论文部分内容阅读
目的分析IHA筛查法评估血吸虫病疫区人群感染率的可靠性。方法在江西省鄱阳湖血吸虫病疫区选取一个村的居民为研究对象,对每位对象收集2次新鲜粪便标本各制作6张Ka-to片(2粪12片)进行病原学检测,同时采用IHA法进行血清学定量检测,分析常规1粪3张Kato片的阳性检出率与漏检率、IHA的诊断效率及IHA与Kato-Katz法结果的相关性。结果3张Ka-to片漏检率达19.7%～66.1%,1粪较2粪漏检率为23.0%。IHA的敏感度和特异度分别为69.6%、89.4%,与Kato-Katz法的总符合率为86.7%。IHA的阴性预测值为96.8%,但阳性预测值较低(36.8%),阳性漏检率高达30.4%;IHA筛查法对试点区人群感染率估算的漏检率达35.8%。结论IHA筛查法对疫区人群实际感染率估算有较大的偏差,IHA作为筛查工具仍需提高其敏感性和特异性,IHA阳性阈值有待进一步探讨。
Objective To analyze the reliability of the IHA screening method in assessing the infection rate of schistosomiasis patients. Methods The residents of a village in Poyang Lake of Jiangxi Province were enrolled in this study. Two fresh stool samples were collected from each subject for 6 Ka-to-2 tablets (2 feces and 12 tablets) for pathogen detection. The IHA Method for quantitative detection of serology, analysis of a regular feces 3 Kato tablets positive detection rate and missed detection rate, IHA diagnostic efficiency and IHA and Kato-Katz results correlation. Results The detection rate of three Ka-to films was 19.7% ~ 66.1%, while that of 1-manure was 23.0%. The sensitivity and specificity of IHA were 69.6% and 89.4%, respectively. The overall coincidence rate with Kato-Katz method was 86.7%. The negative predictive value of IHA was 96.8%, but the positive predictive value was low (36.8%). The positive detection rate was as high as 30.4%. The IHA screening method underestimated the infection rate of 35.8% of the population in the pilot area. Conclusion The IHA screening method has a big bias in estimating the actual infection rate of people in the epidemic area. IHA as a screening tool still needs to improve its sensitivity and specificity. The IHA positive threshold needs to be further explored.