Evaluation of microscopy, serology, circulating anodic antigen (CAA), and eosinophil counts for the follow-up of migrants with chronic schistosomiasis: a prospective cohort study

Parasit Vectors. 2021 Mar 9;14(1):149. doi: 10.1186/s13071-021-04655-z.

Abstract

Background: An accurate test for the diagnosis and post-treatment follow-up of patients with schistosomiasis is needed. We assessed the performance of different laboratory parameters, including the up-converting reporter particle technology lateral flow assay to detect circulating anodic antigen (UCP-LF CAA), for the post-treatment follow-up of schistosomiasis in migrants attending a dedicated outpatient clinic in a non-endemic country.

Methods: Routine anti-Schistosoma serology results and eosinophil counts were obtained of patients with positive urine/stool microscopy and/or PCR (confirmed cases) or only positive serology (possible cases), and at least one follow-up visit at 6 (T6) or 12 (T12) months after praziquantel treatment. All sera samples were tested with the UCP-LF CAA assay.

Results: Forty-eight patients were included, 23 confirmed and 25 possible cases. The percentage seropositivity and median antibody titers did not change significantly during follow-up. UCP-LF CAA was positive in 86.9% of confirmed and 20% of possible cases. The percentage positivity and median CAA levels decreased significantly post-treatment, with only two patients having positive CAA levels at T12.

Conclusions: The UCP-LF CAA assay proved useful for the diagnosis of active infection with Schistosoma spp. and highly valuable for post-treatment monitoring in migrants, encouraging the development of a commercial test.

Keywords: Circulating anodic antigen (CAA); Diagnosis; Follow-up; Microscopy; Migrants; Schistosomiasis; Serology.

Publication types

  • Evaluation Study

MeSH terms

  • Adolescent
  • Adult
  • Animals
  • Antigens, Helminth / blood*
  • Antigens, Helminth / immunology
  • Eosinophils / immunology*
  • Female
  • Glycoproteins / blood*
  • Glycoproteins / immunology
  • Helminth Proteins / blood*
  • Helminth Proteins / immunology
  • Humans
  • Immunologic Tests / methods
  • Immunologic Tests / standards*
  • Leukocyte Count / methods
  • Leukocyte Count / standards
  • Male
  • Microscopy / methods
  • Microscopy / standards*
  • Middle Aged
  • Prospective Studies
  • Schistosoma / classification
  • Schistosoma / genetics
  • Schistosoma / immunology*
  • Schistosomiasis / blood
  • Schistosomiasis / diagnosis*
  • Schistosomiasis / urine
  • Sensitivity and Specificity
  • Transients and Migrants / statistics & numerical data*
  • Young Adult

Substances

  • Antigens, Helminth
  • Glycoproteins
  • Helminth Proteins
  • circulating anodic antigen, Schistosoma mansoni