Department of Emergency Medicine, Eastern Virginia Medical School, Norfolk, VA 23507, USA.
Trop Med Int Health. 2013 Apr;18(4):477-84. doi: 10.1111/tmi.12063. Epub 2013 Jan 20.
To determine whether the detection of human IgG bound to Schistosoma haematobium eggs from filtered urine could be used as a rapid diagnostic test (RDT-Sh).
We filtered 160 urine samples from children in the Kwale District of Kenya to isolate S. haematobium eggs and used anti-human IgG antibody conjugated to horseradish peroxidase to bind to the human IgG attached to the eggs. We then added 3,3'5,5'-tetramethylbenzidine base (TMB), which turns blue in the presence of horseradish peroxidase to detect the S. haematobium eggs. The RDT-Sh was compared in a blinded manner to urine microscopy.
The RDT-Sh was positive in 89% of urine samples containing >1 egg/10 ml (58/65 samples) and 97% of urine samples containing >11 eggs/10 ml urine (35/36 samples) seen by microscopy. The RDT-Sh was negative 79% of the time when no eggs were seen on urine microscopy, but because up to three times more urine was used for the RDT-Sh, there were likely cases in which eggs were on the RDT-Sh filter but not detected by microscopy. We used latent class analysis incorporating urine microscopy, haematuria, proteinuria and RDT-Sh results to determine an overall 97% sensitivity and 78% specificity for RDT-Sh, 96% and 81% for urine microscopy, 71% and 98% for microscopic haematuria and 46% and 89% for proteinuria, respectively.
The RDT-Sh is quick, inexpensive and easy to perform in the field for the diagnosis of S. haematobium.
确定从过滤尿液中检测到与人 IgG 结合的曼氏血吸虫卵能否作为一种快速诊断检测方法（RDT-Sh）。
我们从肯尼亚夸莱区的儿童中过滤了 160 份尿液样本，以分离曼氏血吸虫卵，并使用辣根过氧化物酶结合的抗人 IgG 抗体与附着在卵上的人 IgG 结合。然后，我们添加了 3,3'5,5'-四甲基联苯胺（TMB），在辣根过氧化物酶存在下变为蓝色，以检测曼氏血吸虫卵。RDT-Sh 与尿显微镜检查以盲法进行比较。
RDT-Sh 在显微镜检查可见 >1 个/10ml 尿液（58/65 个样本）的尿液样本中阳性率为 89%，>11 个/10ml 尿液（35/36 个样本）的尿液样本中阳性率为 97%。当显微镜检查未发现卵时，RDT-Sh 阴性率为 79%，但由于 RDT-Sh 使用了多达三倍的尿液，因此可能存在卵在 RDT-Sh 过滤器上但未被显微镜检测到的情况。我们使用包含尿显微镜检查、血尿、蛋白尿和 RDT-Sh 结果的潜在类别分析来确定 RDT-Sh 的总体敏感性为 97%，特异性为 78%，尿显微镜检查为 96%和 81%，显微镜血尿为 71%和 98%，蛋白尿为 46%和 89%。
RDT-Sh 快速、廉价且易于在现场进行，可用于诊断曼氏血吸虫病。
