Point-of-care circulating cathodic antigen positivity and associated factors in school children one year after mass praziquantel administration in an endemic district in Ghana.

BACKGROUND

Mass drug administration of praziquantel is expected to reduce carriage in treated children in endemic communities. However, the effectiveness of this annual exercise has not been assessed in Ghana. Therefore, this study aimed to detect viable infection using point-of-care circulating cathodic antigen (POC-CCA) positivity as proxy and associated factors in children previously treated with praziquantel in an endemic municipality in Ghana.

MATERIALS AND METHODS

This cross-sectional study was done in the Assin Central municipality in the Central Region of Ghana. School children, less than 16 years of age, treated with 40 mg/kg of praziquantel (treatment period: February-March 2019), provided early morning urine (∼40 mL) and stool (∼4 g) samples. Immediately, POC-CCA (ICT International, South Africa) was done, while ova were detected in formalin fixed samples using microscopy later. Additionally, participant's socio-demographic information and factors associated with infection transmission were collected from each child.

RESULTS

A total of 520 children participated in the study (males-51.9%, majority age range [9-11 years, 34.4%]). Overall, 244 (46.9%) were positive for urinary CCA with no detected by microscopy. POC-CCA positivity was higher in females (48.4%), children with 2-3 siblings (49.3%), children aged 6-8-year range (55.4%) and residents of Brofoyedur (52%). However, age ( = 16.1, p = 0.0003) and town of residence ( = 11.7, p = 0.019) associated with CCA positivity. Further, location of water body ( = 16.4, p = 0.008), frequency of water contact ( = 12.3, p = 0.015) and handling of the intermediate host ( = 5.1, p = 0.024) associated with POC-CCA outcome.

CONCLUSION

About 47% of the school children were positive for CCA, one year after mass praziquantel administration in the Assin Central municipality. Varied factors associated with the post-praziquantel administration POC-CCA positivity. This study should be replicated in other endemic areas to identify groups at risk of parasite persistence or reinfection to inform modification of control and preventive measures.