Agudelo Piedad, Botero David, Palacio Luis Guillermo
Instituto Colombiano de Medicina Tropical-instituto de Ciencias de la Salud, Medellin, Colombia.
Biomedica. 2005 Dec;25(4):488-95.
Cysticercosis is a worldwide public health problem. Currently it is diagnosed by detection of specific antibodies or by imaging techniques.
To evaluate an alternative diagnostic tool, a simple antibody detection assay, called Dot ELISA, for immunological diagnosis of patients with neurocysticercosis as well as for endemic population screening.
The test was applied to cysticercosis patients, as well as to healthy controls and individuals with other parasitic infections. A total of 45 serum, 41 plasma and 23 cerebrospinal fluid samples were obtained from patients meeting clinical, surgical, imaging and laboratory criteria for cysticercosis. Samples were processed by enzyme-linked immune-electro-transfer blot assay and by Dot ELISA. Controls included 37 serum, 64 plasma and 17 cerebrospinal fluid samples from healthy individuals without epidemiological history for taeniosis-cysticercosis. Similarly, 43 plasma samples from patients with parasitic infections different from cysticercosis and 663 samples from population survey for cysticercosis were also evaluated.
A total of 933 samples were analyzed. In samples from cysticercosis patients and healthy control individuals, the Dot ELISA test showed an overall sensitivity of 80.7% (CI 95% = 80.2%-81.2%) and a specificity of 92.4% (CI 95% = 91.9%-92.8%). The Dot ELISA performed in serum had a sensitivity of 91.1%, in plasma 85.4%, and in cerebrospinal fluid 52.2%. Similarly, the same test performed in serum, plasma and cerebrospinal fluid, had a specificity of 100%, 85.9% and 100% respectively. The Dot ELISA was applied as a screening test for the diagnosis of cysticercosis in an endemic population in which 1.8% (12/663) of individuals had T. solium antibodies detected by Enzyme-linked immune-electro-transfer blot assay and showed a sensitivity of 58.3% (CI 95% = 54.0-62.7) and a specificity of 100% (CI 95% = 99.9-100.0) with a positive predictive value of 100% and a negative predictive value of 99.2%. All 43 samples from patients with parasitic infections different from cysticercosis were negative for both tests.
These results indicated that Dot ELISA is a promising tool for the diagnosis of cysticercosis as a screening test, as well as for field epidemiological studies.
囊尾蚴病是一个全球性的公共卫生问题。目前，它通过检测特异性抗体或成像技术来诊断。
评估一种替代诊断工具，即一种名为斑点酶联免疫吸附测定（Dot ELISA）的简单抗体检测方法，用于神经囊尾蚴病患者的免疫诊断以及流行人群筛查。
该检测应用于囊尾蚴病患者、健康对照者以及患有其他寄生虫感染的个体。从符合囊尾蚴病临床、手术、影像学和实验室标准的患者中总共获取了45份血清、41份血浆和23份脑脊液样本。样本通过酶联免疫电转移印迹法和斑点酶联免疫吸附测定进行处理。对照包括来自无绦虫病 - 囊尾蚴病流行病学史的健康个体的37份血清、64份血浆和17份脑脊液样本。同样，也对来自非囊尾蚴病寄生虫感染患者的43份血浆样本以及囊尾蚴病人群调查的663份样本进行了评估。
总共分析了933份样本。在囊尾蚴病患者和健康对照个体的样本中，斑点酶联免疫吸附测定显示总体灵敏度为80.7%（置信区间95% = 80.2% - 81.2%），特异性为92.4%（置信区间95% = 91.9% - 92.8%）。斑点酶联免疫吸附测定在血清中的灵敏度为91.1%，在血浆中为85.4%，在脑脊液中为52.2%。同样，在血清、血浆和脑脊液中进行的相同检测，特异性分别为100%、85.9%和100%。斑点酶联免疫吸附测定被用作流行人群中囊尾蚴病诊断的筛查试验，在该人群中，通过酶联免疫电转移印迹法检测到1.8%（12/663）的个体有猪带绦虫抗体，该检测显示灵敏度为58.3%（置信区间95% = 54.0 - 62.7），特异性为100%（置信区间95% = 99.9 - 100.0），阳性预测值为100%，阴性预测值为99.2%。来自非囊尾蚴病寄生虫感染患者的所有43份样本两种检测均为阴性。
这些结果表明，斑点酶联免疫吸附测定作为一种筛查试验以及用于现场流行病学研究，是诊断囊尾蚴病的一种有前景的工具。
