Kerleguer A, Massard S, Janus G, Joussemet M
Centre de Transfusion Sanguine des Armées, 1, rue du Lieutenant-Raoul-Batany, 92141, Clamart, France.
Pathol Biol (Paris). 2007 Dec;55(10):534-8. doi: 10.1016/j.patbio.2007.06.008. Epub 2007 Oct 29.
Chagas disease is a major public health problem in Latin and Central America, 15 to 20 million people are affected and some 100 million is at risk of acquiring Chagas disease. Chagas disease starts to appear in amazonian area and french Guyana. Three kits: Elisa Novagnost (Dade Behring), BioElisa Chagas (Orgentec) et Elisa Cruzi (BioMérieux) were compared using performance panel. Sensibility, reproductibility and specificity (using 40 serum of blood donors who never went to an endemic area) were evaluated. Orgentec assay (recombinant antigens) and BioMérieux assay (whole-epimastigote antigens) performed better than Dade Behring assay. The latter was discarded from the study at this stage. Lack of sensibility seems due to the antigenic composition. Reproductibility and specificity are good for the other two tests. Mixtures of recombinants antigens increased specificity, but sensibility is better using mixtures of whole-epimastigote antigens. For routine blood donor screening both tests must be performed. A prevalence study was done during 11 months on 1570 serum of military blood donors. Despite of a low prevalence (less than 0.7 per thousand), the entire donation from donors who were in the endemic area (7.95% from our whole population) are screened for antibody against Trypanosoma cruzi, with these two assays.
恰加斯病是拉丁美洲和中美洲的一个主要公共卫生问题,1500万至2000万人受到影响,约1亿人有感染恰加斯病的风险。恰加斯病开始在亚马逊地区和法属圭亚那出现。使用性能评估板对三种试剂盒进行了比较:诺瓦诺斯特酶联免疫吸附测定试剂盒(达德拜林公司)、恰加斯生物酶联免疫吸附测定试剂盒(奥根泰克公司)和克鲁齐酶联免疫吸附测定试剂盒(生物梅里埃公司)。评估了敏感性、重复性和特异性(使用40份从未去过流行地区的献血者血清)。奥根泰克检测法(重组抗原)和生物梅里埃检测法(全前鞭毛体抗原)的表现优于达德拜林检测法。在这个阶段,后者被排除在研究之外。敏感性不足似乎是由于抗原组成。另外两种检测方法的重复性和特异性良好。重组抗原混合物提高了特异性,但使用全前鞭毛体抗原混合物时敏感性更好。对于常规献血者筛查,两种检测都必须进行。对1570份军队献血者血清进行了为期11个月的患病率研究。尽管患病率较低(低于千分之0.7),但对来自流行地区的献血者的全部献血(占我们总人口的7.95%)都使用这两种检测方法筛查了抗克鲁斯锥虫抗体。