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Collaborative study on detection of circulating antigens in schistosomiasis japonica
Insights
Eight laboratories evaluated Schistosoma japonicum antigen detection tests. While sensitive for acute cases, most lacked specificity and accuracy for chronic schistosomiasis and post-treatment evaluation, necessitating test improvements.
Area of Science:
- Parasitology
- Immunology
- Tropical Medicine
Background:
- Schistosomiasis japonica remains a significant public health concern in endemic regions.
- Accurate detection of circulating Schistosoma japonicum antigens is crucial for diagnosis and treatment monitoring.
- Existing serological assays varied in performance, necessitating collaborative evaluation.
Purpose of the Study:
- To collaboratively assess the performance of various Schistosoma japonicum antigen detection assays.
- To evaluate the sensitivity and specificity of different test systems for active and cured schistosomiasis.
- To determine the utility of these assays for post-treatment assessment.
Main Methods:
- Eight laboratories participated in a blind study using their developed Schistosoma japonicum antigen detection systems.
- Serum samples included non-endemic controls, active cases, cured cases, and individuals with other infections.
- Assays were performed on 100 controls, 190 active cases, 110 cured cases, and 170 individuals with other conditions.
Main Results:
- Assay specificity (false positive rate) ranged from 2% (Series B) to 14-46% (other series).
- Sensitivity for acute schistosomiasis was high (95-100%), but lower for chronic cases (73.3% for Series A, 72.7% for Series F).
- Negative reversion rates in cured cases within 1-2 years post-treatment were generally high, indicating limited utility for cure confirmation.
Conclusions:
- Significant variations in specificity and sensitivity were observed among the evaluated Schistosoma japonicum antigen detection systems.
- Current assays demonstrate limitations in accurately diagnosing chronic schistosomiasis and confirming treatment efficacy.
- Further improvements in sensitivity, specificity, and pre- and post-treatment evaluation capabilities are essential for all tested systems.
Abstract:
A workshop for collaborative study on circulating Schistosoma japonicum antigen detection was held at the Hunan Institute of Parasitic Diseases, Yueyang, Hunan Province in May, 1993. Eight laboratories from schistosomiasis-endemic provinces (municipalities) were joined in this study. Scientists from these laboratories performed serological assays in blind using their own brought test systems that developed during recent years. The serum samples tested covered 100 non-endemic controls, 190 from patients with active schistosomiasis, 110 from cured cases of schistosome-infection, and 170 from individuals harbouring other parasitic infections or hepatitis. Results of the study revealed an assay specificity, in terms of false positive rate, of 2% in Series B versus 14-46% in the other 7 series. With regard to assay sensitivity, all test series showed 95-100% for acute cases. While for chronic cases, test series A and F demonstrated sensitivities at 73.3% and 72.7% respectively. Other series were all below 70%. Negative reversion rates for sera from cured cases within 1 year post-treatment were below 33.3%, those within 2 years were 60% for Series E, while below 50% for all others except the Series H which was excluded due to an extremely low sensitivity obtained. The low values of these test series for chemotherapy assessment may be attributed to the poor specificity of the detecting systems used and/or the sample donors being not totally cured. It is strongly indicated that all the 8 test systems involved in the present study should further be improved in sensitivity, specificity as well as in capacity for pre-and post-treatment evaluations.
