Owen B M, Stratford C J
Medical School, University of Newcastle upon Tyne.
Lepr Rev. 1995 Mar;66(1):55-62. doi: 10.5935/0305-7518.19950008.
The aim of this study was to assess the efficacy, practicality and patient understanding of 5 methods used for testing sensation in leprosy patients, in a rural setting. The tests used were the WHO test, cottonwool, pin-prick, monofilaments and the biothesiometer. We concentrated on testing sensation in the hands, and the various tests were carried out on 75 patients and 32 controls, all taken from villagers living at Kindwitwi Leprosy Village, Tanzania. Our results showed that although the WHO test, cottonwool and pin-prick were all easy to use, cheap and well accepted they were not sensitive enough to be of any practical value. We found that the monofilaments, as well as being cheap and easy to use, had great potential value, as the 2-g monofilament could be used as a threshold value (indicative of leprosy, but not diagnostic) for protective sensation with a combined false-positive and false-negative value of only 4%. Finally, the biothesiometer was found to be a precise test that can accurately identify leprosy patients from controls and identify patients at risk of ulceration. It was, however, associated with its own problems, chiefly those of expense and its need of electricity, although we found this latter problem could be easily and relatively cheaply solved by the use of a solar powered recharger (Appendix).
本研究旨在评估在农村环境中用于检测麻风病患者感觉功能的5种方法的有效性、实用性及患者的理解程度。所使用的检测方法包括世界卫生组织（WHO）检测法、棉拭子法、针刺法、单丝法和生物感觉阈值测定仪法。我们重点检测手部感觉功能，对来自坦桑尼亚金德维特维麻风病村的75例患者和32例对照者进行了各项检测。我们的结果显示，尽管WHO检测法、棉拭子法和针刺法都易于使用、成本低廉且接受度高，但它们的敏感度不足以具有任何实际价值。我们发现，单丝法不仅成本低廉且易于使用，还具有很大的潜在价值，因为2克的单丝可用作保护性感觉的阈值（表明患有麻风病，但不能用于诊断），其假阳性和假阴性的综合值仅为4%。最后，生物感觉阈值测定仪被发现是一种精确的检测方法，能够准确地将麻风病患者与对照者区分开来，并识别有溃疡风险的患者。然而，它也存在自身问题，主要是费用问题以及需要电力，不过我们发现通过使用太阳能充电器（附录），后一个问题可以轻松且相对廉价地得到解决。
