Innovative methodology for point-of-care circulating cathodic antigen with rapid urine concentration for use in the field for detecting low Schistosoma mansoni infection and for control of cure with high accuracy

Abstract Background Prior to eliminating schistosomiasis, efforts must address accurate and fast individual diagnosis. Diagnosis is still inaccurate by parasitological and point-of-care circulating cathodic antigen (POC-CCA) in areas of low endemicity. Methods Our group has optimized POC-CCA with a...

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Published in:	Transactions of the Royal Society of Tropical Medicine and Hygiene Vol. 112; no. 1; pp. 1 - 7
Main Authors:	Grenfell, Rafaella F Q, Taboada, Diana, Coutinho, Lucélia A, Pedrosa, Maria Luysa C, Assis, Jéssica V, Oliveira, Matheus S P, Cruz, Renata R, Almeida, Aureo, Silva-Moraes, Vanessa, Katz, Naftale, Coelho, Paulo Marcos Z
Format:	Journal Article
Language:	English
Published:	England Oxford University Press 01-01-2018
Subjects:	Schistosomiasis mansoni Control of cure Fast urine concentration Trace readings definition Cross-reactivity POC-CCA improvement
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Summary:	Abstract Background Prior to eliminating schistosomiasis, efforts must address accurate and fast individual diagnosis. Diagnosis is still inaccurate by parasitological and point-of-care circulating cathodic antigen (POC-CCA) in areas of low endemicity. Methods Our group has optimized POC-CCA with a 30 min urine concentration step with no need for specialized technicians or equipment and with high accuracy. We evaluated this new method, called POC-CCA filter (FLT), in two Brazilian endemic areas with distinct profiles. Results At baseline, POC-CCA had a poor performance with several false results and undefined trace readings, revealing a prevalence rate of 10% against a rate of 23% for POC-CCA FLT, which was similar to the parasitological rates. Accuracy increased from as low as 0.36 to 0.96 after urine concentration in one area. POC-CCA properly diagnosed only half of the cases at three post-treatment time points, while POC-CCA FLT was able to diagnose 96, 83 and 100%, respectively. Conclusions The improvement of conventional POC methodology by a fast and simple urine concentration step provided not only an increase in its accuracy before and after praziquantel treatment, but also preserved its applicability in low-prevalence endemic areas, allowing the definition of trace readings as negative cases.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0035-9203 1878-3503
DOI:	10.1093/trstmh/try014