胶体染料试纸条试验在血吸虫病大规模现场查病中应用价值的评价

APPLICATION VALUE OF DIPSTICK DYE IMMUNOASSAY FOR MASS SCREENING SCHISTOSOMIASIS

目的 评价胶体染料试纸条试验 (DDIA )在血吸虫病大规模现场筛查中的效果与费用。方法 在江苏省 10个血吸虫病流行市中 ,对 5～ 6 5周岁居民采用整群轮查的形式进行 DDIA+粪孵查病 ,统计并比较不同地区 (各市 )和不同流行程度 (传播阻断、传播控制、尚未控制 )地区居民 DDIA的阳性检出率 ;再根据各地的工资水平和经济状况 ,计算出不同地区血防查病的总费用 ,分析皮试 +COPT+粪孵和 DDIA +粪孵查病程序中各种费用的构成情况 ,比较两种查病程序的人均免疫筛查费用和人均综合查病费用。结果 2 0 0 3年用 DDIA共筛查 3180 0 9人 ,查出阳性 5 771人 ,平均阳性检出率为 1.81% ,不同地区 (各市 )居民 DDIA阳性率在 0 .0 4 %～ 5 .75 %之间 ;传播阻断、传播控制和尚未控制 3类地区 DDIA方法的居民阳性检出率分别为 0 .4 0 %、2 .6 6 %、4 .74 %。 DDIA程序的人均筛查费用和人均综合查病费用分别为 4 .4 2元和 4 .96元 ,分别比 COPT程序节省了 0 .92元和 0 .6 0元 ,所需人均费用分别减少了 17.2 3%和 10 .79% ,节省的费用主要来源于实验操作人工费。结论 利用 DDIA程序进行大规模综合查病时 ,血检阳性率比 COPT高 1倍 ,人均查病费用比 COPT程序节省10 %。

Objective To evaluate the eff ec t and cost of Dipstick Dye Immunoassay (DDIA) for mass screening schistosomiasis in the field. Methods Ten schistosomiasis ende mic areas in Jiangsu Province were enrolled as study areas. The DDIA and miracidium hatching method were used to detect schistosomiasis in t he population aged 5-65 years old in 2003. All the data were analysed according to the different endemic areas such as transmission interrupted areas, transmiss ion controlled areas and transmission areas, and compared with the data of 2002 when the intradermal test and COPT were used to detect schistosomiasis. The cost -effe ctiveness was assayed. Results A total of 318 0 09 people were tested and 5 771 positive by the DDIA in 2003. The positive rates in thedifferent endemic areas were 0.04%-5.75% and the average was 1.81%. The positive rates of DDIA (2003) in the transmission interrupted areas, transmission controlled areas and transmissi on areas were 0.40%, 2.66% and 4.74% respectively; and the positive rates of COP T (2002) in the transmission interrupted areas, transmission controlled areas an d transmission areas were 0.19%, 0.72% and 1.80% respectively. The cost of DD IA and miracidium hatching method was 4.96 yuan per person. The cost of intraderma l tes t, COPT and miracidium hatching method was 5.56 yuan per person. Conclusion Th e positive rate of DDIA is higher than that of COPT for mass screening schistoso miasis and the cost of DDIA cheaper than that of COPT.