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Accuracy of real-time polymerase chain reaction to detect Schistosoma mansoni – infected individuals from an endemic area with low parasite loads

Published online by Cambridge University Press:  02 June 2020

Fernanda do Carmo Magalhães Open the ORCID record for Fernanda do Carmo Magalhães [Opens in a new window] ,
Samira Diniz Resende ,
Carolina Senra ,
Carlos Graeff-Teixeira ,
Martin Johannes Enk ,
Paulo Marcos Zech Coelho ,
Edward Oliveira ,
Deborah Aparecida Negrão-Corrêa Open the ORCID record for Deborah Aparecida Negrão-Corrêa [Opens in a new window] ,
Stefan Michael Geiger  and
Mariângela Carneiro
Fernanda do Carmo Magalhães*
Affiliation:
Departamento de Parasitologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, 31270-901, Belo Horizonte, MG, Brazil
Samira Diniz Resende
Affiliation:
Departamento de Parasitologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, 31270-901, Belo Horizonte, MG, Brazil
Carolina Senra
Affiliation:
Pesquisa Clínica e Políticas Públicas em Doenças Infecciosas e Parasitárias, Instituto René Rachou, Fundação Oswaldo Cruz (FIOCRUZ), 30190-002, Belo Horizonte, MG, Brazil
Carlos Graeff-Teixeira
Affiliation:
Núcleo de Doenças Infecciosas, Centro de Ciências da Saúde, Universidade Federal do Espírito Santo, Vitória, ES, Brazil
Martin Johannes Enk
Affiliation:
Secretaria de Vigilância em Saúde, Instituto Evandro Chagas, Ministério da Saúde, Belém, Brazil
Paulo Marcos Zech Coelho
Affiliation:
Diagnóstico e Terapia de Doenças Infecciosas e Oncológicas, Instituto René Rachou, Fundação Oswaldo Cruz (FIOCRUZ), 30190-002, Belo Horizonte, MG, Brazil
Edward Oliveira
Affiliation:
Pesquisa Clínica e Políticas Públicas em Doenças Infecciosas e Parasitárias, Instituto René Rachou, Fundação Oswaldo Cruz (FIOCRUZ), 30190-002, Belo Horizonte, MG, Brazil
Deborah Aparecida Negrão-Corrêa
Affiliation:
Departamento de Parasitologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, 31270-901, Belo Horizonte, MG, Brazil
Stefan Michael Geiger
Affiliation:
Departamento de Parasitologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, 31270-901, Belo Horizonte, MG, Brazil
Mariângela Carneiro
Affiliation:
Departamento de Parasitologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, 31270-901, Belo Horizonte, MG, Brazil
*
Author for correspondence: Fernanda do Carmo Magalhães, E-mail: [email protected]
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Abstract

Due to the efforts to control schistosomiasis transmission in tropical countries, a large proportion of individuals from endemic areas present low parasite loads, which hinders diagnosis of intestinal schistosomiasis by the Kato-Katz (KK) method. Therefore, the development of more sensitive diagnostic methods is essential for efficient control measures. The aim was to evaluate the accuracy of a real-time polymerase chain reaction (RT-PCR) to detect Schistosoma mansoni DNA in fecal samples of individuals with low parasite loads. A cross-sectional population-based study was conducted in a rural community (n = 257) in Brazil. POC-CCA® was performed in urine and feces were used for RT-PCR. In addition, fecal exams were completed by 18 KK slides, saline gradient and Helmintex techniques. The combined results of the three parasitological tests detected schistosome eggs in 118 participants (45.9%) and composed the consolidated reference standard (CRS). By RT-PCR, 117 out of 215 tested samples were positive, showing 91.4% sensitivity, 80.2% specificity and good concordance with the CRS (kappa = 0.71). RT-PCR identified 86.9% of the individuals eliminating less than 12 eggs/g of feces, demonstrating much better performance than POC-CCA® (50.8%). Our results showed that RT-PCR is a valuable alternative for the diagnosis of intestinal schistosomiasis in individuals with very low parasite loads.

Keywords

Diagnosislow parasite loadRT-PCRSchistosomiasis mansoni
Type
Research Article
Information
Parasitology , Volume 147 , Issue 10 , September 2020 , pp. 1140 - 1148
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Copyright
Copyright © The Author(s), 2020. Published by Cambridge University Press

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