Chowdhury M S, al Masum A, al Karim E, Semiáo-Santos S, Rahman K M, Ar-Rashid H, el Harith A
Institute of Epidemiology Disease Control & Research (IEDC&R), Mohakhali, Dhaka-Bangladesh.
Arch Inst Pasteur Tunis. 1993 Jul-Oct;70(3-4):333-44.
As part of a large-scale sero-epidemiological survey on visceral leishmaniasis (VL) carried out in Mymensingh district of Bangladesh, applicability of DAT was assessed at the level of a rural health setting in Trishal (upazila) subdistrict. Despite the relatively less optimal conditions encountered, 5854 inhabitants from 7 villages appendant to Trishal were assessed for VL. The demographic distribution for sero-positivity obtained at the rural setting was comparable to that found by DAT as executed at the central laboratory (IEDC&R, Dhaka) on 9619 inhabitants from the same upazila. The overall sero-prevalence rate was 4.4% compared to 3.7% obtained in the population assessed at the central laboratory. In either study, similar VL prevalence rates of 2.1% were obtained in the male populations. Irrespective of sex, younger population (< 20 years) in both studies appeared to have higher VL incidence rate (2.3% and 2.6%) than others of 21- > or = 90 years (1.4% and 1.8%). Local production of DAT antigen employing an authochtonus L. donovani isolate was attempted at the central laboratory (IEDC&R) in Dhaka. By comparison with the reference antigen, titres obtained in all 33 VL sera tested were equally higher (1:6400- > or =: 51200) than in 35 out of 38 negative controls (< or = 1:400-1:1600). A comparable level of reactivity was also obtained in 53 VL and 52 negative control sera using a well characterized L. donovani strain (MHOM/IN/80/D88) from India. However, unlike the reference strain, titres obtained in 7 endemic controls were significantly higher with the authochtonous and homologous antigen (1:3200 - 1:6400) than with the reference (1:100 - 1:1600). The results signify the advantage of employing indigenous L. donovani isolates to further improve DAT sensitivity for detection of early and sub-clinical VL.
作为在孟加拉国迈门辛希区开展的一项关于内脏利什曼病(VL)的大规模血清流行病学调查的一部分,在特里沙尔(乡)分区的农村卫生机构层面评估了直接凝集试验(DAT)的适用性。尽管遇到的条件相对不太理想,但对特里沙尔附属的7个村庄的5854名居民进行了VL评估。在农村地区获得的血清阳性人口统计学分布与达卡中央实验室(疾病控制与研究中心,IEDC&R)对来自同一乡的9619名居民进行DAT检测时发现的分布相当。总体血清流行率为4.4%,而在中央实验室评估的人群中为3.7%。在两项研究中,男性人群的VL患病率均为2.1%。无论性别如何,两项研究中较年轻人群(<20岁)的VL发病率(2.3%和2.6%)似乎高于21岁及以上至90岁人群(1.4%和1.8%)。达卡的中央实验室(IEDC&R)尝试使用当地分离的杜氏利什曼原虫生产DAT抗原。与参考抗原相比,在所有33份检测的VL血清中获得的滴度(1:6400至≥51200)均同样高于38份阴性对照中的35份(≤1:400至1:1600)。使用来自印度的一株特征明确的杜氏利什曼原虫菌株(MHOM/IN/80/D88),在53份VL血清和52份阴性对照血清中也获得了相当的反应水平。然而,与参考菌株不同,在7份地方性对照中,使用当地同源抗原获得的滴度(1:3200至1:6400)明显高于参考抗原(1:100至1:1600)。结果表明,使用当地杜氏利什曼原虫分离株进一步提高DAT检测早期和亚临床VL敏感性的优势。