National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, WHO Collaborating Centre for Tropical Diseases, National Center for International Research on Tropical Diseases, Ministry of Science and Technology, Key Laboratory of Parasite and Vector Biology, Ministry of Health, Shanghai, China.
Bob Champion Research & Education Building, Norwich Medical School, University of East Anglia, Norwich, UK.
Parasit Vectors. 2018 May 23;11(1):311. doi: 10.1186/s13071-018-2896-3.
The larval stages of the tapeworms Echinocoocus granulosus and Echinococcus multilocularis are the causative agents of human cystic echinococcosis (CE) and human alveolar echinococcosis (AE), respectively. Both CE and AE are chronic diseases characterised by long asymptomatic periods of many years. However, early diagnosis of the disease is important if treatment and management of echinococcosis patients are to be successful.
A previously developed rapid diagnostic test (RDT) for the differential detection of CE and AE was evaluated under field conditions with finger prick blood samples taken from 1502 people living in the Ganzi Tibetan Autonomous Prefecture, China, a region with a high prevalence for both forms of human echinococcosis. The results were compared with simultaneously obtained abdominal ultrasonographic scans of the individuals.
Using the ultrasonography as the gold standard, sensitivity and specificity, and the diagnostic accuracy of the RDT were determined to be greater than 94% for both CE and AE. For CE cases, high detection rates (95.6-98.8%) were found with patients having active cysts while lower detection rates (40.0-68.8%) were obtained with patients having transient or inactive cysts. In contrast, detection rates in AE patients were independent of the lesion type. The positive likelihood ratio of the RDT for CE and AE was greater than 20 and thus fairly high, indicating that a patient with a positive test result has a high probability of having echinococcosis.
The results suggest that our previously developed RDT is suitable as a screening tool for the early detection of human echinococcosis in endemic areas.
带绦虫的幼虫阶段，细粒棘球绦虫和多房棘球绦虫，分别是人类包虫病（CE）和人类泡型包虫病（AE）的病原体。CE 和 AE 都是慢性疾病，其特征是多年无症状的潜伏期很长。然而，如果要成功治疗和管理包虫病患者，早期诊断疾病非常重要。
我们评估了一种先前开发的用于 CE 和 AE 鉴别检测的快速诊断检测（RDT），该检测是在现场条件下使用从中国甘孜藏族自治州的 1502 人指尖采血样本进行的，该地区两种形式的人类包虫病流行率都很高。将结果与同时获得的个体腹部超声扫描进行了比较。
使用超声检查作为金标准，RDT 的敏感性、特异性和诊断准确性对于 CE 和 AE 均大于 94%。对于 CE 病例，在具有活性囊肿的患者中发现了高检测率（95.6-98.8%），而在具有短暂或非活性囊肿的患者中检测率较低（40.0-68.8%）。相比之下，AE 患者的检测率与病变类型无关。RDT 对 CE 和 AE 的阳性似然比大于 20，因此相当高，这表明检测结果阳性的患者患有包虫病的可能性很高。
结果表明，我们之前开发的 RDT 适合作为在流行地区早期发现人类包虫病的筛查工具。
