Evaluation of Urine CCA Assays for Detection of Schistosoma mansoni Infection in Western Kenya 英文参考文献.docVIP

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Evaluation of Urine CCA Assays for Detection of Schistosoma mansoni Infection in Western Kenya 英文参考文献.doc

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Evaluation of Urine CCA Assays for Detection of Schistosoma mansoni Infection in Western Kenya 英文参考文献

EvaluationofUrineCCAAssaysforDetectionof SchistosomamansoniInfectioninWesternKenya HillaryL.Shane1,JenniferR.Verani1,BernardAbudho2,SusanP.Montgomery1,AnnaJ.Blackstock1,3, PaulineN.M.Mwinzi2,SaraE.Butler1,DianaM.S.Karanja2,W.EvanSecor1* 1DivisionofParasiticDiseases,CentersforDiseaseControlandPrevention,Atlanta,Georgia,UnitedStatesofAmerica,2CentreforGlobalHealthResearch,KenyaMedical ResearchInstitute,Kisumu,Kenya,3AtlantaResearchandEducationFoundation,Decatur,Georgia,UnitedStatesofAmerica Abstract Although accurate assessment of the prevalence of Schistosoma mansoni is important for the design and evaluation of controlprograms,themostwidelyusedtoolsfordiagnosisarelimitedbysuboptimalsensitivity,slowturn-around-time,or inabilitytodistinguishcurrentfromformerinfections.Recently,twoteststhatdetectcirculatingcathodicantigen(CCA)in urine of patients with schistosomiasis became commercially available. As part of a larger study on schistosomiasis prevalenceinyoungchildren,weevaluatedtheperformanceanddiagnosticaccuracyofthesetests—thecarbonteststrip designedforuseinthelaboratoryandthecassetteformattestintendedforfielduse.Incomparisonto6Kato-Katzexams, thecarbonandcassetteCCAtestshadsensitivitiesof88.4%and94.2%andspecificitiesof70.9%and59.4%,respectively. However,becauseoftheknownlimitationsoftheKato-Katzassay,wealsoutilizedlatentclassanalysis(LCA)incorporating the CCA, Kato-Katz, and schistosome-specific antibody results to determine their sensitivities and specificities. The laboratory-based CCA test had a sensitivity of 91.7% and a specificity of 89.4% by LCA while the cassette test had a sensitivity of 96.3% and a specificity of 74.7%. The intensity of the reaction in both urine CCA tests reflected stool egg burdenandtheirperformancewasnotaffectedbythepresenceofsoiltransmittedhelminthinfections.Ourresultssuggest thaturine-basedassaysforCCAmaybevaluableinscreeningforS.mansoniinfections. Citation: Shane HL, Verani JR, Abudho B, Montgomery SP, Blackstock AJ, et al.(2011) E