Ghieth Marwa A, Kotb Magd A, Abu-Sarea Enas Y, El-Badry Ayman A
Department of Medical Parasitology, Faculty of Medicine, Beni Suef University, Beni Suef, Egypt.
Department of Pediatrics, Kasr Al-Ainy Faculty of Medicine, Cairo University, Giza, Egypt.
J Parasit Dis. 2016 Dec;40(4):1470-1474. doi: 10.1007/s12639-015-0714-9. Epub 2015 Sep 18.
Giardiasis is a prevailing intestinal disease in children. This study aimed to determine molecular prevalence of Giardia intestinalis in children attending Cairo University Pediatrics Hospitals, using copro-PCR assays, conventional methods and to evaluate diagnostic effectiveness of used tests. 229 fecal samples were collected from children suffering from gastrointestinal symptoms and examined for Giardia by microscopy, Immuno-chromatographic test (ICT), copro-DNA using two PCR assays targeting tpi [nested-PCR (nPCR)] and 18S [conventional-PCR (cPCR)] genes. Out of 229 samples assessed, Giardia was diagnosed in 13.9, 17, 17.9, 4.8 % of cases using microscopy, ICT, nPCR (tpi) and cPCR (18S), respectively. Nominating both PCR assays as composite reference standard, microscopy and ICT were of reliable specificity (100 and 96.9 %) and accuracy (95.6 and 93.6 %) but of limited sensitivity (78.6 and 76.2 %). Kappa agreement showed, there was substantial agreement of ICT (0.776) and almost perfect agreement of microscopy (0.839) with PCR assays. showed a molecular prevalence of 18.3 % (42/229). ICT assay for surpassed microscopy but both couldn't be used as a consistent single detection method due to their lowered sensitivities. nPCR targeting tpi is a reliable diagnostic test aiding to determine true prevalence of Giardia.
贾第虫病是儿童中一种常见的肠道疾病。本研究旨在通过粪便聚合酶链反应(copro-PCR)检测、传统方法,确定开罗大学儿科院就诊儿童中肠贾第虫的分子流行率,并评估所用检测方法的诊断效力。从有胃肠道症状的儿童中收集了229份粪便样本,通过显微镜检查、免疫层析试验(ICT)、针对tpi基因的两种聚合酶链反应检测方法(巢式聚合酶链反应(nPCR))和18S基因(常规聚合酶链反应(cPCR))的粪便DNA检测,对贾第虫进行检测。在评估的229份样本中,使用显微镜检查、ICT、nPCR(tpi)和cPCR(18S)分别诊断出贾第虫的病例占13.9%、17%、17.9%和4.8%。将两种聚合酶链反应检测方法作为复合参考标准,显微镜检查和ICT具有可靠的特异性(分别为100%和96.9%)和准确性(分别为95.6%和93.6%),但敏感性有限(分别为78.6%和76.2%)。kappa一致性分析显示,ICT与聚合酶链反应检测方法有高度一致性(0.776),显微镜检查与聚合酶链反应检测方法几乎完全一致(0.839)。分子流行率为18.3%(42/229)。ICT检测优于显微镜检查,但由于二者敏感性较低,均不能作为一致的单一检测方法。针对tpi基因的nPCR是一种可靠的诊断检测方法,有助于确定贾第虫的真实流行率。