An Immunodiagnostic Assay for Scabies

疥疮是一种全球性疾病，也是许多发展中国家的主要健康问题，主要与贫穷和过度拥挤有关。在澳大利亚北方偏远的土著社区，尽管有有效的化疗，但据报道儿童的患病率高达50%。疥疮是由一个微小的螨在皮肤下打洞引起的，症状包括强烈的瘙痒病变，这可能是非常令人痛苦的，往往成为继发性感染A组链球菌。这些皮肤溃疡会导致严重的并发症，包括血液中毒和肾损伤。疥疮的控制受到诊断困难、治疗费用、出现耐药性的证据以及缺乏有效疫苗的阻碍。疥疮感染的症状可以模仿许多其他皮肤病，如皮炎，湿疹，脓疱和过敏反应，传统的测试来诊断疥疮往往低于50%的准确性。流行地区的控制措施包括基于社区的疥疮干预方案，虽然在短期内成功地降低了疥疮的水平，但由于社区内疥疮的持续水平较低，因此难以维持。最近的发展导致疥螨重组抗原的表达和纯化已经确定了一些具有诊断潜力的分子，本研究的目的是调查这些重组蛋白的准确性，以确定疥疮特异性抗体的人与活动性疥疮。一个有效的简单，廉价，快速，敏感和具体的诊断测试疥疮将有助于早期识别疾病，从而治疗。此外，它将使受影响的儿童及其家庭能够得到选择性治疗，减少大规模治疗的需要和相关费用，降低螨抗药性升级的可能性，并为高度受影响地区提供另一种控制疥疮的手段。

Scabies is a global disease and a major health problem in many developing countries, related primarily to poverty and overcrowding. In remote Aboriginal communities in northern Australia prevalences of up to 50% in children have been described, despite the availability of effective chemotherapy. Scabies is caused by a tiny mite burrowing under the skin and symptoms include intensely itching lesions that can be very distressing, and often become secondarily infected with Group A Streptococcus. These skin sores can result in serious complications, including blood poisoning and kidney damage. Control of scabies is hindered by difficulties with diagnosis, the cost of treatment, evidence for emerging resistance, and lack of effective vaccines. The symptoms of scabies infestations can mimic many other skin diseases such as dermatitis, eczema, impetigo, and allergic reactions, and traditional tests to diagnose scabies are often less than 50% accurate. Control measures in endemic regions include community-based scabies intervention programs and although successful at reducing levels of scabies in the short term, have proved difficult to sustain due to low levels of scabies persisting within communities. Recent developments leading to expression and purification of scabies mite recombinant antigens have identified a number of molecules with diagnostic potential and this study aims to investigate the accuracy of these recombinant proteins to identify scabies specific antibodies in people with active scabies. An effective simple, cheap, rapid, sensitive and specific diagnostic test for scabies will aid in the early identification of disease and thus treatment. Furthermore it will enable the selective treatment of affected children and their families, reducing the requirement for mass treatment and associated costs, decrease the potential for escalating mite resistance, and provide another means of controlling scabies in highly affected areas.