埃塞俄比亚学童钩虫感染检测中诊断技术的评估：横断面研究设计
Evaluation of the diagnostic techniques in the detection of hookworm infestation among school children in Ethiopia: Cross-sectional study design.
作者信息
Fenta Abebe, Kebede Destaw, Tilahun Adane, Mesganaw Bewket, Adugna Adane, Yihunie Wubetu, Belew Habtamu, Abebaw Desalegn, Azanaw Gashaw
机构信息
Department of Medical Laboratory Science, Health Science College, Debre markos University, Debre markos, Ethiopia.
Department of Medical Laboratory Science, Microbiology unit, Shegaw Motta General Hospital, Motta town, Ethiopia.
出版信息
Heliyon. 2024 Oct 29;10(21):e39936. doi: 10.1016/j.heliyon.2024.e39936. eCollection 2024 Nov 15.
BACKGROUND
Hookworm infestation is an important public health concern especially in regions with poor sanitation and limited resources. In healthcare institutions in Ethiopia, wet mount microscopy with low performance has been used as the sole diagnostic technique. Sensitive diagnostic methods are essential for the proper identification of hookworm infection in national strategies for hookworm prevention and management. Thus, the objective of the article was to evaluate the performance of diagnostic techniques in the detection of hookworm infestation among school children in the Gozamin district, Northwest Ethiopia.
METHODS
A cross-sectional study with 530 school children was conducted from February to April 2022 in Ethiopia. The study participants were selected by using systematic random sampling technique. Direct wet mount (DWM), Richies, Kato-Katz (KK), and spontaneous tube sedimentation (STS) diagnostic techniques were utilized to process the stool samples. The data were entered into the Epi-data version 4.2 and the data was analyzed using SPSS version 25.0. The sensitivity, specificity, predictive values and test efficiency of the test were calculated with respect to the Composite Reference Standard (CRS) as the reference method. The degree of agreement with the methods of diagnosis was assessed by the Kappa value.
RESULTS
The overall prevalence of hookworm was 34.9 %. The detection rate of STS, Richie's, KK and DWM techniques in hookworm detection was 30.2 %, 27.0 %, 22.3 % and 15.1 %, respectively. The sensitivity and test efficiency of STS to detect hookworm were 86.5 % and 95.3 %, for Richies 77.3 % and 92.1 %, for KK 63.8 % and 87.4 %, for DWM method 43.2 % and 80.2 %, respectively. The agreement of STS, Richies, KK and DWM techniques with CRS were perfect ( = 0.893), perfect ( = 0.816), substantial ( = 0.696) and moderate ( = 0.498), respectively in detecting hookworm parasites.
CONCLUSION
The prevalence of hookworm among school children was high. The STS method is superior to other methods for detecting hookworm infections. The Richie's technique was more successful in detecting the hookworm parasite than the KK and DWM techniques. It is important to implement the STS technique in routine diagnostic methods and in endemic areas of hookworm infection because it cheaper, easy to perform, and identifies a wide range of parasitic species.
背景
钩虫感染是一个重要的公共卫生问题，尤其是在卫生条件差和资源有限的地区。在埃塞俄比亚的医疗机构中，性能不佳的湿片显微镜检查一直被用作唯一的诊断技术。在国家钩虫预防和管理策略中，灵敏的诊断方法对于准确识别钩虫感染至关重要。因此，本文的目的是评估埃塞俄比亚西北部戈扎明地区学童中钩虫感染检测诊断技术的性能。
方法
2022年2月至4月在埃塞俄比亚对530名学童进行了一项横断面研究。研究参与者采用系统随机抽样技术选取。使用直接湿片法（DWM）、瑞氏法、加藤厚涂片法（KK）和自然沉淀法（STS）诊断技术处理粪便样本。数据录入Epi - data 4.2版本，并使用SPSS 25.0版本进行分析。以综合参考标准（CRS）作为参考方法，计算检测的灵敏度、特异度、预测值和检测效率。通过Kappa值评估诊断方法之间的一致性程度。
结果
钩虫总体感染率为34.9%。STS法、瑞氏法、KK法和DWM法检测钩虫的检出率分别为30.2%、27.0%、22.3%和15.1%。STS法检测钩虫的灵敏度和检测效率分别为86.5%和95.3%，瑞氏法为77.3%和92.1%，KK法为63.8%和87.4%，DWM法为43.2%和80.2%。在检测钩虫寄生虫方面，STS法、瑞氏法、KK法和DWM法与CRS的一致性分别为完美（κ = 0.893）、完美（κ = 0.816）、高度一致（κ = 0.696）和中度一致（κ = 0.498）。
结论
学童中钩虫感染率很高。STS法在检测钩虫感染方面优于其他方法。瑞氏法在检测钩虫寄生虫方面比KK法和DWM法更成功。在常规诊断方法以及钩虫感染流行地区实施STS技术很重要，因为它成本较低、易于操作，并且能识别多种寄生虫种类。
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