Rapid and Comprehensive Screening for Urogenital and Gastrointestinal Schistosomiasis with Handheld Digital Microscopy Combined with Circulating Cathodic Antigen Testing

Jean T. Coulibaly Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, Abidjan, Côte d’Ivoire;
Centre Suisse de Recherches Scientifiques en Côte d’Ivoire, Abidjan, Côte d’Ivoire;

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Kigbafori D. Silue Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, Abidjan, Côte d’Ivoire;
Centre Suisse de Recherches Scientifiques en Côte d’Ivoire, Abidjan, Côte d’Ivoire;

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María Díaz de León Derby Department of Bioengineering, University of California, Berkeley, Berkeley, California;

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Daniel A. Fletcher Department of Bioengineering, University of California, Berkeley, Berkeley, California;
Biological Systems and Engineering Division, Lawrence Berkeley National Laboratory, University of California, Berkeley, Berkeley, California;
Chan Zuckerberg Biohub, San Francisco, California;

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Karla N. Fisher Division of General Internal Medicine, Toronto General Hospital, University Health Network, Toronto, Canada;
Division of Infectious Diseases, Toronto General Hospital, University Health Network, Toronto, Canada;

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Jason R. Andrews Division of Infectious Diseases and Geographic Medicine, Stanford University School of Medicine, Stanford, California;

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Isaac I. Bogoch Division of General Internal Medicine, Toronto General Hospital, University Health Network, Toronto, Canada;
Division of Infectious Diseases, Toronto General Hospital, University Health Network, Toronto, Canada;
Department of Medicine, University of Toronto, Toronto, Canada

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ABSTRACT.

Novel methods are required to aid the monitoring of schistosomiasis control and elimination initiatives through mass drug administration. Portable digital and mobile phone microscopy is a promising tool for this purpose. This cross-sectional study evaluated the diagnostic operating characteristics of a converted mobile phone microscope (the SchistoScope) for the detection of Schistosoma haematobium eggs, as determined by community-based field workers and expert microscopists, compared with a field gold standard of light microscopy. Three hundred sixty-five urine samples were evaluated by conventional light microscopy, with 49 (13.4%) positive for S. haematobium. Compared with light microscopy, the sensitivity and specificity of S. haematobium detection by field microscopists trained to use the SchistoScope were 26.5% (95% CI: 14.9–41.1%) and 98.4% (95% CI: 96.3–99.5%), respectively. The sensitivity and specificity of S. haematobium detection by expert microscopists using the SchistoScope was 74% (95% CI: 59.7–85.4%) and 98.1% (95% CI: 95.9–99.3%), respectively, compared with light microscopy. The sensitivity rose to 96.1% and 100% when evaluating for egg counts greater than five and 10 eggs per 10 mL, respectively. A point-of-care circulating cathodic anion (POC CCA) test was used to evaluate Schistosoma mansoni; however, there were too few positive samples to reliably comment on diagnostic characteristics. This study demonstrated that a “urine-only” approach to rapidly screen for schistosomiasis at the point of sample collection can be conducted with mobile phone microscopy (S. haematobium) coupled with POC CCA (S. mansoni). Such an approach may aid in streamlined schistosomiasis control and elimination initiatives.

Author Notes

Disclosures: I. I. Bogoch consults for the Weapons Threat Reduction Program at Global Affairs Canada. Ethical permission was granted by both the local health district officer, from the Comité National d’Éthique des Sciences de la Vie et de la Santé, Abidjan, Côte d’Ivoire (REB #186-21) and the University Health Network, Toronto, Canada (REB #21-5582).

Financial support: I. I. Bogoch is supported by the Ontario Academic Health Sciences Centre (AHSC) Alternative Funding Plan (AFP) Innovation Fund, New Frontiers in Research Fund (NFRFE-2020-00922), and Canadian Institutes of Health Research (PJT-83575).

Current contact information: Jean T. Coulibaly and Kigbafori D. Silue, Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, Abidjan, Côte d’Ivoire, E-mails: jean.coulibaly@csrs.ci and kigbafori.silue@csrs.ci. María Díaz de León Derby, Department of Bioengineering, University of California, Berkeley, Berkeley, CA, E-mail: maria.diaz@berkeley.edu. Daniel A. Fletcher, Department of Bioengineering, University of California, Berkeley, Berkeley, CA, E-mail: fletch@berkeley.edu. Karla N. Fisher, Toronto General Hospital, Toronto, Canada, E-mail: karla.fisher@uhn.ca. Jason R. Andrews, Division of Infectious Diseases and Geographic Medicine, Stanford University School of Medicine, Stanford, CA, E-mail: jandr@stanford.edu. Isaac I. Bogoch, Division of General Internal Medicine, Toronto General Hospital, Toronto, Canada, and Division of Infectious Diseases, Toronto General Hospital, Toronto, Canada, E-mail: isaac.bogoch@uhn.ca.

Address correspondence to Isaac I. Bogoch, Divisions of General Internal Medicine and Infectious Diseases, Toronto General Hospital, 14EN 209, 200 Elizabeth St., Toronto, ON, Canada M5G 2C4. E-mail: isaac.bogoch@uhn.ca
  • 1.

