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ABSTRACT Background: The World Health Organization recommends a market-ready, urine-based point-of-care diagnostic test for circulating cathodic antigens (CCA) to determine the prevalence of S. mansoni. This study evaluated the performance of the URINE CCA (SCHISTO) ECO TESTE® (POC-ECO), which is currently available in Brazil. Methods: Residents from eight sites with different prevalence estimates provided one urine sample for POC-ECO and one stool sample for Kato-Katz (KK) and Helmintex® (HTX) testing as an egg-detecting reference for infection status. Results: None of the study sites had significantly higher POC-ECO accuracy than KK. Conclusions: POC-ECO is not currently recommended in Brazilian schistosomiasis elimination programs.

https://doi.org/10.1590/0037-8682-0238-2022

A review of serological tests available in Brazil for intestinal schistosomiasis diagnosis
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Ramos, Lidia Mara da Silva

; da Silva-Pereira, Rosiane A

; Oliveira, Edward

; Fonseca, Cristina Toscano

; Graeff-Teixeira, Carlos

Memórias do Instituto Oswaldo Cruz

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2023, Volume 118 elocation e230236

Abstract: En | Text: En | PDF: En

The World Health Organization (WHO) roadmap and recommendations for elimination of schistosomiasis were recently updated. With significant reductions in the prevalence and intensity of schistosomiasis infections worldwide, there is a need for more sensitive diagnostic methods. There are a few remaining transmission hotspots in Brazil, although low endemicity settings comprise most of the endemic localities. For the latter, serology may represent a tool for population screening which could help eliminate transmission of schistosomiasis. Here, we review serology tests currently available in Brazil from both public health and private laboratories: immunofluorescent antibody tests (IFATs) on adult worm sections and enzyme-linked immunosorbent assays (ELISAs) with soluble egg and adult worm antigens. Both in-house and commercially available tests have received less than adequate performance evaluations. Our review of immediate basic and operational research goals may help identify local adjustments that can be made to improve control interventions aimed at elimination of schistosomiasis as a public health problem. WHO (WHO updated worldwide methods localities latter Here laboratories IFATs (IFATs enzymelinked enzyme linked ELISAs (ELISAs antigens inhouse house evaluations problem

https://doi.org/10.1590/0074-02760220236

Reliability of point-of-care circulating cathodic antigen assay for diagnosing schistosomiasis mansoni in urine samples from an endemic area of Brazil after one year of storage at -20 degrees Celsius
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Favre, Tereza Cristina

; Beck, Lilian Christina Nóbrega Holsback

; Bezerra, Fernando Schemelzer Moraes

; Graeff-Teixeira, Carlos

; Coelho, Paulo Marcos Zech

; Enk, Martin Johannes

; Katz, Naftale

; Oliveira, Ricardo Riccio

; Reis, Mitermayer Galvão dos

; Pieri, Otávio Sarmento

Revista da Sociedade Brasileira de Medicina Tropical

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2022, Volume 55 elocation e0389-2021

Abstract: En | Text: En | PDF: En

ABSTRACT Background The World Health Organization recommends reliable point-of-care (POC) diagnostic testing to eliminate schistosomiasis. Lateral flow immunoassay that detects schistosome circulating cathodic antigen (CCA) in urine to establish prevalence thresholds for intervention in endemic areas is recommended. Stored urine may be useful if surveying at-risk populations is delayed or interrupted by unforeseen circumstances, such as the current COVID-19 pandemic. This study evaluated the manufacturer’s claim that Schistosoma mansoni infection can be reliably diagnosed in urine samples stored at -20°C for one year. Methods Two-hundred-forty-two subjects from an endemic site in Brazil provided one urine sample each for testing with URINE CCA (SCHISTO) ECO TESTE® (POC-ECO) and one stool sample each for testing with Kato-Katz (KK) and Helmintex® (HTX) as a robust reference standard for infection status. At least 2 ml of urine from each participant was stored at -20°C; after one year, 76 samples were randomly selected for POC-ECO retesting. Results: The POC-ECO agreement between freshly collected and stored urine was inadequate considering trace results as positive (Cohen’s kappa coefficient κ = 0.08) and negative (κ = 0.36). POC-ECO accuracy was not significantly greater than that of routine KK (54%; 95% confidence interval: 42.1%-65.5%). Conclusions The precision and accuracy of POC-ECO have to be optimized in both freshly collected and stored urine before it can be recommended for use in control programs in Brazil.

