Performance of an ultra-sensitive assay targeting the circulating anodic antigen (CAA) for detection of Schistosoma mansoni Infection in a low endemic area in Brazil

Detalhes bibliográficos
Autor(a) principal: Sousa, Mariana Silva
Data de Publicação: 2019
Outros Autores: Dam, Govert J. van, Pinheiro, Marta Cristhiany Cunha, Dood, Claudia J. de, Peralta, Jose Mauro, Peralta, Regina Helena Saramago, Daher, Elizabeth de Francesco, Corstjens, Paul L. A. M, Bezerra, Fernando Schemelzer Moraes
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Institucional da Universidade Federal do Ceará (UFC)
Texto Completo: http://www.repositorio.ufc.br/handle/riufc/49781
Resumo: Techniques with high sensitivity and specificity are required for an accurate diagnosis in low-transmission settings, where the conventional parasitological methods are insensitive. We determined the accuracy of an up-converting phosphor-lateral flow circulating anodic antigen (UCP-LF CAA) assay in urine and serum for Schistosoma mansoni diagnosis in low-prevalence settings in Ceará, Brazil, before and after praziquantel treatment. Clinical samples of a total of 258 individuals were investigated by UCP-LF CAA, point-of-care—circulating cathodic antigen (POC-CCA), soluble worm antigen preparation (SWAP)-ELISA and Kato-Katz (KK); a selection of 128 stools by real-time PCR technique. Three and 6-weeks after treatment, samples were collected and evaluated by detection Schistosoma circulating antigens (CAA and CCA). The UCP-LF CAA assays detected 80 positives (31%) with urine and 82 positives (31.8%) with serum. The urine POC-CCA and serum SWAP-ELISA assays detected 30 (11.6%) and 107 (40.7%) positives, respectively. The Kato-Katz technique revealed only 4 positive stool samples (1.6%). Among the 128 individuals with complete data records, 19 cases were identified by PCR (14.8%); Sensitivities and specificities of the UCP-LF CAA assays, determined versus a combined reference standard based on CCA/KK/PCR positivity, ranged from60–68%to 68–77%, respectively. In addition only for comparative purposes, sensitivities of the different assays were determined vs. a comparative reference based on CAA/KK/PCR positivity, showing the highest sensitivity for the urine CAA assay (80%), followed by the serum CAA (70.9%), SWAP-ELISA (43.6%), PCR (34.5%), POC-CCA (29.1%), whilst triplicate Kato-Katz thick smears had a very low sensitivity (3.6%). CAA concentrations were higher in serum than in urine and were significantly correlated. There was a significant decrease in urine and serum CAA levels 3 and 6-weeks after treatment. The UCP-LF CAA assays revealed 33 and 28 S. mansoni-infected patients at the 3- and 6-week post-treatment follow-up, respectively. The UCP-LF CAA assays show high sensitivity for the diagnosis of S.mansoni in low-endemicity settings. It detects a considerably higher number of infections than microscopy, POC-CCA or PCR. Also it shows to be very useful for evaluating cure rates after treatment. Hence, the UCP-LF CAA assay is a robust and promising diagnostic approach in low-transmission settings.
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spelling Performance of an ultra-sensitive assay targeting the circulating anodic antigen (CAA) for detection of Schistosoma mansoni Infection in a low endemic area in BrazilDiagnósticoDiagnosisFósforoPhosphorusReação em Cadeia da PolimerasePolymerase Chain ReactionSchistosoma mansoniBrasilBrazilTechniques with high sensitivity and specificity are required for an accurate diagnosis in low-transmission settings, where the conventional parasitological methods are insensitive. We determined the accuracy of an up-converting phosphor-lateral flow circulating anodic antigen (UCP-LF CAA) assay in urine and serum for Schistosoma mansoni diagnosis in low-prevalence settings in Ceará, Brazil, before and after praziquantel treatment. Clinical samples of a total of 258 individuals were investigated by UCP-LF CAA, point-of-care—circulating cathodic antigen (POC-CCA), soluble worm antigen preparation (SWAP)-ELISA and Kato-Katz (KK); a selection of 128 stools by real-time PCR technique. Three and 6-weeks after treatment, samples were collected and evaluated by detection Schistosoma circulating antigens (CAA and CCA). The UCP-LF CAA assays detected 80 positives (31%) with urine and 82 positives (31.8%) with serum. The urine POC-CCA and serum SWAP-ELISA assays detected 30 (11.6%) and 107 (40.7%) positives, respectively. The Kato-Katz technique revealed only 4 positive stool samples (1.6%). Among the 128 individuals with complete