Research to Facilitate Elimination of Lymphatic Filariasis in Asia and Africa, and the Application of the Results

我们建立了一种利用尿样检测丝虫感染的酶联免疫吸附试验(尿液酶联免疫吸附试验)，并研究了该方法是否适用于现场发现流行区、评估治疗效果和确认消灭丝虫病。斯里兰卡的研究：(I)对每年的大规模治疗进行了5年的监测，结果显示，社区中的抗体滴度逐渐下降，最终达到阴性水平。(2)根据当地居民提供的象皮病和鞘膜积液信息绘制了丝虫病分布图。用尿液酶联免疫吸附试验证实了他们信息的可靠性。(3)在南方省份的3个区进行了流行病学研究。研究发现，沿海地区的感染率高于内陆地区。(4)已知斯里兰卡有象皮病家族聚集症。为阐明该症状的遗传背景，开展了基础研究。中国的一项研究：在中国研究人员确认消除丝虫病的地区进行了尿液酶联免疫吸附试验(EL ISA)的现场研究，以探讨EL ISA能否再次确认消除丝虫病。这项研究显示，接受检查的10,000多名儿童的尿液ELISA全部呈阴性。肯尼亚的一项研究：血吸虫感染产生与尿液ELISA法交叉反应的抗体，从而导致特异性差。使用重组SXP-1抗原的新的尿液ELISA法成功地消除了交叉反应。东帝汶的一项研究：用尿液酶联免疫吸附试验对34所学校的5661名学生进行了流行病学研究，结果显示阳性率很低，只有2.9%。

We developed an ELISA to detect filarial infection using urine samples (urine ELISA), and studied if the method was applicable in the field to find endemic areas, evaluate treatment effects and to confirm elimination of filariasis.1. Studies in Sri Lanka: (i) Annual mass treatments were monitored for 5 years, which revealed that antibody titers in a community reduced gradually and eventually reached negative levels. (ii) A filariasis distribution map was made based on information on elephantiasis and hydrocele given by lccal people. The reliability of their information was confirmed with urine ELISA. (iii) An epidemiological study was carried out in 3 districts in Southern province. It was found that coastal regions had higher infection rates than inland areas. (iv) Familial accumulation of elephantiasis had been known in Sri Lanka. Basic studies were carried out to clarify genetic backgrounds of the symptom.2. Astudy in China : Afield study with urine ELISA was conducted in the area where filariasis elimination had been confirmed by Chinese researchers to investigate if the ELISA could re-confirm the elimination. The study revealed that all of more than 10, 000 children examined were urine ELISAnegative.3. A study in Kenya : Schistosoma haematobium infection produces cross reactive antibodies with urine ELISA, thus resulting in poor specificity. Anew urine ELISA using a recombinant SXP-1 antigen successfully eliminated the cross reactivity4. A study in East Timor : An epidemiological study was conducted with urine ELISA at 34 schools with 5, 661 students, and revealed a low positive rate of 2.9%.