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Acute schistosomiasis in a cluster of travelers from Rwanda: diagnostic contribution of schistosome DNA detection in serum compared to parasitology and serology.
J Travel Med. 2011 Nov-Dec; 18(6):367-72.JT

Abstract

BACKGROUND

Diagnosis of acute schistosomiasis is often elusive in travelers. Serum schistosome DNA detection is a promising new diagnostic tool. Its performance is compared with current diagnostic procedures in a cluster of travelers recently infected in Rwanda.

METHODS

Recent infection with schistosomiasis was suspected in 13 Belgian children and adults, within 2 months after swimming in the Muhazi Lake, Rwanda. All were subjected to clinical examination, eosinophil count, feces parasite detection, schistosome antibody tests [enzyme-linked immunosorbent assay (ELISA) and hemagglutination inhibition assay (HAI)], and schistosome DNA detection in serum by real-time polymerase chain reaction.

RESULTS

All 13 patients, between 6 and 29 years old, had a high eosinophil count (median 2,120 µL(-1) ; range 1,150-14,270). Seven of nine persons exposed for the first time developed symptoms compatible with acute schistosomiasis. Eggs of Schistosoma mansoni were found in a concentrated feces sample of 9/13 (69%), with low egg counts (median 20 eggs per gram; range 10-120). Antischistosome antibodies (ELISA and/or HAI) were present in serum of 10/13 (77%) patients. Combining schistosome antibody tests and fecal microscopy demonstrated schistosomiasis in 11/13 (85%) patients. Schistosome-specific DNA was isolated in all 13 (100%) serum samples.

CONCLUSION

In this cluster of travelers with acute schistosomiasis, schistosome DNA detection in serum was able to confirm infection in all exposed persons. It clearly outperformed antibody tests and microscopic parasite detection methods as a qualitative diagnostic test.

Authors+Show Affiliations

Department of Clinical Sciences, Institute for Tropical Medicine Antwerp, Antwerp, Belgium. jclerinx@itg.beNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

22017711

Citation

Clerinx, Jan, et al. "Acute Schistosomiasis in a Cluster of Travelers From Rwanda: Diagnostic Contribution of Schistosome DNA Detection in Serum Compared to Parasitology and Serology." Journal of Travel Medicine, vol. 18, no. 6, 2011, pp. 367-72.
Clerinx J, Bottieau E, Wichmann D, et al. Acute schistosomiasis in a cluster of travelers from Rwanda: diagnostic contribution of schistosome DNA detection in serum compared to parasitology and serology. J Travel Med. 2011;18(6):367-72.
Clerinx, J., Bottieau, E., Wichmann, D., Tannich, E., & Van Esbroeck, M. (2011). Acute schistosomiasis in a cluster of travelers from Rwanda: diagnostic contribution of schistosome DNA detection in serum compared to parasitology and serology. Journal of Travel Medicine, 18(6), 367-72. https://doi.org/10.1111/j.1708-8305.2011.00552.x
Clerinx J, et al. Acute Schistosomiasis in a Cluster of Travelers From Rwanda: Diagnostic Contribution of Schistosome DNA Detection in Serum Compared to Parasitology and Serology. J Travel Med. 2011 Nov-Dec;18(6):367-72. PubMed PMID: 22017711.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Acute schistosomiasis in a cluster of travelers from Rwanda: diagnostic contribution of schistosome DNA detection in serum compared to parasitology and serology. AU - Clerinx,Jan, AU - Bottieau,Emmanuel, AU - Wichmann,Dominic, AU - Tannich,Egbert, AU - Van Esbroeck,Marjan, Y1 - 2011/10/12/ PY - 2011/10/25/entrez PY - 2011/10/25/pubmed PY - 2012/3/1/medline SP - 367 EP - 72 JF - Journal of travel medicine JO - J Travel Med VL - 18 IS - 6 N2 - BACKGROUND: Diagnosis of acute schistosomiasis is often elusive in travelers. Serum schistosome DNA detection is a promising new diagnostic tool. Its performance is compared with current diagnostic procedures in a cluster of travelers recently infected in Rwanda. METHODS: Recent infection with schistosomiasis was suspected in 13 Belgian children and adults, within 2 months after swimming in the Muhazi Lake, Rwanda. All were subjected to clinical examination, eosinophil count, feces parasite detection, schistosome antibody tests [enzyme-linked immunosorbent assay (ELISA) and hemagglutination inhibition assay (HAI)], and schistosome DNA detection in serum by real-time polymerase chain reaction. RESULTS: All 13 patients, between 6 and 29 years old, had a high eosinophil count (median 2,120 µL(-1) ; range 1,150-14,270). Seven of nine persons exposed for the first time developed symptoms compatible with acute schistosomiasis. Eggs of Schistosoma mansoni were found in a concentrated feces sample of 9/13 (69%), with low egg counts (median 20 eggs per gram; range 10-120). Antischistosome antibodies (ELISA and/or HAI) were present in serum of 10/13 (77%) patients. Combining schistosome antibody tests and fecal microscopy demonstrated schistosomiasis in 11/13 (85%) patients. Schistosome-specific DNA was isolated in all 13 (100%) serum samples. CONCLUSION: In this cluster of travelers with acute schistosomiasis, schistosome DNA detection in serum was able to confirm infection in all exposed persons. It clearly outperformed antibody tests and microscopic parasite detection methods as a qualitative diagnostic test. SN - 1708-8305 UR - https://www.unboundmedicine.com/medline/citation/22017711/Acute_schistosomiasis_in_a_cluster_of_travelers_from_Rwanda:_diagnostic_contribution_of_schistosome_DNA_detection_in_serum_compared_to_parasitology_and_serology_ L2 - https://academic.oup.com/jtm/article-lookup/doi/10.1111/j.1708-8305.2011.00552.x DB - PRIME DP - Unbound Medicine ER -