data records, 19 cases were identified by PCR (14.8%); Sensitivities and specificities of the UCP-LF CAA assays, determined versus a combined reference standard based on CCA/KK/PCR positivity, ranged from60–68%to 68–77%, respectively. In addition only for comparative purposes, sensitivities of the different assays were determined vs. a comparative reference based on CAA/KK/PCR positivity, showing the highest sensitivity for the urine CAA assay (80%), followed by the serum CAA (70.9%), SWAP-ELISA (43.6%), PCR (34.5%), POC-CCA (29.1%), whilst triplicate Kato-Katz thick smears had a very low sensitivity (3.6%). CAA concentrations were higher in serum than in urine and were significantly correlated. There was a significant decrease in urine and serum CAA levels 3 and 6-weeks after treatment. The UCP-LF CAA assays revealed 33 and 28 S. mansoni-infected patients at the 3- and 6-week post-treatment follow-up, respectively. The UCP-LF CAA assays show high sensitivity for the diagnosis of S.mansoni in low-endemicity settings. It detects a considerably higher number of infections than microscopy, POC-CCA or PCR. Also it shows to be very useful for evaluating cure rates after treatment. Hence, the UCP-LF CAA assay is a robust and promising diagnostic approach in low-transmission settings.Frontiers in Immunology2020-01-31T13:14:12Z2020-01-31T13:14:12Z2019-04info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfSOUSA, M. S. et al. Performance of an ultra-sensitive assay targeting the circulating anodic antigen (CAA) for detection of Schistosoma mansoni infection in a low endemic area in Brazil. Frontiers in Immunology, v. 10, p. 1-16, apr. 2019.1664-3224 (On line)http://www.repositorio.ufc.br/handle/riufc/49781Sousa, Mariana SilvaDam, Govert J. vanPinheiro, Marta Cristhiany CunhaDood, Claudia J. dePeralta, Jose MauroPeralta, Regina Helena SaramagoDaher, Elizabeth de FrancescoCorstjens, Paul L. A. MBezerra, Fernando Schemelzer Moraesengreponame:Repositório Institucional da Universidade Federal do Ceará (UFC)instname:Universidade Federal do Ceará (UFC)instacron:UFCinfo:eu-repo/semantics/openAccess2020-01-31T13:14:12Zoai:repositorio.ufc.br:riufc/49781Repositório InstitucionalPUBhttp://www.repositorio.ufc.br/ri-oai/requestbu@ufc.br || repositorio@ufc.bropendoar:2024-09-11T19:01:15.486604Repositório Institucional da Universidade Federal do Ceará (UFC) - Universidade Federal do Ceará (UFC)false
dc.title.none.fl_str_mv Performance of an ultra-sensitive assay targeting the circulating anodic antigen (CAA) for detection of Schistosoma mansoni Infection in a low endemic area in Brazil
title Performance of an ultra-sensitive assay targeting the circulating anodic antigen (CAA) for detection of Schistosoma mansoni Infection in a low endemic area in Brazil
spellingShingle Performance of an ultra-sensitive assay targeting the circulating anodic antigen (CAA) for detection of Schistosoma mansoni Infection in a low endemic area in Brazil
Sousa, Mariana Silva
Diagnóstico
Diagnosis
Fósforo
Phosphorus
Reação em Cadeia da Polimerase
Polymerase Chain Reaction
Schistosoma mansoni
Brasil
Brazil
title_short Performance of an ultra-sensitive assay targeting the circulating anodic antigen (CAA) for detection of Schistosoma mansoni Infection in a low endemic area in Brazil
title_full Performance of an ultra-sensitive assay targeting the circulating anodic antigen (CAA) for detection of Schistosoma mansoni Infection in a low endemic area in Brazil
title_fullStr Performance of an ultra-sensitive assay targeting the circulating anodic antigen (CAA) for detection of Schistosoma mansoni Infection in a low endemic area in Brazil
title_full_unstemmed Performance of an ultra-sensitive assay targeting the circulating anodic antigen (CAA) for detection of Schistosoma mansoni Infection in a low endemic area in Brazil
title_sort Performance of an ultra-sensitive assay targeting the circulating anodic antigen (CAA) for detection of Schistosoma mansoni Infection in a low endemic area in Brazil
author Sousa, Mariana Silva
author_facet Sousa, Mariana Silva
Dam, Govert J. van
Pinheiro, Marta Cristhiany Cunha
Dood, Claudia J. de
Peralta, Jose Mauro
Peralta, Regina Helena Saramago
Daher, Elizabeth de Francesco
Corstjens, Paul L. A. M
Bezerra, Fernando Schemelzer Moraes
author_role author
author2 Dam, Govert J. van
Pinheiro, Marta Cristhiany Cunha
Dood, Claudia J. de
Peralta, Jose Mauro
Peralta, Regina Helena Saramago
Daher, Elizabeth de Francesco
Corstjens, Paul L. A. M
Bezerra, Fernando Schemelzer Moraes
author2_role author
author
author
author
author
author
author
author
