# name
Accuracy of parasitological and immunological tests for the
                screening of human schistosomiasis in immigrants and refugees
                from African countries: An approach with Latent Class Analysis

# metadata.dc.description.abstract[].value
BACKGROUND: Schistosomiasis is a neglected infection affecting
                millions of people, mostly living in sub-Saharan Africa.
                Morbidity and mortality due to chronic infection are relevant,
                although schistosomiasis is often clinically silent. Different
                diagnostic tests have been implemented in order to improve
                screening and diagnosis, that traditionally rely on
                parasitological tests with low sensitivity. Aim of this study
                was to evaluate the accuracy of different tests for the
                screening of schistosomiasis in African migrants, in a non
                endemic setting. METHODOLOGY/PRINCIPAL FINDINGS: A retrospective
                study was conducted on 373 patients screened at the Centre for
                Tropical Diseases (CTD) in Negrar, Verona, Italy. Biological
                samples were tested with: stool/urine microscopy, Circulating
                Cathodic Antigen (CCA) dipstick test, ELISA, Western blot,
                immune-chromatographic test (ICT). Test accuracy and predictive
                values of the immunological tests were assessed primarily on the
                basis of the results of microscopy (primary reference standard):
                ICT and WB resulted the test with highest sensitivity (94% and
                92%, respectively), with a high NPV (98%). CCA showed the
                highest specificity (93%), but low sensitivity (48%). The
                analysis was conducted also using a composite reference
                standard, CRS (patients classified as infected in case of
                positive microscopy and/or at least 2 concordant positive
                immunological tests) and Latent Class Analysis (LCA). The latter
                two models demonstrated excellent agreement (Cohen's kappa:
                0.92) for the classification of the results. In fact, they both
                confirmed ICT as the test with the highest sensitivity (96%) and
                NPV (97%), moreover PPV was reasonably good (78% and 72%
                according to CRS and LCA, respectively). ELISA resulted the most
                specific immunological test (over 99%). The ICT appears to be a
                suitable screening test, even when used alone. CONCLUSIONS: The
                rapid test ICT was the most sensitive test, with the potential
                of being used as a single screening test for African migrants.

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Reproducció del document publicat a:
                http://dx.doi.org/10.1371/journal.pntd.0005593

# metadata.dc.relation.ispartof[].value
PLoS Neglected Tropical Diseases, 2017, vol. 11, num. 6, p.
                e0005593

# metadata.dc.source[].value
Articles publicats en revistes (ISGlobal)

# metadata.dc.title[].value
Accuracy of parasitological and immunological tests for the
                screening of human schistosomiasis in immigrants and refugees
                from African countries: An approach with Latent Class Analysis