Cross-reaction of POC-CCA urine test for detection of Schistosoma mekongi in Lao PDR: a cross-sectional study  

作　　者：Anousin Homsana Peter Odermatt Phonesavanh Southisavath Aya Yajima Somphou Sayasone 

机构地区：[1]Lao Tropical and Public Health Institute,Ministry of Health,Vientiane Capital,Lao People's Democratic Republic [2]Department of Epidemiology and Public Health,Swiss Tropical and Public Health Institute,P.O.Box,CH-4002 Basel,Switzerland [3]University of Basel,P.O.Box,CH-4003 Basel,Switzerland [4]Department of Radiology,Mahosot Hospital,Ministry of Health,Vientiane Capital,Lao People's Democratic Republic [5]World Health Organization,Western Pacific Regional Office,Manila,Philippines

出　　处：《Infectious Diseases of Poverty》2020年第4期66-74,共9页贫困所致传染病（英文）

基　　金：The World Health Organization,Western Pacific Region,International Development Research Centre,Phase 2 has funded our study,along with the Swiss Agency for Development and Cooperation and the Swiss National Science Foundation(project No.IZ07Z0-160930,R4D).

摘　　要：Background:The point-of-care circulating cathodic antigen(POC-CCA)test is increasingly used as a rapid diagnostic method for Schistosoma mansoni infection.The test has good sensitivity,although false positive results have been reported among pregnant women and patients with urine infections and hematuria.We validated the POC-CCA test's ability to diagnose Schistosoma mekongi infection in Lao People's Democratic Republic(Lao PDR),where S.mekongi is endemic.Of particular interest was the test's specificity and possible cross-reactivity with other helminth infections.Methods:We conducted a cross-sectional study of children and adults in the provinces of Champasack(Schistosoma mekongi and Opisthorchis viverrini endemic),Savannakhet(O.viverrini endemic)and Luang Prabang(soil-transmitted helminths endemic)between October 2018 and April 2019.POC-CCA and urine dipstick tests were administered to all study participants,while an additional pregnancy test was offered to women.Two stool samples were collected from participants and examined with a Kato-Katz test(two smears per stool).Logistic regression was used to associate potential confounding factors(predictors)with POC-CCA test results(outcome).Results:In S.mekongi-endemic Champasack,11.5%(n=366)and 0.5%(n=2)of study participants had positive POC-CCA and Kato-Katz test results,respectively.Only one of the two Kato-Katz positive patients was also POC-CCA positive.In Champasack and Luang Prabang,where S.rnekongi is not endemic,the POC-CCA test yielded(presumably)false positive results for 6.0%(n=22)and 2.5%(n=9)of study participants,respectively,while all of the Kato-Katz tests were negative.POC-CCA positive test results were significantly associated with O.viverrini infection(1.69,95%confidence interval(CI):1.02-2.77,P=0.042),increased leukocytes(adjusted Odds Ratio(aOR)=1.58,95%CI:1.15-2.17,P=0.005)and hematuria(aOR=1.50,95%CI:1.07-2.10,P=0.019)if the observed trace was counted as a positive test result.Two pregnant women from Champasack province had POC-CCA positive tes

关 键 词：POINT-OF-CARE circulating cathodic antigen Lao People's Democratic REPUBLIC Kato-Katz SCHISTOSOMA mekongi OPISTHORCHIS viverrini Soil-transmitted HELMINTH 

分 类 号：R532.2[医药卫生—内科学]