Performance of the point-of-care circulating cathodic antigen (POC-CCA) urine cassette test for follow-up after treatment of S. mansoni infection in Eritrean refugees.


Journal

Travel medicine and infectious disease
ISSN: 1873-0442
Titre abrégé: Travel Med Infect Dis
Pays: Netherlands
ID NLM: 101230758

Informations de publication

Date de publication:
Historique:
received: 24 07 2018
revised: 02 09 2018
accepted: 11 09 2018
pubmed: 22 9 2018
medline: 8 5 2019
entrez: 22 9 2018
Statut: ppublish

Résumé

Point-of-care circulating cathodic antigen (POC-CCA) urine cassette testing has become a popular approach to screen for Schistosoma infection. Since the test is also increasingly used for following-up of treatment success, we assessed the assay's diagnostic accuracy after praziquantel treatment of S. mansoni infection among Eritrean refugees in Switzerland. In our preceding study, 107 asymptomatic Eritrean refugees in Switzerland were screened for schistosomiasis by stool microscopy, serology, and POC-CCA urine testing. Individuals screened positive by any method were treated with praziquantel and invited for a follow-up visit, repeating the same diagnostic procedures one year after treatment. The POC-CCA baseline and follow-up results were analyzed against the 'baseline microscopy positive cases' (= the most reliably true positive cases) and the 'baseline microscopy plus serology negative cases at baseline and follow-up' (= the most reliably true negative cases). Complete diagnostic baseline and follow-up sampling was available from 48 participants. Compared to most reliably true positive cases at baseline, POC-CCA testing had a sensitivity of 90%. Compared to most reliably true negative cases, POC-CCA testing had a specificity of 73.9%. We conclude that the POC-CCA urine test is valuable for screening but its use is not suitable for routine follow-up after treatment.

Sections du résumé

BACKGROUND
Point-of-care circulating cathodic antigen (POC-CCA) urine cassette testing has become a popular approach to screen for Schistosoma infection. Since the test is also increasingly used for following-up of treatment success, we assessed the assay's diagnostic accuracy after praziquantel treatment of S. mansoni infection among Eritrean refugees in Switzerland.
METHODS
In our preceding study, 107 asymptomatic Eritrean refugees in Switzerland were screened for schistosomiasis by stool microscopy, serology, and POC-CCA urine testing. Individuals screened positive by any method were treated with praziquantel and invited for a follow-up visit, repeating the same diagnostic procedures one year after treatment. The POC-CCA baseline and follow-up results were analyzed against the 'baseline microscopy positive cases' (= the most reliably true positive cases) and the 'baseline microscopy plus serology negative cases at baseline and follow-up' (= the most reliably true negative cases).
RESULTS
Complete diagnostic baseline and follow-up sampling was available from 48 participants. Compared to most reliably true positive cases at baseline, POC-CCA testing had a sensitivity of 90%. Compared to most reliably true negative cases, POC-CCA testing had a specificity of 73.9%.
CONCLUSION
We conclude that the POC-CCA urine test is valuable for screening but its use is not suitable for routine follow-up after treatment.

Identifiants

pubmed: 30236539
pii: S1477-8939(18)30236-9
doi: 10.1016/j.tmaid.2018.09.004
pii:
doi:

Substances chimiques

Praziquantel 6490C9U457

Types de publication

Evaluation Study Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

59-63

Informations de copyright

Copyright © 2018. Published by Elsevier Ltd.

Auteurs

Andreas Neumayr (A)

Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland. Electronic address: andreas.neumayr@swisstph.ch.

Afona Chernet (A)

Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland.

Véronique Sydow (V)

Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland.

Kerstin Kling (K)

Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland.

Esther Kuenzli (E)

Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland.

Hanspeter Marti (H)

Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland.

Daniel H Paris (DH)

Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland.

Beatrice Nickel (B)

Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland.

Niklaus D Labhardt (ND)

Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland; Division of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, Basel, Switzerland.

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