Alves Waneska Alexandre, Bevilacqua Paula Dias
Programa de Treinamento em Epidemiologia Aplicada aos Serviços do SUS, Ministério da Saúde, Brasília, Brasil.
Cad Saude Publica. 2004 Jan-Feb;20(1):259-65. doi: 10.1590/s0102-311x2004000100043. Epub 2004 Mar 8.
In Brazil, visceral leishmaniasis poses a serious endemic and epidemic problem. In recent years the disease has spread to several States that had not previously reported any human or animal cases. For canine surveys, the Ministry of Health currently recommends use of the indirect immunofluorescence assay (IIF), with a sensitivity of 90-100% and specificity of 80%. Use of IIF may decrease the effectiveness of the Kala Azar Control Program by not detecting, and thus failing to sacrifice, false-negative infected animals. On the other hand, the program incorrectly identifies and leads to the unwarranted sacrifice of false-positive uninfected animals. Such uncertainties have already led to disagreement over the Program's objectives, such as the recommendation by some veterinarians that infected animals be treated. This work analyzes the quality of diagnosis of canine epidemic surveys against the backdrop of a visceral leishmaniasis epidemic in Belo Horizonte, Minas Gerais State, from 1993 to 1997.
在巴西，内脏利什曼病构成了严重的地方病和流行病问题。近年来，该病已蔓延至几个此前未报告过任何人类或动物病例的州。对于犬类调查，卫生部目前建议使用间接免疫荧光测定法（IIF），其灵敏度为90% - 100%，特异性为80%。使用IIF可能会降低黑热病控制项目的有效性，因为它无法检测到假阴性感染动物，从而无法对其进行扑杀。另一方面，该项目会错误地识别并导致对假阳性未感染动物进行不必要的扑杀。这些不确定性已经导致了对该项目目标的分歧，比如一些兽医建议对感染动物进行治疗。这项工作分析了1993年至1997年在米纳斯吉拉斯州贝洛奥里藏特市内脏利什曼病流行背景下犬类流行病调查的诊断质量。
