Early diagnosis and follow-up of acute schistosomiasis in a cluster of infected Belgian travellers by detection of antibodies and circulating anodic antigen (CAA): A diagnostic evaluation study. Issue 41 (May 2021)

• Record Type: Journal Article
• Authors: Hoekstra, Pytsje T.; van Esbroeck, Marjan; de Dood, Claudia J.; Corstjens, Paul LAM.; Cnops, Lieselotte; van Zeijl-van der Ham, Christel JG.; Wammes, Linda J.; van Dam, Govert J.; Clerinx, Jan; van Lieshout, Lisette
• Is Part Of: Travel medicine and infectious disease. Issue 41(2021)
• Publication Date: 2021-05
• Subjects: Schistosoma haematobium complex -- Circulating anodic antigen -- Diagnostic accuracy -- Sensitivity -- Treatment efficacy; AWA (Adult Worm Antigen) -- CAA (Circulating Anodic Antigen) -- ELISA (Enzyme-Linked ImmunoSorbent Assay) -- IFA (ImmunoFluoresence Assay) -- IHA (Indirect Hemagglutination inhibition Assay) -- ITM (Institute for Tropical Medicine, Antwerp, Belgium) -- LUMC (Leiden University Medical Center, Leiden, The Netherlands) -- PZQ (Praziquantel) -- SCAA (Serum Circulating Anodic Antigen) -- SEA (Soluble Egg Antigen) -- UCAA (Urine Circulating Anodic Antigen) -- UCP-LF (Up-Converting reporter Particle Lateral Flow); Travel -- Health aspects -- Periodicals; Communicable diseases -- Periodicals; Tropical medicine -- Periodicals; 610.5
• DOI: 10.1016/j.tmaid.2021.102053
• Languages: English
• ISSNs: 1477-8939

Abstract

Abstract: Background: In order to evaluate the diagnostic value of schistosome circulating anodic antigen (CAA) detection, serum and urine CAA-levels were determined in a single cluster of 34 Belgian tourists at three timepoints within a period of 14 weeks following proven Schistosoma exposure in South Africa and compared with two in-house antibody assays. Methods: Samples were collected 4–5 and 7–8 weeks post-exposure and subsequently 5–6 weeks following praziquantel treatment. Schistosoma antibodies were detected by an adult worm antigen-immunofluorescence assay (AWA-IFA) and a soluble egg antigen-enzyme-linked immunosorbent assay (SEA-ELISA), while CAA concentrations were determined by the Up-Converting reporter Particle labelled Lateral Flow (UCP-LF) test. Results: Antibodies were detected in 25/34 (73%) travellers pre-treatment and in 27/34 (79%) post-treatment, with the AWA-IFA showing better performance than the SEA-ELISA. Pre-treatment, CAA was detected in 13/34 (38%) and 33/34 (97%) of the travellers in urine and serum, respectively. Post-treatment, all except one traveller became serum CAA negative. This in contrast to the detected antibodies, as well as the previously reported diagnostic results of this cluster. Conclusions: The UCP-LF CAA serum assay has been demonstrated as the most sensitive method for the diagnosis of early Schistosoma infections and post-treatment monitoring in travellers.