丝虫特异IgG4试剂盒在消除丝虫病地区应用价值的探讨

目的　探讨丝虫特异IgG4检测试剂盒在消除丝虫病地区监测中的应用价值。　方法　应用山东省寄生虫病防治研究所和深圳市绿瀚生物技术有限公司联合研制的丝虫特异IgG4检测试剂盒 ,检测原微丝蚴血症者和 12岁以下儿童及消除丝虫病地区居民特异IgG4,并与病原学方法进行对照。　 结果　检测原微丝蚴血症 3 43例 ,特异IgG4阳性6例 ,阳性率 1.75 % ;检测基本消除丝虫病后出生的儿童 5 42人 ,未检出抗体阳性者 ;检测消除丝虫病地区居民 77人 ,特异IgG4阳性 7例 ,阳性率 9.0 9%。病原学检查消除丝虫病地区居民 77人 ,检出微丝蚴血症 2例 ,阳性率 2 .5 9% ;其余人群均未发现微丝蚴血症。　结论　丝虫特异IgG特异检测试剂盒具有较高的灵敏度和特异度 ,适合于消除丝虫病地区流行病学监测和防治效果考核。     

丝虫特异IgG4试剂盒在消除丝虫病地区应用价值的探讨

目的 探讨丝虫特异IgG4检测试剂盒在消除丝虫病地区监测中的应用价值。方法 应用山东省寄生虫病防治研究所和深圳市绿瀚生物技术有限公司联合研制的丝虫特异IgG4检测试剂盒，检测原微丝蚴血症者和12岁以下儿童及消除丝虫病地区居民特异IgG4，并与病原学方法进行对照。结果 检测原微丝蚴血症343例，特异IgG4阳性6例，阳性率1．75％；检测基本消除丝虫病后出生的儿童542人，未检出抗体阳性者；检测消除丝虫病地区居民77人，特异IgG4阳性7例，阳性率9．09％。病原学检查消除丝虫病地区居民77人，检出微丝蚴血症2例，阳性率2．59％；其余人群均未发现微丝蚴血症。结论 丝虫特异IgG特异检测试剂盒具有较高的灵敏度和特异度，适合于消除丝虫病地区流行病学监测和防治效果考核。     

消灭丝虫病地区病原学监测方法的研究

为筛选适宜在消灭丝虫病地区应用的简易、经济、实用的病原学监测方法,对单克隆抗体（McAb）-ELISA检测丝虫特异IgG4和快速免疫色谱技术（ICT）检测血清和血浆中的班氏丝虫抗原诊断丝虫病的效果进行对比研究。结果检测班氏微丝蚴血症者59例,丝虫特异IgG4阳性57例,阳性率96.61%;ICT丝虫抗原阳性56例,阳性率为94.92%。两种方法均具有较高的敏感性,差异无显著性（P＞0.05）。同时分别检测非流行区健康者40人,囊虫病患者30例及25例华支睾吸虫病患者血清,两种方法均呈阴性,未出现交叉反应,特异性为100%。现场研究两种方法分别检测基本消灭丝虫病后出生儿童302人,消灭丝虫病地区人群372人,晚期丝虫病患者55例（乳糜尿41例,象皮肿14例）,原微丝蚴血症转阴者60例。结果仅消灭丝虫病地区人群中1例（以往血检阴性）丝虫特异IgG4强阳性,ICT丝虫抗原弱阳性,但反复镜检未发现微丝蚴。其余均为阴性。研究表明,两种方法均具有较高的敏感性和特异性,均可用于消灭丝虫病地区病原学的监测。McAb-ELISA检测丝虫特异IgG4可大面积用于消灭丝虫病地区的病原学监测。而ICT检测班氏丝虫抗原更适用于个案病例的检测。     