https://doi.org/10.1590/0037-8682-0389-2021

Abdominal angiostrongyliasis can be diagnosed with a immunochromatographic rapid test with recombinant galactin from Angiostrongylus cantonensis
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Graeff-Teixeira, Carlos

; Pascoal, Vanessa Fey

; Rodriguez, Rubens

; Morassutti, Alessandra Loureiro

; Intapan, Pewpan M

; Maleewong, Wanchai

Memórias do Instituto Oswaldo Cruz

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2020, Volume 115 elocation e200201

Abstract: En | Text: En | PDF: En

Angiostrongylus costaricensis is the causative agent of abdominal angiostrongyliasis, a zoonotic infection that may produce severe eosinophilic enterocolitis or hepatitis in humans. Parasites are usually not released in stools and serology has an important role in diagnosis. Since cross-reactivity is demonstrated between A. costaricensis and another metastrongylid worm, A. cantonensis, we tested heterologous recombinant galectin as a probe in an immunochromatographic rapid diagnostic test (ICT-RDT) for detection of anti-A. costaricensis antibodies. Almost all (11/12) positive control sera from A. costaricensis infected patients were positive at ICT RDT. These are preliminary indications that r-galectin ICT-RDT is useful for diagnosing A. costaricensis infection.

https://doi.org/10.1590/0074-02760200201 329 downloads

Infection by Angiostrongylus cantonensis in both humans and the snail Achatina (Lissachatina) fulica in the city of Macapá, in the Amazon Region of Brazil
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Barbosa, Tatiane Alves

; Thiengo, Silvana Carvalho

; Fernandez, Monica Ammon

; Graeff-Teixeira, Carlos

; Morassutti, Alessandra Loureiro

; Mourão, Fábio Rodrigo Paixão

; Miranda, Clóvis Omar Sá

; Jorge, Michel de Moraes

; Costa, Liliane Freitas

; Gomes, Suzete Rodrigues

Memórias do Instituto Oswaldo Cruz

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2020, Volume 115 elocation e200115

Abstract: En | Text: En | PDF: En

In January and February 2019, a malacological survey was conducted in the area surrounding the residence of a 12-year-old child that had contracted cerebral angiostrongyliasis in the municipality of Macapá, capital of the Amapá State, northern Brazil. The serological examination was positive for Angiostrongylus cantonensis infection, the principal etiological agent of this parasitosis. A sample of 54 molluscs was artificially and individually digested for parasitological analysis, containing 38 specimens of Achatina fulica, nine specimens of Bulimulus tenuissimus and seven specimens of Sarasinula linguaeformis. A. fulica was the most abundant mollusc, and the only species infected with A. cantonensis, as well as presenting co-infections with other nematodes. This is the first report of cerebral angiostrongyliasis in the Amazon Region, and the first record of A. fulica infected with A. cantonensis in Amapá. These findings highlight the potential risks of human angiostrongyliasis, and the need to implement public health measures to control the spread of the disease.

https://doi.org/10.1590/0074-02760200115 774 downloads

Schistosomiasis: an epidemiological update on Brazil's southernmost low endemic area in Esteio
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Ramírez, Angélica da Paz

; Favero, Vivian

; Lindholz, Catieli Gobetti

; Veríssimo, Carolina de Marco

; Pascoal, Vanessa Fey

; Candido, Renata Russo Frasca

; Morassutti, Alessandra Loureiro

; Graeff-Teixeira, Carlos

Revista da Sociedade Brasileira de Medicina Tropical

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2020, Volume 53 elocation e20200411

