An Immunodiagnostic Assay for Scabies

麻疹是一种全球性疾病，也是许多发展中国家的主要健康问题，主要与贫困和过度拥挤有关。在澳大利亚北部偏远的原住民社区，尽管有有效的化疗方法，但儿童中的发病率高达50%。溃疡是由皮肤下的微小蠕虫引起的，症状包括强烈瘙痒的皮损，这可能是非常令人痛苦的，通常会继发感染A组链球菌。这些皮肤溃疡可能会导致严重的并发症，包括血液中毒和肾脏损伤。诊断困难、治疗费用高、出现耐药性的证据以及缺乏有效疫苗，阻碍了对麻疹的控制。麻疹侵袭的症状可以模仿许多其他皮肤病，如皮炎、湿疹、脓疱病和过敏反应，而传统的检测方法往往不到50%的准确率。流行地区的控制措施包括以社区为基础的麻疹干预计划，虽然在短期内成功地降低了麻疹水平，但由于社区内持续存在低水平的溃疡，事实证明很难持续下去。近年来，通过表达和纯化重组抗原，已鉴定出一些具有诊断潜力的分子，本研究旨在探讨这些重组蛋白识别活动期溃疡病特异性抗体的准确性。一种有效、简便、廉价、快速、灵敏、特异的麻疹诊断试验将有助于疾病的早期识别和治疗。此外，它将能够有选择地治疗受影响的儿童及其家人，减少大规模治疗的需求和相关费用，减少对尘螨耐药性不断上升的可能性，并提供另一种在高度受影响地区控制溃烂的手段。

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.