Comparison of POC-CCA with Kato-Katz in Diagnosing Schistosoma mansoni Infection in a Pediatric L-Praziquantel Clinical Trial

Introduction Traditionally Schistosoma mansoni infection is diagnosed by the Kato-Katz method. Thick smears from each stool sample are prepared on slides and eggs counted microscopically. Commercially available point-of-care circulating cathodic antigen (POC-CCA) cassette tests detect schistosomiasis antigens urine samples in 20 minutes. POC-CCA results qualitative or semi-quantitative: signal intensity an indicator of amount worm sample. Both methods were used a phase II trial investigating efficacy safety new pediatric formulations praziquantel (PZQ) among children ≤6 years (NCT02806232). This secondary analysis evaluated consistency between methods. Methods was to pre-screen for S. infection. Children with positive tested method, those (>1 egg/1 occurrence) enrolled. Participants (N=444) treated different doses PZQ. performed at 2–3 weeks after treatment evaluate drug efficacy. Cure rate (CR) defined as proportion participants negative result per POC-CCA, no Kato-Katz. Kappa statistic assess agreement cure status, Spearman correlation positivity egg counts evaluated. Sensitivity specificity calculated using reference standard. Results CR measured treatment, 52% [95% confidence interval (CI): 48%, 57%] across all arms except infants aged 3–12 months. 83% (95% CI: 79%, 87%). 0.16 0.09, 0.23), indicating that slightly better than chance. Relative Kato-Katz, POC-CCA’s sensitivity 70% 57%. coefficient 0.26 0.17, 0.34). Conclusion sensitive rapid diagnosing infection, but its performance requires further investigation young children.