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Latent class analysis to evaluate performance of point-of-care CCA for low-intensity Schistosoma mansoni infections in Burundi

Overview of attention for article published in Parasites & Vectors, February 2018
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  • Above-average Attention Score compared to outputs of the same age (61st percentile)

Mentioned by

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6 tweeters

Citations

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21 Dimensions

Readers on

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29 Mendeley
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Title
Latent class analysis to evaluate performance of point-of-care CCA for low-intensity Schistosoma mansoni infections in Burundi
Published in
Parasites & Vectors, February 2018
DOI 10.1186/s13071-018-2700-4
Pubmed ID
Authors

Michelle N. Clements, Paul L. A. M. Corstjens, Sue Binder, Carl H. Campbell, Claudia J. de Dood, Alan Fenwick, Wendy Harrison, Donatien Kayugi, Charles H. King, Dieuwke Kornelis, Onesime Ndayishimiye, Giuseppina Ortu, Mariama Sani Lamine, Antonio Zivieri, Daniel G. Colley, Govert J. van Dam

Abstract

Kato-Katz examination of stool smears is the field-standard method for detecting Schistosoma mansoni infection. However, Kato-Katz misses many active infections, especially of light intensity. Point-of-care circulating cathodic antigen (CCA) is an alternative field diagnostic that is more sensitive than Kato-Katz when intensity is low, but interpretation of CCA-trace results is unclear. To evaluate trace results, we tested urine and stool specimens from 398 pupils from eight schools in Burundi using four approaches: two in Burundi and two in a laboratory in Leiden, the Netherlands. In Burundi, we used Kato-Katz and point-of-care CCA (CCAB). In Leiden, we repeated the CCA (CCAL) and also used Up-Converting Phosphor Circulating Anodic Antigen (CAA). We applied Bayesian latent class analyses (LCA), first considering CCA traces as negative and then as positive. We used the LCA output to estimate validity of the prevalence estimates of each test in comparison to the population-level infection prevalence and estimated the proportion of trace results that were likely true positives. Kato-Katz yielded the lowest prevalence (6.8%), and CCAB with trace considered positive yielded the highest (53.5%). There were many more trace results recorded by CCA in Burundi (32.4%) than in Leiden (2.3%). Estimated prevalence with CAA was 46.5%. LCA indicated that Kato-Katz had the lowest sensitivity: 15.9% [Bayesian Credible Interval (BCI): 9.2-23.5%] with CCA-trace considered negative and 15.0% with trace as positive (BCI: 9.6-21.4%), implying that Kato-Katz missed approximately 85% of infections. CCAB underestimated disease prevalence when trace was considered negative and overestimated disease prevalence when trace was considered positive, by approximately 12 percentage points each way, and CAA overestimated prevalence in both models. Our results suggest that approximately 52.2% (BCI: 37.8-5.8%) of the CCAB trace readings were true infections. Whether measured in the laboratory or the field, CCA outperformed Kato-Katz at the low infection intensities in Burundi. CCA with trace as negative likely missed many infections, whereas CCA with trace as positive overestimated prevalence. In the absence of a field-friendly gold standard diagnostic, the use of a variety of diagnostics with differing properties will become increasingly important as programs move towards elimination of schistosomiasis. It is clear that CCA is a valuable tool for the detection and mapping of S. mansoni infection in the field and CAA may be a valuable field tool in the future.

Twitter Demographics

The data shown below were collected from the profiles of 6 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 29 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 29 100%

Demographic breakdown

Readers by professional status Count As %
Researcher 4 14%
Student > Ph. D. Student 4 14%
Student > Master 3 10%
Student > Bachelor 3 10%
Student > Doctoral Student 3 10%
Other 7 24%
Unknown 5 17%
Readers by discipline Count As %
Medicine and Dentistry 5 17%
Agricultural and Biological Sciences 4 14%
Biochemistry, Genetics and Molecular Biology 3 10%
Nursing and Health Professions 3 10%
Immunology and Microbiology 3 10%
Other 5 17%
Unknown 6 21%

Attention Score in Context

This research output has an Altmetric Attention Score of 4. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 01 July 2020.
All research outputs
#4,846,091
of 15,561,035 outputs
Outputs from Parasites & Vectors
#1,213
of 4,179 outputs
Outputs of similar age
#105,282
of 277,225 outputs
Outputs of similar age from Parasites & Vectors
#1
of 1 outputs
Altmetric has tracked 15,561,035 research outputs across all sources so far. This one has received more attention than most of these and is in the 68th percentile.
So far Altmetric has tracked 4,179 research outputs from this source. They receive a mean Attention Score of 4.7. This one has gotten more attention than average, scoring higher than 70% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 277,225 tracked outputs that were published within six weeks on either side of this one in any source. This one has gotten more attention than average, scoring higher than 61% of its contemporaries.
We're also able to compare this research output to 1 others from the same source and published within six weeks on either side of this one. This one has scored higher than all of them