Shenoy R K, Rahmah N, Suma T K, Kumaraswami V, Thaslim A X, Gopu R B
Filariasis Chemotherapy Unit, T.D. Medical College Hospital, Alappuzha 688 011, Kerala, India.
J Commun Dis. 2009 Jun;41(2):63-70.
Brugian filariasis prevalent mostly in South-East Asian countries including India contributes to a small but significant proportion of the socioeconomic burden due to lymphatic filariasis. Along with bancroftian filariasis, brugian filariasis has been targeted for elimination globally. The lack of a reliable daytime diagnostic test has been seen as an important barrier to the successful implementation and monitoring of elimination programmes in brugia endemic areas. We evaluated an anti-BmRI-IgG4 antibody test namely, 'Brugia Rapid' in a large study meant to understand the clinical and pathological manifestations of brugian filariasis in children. We found the test superior to traditional night blood screening for microfilaraemia. Although an antibody detection test, we found it to be a reliable indicator of brugian infection. Among the 100 children studied extensively, 94% of the microfilaraemics, 86% of those showing filarial dance sign indicating presence of, live adult worms and 78% having abnormal lymphatics on lymphoscintigraphy were IgG4 positive. Coupled with its advantages like ease of use any time of the day, high sensitivity and specificity, this test may be the ideal tool to assist programme managers in their efforts to eliminate lymphatic filariasis where brugian infections are found.
布鲁氏丝虫病主要流行于包括印度在内的东南亚国家，在淋巴丝虫病造成的社会经济负担中占比虽小但意义重大。与班氏丝虫病一样，布鲁氏丝虫病已被列为全球消除目标。缺乏可靠的日间诊断检测方法被视为布鲁氏丝虫病流行地区成功实施和监测消除计划的一个重要障碍。我们在一项大型研究中评估了一种抗BmRI-IgG4抗体检测方法，即“布鲁氏快速检测法”，旨在了解儿童布鲁氏丝虫病的临床和病理表现。我们发现该检测方法优于传统的夜间血检微丝蚴血症。尽管这是一种抗体检测方法，但我们发现它是布鲁氏丝虫感染的可靠指标。在广泛研究的100名儿童中，94%的微丝蚴血症患儿、86%出现丝虫舞动征（表明存在活成虫）的患儿以及78%淋巴闪烁造影显示淋巴管异常的患儿IgG4呈阳性。再加上其使用方便（可在一天中的任何时间进行）、高灵敏度和高特异性等优点，该检测方法可能是协助项目管理人员在发现布鲁氏丝虫感染地区努力消除淋巴丝虫病的理想工具。
