Diagnostic accuracy of Kato-Katz and FLOTAC for assessing anthelmintic drug efficacy.
Diagnostic accuracy of Kato-Katz and FLOTAC for assessing anthelmintic drug efficacy.
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DOI：
10.1371/journal.pntd.0001036
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发表时间：
2011-04-12
影响因子：
3.8
通讯作者：
Utzinger J
中科院分区：
文献类型：
--
作者：
Knopp S;Speich B;Hattendorf J;Rinaldi L;Mohammed KA;Khamis IS;Mohammed AS;Albonico M;Rollinson D;Marti H;Cringoli G;Utzinger J
需要灵敏的诊断工具来准确评估定期驱虫地区蠕虫感染的流行率和严重程度，并监测驱虫药物的疗效。我们在药物疗效试验的框架内比较了Kato-Katz和FLOTAC技术的诊断准确性。在2009年初的基线筛查中，对343名桑给巴尔儿童的粪便样本进行了两次Kato-Katz厚涂片和FLOTAC基本技术检查。FLOTAC在诊断鞭虫（95% vs. 88%，p = 0.012）和蛔虫（88% vs. 68%，p = 0.098）方面的灵敏度高于Kato-Katz方法，但在诊断钩虫方面的灵敏度较低（54% vs. 81%，p = 0.006）。 以两种方法的综合结果作为“金”标准，T。trichiura、钩虫和A.蛔虫感染率分别为71%（95% CI：66-75%）、22%（95% CI：17-26%）和12%（95% CI：8-15%）。随访269例，其中174例给予驱虫药治疗3-5周后，观察对A.蛔虫、钩虫和T.当使用Kato-Katz方法时，鞭毛虫的发生率分别为91%（95% CI：80-100%）、61%（95% CI：48-75%）和41%（95% CI：34-49%）。FLOTAC显示对A的CR较低。蛔虫（83%，95% CI：67-98%）和T.鞭虫的CR率为36%，95% CI：29-43%，但钩虫的CR率为69%，95% CI：57-82%。然而，这些差异缺乏统计学意义。两种方法之间的几何平均粪便虫卵计数存在相当大的差异，FLOTAC测定的虫卵减少率（ERR）较低。我们的研究结果表明，FLOTAC技术，进一步优化后，可能成为一个可行的替代加藤-卡茨方法的驱虫药物疗效的研究和监测和评价驱虫程序。FLOTAC确定的较低CR和ERR值得考虑，并可能对未来的蠕虫控制计划产生战略性影响。在驱虫运动成功减少寄生虫感染的地区，必须仔细监测感染水平和药物疗效。为此，需要具有高灵敏度的诊断方法。我们比较了广泛使用的加藤-卡茨方法与最近开发的FLOTAC技术诊断寄生蠕虫的准确性。我们的研究是在坦桑尼亚的桑给巴尔岛的儿童中进行的，在驱虫药疗效研究的框架内。我们收集了两所小学的343名儿童治疗前后的粪便样本，并用两种方法检查粪便样本。FLOTAC对蛔虫和鞭虫的诊断敏感性高于Kato-Katz，但对钩虫的诊断敏感性低于Kato-Katz。与Kato-Katz相比，FLOTAC确定的蛔虫和鞭虫的治愈率较低。钩虫的情况正好相反。当使用FLOTAC技术时，鸡蛋减少率通常较低。我们的研究结果表明，FLOTAC方法，经过额外的优化，可以成为一个可行的替代加藤-卡茨方法的驱虫药物疗效的研究和监测和评价驱虫程序。
Sensitive diagnostic tools are required for an accurate assessment of prevalence and intensity of helminth infections in areas undergoing regular deworming, and for monitoring anthelmintic drug efficacy. We compared the diagnostic accuracy of the Kato-Katz and FLOTAC techniques in the frame of a drug efficacy trial. Stool samples from 343 Zanzibari children were subjected to duplicate Kato-Katz thick smears and the FLOTAC basic technique in a baseline screening in early 2009. The FLOTAC showed a higher sensitivity than the Kato-Katz method for the diagnosis of Trichuris trichiura (95% vs. 88%, p = 0.012) and Ascaris lumbricoides (88% vs. 68%, p = 0.098), but a lower sensitivity for hookworm diagnosis (54% vs. 81%, p = 0.006). Considering the combined results from both methods as ‘gold’ standard, the prevalences of T. trichiura, hookworm and A. lumbricoides were 71% (95% confidence interval (CI): 66–75%), 22% (95% CI: 17–26%) and 12% (95% CI: 8–15%), respectively. At follow-up, 3–5 weeks after 174 among the 269 re-examined children were administered anthelmintic drugs, we observed cure rates (CRs) against A. lumbricoides, hookworm and