Uganda Heart Institute Ltd, Kampala, Uganda.
Children's National Health System, Washington, District of Columbia, USA.
Arch Dis Child. 2020 Sep;105(9):825-829. doi: 10.1136/archdischild-2020-318859. Epub 2020 Jun 29.
Despite substantial variation of streptococcal antibody titres among global populations, there is no data on normal values in sub-Saharan Africa. The objective of this study was to establish normal values for antistreptolysin O (ASO) and antideoxyribonuclease B (ADB) antibodies in Uganda.
This was an observational cross-sectional study.
This study was conducted at Mulago National Referral Hospital, which is located in the capital city, Kampala, and includes the Uganda Heart Institute.
Participants (aged 0-50 years) were recruited. Of 428 participants, 22 were excluded from analysis, and 183 (44.4%) of the remaining were children aged 5-15 years.
ASO was measured in-country by nephelometric technique. ADB samples were sent to Australia (PathWest) for analysis by enzyme inhibition assay: 80% upper limit values were established.
The median ASO titre in this age group was 220 IU/mL, with the 80th percentile value of 389 IU/mL. The median ADB titre in this age group was 375 IU/mL, with the 80th percentile value of 568 IU/mL.
The estimated Ugandan paediatric population standardised 80% upper-limit-of-normal ASO and ADB titres is higher than many global populations. Appropriateness of using population-specific antibody cutoffs is yet to be determined and has important implications for the sensitivity and specificity of rheumatic fever diagnosis.
尽管全球人群的链球菌抗体滴度存在很大差异，但在撒哈拉以南非洲地区尚无关于正常值的数据。本研究旨在确定乌干达人群抗链球菌溶血素 O（ASO）和脱氧核糖核酸酶 B（ADB）抗体的正常值。
这是一项观察性横断面研究。
本研究在位于首都坎帕拉的穆拉戈国家转诊医院进行，该医院包括乌干达心脏研究所。
招募了年龄在 0-50 岁之间的参与者。在 428 名参与者中，有 22 名被排除在分析之外，其余的 183 名（44.4%）是 5-15 岁的儿童。
采用散射比浊法在国内检测 ASO。ADB 样本被送到澳大利亚（PathWest）进行酶抑制分析：确定 80%上限值。
该年龄组的 ASO 中位数为 220IU/mL，第 80 百分位值为 389IU/mL。该年龄组的 ADB 中位数为 375IU/mL，第 80 百分位值为 568IU/mL。
估计乌干达儿科人群的标准化 80%上限正常 ASO 和 ADB 滴度高于许多全球人群。使用人群特异性抗体切点的适当性尚未确定，这对风湿热诊断的敏感性和特异性有重要影响。