湖北省消除丝虫病后重点地区专项调查报告

目的在丝虫病防治工作薄弱地区搜索残存传染源,为消除丝虫病后的监测工作提供科学依据。方法通过查阅历史资料,与专业人员座谈和实地查访等方式,确定丝虫病防治工作重点地区行政村,对10岁及以上居民进行丝虫特异IgG4抗体检测,阳性者采用ICT卡检测丝虫循环抗原。同时采制厚血膜,检查微丝蚴。结果确定恩施市、利川市、咸丰县、宣恩县和蕲春县等5县(市)8乡镇9个村为防治工作重点地区行政村。抽查村防治前人群平均微丝蚴率0.87%~6.62%,防治后微丝蚴率0~1.02%;检测人群丝虫特异抗体IgG4阳性率0.05%,阳性者ICT检测和病原学检测均阴性。结论湖北省丝虫病防治成果巩固,内源性传染源存在可能性极小,应重点加强流动人口的管理和监测。     

丝虫特异IgG4检测试剂盒的研制

目的　建立丝虫特异IgG4检测试剂盒 ,根据检测不同样本的敏感性、特异性及重复性 ,评价其用于丝虫病防治后期流行病学调查和疾病监测的价值。　方法　利用细胞融合技术制备抗人IgG4单克隆抗体 ,对试验的各环节和条件进行探索 ,结合商品化的酶免疫试剂制作工艺研制一种敏感、特异 ,操作简便 ,经济实用的丝虫特异IgG4检测试剂盒 ,并对丝虫病病人、其它寄生虫病病人和健康对照血清以及滤纸血样本进行检测。　结果　 68例丝虫病病人特异IgG4阳性 64例 ,阳性率为 94.1% ;3 8例正常人及 60例其他寄生虫病病人检测全部阴性 ;对丝虫病病人血清和滤纸血检测结果基本一致。该试剂盒操作简单 ,检测本底很低 ,结果鲜明 ,易于判断。　结论　该试剂盒适于丝虫病防治后期的流行病学调查和疾病监测。     

丝虫特异IgG4检测试剂盒的研制

目的 建立丝虫特异IgG4检测试剂盒，根据检测不同样本的敏感性、特异性及重复性，评价其用于丝虫病防治后期流行病学调查和疾病监测的价值。方法 利用细胞融合技术制备抗人IgG4单克隆抗体，对试验的各环节和条件进行探索，结合商品化的酶免疫试剂制作工艺研制一种敏感、特异，操作简便，经济实用的丝虫特异IgG4检测试剂盒，并对丝虫病病人、其它寄生虫病病人和健康对照血清以及滤纸血样本进行检测。结果 68例丝虫病病人特异IgG4阳性64例，阳性率为94．1％；38例正常人及60例其他寄生虫病病人检测全部阴性；对丝虫病病人血清和滤纸血检测结果基本一致。该试剂盒操作简单，检测本底很低，结果鲜明，易于判断。结论 该试剂盒适于丝虫病防治后期的流行病学调查和疾病监测。     

消灭丝虫病地区病原学监测方法的研究

为筛选适宜在消灭丝虫病地区应用的简易、经济、实用的病原学监测方法，对单克隆抗体（ＭｃＡｂ）－ＥＬＩＳＡ检测丝虫特异ＩｇＧ４和快速免疫色谱技术（ＩＣＴ）检测血清和血浆中的班氏丝虫抗原诊断丝虫病的效果进行对比研究。结果检测班氏微丝蚴血症者５９例，丝虫特异ＩｇＧ４阳性５７例，阳性率９６．６１％；ＩＣＴ丝虫抗原阳性５６例，阳性率为９４．９２％。两种方法均具有较高的敏感性，差异无显著性（Ｐ〉０．０５）。同时分别检测非流行区健康者４０人，囊虫病患者３０例及２５例华支睾吸虫病患者血清，两种方法均呈阴性，未出现交叉反应，特异性为１００％。现场研究两种方法分别检测基本消灭丝虫病后出生儿童３０２人，消灭丝虫病地区人群３７２人，晚期丝虫病患者５５例（乳糜尿４１例，象皮种１４例），原微丝蚴血症转阴者６０例。结果仅消灭丝虫病地区人群中１     

