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

LUIS A. PONTES Laboratory of Clinical Research, and Laboratory of Schistosomiasis, Centro de Pesquisas René Rachou, Fundação Oswaldo Cruz, FIOCRUZ, Belo Horizonte, Minas Gerais, Brazil; Laboratory of Neurosciences, Instituto de Psiquiatria, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil

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MARIA C. OLIVEIRA Laboratory of Clinical Research, and Laboratory of Schistosomiasis, Centro de Pesquisas René Rachou, Fundação Oswaldo Cruz, FIOCRUZ, Belo Horizonte, Minas Gerais, Brazil; Laboratory of Neurosciences, Instituto de Psiquiatria, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil

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NAFTALE KATZ Laboratory of Clinical Research, and Laboratory of Schistosomiasis, Centro de Pesquisas René Rachou, Fundação Oswaldo Cruz, FIOCRUZ, Belo Horizonte, Minas Gerais, Brazil; Laboratory of Neurosciences, Instituto de Psiquiatria, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil

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EMMANUEL DIAS-NETO Laboratory of Clinical Research, and Laboratory of Schistosomiasis, Centro de Pesquisas René Rachou, Fundação Oswaldo Cruz, FIOCRUZ, Belo Horizonte, Minas Gerais, Brazil; Laboratory of Neurosciences, Instituto de Psiquiatria, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil

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ANA RABELLO Laboratory of Clinical Research, and Laboratory of Schistosomiasis, Centro de Pesquisas René Rachou, Fundação Oswaldo Cruz, FIOCRUZ, Belo Horizonte, Minas Gerais, Brazil; Laboratory of Neurosciences, Instituto de Psiquiatria, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil

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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.

Author Notes

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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