Degarege Abraham, Erko Berhanu, Brett-Major David M, Levecke Bruno, Animut Abebe, Negash Yohannes, Broadhurst M Jana, Michaud Tzeyu, Bilder Christopher R
Department of Epidemiology, College of Public Health, University of Nebraska Medical Center, Omaha, NE 68198, USA.
Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa 16417, Ethiopia.
Microorganisms. 2025 Feb 26;13(3):510. doi: 10.3390/microorganisms13030510.
This study evaluated the performance of urine reagent strips (URSs) in detecting infection in individual and pooled urine samples. Between June 2022 and April 2023, 2634 urine samples (10 mL each) from school-age children (5-15 years) in 15 villages across Ethiopia's Afar, Benishangul-Gumuz, and Gambella regions were tested using urine filtration microscopy (UFM) and URSs for blood, a marker of eggs. Pooled samples from 5, 10, 20, and 40 individuals (one positive, others negative) were examined with both methods. UFM results were used to calculate URSs' sensitivity, specificity, and predictive values for detecting infection. A total of 2634 children were screened for infection. UFM detected eggs in 370 samples, while URSs identified infection in 414 children. URSs showed 64% sensitivity and 92% specificity for individual samples. The positive and negative predictive values for individual samples were 57% and 94%, respectively. Sensitivity for pooled samples ranged from 47% (pools of 40) to 53% (pools of 20). In pools with one positive sample, URSs misclassified 220 (50%), 109 (49.5%), 52 (47.0%), and 28 (50.9%) pools as negative for eggs for pool sizes 5, 10, 20, and 40, respectively. Sensitivity for individual samples was higher in children with heavy infection (92.5%) compared to light infection (55.9%), and sensitivity in pooled samples increased with infection intensity ( < 0.001). In conclusion, URSs may misclassify infection in children when samples are examined individually or in pools, potentially leading to unnecessary treatment or missed cases. However, URSs shows promise as a screening tool for detecting infection in areas with high infection intensity.
本研究评估了尿液试剂条（URSs）在检测个体尿液样本和混合尿液样本中感染情况的性能。在2022年6月至2023年4月期间，对来自埃塞俄比亚阿法尔、本尚古勒-古穆兹和甘贝拉地区15个村庄的学龄儿童（5至15岁）的2634份尿液样本（每份10毫升），使用尿液过滤显微镜检查（UFM）和URSs检测血液（一种虫卵标志物）。对来自5、10、20和40名个体（一名阳性，其他为阴性）的混合样本采用这两种方法进行检测。UFM结果用于计算URSs检测感染的敏感性、特异性和预测值。总共对2634名儿童进行了感染筛查。UFM在370份样本中检测到虫卵，而URSs在414名儿童中识别出感染。对于个体样本，URSs的敏感性为64%，特异性为92%。个体样本的阳性预测值和阴性预测值分别为57%和94%。混合样本的敏感性范围为47%（40人混合样本）至53%（20人混合样本）。在含有一份阳性样本的混合样本中，对于样本量为5、10、20和40的混合样本，URSs分别将220份（50%）、109份（49.5%）、52份（47.0%）和28份（50.9%）误分类为虫卵阴性。与轻度感染儿童（55.9%）相比，重度感染儿童个体样本的敏感性更高（92.5%），且混合样本的敏感性随感染强度增加而升高（<0.001）。总之，当单独或混合检测样本时，URSs可能会对儿童感染情况进行错误分类，可能导致不必要的治疗或漏诊病例。然而，URSs有望作为在高感染强度地区检测感染的筛查工具。
