Foo Karen T, Blackstock Anna J, Ochola Elizabeth A, Matete Daniel O, Mwinzi Pauline N M, Montgomery Susan P, Karanja Diana M S, Secor W Evan
Department of Public Health Sciences, Division of Global Health/IHCAR, Karolinska Institute, Stockholm, Sweden; Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia; Centre for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya.
Department of Public Health Sciences, Division of Global Health/IHCAR, Karolinska Institute, Stockholm, Sweden; Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia; Centre for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya
Am J Trop Med Hyg. 2015 Jun;92(6):1227-32. doi: 10.4269/ajtmh.14-0643. Epub 2015 Apr 13.
We evaluated the performance of a point-of-contact circulating cathodic antigen assay (POC-CCA) to detect schistosome infections in primary school children (N = 1,801) living in areas with low, moderate, and high Schistosoma mansoni prevalence in western Kenya. The commercially available assay (CCA-1) and a second, experimental formulation (CCA-2) were compared against Kato-Katz stool examinations and an anti-schistosome enzyme-linked immunosorbent assay (ELISA). A latent class model based on the four tests was used to establish "true infection status" in three different zones based on their distance from Lake Victoria. As a screening tool for community treatment according to World Health Organization (WHO) guidelines, the Kato-Katz examination was in closest agreement with the latent class model, followed by the experimental CCA-2, soluble adult worm antigen preparation (SWAP) ELISA, and CCA-1, which had high sensitivity compared with the other tests but was consistently the least specific. Our experience suggests that POC-CCA tests offer a field-friendly alternative to Kato-Katz, but need further interpretation for appropriate field use.
我们评估了一种即时循环阴极抗原检测法（POC-CCA）在肯尼亚西部曼氏血吸虫流行程度低、中、高的地区检测小学生（N = 1801）血吸虫感染的性能。将市售检测法（CCA-1）和第二种实验性制剂（CCA-2）与加藤厚涂片粪便检查法和抗血吸虫酶联免疫吸附测定法（ELISA）进行比较。基于这四项检测结果，使用潜在类别模型根据三个不同区域与维多利亚湖的距离来确定“真实感染状态”。作为根据世界卫生组织（WHO）指南进行社区治疗的筛查工具，加藤厚涂片检查法与潜在类别模型的一致性最高，其次是实验性的CCA-2、可溶性成虫抗原制剂（SWAP）ELISA和CCA-1，CCA-1与其他检测方法相比灵敏度较高，但特异性始终最低。我们的经验表明，POC-CCA检测法为加藤厚涂片检查法提供了一种便于现场操作的替代方法，但在现场适当使用时需要进一步解读。
