부산대학교 도서관

Background: The diagnosis of urogenital schistosomiasis is based on the complementarity of serological technique and microscopic examination (ME). Between 2015 and 2019, the number of urinary schistosomiasis tests received in our laboratory increased sharply from 300 to 900 per year. Therefore, we wanted to evaluate the reliability of urine microscopic examination (ME, reference and routine technique) from urine sample by comparing it to other techniques (antigenic technique and PCR). To this end, we optimized two real-time PCRs targeting respectively Schistosoma haematobium (Sh) and Schistosoma mansoni (Sm). Methodology/Principal findings: 914 urine samples from 846 patients suspected of urogenital schistosomiasis were prescribed and analyzed by PCR and also by antigenic technique for the first 143 samples. The antigenic technique evaluated was Schisto POC-CCA, Rapid Medical Diagnostics. These results (antigenic technique and PCR) were compared to ME which was performed from all urines. The percentage of 14% (128/914) positive cases with the PCR technique and the percentage of 6.0% (54/914) positive cases with ME is significantly different (Chi 2 test, p<0.001). These 128 positive PCRs correspond to 120 different patients, 88.3% (106/120) of them were young migrants and 11.7% (14/120) were French patients returning from travel. Among these migrants, more than 75% (80/106) came from French-speaking West Africa. In addition, the Schisto POC-CCA showed a specificity of 39% (46/117), too poor to be used as a screening tool in low or non-endemic areas. Conclusion/Significance: Targeted Sh and Sm PCRs in urine are reliable techniques compared to ME (reference technique). In view of our results, we decided to screen urinary schistosomiasis by direct ME always coupled by the PCR technique, which has shown better reliability criteria. Author summary: Urogenital schistosomiasis caused by Schistosoma haematobium (Sh) is a neglected tropical disease that is widespread in Africa and the Middle East. It is estimated that more than 100 million people are infected for a total population of 1600 million in these areas. Humans are infected during contact with freshwater by direct skin penetration by larvae. At present, the diagnosis of urogenital schistosomiasis is based on the complementarity of serological technique and urine microscopic examination (ME). ME remains the gold standard for the diagnosis of schistosomiasis in Africa. The aim of this work was to evaluate 2 new techniques and compare it to ME in order to improve the diagnosis from 914 urine samples. The first technique (Immunochromatographic antigen technique) showed a specificity of 39%, too poor to be used in low or non-endemic areas as in Europe. The second technique allowing (DNA based diagnostic -PCR) enabled us to increase the number of positive results by a factor of 2.4, from 54 diagnoses by ME to 128 by PCR. In view of our results, we decided to screen urogenital schistosomiasis by direct ME always coupled by PCR, which has shown better reliability criteria. [ABSTRACT FROM AUTHOR]