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Trop. Med. Infect. Dis. 2018, 3(2), 54; https://doi.org/10.3390/tropicalmed3020054

Diagnostic Performance of Kato Katz Technique and Point-of-Care Circulating Cathodic Antigen Rapid Test in Diagnosing Schistosoma mansoni Infection in HIV-1 Co-Infected Adults on the Shoreline of Lake Victoria, Tanzania

1
Department of Medical Parasitology, School of Medicine, Catholic University of Health and Allied Sciences, P.O. Box 1464, Mwanza, Tanzania
2
Department of Community Health, School of Medicine, Federal University of Ceará, Fortaleza CE 60430-140, Brazil
3
College of Public Health, Medical and Veterinary Sciences, Division of Tropical Health and Medicine, James Cook University, Townsville 4811, Queensland, Australia
*
Author to whom correspondence should be addressed.
Received: 7 May 2018 / Revised: 21 May 2018 / Accepted: 22 May 2018 / Published: 29 May 2018
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Abstract

Background: The diagnostic performance of the Kato Katz (KK) technique and the point-of-care circulating cathodic antigen (POC-CCA) test in detecting S. mansoni infection in the presence of the human immunodeficiency virus-1 (HIV-1) infection has remained inconclusive. The present cross-sectional survey compared the diagnostic performance of the KK technique and the POC-CCA test in diagnosing S. mansoni infection in an adult population co-infected with HIV-1 in northwestern Tanzania. Methods: Single urine and stool samples from 979 adults were screened for S. mansoni infection using both the KK technique and POC-CCA tests. To compare the performance of the two diagnostic tests a combined artificial gold standard was created, based on either an egg-positive KK technique or a POC-CCA-positive test. Results: Based on the KK technique, the prevalence of S. mansoni was 47.3% (463/979, 95% CI: 44.2–50.4), as compared to 60.5% by the POC-CCA test (592/979; 95% CI: 57.4–63.5). The overall sensitivity and specificity of the POC-CCA test were 92.5% (95% CI: 89.4–94.9) and 73.3% (95% CI: 69.6–76.8), respectively. In the HIV-1 seropositive group, the sensitivity and specificity of the POC-CCA test were 78.1% (95% CI: 60.0–90.7) and 45.9% (95% CI: 35.8–56.3). Using a combined gold standard, the sensitivity of the POC-CCA test increased to >90% in both subgroups whereas that of the KK technique in the HIV-1 seropositive group was low (49.5%; 95% CI: 39.6–59.5). Conclusion: In the presence of HIV-1 co-infection, the KK technique attained a very low sensitivity. The POC-CCA test offers the best option for the rapid screening of S. mansoni infection in communities with a high prevalence of HIV-1 infection. View Full-Text
Keywords: Schistosoma mansoni; HIV-1; point-of-care circulating cathodic antigen; sensitivity; specificity; adult; Tanzania Schistosoma mansoni; HIV-1; point-of-care circulating cathodic antigen; sensitivity; specificity; adult; Tanzania
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).
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Mazigo, H.D.; Heukelbach, J. Diagnostic Performance of Kato Katz Technique and Point-of-Care Circulating Cathodic Antigen Rapid Test in Diagnosing Schistosoma mansoni Infection in HIV-1 Co-Infected Adults on the Shoreline of Lake Victoria, Tanzania. Trop. Med. Infect. Dis. 2018, 3, 54.

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