Comparative performance of Kato-Katz and spontaneous sedimentation methods for schistosomiasis mansoni diagnosis in endemic areas of Northeastern Brazil

Schistosomiasis mansoni, caused by the trematode <i>Schistosoma mansoni</i>, is a major public health issue in Northeastern Brazil. This study compares the diagnostic performance of Kato-Katz (KK) and spontaneous sedimentation (Lutz) techniques in detecting <i>S. mansoni</i> infections in three areas of Sergipe, Northeastern Brazil, each with varying degrees of schistosomiasis endemicity. We compared the performance of Kato-Katz (KK) and spontaneous sedimentation (SSM) in three localities of Sergipe and Alagoas with different endemicity levels. Stool samples were examined by both methods, and individuals were considered positive if at least one test was positive. KK showed higher sensitivity across all sites (88.5%-100%), while SSM performed better in moderately endemic areas (up to 61.5%). These complementary performance profiles suggest that using both methods in combination could yield a measurable increase in case detection - potentially improving prevalence estimates, guiding more accurate treatment interventions, and strengthening surveillance strategies in areas with heterogeneous transmission intensities.