Schistosoma mansoni Infections in Young Children When Are Schistosome Antigens in Urine, Eggs in Stool and Antibodies to Eggs First Detectable 英文参考文献.docVIP

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Schistosoma mansoni Infections in Young Children When Are Schistosome Antigens in Urine, Eggs in Stool and Antibodies to Eggs First Detectable 英文参考文献.doc

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Schistosoma mansoni Infections in Young Children When Are Schistosome Antigens in Urine, Eggs in Stool and Antibodies to Eggs First Detectable 英文参考文献

SchistosomamansoniInfectionsinYoungChildren: WhenAreSchistosomeAntigensinUrine,EggsinStool andAntibodiestoEggsFirstDetectable? J.RussellStothard1*,JoseC.Sousa-Figuereido1,2,MarthaBetson1,MosesAdriko3,MosesArinaitwe3, CandiaRowell3,FredBesiyge3,NarcisB.Kabatereine3 1Wolfson Wellcome Biomedical Laboratories, Department of Zoology, Natural History Museum, London, United Kingdom, 2Department of Infectious and Tropical Diseases,LondonSchoolofHygieneandTropicalMedicine,London,UnitedKingdom,3VectorControlDivision,MinistryofHealth,Kampala,Uganda Abstract Background: In Uganda, control of intestinal schistosomiasis with preventive chemotherapy is typically focused towards treatment of school-aged children; the needs of younger children are presently being investigated as in lakeshore communities very young children can be infected. In the context of future epidemiological monitoring, we sought to comparethedetectionthresholdsofavailablediagnostictoolsforSchistosomamansoniandestimatealikelyageoffirst infectionforthesechildren. MethodsandFindings:Atotalof242infantsandpreschoolchildren(134boysand108girls,meanage2.9years,minimum 5 months and maximum 5 years) were examined from Bugoigo, a well-known disease endemic village on Lake Albert. Schistosomeantigensinurine,eggsinstoolandhostantibodiestoeggswereinspectedtorevealageneralprevalenceof 47.5%(CI95 41.1–54.0%),asascertainedbyapositivecriterionfromatleastonediagnosticmethod.Althoughchildrenas youngas6monthsoldcouldbefoundinfected,theaverageageofinfectedchildrenwasbetween3J–3Lyears,when diagnostictechniquesbecamebroadlycongruent. Conclusion: Whilst different assays have particular (dis)advantages, direct detection of eggs in stool was least sensitive havingatemporallagbehindantigenandantibodymethods.Settingpreciselyageneralageoffirstinfectionisproblematic butifpresentUgandanpoliciescontinue,alargeproportionofinfectedchildrencouldwaitupto3–4yearsbeforereceiving firstmedication.Tobettertailortreatmentneedsforthisyoungerageclass,w