Abstract
BackgroundDetermining the variation of circulating cathodic antigen (CCA) in urine and egg counts variation in stool between days in Schistosoma mansoni (S. mansoni) infected individuals is vital to decide whether or not to rely on a single-sample test for diagnosis of Schistosomiasis. In this study, the magnitude of day-to-day variation in urine-CCA test scores and in faecal egg counts was evaluated in school children in Ethiopia.MethodsA total of 620 school children (age 8 to 12 years) were examined for S. mansoni infection using double Kato-Katz and single urine-CCA cassette methods (batch 32727) on three consecutive days.ResultsThe prevalence of S. mansoni infection was 81.1% based on triple urine-CCA-cassette test and 53.1% based on six Kato-Katz thick smears. Among the study participants, 26.3% showed fluctuation in urine CCA and 32.4% showed fluctuation in egg output. Mean egg count as well as number of cases in each class of intensity and intensity of cassette band color varied over the three days of examination. Over 85% of the children that showed day-to-day variations in status of S. mansoni infection from negative to positive or vice versa by the Kato-Katz and the CCA methods had light intensity of infection. The fluctuation in both the CCA test scores and faecal egg count was not associated with age and sex.ConclusionsThe current study showed day-to-day variation in CCA and Kato-Katz test results of children infected with S. mansoni. This indicates the necessity of more than one urine or stool samples to be collected on different days for more reliable diagnosis of S. mansoni infection in low endemic areas.
Highlights
Determining the variation of circulating cathodic antigen (CCA) in urine and egg counts variation in stool between days in Schistosoma mansoni (S. mansoni) infected individuals is vital to decide whether or not to rely on a single-sample test for diagnosis of Schistosomiasis
S. mansoni infection status based on the urine-CCA cassette test Using urine-CCA cassette test, 54.8% (340/620) of the children were positive for S. mansoni infection on all the three consecutive days, 18.9% (117/620) were negative in all the three consecutive days, and 26.3% (163/620) had fluctuating results
Variation in urine-CCA cassette test over the three days of examination decreased as the intensity of infection increased
Summary
Determining the variation of circulating cathodic antigen (CCA) in urine and egg counts variation in stool between days in Schistosoma mansoni (S. mansoni) infected individuals is vital to decide whether or not to rely on a single-sample test for diagnosis of Schistosomiasis. The magnitude of day-to-day variation in urine-CCA test scores and in faecal egg counts was evaluated in school children in Ethiopia. S. mansoni infection is a common public health problem in the developing world [1]. The objective of this study was to evaluate day-to-day variation in urine-CCA test scores and in faecal egg counts while using the urine-CCA cassette test (batch 32727) and the Kato-Katz thick smear for the diagnosis of S. mansoni infection in children. The current paper is building on the same data set reported in Erko et al [14], but different analysis was used to approach day-to-day variation in urine-CCA cassette test and egg out puts in the diagnosis of S. mansoni infection
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