Ibironke O., Koukounari A., Asaolu S., Moustaki I., Shiff C.
Department of Molecular Microbiology and Immunology, Johns Hopkins University, Baltimore, MD, United States; MRC Centre of Outbreak Analysis and Modeling, Department of Infectious Disease Epidemiology, Imperial College London, St. Mary's Campus, London, U
Ibironke, O., Department of Molecular Microbiology and Immunology, Johns Hopkins University, Baltimore, MD, United States; Koukounari, A., MRC Centre of Outbreak Analysis and Modeling, Department of Infectious Disease Epidemiology, Imperial College London, St. Mary's Campus, London, United Kingdom; Asaolu, S., Department of Zoology, Obafemi Awolowo University, Ile Ife, Nigeria; Moustaki, I., Department of Statistics, London School of Economics, London, United Kingdom; Shiff, C., Department of Molecular Microbiology and Immunology, Johns Hopkins University, Baltimore, MD, United States
Background: Diagnosis of urogenital schistosomiasis in chronically infected adults is challenging but important, especially because long term infection of the bladder and urinary tract can have dire consequences. We evaluated three tests for viable infection: detection of parasite specific DNA Dra1 fragments, haematuria and presence of parasite eggs for sensitivity (Se) and specificity (Sp). Methods: Over 400 urine specimens collected from adult volunteers in an endemic area in Western Nigeria were assessed for haematuria then filtered in the field, the filter papers dried and later examined for eggs and DNA. The results were stratified according to sex and age and subjected to Latent Class analysis. Conclusions: Presence of Dra1 in males (Se = 100%; Sp = 100%) exceeded haematuria (Se = 87.6%: Sp = 34.7%) and detection of eggs (Se = 70.1%; Sp = 100%). In females presence of Dra1 was Se = 100%: Sp = 100%, exceeding haematuria (Se = 86.7%: Sp = 77.0%) and eggs (Se = 70.1%; Sp = 100%). Dra1 became undetectable 2 weeks after praziquantel treatment. We conclude detection of Dra1 fragment is a definitive test for the presence of Schistosoma haematobium infection. © 2012 Ibironke et al.
DNA fragment; dra1 DNA fragment; praziquantel; unclassified drug; helminth DNA; helminth protein; adult; article; diagnostic test accuracy study; female; hematuria; human; latent class analysis; male; microscopy; Nigeria; nonhuman; parasite identification; polymerase chain reaction; Schistosoma hematobium; schistosomiasis; sensitivity and specificity; statistical analysis; urinalysis; animal; chemistry; genetics; hematuria; isolation and purification; middle aged; parasitology; schistosomiasis haematobia; urine; validation study; Adult; Animals; DNA, Helminth; Female; Helminth Proteins; Hematuria; Humans; Male; Middle Aged; Nigeria; Parasite Egg Count; Schistosoma haematobium; Schistosomiasis haematobia; Sensitivity and Specificity; Urine