School of Life Sciences, University of Nottingham, University Park, Nottingham, NG7 2RD, UK.
Trans R Soc Trop Med Hyg. 2013 Oct;107(10):639-47. doi: 10.1093/trstmh/trt077. Epub 2013 Aug 24.
A sensitive and reliable rapid diagnostic test (RDT) which should have comparable diagnostic performance against reference host serological methods is urgently needed for use in point-of-care (POC) diagnosis of intestinal schistosomiasis in pre school-aged children.
The diagnostic accuracy of a RDT incorporating Schistosoma mansoni cercarial transformation fluid (SmCTF) for anti-schistosome antibody detection was evaluated with serum samples from a cohort of children from Uganda: 42 children aged under the age of 3 years and 40 children aged between 3 and 5 years. The infection status of these children had been previously determined by inspection of quadruplicate Kato-Katz faecal smears, a single urine circulating cathodic antigen (CCA) dipstick and antibody titres to S. mansoni soluble egg antigen (SmSEA) with a commercially available ELISA.
Upon comparison with quadruplicate Kato-Katz the sensitivity and specificity of the RDT were 75.7% and 31.1%, respectively. When using the SmSEA-ELISA as an alternate reference test, the RDT achieved 81.3% sensitivity and 61.1% specificity. Sensitivity and specificity compared to the urine-CCA test was 74.5% and 32.3% respectively. Sensitivity differed significantly according to age group.
The performance of the RDT within this study appeared favourable when compared with the currently-available SmSEA-ELISA. Looking to the future a serological POC test would be particularly promising for use in disease mapping in younger children especially in guiding administration of praziquantel treatment in selective treatment settings.
迫切需要一种灵敏、可靠的快速诊断检测（RDT），该检测应与参考血清学方法具有相当的诊断性能，以便在现场即时诊断学前儿童的肠道血吸虫病。
我们评估了一种含有曼氏血吸虫尾蚴转化液（SmCTF）的 RDT 检测抗血吸虫抗体的诊断准确性，使用了来自乌干达儿童队列的血清样本：42 名年龄在 3 岁以下的儿童和 40 名年龄在 3 至 5 岁的儿童。这些儿童的感染状况先前已通过检查四份加藤氏粪便涂片、单次尿循环阴极抗原（CCA）检测条以及用商业 ELISA 检测到的曼氏血吸虫可溶性卵抗原（SmSEA）抗体滴度来确定。
与四重加藤氏相比，RDT 的灵敏度和特异性分别为 75.7%和 31.1%。当使用 SmSEA-ELISA 作为替代参考检测时，RDT 的灵敏度为 81.3%，特异性为 61.1%。与尿 CCA 检测相比，灵敏度和特异性分别为 74.5%和 32.3%。灵敏度根据年龄组而有显著差异。
与目前可用的 SmSEA-ELISA 相比，该研究中 RDT 的性能似乎良好。展望未来，一种血清学现场即时检测对于在年幼儿童中进行疾病制图特别有希望，特别是在指导在选择性治疗环境中使用吡喹酮治疗。
