Defining cutoffs for the Point-of-Care Circulating Cathodic Antigen (POC CCA) assay in areas of low Schistosoma mansoni prevalence in western Kenya

项目摘要 曼氏血吸虫病控制方案的监测和评价目前正在进行， 通过使用Kato-Katz技术检测粪便样本中的寄生虫卵进行。 该方法具有已知的灵敏度限制，并且需要训练有素的显微镜操作员， 功能显微镜进行评估。最近（2008年）， (POC)检测S的测试。尿中的曼氏循环阴极抗原（CCA） 变得商业化。它更便宜，易于部署，具有更高的灵敏度， 粪便检查，并在成功治疗后迅速变为阴性。世卫组织 2015年2月，工作组和 随后，战略和技术咨询小组鼓励增加 验证POC-CCA，以更好地定义应用于计划的截止值 决策以及监测和评价的S。曼索尼控制 程序.需要更多关于新开发的染色体的性能的数据 在地方病和MDA后环境中进行抗原检测，以便能够开发 这些工具的方案使用建议。现有证据表明， 在高患病率地区（≥ 50%），Kato-Katz和POC-CCA检测均提供 合理和可比的流行水平，目前的准则是 完全足以控制发病率。然而，缺乏可比数据， 在发病率低的地区（< 30%）。因此，我们建议在这项研究中评估 POC CCA和Kato-Katz测定在低S地区的诊断性能。 肯尼亚西部的曼索尼病流行情况。这项研究的结果将有助于澄清 Kato-Katz和POC-CCA之间的关系，并确定视觉POC- CCA谱带强度可用于评估治疗效果，以告知 方案干预。

Project Abstract Monitoring and evaluation of control programs for Schistosoma mansoni is currently performed by detection of parasite eggs in stool samples using the Kato-Katz technique. This method has known limitations in sensitivity and requires trained microscopists and functional microscopes to perform the assessments. Recently (in 2008), a point of care (POC) test that detects S. mansoni circulating cathodic antigen (CCA) in urine has become commercially available. It is cheaper, easy to deploy, has greater sensitivity than stool exam and rapidly becomes negative upon successful treatment. At the WHO meeting on schistosome diagnostics in February 2015, the working group and subsequently the Strategic and Technical Advisory Group (STAG) encouraged additional validation of the POC-CCA to better define what cutoffs should be used for program decision making as well as for monitoring and evaluation for S. mansoni control programs. More data are needed on the performance of newly developed schistosomal antigen tests in endemic and post-MDA settings in order to be able to develop recommendations for programmatic use of these tools. Existing evidence suggests that in areas of high prevalence (≥ 50%), the Kato-Katz and POC-CCA assays both provide reasonable and comparable levels of prevalence and that the current guidelines are entirely adequate for morbidity control. However, there is a paucity of comparable data in areas of low (< 30%) prevalence. Thus, we propose in this study to evaluate the diagnostic performance of the POC CCA and Kato-Katz assays in areas of low S. mansoni prevalence in western Kenya. Findings from this study will help to clarify the relationship between Kato-Katz and POC-CCA and determine whether the visual POC- CCA band intensities can be used to evaluate treatment efficacy in order to inform program interventions.