Discriminating acute from chronic human schistosomiasis mansoni

Area of Science:

• Immunology
• Parasitology
• Diagnostic Development

Background:

• Schistosomiasis diagnosis relies on accurate methods to distinguish disease stages.
• Serological tests are crucial for identifying infections and differentiating between acute and chronic schistosomiasis.

Purpose of the Study:

• To evaluate the diagnostic accuracy of specific immunoglobulin responses (IgA, IgG, IgM) against different schistosomiasis antigens.
• To determine the utility of these tests in differentiating acute from chronic schistosomiasis and from other parasitic infections.

Main Methods:

• Enzyme-linked immunosorbent assay (ELISA) was used to measure immunoglobulin levels (IgA, IgG, IgM).
• Antigen targets included soluble egg antigen (SEA), soluble worm adult protein (SWAP), and keyhole limpet hemocyanin (KLH).
• Receiver operating characteristic (ROC) curve analysis was performed to calculate areas under the curve (AUCs) for diagnostic discrimination.

Main Results:

• Soluble egg antigen IgA (SEA IgA) and KLH IgM showed high discriminatory power between acute and chronic schistosomiasis (AUCs 0.88 and 0.82).
• SEA IgA was not effective in distinguishing schistosomiasis from other intestinal parasite infections.
• Soluble worm adult protein IgG (SWAP IgG) and SEA IgG effectively discriminated schistosomiasis patients from healthy individuals and those with other parasitic infections (AUCs 0.96 and 0.85).

Conclusions:

• A combination of serological tests, specifically SEA IgA and SWAP IgG, can simultaneously diagnose schistosomiasis and differentiate between acute and chronic forms.
• SWAP IgG and SEA IgG are valuable for diagnosing schistosomiasis in the presence of other parasitic co-infections.