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对于人类肠道线虫感染的核酸放大试验的诊断准确性:系统性审查和元分析
Nalini Jayakody1,2, Catherine A Gordon3,4,5, Nuwan Wickramasinghe6
1Department of Parasitology, Faculty of Medicine, Wayamba University of Sri Lanka, Kuliyapitiya, Sri Lanka.
PLoS neglected tropical diseases
|February 11, 2026
概括
与卡托-卡茨等传统方法相比,核酸放大测试 (NAAT) 显著改善了对人类肠道线虫感染 (HININ) 的检测. 这些先进的分子技术提供了更高的灵敏度,有助于更准确地诊断和控制寄生虫疾病.
科学领域:
- 医学寄生虫学 医学寄生虫学
- 诊断的准确性 诊断的准确性
- 分子诊断学 分子诊断学
背景情况:
- 诊断人类肠道线虫感染 (HINIs) 是具有挑战性的,因为缺乏明确的黄金标准和不同的流行性.
- 现有的诊断方法,如Kato-Katz (KK) 和浮动,在不同的临床环境中在准确性和可行性方面存在局限性.
- 需要准确,具有成本效益和可行的HINIs诊断工具来支持全球控制计划.
研究的目的:
- 系统地审查和评估核酸放大试验 (NAAT) 对常见HINIs的诊断准确性.
- 为了比较NAAT与传统方法的性能,如卡托卡茨 (KK),浮动,贝尔曼技术 (BT) 和苏格兰带测试.
- 根据复合参考标准 (CRS) 对NAAT进行评估,以全面了解其诊断实用性.
主要方法:
- 在主要数据库 (PubMed,Scopus,Web of Science等) 中进行了系统的文献搜索. 对于在2024年9月之前12年内发表的研究.
- 包括的研究的质量评估是使用诊断准确性研究质量评估 - 版本2 (QUADAS-2) 工具进行的.
- 数据被提取到2x2的应急表中,并使用双变随机效应模型计算了聚合的灵敏度和特异性.
主要成果:
- 与KK和浮动方法相比,NAAT对各种寄生虫的综合敏感性显著更高,包括Ascaris lumbricoides,Trichuris trichiura和虫.
- 对于虫,NAAT对CRS的敏感度达到88-95%,大大超过KK (43%) 和浮动 (59%),特异性超过87%.
- 与传统显微镜相比,NAAT检测到虫感染的数量是虫感染的两到三倍,这表明当前标准方法的检测不足.
结论:
- 核酸放大试验 (NAATs) 的灵敏度明显高于传统的copro-microscopy用于诊断HINIs,特别是在低强度感染.
- 常规显微镜与有针对性的NAAT部署的整合以及低成本分子方法的开发可以提高诊断准确性和监测.
- 结合NAAT的优化诊断策略对于加强HINI控制计划和实现世卫组织2030年除虫和消除目标至关重要.
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