Accuracy of point-of-care testing for circulatory cathodic antigen in the detection of schistosome infection: systematic review and meta-analysis

Danso-Appiah, A., Minton, J. , Boamah, D., Otchere, J., Asmah, R. H., Rodgers, M., Bosompem, K. M., Eusebi, P. and De Vlas, S. J. (2016) Accuracy of point-of-care testing for circulatory cathodic antigen in the detection of schistosome infection: systematic review and meta-analysis. Bulletin of the World Health Organization, 94(7), pp. 481-556. (doi:10.2471/BLT.15.158741) (PMID:27429491) (PMCID:PMC4933137)

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Publisher's URL: http://www.who.int/bulletin/volumes/94/7/15-158741-ab/en/

Abstract

Objective To assess the accuracy of point-of-care testing for circulating cathodic antigen in the diagnosis of schistosome infection. Methods We searched MEDLINE, EMBASE, LILACS and other bibliographic databases for studies published until 30 September 2015 that described circulatory cathodic antigen testing compared against one to three Kato–Katz tests per subject – for Schistosoma mansoni – or the filtration of one 10-ml urine sample per subject – for S. haematobium. We extracted the numbers of true positives, false positives, true negatives and false negatives for the antigen testing and performed meta-analyses using a bivariate hierarchical regression model. Findings Twenty-six studies published between 1994 and 2014 met the inclusion criteria. In the detection of S. mansoni, a single antigen test gave a pooled sensitivity of 0.90 (95% confidence interval, CI: 0.84–0.94) and a pooled specificity of 0.56 (95% CI: 0.54–0.61; n = 7) when compared against a single Kato–Katz test. The corresponding values from comparisons with two to three Kato–Katz tests per subject were 0.85 (95% CI: 0.80–0.88) and 0.66 (95% CI: 0.54–0.76; n = 14), respectively. There appeared to be no advantage in using three antigen tests per subject instead of one. When compared against the results of urine filtration, antigen testing for S. haematobium showed poor sensitivity and poor specificity. The performance of antigen testing was better in areas of high endemicity than in settings with low endemicity. Conclusion Antigen testing may represent an effective tool for monitoring programmes for the control of S. mansoni.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Minton, Dr Jonathan
Authors: Danso-Appiah, A., Minton, J., Boamah, D., Otchere, J., Asmah, R. H., Rodgers, M., Bosompem, K. M., Eusebi, P., and De Vlas, S. J.
College/School:College of Social Sciences > School of Social and Political Sciences > Urban Studies
Journal Name:Bulletin of the World Health Organization
Publisher:World Health Organization
ISSN:0042-9686
ISSN (Online):1564-0604
Copyright Holders:Copyright © 2016 WHO
First Published:First published in Bulletin of the World Health Organization 94(7): 481-556
Publisher Policy:Reproduced in accordance with the publisher copyright policy

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