ArticleFrontiers in tropical diseases2022
Translating From Egg- to Antigen-Based Indicators for
Article in Frontiers in tropical diseases, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed.
- Interpretable machine learning and signal processing for automated reading and quality control of lateral flow tests for schistosomiasis.Nature communications · 2026Article
- Diagnostic accuracy of plasma cell-free DNA qPCR for Schistosoma haematobium assessed by Bayesian latent class analysis in a cohort of pregnant women from Lambaréné, Gabon.Infectious diseases of poverty · 2026Article
- A multi-site laboratory evaluation of the MEDSCAN application for automated POC-CCA interpretation.Frontiers in parasitology · 2026Article
- Local habitual movement as a mechanism for Schistosoma mansoni transmission resurgence: a causal analysis of cross-sectional survey data.BMJ public health · 2026Article
- Interpretable machine learning and signal processing for automated reading and quality control of lateral flow tests for schistosomiasis.medRxiv : the preprint server for health sciences · 2025Article
- The associations between Schistosoma mansoni infection, pre-treatment symptoms, praziquantel side effects, and treatment efficacy in Ugandan school-aged children.PLoS neglected tropical diseases · 2025Article
- The relationship between expelled eggs, morbidity and age in a Schistosoma mansoni endemic setting in Uganda: Implications for current elimination policies.PLoS neglected tropical diseases · 2025Article
- Detecting twoFrontiers in parasitology · 2024Article
- Evaluation of Kato-Katz and multiplex quantitative polymerase chain reaction performance for clinical helminth infections in Thailand using a latent class analysis.Philosophical transactions of the Royal Society of London. Series B, Biological sciences · 2023Article
- Reproducibility matters: intra- and inter-sample variation of the point-of-care circulating cathodic antigen test in twoPhilosophical transactions of the Royal Society of London. Series B, Biological sciences · 2023Article
- Understanding perceptions of schistosomiasis and its control among highly endemic lakeshore communities in Mayuge, Uganda.PLoS neglected tropical diseases · 2023Article
Corrections and comments
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Authors and funding
15 authors.
Funding
Abstract
Schistosomiasis is a parasitic disease affecting over 240-million people. World Health Organization (WHO) targets for Schistosoma mansoni elimination are based on Kato-Katz egg counts, without translation to the widely used, urine-based, point-of-care circulating cathodic antigen diagnostic (POC-CCA). We aimed to standardize POC-CCA score interpretation and translate them to Kato-Katz-based standards, broadening diagnostic utility in progress towards elimination. A Bayesian latent-class model was fit to data from 210 school-aged-children over four timepoints pre- to six-months-post-treatment. We used 1) Kato-Katz and established POC-CCA scoring (Negative, Trace, +, ++ and +++), and 2) Kato-Katz and G-Scores (a new, alternative POC-CCA scoring (G1 to G10)). We established the functional relationship between Kato-Katz counts and POC-CCA scores, and the score-associated probability of true infection. This was combined with measures of sensitivity, specificity, and the area under the curve to determine the optimal POC-CCA scoring system and positivity threshold. A simulation parametrized with model estimates established antigen-based elimination targets. True infection was associated with POC-CCA scores of ≥ + or ≥G3. POC-CCA scores cannot predict Kato-Katz counts because low infection intensities saturate the POC-CCA cassettes. Post-treatment POC-CCA sensitivity/specificity fluctuations indicate a changing relationship between egg excretion and antigen levels (living worms). Elimination targets can be identified by the POC-CCA score distribution in a population. A population with ≤2% ++/+++, or ≤0.5% G7 and above, indicates achieving current WHO Kato-Katz-based elimination targets. Population-level POC-CCA scores can be used to access WHO elimination targets prior to treatment. Caution should be exercised on an individual level and following treatment, as POC-CCAs lack resolution to discern between WHO Kato-Katz-based moderate- and high-intensity-infection categories, with limited use in certain settings and evaluations.
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