De Clercq D, Sacko M, Vercruysse J, Diarra A, Landouré A, vanden Bussche V, Gryseels B, Deelder A
Institut National de Recherche en Santé Publique, Service de Parasitologie, Bamako, Mali.
Trans R Soc Trop Med Hyg. 1995 Jul-Aug;89(4):395-7. doi: 10.1016/0035-9203(95)90024-1.
The applicability of a circulating Schistosoma antigen detection assay for determining rates of infection and efficacy of chemotherapy was evaluated in Mali. Urine egg counts were compared to circulating anodic antigen enzyme-linked immunosorbent assay (CAA-ELISA) titres in serum, before and 6 weeks after treatment with a single dose of praziquantel (40 mg/kg), in 2 villages in Dogon Country, an area endemic for S. haematobium, the predominant schistosome infection in Mali. In Kassa, a village with a moderate prevalence of infection, the serological prevalence (48%) was significantly higher than the parasitological prevalence (31%). In Boro, a village with high parasitological prevalence (76%), no difference was observed between the results of both methods (prevalence by CAA-ELISA was 75%). Cure rates estimated by CAA-ELISA were lower than those determined parasitologically, suggesting that cure rates are overestimated by egg counting. The sensitivity of the CAA-ELISA was 78%. In both villages, before treatment, a positive correlation was found between the number of eggs in urine and serum CAA titres. It is concluded that, although further simplification and improvement of the sensitivity of the assay is needed, in its present ELISA format the antigen detection assay is useful for monitoring sentinel populations. Furthermore, the serum CAA assay performed adequately in a public health laboratory within an endemic country.
在马里评估了一种循环血吸虫抗原检测方法在确定感染率和化疗疗效方面的适用性。在马里血吸虫病（该国主要的血吸虫感染类型）流行的多贡地区的两个村庄，对单剂量吡喹酮（40毫克/千克）治疗前及治疗后6周的血清中循环阳极抗原酶联免疫吸附测定（CAA-ELISA）滴度与尿虫卵计数进行了比较。在感染率中等的卡萨村，血清学感染率（48%）显著高于寄生虫学感染率（31%）。在寄生虫学感染率高（76%）的博罗村，两种方法的结果未观察到差异（CAA-ELISA检测的感染率为75%）。通过CAA-ELISA估计的治愈率低于寄生虫学确定的治愈率，这表明通过虫卵计数高估了治愈率。CAA-ELISA的灵敏度为78%。在两个村庄治疗前，尿中虫卵数量与血清CAA滴度之间发现呈正相关。结论是，尽管该检测方法需要进一步简化并提高其灵敏度，但就目前的ELISA形式而言，抗原检测方法对于监测哨点人群是有用的。此外，血清CAA检测在流行国家的公共卫生实验室中表现良好。
