Journal
PATHOGENS
Volume 10, Issue 6, Pages -Publisher
MDPI
DOI: 10.3390/pathogens10060722
Keywords
schistosomiasis; blood samples; Madagascar; pregnancy; test comparison; epidemiology
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Funding
- German Ministry of Defense (MoD) [36K2-S-45 1922]
- open access publishing fund of the University Medicine Rostock
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This study assessed the disease burden of schistosomiasis in pregnant women in Madagascar, with an overall prevalence of 40.4%. The S. mansoni specific real-time PCR showed higher sensitivity (74%) in blood compared to the genus-specific real-time PCR, which had higher specificity (80%). The laborious immunofluorescence assay slightly outperformed the ELISA in detecting Schistosoma-specific IgM and IgG antibodies.
This work was conducted as a cross sectional study to define the disease burden of schistosomiasis in pregnant Madagascan women and to evaluate serological and molecular diagnostic assays. A total of 1154 residual EDTA blood samples from pregnant Madagascan women were assessed. The nucleic acid extractions were subjected to in-house real-time PCRs specifically targeting S. mansoni complex, S. haematobium complex, and African Schistosoma spp. on genus level, while the EDTA plasma samples were analyzed using Schistosoma-specific IgG and IgM commercial ELISA and immunofluorescence assays. The analyses indicated an overall prevalence of schistosomiasis in Madagascan pregnant women of 40.4%, with only minor regional differences and differences between serology- and blood PCR-based surveillance. The S. mansoni specific real-time PCR showed superior sensitivity of 74% (specificity 80%) compared with the genus-specific real-time PCR (sensitivity 13%, specificity 100%) in blood. The laborious immunofluorescence (sensitivity IgM 49%, IgG 87%, specificity IgM 85%, IgG 96%) scored only slightly better than the automatable ELISA (sensitivity IgM 38%, IgG 88%, specificity IgM 78%, IgG 91%). Infections with S. mansoni were detected only. The high prevalence of schistosomiasis recorded here among pregnant women in Madagascar calls for actions in order to reduce the disease burden.
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