Detection of Onchocerca volvulus infection in low prevalence areas:: a comparison of three diagnostic methods

被引:46
作者
Boatin, BA
Toé, L
Alley, ES
Nagelkerke, NJD
Borsboom, G
Habbema, JDF
机构
[1] Erasmus Univ, Dept Publ Hlth, iMGZ, NL-3000 DR Rotterdam, Netherlands
[2] WHO, Onchocerciasis Control Programme, Ouagadougou, Burkina Faso
关键词
onchocerciasis; diagnostics; PCR; skin snipping; diethylcarbamazine patch test;
D O I
10.1017/S0031182002002494
中图分类号
R38 [医学寄生虫学]; Q [生物科学];
学科分类号
07 ; 0710 ; 09 ; 100103 ;
摘要
The standard assay for onchocerciasis diagnosis is microscopical detection of microfilariae in skin snips. Skin snipping is painful, requires appropriate sterilization of equipment, and may fail to diagnose light infections. Two alternatives are a polymerase chain reaction (PCR) test which detects parasite DNA in pieces or scrapings of skin and a test based on allergic reactions to topical application of diethylcarbamazine (DEC). We compared these 2 diagnostics with standard skin snip microscopy in 313 individuals from 2 villages in Guinea, with low prevalence after over 10 years of control by the Onchocerciasis Control Programme. Lower and upper bounds on sensitivities and specificities of these 3 tests were estimated. In addition, these parameters were estimated using 5 different statistical models. Where prevalence was low, PCR and the DEC patch test appeared to be more sensitive than skin snipping which has low sensitivity, As the DEC test is non-invasive, simple and cheap, it may provide a good alternative to skin snipping alone for surveillance in low prevalence areas.
引用
收藏
页码:545 / 552
页数:8
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