Am J Trop Med Hyg. 2013 Mar;88(3):426-432. doi: 10.4269/ajtmh.12-0639. Epub 2013 Jan 21.
We evaluated a commercial point-of-care circulating cathodic antigen (POC-CCA) test for assessing Schistosoma mansoni infection prevalence in areas at risk. Overall, 4,405 school-age children in Cameroon, Côte d'Ivoire, Ethiopia, Kenya, and Uganda provided urine for POC-CCA testing and stool for Kato-Katz assays. By latent class analysis, one POC-CCA test was more sensitive (86% versus 62%) but less specific (72% versus ~100%) than multiple Kato-Katz smears from one stool. However, only 1% of POC-CCA tests in a non-endemic area were false positives, suggesting the latent class analysis underestimated the POC-CCA specificity. Multivariable modeling estimated POC-CCA as significantly more sensitive than Kato-Katz at low infection intensities (< 100 eggs/gram stool). By linear regression, 72% prevalence among 9-12 year olds by POC-CCA corresponded to 50% prevalence by Kato-Katz, whereas 46% POC-CCA prevalence corresponded to 10% Kato-Katz prevalence. We conclude that one urine POC-CCA test can replace Kato-Katz testing for community-level S. mansoni prevalence mapping.
我们评估了一种商业化的即时循环阴沟抗原（POC-CCA）检测方法，用于评估有风险地区的曼氏血吸虫感染流行率。总体而言，喀麦隆、科特迪瓦、埃塞俄比亚、肯尼亚和乌干达的 4405 名学龄儿童提供了尿液进行 POC-CCA 检测和粪便进行加藤氏检测。通过潜在类别分析，一次 POC-CCA 检测比多次加藤氏涂片更敏感（86%对 62%），但特异性较低（72%对~100%）。然而，在非流行地区，只有 1%的 POC-CCA 检测呈假阳性，这表明潜在类别分析低估了 POC-CCA 的特异性。多变量建模估计 POC-CCA 在低感染强度（<100 个/克粪便卵）时比加藤氏检测更敏感。通过线性回归，POC-CCA 在 9-12 岁儿童中的 72%流行率相当于加藤氏检测的 50%流行率，而 46%的 POC-CCA 流行率相当于加藤氏检测的 10%流行率。我们得出结论，一次尿液 POC-CCA 检测可以替代加藤氏检测用于社区层面的曼氏血吸虫流行率绘图。
