Diagnostic Accuracy and Feasibility of Serological Tests on Filter Paper Samples for Outbreak Detection of T.b. gambiense Human African Trypanosomiasis

Diagnostic Accuracy and Feasibility of Serological Tests on Filter Paper Samples for Outbreak Detection of T.b. gambiense Human African Trypanosomiasis
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DOI:
10.4269/ajtmh.2010.09-0735
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发表时间:
2010-08-01
影响因子:
3.3
通讯作者:
Boelaert, Marleen
Boelaert, Marleen
中科院分区:
医学4区
文献类型:
--
作者:
Hasker, Epco;Lutumba, Pascal;Boelaert, Marleen

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刚果民主共和国对非洲锥虫病的控制是通过移动的小组进行大规模人群筛查,一种昂贵的劳动密集型方法我们假设由村卫生工作者在滤纸上收集血液样本并在中心实验室处理可能是一种具有成本效益的替代方法。我们评估了锥虫病微卡凝集试验的敏感性和特异性。将滤纸样本上的微量CATT和酶联免疫吸附试验(ELISA)/冈比亚结核菌与基于寄生虫学的病例分类进行比较,并将结果用于批量质量保证采样(LQAS)方法的Monte Gallo模拟。(92.7%[95%CI 87.4- 98.0%]和82.2%[95%CI 75.3-90.4%])和极高特异性(99.4% [95% CI 99 0-99 9%]和99 8% [95% CI 99.5-100%],条件是每批样本量较高(>= 60%),这两种测试都可以可靠地区分2%和零流行率在村庄一级,或者,这些测试可以用来确定个人HAT嫌疑人,随后确认。
Control of human African trypanosomiasis (HAT) in the Democratic Republic of Congo is based on mass population screening by mobile teams, a costly and labor-intensive approach We hypothesized that blood samples collected on filter paper by village health workers and processed in a central laboratory might be a cost-effective alternative We estimated sensitivity and specificity of micro-card agglutination test for trypanosomasis (micro-CATT) and enzyme-linked immunosorbent assay (ELISA)/Tb gambiense on filter paper samples compared with parasitology-based case classification and used the results in a Monte Gallo simulation of a lot quality assurance sampling (LQAS) approach Micro-CATT and ELISA/Tb gambiense showed acceptable sensitivity (92 7% [95% Cl 87.4-98 0%] and 82 2% [95% CI 75.3-90.4%]) and very high specificity (99.4% [95% Cl 99 0-99 9%] and 99 8% [95% Cl 99.5-100%], respectively Conditional on high sample size per lot (>= 60%), both tests could reliably distinguish a 2% from a zero prevalence at village level Alternatively, these tests could be used to identify individual HAT suspects for subsequent confirmation.