dc.contributor.author.fl_str_mv Sousa, Mariana Silva
Dam, Govert J. van
Pinheiro, Marta Cristhiany Cunha
Dood, Claudia J. de
Peralta, Jose Mauro
Peralta, Regina Helena Saramago
Daher, Elizabeth de Francesco
Corstjens, Paul L. A. M
Bezerra, Fernando Schemelzer Moraes
dc.subject.por.fl_str_mv Diagnóstico
Diagnosis
Fósforo
Phosphorus
Reação em Cadeia da Polimerase
Polymerase Chain Reaction
Schistosoma mansoni
Brasil
Brazil
topic Diagnóstico
Diagnosis
Fósforo
Phosphorus
Reação em Cadeia da Polimerase
Polymerase Chain Reaction
Schistosoma mansoni
Brasil
Brazil
description Techniques with high sensitivity and specificity are required for an accurate diagnosis in low-transmission settings, where the conventional parasitological methods are insensitive. We determined the accuracy of an up-converting phosphor-lateral flow circulating anodic antigen (UCP-LF CAA) assay in urine and serum for Schistosoma mansoni diagnosis in low-prevalence settings in Ceará, Brazil, before and after praziquantel treatment. Clinical samples of a total of 258 individuals were investigated by UCP-LF CAA, point-of-care—circulating cathodic antigen (POC-CCA), soluble worm antigen preparation (SWAP)-ELISA and Kato-Katz (KK); a selection of 128 stools by real-time PCR technique. Three and 6-weeks after treatment, samples were collected and evaluated by detection Schistosoma circulating antigens (CAA and CCA). The UCP-LF CAA assays detected 80 positives (31%) with urine and 82 positives (31.8%) with serum. The urine POC-CCA and serum SWAP-ELISA assays detected 30 (11.6%) and 107 (40.7%) positives, respectively. The Kato-Katz technique revealed only 4 positive stool samples (1.6%). Among the 128 individuals with complete data records, 19 cases were identified by PCR (14.8%); Sensitivities and specificities of the UCP-LF CAA assays, determined versus a combined reference standard based on CCA/KK/PCR positivity, ranged from60–68%to 68–77%, respectively. In addition only for comparative purposes, sensitivities of the different assays were determined vs. a comparative reference based on CAA/KK/PCR positivity, showing the highest sensitivity for the urine CAA assay (80%), followed by the serum CAA (70.9%), SWAP-ELISA (43.6%), PCR (34.5%), POC-CCA (29.1%), whilst triplicate Kato-Katz thick smears had a very low sensitivity (3.6%). CAA concentrations were higher in serum than in urine and were significantly correlated. There was a significant decrease in urine and serum CAA levels 3 and 6-weeks after treatment. The UCP-LF CAA assays revealed 33 and 28 S. mansoni-infected patients at the 3- and 6-week post-treatment follow-up, respectively. The UCP-LF CAA assays show high sensitivity for the diagnosis of S.mansoni in low-endemicity settings. It detects a considerably higher number of infections than microscopy, POC-CCA or PCR. Also it shows to be very useful for evaluating cure rates after treatment. Hence, the UCP-LF CAA assay is a robust and promising diagnostic approach in low-transmission settings.
publishDate 2019
dc.date.none.fl_str_mv 2019-04
2020-01-31T13:14:12Z
2020-01-31T13:14:12Z
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv SOUSA, M. S. et al. Performance of an ultra-sensitive assay targeting the circulating anodic antigen (CAA) for detection of Schistosoma mansoni infection in a low endemic area in Brazil. Frontiers in Immunology, v. 10, p. 1-16, apr. 2019.
1664-3224 (On line)
http://www.repositorio.ufc.br/handle/riufc/49781
identifier_str_mv SOUSA, M. S. et al. Performance of an ultra-sensitive assay targeting the circulating anodic antigen (CAA) for detection of Schistosoma mansoni infection in a low endemic area in Brazil. Frontiers in Immunology, v. 10, p. 1-16, apr. 2019.
1664-3224 (On line)
url http://www.repositorio.ufc.br/handle/riufc/49781
dc.language.iso.fl_str_mv eng
language eng
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv Frontiers in Immunology
publisher.none.fl_str_mv Frontiers in Immunology
dc.source.none.fl_str_mv reponame:Repositório Institucional da Universidade Federal do Ceará (UFC)
instname:Universidade Federal do Ceará (UFC)
instacron:UFC
instname_str Universidade Federal do Ceará (UFC)
instacron_str UFC
institution UFC
reponame_str Repositório Institucional da Universidade Federal do Ceará (UFC)
collection Repositório Institucional da Universidade Federal do Ceará (UFC)
repository.name.fl_str_mv Repositório Institucional da Universidade Federal do Ceará (UFC) - Universidade Federal do Ceará (UFC)
repository.mail.fl_str_mv bu@ufc.br || repositorio@ufc.br
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