重庆市消除丝虫病后的监测

目的探讨达到消除丝虫病后的监测措施 ,巩固消除丝虫病的防治成果。方法 1 998-2 0 0 1年 ,选择 1个村为纵向监测点 ,进行病原学和蚊媒纵向监测。对原丝虫病流行县防治工作薄弱地区、重流行区、边界地区 ,每年选择 2个县 2个村开展病原学和蚊媒的横向监测。加强流动人口 ,应征入伍青年重点对象的监测。结果纵向监测点累计血检 6 91 1人次 ,未检出微丝蚴血症者 ;解剖致倦库蚊 5 4 31只 ,未检出人体幼丝虫阳性蚊。横向监测共 7个点县 (区 ) ,累计血检 1 0 1 82人 ,未检出微丝蚴血症者 ;解剖致倦库蚊 1 31 94只 ,未检出人体幼丝虫阳性蚊。重点人群监测流动人口 5 0 5 1人 ,应征入伍青年 92 2 1人 ,均未检出微丝蚴血症者。结论监测结果表明 ,重庆市内源性传染源存在的可能性极小 ,已肃清了传染源 ,巩固了消除丝虫病的成果     

晚期丝虫病患者血清特异性抗体及抗体亚型的分析

目的评价晚期丝虫病患者血清抗丝虫抗体及抗体亚型的免疫学特性.方法用马来丝虫成虫和微丝蚴抗原,以ELISA法检测120份血清标本抗丝虫特异性抗体和抗体亚型,FPT方法进行丝虫皮内试验.结果病原学检查120份受试者均为非微丝蚴血症.80例晚期丝虫病患者FPT试验阳性率为95%(76/80),晚期丝虫病患者血清抗微丝蚴和成虫特异性抗体阳性率分别为82.5%(66/80)和80%(64/80).流行区对照抗体阳性率为10%(2/20),非流行区正常人则均为阴性.晚期丝虫病患者血清抗体亚型以IgG2为主,阳性率92.5%,其它亚型分别为IgG11.25%、IgG322.5%、IgG46.25%.结论晚期丝虫病患者血清中存在抗丝虫特异性抗体,抗体亚型主要是IgG2,它也可能是晚期丝虫病患者特异的抗体亚型.     

河南省基本消除丝虫病后残存微丝蚴血症者传播作用的研究

目的探讨基本消除丝虫病后残存微丝蚴血症者在不采取任何病原防治措施下的传播作用。方法选择柘城县张庄村为观察点,病原学监测和蚊媒监测采取常规方法,血清学检测采用IFAT、ELISA、Dot-ELISA(查抗体)和ICT(查循环抗原)方法,同时进行居民防蚊情况调查。结果1990年残存微丝蚴血症者39人,人群微丝蚴率2.01%(39/2040),2000年微丝蚴血症者全部转阴,人群微丝蚴率降为0;1990、1991和1994年检测人群丝虫抗体阳性率和抗体阳性者的几何平均滴度均逐渐下降,1998年检测92名12岁以下儿童血中丝虫循环抗原均为阴性;淡色库蚊幼丝虫自然感染率逐年下降,自1997年未再发现感染蚊;1990~2002年当地居民经济收人逐渐增加,普遍采取防蚊措施。结论基本消除丝虫病后,随居民经济和文化水平的逐渐提高,防病意识的不断增强以及防蚊措施的加强,即使未采取任何干预措施,残存微丝蚴血症者也不能引发丝虫病流行,丝虫病传播已经被阻断。     

Bancroftian filariasis infection,disease, and specific antibody response patterns in a high and a low endemicity community in East Africa

Bancroftian filariasis infection, disease and specific antibody response patterns in a high and a low endemicity community in East Africa were analyzed and compared to assess the relationship between these parameters and community transmission intensity. Overall prevalences of microfilaremia and circulating filarial antigenemia were 24.9% and 52.2% in the high and 2.7% and 16.5% in the low endemicity community, respectively. A positive history of acute attacks of adenolymphangitis was given by 12.2% and 7.1% of the populations, 4.0% and 0.9% of the adult (> or = 20 years old) individuals presented with limb lymphedema, and 25.3% and 5.3% of the adult males had hydrocele, in the high and the low endemicity community, respectively. Both infection and disease appeared earlier and reached much higher levels in the high than in the low endemicity community. The observed overall and age-specific infection and disease patterns in the two communities were in agreement with the view that these are primarily shaped by transmission intensity. No statistically significant relationships between infection status of fathers and mothers and that of their children were observed in any of the communities for either microfilaremia or for circulating filarial antigenemia. The overall levels (prevalence and geometric mean intensity) of filarial-specific IgG1, IgG2, IgG4, and IgE were significantly higher in the high endemicity community than in the low endemicity dommunity. Surprisingly, the opposite pattern was found for IgG3. Community transmission intensity thus appears to be an important determinant of observed inter-community variation in infection, disease, and host response patterns in Bancroftian filariasis.     

