CIRCULATING CATHODIC ANTIGEN VERSUS MICROSCOPY FOR DIAGNOSING URINARY SCHISTOSOMIASIS AMONG CHILDREN, IN SOHAG UNIVERSITY HOSPITALS

Authors

1 Department of Medical Parasitology, Faculty of Medicine, Sohag University, Egyp

2 Department of Medical Parasitology, Faculty of Medicine, Sohag University, Egypt

3 Department of Pediatrics, Faculty of Medicine, Sohag University, Egypt

Abstract

Urinary schistosomiasis caused by Schistosoma haematobium constitutes a major public
health problem in many tropical and sub-tropical countries. Rapid diagnostic tests are needed
for the implementation and monitoring of national schistosomiasis control programs.
The study estimated prevalence and risk factors of S. haematobium by the circulating cathodic
antigen test (POC-CCA) versus microscopic urine examinations. A cross-sectional study
was conducted on 100 outpatient children aged 3 to 15 years attended Sohag University Hospitals.
Demographic data and risk factors were collected using a structured questionnaire. Urine
samples were examined by microscopic examination techniques (sedimentation centrifugation
and Nucleopore filtration methods) for detection of S. haematobium eggs and by a commercially
available cassette test POC-CCA, for detection of S. haematobium circulating cathodic
antigens.
The results showed that S. haematobium infected children as indicated by microscopy was
23%. The study reported increasing age (OR=6.9-8.3), male (OR= 3.5), living in rural areas
(OR=4.1), exposures to canal water (OR=26.4), history of schistosomiasis (OR= 3.3) and history
of burning micturition (OR= 7.4) or hematuria (OR= 10.1) as significant risk factors. Using
microscopy as the gold standard for S. haematobium detection, sensitivity, specificity,
PPV & NPV of POC-CCA tests, were 56.5%, 92.2%, 68.4% & 87.7% respectively with an
accuracy 84% and area under curve (AUC) was 0.744. In light cases, the POC CCA detected
52.6%, but in heavy cases it increased to 75% without significant difference (P < 0.412).

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