    King CH , Galvani AP , 2018. Underestimation of the global burden of schistosomiasis. Lancet 391: 307308.

  • 2.

    Colley DG , Bustinduy AL , Secor WE , King CH , 2014. Human schistosomiasis. Lancet 383: 22532264.

  • 3.

    Warren KS , 1978. The pathology, pathobiology and pathogenesis of schistosomiasis. Nature 5664: 609612.

  • 4.

    World Health Organization , 2022. WHO Guideline on Control and Elimination of Human Schistosomiasis. Geneva, Switzerland: WHO.

  • 5.

    World Health Organization , 2021. Diagnostic Target Product Profiles for Monitoring, Evaluation and Surveillance of Schistosomiasis Control Programmes. Geneva, Switzerland: WHO.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 6.

    Coulibaly JT , Ouattara M , D’Ambrosio MV , Fletcher DA , Keiser J , Utzinger J , N’Goran EK , Andrews JR , Bogoch II , 2016. Accuracy of mobile phone and handheld light microscopy for the diagnosis of schistosomiasis and intestinal protozoa infections in Côte d’Ivoire. PLoS Negl Trop Dis 10: e0004768.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 7.

    Vasiman A , Stothard JR , Bogoch II , 2019. Mobile phone devices and handheld microscopes as diagnostic platforms for malaria and neglected tropical diseases (NTDs) in low-resource settings: A systematic review, historical perspective and future outlook. Adv Parasitol 103: 151173.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 8.

    Coulibaly JT , Silue KD , Armstrong M , de León Derby MD , D’Ambrosio MV , Fletcher DA , Keiser J , Fisher K , Andrews JR , Bogoch II , 2023. High sensitivity of mobile phone microscopy screening for Schistosoma haematobium in Azaguié, Côte d’Ivoire. Am J Trop Med Hyg 108: 4143.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 9.

    Coulibaly JT , N’Gbesso YK , Knopp S , N’Guessan NA , Silué KD , van Dam GJ , N’Goran EK , Utzinger J , 2013. Accuracy of urine circulating cathodic antigen test for the diagnosis of Schistosoma mansoni in preschool-aged children before and after treatment. PLoS Negl Trop Dis 7: e2109.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 10.

    Assaré RK , Tra MBI , Ouattara M , Hürlimann E , Coulibaly JT , N’Goran EK , Utzinger J , 2018. Sensitivity of the point-of-care circulating cathodic antigen urine cassette test for diagnosis of Schistosoma mansoni in low-endemicity settings in Côte d’Ivoire. Am J Trop Med Hyg 99: 15671572.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 11.

    Assare RK , Tra-Bi MI , Coulibaly JT , Corstjens PLAM , Ouattara M , Hurlimann E , van Dam GJ , Utzinger J , N’Goran EK , 2021. Accuracy of two circulating antigen tests for the diagnosis and surveillance of Schistosoma mansoni infection in low-endemicity settings of Côte d’Ivoire. Am J Trop Med Hyg 105: 677683.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 12.

    Peters PA , Mahmoud AAF , Warren KS , Ouma JH , Siongok TK , 1976. Field studies of a rapid, accurate means of quantifying Schistosoma haematobium eggs in urine samples. Bull World Health Organ 54: 159162.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 13.

    Armstrong M , Harris AR , D’Ambrosio MV , Coulibaly JT , Essien-Baidoo S , Ephraim RKD , Andrews JR , Bogoch II , Fletcher DA , 2022. Point-of-care sample preparation and automated quantitative detection of Schistosoma haematobium using mobile phone microscopy. Am J Trop Med Hyg 106: 14421449.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 14.

    D’Ambrosio MV et al., 2015. Point-of-care quantification of blood-borne filarial parasites with a mobile phone microscope. Sci Transl Med 7: 286re4.

  • 15.

    Katz N , Chaves A , Pellegrino J , 1972. A simple device for quantitative stool thick-smear technique in Schistosomiasis mansoni. Rev Inst Med Trop São Paulo 14: 397400.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 16.

    World Health Organization , 2002. Prevention and control of schistosomiasis and soil-transmitted helminthiasis: Report of a WHO Expert Committee. World Health Organ Tech Rep Ser 912: ivi, 1–57.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 17.

    Rajchgot J , Coulibaly JT , Keiser J , Utzinger J , Lo NC , Mondry MK , Andrews JR , Bogoch II , 2017. Mobile-phone and handheld microscopy for neglected tropical disease. PLoS Negl Trop Dis 11: e0005550.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 18.

    Kamgno J et al., 2017. A test-and-not-treat strategy for onchocerciasis in Loa –endemic areas. N Engl J Med 377: 20442052.

  • 19.

    Bogoch II , Andrews JR , Speich B , Utzinger J , Ame SM , Ali SM , Keiser J , 2013. Short report: Mobile phone microscopy for the diagnosis of soil-transmitted helminth infections: A proof-of-concept study. Am J Trop Med Hyg 88: 626629.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 20.

    Peralta JM , Cavalcanti MG , 2018. Is POC-CCA a truly reliable test for schistosomiasis diagnosis in low endemic areas? The trace results controversy. PLoS Negl Trop Dis 12: e0006813.

    • PubMed
    • Search Google Scholar
    • Export Citation
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