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目的评价改良加藤法在血吸虫病大规模现场普查中的实施效果。方法在湖北、江西、江苏、四川和云南5省流行区随机选择8个调查点,用ELISA法进行血清学筛查,对阳性反应者,同时采用尼龙绢集卵孵化法(粪孵法)和改良加藤法进行病原学检查。以尼龙绢集卵孵化法为金标准,估算改良加藤法漏检率。结果ELISA法共筛查9853人,阳性2824人。采用改良加藤法和尼龙绢集卵孵化法共检查3853人,调查点的感染率在0.10%~11.77%之间,两法检出阳性508人,其中加藤阳性355人,粪孵阳性456人。改良加藤法的漏检率为30.12%,粪孵法的漏检率为10.24%。8个调查点疫情分轻、重度两组,两组改良加藤法漏检率分别为64.34%及18.47%,差异有显著性(P<0.01)。结论不同地区大规模现场查病,单一使用改良加藤法漏检率偏高,联合运用改良加藤法和粪孵检查可提高血吸虫卵的检出率。
Objective To evaluate the effect of improved Kato method in the large-scale site screening of schistosomiasis. Methods Eight survey sites were randomly selected in epidemic areas of Hubei, Jiangxi, Jiangsu, Sichuan and Yunnan provinces. Serological screening was performed by ELISA. Positive reaction was observed with nylon silk hatching method (stool hatching method) and Kato method improved etiological examination. With nylon silk hatching method as the gold standard, to estimate the rate of improvement Kato missed. Results A total of 9853 people were screened by ELISA, 2824 were positive. Using improved Kato method and nylon silk hatching method, a total of 3853 people were examined. The infection rate at the investigation point was between 0.10% and 11.77%. There were 508 positives in the two methods, of which 355 were positive for Kato and 456 were positive for hatch. The improved Kato method missed the detection rate of 30.12%, dung hatching method missed detection rate of 10.24%. The eight outbreaks were divided into mild and severe cases, and the detection rate of modified Kato method in the two groups was 64.34% and 18.47% respectively, with significant difference (P <0.01). Conclusions Large-scale on-site investigation of disease in different areas can improve the detection rate of Schistosoma japonicum egg by using Kato method and stool incubation in combination with the single-use modified Kato method.