Testing the Infection Prevalence of Schistosoma mansoni after Mass Drug Administration by Comparing Sensitivity and Specificity of Species-Specific Repeat Fragment Amplification by PCR and Loop-Mediated Isothermal Amplification

Miriam Price Department of Clinical Laboratory Science, Marquette University, Milwaukee, Wisconsin;

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Austin Cyrs Department of Clinical Laboratory Science, Marquette University, Milwaukee, Wisconsin;

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Chummy S. Sikasunge Department of Para-clinical Studies, The University of Zambia, Lusaka, Zambia;

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James Mwansa University Teaching Hospital, The University of Zambia, Lusaka, Zambia

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Nilanjan Lodh Department of Clinical Laboratory Science, Marquette University, Milwaukee, Wisconsin;

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Schistosomiasis is a blood parasitic disease caused by trematode parasites of the genus Schistosoma. Schistosoma mansoni is one of the main contributors of the disease and 90% of the global burden of schistosomiasis is in Africa. Mass drug administration (MDA) has been implemented to reduce the disease burden in endemic areas. Because of MDA, the diagnostic sensitivity and specificity for classical diagnostic tests are reduced. In any disease situation, diagnosis is vital in determining asymptomatic, concurrent, current, new, and reinfection cases to evaluate the efficacy of any control program. We have evaluated the positive infection for S. mansoni from filtered urine samples collected from Zambian school children after MDA using loop-mediated isothermal amplification (LAMP) and compared its sensitivity and specificity with polymerase chain reaction (PCR). One hundred eleven urine samples collected from school children aged between 7 and 15 years from Siavonga district in southern Zambia were evaluated by PCR and LAMP for DNA extracted by two different protocols (filter-based versus crude extraction). The infection prevalence was 77% with PCR and almost 94% with mansoni-LAMP. Also, LAMP detected 16% (Qiagen extraction) and 10% (LAMP-Procedure for Ultra Rapid Extraction) more positive S. mansoni infection than PCR. We have demonstrated the efficacy of LAMP in a laboratory setup after MDA. The possible inclusion of LAMP as a field-based point-of-care test for surveillance can provide reliable prevalence of schistosomiasis after MDA and help in determining the efficacy of a control program.

Author Notes

Address correspondence to Nilanjan Lodh, Department of Clinical Laboratory Science, College of Health Sciences, Marquette University, Milwaukee, WI 53210–1881. E-mail: nilanjan.lodh@marquette.edu

Financial support: The Member Research Grant from the American Society of Clinical Laboratory Science (ASCLS) Education and Research Fund supported this study. Also, partial support came from Early Career Research award from Thrasher Research Fund (13344).

Authors’ addresses: Miriam Price, Austin Cyrs, and Nilanjan Lodh, Department of Clinical Laboratory Science, College of Health Sciences, Marquette University, Milwaukee, WI, E-mails: miriam.price@marquette.edu, ajcyrs@gmail.com, and nilanjan.lodh@marquette.edu. Chummy S. Sikasunge, Department of Para-clinical Studies, The University of Zambia, Lusaka, Zambia, E-mail: chumsika@yahoo.co.uk. James Mwansa, University Teaching Hospital, The University of Zambia, Lusaka, Zambia, E-mail: mwansaj@gmail.com.

These authors contributed equally to this work.

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