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BioMed Research International
Volume 2015 (2015), Article ID 135689, 16 pages
http://dx.doi.org/10.1155/2015/135689
Research Article

Comparative Study of the Accuracy of Different Techniques for the Laboratory Diagnosis of Schistosomiasis Mansoni in Areas of Low Endemicity in Barra Mansa City, Rio de Janeiro State, Brazil

1Department of Infectious and Parasitic Diseases and Laboratory of Immunopathology of Schistosomiasis (LIM-06), School of Medicine, University of São Paulo, 05403-000 São Paulo, SP, Brazil
2University Center of Volta Redonda, 27240-560 Volta Redonda, RJ, Brazil
3Department of Gastroenterology and Laboratory of Tropical Gastroenterology and Hepatology, School of Medicine, University of São Paulo, 05403-000 São Paulo, SP, Brazil
4Department of Enteroparasites at the Parasitology and Mycology Service from the Adolfo Lutz Institute, 01246-902 São Paulo, SP, Brazil
5Laboratory of Seroepidemiology and Immunobiology, Institute of Tropical Medicine, University of São Paulo, 05403-000 São Paulo, SP, Brazil
6Laboratory of Medical Genomics, AC Camargo Cancer Center, 01509–010 São Paulo, SP, Brazil
7Institute of Psychiatry (LIM-27), São Paulo Medical School, University of São Paulo, 01246-903 São Paulo, SP, Brazil
8Section of Parasitology, Central Laboratory Division of Hospital das Clínicas, School of Medicine, University of São Paulo, 05403-000 São Paulo, SP, Brazil
9Santa Casa Medical School, 01221-020 São Paulo, SP, Brazil
10Institute of Tropical Medicine, University of São Paulo, 05403-000 São Paulo, SP, Brazil

Received 2 March 2015; Revised 6 May 2015; Accepted 10 May 2015

Academic Editor: Stephan Karl

Copyright © 2015 Maria Cristina Carvalho Espírito-Santo et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Schistosomiasis constitutes a major public health problem, with an estimated 200 million people infected worldwide. Many areas of Brazil show low endemicity of schistosomiasis, and the current standard parasitological techniques are not sufficiently sensitive to detect the low-level helminth infections common in areas of low endemicity (ALEs). This study compared the Kato-Katz (KK); Hoffman, Pons, and Janer (HH); enzyme-linked immunosorbent assay- (ELISA-) IgG and ELISA-IgM; indirect immunofluorescence technique (IFT-IgM); and qPCR techniques for schistosomiasis detection in serum and fecal samples, using the circumoval precipitin test (COPT) as reference. An epidemiological survey was conducted in a randomized sample of residents from five neighborhoods of Barra Mansa, RJ, with 610 fecal and 612 serum samples. ELISA-IgM (21.4%) showed the highest positivity and HH and KK techniques were the least sensitive (0.8%). All techniques except qPCR-serum showed high accuracy (82–95.5%), differed significantly from COPT in positivity , and showed poor agreement with COPT. Medium agreement was seen with ELISA-IgG (Kappa = 0.377) and IFA (Kappa = 0.347). Parasitological techniques showed much lower positivity rates than those by other techniques. We suggest the possibility of using a combination of laboratory tools for the diagnosis of schistosomiasis in ALEs.