Andrews J A, Bligh W J, Chiodini P L, Bradley J E, Nde P N, Lucius R
Department of Clinical Parasitology, The Hospital for Tropical Diseases, Mortimer Market, London WC1E 6AU, UK.
J Clin Pathol. 2008 Mar;61(3):347-51. doi: 10.1136/jcp.2006.037093. Epub 2007 Oct 8.
Onchocerca volvulus infection is traditionally diagnosed by examination of skin snips for the presence of microfilariae. A disadvantage of this method is the low sensitivity particularly with light or prepatent infection. Serodiagnosis using recombinant-antigen-based assays may provide a more sensitive diagnostic test. An ELISA based on a recombinant antigen OvH3 has previously been validated using sera from endemic areas. This study investigated the role of this ELISA-based assay for use in the serodiagnosis of onchocerciasis in non-endemic areas.
The ELISA-based assay was tested on sera from untreated patients with known onchocerciasis and on untreated and treated patients with definite or probable onchocerciasis identified from a hospital diagnostic database. The assay was also tested on sera from patients with other helminthic infections to determine the sensitivity and specificity of this assay in a tertiary referral laboratory dealing with sera from a variety of patients.
The sensitivity and specificity of the OvH3 assay were 93.2% and 93.5%, respectively, when tested on non-endemic patients with clinical diagnosis of onchocerciasis.
This study demonstrates the potential role of the assay as a sensitive and specific test for use in the serodiagnosis of onchocerciasis in a reference laboratory dealing with sera from patients in non-endemic setting.
盘尾丝虫感染传统上通过检查皮肤切片中微丝蚴的存在来诊断。该方法的一个缺点是敏感性低,尤其是对于轻度或感染前期的情况。使用基于重组抗原的检测方法进行血清学诊断可能会提供一种更敏感的诊断测试。一种基于重组抗原OvH3的酶联免疫吸附测定(ELISA)先前已使用来自流行地区的血清进行了验证。本研究调查了这种基于ELISA的检测方法在非流行地区盘尾丝虫病血清学诊断中的作用。
对来自已知患有盘尾丝虫病的未治疗患者的血清,以及从医院诊断数据库中识别出的患有确诊或疑似盘尾丝虫病的未治疗和已治疗患者的血清进行基于ELISA的检测。还对患有其他蠕虫感染的患者的血清进行检测,以确定该检测方法在处理来自各种患者血清的三级转诊实验室中的敏感性和特异性。
当对临床诊断为盘尾丝虫病的非流行地区患者进行检测时,OvH3检测方法的敏感性和特异性分别为93.2%和93.5%。
本研究证明了该检测方法在处理非流行地区患者血清的参考实验室中作为盘尾丝虫病血清学诊断的敏感和特异性检测方法的潜在作用。