Assessment of the performance of a rapid diagnostic test for detecting circulating cathodic antigens of Schistosoma mansoni in urine in Burkina Faso

Abstract

This study aimed to evaluate the performance of the rapid diagnostic test for the detection of circulating cathodic antigens (RDT_CCA) of Schistosoma (S.) mansoni in urine in Burkina Faso.

A cross-sectional study was conducted from February to March 2020 among 223 preschool-aged children in the village of Panamasso. The Kato-Katz and modified Ritchie microscopic techniques were used to detect S. mansoni eggs in stool samples, while the TDR_ACC was used for antigen detection in urine. The combination of both microscopic methods was considered the gold standard, and the agreement between the RDT_CCA and the gold standard was assessed using Cohen’s Kappa coefficient.

The prevalence of S. mansoni infection detected by the RDT_CCA (80.72%) was significantly higher than that obtained with the gold standard (48.43%) (p < 0.001). The test showed a sensitivity of 97.22% (95% CI: 92.10–99.42), a specificity of 34.78% (95% CI: 26.14–44.23), and a moderate agreement (Kappa = 0.31; p < 0.001). Only a few light or moderate infections were negative by RDT_CCA, whereas all severe infections were detected as positive.

The RDT_CCA demonstrated excellent sensitivity for the detection of S. mansoni, confirming its relevance as a screening tool in endemic areas. However, the low specificity observed warrants further investigations to better understand its limitations and optimize its use in national schistosomiasis control programs in Burkina Faso.