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Background  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.    Methods  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.    Results  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.    Conclusions  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.

bmc infectious diseases

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