Abstract: En | Text: En | PDF: En

Abstract INTRODUCTION: Brazil’s southernmost state, Rio Grande do Sul (RGS), was considered schistosomiasis-free until 1998 when a low endemic focus was identified in Esteio, a city located next to the capital of RGS. In the last two decades, the control interventions applied in the region have been apparently successful, and the absence of new cases indicated the possibility of interrupted schistosomiasis transmission. The objective of this study was to update the clinical and epidemiological data of schistosomiasis in Esteio. METHODS: We reviewed all 28 individuals diagnosed with the infection since 1997 and a survey was applied to a group of 29 school-aged children residing in Vila Pedreira, one of the most affected neighborhoods. RESULTS No eggs were detected in fecal samples using the Helmintex method, and all samples were negative for serum antibodies on examination by the western blot technique using the Schistosoma mansoni microsomal antigen (MAMA- WB). In contrast, 23 individuals (79%) tested positive for the cathodic circulating antigen with the point-of-care immunochromatographic test (POC-CCA) on urine samples. Of the 28 formerly infected individuals, only eight were located, of which four tested positive, and four tested negative for serum antibodies using the MAMA-WB technique. CONCLUSIONS: Current adverse conditions for S. mansoni transmission in Esteio and the absence of a confirmed diagnosis suggests that there is (i) a lack of specificity of the POC-CCA test in low endemic settings, and (ii) a high probability that interruption of schistosomiasis has been achieved in Esteio.

https://doi.org/10.1590/0037-8682-0411-2020 349 downloads

Criteria for identification of Schistosoma mansoni eggs in faecal sediments prepared with the Helmintex method and stained by ninhydrin
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de Souza, Renata Perotto

; Favero, Vivian

; Pascoal, Vanessa Fey

; Lindholz, Catieli

; Bittencourt, Hélio Radke

; Graeff-Teixeira, Carlos

Memórias do Instituto Oswaldo Cruz

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2019, Volume 114 elocation e180529

Abstract: En | Text: En | PDF: En

Helmintex is a sensitive method used for detecting Schistosoma mansoni eggs. Here, we describe the observed frequency of six proposed criteria associated with the identification of S. mansoni eggs prepared with the Helmintex method and stained with ninhydrin. The efficacy of these criteria in classifying S. mansoni eggs when applied in various combinations was also examined. Nine observers registered the presence or absence of 6 different criteria in 100 eggs using a microscope at 100x magnification. Ninhydrin purple, which was frequently observed, was the criterion associated with the lowest inter-observer variability. At least three criteria were associated with a significantly better performance in egg identification. In conclusion, ninhydrin staining and a combination of criteria are recommended for microscope examination of faecal sediments.

https://doi.org/10.1590/0074-02760180529 726 downloads

Evaluation of the immunogenicity of Schistosoma mansoni egg surface
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Candido, Renata Russo Frasca

; Pierre, Timothy Guy St.

; Jones, Malcolm Kenneth

; Graeff-Teixeira, Carlos

Revista da Sociedade Brasileira de Medicina Tropical

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sep 2017, Volume 50 N. 5 Pages 652 - 657

Abstract: En | Text: En | PDF: En

Abstract INTRODUCTION Immunogenicity of Schistosoma mansoni egg surface was examined to determine whether intact eggshells have lower antigenicity than ruptured eggs. METHODS: Swiss Webster mice were inoculated with intact or ultrasonicated S. mansoni eggs isolated from infected human feces. Mice were separated into four groups of six animals each and immunizations were performed approximately every 20 days during a 60-day period. Groups 1-4 were administered with saline solution, sonicated eggs with Freund’s adjuvant, sonicated eggs without Freund’s adjuvant, and intact eggs, respectively. IgG humoral immune response was assessed by ELISA using Soluble Egg Antigen produced from eggs isolated from the livers of infected mice. RESULTS Sonicated eggs co-administered with adjuvant induced the highest humoral response at 58 days, which was 11.9-fold (95% CI 6.2-17.5) greater than the response induced by saline solution. Sonicated eggs without adjuvant induced a 4.3-fold stronger response (95% CI 2.4-6.2) than normal saline. Intact eggs induced humoral response that was nominally twice stronger (95% CI 0.8-3.2) than that induced by normal saline but the effect did not reach statistical significance. CONCLUSIONS Soluble antigens are not abundant on the surface of S. mansoni eggs and/or are not secreted in sufficient quantities to induce a significant immune response to intact eggs. Assuming that isolation procedures had not damaged the eggs used for inoculation, our observations suggest that intact eggs either do not induce a significant immune response or, if they do, the mechanism involves insoluble antigens from the egg surface.

