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Real-Time Polymerase Chain Reaction for Detection of Low-Intensity Schistosoma japonicum Infections in China

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  • 1 Department of Microbiology and Infection Control, University Hospital of North Norway, Tromsø, Norway; Department of Microbiology and Virology, Faculty of Medicine, University of Tromsø, Tromsø, Norway; Anhui Institute of Parasitic Diseases, Wuhu, People’s Republic of China; Department of Infectious Diseases, Faculty of Medicine, Imperial College, London, United Kingdom; DBL–Centre for Health Research and Development, Faculty of Life Sciences, University of Copenhagen, Copenhagen, Denmark
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More sensitive methods for diagnosing infection with Schistosoma japonicum are needed as control becomes more effective. We compared a real-time polymerase chain reaction (PCR) for stool samples with conventional diagnostic methods in a study of 1,727 persons from Anhui Province, China. Seroprevalence determined by using an indirect hemagglutination assay (IHA) was much higher (26.1%) than the prevalence in stool-based tests, which were 5.3%, 3.2%, and 3.0% for PCR, hatching test, and Kato-Katz thick smear, respectively. A large proportion of the positive stool samples were only positive in one or two tests. The PCR showed better agreement with IHA than the other two stool-based tests. A commonly used diagnostic algorithm with initial screening for antibodies and subsequent testing with the Kato-Katz thick smear of the seropositive results would have resulted in treatment of 22 people compared with 50 people if the PCR replaced the Kato-Katz thick smear. As prevalence and intensity decrease, the benefit of increased sensitivity using the PCR must be weighed against additional costs.

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