Infection intensity-dependent accuracy of reagent strip for the diagnosis of Schistosoma haematobium and estimation of treatment prevalence thresholds.
Infection intensity-dependent accuracy of reagent strip for the diagnosis of Schistosoma haematobium and estimation of treatment prevalence thresholds.
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DOI：
10.1371/journal.pntd.0010332
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发表时间：
2022-04
影响因子：
3.8
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中科院分区：
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检测微量血尿的试剂条作为埃及血吸虫感染的替代品，已被认为是尿液过滤的替代品，用于个体诊断和基于社区的预防性化疗治疗需求估计。然而，试剂条的诊断准确性需要进一步研究，特别是在低感染强度水平。我们使用了在坦桑尼亚进行的一项研究的现有数据，该研究采用尿液过滤和试剂条检测S。在两个村庄进行了一次关于埃及血吸虫病的调查，包括一次基线调查和吡喹酮治疗后的六次随访调查，这些调查表明感染率范围很广。我们开发了一个贝叶斯模型，将个体S。根据尿液过滤获得的血吸虫虫卵计数数据与多天可用的试剂条二元检测结果进行比较，并估计感染强度与试剂条灵敏度之间的关系。此外，我们模拟了来自3,000个假设人群的数据，这些人群具有不同的平均感染强度，以推断通过尿液过滤观察到的患病率与试剂条读数解释之间的关系。试剂条显示出良好的灵敏度，即使在约15个S卵的单次测量也达到100%。当试剂条上的痕量被认为是阳性时，每10 ml尿液中的嗜血杆菌。相应的特异性为97%。当痕量被认为是阴性时，试剂条的诊断准确性等同于在一天内获得的尿液过滤数据。当微量被认为是阴性时，基于单日采样的10%和50%的尿液过滤患病率分别对应于试剂条的11.2%和48.6%患病率，当微量被认为是阳性时，分别对应于17.6%和57.7%患病率。当需要高灵敏度时，痕量结果应包括在试剂条读数中，但当需要高特异性时，应排除痕量结果。当痕量被认为是阴性时，观察到的试剂条结果的流行率是S流行率估计的良好代表。一天内通过尿液过滤感染了一株嗜血杆菌。血吸虫病是一种寄生虫感染，影响到全世界2亿多人，控制血吸虫病主要依靠对学龄儿童以及该疾病特别猖獗地区的成年人大规模服用吡喹酮药物。世界卫生组织设定了观察到的流行率阈值，需要采取干预措施，以实现到2025年消除血吸虫病这一公共卫生问题的目标。干预阈值是根据寄生虫学方法确定的，即埃及血吸虫的尿液过滤。有替代的诊断方法来检测S。血吸虫病，如尿中检测到血，这是泌尿生殖道血吸虫病的常见症状。我们使用坦桑尼亚两个村庄在多个时间点（驱虫药吡喹酮治疗前一次和治疗后多次）的数据确定了试剂条检测微量血尿的诊断灵敏度和特异性，并将尿液过滤干预阈值转换为试剂条等效值。我们表明，包括微量结果的试剂条几乎是完全敏感的感染超过15个鸡蛋的S。每10 ml尿液中存在10%的嗜血杆菌，通过尿液过滤观察到的10%患病率对应于通过包括痕量的试剂条观察到的17.6%患病率。
Reagent strip to detect microhematuria as a proxy for Schistosoma haematobium infections has been considered an alternative to urine filtration for individual diagnosis and community-based estimates of treatment needs for preventive chemotherapy. However, the diagnostic accuracy of reagent strip needs further investigation, particularly at low infection intensity levels. We used existing data from a study conducted in Tanzania that employed urine filtration and reagent strip testing for S. haematobium in two villages, including a baseline and six follow-up surveys after praziquantel treatment representing a wide range of infection prevalence. We developed a Bayesian model linking individual S. haematobium egg count data based on urine filtration to reagent strip binary test results available on multiple days and estimated the relation between infection intensity and sensitivity of reagent strip. Furthermore, we simulated data from 3,000 hypothetical populations with varying mean infection intensity to infer on the relation between prevalence observed by urine filtration and the interpretation of reagent strip readings. Reagent strip showed excellent sensitivity even for single measurement reaching 100% at around 15 eggs of S. haematobium per 10 ml of urine when traces on reagent strip were considered positive. The corresponding specificity was 97%. When traces were considered negative, the diagnostic accuracy of the reagent strip was equivalent to urine filtration data obtained on a single day. A 10% and 50% urine filtration prevalence based on a single day sampling corresponds to 11.2% and 48.6% prevalence by reagent strip, respectively, when traces were considered negative, and 17.6% and 57.7%, respectively, when traces were considered positive. Trace results should be included in reagent strip readings when high sensitivity is required, but excluded when high specificity is needed. The observed prevalence of reagent strip results, when traces are considered negative, is a good proxy for prevalence estimates of S. haematobium infection by urine filtration on a single day. Control of schistosomiasis, a parasitic worm infection affecting more than 200 million people worldwide, relies mainly on mass drug administration of praziquantel to school-age children as well as adults in areas where the disease is particularly rampant. The World Health Organization has set thresholds of observed prevalence that require intervention to reach the goal of eliminating schistosomiasis as a public health problem by 2025. Intervention thresholds are defined based on parasitologic methods, which is urine filtration for Schistosoma haematobium. There are alternative diagnostic methods to detect S. haematobium, such as the detection of blood in urine that is a common symptom of urogenital schistosomiasis. We determined the diagnostic sensitivity and specificity of a reagent strip to detect microhematuria using data from two villages in Tanzania at multiple time points (once before and several times after treatment with the deworming drug praziquantel) and translate the urine filtration intervention thresholds to reagent strip equivalents. We show that the reagent strip including trace results is almost perfectly sensitive for infections above 15 eggs of S. haematobium per 10 ml of urine and that a 10% observed prevalence by urine filtration corresponds to 17.6% observed prevalence by reagent strip including traces.
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影响因子：
3.2
作者：
Krauth SJ;Greter H;Stete K;Coulibaly JT;Traoré SI;Ngandolo BN;Achi LY;Zinsstag J;N'Goran EK;Utzinger J
通讯作者：
Utzinger J
影响因子：
3.8
作者：
Hotez PJ;Alvarado M;Basáñez MG;Bolliger I;Bourne R;Boussinesq M;Brooker SJ;Brown AS;Buckle G;Budke CM;Carabin H;Coffeng LE;Fèvre EM;Fürst T;Halasa YA;Jasrasaria R;Johns NE;Keiser J;King CH;Lozano R;Murdoch ME;O'Hanlon S;Pion SD;Pullan RL;Ramaiah KD;Roberts T;Shepard DS;Smith JL;Stolk WA;Undurraga EA;Utzinger J;Wang M;Murray CJ;Naghavi M
通讯作者：
Naghavi M
DOI：
10.1016/0035-9203(86)90367-6
发表时间：
1986-01-01
影响因子：
2.2
作者：
ANDERSON, RM
通讯作者：
ANDERSON, RM
影响因子：
81.5
作者：
McManus, Donald P.;Dunne, David W.;Zhou, Xiao-Nong
通讯作者：
Zhou, Xiao-Nong
影响因子：
3.8
作者：
Knopp, Stefanie;Corstjens, Paul L. A. M.;van Dam, Govert J.
通讯作者：
van Dam, Govert J.