Early diagnosis and follow-up of acute schistosomiasis in a cluster of infected Belgian travellers by detection of antibodies and Circulating Anodic Antigen (CAA): a diagnostic evaluation study

Pytsje T Hoekstra, Marjan van Esbroeck, Claudia J de Dood, Paul Lam Corstjens, Lieselotte Cnops, Christel Jg van Zeijl-van der Ham, Linda J Wammes, Govert J van Dam, Jan Clerinx, Lisette van Lieshout

Research output: Contribution to journalA1: Web of Science-article

Abstract

BACKGROUND: In order to evaluate the diagnostic value of schistosome circulating anodic antigen (CAA) detection, serum and urine CAA levels were determined in a single cluster of 34 Belgian tourists at three timepoints within a period of 14 weeks following proven Schistosoma exposure in South Africa and compared with two in-house antibody assays.

METHODS: Samples were collected 4-5 and 7-8 weeks post-exposure and subsequently 5-6 weeks following praziquantel treatment. Schistosoma antibodies were detected by an adult worm antigen-immunofluorescence assay (AWA-IFA) and a soluble egg antigen-enzyme-linked immunosorbent assay (SEA-ELISA), while CAA concentrations were determined by the Up-Converting reporter Particle labelled Lateral Flow (UCP-LF) test.

RESULTS: Antibodies were detected in 25/34 (73%) travellers pre-treatment and in 27/34 (79%) post-treatment, with the AWA-IFA showing better performance than the SEA-ELISA. Pre-treatment, CAA was detected in 13/34 (38%) and 33/34 (97%) of the travellers in urine and serum, respectively. Post-treatment, all except one traveller became serum CAA negative. This in contrast to the detected antibodies, as well as the previously reported diagnostic results of this cluster.

CONCLUSIONS: The UCP-LF CAA serum assay has been demonstrated as the most sensitive method for the diagnosis of early Schistosoma infections and post-treatment monitoring in travellers.

Original languageEnglish
Article number102053
JournalTravel Medicine and Infectious Disease
Volume41
Number of pages6
ISSN1477-8939
DOIs
Publication statusPublished - 2021

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