Superiority of rectal snip over serology in detection of schistosomiasis eradication: A pilot study

Abstract

Background and study aimsThe diagnosis of schistosomiasis is based on serological determination of anti-schistosoma antibody and schistosoma antigen in serum and urine but the gold standard test is the microscopic detection of schistosoma eggs in urine and stool. However, there is an urgent demand to reach the elimination goal with higher sensitivity and specificity tools. This study aimed to evaluate the sensitivity and specificity of anti-schistosoma antibody and schistosoma antigen in comparaison with rectal snip in the detection and prediction of eradication of schistosomiasis in previously and/or incidentaly diagnosed patients. Patients and methodsSixty patients were divided into 48 patients with ultrasound evidence of periportal fibrosis and non-calcified Schistosoma eggs detected microscopically in rectal snip biopsy and 12 control subjects with ultrasound evidence of periportal fibrosis only. ResultsRectal snip was more sensitive than standard serological tests in the investigation for detection and eradication of schistosomiasis infection with 100% sensitivity when compared to the sensitivity of Schistosoma antigen (45.8%) and that of Schistosoma antibody (31.2%). ConclusionPatients presenting to tropical medicine clinics with periportal fibrosis and/or abdominal symptoms with history of close proximity to fresh water bodies should be assessed by serology for schistosomiasis infection especially in highly endemic area. Rectal snip sampling should be done for negative or relapsed cases to exclude infection and confirm schistosomiasis clearance.