Circulating cathodic antigen cassette test versus haematuria strip test in diagnosis of urinary schistosomiasis

Urinary schistosomiasis caused by Schistosoma haematobium constitutes a major public health problem in many tropical and sub-tropical countries. This study was conducted to evaluate circulating cathodic antigen cassette test and haematuria strip test for detection of S. haematobium in urine samples and to evaluate their screening performance among the study population. Microscopy was used as a gold standard. A total of 600 urine samples were examined by microscopy for detection of S. haematobium eggs, screened for microhaematuria using Self-Stik reagent strips and screened for circulating cathodic antigen (CCA) using the urine-CCA cassette test. The specificity of CCA, microhaematuria and macrohaematuria was 96.4, 40.6 and 31.2 % respectively while the sensitivity was 88.2, 99.3 and 100 % respectively which was statistically significant (P < 0.001). These findings suggest that using of urine-CCA cassette test in diagnosis of urinary schistosomiasis is highly specific (96.4 %) compared with the highly sensitive haematuria strip test (100 %). The degree of agreement between microscopic examination and CCA detection was 99.3 % with highly statistically significant difference (P < 0.001). The combination of two techniques could potentially use for screening and mapping of S. haematobium infection.