Su Shih-Bin, Guo How-Ran, Chuang Yin-Ching, Chen Kow-Ton, Lin Ching-Yih
Department of Environmental and Occupational Health, Tainan Science-Based Industrial Park Clinic, National Cheng Kung University, Tainan, Taiwan.
Infect Control Hosp Epidemiol. 2007 Jun;28(6):679-83. doi: 10.1086/518351. Epub 2007 Apr 19.
Investigation of a program to eradicate amebiasis using consecutive intensive mass screenings followed by medication in a large institute for adults with mental retardation in Taiwan.
Prospective cohort study, with 3 years of follow-up.
A large, 450-bed institution for adults with mental retardation located in southern Taiwan.
All 443 adults with mental retardation in the institution, who have various motor and/or mental handicaps, were included in this study.
A total of 7 consecutive intensive mass screenings for amebiasis for all residents (performed in March, August and November 2001, March and August 2002, January 2003, and May 2004). Infected patients were treated using the standard protocol of the Center for Disease Control of Taiwan.
Enzyme immunoassay testing was used for the amebiasis screening, with the rapid detection of the specific antigen for Entamoeba histolytica in human fecal specimens confirmed by microscopic examination. The serial prevalence and cumulative incidence were then calculated. The prevalence of amebic infection declined in serial screenings, but new infections and reinfections were detected in 5 of 6 follow-up screenings. The prevalence was 10.8% at the beginning of the program and then gradually reduced, falling to 6.3%, 3.6%, 2.7%, 3.4%, and 2.2%. Finally, no more positive cases were identified in the last screening (May 2004). The cumulative incidence rate stabilized at around 40% by the fifth screening. Of the 179 infected patients, 120 had primary infections, with 59 cases of multiple amebic infections.
Active surveillance with intensive mass screening is an effective method of identifying asymptomatic and latent cases of amebiasis in areas where it is endemic, such as an institution for adults with mental retardation.
在台湾一所大型成人智障机构中，调查一项通过连续强化大规模筛查并随后进行药物治疗来根除阿米巴病的项目。
前瞻性队列研究，随访3年。
位于台湾南部的一家拥有450张床位的大型成人智障机构。
该机构中所有443名患有各种运动和/或智力障碍的成人智障者均纳入本研究。
对所有居民连续进行7次强化大规模阿米巴病筛查（分别在2001年3月、8月和11月，2002年3月和8月，2003年1月以及2004年5月进行）。对感染患者采用台湾疾病控制中心的标准方案进行治疗。
采用酶免疫测定法进行阿米巴病筛查，通过显微镜检查确认在人类粪便标本中快速检测到溶组织内阿米巴的特异性抗原。然后计算系列患病率和累积发病率。在系列筛查中，阿米巴感染的患病率下降，但在6次随访筛查中的5次中检测到新感染和再感染情况。项目开始时患病率为10.8%，随后逐渐降低，降至6.3%、3.6%、2.7%、3.4%和2.2%。最后，在最后一次筛查（2004年5月）中未再发现阳性病例。到第五次筛查时，累积发病率稳定在40%左右。在179例感染患者中，120例为初次感染，59例为多重阿米巴感染。
在阿米巴病流行地区，如成人智障机构，通过强化大规模筛查进行主动监测是识别无症状和潜伏性阿米巴病病例的有效方法。
