Bern Caryn, Amann Josef, Haque Rashidul, Chowdhury Rajib, Ali Mustakim, Kurkjian Katie M, Vaz Louise, Wagatsuma Yukiko, Breiman Robert F, Secor W Evan, Maguire James H
Centers for Disease Control and Prevention, Atlanta, GA 30341, USA.
Am J Trop Med Hyg. 2006 Oct;75(4):744-8.
Annual leishmanin skin test (LST) surveys were conducted in a visceral leishmaniasis-endemic Bangladeshi community from 2002 through 2004, using Leishmania infantum antigen from the same manufacturer and batch. In 2002, 530 (35%) of 1,532 had positive LST results; the prevalence increased with increasing age. The LST result was positive in 24 (51%) of 47, 18 (72%) of 25, and 11 (85%) of 13 kala-azar patients treated in the previous 1-11, 12-23, and 24-35 months. A positive LST result in 2002 was associated with protection against subsequent kala-azar (P < 0.0001). In 2003-2004, decreased antigen sensitivity was observed. Among 686 participants, 34% were LST-positive in 2002, 29% in 2003, and 19% in 2004. Of 63 cured kala-azar patients, 70% were positive in 2002, 53% in 2003, and only 30% in 2004. Among 171 participants tested with both antigens, L. infantum study antigen sensitivity was 70% compared with L. amazonensis antigen. Our data underscore the need for better production, standardization, and documentation of sensitivity, potency, and stability of leishmanin antigens.
2002年至2004年期间，在孟加拉国一个内脏利什曼病流行社区进行了年度利什曼原虫皮肤试验（LST）调查，使用的是同一生产商和批次的婴儿利什曼原虫抗原。2002年，1532人中530人（35%）LST结果呈阳性；患病率随年龄增长而增加。在前1至11个月、12至23个月和24至35个月接受治疗的47例、25例和13例黑热病患者中，LST结果呈阳性的分别有24例（51%）、18例（72%）和11例（85%）。2002年LST结果呈阳性与预防后续黑热病相关（P<0.0001）。2003年至2004年，观察到抗原敏感性下降。在686名参与者中，2002年LST阳性率为34%，2003年为29%，2004年为19%。在63例治愈的黑热病患者中，2002年阳性率为70%，2003年为53%，而2004年仅为30%。在171名同时用两种抗原进行检测的参与者中，与亚马逊利什曼原虫抗原相比，婴儿利什曼原虫研究抗原的敏感性为70%。我们的数据强调需要更好地生产、标准化以及记录利什曼原虫抗原的敏感性、效价和稳定性。
