Zhu Hong-Qing, Xu Jing, Zhu Rong, Cao Chun-Li, Bao Zi-Ping, Yu Qing, Zhang Li-Juan, Xu Xiao-Lin, Feng Zheng, Guo Jia-Gang
Southeast Asian J Trop Med Public Health. 2014 Jan;45(1):20-5.
The diagnosis of Schistosoma japonicum (Sj) infection in low prevalence areas of the People's Republic of China is challenging due to the sensitivity of the detection methods, leading to an underestimation of the disease burden. We compared the sensitivities of the miracidium hatching test (MHT) with the modified Kato-Katz method (KK) and the combination of the two methods (KK-MHT) to detect Sj infection in low prevalence areas of China. The stool samples of 3,853 residents from 8 villages with a light to moderate prevalence (0-23%) of Sj infection were examined by KK, MHT and KK-MHT. The findings were inconsistent. The KK-MHT conbination gave more positives than either the KK or MHT alone. Using the KK-MHT, we determined the missed rates with the KK (mR(K)) and MHT (mR(H)) to be 30.1% and 10.2%, respectively. At light prevalence sites (infection rate < 10%) the mR(K) was 60.6%, significantly higher than the mR(K) of 22.3% found at moderate prevalence sites (10-23%). However, the mR(H) at the light and moderate prevalence sites were 11.54% and 9.90%, respectively (p > 0.05). The combination KK-MHT had the best sensitivity in low Sj prevalence areas in China and the KK method alone was the least sensitive. Using KK alone as a screening method will result in an underestimation of Sj infection disease burden.
在中国血吸虫病低流行地区，由于检测方法的敏感性问题，日本血吸虫（Sj）感染的诊断颇具挑战，这导致了对疾病负担的低估。我们比较了毛蚴孵化试验（MHT）、改良加藤厚涂片法（KK）以及两种方法联合使用（KK-MHT）在中国低流行地区检测Sj感染的敏感性。对来自8个村庄、Sj感染率为轻度至中度（0-23%）的3853名居民的粪便样本进行了KK法、MHT法和KK-MHT法检测。结果并不一致。KK-MHT联合检测法得出的阳性结果比单独使用KK法或MHT法更多。使用KK-MHT法，我们确定单独使用KK法（mR(K)）和MHT法（mR(H)）的漏检率分别为30.1%和10.2%。在低流行地区（感染率<10%），mR(K)为60.6%，显著高于中度流行地区（10-23%）的22.3%。然而，低流行地区和中度流行地区的mR(H)分别为11.54%和9.90%（p>0.05）。在中国Sj低流行地区，KK-MHT联合检测法的敏感性最高，单独使用KK法的敏感性最低。仅将KK法作为筛查方法会导致对Sj感染疾病负担的低估。
