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首页> 外文期刊>The American Journal of Tropical Medicine and Hygiene >A comparative study of the effectiveness of diagnostic tests for visceral leishmaniasis.
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A comparative study of the effectiveness of diagnostic tests for visceral leishmaniasis.

机译：内脏利什曼病诊断测试效果的比较研究。

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摘要

We compared the validity of pancytopenia, the formol-gel test (FGT), the indirect fluorescence antibody test (IFAT), the direct agglutination test (DAT), and the rK39 dipstick test as diagnostic criteria for visceral leishmaniasis (VL) in Nepal. Between September 2000 and January 2002, 310 clinical suspects had a bone marrow aspirate, and if negative, a spleen aspirate smear examined for Leishmania donovani. Sensitivity and specificity of all tests were determined compared with parasitology and by latent class analysis (LCA). Compared with parasitology, the sensitivities of the other tests were as follows: pancytopenia = 16.3% (95% confidence interval [CI] = 11.3-22.5%), FGT = 39.9% (95% CI = 32.7-47.4%), IFAT = 28.4% (95% CI = 22.0-35.5%), DAT = 95.1% (95% CI = 90.8-97.7%), and the rK39 dipstick test = 87.4% (95% CI = 81.7-91.9%). Sensitivity estimates obtained by LCA were similar, but specificity estimates were substantially higher (DAT = 93.7% versus 77.8%; rK39 dipstick test = 93.1% versus 77.0%). The DAT or the rK39 dipstick test can replace parasitology as the basis of a decision to treat VL in Nepalese peripheral health services.
机译：我们比较了全血细胞减少症，formol-gel试验（FGT），间接荧光抗体试验（IFAT），直接凝集试验（DAT）和rK39试纸法作为尼泊尔内脏利什曼病（VL）的诊断标准的有效性。在2000年9月至2002年1月之间，有310名临床嫌疑人进行了一次骨髓穿刺检查，如果检查结果为阴性，则进行了一次脾脏抽出涂片检查以检查利什曼原虫。所有测试的敏感性和特异性均与寄生虫学进行了比较，并通过潜在类别分析（LCA）确定。与寄生虫学相比，其他测试的敏感性如下：全血细胞减少症= 16.3％（95％置信区间[CI] = 11.3-22.5％），FGT = 39.9％（95％CI = 32.7-47.4％），IFAT = 28.4％（95％CI = 22.0-35.5％），DAT = 95.1％（95％CI = 90.8-97.7％）和rK39油尺测试= 87.4％（95％CI = 81.7-91.9％）。通过LCA获得的灵敏度估计值相似，但特异性估计值则更高（DAT = 93.7％对77.8％; rK39量油尺测试= 93.1％对77.0％）。 DAT或rK39量油尺测试可替代寄生虫学，作为决定在尼泊尔周边卫生服务中治疗VL的基础。

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