A five-country evaluation of a point-of-care circulating cathodic antigen urine assay for the prevalence of Schistosoma mansoni.

A five-country evaluation of a point-of-care circulating cathodic antigen urine assay for the prevalence of Schistosoma mansoni.
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DOI:
10.4269/ajtmh.12-0639
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发表时间:
2013-03
期刊:
The American journal of tropical medicine and hygiene
影响因子:
--
通讯作者:
Rathbun S
Rathbun S
中科院分区:
其他
文献类型:
--
作者:
Colley DG;Binder S;Campbell C;King CH;Tchuem Tchuenté LA;N'Goran EK;Erko B;Karanja DMS;Kabatereine NB;van Lieshout L;Rathbun S

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我们评估了一种商业护理点循环阴极抗原(POC-CCA)测试,用于评估高危地区曼氏血吸虫感染的流行情况。总体而言,喀麦隆、科特迪瓦、埃塞俄比亚、肯尼亚和乌干达的 4,405 名学龄儿童提供了尿液用于 POC-CCA 检测,并提供了粪便用于 Kato-Katz 检测。通过潜类别分析,一项 POC-CCA 测试比一次粪便的多次 Kato-Katz 涂片更敏感(86% 对比 62%),但特异性较差(72% 对比~100%)。然而,非流行地区只有 1% 的 POC-CCA 测试出现假阳性,这表明潜在类别分析低估了 POC-CCA 特异性。多变量模型估计 POC-CCA 在低感染强度(< 100 个虫卵/克粪便)下比 Kato-Katz 更敏感。通过线性回归,9-12岁儿童中POC-CCA的72%患病率对应于Kato-Katz的50%患病率,而46%的POC-CCA患病率对应于Kato-Katz的10%患病率。我们得出的结论是,一种尿液 POC-CCA 测试可以取代 Kato-Katz 测试来绘制社区级曼氏沙门氏菌患病率。
We evaluated a commercial point-of-care circulating cathodic antigen (POC-CCA) test for assessing Schistosoma mansoni infection prevalence in areas at risk. Overall, 4,405 school-age children in Cameroon, Côte d'Ivoire, Ethiopia, Kenya, and Uganda provided urine for POC-CCA testing and stool for Kato-Katz assays. By latent class analysis, one POC-CCA test was more sensitive (86% versus 62%) but less specific (72% versus ∼100%) than multiple Kato-Katz smears from one stool. However, only 1% of POC-CCA tests in a non-endemic area were false positives, suggesting the latent class analysis underestimated the POC-CCA specificity. Multivariable modeling estimated POC-CCA as significantly more sensitive than Kato-Katz at low infection intensities (< 100 eggs/gram stool). By linear regression, 72% prevalence among 9–12 year olds by POC-CCA corresponded to 50% prevalence by Kato-Katz, whereas 46% POC-CCA prevalence corresponded to 10% Kato-Katz prevalence. We conclude that one urine POC-CCA test can replace Kato-Katz testing for community-level S. mansoni prevalence mapping.
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