Accuracy and precision of dried urine spot method for the detection of Schistosoma mansoni circulating cathodic antigens in resource-limited settings.

IF 8.1 1区医学

Infectious Diseases of Poverty Pub Date : 2024-02-18 DOI:10.1186/s40249-024-01183-7

Abdallah Zacharia, Clemence Kinabo, Twilumba Makene, Huda Omary, George Ogweno, Faraja Lyamuya, Billy Ngasala

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引用次数: 0

Abstract

Background: The World Health Organization recommends the use of Schisto point-of-care circulating cathodic antigens (Schisto POC-CCA) for screening of Schistosoma mansoni as it offers better sensitivity than microscopy. However, there are limitation facing the use of this method including timely availability of the test cassettes. The aim of this study was to determine the reliability of dried urine spot (DUS) method for collection of urine and detection of S. mansoni using Schisto POC-CCA cassettes in a resource-limited settings.

Methods: A cross-sectional study was conducted between October and November 2022 among 250 primary school children in Sengerema District, northwestern Tanzania. S. mansoni CCA was detected in filter paper-based DUS, liquid urine using DUS Schisto POC-CCA (index), and direct urine Schisto POC-CCA (comparator) methods respectively. S. mansoni eggs in stool were detected using duplicate Kato-Katz (KK) method. The measures of accuracy were computed and compared between the index and comparator methods. The strength of agreement between inter-raters precisions was tested using Cohen's kappa (k).

Results: This study revealed S. mansoni prevalence rates of 28.8%, 54.0% and 50.8% by duplicate KK, direct urine Schisto POC-CCA and DUS Schisto POC-CCA methods respectively. The mean intensity of infection among infected participants was 86.3 eggs per gram of stool (EPG) ranging from 12.0 EPG to 824.0 EPG. The sensitivity of DUS Schisto POC-CCA and direct urine Schisto POC-CCA was 94.44% (95% CI: 89.15-99.74%) and 97.22% (95% CI: 93.43-100.00%) respectively. The DUS Schisto POC-CCA method had slightly higher specificity (66.85%) than direct urine Schisto POC-CCA method (63.48%). The accuracy of the DUS Schisto POC-CCA was found to be slightly high (74.80%, 95% CI: 68.94-79.06%) compared to that of direct urine Schisto POC-CCA (73.20%, 95% CI: 67.25-78.59%). There was good agreement between two laboratory technologists who performed the DUS Schisto POC-CCA method on similar samples (k = 0.80, 95% CI: 0.59-0.95).

Conclusions: The DUS Schisto POC-CCA method had comparable S. mansoni detection accuracy to direct urine Schisto POC-CCA. This suggests that the method could be a potential alternative to direct urine Schisto POC-CCA for screening S. mansoni in resource-limited situations.

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在资源有限的环境中采用干尿点法检测曼氏血吸虫循环阴性抗原的准确性和精确性。

背景：世界卫生组织建议使用血吸虫护理点循环阴性抗原（Schisto POC-CCA）筛查曼氏血吸虫，因为它比显微镜检查具有更高的灵敏度。然而，这种方法的使用也面临一些限制，包括检测盒的及时供应。本研究旨在确定在资源有限的环境中使用干尿点法（DUS）收集尿液和使用 Schisto POC-CCA 检测盒检测曼氏血吸虫的可靠性：2022 年 10 月至 11 月期间，在坦桑尼亚西北部森格雷马区的 250 名小学生中开展了一项横断面研究。分别在滤纸DUS、使用DUS Schisto POC-CCA（指标）的液体尿液和直接尿液Schisto POC-CCA（比较）方法中检测曼森氏杆菌CCA。粪便中的曼氏沙门氏菌卵采用卡托-卡茨（KK）重复法检测。计算并比较了指数法和比较法的准确度。使用 Cohen's kappa (k)检验了评分者之间准确度的一致性：结果：这项研究显示，采用重复 KK 法、直接尿液 Schisto POC-CCA 法和 DUS Schisto POC-CCA 法检测的曼氏沙门氏菌感染率分别为 28.8%、54.0% 和 50.8%。受感染者的平均感染强度为每克粪便中含 86.3 个虫卵（EPG），范围从 12.0 EPG 到 824.0 EPG 不等。DUS Schisto POC-CCA 和直接尿液 Schisto POC-CCA 的灵敏度分别为 94.44% (95% CI: 89.15-99.74%) 和 97.22% (95% CI: 93.43-100.00%)。DUS Schisto POC-CCA 方法的特异性（66.85%）略高于直接尿液 Schisto POC-CCA 方法（63.48%）。DUS Schisto POC-CCA 的准确率（74.80%，95% CI：68.94-79.06%）略高于直接尿液 Schisto POC-CCA 的准确率（73.20%，95% CI：67.25-78.59%）。两名实验室技术人员在对相似样本进行 DUS Schisto POC-CCA 方法检测时，结果一致性良好（k = 0.80，95% CI：0.59-0.95）：DUS Schisto POC-CCA 方法与直接尿液 Schisto POC-CCA 检测曼氏沙门氏菌的准确性相当。这表明，在资源有限的情况下，该方法可替代直接尿液施氏POC-CCA筛查曼森氏杆菌。

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来源期刊

Infectious Diseases of Poverty INFECTIOUS DISEASES-

自引率

1.20%

发文量

368

期刊介绍： Infectious Diseases of Poverty is an open access, peer-reviewed journal that focuses on addressing essential public health questions related to infectious diseases of poverty. The journal covers a wide range of topics including the biology of pathogens and vectors, diagnosis and detection, treatment and case management, epidemiology and modeling, zoonotic hosts and animal reservoirs, control strategies and implementation, new technologies and application. It also considers the transdisciplinary or multisectoral effects on health systems, ecohealth, environmental management, and innovative technology. The journal aims to identify and assess research and information gaps that hinder progress towards new interventions for public health problems in the developing world. Additionally, it provides a platform for discussing these issues to advance research and evidence building for improved public health interventions in poor settings.