Comparative Assessment of Urine Circulating Cathodic Antigen (CCA) Detection Cassette and Microscopy for the Diagnosis of Schistosomiasis in North Central Nigeria

Abstract

This study was carried out between May and December 2019 in four States (Benue, Kogi, Kwara and Niger) in North Central Nigeria to determine the prevalence of schistosomiasis (urinary and intestinal) among primary school pupils using the newly developed Schisto point-of-care (PoC) Urine Circulating Cathodic Antigen (CCA) detection cassette and microscopy in order to evaluate the performance of the CCA detection cassette test. One thousand, one hundred and seventy-six stool and urine specimens were collected from participants and examined using urine CCA detection cassette test and microscopy (Kato-Katz method for stool and urine filtration techniques for urine specimens).

A total of 524 (40.9%) out of the1,176 pupils sampled tested positive using CCA detection cassette, while 381 (33.5%) pupils were positive using microscopy. The difference in the prevalence of schistosomiasis using CCA detection cassette and microscopy was statistically significantly (p = 0.000). The sensitivity and specificity of CCA detection cassette using latent class analysis (LCA) were 76.3% and 76.9% respectively, while the sensitivity and specificity of microscopy were 62.5% and 86.5% respectively. The prevalence of schistosomiasis in males and females was 42.6% and 38.2% respectively using CCA detection cassette, while microscopy method had a prevalence of 32.4% in males and 35.3% in females (p = 0.693) respectively. There were no significant differences in prevalence in both sexes using CCA detection cassette and microscopy

It was concluded that the newly developed Urine CCA detection cassette having identified more schistosomiasis cases than the old microscopic methods, stands to be more promising for clinical and community diagnosis of schistosomiasis as compared to the old microscopic methods although further evaluation is required.

Key words: Comparative Assessment, Newly Developed, Urine Circulating Cathodic Antigen, Detection, Microscopy.