Accuracy of the urine point-of-care circulating cathodic antigen assay for diagnosing Schistosomiasis mansoni infection in Brazil: a multicenter study

Secretaria de Vigilância em Saúde / Fundo Nacional de Saúde / Ministério da Saúde - [TED/FNS: 118/2017; SIAFI: 691919 / 25000.479741/2017-05Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Educação em Ambiente e Saúde. Rio de Janeiro, RJ, Brasil.Universidade Federal do Ceará. Departamento de Análises Clínicas e Toxicológicas. Fortaleza, CE, Brasil.Fundação Oswaldo Cruz. Instituto René Rachou. Belo Horizonte, MG, Brasil.Ministério da Saúde. Secretaria de Ciência, Tecnologia, Inovação e Insumos Estratégicos. Instituto Evandro Chagas. Laboratório de Parasitoses Intestinais, Esquistossomose e Malacologia. Ananindeua, PA, Brasil.Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Educação em Ambiente e Saúde. Rio de Janeiro, RJ, Brasil.Universidade Federal do Espírito Santo. Centro de Ciências da Saúde. Unidade de Doenças Infecciosas. Vitória, ES, Brasil / Pontifícia Universidade Católica do Rio Grande do Sul. Laboratório de Parasitologia Biomédica. Porto Alegre, RS, Brasil.Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Salvador, BA, Brasil.Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Salvador, BA, Brasil / Universidade Federal da Bahia. Faculdade de Medicina. Salvador, BA, Brasil / Yale University. School of Public Health. Department of Epidemiology of Microbial Diseases. New Haven, CT, USA.Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Salvador, BA, Brasil.Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Educação em Ambiente e Saúde. Rio de Janeiro, RJ, Brasil.Pontifícia Universidade Católica do Rio Grande do Sul. Laboratório de Parasitologia Biomédica. Porto Alegre, RS, Brasil.Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Salvador, BA, Brasil.Ministério da Saúde. Secretaria de Ciência, Tecnologia, Inovação e Insumos Estratégicos. Instituto Evandro Chagas. Laboratório de Parasitoses Intestinais, Esquistossomose e Malacologia. Ananindeua, PA, Brasil.Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Salvador, BA, Brasil.Pontifícia Universidade Católica do Rio Grande do Sul. Laboratório de Parasitologia Biomédica. Porto Alegre, RS, Brasil.Universidade Federal do Ceará. Departamento de Análises Clínicas e Toxicológicas. Fortaleza, CE, Brasil.Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Salvador, BA, Brasil.Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Salvador, BA, Brasil.Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Salvador, BA, Brasil.Pontifícia Universidade Católica do Rio Grande do Sul. Laboratório de Parasitologia Biomédica. Porto Alegre, RS, Brasil.Fundação Oswaldo Cruz. Instituto René Rachou. Belo Horizonte, MG, Brasil.Background: The World Health Organization recommends a market-ready, urine-based point-of-care diagnostic test for circulating cathodic antigens (CCA) to determine the prevalence of S. mansoni. This study evaluated the performance of the URINE CCA (SCHISTO) ECO TESTE® (POC-ECO), which is currently available in Brazil. Methods: Residents from eight sites with different prevalence estimates provided one urine sample for POC-ECO and one stool sample for Kato-Katz (KK) and Helmintex® (HTX) testing as an egg-detecting reference for infection status. Results: None of the study sites had significantly higher POC-ECO accuracy than KK. Conclusions: POC-ECO is not currently recommended in Brazilian schistosomiasis elimination programs

Assessment of schistosomiasis in the semi-arid Northeast region of Brazil: the São Francisco River large-scale water transposition project

Abstract: INTRODUCTION Risk of schistosomiasis expansion to semi-arid northeastern Brazil under the influence of the Integration Project of the São Francisco River (IPSFR) was assessed. METHODS: Stool examinations of schoolchildren, epidemiological investigation, and survey of the local host snail Biomphalaria straminea were performed in five IPSFR municipalities. RESULTS Six of 4,770 examined schoolchildren were egg-positive for Schistosoma mansoni. Biomphalaria straminea was widespread, but not naturally infected with S. mansoni. Snails experimentally exposed to two laboratory S. mansoni strains yielded infection indices of 1-4.5%. CONCLUSIONS: There is evidence of active schistosomiasis transmission in the area; thus, intensive surveillance actions are required

