Jamail M, Andrew K, Junaidi D, Krishnan A K, Faizal M, Rahmah N
Sarawak Health Office, Sarawak, Malaysia.
Trop Med Int Health. 2005 Jan;10(1):99-104. doi: 10.1111/j.1365-3156.2004.01334.x.
We conducted a field study of a rapid test (Brugia Rapid) for detection of Brugia malayi infection to validate its sensitivity and specificity under operational conditions. Seven districts in the state of Sarawak, Malaysia, which are endemic for brugian filariasis, were used to determine the test sensitivity. Determination of specificity was performed in another state in Malaysia (Bachok, Kelantan) which is non-endemic for filariasis but endemic for soil-transmitted helminths. In Sarawak both the rapid test and thick blood smear preparation were performed in the field. The rapid test was interpreted on site, whereas blood smears were taken to the district health centres for staining and microscopic examination. Sensitivity of Brugia Rapid dipstick as compared with microscopy of thick blood smears was 87% (20/23; 95% CI: 66.4-97.2) whereas the specificity was 100% (512/512). The lower sensitivity of the test in the field than in laboratory evaluations (> or =95%), was probably due to the small number of microfilaraemic individuals, in addition to difficulties in performing the test in remote villages by field personnel. The overall prevalence of brugian filariasis as determined by the dipstick is 9.4% (95% CI: 8.2-0.5) while that determined by microscopy is 0.90% (95% CI: 0.5-1.3) thus the dipstick detected about 10 times more cases than microscopy. Equal percentages of adults and children were found to be positive by the dipstick whereas microscopy showed that the number of infected children was seven times less than infected adults. The rapid dipstick test was useful as a diagnostic tool for mapping and certification phases of the lymphatic filariasis elimination programme in B. malayi-endemic areas.
我们开展了一项关于用于检测马来布鲁线虫感染的快速检测法（Brugia Rapid）的现场研究，以验证其在实际操作条件下的敏感性和特异性。马来西亚砂拉越州有7个地区为布鲁氏丝虫病流行区，利用这些地区来确定检测的敏感性。特异性的测定在马来西亚的另一个州（吉兰丹州巴卓）进行，该州无丝虫病流行，但有土源性蠕虫流行。在砂拉越，快速检测和厚血膜涂片均在现场进行。快速检测在现场判读结果，而血涂片则送至地区卫生中心进行染色和显微镜检查。与厚血膜涂片显微镜检查相比，Brugia Rapid试纸条检测的敏感性为87%（20/23；95%可信区间：66.4 - 97.2），而特异性为100%（512/512）。该检测在现场的敏感性低于实验室评估（≥95%），这可能是由于微丝蚴血症患者数量较少，此外现场工作人员在偏远村庄进行检测存在困难。通过试纸条测定的布鲁氏丝虫病总体患病率为9.4%（95%可信区间：8.2 - 10.5），而通过显微镜检查测定的患病率为0.90%（95%可信区间：0.5 - 1.3），因此试纸条检测出的病例数约为显微镜检查的10倍。通过试纸条检测发现成人和儿童的阳性百分比相同，而显微镜检查显示感染儿童的数量比感染成人少7倍。快速试纸条检测作为马来布鲁线虫流行地区淋巴丝虫病消除计划绘图和认证阶段的诊断工具很有用。
