Accuracy of the urine point-of-care circulating cathodic antigen assay for diagnosing <i>Schistosomiasis mansoni</i> infection in Brazil: A multicenter study

Pieri, Otavio Sarmento; Bezerra, Fernando Schemelzer Moraes; Coelho, Paulo Marcos Zech; Enk, Martin Johannes; Favre, Tereza Cristina; Graeff-Teixeira, Carlos; Oliveira, Ricardo Riccio; Reis, Mitermayer Galvão dos; Andrade, Lee Senhorinha de Almeida; Beck, Lilian Christina Nóbrega Holsbach; Favero, Vivian; Fialho, Thainá Rodrigues de Souza; Guimarães, Ricardo José de Paula Souza e; Oliveira, Bruna Souza Santos; Pascoal, Vanessa Fey; Pinheiro, Marta Cristhiany Cunha; Santos, Ronald Alves dos; Silva, Luciano Kalabric; Siqueira, Isadora Cristina de; Souza, Renata Perotto de; Katz, Naftale

doi:10.1590/0037-8682-0238-2022

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Short Communication • Rev. Soc. Bras. Med. Trop. 56 • 2023 • https://doi.org/10.1590/0037-8682-0238-2022 copy

Accuracy of the urine point-of-care circulating cathodic antigen assay for diagnosing Schistosomiasis mansoni infection in Brazil: A multicenter study

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Background:

The World Health Organization recommends a market-ready, urine-based point-of-care diagnostic test for circulating cathodic antigens (CCA) to determine the prevalence of S. mansoni. This study evaluated the performance of the URINE CCA (SCHISTO) ECO TESTE® (POC-ECO), which is currently available in Brazil.

Methods:

Residents from eight sites with different prevalence estimates provided one urine sample for POC-ECO and one stool sample for Kato-Katz (KK) and Helmintex® (HTX) testing as an egg-detecting reference for infection status.

Results:

None of the study sites had significantly higher POC-ECO accuracy than KK.

Conclusions:

POC-ECO is not currently recommended in Brazilian schistosomiasis elimination programs.

Keywords:
Schistosoma mansoni; Point-of-care (POC); Circulating cathodic antigen (CCA); Kato-Katz; Helmintex; Brazil

		KK+HTX		POC-ECO t+		POC-ECO t-		Helmintex		Kato-Katz
Site (N)	Outcome	n	% positives (95% CI)	n	% positives (95% CI)	n	% positives (95% CI)	n	% positives (95% CI)	n	% positives (95% CI)
Sempre Viva (381)	Negative	222		122		216		246		277
	Positive	159	41.7 (36.7-46.9)	259	68.0 (62.2-73.2)	165	43.3 (37.5-49.1)	135	35.4 (29.9-41.1)	104	27.3 (22.2-32.7)
Jaguaritira (242)	Negative	101		55		103		107		193
	Positive	141	58.3 (51.8-64.6)	187	77.3 (70.5-83.0)	139	57.4 (50.0-64.5)	135	55.8 (48.2-62.9)	49	20.2 (14.6-26.6)
Cajueirinho (255)	Negative	174		101		156		176		224
	Positive	81	31.8 (26.1-37.9)	154	60.4 (53.1-67.1)	99	38.8 (31.9-45.9)	79	31.0 (24.5-37.8)	31	12.2 (7.9-17.4)
Itaquara (289)	Negative	238		163		253		243		271
	Positive	51	17.7 (13.4-22.5)	126	43.6 (36.9-50.3)	36	12.5 (8.4-17.4)	46	15.9 (11.3-21.3)	18	6.2 (3.4-10.1)
Gavião (286)	Negative	263		88		213		264		279
	Positive	23	8.0 (5.2-11.8)	198	69.2 (62.6-75.1)	73	25.5 (19.8-31.7)	22	7.7 (4.5-11.1)	7	2.4 (0.8-5.3)
Est. Miralta (98)	Negative	96		56		81		96		96
	Positive	2	2.0 (0.2-7.2)	42	42.9 (31.3-54.4)	17	17.3 (9.4-27.4)	2	2.0 (0.1-7.8)	2	2.0 (0.1-7.8)
Palmital (97)	Negative	93		95		95		93		96
	Positive	4	4.1 (1.1-10.2)	2	2.1 (0.1-7.9)	2	2.1 (0.1-7.9)	4	4.1 (0.7-11.0)	1	1.0 (0.0-6.2)
Bom Jesus (247)	Negative	246		213		247		246		246
	Positive	1	0.4 (0.0-2.2)	34	13.8 (9.1-19.3)	0	0 (0.0-1.8)	1	0.4 (0.0-2.5)	1	0.4 (0.0-2.5)

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[1] Corresponding author: Otávio Sarmento Pieri. e-mail:otavio.pieri@gmail.com