Development of point-of-care testing tool using immunochromatography for rapid diagnosis of human paragonimiasis

Abstract

Paragonimiasis, an important food-borne zoonosis, is caused by lung flukes of the genus Paragonimus. Several million people are actually infected or at risk. Paragonimiasis is a re-emerging disease in developing countries. Diagnosis of pulmonary paragonimiasis is made by finding eggs in sputa and/or fecal samples. Eggs are typically not found in ectopic paragonimiasis cases, so diagnosis depends on supportive information, such as a history of eating fresh water crabs or crayfishes, radiographic findings and immunological tests. Here, a new point-of-care-testing (POCT) tool is presented. It uses immunochromatography for serodiagnosis of human paragonimiasis using excretory-secretory antigen from Paragonimus heterotremus. It proved effective in diagnosing infections due to P. heterotremus, and was also successfully diagnosed with sera from infections with P. westermani and P. miyazakii. The diagnostic sensitivity, specificity, positive and negative predictive values and accuracy were 97.9%, 87.6%, 78%, 98.9%, and 90.8%, respectively. The developed POCT tool is rapid and simple to use not only for clinical diagnosis of paragonimiasis at the bedside or at well-equipped laboratories, but also at local and remote hospitals with limited facilities. Moreover, the POCT tool could be applied for epidemiological surveys of paragonimaisis in Asia where P. heterotremus, P. westermani and P. miyazakii are endemic.