Biomedical Science Program, Graduate School, Khon Kaen University, Khon Kaen, Thailand.
Department of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.
Acta Trop. 2021 Jun;218:105896. doi: 10.1016/j.actatropica.2021.105896. Epub 2021 Mar 20.
Recent work has found urine analysis to be as sensitive as serology for diagnosis of strongyloidiasis. Here, we examined the daily variation of Strongyloides-specific IgG in urine by qualitative and quantitative ELISA and its effects on diagnostic accuracy and reliability. In the first part of the study, matched urine and fecal samples were collected from project participants in northeast Thailand for three consecutive days. Urine samples were analyzed for Strongyloides-specific IgG by ELISA using Strongyloides ratti as the antigen source. Performance of urine ELISA was compared with parasitological diagnosis by agar plate culture technique (APCT) and formalin-ethyl acetate concentration technique (FECT). In the second part of the study, urine IgG levels were compared daily for thirty consecutive days. The prevalence of Strongyloides infection, as measured by urine ELISA for three consecutive days, was significantly higher than that found using parasitological methods (63.1% vs. 22%). There was slight daily variation in prevalence estimates according to urine ELISA while there were significant variations according to parasitological examination methods over three consecutive days. For the 3-day experiment, urine ELISA had 83-86% diagnostic sensitivity when compared with the fecal examination method or with a composite standard (combined results from fecal examination methods (APCT or FECT) and/or urine ELISA). The levels of parasite-specific IgG in urine were stable throughout both the 3-day and the 30-day studies. In conclusion, diagnosis of strongyloidiasis by urine ELISA is more sensitive than by fecal methods, with minimal daily variation for qualitative and quantitative diagnosis. Urine ELISA has potential for clinical diagnosis and population screening of strongyloidiasis.
最近的研究发现，尿液分析在诊断类圆线虫病方面与血清学一样敏感。在这里，我们通过定性和定量 ELISA 检查尿液中类圆线虫特异性 IgG 的日变化，并研究其对诊断准确性和可靠性的影响。在研究的第一部分，我们连续三天从泰国东北部的项目参与者中采集了匹配的尿液和粪便样本。通过 ELISA 用鼠类类圆线虫作为抗原源来分析尿液中的类圆线虫特异性 IgG。尿液 ELISA 的性能与琼脂平板培养技术 (APCT) 和甲醛-乙酸乙酯浓缩技术 (FECT) 的寄生虫学诊断进行了比较。在研究的第二部分，连续 30 天每天比较尿液 IgG 水平。用 3 天连续尿液 ELISA 测量的类圆线虫感染患病率明显高于用寄生虫学方法发现的患病率（63.1% vs. 22%）。根据尿液 ELISA，患病率估计值每天略有变化，而根据寄生虫学检查方法在连续 3 天内有明显变化。对于 3 天实验，与粪便检查方法或综合标准（粪便检查方法（APCT 或 FECT）和/或尿液 ELISA 的组合结果）相比，尿液 ELISA 的诊断敏感性为 83-86%。在 3 天和 30 天的研究中，尿液中寄生虫特异性 IgG 的水平都很稳定。总之，尿液 ELISA 诊断类圆线虫病比粪便方法更敏感，定性和定量诊断的日变化最小。尿液 ELISA 具有用于临床诊断和人群筛查类圆线虫病的潜力。
