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Article

Diagnosis of Schistosomiasis without a Microscope: Evaluating Circulating Antigen (CCA, CAA) and DNA Detection Methods on Banked Samples of a Community-Based Survey from DR Congo

by
Pytsje T. Hoekstra
1,*,
Joule Madinga
2,3,
Pascal Lutumba
4,5,
Rebecca van Grootveld
6,
Eric A. T. Brienen
1,
Paul L. A. M. Corstjens
7,
Govert J. van Dam
1,
Katja Polman
3,8 and
Lisette van Lieshout
1
1
Department of Parasitology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
2
Institute of Health and Society, Université Catholique de Louvain, 1348 Brussels, Belgium
3
Department of Biomedical Sciences, Institute of Tropical Medicine, 2000 Antwerp, Belgium
4
Institut National de Recherche Biomédicale, Kinshasa 1197, Democratic Republic of the Congo
5
Department of Tropical Medicine, University of Kinshasa, Kinshasa 7948, Democratic Republic of the Congo
6
Department of Clinical Microbiology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
7
Department of Cell and Chemical Biology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
8
Department of Health Sciences, VU University Amsterdam, 1081 HV Amsterdam, The Netherlands
*
Author to whom correspondence should be addressed.
Trop. Med. Infect. Dis. 2022, 7(10), 315; https://doi.org/10.3390/tropicalmed7100315
Submission received: 6 September 2022 / Revised: 13 October 2022 / Accepted: 17 October 2022 / Published: 19 October 2022
(This article belongs to the Special Issue Schistosomiasis in Endemic Countries and in Travelers—Two Sides of the Same Coin)
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Abstract

Detection of Schistosoma eggs in stool or urine is known for its low sensitivity in diagnosing light infections. Alternative diagnostics with better sensitivity while remaining highly specific, such as real-time PCR and circulating antigen detection, are progressively used as complementary diagnostic procedures but have not yet replaced microscopy. This study evaluates these alternative methods for the detection of Schistosoma infections in the absence of microscopy. Schistosomiasis presence was determined retrospectively in 314 banked stool and urine samples, available from a previous survey on the prevalence of taeniasis in a community in the Democratic Republic of the Congo, using real-time PCR, the point-of-care circulating cathodic antigen (POC-CCA) test, as well as the up-converting particle lateral flow circulating anodic antigen (UCP-LF CAA) test. Schistosoma DNA was present in urine (3%) and stool (28%) samples, while CCA (28%) and CAA (69%) were detected in urine. Further analysis of the generated data indicated stool-based PCR and the POC-CCA test to be suitable diagnostics for screening of S. mansoni infections, even in the absence of microscopy. A substantial proportion (60%) of the 215 CAA-positive cases showed low antigen concentrations, suggesting that even PCR and POC-CCA underestimated the “true” number of schistosome positives.
Keywords: schistosomiasis; diagnostics; community-based survey; circulating antigen; DNA detection; CCA; CAA; PCR; urine; stool schistosomiasis; diagnostics; community-based survey; circulating antigen; DNA detection; CCA; CAA; PCR; urine; stool

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MDPI and ACS Style

Hoekstra, P.T.; Madinga, J.; Lutumba, P.; van Grootveld, R.; Brienen, E.A.T.; Corstjens, P.L.A.M.; van Dam, G.J.; Polman, K.; van Lieshout, L. Diagnosis of Schistosomiasis without a Microscope: Evaluating Circulating Antigen (CCA, CAA) and DNA Detection Methods on Banked Samples of a Community-Based Survey from DR Congo. Trop. Med. Infect. Dis. 2022, 7, 315. https://doi.org/10.3390/tropicalmed7100315

AMA Style

Hoekstra PT, Madinga J, Lutumba P, van Grootveld R, Brienen EAT, Corstjens PLAM, van Dam GJ, Polman K, van Lieshout L. Diagnosis of Schistosomiasis without a Microscope: Evaluating Circulating Antigen (CCA, CAA) and DNA Detection Methods on Banked Samples of a Community-Based Survey from DR Congo. Tropical Medicine and Infectious Disease. 2022; 7(10):315. https://doi.org/10.3390/tropicalmed7100315

Chicago/Turabian Style

Hoekstra, Pytsje T., Joule Madinga, Pascal Lutumba, Rebecca van Grootveld, Eric A. T. Brienen, Paul L. A. M. Corstjens, Govert J. van Dam, Katja Polman, and Lisette van Lieshout. 2022. "Diagnosis of Schistosomiasis without a Microscope: Evaluating Circulating Antigen (CCA, CAA) and DNA Detection Methods on Banked Samples of a Community-Based Survey from DR Congo" Tropical Medicine and Infectious Disease 7, no. 10: 315. https://doi.org/10.3390/tropicalmed7100315

APA Style

Hoekstra, P. T., Madinga, J., Lutumba, P., van Grootveld, R., Brienen, E. A. T., Corstjens, P. L. A. M., van Dam, G. J., Polman, K., & van Lieshout, L. (2022). Diagnosis of Schistosomiasis without a Microscope: Evaluating Circulating Antigen (CCA, CAA) and DNA Detection Methods on Banked Samples of a Community-Based Survey from DR Congo. Tropical Medicine and Infectious Disease, 7(10), 315. https://doi.org/10.3390/tropicalmed7100315

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