Kinkel H.-F., Dittrich S., Baümer B., Weitzel T.
Institute of Tropical Medicine and International Health, Charité-University Medicine Berlin, Berlin, Germany; Clinica Alemana, Universidad del Desarrollo, Santiago, Chile; Department of Family Medicine, University of Pretoria, Pretoria, South Africa; Wellcome Trust-Mahosot Hospital-Oxford Tropical Medicine Research Collaboration, Microbiology Laboratory, Mahosot Hospital, Vientiane, Laos; Nuffield Department of Clinical Medicine, Churchill Hospital, University of Oxford, Oxford, United Kingdom
Kinkel, H.-F., Institute of Tropical Medicine and International Health, Charité-University Medicine Berlin, Berlin, Germany, Department of Family Medicine, University of Pretoria, Pretoria, South Africa; Dittrich, S., Institute of Tropical Medicine and International Health, Charité-University Medicine Berlin, Berlin, Germany, Wellcome Trust-Mahosot Hospital-Oxford Tropical Medicine Research Collaboration, Microbiology Laboratory, Mahosot Hospital, Vientiane, Laos, Nuffield Department of Clinical Medicine, Churchill Hospital, University of Oxford, Oxford, United Kingdom; Baümer, B., Institute of Tropical Medicine and International Health, Charité-University Medicine Berlin, Berlin, Germany; Weitzel, T., Institute of Tropical Medicine and International Health, Charité-University Medicine Berlin, Berlin, Germany, Clinica Alemana, Universidad del Desarrollo, Santiago, Chile
The diagnosis of schistosomiasis in individuals from countries where the disease is not endemic is challenging, and few data are available on the accuracy of serological diagnosis in those patients. We evaluated the performance of eight serological assays, including four commercial kits, in the diagnosis of imported schistosomiasis in individuals from areas where the disease is not endemic, including six enzyme-linked immunosorbent assays using three different antigens, an indirect hemagglutination assay, and an indirect immunofluorescent-antibody test. To analyze the assays, we used a total of 141 serum samples, with 121 derived from patients with various parasitic infections (among which were 37 cases of schistosomiasis) and 20 taken from healthy volunteers. The sensitivity values for detection of schistosomiasis cases ranged from 41% to 78% and were higher for Schistosoma mansoni than for S. haematobium infections. Specificity values ranged from 76% to 100%; false-positive results were most frequent for samples from patients with cestode infections. By combining two or more tests, sensitivity improved markedly and specificity decreased only moderately. Serological tests are useful instruments for diagnosing imported schistosomiasis in countries where the disease is not endemic, but due to limitations in test sensitivities, we recommend the use of two or more assays in parallel. Copyright © 2012, American Society for Microbiology. All Rights Reserved.
article; cestodiasis; clinical article; controlled study; diagnostic test accuracy study; diagnostic value; enzyme linked immunosorbent assay; false negative result; false positive result; female; hemagglutination test; human; immunofluorescence test; male; nonhuman; priority journal; Schistosoma hematobium; Schistosoma intercalatum; Schistosoma mansoni; schistosomiasis; schistosomiasis haematobia; schistosomiasis intercalatum; schistosomiasis mansoni; sensitivity and specificity; serology; Animals; Antibodies, Helminth; Clinical Laboratory Techniques; False Positive Reactions; Female; Humans; Male; Parasitology; Schistosoma haematobium; Schistosoma mansoni; Schistosomiasis; Sensitivity and Specificity; Serologic Tests