000			03770nam a22002657a 4500
003			OSt
005			20240305193722.0
008			221104b |||||||| |||| 00| 0 eng d
028			_bPhone: +255 28 298 3384
028			_b Fax: +255 28 298 3386
028			_b Email: vc@bugando.ac.tz
028			_bWebsite: www.bugando.ac.tz
040			_cDLC
041			_aEnglish
100			_aAntje Fuss _945045
245			_aEvaluation of serum-based real-time PCR to detect Schistosoma mansoni infection before and after treatment
260			_aMwanza: _bEditorial Office of Infectious Diseases of Poverty, National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention & _b Tanzania Catholic University of Health and Allied Sciences [CUHAS – Bugando] _c22 June 2020
300			_aPages 114-120
490			_v Infectious Diseases of Poverty Volume 9 Issue 03
520			_aAbstract Background: To detect acute schistosomiasis, low-intensity infections, or to verify the success of treatment with praziquantel, highly sensitive test methods are required. The aim of this study was therefore to demonstrate the performance of Schistosoma mansoni specific DNA detection in serum and urine using real-time polymerase chain reaction (PCR) in an endemic area before and after treatment. Methods: The study pursued a 1-week and 20-weeks longitudinal design with a treatment intervention among 36 study participants aged 18 to 70 years in the community of Kayenze, a fishing village in Ilemela district on the southern shore of Lake Victoria in north-western Tanzania between February and June 2018. Blood, urine and stool samples were collected from each participant to diagnose Schistosoma mansoni infection before and two times after treatment with praziquantel using serum-and urine based real-time PCR, point-of-care circulating cathodic antigen (POC-CCA) rapid diagnostic test and the microscopic Kato-Katz (KK) method. Kappa coefficient (κ) was used to estimate the agreement between these diagnostic tests compared to a combined "gold standard" of positive results by serum-based real-time PCR and/or positive egg counts determined by KK. Kendall’s Tau rank correlation was used to examine the relationship between cycle threshold (Ct)-values and egg counts and the Wilcoxon signed-rank test was used to compare the median Ct-values of the different examination time points. Results: By using the combined "gold standard" of the parasitological Kato-Katz test and/or serum-based real-time PCR, a S. mansoni prevalence of 77.1% could be determined at baseline. In terms of sensitivity, serum-based realtime PCR (96.3%) and POC-CCA assay (77.8%) showed the highest results. The detection of DNA from urine samples showed the lowest sensitivity (33.3%). Treatment with praziquantel resulted in a significantly reduced prevalence of S. mansoni. No infection could be detected by Kato-Katz, with the POC-CCA test only 33.3%. The analysis of the median Ct values over time (which were determined by the serum-based real-time PCR) showed that the Ct decreases significantly shortly after treatment (from 30.3 to 28) and increases above baseline level (34.9) three months later. Conclusions: The data presented here show that the serum-based real-time PCR exhibits excellent diagnostic accuracy, in contrast to the use of urine as sample material for S. mansoni DNA detection. However, as circulating DNA does not necessarily reflect the persistence of living worms in schistosomiasis, this method is less well suited to verify the success of treatment with praziquantel.
700			_aHumphrey Deogratias Mazigo _922617
700			_aAndreas Mueller _923020
856			_u10.1186/s40249-020-00698-z
942			_2ddc _cVM
999			_c19302 _d19302