Diagnostic performance of parasitological, immunological and molecular tests for the diagnosis of Schistosoma mansoni infection in a community of low transmission in Venezuela

• Published in: Acta tropica 2020-04, Vol.204, p.105360-105360, Article 105360
• Main Authors: Ferrer, Elizabeth, Villegas, Berenice, Mughini-Gras, Lapo, Hernández, Diego, Jiménez, Verónica, Catalano, Emily, Incani, Renzo Nino
• Format: Article
• Language: English
• Subjects: Immunodiagnosis; Kato–Katz; Low transmission area; PCR; Schistosomiasis; Venezuela
• ISSN: 0001-706X; 1873-6254
• DOI: 10.1016/j.actatropica.2020.105360

•A Schistosomiasis study was carried out in a low endemic area of Venezuela.•Diagnosis was made by parasitological, immunological and molecular tests.•Diagnostic performance of Kato-Katz, ELISA, COPT and PCR was determined.•A high prevalence was obtained using a series of tests that complement one another.•ELISA is the best approach for recent and past infections and PCR for recent ones. In Venezuela, areas endemic for schistosomiasis are of low transmission, with low parasite loads. Immunological tests often lack specificity and cannot differentiate past from present infections. Molecular tests are an alternative, although validation studies in endemic areas are needed. The aim of this study was to determine the performance of parasitological, immunological and molecular tests for the diagnosis of Schistosoma mansoni infection in low-transmission settings. A cross-sectional study was carried out in a rural community located in a schistosomiasis-endemic area of Venezuela to determine the prevalence and diagnostic performance of the Kato-Katz (KK) technique, Circumoval Precipitin Test (COPT), ELISA based on soluble egg antigen (ELISA-SEA) with and without treatment with sodium metaperiodate (ELISA-SEA-SMP), and PCR for amplification of the 121 bp highly repeated sequence of Schistosoma mansoni in faeces, urine and serum samples. The highest prevalence rates were obtained with ELISA-SEA (38.7%), COPT (33.3%), ELISA-SEA-SMP (31.5%), PCR on faeces (21.6%), and KK (17.1%), whereas PCR-based prevalence in urine was 6.2% and no positivity was detected in serum samples. Results showed that ELISA-SEA is the best method for the diagnosis of both current and former infections and that PCR on faeces is the best method for detecting recent transmission. The use of different tests that complement one another also allowed for a better diagnosis of Schistosoma mansoni infection, revealing a relatively high prevalence (33.8%) of schistosomiasis in a community of low transmission. [Display omitted]