Szumlewicz A P, Muller C A
Instituto Oswaldo Cruz, Departamento de Entomologia, Laboratório de Vetores da Doença de Chagas, Rio de Janeiro, Brasil.
Mem Inst Oswaldo Cruz. 1987 Apr-Jun;82(2):259-72. doi: 10.1590/s0074-02761987000200014.
In order to upgrade the reliability of xenodiagnosis, attention has been directed towards population dynamics of the parasite, with particular interest for the following factors: 1. Parasite density which by itself is not a research objective, but by giving an accurate portrayal of parasite development and multiplication, has been incorporated in screening of bugs for xenodiagnosis. 2. On the assumption that food availability might increase parasite density, bugs from xenodiagnosis have been refed at biweekly intervals on chicken blood. 3. Infectivity rates and positives harbouring large parasite yields were based on gut infections, in which the parasite population comprised of all developmental forms was more abundant and easier to detect than in fecal infections, thus minimizing the probability of recording false negatives. 4. Since parasite density, low in the first 15 days of infection, increases rapidly in the following 30 days, the interval of 45 days has been adopted for routine examination of bugs from xenodiagnosis. By following the enumerated measures, all aiming to reduce false negative cases, we are getting closer to a reliable xenodiagnostic procedure. Upgrading the efficacy of xenodiagnosis is also dependent on the xenodiagnostic agent. Of 9 investigated vector species, Panstrongylus megistus deserves top priority as a xenodiagnostic agent. Its extraordinary capability to support fast development and vigorous multiplication of the few parasites, ingested from the host with chronic Chagas' disease, has been revealed by the strikingly close infectivity rates of 91.2% vs. 96.4% among bugs engorged from the same host in the chronic and acute phase of the disease respectively (Table V), the latter comporting an estimated number of 12.3 x 10(3) parasites in the circulation at the time of xenodiagnosis, as reported previously by the authors (1982).
为了提高异种诊断的可靠性,人们已将注意力转向寄生虫的种群动态,尤其关注以下因素:1. 寄生虫密度本身并非研究目标,但它能准确描述寄生虫的发育和繁殖情况,已被纳入用于异种诊断的臭虫筛选过程中。2. 基于食物供应可能会增加寄生虫密度这一假设,每隔两周就用鸡血对用于异种诊断的臭虫进行再次喂食。3. 感染率和携带大量寄生虫的阳性样本是基于肠道感染得出的,在肠道感染中,由各种发育形态组成的寄生虫种群比粪便感染中的更为丰富且更容易检测到,从而将记录假阴性的可能性降至最低。4. 由于感染后前15天寄生虫密度较低,而在接下来的30天内会迅速增加,因此采用45天的间隔对用于异种诊断的臭虫进行常规检查。通过遵循上述所有旨在减少假阴性病例的措施,我们正朝着可靠的异种诊断程序迈进。提高异种诊断的效果还取决于异种诊断媒介。在9种被研究的媒介物种中,巨头潘氏锥蝽作为异种诊断媒介应被列为首要选择。从患有慢性恰加斯病的宿主摄取的少量寄生虫,在这种媒介中能快速发育并大量繁殖,其非凡能力已通过以下数据得以体现:在疾病慢性期和急性期分别从同一宿主饱血的臭虫中,感染率惊人地接近,分别为91.2%和96.4%(表五),如作者之前(1982年)所报道,后者在异种诊断时循环系统中估计有1.23×10³个寄生虫。