Siqueira Liliane Maria Vidal, Gomes Luciana Inácia, Oliveira Edward, Oliveira Eduardo Ribeiro de, Oliveira Áureo Almeida de, Enk Martin Johannes, Carneiro Nídia Figueiredo, Rabello Ana, Coelho Paulo Marcos Zech
Laboratório de Esquistossomose, Fiocruz, Belo Horizonte, MG, Brasil.
Laboratório de Pesquisas Clínicas, Centro de Pesquisas René Rachou, Fiocruz, Belo Horizonte, MG, Brasil.
Mem Inst Oswaldo Cruz. 2015 Apr;110(2):209-14. doi: 10.1590/0074-02760140375.
This study evaluated parasitological and molecular techniques for the diagnosis and assessment of cure of schistosomiasis mansoni. A population-based study was performed in 201 inhabitants from a low transmission locality named Pedra Preta, municipality of Montes Claros, state of Minas Gerais, Brazil. Four stool samples were analysed using two techniques, the Kato-Katz® (KK) technique (18 slides) and the TF-Test®, to establish the infection rate. The positivity rate of 18 KK slides of four stool samples was 28.9% (58/201) and the combined parasitological techniques (KK+TF-Test®) produced a 35.8% positivity rate (72/201). Furthermore, a polymerase chain reaction (PCR)-ELISA assay produced a positivity rate of 23.4% (47/201) using the first sample. All 72 patients with positive parasitological exams were treated with a single dose of Praziquantel® and these patients were followed-up 30, 90 and 180 days after treatment to establish the cure rate. Cure rates obtained by the analysis of 12 KK slides were 100%, 100% and 98.4% at 30, 90 and 180 days after treatment, respectively. PCR-ELISA revealed cure rates of 98.5%, 95.5% and 96.5%, respectively. The diagnostic and assessment of cure for schistosomiasis may require an increased number of KK slides or a test with higher sensitivity, such as PCR-ELISA, in situations of very low parasite load, such as after therapeutic interventions.
本研究评估了用于曼氏血吸虫病诊断和治愈评估的寄生虫学及分子技术。在巴西米纳斯吉拉斯州蒙特斯克拉罗斯市一个名为佩德拉普雷塔的低传播地区的201名居民中开展了一项基于人群的研究。使用两种技术对四份粪便样本进行分析，即加藤厚涂片法（KK法，18张涂片）和TF检测法，以确定感染率。四份粪便样本的18张KK涂片阳性率为28.9%（58/201），联合寄生虫学技术（KK + TF检测法）的阳性率为35.8%（72/201）。此外，聚合酶链反应（PCR）-酶联免疫吸附测定法对首个样本检测的阳性率为23.4%（47/201）。所有72名寄生虫学检查呈阳性的患者均接受了单剂量吡喹酮治疗，并在治疗后30、90和180天对这些患者进行随访以确定治愈率。通过分析12张KK涂片得出的治愈率在治疗后30、90和180天分别为100%、100%和98.4%。PCR-酶联免疫吸附测定法显示的治愈率分别为98.5%、95.5%和96.5%。在寄生虫负荷非常低的情况下，如治疗干预后，曼氏血吸虫病的诊断和治愈评估可能需要增加KK涂片数量或采用更高灵敏度的检测方法，如PCR-酶联免疫吸附测定法。
