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首页> 外文期刊>Frontiers in Public Health >Additional Evaluation of the Point-of-Contact Circulating Cathodic Antigen Assay for Schistosoma mansoni Infection
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Additional Evaluation of the Point-of-Contact Circulating Cathodic Antigen Assay for Schistosoma mansoni Infection

机译：曼氏血吸虫感染接触点循环阴极抗原检测的其他评估

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Studies of the urine-based point-of-contact cathodic circulating antigen test (POC-CCA) in Schistosoma mansoni-endemic settings in Africa indicate it has good sensitivity in detecting infections, but in areas of low prevalence, the POC-CCA can be positive for persons who are egg-negative by Kato-Katz stool assays. We examined the POC-CCA assay for: (a) batch-to-batch stability; (b) intra-reader and inter-reader variability; (c) day-to-day variability compared to Kato-Katz stool assays, and (d) to see if praziquantel (PZQ) treatment converted Kato-Katz-negative/POC-CCA positive individuals to POC-CCA negativity. We found essentially no batch-to-batch variation, negligible intra-reader variability (2%), and substantial agreement for inter-reader reliability. Some day-to-day variation was observed over 5 days of urine collection, but less than the variation in Kato-Katz stool assays over 3 days. To evaluate the effect of treatment on Kato-Katz(−)/POC-CCA(+) children, 149 children in an area of 10–15% prevalence who were Kato-Katz(−) based on 3 stool samples but POC-CCA(+) were enrolled. Seven days after treatment (PZQ 40 mg/kg) samples were again collected and tested. Almost half (47%) POC-CCA positive children turned negative. Those still POC-CCA positive received a second treatment, and 34% of them turned POC-CCA negative upon this second treatment. Most who remained POC-CCA positive shifted each time to a “lesser” POC-CCA “level of positivity.” The data suggest that most Kato-Katz-negative/POC-CCA positive individuals harbor low-intensity infections, and each treatment kills all or some of their adult worms. The data also suggest that when evaluated by a more sensitive assay, the effective cure rates for PZQ are significantly less than those inferred from fecal testing. These findings have public health significance for the mapping and monitoring of Schistosoma infections and in planning the transition from schistosomiasis morbidity control to elimination of transmission.
机译：在非洲曼氏血吸虫流行地区基于尿液的接触点阴极循环抗原测试（POC-CCA）的研究表明，它对检测感染具有良好的敏感性，但是在低流行地区，POC-CCA可以通过Kato-Katz粪便测定法检测为阴性鸡蛋的人呈阳性。我们检查了POC-CCA分析的结果：（a）批次间稳定性; （b）阅读器内和阅读器间的差异; （c）与Kato-Katz粪便测定法相比的日常变化，以及（d）查看吡喹酮（PZQ）处理是否将Kato-Katz阴性/ POC-CCA阳性个体转化为POC-CCA阴性。我们发现基本上没有批次间的差异，阅读器内部的变异性可以忽略不计（2％），并且阅读器间的可靠性基本一致。在收集尿液的5天内，每天都有一些变化，但在3天内，Kato-Katz粪便测定的变化却很小。为了评估治疗对Kato-Katz（-）/ POC-CCA（+）儿童的效果，基于3个粪便样本，但POC-CCA，患病率为10-15％的149名儿童为Kato-Katz（-） （+）名参加。处理后七天（PZQ40μmg/ kg）再次收集并测试。 POC-CCA阳性儿童中近一半（47％）变为阴性。那些仍为POC-CCA阳性的患者接受了第二次治疗，其中34％的患者在第二次治疗后变为POC-CCA阴性。大部分保持POC-CCA阳性的人每次都转向“较少”的POC-CCA“阳性水平”。数据表明，大多数加藤-卡兹氏阴性/ POC-CCA阳性个体都携带低强度感染，并且每种疗法杀死所有或部分成虫。数据还表明，当通过更敏感的分析进行评估时，PZQ的有效治愈率显着低于粪便检测的推断。这些发现对血吸虫感染的测绘和监测以及从血吸虫病发病率控制到消除传播的过渡计划具有公共卫生意义。

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