Field Validity and Feasibility of Four Techniques for the Detection of Trichuris in Simians: A Model for Monitoring Drug Efficacy in Public Health?
Field Validity and Feasibility of Four Techniques for the Detection of Trichuris in Simians: A Model for Monitoring Drug Efficacy in Public Health?
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DOI：
10.1371/journal.pntd.0000366
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发表时间：
2009-01-01
影响因子：
3.8
通讯作者：
Vercruysse, Jozef
中科院分区：
文献类型：
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作者：
Levecke, Bruno;De Wilde, Nathalie;Vercruysse, Jozef
背景：通过土壤传播的蠕虫，如鞭虫，是公共卫生中的主要问题。目前控制这些蠕虫感染的努力包括在流行地区定期进行大规模治疗。由于这些大规模干预措施可能会加强，监测药物疗效将变得不可或缺。然而，基于灵敏度、粪卵计数(FEC)、大规模诊断的可行性和药物疗效评估的检测技术的比较研究很少。方法/主要发现：在本研究中，基于有效性和可行性对100个非人类灵长类动物粪便样本中鞭毛虫卵检出的有效性和可行性，比较了乙醚浓缩法、无溶剂(SF)法、McMaster和FLOTAC技术。此外，使用统计模拟检验了定量技术的药效估计。47%的样本中发现了鞭毛虫卵。FLOTAC是最敏感的技术(100%)，其次是Parasep SF(83.0%[95%可信区间：82.4-83.6%])和乙醚浓缩法(76.6%[95%CI：75.8-77.3%])。McMaster的敏感性最低(61.7%[95%CI：60.7~62.6%])，未能检出低FEC。定量比较显示，四种技术之间呈正相关(Rs=0.0001.85~0.93；p<；0.0 5)。然而，乙醚浓缩技术和Parasep SF检测到的虫卵明显少于麦克马斯特和FLOTAC(p<；0.0083)。总体而言，McMaster是最可行的技术(用于仪器的准备、读取和清洁的3.9min/样品)，其次是乙醚浓缩技术(7.7min/样品)和FLOTAC(9.8min/样品)。Parasep SF最不可行(17.7min/例)。仿真结果表明，FLOTAC和McMaster的灵敏度对监测药物疗效的重要性较小，FLOTAC和McMaster都是可靠的估计器。结论/意义：本研究结果表明，McMaster是一种利用FEC监测鞭虫药物疗效的有前景的技术。
Background: Soil-transmitted helminths, such as Trichuris trichiura, are of major concern in public health. Current efforts to control these helminth infections involve periodic mass treatment in endemic areas. Since these large-scale interventions are likely to intensify, monitoring the drug efficacy will become indispensible. However, studies comparing detection techniques based on sensitivity, fecal egg counts (FEC), feasibility for mass diagnosis and drug efficacy estimates are scarce.Methodology/Principal Findings: In the present study, the ether-based concentration, the Parasep Solvent Free (SF), the McMaster and the FLOTAC techniques were compared based on both validity and feasibility for the detection of Trichuris eggs in 100 fecal samples of nonhuman primates. In addition, the drug efficacy estimates of quantitative techniques was examined using a statistical simulation. Trichuris eggs were found in 47% of the samples. FLOTAC was the most sensitive technique (100%), followed by the Parasep SF (83.0% [95% confidence interval (CI): 82.4-83.6%]) and the ether-based concentration technique (76.6% [ 95% CI: 75.8-77.3%]). McMaster was the least sensitive (61.7% [ 95% CI: 60.7-62.6%]) and failed to detect low FEC. The quantitative comparison revealed a positive correlation between the four techniques (Rs = 0.85-0.93; p < 0.0001). However, the ether-based concentration technique and the Parasep SF detected significantly fewer eggs than both the McMaster and the FLOTAC (p < 0.0083). Overall, the McMaster was the most feasible technique (3.9 min/sample for preparing, reading and cleaning of the apparatus), followed by the ether-based concentration technique (7.7 min/sample) and the FLOTAC (9.8 min/sample). Parasep SF was the least feasible (17.7 min/ sample). The simulation revealed that the sensitivity is less important for monitoring drug efficacy and that both FLOTAC and McMaster were reliable estimators.Conclusions/Significance: The results of this study demonstrated that McMaster is a promising technique when making use of FEC to monitor drug efficacy in Trichuris.