Accuracy of point-of-care testing for circulatory cathodic antigen in the detection of schistosome infection: Systematic review and meta-analysis

Anthony Danso-Appiah; Jonathan Minton; Daniel Boamah; Joseph Otchere; Richard H. Asmah; Mark Rodgers; Kwabena M. Bosompem; Paolo Eusebi; Sake J. De Vlas

doi:10.2471/BLT.15.158741

Accuracy of point-of-care testing for circulatory cathodic antigen in the detection of schistosome infection: Systematic review and meta-analysis

Anthony Danso-Appiah^*, Jonathan Minton, Daniel Boamah, Joseph Otchere, Richard H. Asmah, Mark Rodgers, Kwabena M. Bosompem, Paolo Eusebi, Sake J. De Vlas

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

Abstract

Objective To assess the accuracy of point-of-care testing for circulatory cathodic antigen in the diagnosis of schistosome infection. Methods We searched MEDLINE, EMBASE, LILACS and other bibliographic databases for studies published until 30 September 2015 that described circulatory cathodic antigen testing compared against one to three Kato–Katz tests per subject – for Schistosoma mansoni – or the filtration of one 10-ml urine sample per subject – for S. haematobium. We extracted the numbers of true positives, false positives, true negatives and false negatives for the antigen testing and performed meta-analyses using a bivariate hierarchical regression model. Findings Twenty-six studies published between 1994 and 2014 met the inclusion criteria. In the detection of S. mansoni, a single antigen test gave a pooled sensitivity of 0.90 (95% confidence interval, CI: 0.84–0.94) and a pooled specificity of 0.56 (95% CI: 0.39–0.71; n = 7) when compared against a single Kato–Katz test. The corresponding values from comparisons with two to three Kato–Katz tests per subject were 0.85 (95% CI: 0.80–0.88) and 0.66 (95% CI: 0.53–0.76; n = 14), respectively. There appeared to be no advantage in using three antigen tests per subject instead of one. When compared against the results of urine filtration, antigen testing for S. haematobium showed poor sensitivity and poor specificity. The performance of antigen testing was better in areas of high endemicity than in settings with low endemicity. Conclusion Antigen testing may represent an effective tool for monitoring programmes for the control of S. mansoni.

Original language	English
Pages (from-to)	522-533
Journal	Bulletin of the world health organization
Volume	94
Issue number	7
DOIs	https://doi.org/10.2471/BLT.15.158741
Publication status	Published - 22 Apr 2016

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BLT-2015-158741v3-Danso-Appiah
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Danso-Appiah, A., Minton, J., Boamah, D., Otchere, J., Asmah, R. H., Rodgers, M., Bosompem, K. M., Eusebi, P., & De Vlas, S. J. (2016). Accuracy of point-of-care testing for circulatory cathodic antigen in the detection of schistosome infection: Systematic review and meta-analysis. Bulletin of the world health organization, 94(7), 522-533. https://doi.org/10.2471/BLT.15.158741

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title = "Accuracy of point-of-care testing for circulatory cathodic antigen in the detection of schistosome infection: Systematic review and meta-analysis",

abstract = "Objective To assess the accuracy of point-of-care testing for circulatory cathodic antigen in the diagnosis of schistosome infection. Methods We searched MEDLINE, EMBASE, LILACS and other bibliographic databases for studies published until 30 September 2015 that described circulatory cathodic antigen testing compared against one to three Kato–Katz tests per subject – for Schistosoma mansoni – or the filtration of one 10-ml urine sample per subject – for S. haematobium. We extracted the numbers of true positives, false positives, true negatives and false negatives for the antigen testing and performed meta-analyses using a bivariate hierarchical regression model. Findings Twenty-six studies published between 1994 and 2014 met the inclusion criteria. In the detection of S. mansoni, a single antigen test gave a pooled sensitivity of 0.90 (95% confidence interval, CI: 0.84–0.94) and a pooled specificity of 0.56 (95% CI: 0.39–0.71; n = 7) when compared against a single Kato–Katz test. The corresponding values from comparisons with two to three Kato–Katz tests per subject were 0.85 (95% CI: 0.80–0.88) and 0.66 (95% CI: 0.53–0.76; n = 14), respectively. There appeared to be no advantage in using three antigen tests per subject instead of one. When compared against the results of urine filtration, antigen testing for S. haematobium showed poor sensitivity and poor specificity. The performance of antigen testing was better in areas of high endemicity than in settings with low endemicity. Conclusion Antigen testing may represent an effective tool for monitoring programmes for the control of S. mansoni.",

author = "Anthony Danso-Appiah and Jonathan Minton and Daniel Boamah and Joseph Otchere and Asmah, {Richard H.} and Mark Rodgers and Bosompem, {Kwabena M.} and Paolo Eusebi and {De Vlas}, {Sake J.}",

note = "This is an author-produced version of the published paper. Uploaded in accordance with the publisher{\textquoteright}s self-archiving policy. Further copying may not be permitted; contact the publisher for details",

