{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T16:56:54Z","timestamp":1791219414127,"version":"4.1.0"},"reference-count":0,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"4","license":[{"start":{"date-parts":[[2022,4,6]],"date-time":"2022-04-06T00:00:00Z","timestamp":1649203200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,4,6]]},"abstract":"<jats:title>ABSTRACT.<\/jats:title>\n<jats:p>The increasing number of refugees coming from or passing through <jats:italic>Schistosoma<\/jats:italic>-endemic areas and arriving in Europe highlights the importance of screening for schistosomiasis on arrival, and focuses attention on the choice of diagnostic test. We evaluate the diagnostic performance of circulating anodic antigen (CAA) detection in 92 asymptomatic refugees from Eritrea. Results were compared with already-available stool microscopy, serology, and urine point-of-care circulating cathodic antigen (POC-CCA) data. For a full diagnostic comparison, real-time polymerase chain reaction (PCR) and the POC-CCA were included. All outcomes were compared against a composite reference standard. Urine and serum samples were subjected to the ultra-sensitive and highly specific up-converting particle lateral flow CAA test, <jats:italic>Schistosoma <\/jats:italic>spp. real-time PCR was performed on urine and stool, and the POC-CCA was used on urine using the G-score method. CAA was detected in 43% of urine and in 40% of serum samples. Urine PCR was negative in all 92 individuals, whereas 25% showed <jats:italic>Schistosoma<\/jats:italic> DNA in stool. POC-CCA was positive in 30% of individuals. The CAA test confirmed all microscopy positives, except for two cases that were also negative by all other diagnostic procedures. Post-treatment, a significant reduction in the number of positives and infection intensity was observed, in particular regarding CAA levels. Our findings confirm that microscopy, serology, and POC-CCA lack the sensitivity to detect all active <jats:italic>Schistosoma<\/jats:italic> infections. Accuracy of stool PCR was similar to microscopy, indicating that this method also lacks sensitivity. The CAA test appeared to be the most accurate method for screening active <jats:italic>Schistosoma<\/jats:italic> infections and for monitoring treatment efficacy.<\/jats:p>","DOI":"10.4269\/ajtmh.21-0803","type":"journal-article","created":{"date-parts":[[2022,2,28]],"date-time":"2022-02-28T13:11:56Z","timestamp":1646053916000},"page":"1240-1246","source":"Crossref","is-referenced-by-count":25,"title":["Sensitive Diagnosis and Post-Treatment Follow-Up of Schistosoma mansoni Infections in Asymptomatic Eritrean Refugees by Circulating Anodic Antigen Detection and Polymerase Chain Reaction"],"prefix":"10.4269","volume":"106","author":[{"given":"Pytsje T.","family":"Hoekstra","sequence":"first","affiliation":[{"name":"1Department of Parasitology, Leiden University Medical Center, Leiden, The Netherlands;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Afona","family":"Chernet","sequence":"additional","affiliation":[{"name":"2Swiss Tropical and Public Health Institute, Basel, Switzerland;"},{"name":"3University of Basel, Basel, Switzerland;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia J.","family":"de Dood","sequence":"additional","affiliation":[{"name":"4Department of Cell and Chemical Biology, Leiden University Medical Center, Leiden, The Netherlands;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric A. T.","family":"Brienen","sequence":"additional","affiliation":[{"name":"1Department of Parasitology, Leiden University Medical Center, Leiden, The Netherlands;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul L. A. M.","family":"Corstjens","sequence":"additional","affiliation":[{"name":"4Department of Cell and Chemical Biology, Leiden University Medical Center, Leiden, The Netherlands;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Niklaus D.","family":"Labhardt","sequence":"additional","affiliation":[{"name":"2Swiss Tropical and Public Health Institute, Basel, Switzerland;"},{"name":"3University of Basel, Basel, Switzerland;"},{"name":"5Department of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, Basel, Switzerland;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beatrice","family":"Nickel","sequence":"additional","affiliation":[{"name":"2Swiss Tropical and Public Health Institute, Basel, Switzerland;"},{"name":"3University of Basel, Basel, Switzerland;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linda J.","family":"Wammes","sequence":"additional","affiliation":[{"name":"6Department of Medical Microbiology, Leiden University Medical Center, Leiden, The Netherlands;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Govert J.","family":"van Dam","sequence":"additional","affiliation":[{"name":"1Department of Parasitology, Leiden University Medical Center, Leiden, The Netherlands;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas","family":"Neumayr","sequence":"additional","affiliation":[{"name":"2Swiss Tropical and Public Health Institute, Basel, Switzerland;"},{"name":"3University of Basel, Basel, Switzerland;"},{"name":"7Department of Public Health and Tropical Medicine, College of Public Health, Medical and Veterinary Sciences, James Cook University, Queensland, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisette","family":"van Lieshout","sequence":"additional","affiliation":[{"name":"1Department of Parasitology, Leiden University Medical Center, Leiden, The Netherlands;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2795","container-title":["The American Journal of Tropical Medicine and Hygiene"],"original-title":[],"link":[{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/106\/4\/article-p1240.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/106\/4\/article-p1240.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,4,6]],"date-time":"2022-04-06T12:38:47Z","timestamp":1649248727000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/106\/4\/article-p1240.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,4,6]]},"references-count":0,"journal-issue":{"issue":"4"},"URL":"https:\/\/doi.org\/10.4269\/ajtmh.21-0803","relation":{},"ISSN":["0002-9637","1476-1645"],"issn-type":[{"value":"0002-9637","type":"print"},{"value":"1476-1645","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,4,6]]}}}