手持式数字显微镜联合循环阴极抗原检测快速全面筛查泌尿生殖和胃肠道血吸虫病。
Rapid and Comprehensive Screening for Urogenital and Gastrointestinal Schistosomiasis with Handheld Digital Microscopy Combined with Circulating Cathodic Antigen Testing.
机构信息
Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, Abidjan, Côte d'Ivoire.
Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire.
出版信息
Am J Trop Med Hyg. 2024 Jun 11;111(2):387-390. doi: 10.4269/ajtmh.24-0043. Print 2024 Aug 7.
Novel methods are required to aid the monitoring of schistosomiasis control and elimination initiatives through mass drug administration. Portable digital and mobile phone microscopy is a promising tool for this purpose. This cross-sectional study evaluated the diagnostic operating characteristics of a converted mobile phone microscope (the SchistoScope) for the detection of Schistosoma haematobium eggs, as determined by community-based field workers and expert microscopists, compared with a field gold standard of light microscopy. Three hundred sixty-five urine samples were evaluated by conventional light microscopy, with 49 (13.4%) positive for S. haematobium. Compared with light microscopy, the sensitivity and specificity of S. haematobium detection by field microscopists trained to use the SchistoScope were 26.5% (95% CI: 14.9-41.1%) and 98.4% (95% CI: 96.3-99.5%), respectively. The sensitivity and specificity of S. haematobium detection by expert microscopists using the SchistoScope was 74% (95% CI: 59.7-85.4%) and 98.1% (95% CI: 95.9-99.3%), respectively, compared with light microscopy. The sensitivity rose to 96.1% and 100% when evaluating for egg counts greater than five and 10 eggs per 10 mL, respectively. A point-of-care circulating cathodic anion (POC CCA) test was used to evaluate Schistosoma mansoni; however, there were too few positive samples to reliably comment on diagnostic characteristics. This study demonstrated that a "urine-only" approach to rapidly screen for schistosomiasis at the point of sample collection can be conducted with mobile phone microscopy (S. haematobium) coupled with POC CCA (S. mansoni). Such an approach may aid in streamlined schistosomiasis control and elimination initiatives.
需要新的方法来辅助监测通过大规模药物治疗进行的血吸虫病控制和消除工作。便携式数字和移动电话显微镜是一种很有前途的工具。本横断面研究评估了经改装的移动电话显微镜(SchistoScope)用于检测埃及血吸虫卵的诊断工作特性,该显微镜由社区现场工作人员和专家显微镜检查人员使用,与现场显微镜检查的金标准相比,采用了光镜检查。对 365 份尿液样本进行了常规光镜检查,其中 49 份(13.4%)为埃及血吸虫阳性。与光镜检查相比,经培训使用 SchistoScope 的现场显微镜检查人员检测埃及血吸虫的敏感性和特异性分别为 26.5%(95%CI:14.9-41.1%)和 98.4%(95%CI:96.3-99.5%)。使用 SchistoScope 的专家显微镜检查人员检测埃及血吸虫的敏感性和特异性分别为 74%(95%CI:59.7-85.4%)和 98.1%(95%CI:95.9-99.3%),与光镜检查相比。当评估每 10 毫升尿液中的卵数大于 5 个和 10 个时,敏感性分别上升至 96.1%和 100%。点式循环阴离子(POC CCA)检测法用于评估曼氏血吸虫,但阳性样本太少,无法可靠地评价诊断特征。本研究表明,在样本采集点使用移动电话显微镜(埃及血吸虫)结合 POC CCA(曼氏血吸虫)进行快速筛查血吸虫病的“仅尿液”方法是可行的。这种方法可能有助于简化血吸虫病控制和消除工作。