The control and surveillance of filariasis in Hainan Province, China

Hainan is a single bancroftian filariasis endemic province where filariasis is prevalent in all 18 cities and counties. A program to control filariasis was started in 1953. The strategy of eliminating infection sources has been adopted as the principal intervention measure in filariasis control. Over 30 years, the sustained effort throughout the province reached the point of basic elimination of filariasis in 1987. After the basic elimination of filariasis, the patterns of filariasis transmission in residual microfilaremia cases in Hainan Province were studied so as to provide a scientific basis for formulating strategies to eliminate filariasis. According to the "Technical scheme for surveillance in areas where fialariasis has been basically eliminated" issued by the Ministry of Health, a longitudinal and cross-sectional and entomological surveillance of fialariasis was carried out using parasitological and entomological and serological methods in the whole province during 1983-2004. In the cross-sectional and entomological surveillances, the last microfilaremia case was found in 1999, no mosquitoes were found to be infected with filarial larvae. A total of 132 microfilaremia cases found in the longitudinal surveillance become negative by 10 years. Since 1997 no mosquitoes were found to be infected with filarial larvae in the longitudinal surveillance. Serological surveillance of the population showed the mean positive rate of IFAT dropped from 10.63% in 1990 to 0.28% in 2000, which being similar to that of nonendemic areas. The results show that residual sources of infection after basic elimination of filariasis were tending to be naturally eliminated and transmission of filariasis has been interrupted in Hainan Province.     

Mapping of Wuchereria bancrofti infection in children and adolescents in an endemic area of Brazil

A parasitological survey was conducted among children and adolescents in the municipality of Jaboat?o dos Guararapes, Brazil to describe the occurrence and spatial distribution of lymphatic filariasis. Microfilaraemia was investigated through the thick smear technique, using 50 μl of capillary blood that was collected at night. The spatial analysis used a digital base map of the municipality, divided into districts, which were classified as hypoendemic, mesoendemic or hyperendemic. 8670 children were examined and 96 cases of microfilaraemia were identified (1.1%). The prevalence rate did not differ significantly between the sexes. Occurrences of filarial infection increased with increasing age: the greatest prevalence was recorded between 15 and 18 years of age (P<0.05). There were 49 reports of clinical manifestations. The spatial distribution of microfilaraemia according to residential district showed that 13 (54.2%) of the 24 districts investigated were positive. Approximately 33% of the districts were hyperendemic. The results demonstrated that the pediatric population had intense early exposure to the parasite, thus characterizing filariasis as endemic in the municipality. The spatial analysis allowed identification of areas with greater occurrence of infection among children, and showed localities where the populations most exposed to transmission were concentrated. Epidemiological surveillance of microfilaraemia among children and spatial analysis are important local transmission indicators and form instruments for planning actions within the Global Program to Eliminate Lymphatic Filariasis, since they make it possible to identify priority areas.     

