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COMPARISON OF A POLYMERASE CHAIN REACTION AND THE KATO-KATZ TECHNIQUE FOR DIAGNOSING INFECTION WITH SCHISTOSOMA MANSONI

Fecal samples from 194 individuals living in an area of Brazil endemic for Schistosoma mansoni were analyzed by a polymerase chain reaction (PCR) and the Kato-Katz parasitologic examination. Statistical analysis of the results showed a kappa index of 0.8 between the two methods. The prevalence of infection was 30.9% in three fecal samples examined by the Kato-Katz method, but 38.1% in one fecal sample examined by the PCR technique. Repeated survey of discordant results showed that five (41.6%) of 12 parasitologically negative cases for which PCR gave positive results were misdiagnosed by Kato-Katz examinations. The PCR technique showed a sensitivity of 96.7% and a specificity of 88% when the parasitologic examination was used as the reference test. The efficacy of cure with praziquantel was 87.8% in three parasitologic stool examinations and 75.6% in one PCR survey. These results demonstrate that the PCR assay might be a valuable alternative for diagnosing Schistosoma infections.

Received October 26, 2002. Accepted for publication February 3, 2003.

Acknowledgment: We thank Aureo Almeida for excellent technical assistance.

Financial support: This work was partially supported by the Conselho Nacional de Pesquisa (CNPq-Brazil) and the PAPES/Fundação Oswaldo Cruz. Emmanuel Dias-Neto thanks the Associação Beneficente Alzira Denise Hertzog Silva for their support.

Authors’ addresses: Luis A. Pontes, Maria C. Oliveira, and Ana Rabello, Laboratory of Clinical Research, Centro de Pesquisas René Rachou, Fundação Oswaldo Cruz-Fiocruz, Av. Augusto de Lima, 1715, 30190-002, Barro Preto, Belo Horizonte, Minas Gerais, Brazil, Telephone: 55-31-3295-3566, E-mail: luis{at}cpqrr.fiocruz.br. Naftale Katz, Laboratory of Schistosomiasis, Centro de Pesquisas René Rachou, Fundação Oswaldo Cruz-Fiocruz, Av. Augusto de Lima, 1715, 30190-002, Barro Preto, Belo Horizonte, Minas Gerais, Brazil. Emmanuel Dias-Neto, Laboratory of Neurosciences, Instituto de Psiquiatria, Faculdade de Medicina, Universidade de Sao Paulo. R. Dr. Ovidio de Campos, s/n Consolacao, 05403-010, São Paulo, SP, Brazil.

Reprints requests: Luís A. Pontes, Laboratory of Clinical Research, Centro de Pesquisas René Rachou, Fundação Oswaldo Cruz-Fiocruz, Av. Augusto de Lima, 1715, 30190-002, Barro Preto, Belo Horizonte, Minas Gerais, Brazil.

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