Effect of a mass treatment with praziquantel on the excretion in urine of a polysaccharide antigen used for diagnosis of schistosomiasis due to S. mansoni in Cameroon.

The detection in urine, with a monoclonal antibody, of an excreted polysaccharide antigen characteristic of the genus Schistosoma, allows evaluation of the effect of praziquantel used for mass treatment, in a focus of S. mansoni infection. Inhibition of the passive haemagglutination test, which was used for detecting the polysaccharide antigen in urine, is more sensitive for measuring prevalence than the determination of eggs in stools by means of direct examination and the formalin-ether concentration technique. Nine months after anthelminthic treatment, the percentage of inhabitants excreting antigen in urine diminished markedly, while the circulating antibody levels remained high. The test for detecting the antigen in urine seems to be the most efficient way to monitor the effect of mass treatment in intestinal schistosomiasis.

Detection with a monoclonal antibody of an antigen, characteristic of the genus Schistosoma, excreted in the urine.

In the host, the antigen excreted by schistosomes in the circulating blood is concentrated in the urine. A mouse monoclonal antibody of the IgM class type lambda, directed against an epitope of the intestinal epithelium of the adult worm, is obtained. The antigen found in the urine of the host as well as the monoclonal antibody has been previously characterized. It is of a polysaccharidic nature, is thermostable and specific for the genus Schistosoma. The antigen is found at all stages of the life cycle and, particularly, in the egg where it is found in large amounts. Detection of the antigen is by means of inhibition of the passive haemagglutination test. There is a fundamental advantage in detecting the metabolic antigen excreted by schistosomes instead of looking for circulating antibodies. The antigen is directly released by the parasite itself, antibodies being, by contrast, produced by the host, indirectly therefore, and in a way that varies from one individual to the next. Collecting urine specimens is, for field workers, easier than obtaining blood from the inhabitants. The detection of the antigen in the urine is made a rather simple procedure since the antigen is concentrated by the kidney and free in urine, instead of remaining conjugated with antibodies like it is in the blood. When used in the Cameroon for the study of prevalence in two foci of schistosomiasis, intestinal (Nalassi Emana) and urinary (Barombi Kotto), the test detecting the antigen in urine gives good correlations with the parasitological examinations looking for eggs of S. mansoni and S. haematobium in feces and urine.