Chang Sui-Yuan, Sun Hsin-Yun, Ji Dar-Der, Lo Yi-Chun, Wu Cheng-Hsin, Wu Pei-Ying, Liu Wen-Chun, Hung Chien-Ching, Chang Shan-Chwen
Department of Laboratory Medicine, National Taiwan University Hospital, and National Taiwan University College of Medicine, Taipei, Taiwan.
J Clin Microbiol. 2008 Sep;46(9):3077-9. doi: 10.1128/JCM.01151-08. Epub 2008 Jul 2.
Among 345 persons who underwent indirect hemagglutination (IHA) serological assays and assays of specific amebic antigens in their stool samples, 24 of 36 (66.7%) who were seropositive for Entamoeba histolytica had intestinal amebiasis as determined by antigen assays compared with 2 of 309 (0.2%) who were seronegative (odds ratio, 307; 95% confidence interval, 64.9 to 1,451). The estimated cost to detect a case of intestinal amebiasis by serology followed by antigen assays ($52) could be reduced by 74.3% and 69.9%, respectively, compared with the costs of the concurrent use of both assays ($202) and the antigen assays alone ($173). Our finding suggests that IHA assays followed by specific-amebic-antigen assays can be cost-effective in the diagnosis of intestinal amebiasis among persons with or without human immunodeficiency virus infection who are at risk for E. histolytica infection.
在345名接受间接血凝试验（IHA）血清学检测以及粪便样本中特异性阿米巴抗原检测的人员中，通过抗原检测确定，溶组织内阿米巴血清学阳性的36人中有24人（66.7%）患有肠道阿米巴病，而血清学阴性的309人中有2人（0.2%）患病（比值比为307；95%置信区间为64.9至1451）。与同时使用两种检测方法（202美元）和仅使用抗原检测方法（173美元）的成本相比，通过血清学检测随后进行抗原检测来发现一例肠道阿米巴病的估计成本（52美元）可分别降低74.3%和69.9%。我们的研究结果表明，对于有或没有人类免疫缺陷病毒感染且有溶组织内阿米巴感染风险的人，先进行IHA检测再进行特异性阿米巴抗原检测在诊断肠道阿米巴病方面可能具有成本效益。
