Abstract
BackgroundSchistosomiasis remains a serious public health problem in affected countries, and routine, highly sensitive and cost-effective diagnostic methods are lacking. We evaluated two immunodiagnostic techniques for the detection of Schistosoma japonicum infections: circulating antibody and circulating antigen assays.MethodsA total of 1864 individuals (between 6 and 72 years old) residing in five administrative villages in Hubei province were screened by serum examination with an indirect hemagglutination assay (IHA). The positive individuals (titer ≥20 in IHA) were reconfirmed by stool examination with the Kato-Katz method (three slides from a single stool specimen). Samples of good serum quality and a volume above 0.5 ml were selected for further testing with two immunodiagnostic antibody (DDIA and ELISA) and two antigen (ELISA) assays.ResultsThe average antibody positive rate in the five villages was 12.7%, while the average parasitological prevalence was 1.50%; 25 of the 28 egg-positive samples were also circulating antigen-positive. Significant differences were observed between the prevalence according to the Kato-Katz method and all three immunodiagnostic antibody assays (P-value <0.0001). Similar differences were observed between the Kato-Katz method and the two immunodiagnostic antigen assays (P-value <0.0001) and between the antigen and antibody assays (P-value <0.0001).ConclusionBoth circulating antibody and circulating antigen assays had acceptable performance characteristics. Immunodiagnostic techniques to detect circulating antigens have potential to be deployed for schistosomiasis japonica screening in the endemic areas.
Highlights
Schistosomiasis remains a serious public health problem in affected countries, and routine, highly sensitive and cost-effective diagnostic methods are lacking
The sero-prevalence of Schistosoma japonicum according to different methods Among the 1864 individual sera, 240 were antibody positive as tested with the indirect hemagglutination assay (IHA) method in the field immediately after the serum samples were collected
The ELISA method gave the same results as the IHA but the number of positive samples according to the Dipstick Dye Immunoassay (DDIA) method was a little
Summary
Schistosomiasis remains a serious public health problem in affected countries, and routine, highly sensitive and cost-effective diagnostic methods are lacking. It must be considered that for the Kato-Katz method, only 41.7 mg of fecal material are examined per slide, limiting the chance to detect eggs in the case of light-intensity infections. This results in high rates of false-negative results in certain populations, most notably following repeated rounds of mass praziquantel administration, the current mainstay of schistosomiasis control worldwide [15,16,17,18,19]. It follows that the current diagnostic gold standard may be unsuitable for surveys and surveillance in communities with predominantly low-intensity infections [20,21,22,23,24,25]
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