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Diagnostic comparison of stool exam and point-of-care circulating cathodic antigen (POC-CCA) test for schistosomiasis mansoni diagnosis in a high endemicity area in northeastern Brazil

Published online by Cambridge University Press:  16 November 2020

Danielle de Freitas Bezerra ,
Marta Cristhiany Cunha Pinheiro ,
Luciene Barbosa ,
Agostinho Gonçalves Viana ,
Ricardo Toshio Fujiwara  and
Fernando Schemelzer de Moraes Bezerra Open the ORCID record for Fernando Schemelzer de Moraes Bezerra [Opens in a new window]
Danielle de Freitas Bezerra*
Affiliation:
Post-Graduate Program in Pathology, School of Medicine, Federal University of Ceará, Fortaleza, Brazil
Marta Cristhiany Cunha Pinheiro
Affiliation:
Laboratory of Parasitology and Mollusc Biology, Department of Clinical Analysis and Toxicology, Federal University of Ceará, Fortaleza, Brazil
Luciene Barbosa
Affiliation:
Parasitology and Tropical Entomology Laboratory, Department of Morphology, Federal University of Sergipe, Aracajú, Brazil
Agostinho Gonçalves Viana
Affiliation:
Institute of Biological Sciences, Federal University of Minas Gerais, Belo Horizonte, Brazil
Ricardo Toshio Fujiwara
Affiliation:
Institute of Biological Sciences, Federal University of Minas Gerais, Belo Horizonte, Brazil
Fernando Schemelzer de Moraes Bezerra*
Affiliation:
Post-Graduate Program in Pathology, School of Medicine, Federal University of Ceará, Fortaleza, Brazil Laboratory of Parasitology and Mollusc Biology, Department of Clinical Analysis and Toxicology, Federal University of Ceará, Fortaleza, Brazil Post-Graduate Program in Medical Sciences, School of Medicine, Federal University of Ceará, Fortaleza, Brazil
*
Author for correspondence: Fernando Schemelzer de Moraes Bezerra, E-mail: schemelzer@gmail.com
Author for correspondence: Fernando Schemelzer de Moraes Bezerra, E-mail: schemelzer@gmail.com
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Abstract

This study aimed to evaluate the performance of the point-of-care circulating cathodic antigen (POC-CCA) test in a highly endemic area in Brazil, comparing it to the Kato-Katz (KK) technique for sensitivity, specificity and the intensity of the reaction of the test in relation to the parasitic load. The community in Sergipe, Brazil, participated in the study, providing three stool samples, one of urine (POC-CCA) and fingers tick blood sample was tested by enzyme-linked immunosorbent assay (ELISA). Sensitivity, specificity, positive predictive value, negative predictive value, accuracy, kappa coefficient and Spearman's correlation were calculated for the POC-CCA test using the KK as the reference. The prevalence of schistosomiasis by KK testing was 48.82%; POC-CCA (t+) 66.14%; POC-CCA (t−) 45.24%. ELISA results showed 100% agreement in individuals with high and moderate eggs per gram (EPG). POC-CCA presented good diagnostic performance in individuals with medium and high EPG, but there were a high number of false negatives in individuals with low intensity infections. As observed, POC-CCA-filter test improves accuracy and sensitivity compared to a conventional test.

Keywords

Diagnosishigh endemicityimmunochromatographyKato-KatzPOC-CCASchistosoma mansoni
Type
Research Article
Information
Parasitology , Volume 148 , Issue 4 , April 2021 , pp. 420 - 426
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Copyright
Copyright © The Author(s), 2020. Published by Cambridge University Press

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