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<p>The diagnosis of schistosomiasis in preschool-aged children (PSAC) is challenging. The point-of-care circulating cathodic antigen (POC-CCA) assay offers potential improvements in diagnostic access in hard-to-reach areas over the conventional Kato-Katz (KK) test. This study compared the diagnostic accuracy of KK versus POC-CCA in stool and urine samples from PSAC in a PSAC population residing in a <i>S. mansoni</i> endemic hard-to-reach area in Kenya. Using combined positive results of both KK and POC-CCA tests as the “gold standard,” the overall sensitivity of KK (57.6%; 95% CI, 49.1–65.8) was significantly lower than that of POC-CCA (73.2%; 95% CI, 65.0–80.4); <InlineEquation ID="IEq1"> <InlineMediaObject> <ImageObject Color="BlackWhite" FileRef="436_2025_8467_Article_IEq1.gif" Format="GIF" Height="20" Rendition="HTML" Resolution="72" Type="Linedraw" Width="25" /> </InlineMediaObject> <EquationSource Format="TEX">\({\chi }_{m}^{2}\)</EquationSource> <EquationSource Format="MATHML"><math> <msubsup> <mi>χ</mi> <mrow> <mi>m</mi> </mrow> <mn>2</mn> </msubsup> </math></EquationSource> </InlineEquation>= 5.88, <i>p</i> = 0.015. There was moderate agreement between KK and the combined results (<i>k</i> = 0.599, <i>p</i> &lt; 0.001, concordance 80.9%) and a substantial agreement between POC-CCA and the combined results (<i>k</i> = 0.753, <i>p</i> &lt; 0.001, concordance 88.1%). POC-CCA is a more sensitive diagnostic tool for schistosomiasis surveillance in PSAC compared to KK, particularly in hard-to-reach endemic areas.</p>

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Kato-Katz versus urine POC-CCA for the diagnosis of Schistosoma mansoni in preschool-aged children in Homa Bay County, Kenya

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  • 发表日期：

    2025年2月21日

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  • Phyllis Munyiva Isaiah,
  • Bryan Nyawanda,
  • Collins Okoyo,
  • Peter Steinmann

摘要

The diagnosis of schistosomiasis in preschool-aged children (PSAC) is challenging. The point-of-care circulating cathodic antigen (POC-CCA) assay offers potential improvements in diagnostic access in hard-to-reach areas over the conventional Kato-Katz (KK) test. This study compared the diagnostic accuracy of KK versus POC-CCA in stool and urine samples from PSAC in a PSAC population residing in a S. mansoni endemic hard-to-reach area in Kenya. Using combined positive results of both KK and POC-CCA tests as the “gold standard,” the overall sensitivity of KK (57.6%; 95% CI, 49.1–65.8) was significantly lower than that of POC-CCA (73.2%; 95% CI, 65.0–80.4); \({\chi }_{m}^{2}\) χ m 2 = 5.88, p = 0.015. There was moderate agreement between KK and the combined results (k = 0.599, p < 0.001, concordance 80.9%) and a substantial agreement between POC-CCA and the combined results (k = 0.753, p < 0.001, concordance 88.1%). POC-CCA is a more sensitive diagnostic tool for schistosomiasis surveillance in PSAC compared to KK, particularly in hard-to-reach endemic areas.