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Danso-Appiah, A, Minton, J, Boamah, D, Otchere, J, Asmah, RH, Rodgers, M, Bosompem, KM, Eusebi, P & De Vlas, SJ 2016, 'Accuracy of point-of-care testing for circulatory cathodic antigen in the detection of schistosome infection: Systematic review and meta-analysis', Bulletin of the world health organization, vol. 94, no. 7, pp. 522-533. https://doi.org/10.2471/BLT.15.158741

TY - JOUR

T1 - Accuracy of point-of-care testing for circulatory cathodic antigen in the detection of schistosome infection

T2 - Systematic review and meta-analysis

AU - Danso-Appiah, Anthony

AU - Minton, Jonathan

AU - Boamah, Daniel

AU - Otchere, Joseph

AU - Asmah, Richard H.

AU - Rodgers, Mark

AU - Bosompem, Kwabena M.

AU - Eusebi, Paolo

AU - De Vlas, Sake J.

N1 - This is an author-produced version of the published paper. Uploaded in accordance with the publisher’s self-archiving policy. Further copying may not be permitted; contact the publisher for details

PY - 2016/4/22

Y1 - 2016/4/22

N2 - Objective To assess the accuracy of point-of-care testing for circulatory cathodic antigen in the diagnosis of schistosome infection. Methods We searched MEDLINE, EMBASE, LILACS and other bibliographic databases for studies published until 30 September 2015 that described circulatory cathodic antigen testing compared against one to three Kato–Katz tests per subject – for Schistosoma mansoni – or the filtration of one 10-ml urine sample per subject – for S. haematobium. We extracted the numbers of true positives, false positives, true negatives and false negatives for the antigen testing and performed meta-analyses using a bivariate hierarchical regression model. Findings Twenty-six studies published between 1994 and 2014 met the inclusion criteria. In the detection of S. mansoni, a single antigen test gave a pooled sensitivity of 0.90 (95% confidence interval, CI: 0.84–0.94) and a pooled specificity of 0.56 (95% CI: 0.39–0.71; n = 7) when compared against a single Kato–Katz test. The corresponding values from comparisons with two to three Kato–Katz tests per subject were 0.85 (95% CI: 0.80–0.88) and 0.66 (95% CI: 0.53–0.76; n = 14), respectively. There appeared to be no advantage in using three antigen tests per subject instead of one. When compared against the results of urine filtration, antigen testing for S. haematobium showed poor sensitivity and poor specificity. The performance of antigen testing was better in areas of high endemicity than in settings with low endemicity. Conclusion Antigen testing may represent an effective tool for monitoring programmes for the control of S. mansoni.

AB - Objective To assess the accuracy of point-of-care testing for circulatory cathodic antigen in the diagnosis of schistosome infection. Methods We searched MEDLINE, EMBASE, LILACS and other bibliographic databases for studies published until 30 September 2015 that described circulatory cathodic antigen testing compared against one to three Kato–Katz tests per subject – for Schistosoma mansoni – or the filtration of one 10-ml urine sample per subject – for S. haematobium. We extracted the numbers of true positives, false positives, true negatives and false negatives for the antigen testing and performed meta-analyses using a bivariate hierarchical regression model. Findings Twenty-six studies published between 1994 and 2014 met the inclusion criteria. In the detection of S. mansoni, a single antigen test gave a pooled sensitivity of 0.90 (95% confidence interval, CI: 0.84–0.94) and a pooled specificity of 0.56 (95% CI: 0.39–0.71; n = 7) when compared against a single Kato–Katz test. The corresponding values from comparisons with two to three Kato–Katz tests per subject were 0.85 (95% CI: 0.80–0.88) and 0.66 (95% CI: 0.53–0.76; n = 14), respectively. There appeared to be no advantage in using three antigen tests per subject instead of one. When compared against the results of urine filtration, antigen testing for S. haematobium showed poor sensitivity and poor specificity. The performance of antigen testing was better in areas of high endemicity than in settings with low endemicity. Conclusion Antigen testing may represent an effective tool for monitoring programmes for the control of S. mansoni.

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JO - Bulletin of the world health organization

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Accuracy of point-of-care testing for circulatory cathodic antigen in the detection of schistosome infection: Systematic review and meta-analysis

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