Selecting accurate post-elimination monitoring tools to prevent reemergence of urogenital schistosomiasis in Morocco: a pilot study.
Selecting accurate post-elimination monitoring tools to prevent reemergence of urogenital schistosomiasis in Morocco: a pilot study.
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DOI：
10.1186/s40249-017-0289-z
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发表时间：
2017-04-06
影响因子：
8.1
通讯作者：
Adlaoui EB
中科院分区：
文献类型：
--
作者：
Balahbib A;Amarir F;Corstjens PL;de Dood CJ;van Dam GJ;Hajli A;Belhaddad M;El Mansouri B;Sadak A;Rhajaoui M;Adlaoui EB
在据称血吸虫病传播停止后，以及在消灭后的环境中，需要敏感的工具来监测感染状况，以防止可能的重新出现。在拉哈拉，自2004年以来，埃及血吸虫的传播周期被中断，但30%的蜗牛仍然感染了埃及血吸虫。牛，潜在的人类S.不能排除牛的感染。由于基于卵计数的方法不能提供所需的灵敏度，因此设想抗体或抗原测定法作为这种监测的最适当工具。在该初步研究中，比较了三种检测方法的性能：两种市售抗体检测（ELISA和血凝形式）表明暴露，一种抗原检测（侧流试纸形式）表明活动性感染。所有37例招募的研究参与者均居住在Rahala（阿卡，摩洛哥塔塔省）。参与者在1983年至2003年期间被诊断并治愈血吸虫病。2015年，这些无症状参与者提供了新鲜的临床样本（血液和尿液），用于上述诊断测试的分析。在37名参与者的尿液中没有发现鸡蛋。血凝试验显示6例抗体阳性，而ELISA显示28例抗体阳性，1例不确定，1例假阳性。ELISA和血凝结果匹配的18个人，其中5个6血凝阳性。通过抗原试验（对成对的血清和尿液样本进行），来自两名参与者（21年和32年前治愈）的血清表明存在低水平的高度特异性血吸虫循环阳极抗原（CAA），表明低蠕虫水平感染（低于5 pg/ml，对应于可能的单蠕虫对）。其中一人的尿液检测也呈CAA阳性。两例CAA阳性患者的ELISA检测结果均为人抗血吸虫抗体阳性，血凝试验均为阴性。为了防止血吸虫病在摩洛哥重新出现，目前的监测方案需要具体的方案，包括通过UCP-LF CAA测试检测活动性感染的抗体阳性，这是识别旅行者、移民和假定治愈病例中血吸虫低度感染的适当诊断工具。该测试是属特异性的，也将识别与S有关的感染。牛。本文的在线版本（doi：10.1186/s40249-017-0289-z）包含补充材料，可供授权用户使用。
After alleged stop of transmission of schistosomiasis and further down the line in post elimination settings, sensitive tools are required to monitor infection status to prevent potential re-emergence. In Rahala, where transmission cycle of Schistosoma haematobium is interrupted since 2004 but where 30% of snails are still infected by S. bovis, potential human S. bovis infection can’t be excluded. As methods based on egg-counts do not provide the required sensitivity, antibody or antigen assays are envisaged as the most appropriate tools for this type of monitoring. In this pilot study, the performances of three assays were compared: two commercially available antibody tests (ELISA and haemagglutination format) indicating exposure, and an antigen test (lateral flow strip format) demonstrating active infection. All 37 recruited study participants resided in Rahala (Akka, province Tata, Morocco). Participants had been diagnosed and cured from schistosomiasis in the period between 1983 and 2003. In 2015 these asymptomatic participants provided fresh clinical samples (blood and urine) for analysis with the aforementioned diagnostics tests. No eggs were identified in the urine of the 37 participants. The haemagglutination test indicated 6 antibody positives whereas the ELISA indicated 28 antibody positives, one indecisive and one false positive. ELISA and haemagglutination results matched for 18 individuals, amongst which 5 out of 6 haemagglutination positives. With the antigen test (performed on paired serum and urine samples), serum from two participants (cured 21 and 32 years ago) indicated the presence of low levels of the highly specific Schistosoma circulating anodic antigen (CAA), demonstrating low worm level infections (less than 5 pg/ml corresponding to probably single worm pair). One tested also CAA positive with urine. ELISA indicated the presence of human anti-Schistosoma antibodies in these two CAA positive cases, haemagglutination results were negative. To prevent reemergence of schistosomiasis in Morocco current monitoring programs require specific protocols that include testing of antibody positives for active infection by the UCP-LF CAA test, the appropriate diagnostic tool to identify Schistosoma low grade infections in travelers, immigrants and assumed cured cases. The test is genus specific will also identify infections related to S. bovis. The online version of this article (doi:10.1186/s40249-017-0289-z) contains supplementary material, which is available to authorized users.