Performance of Polymerase Chain Reaction, Kato-Katz, and Circulating Cathodic Antigen Techniques in Determining Schistosoma Mansoni Prevalence in Mwea, Kenya

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Date
2023-11
Authors
Chieng, Benard
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Kenyatta University
Abstract
Schistosoma species are the causative agents of schistosomiasis. In the Mwea irrigation scheme, the known species is Schistosoma mansoni, which causes intestinal schistosomiasis. Kato-Katz is the primary technique employed to detect intestinal schistosomiasis, but it has weaknesses of minimal sensitivity, and it is tedious. An alteative approach is the point-of-care circulating cathodic antigen (POC-CCA) method. However, it is characterized by minimal sensitivity and high cross-reactivity. Contrarily, a polymerase chain reaction has excellent precision and sensitivity. The study aimed to evaluate the prevalence of S. mansoni in the Mwea West irrigation scheme and the efficacy of Kato-Katz, POC-CCA, and quantitative PCR methods in parasite screening. A cross-sectional analysis was adopted involving 357 individuals residing in the scheme. The three tests were employed to screen for S. mansoni in stool and urine samples. Data analysis was undertaken using STATA version 15.1. S mansoni prevalence was carried out at a confidence level of 95% McNemar's chi-square test was performed to describe data on specificity and sensitivity. As determined by the KK technique, the total prevalence rate of S. mansoni in Mwea West was 32.8%. The positivity rate was highest in individuals above 14 years (75%) and males (56%). Using the mean of the three tests as the reference, the sensitivity for KK, POC-CCA, and qPCR was 41.6%, 79.4%, and 92.5%, respectively. This study shows that S. mansoni infection remains prevalent among residents of the Mwea West irrigation scheme, posing severe public health challenges. This necessitates the implementation of enhanced measures for disease control in the region. From the study, qPCR revealed the highest sensitivity, whereas KK had the lowest sensitivity. As a result, the QPCR method can be used as a confirmatory test in research settings, whereas POC-CCA can be used in epidemiological surveillance instead of Kato-Katz.
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Keywords
Performance, Polymerase Chain Reaction, Kato-Katz, Circulating Cathodic Antigen Techniques, Schistosoma Mansoni, Prevalence, Mwea, Kenya
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