Roure Silvia, Pérez-Quílez Olga, Vallès Xavier, Valerio Lluís, Fernández-Rivas Gemma, Rivaya Belén, López-Muñoz Israel, Soldevila Laura, Villanova Xavier, Paredes Roger, Pedro-Botet Maria-Lluïsa, Videla Sebastián, Clotet Bonaventura
North Metropolitan International Health Program (PROSICS), Badalona, Spain.
Infectious Diseases Department, Germans Trias i Pujol University Hospital, Universitat Autònoma de Barcelona, Badalona, Spain.
Public Health Pract (Oxf). 2022 Mar 18;3:100245. doi: 10.1016/j.puhip.2022.100245. eCollection 2022 Jun.
We sought to test the sensitivity and feasibility of a infection screening process consisting of a scored patient consultation questionnaire and a serological diagnostic test.
Prospective cross-sectional study.
We collected from Schistosoma-exposed individuals a 14-point check list of clinical and laboratory data related to infection, alongside a serological test to detect spp infection. A check list score was created and compared with the risk of infection and clinical recovery through an agreement analysis.
Two-hundred and fifty individuals were enrolled, of whom 220 (88%) were male and 30 (12%) female. The median age was 39 (range 18-78). One hundred-fifty (60%, 95% CI 54.9%-65.1%) had a check-list score ≥2. Serology test results were positive for 142 (56.8%, 95% CI 51.6%-62%). Chronic complications compatible with long-term infection were detected in 29 out of these 142 (20.4%, 95% CI 13.8%-27%).,. The median score value was 3, the area under the receiver operating characteristic (ROC) curve against serology results was 0.85 and the estimated intercept check-list questionnaire score value was 1.72 (95%, CI: 1.3-2.2). Participants with a positive serological test had a substantially higher check-list score (Cohen's kappa coefficient: 0.62, 95% CI: 0.54-0.70). Ninety four percent patients empirically treated showed a subsequent improvement in clinical and laboratory parameters.
A two-component process consisting of a scored patient consultation questionnaire followed by serological assay can be a suitable strategy for screening populations at high risk of schistosomiasis infection.
我们试图测试一种感染筛查流程的敏感性和可行性，该流程包括一份有评分的患者咨询问卷和一项血清学诊断测试。
前瞻性横断面研究。
我们从接触过血吸虫的个体中收集了一份与感染相关的临床和实验室数据的14项检查清单，以及一项用于检测血吸虫属感染的血清学测试。创建了一个检查清单分数，并通过一致性分析将其与感染风险和临床恢复情况进行比较。
共招募了250名个体，其中220名（88%）为男性，30名（12%）为女性。中位年龄为39岁（范围18 - 78岁）。150名（60%，95%置信区间54.9% - 65.1%）的检查清单分数≥2。血清学测试结果为142名（56.8%，95%置信区间51.6% - 62%）呈阳性。在这142名中有29名（20.4%，95%置信区间13.8% - 27%）检测到与长期血吸虫感染相符的慢性并发症。中位分数值为3，针对血清学结果的受试者操作特征（ROC）曲线下面积为0.85，估计的检查清单问卷分数值截距为1.72（95%，置信区间：1.3 - 2.2）。血清学测试呈阳性的参与者的检查清单分数显著更高（科恩kappa系数：0.62，95%置信区间：0.54 - 0.70）。经验性治疗的患者中有94%在临床和实验室参数方面随后出现改善。
由一份有评分的患者咨询问卷随后进行血清学检测组成的双组分流程可能是筛查血吸虫病感染高危人群的合适策略。
