CIRCULATING CATHODIC ANTIGEN VERSUS MICROSCOPY FOR DIAGNOSING URINARY SCHISTOSOMIASIS AMONG CHILDREN, IN SOHAG UNIVERSITY HOSPITALS

Abstract

Urinary schistosomiasis caused by Schistosoma haematobium constitutes a major public health problem in many tropical and sub-tropical countries. Rapid diagnostic tests are needed for the implementation and monitoring of national schistosomiasis control programs. The study estimated prevalence and risk factors of S. haematobium by the circulating catho-dic antigen test (POC-CCA) versus microscopic urine examinations. A cross-sectional study was conducted on 100 outpatient children aged 3 to 15 years attended Sohag University Hospitals. Demographic data and risk factors were collected using a structured questionnaire. Urine samples were examined by microscopic examination techniques (sedimentation centrifugation and Nucleopore filtration methods) for detection of S. haematobium eggs and by a commercially available cassette test POC-CCA, for detection of S. haematobium circulating cathodic antigens. The results showed that S . haematobium infected children as indicated by microscopy was 23%. The study reported increasing age (OR=6.9-8.3), male (OR= 3.5), living in rural areas (OR=4.1), exposures to canal water (OR=26.4), history of schistosomiasis (OR= 3.3) and history of burning micturition (OR= 7.4) or hematuria (OR= 10.1) as significant risk factors . Using microscopy as the gold standard for S . haematobium detection, sensitivity, specificity, PPV & NPV of POC-CCA tests, were 56.5%, 92.2%, 68.4% & 87.7% respectively with an accuracy 84% and area under curve (AUC) was 0.744. In light cases, the POC CCA detected 52.6%, but in heavy cases it increased to 75% without significant difference (P < 0.412).