日本血吸虫抗体检测试剂盒在鄱阳湖区现场应用分析

Comparative Evaluation of Five Test Kits for Antibody Detection in Schistosoma japonicum Endemic Areas of Poyang Lake Region

目的分析常用的日本血吸虫抗体检测试剂盒在鄱阳湖区日本血吸虫病流行区人群的应用价值。方法在鄱阳湖区3个日本血吸虫病不同流行程度的行政村(新建县曹会村、都昌县井头村和星子县新华村),对5岁以上的常住居民同时采用日本血吸虫感染的病原学(Kato-Katz法和尼龙绢集卵孵化法)检查方法和常用5种抗体检测试剂盒检查人群日本血吸虫感染情况。结果 3个调查点人群的5种常用免疫诊断试剂盒检测的抗体阳性率(33.1%～57.1%)均显著高于粪检阳性率(5.0%-8.2%)(P<0.05)。抗体阳性率的年龄分布趋势与粪检结果一致,人群粪检阳性率、抗体阳性率高峰均出现在40～49岁组人群。不同免疫诊断试剂盒的抗体阳性率随着感染度的增加而增高,敏感性为81.2%～94.5%,其中ELISA检测试剂盒敏感性最高;但粪检阴性者中仍有约26.9%～46.1%为抗体阳性。粪检阳性者中,仍有5.5%～18.8%为抗体阴性。结论 5种免疫诊断试剂盒均可用于流行区群体水平的血吸虫病流行病学调查,其中ELISA诊断试剂敏感性最高,且在不同感染度水平间无显著性差异。

Objective To evaluate the efficacy of five diagnostic test kits for the detection of antibodies to Schistosoma japonicum in endemic areas of Poyang Lake.Methods Residents over 5 years old in three schistosomiasis-endemic administrative villages in the lake region were simultaneously examined by modified Kato-Katz thick smears and nylon bag sedimentation/hatching method.At the same time,five sero-diagnostic test kits for detection of IgG antibody against soluble egg antigen of S.japonicum were carried out.Results The distribution of seropositive rates of S.japonicum IgG antibodies determined by sero-diagnostic tests showed similar trends with that of egg positive rates in different age groups,but the seropositive rate （33.1%-57.1%）was significantly higher than that of egg positive rate （5.0%-8.2%）,both reached a peak in 40-49-year-old group.The antibody positive rates determined by each test increased with the infection intensity.The sensitivity of the evaluated test kits ranged from 81.2%-94.5%.26.9% to 46.1% among those egg negatives were antibody positive by the kits.Furthermore,5.5%-18.8% of the egg positives were antibody negative by the kits.Conclusion The five sero-diagnostic kits can be used for epidemiological survey in schistosomiasis endemic areas at community level.Among them,enzyme-linked immunosorbent assay shows higher sensitivity.