Am J Trop Med Hyg. 2014 Mar;90(3):535-545. doi: 10.4269/ajtmh.13-0268. Epub 2014 Jan 20.
Sensitive diagnostic tools are crucial for an accurate assessment of helminth infections in low-endemicity areas. We examined stool samples from Tanzanian individuals and compared the diagnostic accuracy of a real-time polymerase chain reaction (PCR) with the FLOTAC technique and the Kato-Katz method for hookworm and the Baermann method for Strongyloides stercoralis detection. Only FLOTAC had a higher sensitivity than the Kato-Katz method for hookworm diagnosis; the sensitivities of PCR and the Kato-Katz method were equal. PCR had a very low sensitivity for S. stercoralis detection. The cycle threshold values of the PCR were negatively correlated with the logarithm of hookworm egg and S. stercoralis larvae counts. The median larvae count was significantly lower in PCR false negatives than true positives. All methods failed to detect very low-intensity infections. New diagnostic approaches are needed for monitoring of progressing helminth control programs, confirmation of elimination, or surveillance of disease recrudescence.
在低流行地区，敏感的诊断工具对于准确评估寄生虫感染至关重要。我们检查了来自坦桑尼亚个体的粪便样本，并比较了实时聚合酶链反应（PCR）与 FLOTAC 技术和加藤厚涂片法检测钩虫以及贝曼氏法检测粪类圆线虫的诊断准确性。只有 FLOTAC 对钩虫诊断的敏感性高于加藤厚涂片法；PCR 和加藤厚涂片法的敏感性相等。PCR 对粪类圆线虫检测的敏感性非常低。PCR 的循环阈值与钩虫卵和粪类圆线虫幼虫计数的对数呈负相关。PCR 假阴性的幼虫计数中位数明显低于真阳性。所有方法均未能检测到低强度感染。需要新的诊断方法来监测进展中的寄生虫控制计划、消除确认或疾病复发监测。
