In Uganda, schistosomiasis continues to silently affect millions, particularly in hard-to-reach and high-risk communities. For years, diagnosing this parasitic disease largely relied on the Kato-Katz (KK) technique which involved examining stool samples under a microscope to detect parasite eggs. While useful, KK often misses mild or early infections and depends heavily on skilled personnel. Recognizing these limitations, the Uganda Schistosomiasis Multidisciplinary Research Centre (U-SMRC) sought to enhance diagnostic accuracy by adopting and integrating more sensitive tools into its research and surveillance activities.
Addressing the gaps in existing methods
As U-SMRC began its work, the team carefully evaluated existing diagnostic methods and their limitations. It became clear that relying solely on KK, as had been done in many previous studies, would not sufficiently capture the true burden of Schistosoma mansoni infections especially in low-intensity or post-treatment settings.
To address this, U-SMRC adopted a range of already-established diagnostic tools and adapted them for use in the Ugandan context. These tools have improved case detection, particularly in rural communities where accurate and timely diagnosis is essential.
Molecular Diagnostics (Stool Testing)
To improve detection, U-SMRC adopted the PCR (Polymerase Chain Reaction) testing. By identifying schistosome DNA in stool, this technique is much more sensitive even when parasite levels are low. With the adoption of a faster DNA extraction method using the Fast Spin DNA kit, what once took days can now be done in just a few hours. That means lab teams can have same-day diagnosis and treatment in the field.
Urine-Based Simplicity
To reduce the invasiveness and logistical burden of stool collection, the Centre also adopted the use of the Circulating Cathodic Antigen (CCA) test. This urine-based test offers a quick and non-invasive alternative and has proven helpful in identifying infections that KK might miss.
For improved accuracy, especially in borderline results, U-SMRC employed a digital Point-of-Care (POC) CCA reader. This tool enhances interpretation consistency, making it ideal for use in large-scale field studies.
Blood-Based Sensitivity
The team also incorporated the Circulating Anodic Antigen (CAA) test, which can detect even very low levels of infection. This assay is particularly valuable for follow-up after treatment, helping to confirm if a person has cleared the infection.
Looking ahead
By strategically adopting and combining these diagnostic approaches, U-SMRC has significantly improved the quality and reliability of schistosomiasis diagnosis in Uganda. These enhancements not only support better patient outcomes but also contribute to national and global efforts to eliminate the disease.
With continued collaboration and innovation, U-SMRC is helping to set a new standard for schistosomiasis research, one that prioritizes precision, adaptability, and community impact.
