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Performance characteristics of diagnostic assays for schistosomiasis in Ontario, Canada
INTRODUCTION: Due to lower intensity of infection and greater intervals from last exposure, parasitologic detection methods for schistosomiasis are poorly sensitive in non-endemic areas, challenging accurate diagnosis. METHODS: We evaluated parasitologic versus indirect detection methods for schisto...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
SAGE Publications
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10201143/ https://www.ncbi.nlm.nih.gov/pubmed/37223452 http://dx.doi.org/10.1177/20499361231173843 |
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author | Lau, Rachel Makhani, Leila Omoruna, Osaru Lecce, Celine Shao, Eric Cunanan, Marlou Ralevski, Filip Cheema, Karamjit Boggild, Andrea K. |
author_facet | Lau, Rachel Makhani, Leila Omoruna, Osaru Lecce, Celine Shao, Eric Cunanan, Marlou Ralevski, Filip Cheema, Karamjit Boggild, Andrea K. |
author_sort | Lau, Rachel |
collection | PubMed |
description | INTRODUCTION: Due to lower intensity of infection and greater intervals from last exposure, parasitologic detection methods for schistosomiasis are poorly sensitive in non-endemic areas, challenging accurate diagnosis. METHODS: We evaluated parasitologic versus indirect detection methods for schistosomiasis. We included specimens submitted for Schistosoma serology, and stool for ova and parasite microscopy. Three real-time PCR assays targeting Schistosoma mansoni and S. haematobium were performed. Primary outcome measures were sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV), where both microscopy and serology were the composite reference standard against serum PCR. RESULTS: Of 8168 serum specimens submitted for Schistosoma serology, 638 (7.8%) were reactive and 6705 (82.1%) were non-reactive. Of 156,771 stool specimens submitted for ova and parasite testing, 46 (0.03%) were positive for eggs of S. mansoni. Four (0.5%) urine specimens were positive for eggs of S. haematobium. Combined serum PCRs targeting S. mansoni had a sensitivity and specificity of 27.8% (95% CI = 18.3–39.1%) and 100% (95% CI = 83.9–100%), respectively, with PPV of 100% (95% CI = 100%) and NPV of 26.9% (95% CI = 24.3–29.7%). The one serum sample positive for S. haematobium was also detectable by our S. haematobium PCR. No cross-reactivity was observed for all three PCR assays. CONCLUSIONS: Although serology is highly sensitive, parasitologic tests signify active infection, but are limited by low population-level sensitivity, particularly in non-endemic settings. Although serum PCR offered no performance advantage over stool microscopy, its role in diagnostic parasitology should be pursued due to its high-throughput and operator-independent nature. |
format | Online Article Text |
id | pubmed-10201143 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | SAGE Publications |
record_format | MEDLINE/PubMed |
spelling | pubmed-102011432023-05-23 Performance characteristics of diagnostic assays for schistosomiasis in Ontario, Canada Lau, Rachel Makhani, Leila Omoruna, Osaru Lecce, Celine Shao, Eric Cunanan, Marlou Ralevski, Filip Cheema, Karamjit Boggild, Andrea K. Ther Adv Infect Dis Original Research INTRODUCTION: Due to lower intensity of infection and greater intervals from last exposure, parasitologic detection methods for schistosomiasis are poorly sensitive in non-endemic areas, challenging accurate diagnosis. METHODS: We evaluated parasitologic versus indirect detection methods for schistosomiasis. We included specimens submitted for Schistosoma serology, and stool for ova and parasite microscopy. Three real-time PCR assays targeting Schistosoma mansoni and S. haematobium were performed. Primary outcome measures were sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV), where both microscopy and serology were the composite reference standard against serum PCR. RESULTS: Of 8168 serum specimens submitted for Schistosoma serology, 638 (7.8%) were reactive and 6705 (82.1%) were non-reactive. Of 156,771 stool specimens submitted for ova and parasite testing, 46 (0.03%) were positive for eggs of S. mansoni. Four (0.5%) urine specimens were positive for eggs of S. haematobium. Combined serum PCRs targeting S. mansoni had a sensitivity and specificity of 27.8% (95% CI = 18.3–39.1%) and 100% (95% CI = 83.9–100%), respectively, with PPV of 100% (95% CI = 100%) and NPV of 26.9% (95% CI = 24.3–29.7%). The one serum sample positive for S. haematobium was also detectable by our S. haematobium PCR. No cross-reactivity was observed for all three PCR assays. CONCLUSIONS: Although serology is highly sensitive, parasitologic tests signify active infection, but are limited by low population-level sensitivity, particularly in non-endemic settings. Although serum PCR offered no performance advantage over stool microscopy, its role in diagnostic parasitology should be pursued due to its high-throughput and operator-independent nature. SAGE Publications 2023-05-19 /pmc/articles/PMC10201143/ /pubmed/37223452 http://dx.doi.org/10.1177/20499361231173843 Text en © The Author(s), 2023 https://creativecommons.org/licenses/by-nc/4.0/This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page (https://us.sagepub.com/en-us/nam/open-access-at-sage). |
spellingShingle | Original Research Lau, Rachel Makhani, Leila Omoruna, Osaru Lecce, Celine Shao, Eric Cunanan, Marlou Ralevski, Filip Cheema, Karamjit Boggild, Andrea K. Performance characteristics of diagnostic assays for schistosomiasis in Ontario, Canada |
title | Performance characteristics of diagnostic assays for schistosomiasis
in Ontario, Canada |
title_full | Performance characteristics of diagnostic assays for schistosomiasis
in Ontario, Canada |
title_fullStr | Performance characteristics of diagnostic assays for schistosomiasis
in Ontario, Canada |
title_full_unstemmed | Performance characteristics of diagnostic assays for schistosomiasis
in Ontario, Canada |
title_short | Performance characteristics of diagnostic assays for schistosomiasis
in Ontario, Canada |
title_sort | performance characteristics of diagnostic assays for schistosomiasis
in ontario, canada |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10201143/ https://www.ncbi.nlm.nih.gov/pubmed/37223452 http://dx.doi.org/10.1177/20499361231173843 |
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