Martínez-García M C, Muñoz O, Garduño-Rodríguez G, Sánchez-Pares M E, Valadez-Salazar A, Palacios-Beristain O, Calderón-Segura M, Isibasi-Araujo A, Gutiérrez G
Unidad de Investigación Clínica en Enfermedades Infeccionas y Parasitarias, I.M.S.S. México, D.F.
Arch Invest Med (Mex). 1990;21 Suppl 1:147-52.
a) to describe the frequency of pathogenic and nonpathogenic zymodemes of E. histolytica in asymptomatic carriers in rural Mexico, b) to identify the isoenzymatic pattern of the zymodemes and c) to measure the concordance of pathogenic zymodemes and positive serology.
Descriptive cross-sectional survey. Reference population: rural communities of the mexican highlands.
2048 individuals from 341 families of 5 rural communities.
From the local census of each community, 70 to 100 families were selected by random sampling. All members of each family were studied. After obtaining the consent the following activities were done: a) filling of a questionnaire about housing and sanitary condition and structure of the family; age, sex, literacy and digestive symptoms and illness during the previous 4 weeks, in each individual; b) a blood sample for serology (CEIP and IHA) and c) a stool sample for coproparasitoscopic analysis (CPS) and zymodemes identification, in each individual. Statistical evaluation was done by kappa index and receiving operating curves (ROC).
there were 122/1730 (7.1%) CPS studies positive to E histolytica cysts, 100/1730 (5.8%) zymodemes isolated and 137/1886 (7.3%) positive serologic studies. Of the 100 zymodemes 30 had a pathogenic pattern, three had a mixture (pathogenic/nonpathogenic) and 67 had a non-pathogenic patterns. There were two (XVII, XVIII) patterns described for the first time in Mexico. Concordance between pathogenic zymodemes and positive serology (IHA greater than 1:128) was very low, Kappa = 0.05. ROC curves for IHA in pathogenic and non-pathogenic zymodemes showed little relationship between positive serology and pathogenic pattern.
Although the frequency of positive serology, coproparasitoscopic studies and zymodemes identification was similar, the concordance between serology and the coprologic studies was very low. This disagrees with other reports, and deserves further investigation using methodologic standards in design.
a) 描述墨西哥农村无症状携带者中溶组织内阿米巴致病和非致病酶型的频率，b) 鉴定酶型的同工酶模式，c) 测量致病酶型与血清学阳性的一致性。
描述性横断面调查。参考人群：墨西哥高地的农村社区。
来自5个农村社区341个家庭的2048名个体。
从每个社区的当地人口普查中，通过随机抽样选择70至100个家庭。对每个家庭的所有成员进行研究。在获得同意后，进行了以下活动：a) 填写一份关于住房、卫生条件和家庭结构的问卷；询问每个个体的年龄、性别、识字情况以及前4周的消化症状和疾病；b) 采集一份血液样本进行血清学检测（CEIP和IHA）；c) 采集一份粪便样本进行粪便寄生虫镜检分析（CPS）和酶型鉴定。通过kappa指数和接受操作曲线（ROC）进行统计评估。
1730份粪便寄生虫镜检研究中有122份（7.1%）对溶组织内阿米巴囊肿呈阳性，分离出100份（5.8%）酶型，1886份血清学研究中有137份（7.3%）呈阳性。在100份酶型中，30份具有致病模式，3份具有混合模式（致病/非致病），67份具有非致病模式。有两种（XVII、XVIII）模式是在墨西哥首次描述。致病酶型与血清学阳性（IHA大于1:128）之间的一致性非常低，Kappa = 0.05。致病和非致病酶型中IHA的ROC曲线显示血清学阳性与致病模式之间关系不大。
虽然血清学阳性、粪便寄生虫镜检研究和酶型鉴定的频率相似，但血清学与粪便学研究之间的一致性非常低。这与其他报告不一致，值得在设计中采用方法学标准进行进一步调查。