T. trichiura of 91% (95% CI: 80–100%), 61% (95% CI: 48–75%) and 41% (95% CI: 34–49%), respectively, when using the Kato-Katz method. FLOTAC revealed lower CRs against A. lumbricoides (83%, 95% CI: 67–98%) and T. trichiura (36%, 95% CI: 29–43%), but a higher CR against hookworm (69%, 95% CI: 57–82%). These differences, however, lacked statistical significance. Considerable differences were observed in the geometric mean fecal egg counts between the two methods with lower egg reduction rates (ERRs) determined by FLOTAC. Our results suggest that the FLOTAC technique, following further optimization, might become a viable alternative to the Kato-Katz method for anthelmintic drug efficacy studies and for monitoring and evaluation of deworming programs. The lower CRs and ERRs determined by FLOTAC warrant consideration and could strategically impact future helminth control programs. In areas where parasitic worm infections have been successfully reduced as a result of deworming campaigns, the level of infections and drug efficacy must be carefully monitored. For this purpose, diagnostic methods with a high sensitivity are needed. We compared the accuracy of the widely used Kato-Katz method with the more recently developed FLOTAC technique for the diagnosis of parasitic worms. Our study was done with children on Zanzibar island, Tanzania, within the frame of an anthelmintic drug efficacy study. We collected stool samples from 343 children in two primary schools before and after treatment and examined the stool samples with both methods. FLOTAC showed a higher sensitivity than Kato-Katz for the diagnosis of roundworm and whipworm, but a lower sensitivity for hookworm diagnosis. The cure rates determined by FLOTAC were lower for roundworm and whipworm when compared with Kato-Katz. The opposite was found for hookworm. Egg reduction rates were generally lower when the FLOTAC technique was used. Our results suggest that the FLOTAC method, after additional optimization, can become a viable alternative to the Kato-Katz method for anthelmintic drug efficacy studies and for monitoring and evaluation of deworming programs.
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比较Kato-Katz，Koga琼脂板，以太浓度和FLOTAC的诊断精度，用于曼森和土壤传播的蠕虫。
影响因子：
3.8
作者：
Glinz, Dominik;Silue, Kigbafori D.;Knopp, Stefanie;Lohourignon, Laurent K.;Yao, Kouassi P.;Steinmann, Peter;Rinaldi, Laura;Cringoli, Giuseppe;N'Goran, Eliezer K.;Utzinger, Juerg
通讯作者：
Utzinger, Juerg
影响因子：
2.6
作者：
Hawass, NED
通讯作者：
Hawass, NED
DOI：
10.1016/j.trstmh.2009.05.012
发表时间：
2009-12-01
影响因子：
2.2
作者：
Knopp, Stefanie;Glinz, Dominik;Utzinger, Juerg
通讯作者：
Utzinger, Juerg
影响因子：
11.8
作者：
Knopp, Stefanie;Mohammed, Khalfan A.;Utzinger, Juerg
通讯作者：
Utzinger, Juerg
影响因子：
2.7
作者：
Albonico, M
通讯作者：
Albonico, M