Zhang Xia, Cui Cai-Xia, Zhang Wei-Rong, Wen Xiao-Hong, Ma Nian, Zou Ping, Tu Zu-Wu, Hu He-Hua, Liu Xiong, Cao Chun-Li, Xu Jing
Zhongguo Xue Xi Chong Bing Fang Zhi Za Zhi. 2014 Dec;26(6):618-21.
To evaluate the efficacy of routinely used pattern for schistosomiasis diagnosis in lake and marshland regions.
A historically heavy endemic village of schistosomiasis named Jinggan Village from Jiangling County was selected for field survey. The residents aged 6-65 years were screened by indirect hemagglutination assay (IHA) and dipstick dye immunoassay (DDIA) in parallel. The serological positives were examined by Kato-Katz technique and miracidium hatching technique to determine the infection of schistosome. The consistency of the two serological methods was evaluated. In addition, the schistosome infection rates were estimated accordingto the 3 detection patterns namely IHA, DDIA, IHA+DDIA combined with the etiologic examination.
A total of 530 individuals were examined by the serological tests. The positive rate of DDIA was 46.98% (249/530), significantly higher than that of IHA (28.49%, 151/530) (χ2 = 59.55, P < 0.01). Totally 279 individuals were serological positives determined by IHA or DDIA, while 252 of them were detected by stool examination, and 22 cases were determined as parasitological positives, while 7 and 3 cases were diagnosed as antibody negatives by IHA and DDIA, respectively. The estimated infection rates determined by IHA, DDIA, IHA plus DDIA combined with stool examination were 3.14%, 3.97%, 4.60%, respectively.
Under the condition of endemic situation becoming more and more waning, the current routinely used pattern for schistosomiasis detection may lead to missed diagnosis. So, more sensitive and effective diagnostic tools or appropriate detection patterns need to be explored.
评估湖区和沼泽地区常规使用的血吸虫病诊断模式的效果。
选择江陵县一个历史上血吸虫病重流行村——荆干村进行现场调查。对6至65岁居民同时采用间接血凝试验（IHA）和试纸条染料免疫分析法（DDIA）进行筛查。对血清学阳性者采用加藤厚涂片法和毛蚴孵化法检查以确定血吸虫感染情况。评估两种血清学方法的一致性。此外，根据IHA、DDIA、IHA + DDIA三种检测模式结合病原学检查估计血吸虫感染率。
共530人接受血清学检测。DDIA阳性率为46.98%（249/530），显著高于IHA（28.49%，151/530）（χ2 = 59.55，P < 0.01）。IHA或DDIA检测出279例血清学阳性者，其中252例经粪便检查发现，22例被确定为寄生虫学阳性，IHA和DDIA分别有7例和3例被诊断为抗体阴性。IHA、DDIA、IHA加DDIA结合粪便检查确定的估计感染率分别为3.14%、3.97%、4.60%。
在疫情日益消退的情况下，目前常规使用的血吸虫病检测模式可能导致漏诊。因此，需要探索更敏感有效的诊断工具或合适的检测模式。