https://doi.org/10.1590/0037-8682-0040-2017 1236 downloads

Eosinophilic meningitis caused by Angiostrongylus cantonensis: an emergent disease in Brazil
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Morassutti, Alessandra Loureiro

; Thiengo, Silvana Carvalho

; Fernandez, Monica

; Sawanyawisuth, Kittisak

; Graeff-Teixeira, Carlos

Memórias do Instituto Oswaldo Cruz

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jul 2014, Volume 109 N. 4 Pages 399 - 407

Abstract: En | Text: En | PDF: En

Eosinophilic meningitis (EoM) is an acute disease that affects the central nervous system. It is primarily caused by infection with the nematode Angiostrongylus cantonensis. This infection was previously restricted to certain Asian countries and the Pacific Islands, but it was first reported in Brazil in 2007. Since then, intermediate and definitive hosts infected with A. cantonensis have been identified within the urban areas of many states in Brazil, including those in the northern, northeastern, southeastern and southern regions. The goals of this review are to draw the attention of the medical community and health centres to the emergence of EoM in Brazil, to compile information about several aspects of the human infection and mode of transmission and to provide a short protocol of procedures for the diagnosis of this disease.

https://doi.org/10.1590/0074-0276140023 5498 downloads Cited 16 times in SciELO

10.

First report of Angiostrongylus cantonensis in Porto Alegre, State of Rio Grande do Sul, Southern Brazil
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Cognato, Bianca Barbieri

; Morassutti, Alessandra Loureiro

; Silva, Ana Cristina Aramburu da

; Graeff-Teixeira, Carlos

Revista da Sociedade Brasileira de Medicina Tropical

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sep 2013, Volume 46 N. 5 Pages 664 - 665

Abstract: En | Text: En | PDF: En

https://doi.org/10.1590/0037-8682-0073-2013 2525 downloads Cited 2 times in SciELO

11.

Comparison of the Kato-Katz and Helmintex methods for the diagnosis of schistosomiasis in a low-intensity transmission focus in Bandeirantes, Paraná, southern Brazil
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Caldeira, Kerlen

; Teixeira, Candida Fagundes

; Silveira, Manoela Borges da

; Fries, Lucas Castello Costa de

; Romanzini, Juliano

; Bittencourt, Hélio Radke

; Graeff-Teixeira, Carlos

Memórias do Instituto Oswaldo Cruz

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aug 2012, Volume 107 N. 5 Pages 690 - 692

Abstract: En | Text: En | PDF: En

The diagnosis of schistosomiasis is problematic in low-intensity transmission areas because parasitological methods lack sensitivity and molecular methods are neither widely available nor extensively validated. Helmintex is a method for isolating eggs from large faecal samples. We report preliminary results of a comparative evaluation of the Helmintex and Kato-Katz (KK) methods for the diagnosis of schistosomiasis in a low-intensity transmission area in Bandeirantes, Paraná, southern Brazil. Eggs were detected by both methods in seven patients, whereas only Helmintex yielded positive results in four individuals. The results confirm the previously demonstrated higher sensitivity of the Helmintex method compared with the KK method.

2661 downloads Cited 4 times in SciELO

12.

Henrique Leonel Lenzi (<img src="/img/revistas/rsbmt/v45n2/a34est.jpg" width="21" height="22"align="texttop">1943 †2011)
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Teixeira, Carlos Graeff

; Tosta, Carlos Eduardo

Revista da Sociedade Brasileira de Medicina Tropical

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apr 2012, Volume 45 N. 2 Pages 282 - 282

Abstract: En | Text: En | PDF: En

1705 downloads

13.

