An evaluation of urine-CCA strip test and fingerprick blood SEA-ELISA for detection of urinary schistosomiasis in schoolchildren in Zanzibar
An evaluation of urine-CCA strip test and fingerprick blood SEA-ELISA for detection of urinary schistosomiasis in schoolchildren in Zanzibar
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DOI：
10.1016/j.actatropica.2009.02.009
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发表时间：
2009-07-01
期刊：
影响因子：
2.7
通讯作者：
Rollinson, David
中科院分区：
文献类型：
--
作者：
Stothard, J. Russell;Sousa-Figueiredo, Jose C.;Rollinson, David
为了制定更好的监测方案，以检测尿血吸虫病正在进行的控制干预措施，两个市售的诊断测试-尿循环阴极抗原（CCA）条和可溶性鸡蛋抗原酶联免疫吸附试验（SEA-ELISA）-进行了评价，以检测150名学童从桑给巴尔的血吸虫感染。这些儿童来自五所小学，代表了全岛不同程度的疾病流行：使用标准的尿液过滤评估和显微镜检查，S。血尿的发生率为30.7%（95%可信区间（CI）= 23.4 - 38.7%），显微血尿和肉眼血尿的发生率分别为35.3%（95% CI = 27.7 - 43.5%）和8.0%（95% CI = 4.2 - 13.6%）。尿-CCA条的诊断评分不令人满意，观察到9%（95%CI = 2 - 21%）的非常差的灵敏度，排除了任何进一步的考虑。与之相比，用手指血制备的血清进行SEA-ELISA的性能较好;灵敏度为89%（95% CI = 76 - 96%），特异性为70%（95% CI = 60 - 79%），阳性预测值为57%（95% CI = 45 - 69%），阴性预测值为90%（95%CI = 86 - 98%）。在学校的单位，从寄生虫学检查和SEA-ELISA方法推断的流行率之间存在正线性关系。SEA-ELISA有望作为一个补充领域-的方法监测感染动态的学童超过标准的寄生虫学方法。皇冠版权所有（C）2009年出版的爱思唯尔B.V.保留所有权利。
To develop better monitoring protocols for detection of urinary schistosomiasis during ongoing control interventions, two commercially available diagnostic tests - the urine-circulating cathodic antigen (CCA) strip and the soluble egg antigen enzyme-linked immunosorbent assay (SEA-ELISA) - were evaluated for detection of Schistosoma haematobium infections in 150 schoolchildren from Zanzibar. The children originated from five primary schools representative of different levels of disease endemicity across the island: using standard urine filtration assessment with microscopy, mean prevalence of S. haematobium was 30.7% (95% confidence interval (CI) = 23.4-38.7%) and a total of 35.3% (95% CI = 27.7-43.5%) and 8.0% (95% CI = 4.2-13.6%) children presented with micro- and macro-haematuria, respectively. Diagnostic scores of the urine-CCA strip were not satisfactory, a very poor sensitivity of 9% (95% CI = 2-21%) was observed, precluding any further consideration. By contrast, the performance of the SEA-ELISA using sera from fingerprick blood was good; a sensitivity of 89% (95% CI = 76-96%), a specificity of 70% (95% CI = 60-79%), a positive predictive value of 57% (95% CI = 45-69%) and a negative predictive value of 90% (95% CI = 86-98%) were found. At the unit of the school, a positive linear association between prevalence inferred from parasitological examination and SEA-ELISA methods was found. The SEA-ELISA holds promise as a complementary field-based method for monitoring infection dynamics in schoolchildren over and above standard parasitological methods. Crown Copyright (C) 2009 Published by Elsevier B.V. All rights reserved.