Circulating Schistosoma DNA in seropositive patients: A twostep diagnostic approach to rule-out acute and active chronic schistosomiasis in low transmission settings | ||||
Parasitologists United Journal | ||||
Article 11, Volume 14, Issue 1, April 2021, Page 72-76 PDF (316.8 K) | ||||
Document Type: Original Article | ||||
DOI: 10.21608/puj.2021.66431.1109 | ||||
View on SCiNiTO | ||||
Authors | ||||
Farouk Gawish1; Ahmed Bayoumy 2; Mohamed Abd El Raheem1; Anwar Abo Hashim3; Ayman El Badry* 4 | ||||
1Departments of Medical Parasitology, Faculty of Medicine, Al-Azhar Universities, Assiut | ||||
2Departments of Medical Parasitology, Faculty of Medicine , Assiut | ||||
3Departments of Medical Parasitology, Faculty of Medicine ,Cairo | ||||
4Department of Clinical Microbiology, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia | ||||
Abstract | ||||
Background: Since its discovery in 1850 by Theodor Bilharz at Kasr Al-Ainy hospital, Cairo, Egypt, schistosomiasis continues to be a significant health challenge with a wide spectrum of chronic sequelae. There is no reliable single gold standard conventional method (microscopy or serology) for communities with low intensity and low transmission settings. Objectives: To evaluate a two-step immunomolecular diagnostic approach to rule-out recent Schistosoma re-infection in patients with characteristic pathological radiological features of chronic schistosomiasis. Subjects and Methods: Single serum samples were collected from patients from Kafr El Sheikh, Egypt. Selection of patients was based on microscopic absence of Schistosoma spp. eggs in either stool or urine samples; abstinence from treatment by Praziquantel in the last 2 months; and clinical and radiological diagnosis of pathological features of chronic schistosomiasis. All serum samples were serologically examined using indirect hemagglutination test (IHAT) for identification of anti-Schistosoma antibodies. Serum samples from 100 seropositive patients using IHAT were tested by multiplex PCR (mPCR) for detection of species-specific cell-free circulating Schistosoma DNA. Results: None of the seropositive serum samples were positive by PCR targeting Schistosoma speciesspecific gene. Patients who were farmers and/or who had received Praziquantel treatment were associated with Schistosoma seropositivity with statistical significance. Conclusion: A two-step immunomolecular diagnostic approach, using a single serum sample, can rule-out acute or active chronic schistosomiasis in patients that have characteristic pathological and radiological features of chronic schistosomiasis. Also, the two-step approach avoids over-treatment and development of drug resistance to Praziquantel, the only effective broad anti-Schistosoma medicine. | ||||
Keywords | ||||
circulating Schistosoma-DNA; Egypt; IHAT; PCR; praziquantel; schistosomiasis; seropositive | ||||
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