输入性传染源对山东省消除丝虫病影响的调查

目的了解输入性传染源对山东省不同流行地区消除丝虫病的影响。方法选择原高度流行区的峰城区和原低度流行区的德州市,分别对外来人口和当地居民血检微丝蚴;现场捕获吸血蚊虫解剖计算经产蚊比率和自然感染比率,并做血源鉴定;实验室微丝蚴血饲感染蚊媒观察幼丝虫发育时间和蚊媒生殖营养周期,推算媒介能量和传染源的传播量。结果外来人口微丝蚴率德州为3.32％,峰城为0.65％。当地居民德州血检9411人无微丝蚴血症者,峰城血检692人,发现2例残存微丝蚴血症者。在德州解剖淡色库蚊3201只,自然感染率为3.81％,未发现三期幼虫(L3)。德州和峰城淡色库蚊生殖营养周期分别为4.95d和4.33d,幼丝虫发育成熟最短时间分别为16d和11d,两地媒介能量和传染源传播量之比分别为1:4.41和1:5.82。结论德州以北地区由于气温较低,气候相对干燥,昼夜温差大,媒介能量和传染源传播量低,部分传染源的输入不会影响当地消除丝虫病。峰城等原高度流行区如有较多传染源输入,则可能造成低水平传播。     

检测特异IgG4用于丝虫病监测的研究

应用细胞融合技术建立抗人ＩｇＧ４ＭｃＡｂ杂交瘤细胞，生产ＭｃＡｂ。以此为探针，应用ＥＬＩＳＡ方法检测班氏微丝蚴血症血清中特异ＩｇＧ４的阳性率为９５．９１％（４７／４９）；治疗后的原微丝蚴血症ＩｇＧ４阳性率为１．４５％（１／６９）；７７例晚期丝虫病症状者及５０份非流行区健康人血清均为阴性；肠道线虫感染、囊虫感染及华支睾吸虫感染者血清均未出现交叉反应；检测原班氏丝虫病高、中度流行区正常人群滤纸干血的特异ＩｇＧ４阳性率分别为０．７９％（６／７６０）和０．２７％（３／１０９５）。显示特异ＩｇＧ４检测具有较高的敏感性与特异性。是诊断丝虫感染的有效方法，可取代微丝蚴血检用于现场的人群丝虫病监测。     

河南省消除丝虫病的监测与审评

目的消除丝虫病残存传染源。方法1995~2002年应用厚血膜法和蚊媒解剖法,对全省69个原丝虫病流行县市实施纵、横向病原学和蚊媒监测。2003年依照卫生部消除丝虫病审评办法,对全省各丝虫病流行县进行了消除丝虫病达标审评。结果全省69个县市实施消除丝虫病监测,总监测乡镇数覆盖原丝虫病流行乡镇38.58%(以县为单位30%~100%),总监测人口覆盖流行区人口3.92%(以县为单位在3%~21.76%之间)。全省390个蚊媒监测点共捕获、剖检媒介蚊虫245878只,其中淡色库蚊213746只、中华按蚊32132只;各流行县市均达到了部颁消除丝虫病蚊媒监测标准。未发现微丝蚴血症者和幼丝虫阳性蚊。结论通过对全省69各流行县市的丝虫病达标监测和审评,证实河南省已经消除丝虫病传染源,达到了卫生部颁消除丝虫病标准。     

Wuchereria bancrofti in a community with seasonal transmission: stability of microfilaraemia, antigenaemia and filarial-specific antibody concentrations

The effect of seasonal transmission on microfilaraemia, antigenaemia and filarial-specific antibody levels in individuals infected with Wuchereria bancrofti was investigated in a follow-up study in an endemic community in north-eastern Tanzania. The subjects were 37 adult male residents who were found to be positive for circulating filarial antigen (CFA) at the beginning of the study (26 of whom were also found microfilaraemic with W. bancrofti at this time). Blood samples were collected from each subject in July 1998, January 1999 and July 1999, during the seasons when transmission intensity was high, low and high, respectively. The mean intensities of microfilaraemia and the mean concentrations of CFA were each slightly higher during the low-transmission season than during the two high-transmission seasons but the differences were not statistically significant (P > 0.05). Similarly, the mean levels of filarial-specific IgG1, IgG2, IgG3, IgG4 or IgE did not differ to a statistically significant degree between the three examination times. Microfilaraemias and the levels of CFA and filarial-specific antibodies all therefore appeared to be remarkably stable and largely unaffected by the seasonal variation in transmission. That no variation in the mean IgG4/IgE ratio was observed over the study period may indicate that the level of resistance to W. bancrofti infection in the study subjects was also unaffected by the transmission season.