Use of heterologous antigens for the immunodiagnosis of abdominal angiostrongyliasis by an enzyme-linked immunosorbent assay
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Ben, Renata

; Rodrigues, Rubens

; Agostini, Aventino Alfredo

; Graeff-Teixeira, Carlos

Memórias do Instituto Oswaldo Cruz

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nov 2010, Volume 105 N. 7 Pages 914 - 917

Abstract: En | Text: En | PDF: En

Angiostrongylus costaricensis has a broad geographic distribution spanning from North to South America and the infections of vertebrates with this nematode can result in abdominal complications. Human infections are diagnosed by histological or serological methods because the isolation of larvae from feces is not feasible, as most parasites become trapped in intestinal tissues due to intense eosinophilic inflammation. Because A. costaricensis is difficult to maintain in the laboratory, an immunodiagnostic IgG enzyme-linked immunosorbent assay (ELISA) using antigens from the congeneric Angiostrongylus cantonensis species was evaluated against a panel of serum samples from patients who were histologically diagnosed with A. costaricensis infections. Sera from uninfected individuals and individuals infected with other parasites were used as controls. The sensitivity and specificity of the assay were estimated at 88.4% and 78.7%, respectively. Because the use of purified or cloned antigens has not been established as a reliable diagnostic tool, the use of heterologous antigens may provide a viable alternative for the development of an ELISA-based immunodetection system for the diagnosis of abdominal angiostrongyliasis.

1922 downloads Cited 4 times in SciELO

14.

Susceptibility and morbidity between male and female Swiss mice infected with Angiostrongylus costaricensis: Susceptibilidade e morbidade entre camundongos Swiss machos e fêmeas infectados com Angiostrongylus costaricensis
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Mentz, Márcia B.

; Dallegrave, Eliane

; Graeff-Teixeira, Carlos

Revista do Instituto de Medicina Tropical de São Paulo

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oct 2010, Volume 52 N. 5 Pages 267 - 268

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

O sexo dos hospedeiros vertebrados pode influenciar no resultado de infecções parasitárias. A infecção experimental de camundongos com Angiostrongylus costaricensis foi acompanhada com observação do peso corporal, eliminação de larvas nas fezes, número e comprimento dos vermes adultos, número de lesões macroscópicas nos intestinos e mortalidade. Grupos de camundongos Swiss machos e fêmeas foram infectados cada um com 10 larvas de terceiro estágio de A. costaricensis. Os resultados indicam que não há diferenças significativas relacionados ao sexo dos hospedeiros, exceto pelo maior comprimento dos vermes nos hospedeiros machos.

The gender of vertebrate hosts may affect the outcome of parasitic infections. An experimental murine infection with Angiostrongylus costaricensis was followed with determinations of body weight, fecal larval elimination, number and length of adult worms, number of macroscopic intestinal lesions, and mortality. Groups of male and female Swiss mice were infected with 10 3rd-stage A. costaricensis larvae per animal. The results indicate there are no significant differences related to gender of the host, except for higher length of worms developed in male mice.

1705 downloads

15.

Individual serological follow-up of patients with suspected or confirmed abdominal angiostrongyliasis
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Palominos, Penélope E

; Gasnier, Rose

; Rodriguez, Rubens

; Agostini, Aventino A

; Graeff-Teixeira, Carlos

Memórias do Instituto Oswaldo Cruz

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feb 2008, Volume 103 N. 1 Pages 93 - 97

Abstract: En | Text: En | PDF: En

Abdominal angiostrongyliasis (AA) is a zoonotic nematode infection caused by Angiostrongylus costaricensis, with widespread occurrence in the Americas. Although the human infection may be highly prevalent, morbidity is low in Southern Brazil. Confirmed diagnosis is based on finding parasitic structures in pathological examination of biopsies or surgical resections. Serology stands as an important diagnostic tool in the less severe courses of the infection. Our objective is to describe the follow up of humoral reactivity every 2-4 weeks up to one year, in six individuals with confirmed (C) and ten suspected (S) AA. Antibody (IgG) detection was performed by ELISA and resulted in gradually declining curves of reactivity in nine subjects (56%) (4C + 5S), that were consistently negative in only three of them (2C + 1S) after 221, 121 and 298 days. Three individuals (2C + 1S) presented with low persistent reacitivity, other two (1C + 1S) were serologically negative from the beginning, but also presenting a declining tendency. The study shows indications that abdominal angiostrongyliasis is usually not a persistent infection: although serological negativation may take many months, IgG reactivity is usually declining along time and serum samples pairing may add valuable information to the diagnostic workout.

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