Kabbas-Piñango, E. , Arinaitwe, M., van Dam, G. J., Moses, A., Namukuta, A., Nankasi, A. B., Khayinja Mwima, N., Besigye, F., Prada, J. M. and Lamberton, P. H. L. (2023) Reproducibility matters: intra- and inter-sample variation of the point-of-care circulating cathodic antigen test (POC-CCA) in two Schistosoma mansoni endemic areas in Uganda. Philosophical Transactions of the Royal Society B: Biological Sciences, 378(1887), 20220275. (doi: 10.1098/rstb.2022.0275) (PMID:37598698)
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Abstract
Over 240 million people are infected with schistosomiasis. Detecting Schistosoma mansoni eggs in stool using Kato–Katz thick smears (Kato-Katzs) is highly specific but lacks sensitivity. The urine-based point-of-care circulating cathodic antigen test (POC-CCA) has higher sensitivity, but issues include specificity, discrepancy between batches and interpretation of trace results. A semi-quantitative G-score and latent class analyses making no assumptions about trace readings have helped address some of these issues. However, intra-sample and inter-sample variation remains unknown for POC-CCAs. We collected 3 days of stool and urine from 349 and 621 participants, from high- and moderate-endemicity areas, respectively. We performed duplicate Kato-Katzs and one POC-CCA per sample. In the high-endemicity community, we also performed three POC-CCA technical replicates on one urine sample per participant. Latent class analysis was performed to estimate the relative contribution of intra- (test technical reproducibility) and inter-sample (day-to-day) variation on sensitivity and specificity. Within-sample variation for Kato-Katzs was higher than between-sample, with the opposite true for POC-CCAs. A POC-CCA G3 threshold most accurately assesses individual infections. However, to reach the WHO target product profile of the required 95% specificity for prevalence and monitoring and evaluation, a threshold of G4 is needed, but at the cost of reducing sensitivity. This article is part of the theme issue ‘Challenges and opportunities in the fight against neglected tropical diseases: a decade from the London Declaration on NTDs’.
| Item Type: | Articles |
|---|---|
| Additional Information: | This work was supported by E.K.-P.'s Medical Research Scotland PhD studentship awarded to P.H.L.L., the primary supervisor (MRS PhD-1183-2017); the European Research Council (ERC Starting Grant awarded to P.H.L.L., SCHISTO_PERSIST 680088); and the Engineering and Physical Sciences Research Council (EPSRC EP/T003618/1 awarded to J.M.P. and P.H.L.L.). |
| Status: | Published |
| Refereed: | Yes |
| Glasgow Author(s) Enlighten ID: | Lamberton, Professor Poppy and Kabbas Piñango, Elías |
| Authors: | Kabbas-Piñango, E., Arinaitwe, M., van Dam, G. J., Moses, A., Namukuta, A., Nankasi, A. B., Khayinja Mwima, N., Besigye, F., Prada, J. M., and Lamberton, P. H. L. |
| College/School: | College of Medical Veterinary and Life Sciences > School of Biodiversity, One Health & Veterinary Medicine |
| Journal Name: | Philosophical Transactions of the Royal Society B: Biological Sciences |
| Publisher: | The Royal Society |
| ISSN: | 0962-8436 |
| ISSN (Online): | 1471-2970 |
| Published Online: | 21 August 2023 |
| Copyright Holders: | Copyright © 2023 The Authors |
| First Published: | First published in Philosophical Transactions of the Royal Society B: Biological Sciences 378(1887):20220275 |
| Publisher Policy: | Reproduced with the permission of the publisher |
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