Understanding the relationship between egg and antigen based diagnostics of Schistosoma mansoni infection pre- and post-treatment in Uganda

Prada, J. M., Touloupou, P., Adriko, M., Tukahebwa, E. M., Lamberton, P. H.L. and Hollingsworth, T. D. (2018) Understanding the relationship between egg and antigen based diagnostics of Schistosoma mansoni infection pre- and post-treatment in Uganda. Parasites and Vectors, 11(1), 21. (doi:10.1186/s13071-017-2580-z) (PMID:29310695) (PMCID:PMC5759883)

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Abstract

Background: Schistosomiasis is a major socio-economic and public health problem in many sub-Saharan African countries. After large mass drug administration (MDA) campaigns, prevalence of infection rapidly returns to pre-treatment levels. The traditional egg-based diagnostic for schistosome infections, Kato-Katz, is being substituted in many settings by circulating antigen recognition-based diagnostics, usually the point-of-care circulating cathodic antigen test (CCA). The relationship between these diagnostics is poorly understood, particularly after treatment in both drug-efficacy studies and routine monitoring. Results: We created a model of schistosome infections to better understand and quantify the relationship between these two egg- and adult worm antigen-based diagnostics. We focused particularly on the interpretation of “trace” results after CCA testing. Our analyses suggest that CCA is generally a better predictor of prevalence, particularly after treatment, and that trace CCA results are typically associated with truly infected individuals. Conclusions: Even though prevalence rises to pre-treatment levels only six months after MDAs, our model suggests that the average intensity of infection is much lower, and is probably in part due to a small burden of surviving juveniles from when the treatment occurred. This work helps to better understand CCA diagnostics and the interpretation of post-treatment prevalence estimations.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Lamberton, Dr Poppy
Authors: Prada, J. M., Touloupou, P., Adriko, M., Tukahebwa, E. M., Lamberton, P. H.L., and Hollingsworth, T. D.
College/School:College of Medical Veterinary and Life Sciences > Institute of Biodiversity Animal Health and Comparative Medicine
Journal Name:Parasites and Vectors
Publisher:BioMed Central
ISSN:1756-3305
ISSN (Online):1756-3305
Copyright Holders:Copyright © 2018 The Authors
First Published:First published in Parasites and Vectors 11:21
Publisher Policy:Reproduced under a Creative Commons License

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