: 11/29/2022] Open
Abstract
This review describes and appraises a novel protein-based antigen detection test for visceral leishmaniasis (VL). The test detects in patient’s urine six proteins from Leishmania infantum (chagasi) and Leishmania donovani, the etiological agents of VL. The gold standard test for VL is microscopic observation of the parasites in aspirates from spleen, liver, or bone marrow (and lymph node for dogs). Culture of the parasites or detection of their DNA in these aspirates are also commonly used. Serological tests are available but they cannot distinguish patients with active VL from either healthy subjects exposed to the parasites or from subjects who had a successful VL treatment. An antigen detection test based on the agglutination of anti-leishmania carbohydrates antibody coated latex beads has been described. However, the results obtained with this carbohydrate-based test have been conflicting. Using mass spectrometry, we discovered six L. infantum/L. donovani proteins excreted in the urine of VL patients and used them as markers for the development of a robust mAb-based antigen (protein) detection test. The test is assembled in a multiplexed format to simultaneously detect all six markers. Its initial clinical validation showed a sensitivity of 93% and specificity of 100% for VL diagnosis.
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26
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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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27
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Binder S, Campbell CH, Andros TS, Castleman JD, Kittur N, King CH, Colley DG. The Schistosomiasis Consortium for Operational Research and Evaluation 2008-2020: Approaches, Experiences, Lessons, and Recommendations. Am J Trop Med Hyg 2020; 103:114-124. [PMID: 32400350 PMCID: PMC7351309 DOI: 10.4269/ajtmh.19-0786] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
For the past 10 years, the Schistosomiasis Consortium for Operational Research and Evaluation (SCORE), funded by the Bill & Melinda Gates Foundation, has been supporting operational research to provide a stronger evidence base for controlling and moving toward elimination of schistosomiasis. The SCORE portfolio was developed and implemented with engagement from many stakeholders and sectors. Particular efforts were made to include endemic country neglected tropical disease program managers. Examples of the challenges we encountered include the need to balance rigor (e.g., conducting large cluster-randomized trials) with ensuring relevance to real-world settings, allowing for local contexts while standardizing key study aspects, adjusting to evolving technologies, and incorporating changing technologies into multiyear studies. The Schistosomiasis Consortium for Operational Research and Evaluation's findings and data and the collected specimens will continue to be useful in the years to come. Our experiences and lessons learned can benefit both program managers and researchers conducting similar work in the future.
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Affiliation(s)
- Sue Binder
- Schistosomiasis Consortium for Operational Research and Evaluation, Center for Tropical and Emerging Global Diseases, University of Georgia, Athens, Georgia
| | - Carl H Campbell
- Schistosomiasis Consortium for Operational Research and Evaluation, Center for Tropical and Emerging Global Diseases, University of Georgia, Athens, Georgia
| | - Tamara S Andros
- Schistosomiasis Consortium for Operational Research and Evaluation, Center for Tropical and Emerging Global Diseases, University of Georgia, Athens, Georgia
| | - Jennifer D Castleman
- Schistosomiasis Consortium for Operational Research and Evaluation, Center for Tropical and Emerging Global Diseases, University of Georgia, Athens, Georgia
| | - Nupur Kittur
- Schistosomiasis Consortium for Operational Research and Evaluation, Center for Tropical and Emerging Global Diseases, University of Georgia, Athens, Georgia
| | - Charles H King
- Center for Global Health and Diseases, Case Western Reserve University School of Medicine, Cleveland, Ohio.,Schistosomiasis Consortium for Operational Research and Evaluation, Center for Tropical and Emerging Global Diseases, University of Georgia, Athens, Georgia
| | - Daniel G Colley
- Department of Microbiology, University of Georgia, Athens, Georgia.,Schistosomiasis Consortium for Operational Research and Evaluation, Center for Tropical and Emerging Global Diseases, University of Georgia, Athens, Georgia
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