IFAT.ELISA在丝虫病监测中的应用研究

STUDIES ON APPLICATION OF SEROLOGICAL TESTS IN THE FILARIASIS SURVEILLANCE

实验表明,对班氏 mf(+)者40例和马来 mf(+)者98例检测,IFAT 获得阳性率分别为90%和94%,FLISA 为95%和94%,对非流行区健康对照者,检测假阳性率 IFAT 为3.6%,ELISA 为5.4%。两种方法的敏感性和特异性均在90%以上,提示可用于丝虫病的免疫诊断。在基本消灭丝虫病11—14年的原班氏丝虫病高度流行区,以 IFAT 检测的抗体阳性率原 mf(+)组为10%(6/61),原 mf(-)组为6%(3/45),儿童组为3.23%(1/31),非流行区对照组为3.6%(4/111);ELISA 的实验结果为原 mf(+)组抗体阳性率16%(10/61),原 mf(-)组18%(9/50),儿童组为14%(1/31)。ELISA 检测的三组人群之间无显著性差异,但仍高于非流行区人群的抗体水平(5.4%)(P<0.01,P<0.01)。IFAT 的实验结果表明,经过10年以上,原班氏高度流行区的人群抗体水平已降至非流行区和正常人群水平。对两科方法联合应用于监测进行了观察,结果显示联合监测较单一方法为优,两种方法并联使用,敏感性提高至99.6%,特异性仍为90.8%,较适宜于对流行区人群的宏观监测。

During 1987—1988 in the historical Wuchereria bancrofti hyperendemic areas where filariasis has been basically eliminated for 11—14 years,IFAT positiv rate was 10% (6/61) in formerly mf carriers,6% in amicrofilarial persons and 3.23%in ehildren. ELISA positive rate was 16%,18% and 14% respectively.There Was no significant difference in the IFAT positive rate among these three groups,and nor between these groups and controls (3.6%). It was proved that the combination of the two tests was superior to each of them in the surveillance.In parallel experiments,the sensitivity increased to 99.6% with speci- ficity still above 90%,so it was more suitable for macroscopic surveillance,Howerer in series experiments the specificity increased to 99.8%.The incidence of missed cases sharply lowered.Hence it could bey sed in differential diagnosis of disputed eases in field and in clinics.