PDF(Pubmed)
Abstract：
Soil-transmitted helminths (STH) are a significant public health problem in impoverished communities of tropical and subtropical areas. Improved diagnostic methods are crucial for Neglected Tropical Diseases programs, particularly for S. stercoralis, as traditional methods are inadequate. Thus, it is important to identify the most accurate and efficient methods for the diagnosis of STH. We performed a retrospective study analyzing laboratory data at the Instituto de Investigaciones de Enfermedades Tropicales from 2010 to 2019. The study included data from outpatients referred for stool analysis and public health interventions from urban and rural communities in northern Salta province, Argentina. Samples were included in this analysis if processed through sedimentation/concentration, Baermann, Harada-Mori and McMaster\'s, with a subgroup that also included Agar plate culture method (APC). Sensitivity was calculated against a composite reference standard. Of the 5625 samples collected, 944 qualified for this analysis, with a prevalence of 11.14% for A. lumbricoides, 8.16% for hookworm, 1.38% for T. trichiura, and 6.36% for S. stercoralis. The sedimentation/concentration method was the most sensitive for A. lumbricoides (96%), compared to the McMaster method, with a sensitivity of 62%. Similarly, for hookworms, sedimentation/concentration was more sensitive than McMaster\'s, Harada-Mori, and Baermann with sensitivities of 87%, 70%, 43%, and 13%, respectively. Most of these infections were of light intensity. For S. stercoralis, Baermann and sedimentation/concentration methods were the most sensitive, with 70% and 62% respectively, while Harada-Mori was the least sensitive. In a subset of 389 samples also analyzed by the APC, Baermann was more sensitive than APC for detecting S. stercoralis, and both methods were superior to Harada-Mori. Parasitological methods, mostly when used combined, offer adequate opportunities for the diagnosis of STH in clinical and public health laboratories. The incorporation of S. stercoralis into the control strategies of the World Health Organization requires rethinking the current diagnostic approach used for surveys. With sedimentation/concentration and Baermann appearing as the most sensitive methods for this species. Further studies, including implementation assessments, should help in identifying the most adequate and feasible all-STH diagnostic approach.
摘要：
土壤传播的蠕虫（STH）是热带和亚热带地区贫困社区的重大公共卫生问题。改进的诊断方法对于被忽视的热带病计划至关重要，特别是对于S.stercoralis，因为传统方法是不够的。因此，确定最准确、最有效的STH诊断方法非常重要。我们进行了一项回顾性研究，分析了2010年至2019年Tropicales研究所的实验室数据。该研究包括来自萨尔塔省北部城市和农村社区的门诊患者的粪便分析和公共卫生干预措施的数据，阿根廷。如果通过沉降/浓缩处理，则将样品包括在此分析中。Baermann,原田森和麦克马斯特,亚组还包括琼脂平板培养法(APC)。相对于复合参考标准计算灵敏度。在收集的5625个样本中，944有资格进行此分析，A.lumbricoides的患病率为11.14%，钩虫8.16%，T.trichiura为1.38%，和6.36%。沉降/浓缩方法对A.lumbricoides最敏感(96%)，与麦克马斯特方法相比，灵敏度为62%。同样，对于钩虫来说，沉降/浓度比麦克马斯特更敏感，Harada-Mori,Baermann的敏感度为87%,70%,43%,13%,分别。这些感染大多数是光强度的。对于S.stercoralis，Baermann和沉降/浓缩方法最敏感，分别为70%和62%，而原田森是最不敏感的。在APC也分析的389个样本的子集中，Baermann比APC对检测胸骨链球菌更敏感，两种方法都优于原田森。寄生虫学方法,主要是结合使用时，为临床和公共卫生实验室的STH诊断提供足够的机会。将S.stercoralis纳入世界卫生组织的控制策略需要重新考虑当前用于调查的诊断方法。沉降/浓缩和Baermann似乎是该物种最敏感的方法。进一步研究,包括执行情况评估，应有助于确定最充分和可行的全STH诊断方法。
