Field Evaluation of a PCR Test for Schistosoma japonicum Egg Detection in Low-Prevalence Regions of China

Mai S. Fung Environmental Health Sciences, School of Public Health, University of California, Berkeley, California; Institute of Parasitic Diseases, Sichuan Center for Disease Control and Prevention, Chengdu, Sichuan, China; National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Laboratory of Parasite and Vector Biology, Ministry of Health; WHO Collaborating Center for Malaria, Schistosomiasis and Filariasis, Shanghai, China

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Ning Xiao Environmental Health Sciences, School of Public Health, University of California, Berkeley, California; Institute of Parasitic Diseases, Sichuan Center for Disease Control and Prevention, Chengdu, Sichuan, China; National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Laboratory of Parasite and Vector Biology, Ministry of Health; WHO Collaborating Center for Malaria, Schistosomiasis and Filariasis, Shanghai, China

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Shuo Wang Environmental Health Sciences, School of Public Health, University of California, Berkeley, California; Institute of Parasitic Diseases, Sichuan Center for Disease Control and Prevention, Chengdu, Sichuan, China; National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Laboratory of Parasite and Vector Biology, Ministry of Health; WHO Collaborating Center for Malaria, Schistosomiasis and Filariasis, Shanghai, China

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Elizabeth J. Carlton Environmental Health Sciences, School of Public Health, University of California, Berkeley, California; Institute of Parasitic Diseases, Sichuan Center for Disease Control and Prevention, Chengdu, Sichuan, China; National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Laboratory of Parasite and Vector Biology, Ministry of Health; WHO Collaborating Center for Malaria, Schistosomiasis and Filariasis, Shanghai, China

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Sensitive Schistosoma japonicum detection methods are needed to progress from schistosomiasis control to elimination. The sensitivity of the Kato-Katz thick smear and miracidium hatching tests decrease with infection intensity and serological tests cannot always identify current infections. We evaluated a fecal polymerase chain reaction (PCR) assay to detect S. japonicum infection in 106 humans and 8 bovines in China. PCR was highly sensitive, detecting S. japonicum DNA at 0.5 eggs/g of stool. Comparing PCR examination of a single stool sample to the miracidium hatching test using three consecutive stool samples, more humans were hatching test positive (20%) than PCR positive (15%). However, two individuals were PCR positive in a village where no infections were detected by coprological methods. The sensitivity of PCR makes it a promising tool for schistosomiasis diagnostics and screening, although egg shedding variability and stool sample size present challenges for any detection method in low-transmission areas.

Author Notes

* Address correspondence to Elizabeth J. Carlton, Environmental Health Sciences, School of Public Health, University of California, Berkeley, 50 University Hall, Berkeley, CA 94720-7360. E-mail: ejcarlton@berkeley.edu

Financial support: This work was made possible by a grant from the Center for Global Public Health at the University of California, Berkeley and a grant from the National Institute for Allergy and Infectious Diseases (R01AI068854).

Authors' addresses: Mai S. Fung, Shuo Wang, and Elizabeth J. Carlton, Environmental Health Sciences, School of Public Health, University of California, Berkeley, Berkeley, CA, E-mails: maifung@berkeley.edu, shuowang@berkeley.edu, and ejcarlton@berkeley.edu. Ning Xiao, Institute of Parasitic Diseases, Sichuan Center for Disease Control and Prevention, Chengdu, Sichuan, China (Ning Xiao's current address is National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, Laboratory of Parasite and Vector Biology, Ministry of Health; WHO Collaborating Center for Malaria, Schistosomiasis and Filariasis, Shanghai, China), E-mail: ningxiao116@yahoo.com.cn.

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