用于现场检测曼氏血吸虫低感染情况并高精度控制治疗效果的即时检测循环阴极抗原的创新方法，该方法采用快速尿液浓缩技术。

Innovative methodology for point-of-care circulating cathodic antigen with rapid urine concentration for use in the field for detecting low Schistosoma mansoni infection and for control of cure with high accuracy.

作者信息

Grenfell Rafaella F Q, Taboada Diana, Coutinho Lucélia A, Pedrosa Maria Luysa C, Assis Jéssica V, Oliveira Matheus S P, Cruz Renata R, Almeida Aureo, Silva-Moraes Vanessa, Katz Naftale, Coelho Paulo Marcos Z

机构信息

Schistosomiasis Laboratory, Rene Rachou Research Center, Oswaldo Cruz Foundation (Fiocruz), Belo Horizonte, Minas Gerais, 30190-002, Brazil.

Department of Infectious Diseases, College of Veterinary Medicine, University of Georgia, Athens, Georgia 30602-7387, USA.

出版信息

Trans R Soc Trop Med Hyg. 2018 Jan 1;112(1):1-7. doi: 10.1093/trstmh/try014.

DOI:10.1093/trstmh/try014

PMID:29522211

Abstract

BACKGROUND

Prior to eliminating schistosomiasis, efforts must address accurate and fast individual diagnosis. Diagnosis is still inaccurate by parasitological and point-of-care circulating cathodic antigen (POC-CCA) in areas of low endemicity.

METHODS

Our group has optimized POC-CCA with a 30 min urine concentration step with no need for specialized technicians or equipment and with high accuracy. We evaluated this new method, called POC-CCA filter (FLT), in two Brazilian endemic areas with distinct profiles.

RESULTS

At baseline, POC-CCA had a poor performance with several false results and undefined trace readings, revealing a prevalence rate of 10% against a rate of 23% for POC-CCA FLT, which was similar to the parasitological rates. Accuracy increased from as low as 0.36 to 0.96 after urine concentration in one area. POC-CCA properly diagnosed only half of the cases at three post-treatment time points, while POC-CCA FLT was able to diagnose 96, 83 and 100%, respectively.

CONCLUSIONS

The improvement of conventional POC methodology by a fast and simple urine concentration step provided not only an increase in its accuracy before and after praziquantel treatment, but also preserved its applicability in low-prevalence endemic areas, allowing the definition of trace readings as negative cases.

摘要

背景

在消除血吸虫病之前，必须致力于实现准确、快速的个体诊断。在低流行地区，寄生虫学诊断和即时检测循环阴极抗原（POC-CCA）诊断仍然不准确。

方法

我们团队对POC-CCA进行了优化，增加了一个30分钟的尿液浓缩步骤，无需专业技术人员或设备，且准确性高。我们在巴西两个不同特征的流行地区对这种名为POC-CCA过滤器（FLT）的新方法进行了评估。

结果

在基线时，POC-CCA表现不佳，出现了几个错误结果和不确定的微量读数，显示患病率为10%，而POC-CCA FLT的患病率为23%，与寄生虫学诊断率相似。在一个地区，尿液浓缩后准确性从低至0.36提高到了0.96。在三个治疗后时间点，POC-CCA仅正确诊断了一半的病例，而POC-CCA FLT分别能够诊断96%、83%和100%的病例。