Department of Parasitology and Excellence in Medical Innovation, and Technology Research Group, Faculty of Medicine and Research and Diagnostic Center for Emerging Infectious Diseases, Mekong Health Science Research Institute, Khon Kaen University, Khon Kaen, Thailand.
Department of Parasitology, National Institute of Infectious Diseases, Ministry of Health, Labour and Welfare, Tokyo, Japan.
Acta Trop. 2020 Mar;203:105325. doi: 10.1016/j.actatropica.2019.105325. Epub 2019 Dec 28.
Paragonimiasis, an important food-borne zoonosis, is caused by lung flukes of the genus Paragonimus. Several million people are actually infected or at risk. Paragonimiasis is a re-emerging disease in developing countries. Diagnosis of pulmonary paragonimiasis is made by finding eggs in sputa and/or fecal samples. Eggs are typically not found in ectopic paragonimiasis cases, so diagnosis depends on supportive information, such as a history of eating fresh water crabs or crayfishes, radiographic findings and immunological tests. Here, a new point-of-care-testing (POCT) tool is presented. It uses immunochromatography for serodiagnosis of human paragonimiasis using excretory-secretory antigen from Paragonimus heterotremus. It proved effective in diagnosing infections due to P. heterotremus, and was also successfully diagnosed with sera from infections with P. westermani and P. miyazakii. The diagnostic sensitivity, specificity, positive and negative predictive values and accuracy were 97.9%, 87.6%, 78%, 98.9%, and 90.8%, respectively. The developed POCT tool is rapid and simple to use not only for clinical diagnosis of paragonimiasis at the bedside or at well-equipped laboratories, but also at local and remote hospitals with limited facilities. Moreover, the POCT tool could be applied for epidemiological surveys of paragonimaisis in Asia where P. heterotremus, P. westermani and P. miyazakii are endemic.
并殖吸虫病是一种重要的食源性人兽共患寄生虫病，由并殖科并殖属的肺吸虫引起。实际上有数百万人受到感染或面临感染风险。在发展中国家，肺吸虫病是一种重新出现的疾病。肺并殖吸虫病的诊断是通过在痰液和/或粪便样本中发现虫卵来进行的。异位并殖吸虫病病例通常不会发现虫卵，因此诊断取决于支持性信息，例如食用淡水蟹或小龙虾的病史、影像学发现和免疫学测试。在这里，提出了一种新的即时检测（POCT）工具。它使用免疫层析法，使用来自 Paragonimus heterotremus 的排泄分泌抗原进行人并殖吸虫病的血清学诊断。它被证明对诊断 P. heterotremus 感染有效，并且还成功地诊断了 P. westermani 和 P. miyazakii 感染的血清。诊断的敏感性、特异性、阳性预测值、阴性预测值和准确性分别为 97.9%、87.6%、78%、98.9%和 90.8%。开发的 POCT 工具快速且易于使用，不仅可用于床边或设备齐全的实验室进行临床诊断，还可用于设施有限的当地和偏远医院进行诊断。此外，该 POCT 工具可用于亚洲流行 P. heterotremus、P. westermani 和 P. miyazakii 的并殖吸虫病的流行病学调查。
