Open Access Open Badges Research article

Day-to-day fluctuation of point-of-care circulating cathodic antigen test scores and faecal egg counts in children infected with Schistosoma mansoni in Ethiopia

Abraham Degarege*, Mengistu Legesse, Girmay Medhin, Tilahun Teklehaymanot and Berhanu Erko

Author Affiliations

Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia

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BMC Infectious Diseases 2014, 14:210  doi:10.1186/1471-2334-14-210

Published: 17 April 2014



Determining the variation of circulating cathodic antigen (CCA) in urine and egg counts variation in stool between days in Schistosoma mansoni (S. mansoni) infected individuals is vital to decide whether or not to rely on a single-sample test for diagnosis of Schistosomiasis. In this study, the magnitude of day-to-day variation in urine-CCA test scores and in faecal egg counts was evaluated in school children in Ethiopia.


A total of 620 school children (age 8 to 12 years) were examined for S. mansoni infection using double Kato-Katz and single urine-CCA cassette methods (batch 32727) on three consecutive days.


The prevalence of S. mansoni infection was 81.1% based on triple urine-CCA-cassette test and 53.1% based on six Kato-Katz thick smears. Among the study participants, 26.3% showed fluctuation in urine CCA and 32.4% showed fluctuation in egg output. Mean egg count as well as number of cases in each class of intensity and intensity of cassette band color varied over the three days of examination. Over 85% of the children that showed day-to-day variations in status of S. mansoni infection from negative to positive or vice versa by the Kato-Katz and the CCA methods had light intensity of infection. The fluctuation in both the CCA test scores and faecal egg count was not associated with age and sex.


The current study showed day-to-day variation in CCA and Kato-Katz test results of children infected with S. mansoni. This indicates the necessity of more than one urine or stool samples to be collected on different days for more reliable diagnosis of S. mansoni infection in low endemic areas.

Schistosoma mansoni; Urine-CCA cassette; Kato-Katz method; Variation; Ethiopia