两种循环抗原检测方法在科特迪瓦低流行地区曼氏血吸虫感染诊断和监测中的准确性。

Accuracy of Two Circulating Antigen Tests for the Diagnosis and Surveillance of Schistosoma mansoni Infection in Low-Endemicity Settings of Côte d'Ivoire.

机构信息

1Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, Abidjan, Côte d'Ivoire.

2Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire.

出版信息

Am J Trop Med Hyg. 2021 Jul 19;105(3):677-683. doi: 10.4269/ajtmh.21-0031.

Abstract

In low-endemicity settings, current tools for the diagnosis and surveillance of schistosomiasis are often inaccurate in detecting true infection. We assessed the accuracy of an up-converting phosphor lateral flow circulating anodic antigen (UCP-LF CAA) test and a point-of-care circulating cathodic antigen (POC-CCA) urine cassette test for the diagnosis of Schistosoma mansoni. Our study was conducted in eight schools of western Côte d'Ivoire. Fifty children, aged 9-12 years, were enrolled per school. From each child, a single urine specimen and two stool specimens were collected over consecutive days for diagnostic work-up. Urine samples were subjected to UCP-LF CAA and POC-CCA tests. From each stool sample, triplicate Kato-Katz thick smears were examined. Overall, 378 children had complete data records. The prevalence of S. mansoni, as assessed by six Kato-Katz thick smears, was 4.0%. The UCP-LF CAA and POC-CCA tests revealed S. mansoni prevalence of 25.4% and 30.7%, respectively, when considering trace results as positive, and prevalence of 23.3% and 10.9% when considering trace results as negative. In the latter case, based on a composite "gold" standard, the sensitivity of UCP-LF CAA (80.7%) was considerably higher than that of POC-CCA (37.6%) and six Kato-Katz thick smears (13.8%). The negative predictive value of UCP-LF CAA, POC-CCA, and six Kato-Katz thick smears was 92.8%, 79.8%, and 74.1%, respectively. Our results confirm that UCP-LF CAA is more accurate than Kato-Katz and POC-CCA for the diagnosis of S. mansoni in low-endemicity settings.

摘要

在低流行地区,目前用于诊断和监测血吸虫病的工具在检测真正感染方面往往不够准确。我们评估了上转换磷侧向流动循环阳极抗原(UCP-LF CAA)检测和即时检测循环阴极抗原(POC-CCA)尿液盒检测对曼氏血吸虫病的诊断准确性。我们的研究在科特迪瓦西部的八所学校进行。每所学校招募 50 名 9-12 岁的儿童。从每个儿童采集单个尿液样本和两个粪便样本,连续两天进行诊断。尿液样本接受 UCP-LF CAA 和 POC-CCA 检测。从每个粪便样本中采集三份加藤厚涂片进行检查。总的来说,有 378 名儿童有完整的数据记录。根据六份加藤厚涂片评估,曼氏血吸虫病的流行率为 4.0%。当考虑痕量结果为阳性时,UCP-LF CAA 和 POC-CCA 检测分别显示曼氏血吸虫病的流行率为 25.4%和 30.7%,而当考虑痕量结果为阴性时,流行率分别为 23.3%和 10.9%。在后一种情况下,基于综合“金”标准,UCP-LF CAA 的敏感性(80.7%)明显高于 POC-CCA(37.6%)和六份加藤厚涂片(13.8%)。UCP-LF CAA、POC-CCA 和六份加藤厚涂片的阴性预测值分别为 92.8%、79.8%和 74.1%。我们的结果证实,在上转换磷侧向流动循环阳极抗原(UCP-LF CAA)在低流行地区诊断曼氏血吸虫病方面比加藤厚涂片和即时检测循环阴极抗原(POC-CCA)更准确。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4650/8592340/9f213a4e28b9/tpmd210031f1.jpg

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