Samad Mohammad Sohel, Itoh Makoto, Moji Kazuhiko, Hossain Moazzem, Mondal Dinesh, Alam Mohammad Shafiul, Kimura Eisaku
Department of Infection and Immunology, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, Aichi 480-1195, Japan.
Parasitol Int. 2013 Dec;62(6):564-7. doi: 10.1016/j.parint.2013.08.007. Epub 2013 Aug 27.
In Sri Lanka, urine ELISA showed high sensitivity and specificity in detecting filaria-specific IgG4. It also produced much higher positive rates than antigen tests in prevalence studies with young children. In this study, we have confirmed the usefulness of urine ELISA in the field of Bangladesh. The ELISA detected 89 of 105 (85%) ICT antigen test positive subjects in endemic areas. With both ICT and microfilaria positives, the sensitivity was 97% (30/31). All of 104 ICT negative people in a non-endemic area were ELISA negative (100% specificity). In a prevalence study with 319 young children (5-10 years) from a low endemic area after five rounds of MDA, seven (2.2%) were detected by the present urine test, but only one (0.3%) by ICT (P=0.075). The satisfactorily high sensitivity, 100% specificity and effective case detection among young ages along with scope for analyzing the titers will indicate urine ELISA to be an effective tool in the post-MDA surveys to confirm elimination or to detect resurgence in Bangladesh.
在斯里兰卡，尿液酶联免疫吸附测定（ELISA）在检测丝虫特异性IgG4方面显示出高灵敏度和特异性。在针对幼儿的患病率研究中，其阳性率也远高于抗原检测。在本研究中，我们证实了尿液ELISA在孟加拉国领域的实用性。ELISA在流行地区检测出105名免疫层析试验（ICT）抗原检测呈阳性的受试者中的89名（85%）。对于ICT和微丝蚴均呈阳性的情况，灵敏度为97%（30/31）。在一个非流行地区的104名ICT检测呈阴性的人中，ELISA检测均为阴性（特异性为100%）。在对来自低流行地区的319名5至10岁幼儿进行五轮大规模药物治疗（MDA）后的患病率研究中，通过当前尿液检测发现7名（2.2%）呈阳性，但通过ICT仅检测出1名（0.3%）呈阳性（P = 0.075）。令人满意的高灵敏度、100%的特异性以及在幼儿中有效检测病例的能力，再加上分析滴度的可能性，表明尿液ELISA将成为孟加拉国MDA后调查中确认消除或检测疫情复发的有效工具。
