Accuracy of Urine Circulating Cathodic Antigen (CCA) Test for Schistosoma mansoni Diagnosis in Different Settings of Côte d'Ivoire

We aimed to assess the accuracy of a commercially available rapid diagnostic test for the detection of an infection with the blood fluke Schistosoma mansoni in urine. In total, 446 school children from three different settings of south Côte d'Ivoire provided three stool and three urine samples. Stool samples were examined with the widely used Kato-Katz technique and analyzed with a microscope for S. mansoni eggs. Urine samples were examined with a filtration method for S. haematobium eggs and with a rapid diagnostic test for S. mansoni that is based on detecting circulating cathodic antigens (CCA). We used a commercially available test (designated CCA-A) and an experimental formulation (CCA-B). Examination of nine Kato-Katz thick smears per child revealed a prevalence of S. mansoni in the three settings of 32.9%, 53.1%, and 91.8%. The sensitivity of triplicate Kato-Katz from the first stool sample was comparable to a single CCA-A (47.9–94.2% vs. 56.3–89.6%), and significantly higher than the sensitivity of a single CCA-B test (10.4–75.0%). CCA-A showed a considerably lower specificity than CCA-B (76.9–84.2% vs. 96.7–100%). In the settings studied in south Côte d'Ivoire, the CCA-A test holds promise for the diagnosis of S. mansoni, whereas results with CCA-B were suboptimal

Adverse events 4 and 24 hours after administration of crushed praziquantel tablets (<i>n</i> = 234).

<p>The study was carried out in two villages in Azaguié, south Côte d'Ivoire between June and November 2011, focusing on preschool-aged children.</p

<i>S. mansoni</i> and <i>S. haematobium</i> cure and egg reduction rates, as assessed 3 weeks after praziquantel treatment, stratified by diagnostic approach.

<p>The study was carried out in two villages in Azaguié, south Côte d'Ivoire, between June and November 2011, focusing on preschool-aged children.</p><p>CI, confidence interval; CR, cure rate; EPG, eggs/gram of stool; ERR, egg reduction rate; NA, not applicable; POC-CCA, point-of-care circulating cathodic antigen.</p

Baseline prevalence of <i>S. mansoni</i> and <i>S. haematobium</i>, stratified by sex and diagnostic approach.

<p>The study was carried out in two villages in Azaguié, south Côte d'Ivoire, between June and November 2011. All preschool-aged children who had at least one stool sample examined with duplicate Kato-Katz thick smears and one urine sample subjected to a filtration method before and 3 weeks after praziquantel administration were included (per-protocol analysis).</p><p>POC-CCA, point-of-care circulating cathodic antigen.</p

Flow chart and study adherence.

<p>The study was carried out in the villages of Azaguié Makouguié and Azaguié M'Bromé in south Côte d'Ivoire, between June and November 2011.</p