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Validation of a Point-of-Care Circulating Cathodic Antigen Urine Cassette Test for Schistosoma mansoni Diagnosis in the Sahel, and Potential Cross-Reaction in Pregnancy
On the shores of Lake Chad, schistosomiasis among mobile pastoralists was investigated in a field laboratory. Point-of-care circulating cathodic antigen (POC-CCA) cassette test, reagent strip, and filtration were conducted on urine samples. Fresh stool samples were subjected to the Kato-Katz technique, and fixed samples were examined with an ether-concentration method at a reference laboratory. POC-CCA urine cassette tests revealed a Schistosoma mansoni prevalence of 6.9%, compared with only 0.5% by stool microscopy. Three pregnant women with otherwise negative urine and stool testing had positive POC-CCA. This observation raises concern of cross-reactivity in pregnancy. Hence, two pregnant women in Switzerland with no history of schistosomiasis were subjected to POC-CCA and one tested positive. Our data suggest that POC-CCA can be performed under extreme Sahelian conditions (e.g., temperatures > 40°C), and it is more sensitive than stool microscopy for S. mansoni diagnosis. However, potential cross-reactivity in pregnancy needs further investigation.
Author Notes
Financial support: Funding for this study was provided by the Swiss National Science Foundation (Bern, Switzerland; grant no. 320030 141246). Training of the Chadian laboratory technicians was supported by the Rudolf Geigy Foundation (Basel, Switzerland).
Authors' addresses: Helena Greter, Stefanie J. Krauth, Jakob Zinsstag, and Jürg Utzinger, Swiss Tropical and Public Health Institute, and University of Basel, Basel, Switzerland, E-mails: helena.greter@unibas.ch, stefanie.krauth@unibas.ch, jakob.zinsstag@unibas.ch, and juerg.utzinger@unibas.ch. Stefanie J. Krauth, Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire. Bongo N. R. Ngandolo and Idriss O. Alfaroukh, Institut de Recherche en Elevage pour le Développement, N'Djamena, Chad, E-mails: bongo_nov@yahoo.fr and aolidriss@yahoo.fr.