Schistosoma Mansoni infection and related knowledge among schoolchildren in an endemic area of Minas Gerais, Brazil, prior to educational actions

This study was supported by Papes VI - Fiocruz/CBPq (grant 407616/2012-8) and CAPESOswaldo Cruz Foundation. Oswaldo Cruz Institute. Laboratory of Environmental and Health Education. Rio de Janeiro, RJ, Brazil.Oswaldo Cruz Foundation. Oswaldo Cruz Institute. Laboratory of Environmental and Health Education. Rio de Janeiro, RJ, Brazil.Oswaldo Cruz Foundation. René Rachou Research Centre. Research Group on Helminthology and Medical Malacology. Minas Gerais, MG, Brazil.Oswaldo Cruz Foundation. Oswaldo Cruz Institute. Laboratory of Environmental and Health Education. Rio de Janeiro, RJ, Brazil.Ministério da Saúde. Secretaria de Vigilância em Saúde. Instituto Evandro Chagas. Laboratório de Geoprocessamento. Ananindeua, PA, Brasil.Oswaldo Cruz Foundation. Oswaldo Cruz Institute. Laboratory of Environmental and Health Education. Rio de Janeiro, RJ, Brazil.Oswaldo Cruz Foundation. René Rachou Research Centre. Group of Transdisciplinary Studies in Education on Health and Environment. Minas Gerais, MG, Brazil.Oswaldo Cruz Foundation. Oswaldo Cruz Institute. Laboratory of Environmental and Health Education. Rio de Janeiro, RJ, Brazil.As a signatory to World Health Assembly Resolution WHA65.21 on eliminating schistosomiasis, the Brazilian Ministry of Health (MoH) recommends early identification and timely treatment of the infection carriers for morbidity control, plus complementary preventive measures, such as health education, for transmission control. This study reports infection and awareness of schistosomiasis among schoolchildren before the implementation of school-based educational actions in an endemic municipality with persisting moderate prevalence levels despite successive control campaigns since the late 1990s. A questionnaire was applied in April 2013 to schoolchildren in the middle years of schooling (6th to 8th year) of Malacacheta municipality to assess baseline knowledge and risk behaviour related to schistosomiasis. A stool survey was conducted in May/June 2013 in 2519 schoolchildren from all years of fundamental education (first to 9th year) to identify the infection carriers, as well as to assess baseline prevalence and intensity of infection using the Kato-Katz method (one sample, two slides). The infected schoolchildren were treated promptly with single-dose praziquantel 60 mg/kg and followed up after 45 days for treatment efficacy. Relevant outcomes from baseline stool survey, treatment and follow-up were statistically evaluated in relation to area of residence (rural/urban), gender, age group (<11/≥years) and infection. Adherence to baseline survey was 81.2%, and prevalence of infection was 21.4%. Of the 539 positives, 60 (11.1%) had ≥400 eggs per gram of faeces (heavy-intensity infection). Prevalence of infection was significantly higher among rural residents and ≥11 year olds, whereas intensity of infection was higher among rural residents, ≥11 year olds and boys. Adherence by the positives to treatment was 93.3% and adherence by the treated children to 45-day follow-up was 72.2%. At 45 days after treatment, 97.0% of the 363 children surveyed were egg-negative; the egg reduction rate was 99.4%. Of the 924 children who responded to the questionnaire, 95.5% showed awareness of schistosomiasis, although 76.2% reported contact with natural, unsafe bodies of water. Reported contact with water was significantly more frequent among infected than non-infected, and boys than girls. The results show persisting infection and risk behaviour among schoolchildren, regardless of their basic knowledge about schistosomiasis. These are grounds for implementing specific educational actions to improve awareness and behavioural change, jointly with other control measures, to attain the MoH goals