A combination of the Kato-Katz methods and ELISA to improve the diagnosis of clonorchiasis in an endemic area, China
Examination of feces by light microscopy is widely used for specific parasitological diagnosis of clonorchiasis. However, the true incidence of infection is underestimated owing to the high missing diagnosis rate of this method. The enzyme-linked immunosorbent assay (ELISA) is widely used for the de...
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| description | Examination of feces by light microscopy is widely used for specific parasitological diagnosis of clonorchiasis. However, the true incidence of infection is underestimated owing to the high missing diagnosis rate of this method. The enzyme-linked immunosorbent assay (ELISA) is widely used for the detection and control of clonorchiasis but the practicality of this method is unclear. The purpose of this study was to evaluate the effect of ELISA as a supplementary method for the diagnosis of clonorchiasis.
The present study recruited 2,359 clinically suspected patients from Heilongjiang Province, China. In all, 954 cases were identified as antibody-positive by immunoglobulin (IgG)-ELISA and 495 individuals were diagnosed as egg-positive by the Kato-Katz (KK) method. The seropositive and egg-negative individuals were re-examined by repeated egg counts and/or the number of KK slides and 18 (18.18%) cases were confirmed as clonorchiasis. The 40.44%, antibody-positive rate determined by IgG-ELISA was significantly higher (P |
| doi_str_mv | 10.1371/journal.pone.0046977 |
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The present study recruited 2,359 clinically suspected patients from Heilongjiang Province, China. In all, 954 cases were identified as antibody-positive by immunoglobulin (IgG)-ELISA and 495 individuals were diagnosed as egg-positive by the Kato-Katz (KK) method. The seropositive and egg-negative individuals were re-examined by repeated egg counts and/or the number of KK slides and 18 (18.18%) cases were confirmed as clonorchiasis. The 40.44%, antibody-positive rate determined by IgG-ELISA was significantly higher (P<0.05) than the 21.75% egg-positive rate found by examination of feces. A Bayesian approach indicated that the prevalence of clonorchiasis in this region was 22.27% and that the sensitivity, specificity, positive predictive value and negative predictive value of IgG-ELISA were 98.7%, 76.53%, 54.66% and 99.52%, respectively. The agreement between the two methods was moderate (kappa value = 0.564). The clonorchiasis patients lived mainly along the Songhua River. The risk factors, except for ethnic factors, were estimated effectively by both methods.
The present study suggested that clonorchiasis was widely distributed in Heilongjiang Province, China. The missing diagnosis rate was high using the KK technique alone. The combination of immunological methods and parasitological techniques could improve diagnostic accuracy and reduce the missing diagnosis rate. ELISA used as an auxiliary diagnostic method was realistic and practical for a large-scale screening test, monitoring the prevalence and assessing the risk factors of clonorchiasis.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0046977</identifier><identifier>PMID: 23056547</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Adolescent ; Adult ; Aged ; Aged, 80 and over ; Analysis ; Animals ; Bayesian analysis ; Biology ; Child ; Child, Preschool ; China - epidemiology ; Clonorchiasis - diagnosis ; Clonorchiasis - epidemiology ; Clonorchiasis - parasitology ; Clonorchiasis - prevention & control ; Clonorchis sinensis ; Clonorchis sinensis - physiology ; Diagnosis ; Diagnostic systems ; Disease control ; Endemic Diseases - prevention & control ; Enzyme-linked immunosorbent assay ; Enzyme-Linked Immunosorbent Assay - methods ; Enzymes ; Ethnic factors ; Feces ; Female ; Fluke infections ; Health aspects ; Humans ; Immunoglobulin G ; Immunology ; Infections ; Laboratories ; Light microscopy ; Male ; Medical diagnosis ; Medical research ; Medicine ; Methods ; Middle Aged ; Parasites ; Parasitic diseases ; Parasitology ; Patients ; Risk analysis ; Risk factors ; Rivers ; Rivers - parasitology ; Sensitivity and Specificity ; Tropical diseases ; Young Adult</subject><ispartof>PloS one, 2012-10, Vol.7 (10), p.e46977-e46977</ispartof><rights>COPYRIGHT 2012 Public Library of Science</rights><rights>Han et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License: https://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2012 Han et al 2012 Han et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c758t-e53bb5486de6011b0382f2a9b628991213a679bbef94e456b22532abed0db6873</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3466177/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3466177/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,864,885,2101,2927,23865,27923,27924,53790,53792,79471,79472</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23056547$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Bejon, Philip</contributor><creatorcontrib>Han, Su</creatorcontrib><creatorcontrib>Zhang, Xiaoli</creatorcontrib><creatorcontrib>Wen, Jingshan</creatorcontrib><creatorcontrib>Li, Yihong</creatorcontrib><creatorcontrib>Shu, Jing</creatorcontrib><creatorcontrib>Ling, Hong</creatorcontrib><creatorcontrib>Zhang, Fengmin</creatorcontrib><title>A combination of the Kato-Katz methods and ELISA to improve the diagnosis of clonorchiasis in an endemic area, China</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>Examination of feces by light microscopy is widely used for specific parasitological diagnosis of clonorchiasis. However, the true incidence of infection is underestimated owing to the high missing diagnosis rate of this method. The enzyme-linked immunosorbent assay (ELISA) is widely used for the detection and control of clonorchiasis but the practicality of this method is unclear. The purpose of this study was to evaluate the effect of ELISA as a supplementary method for the diagnosis of clonorchiasis.
The present study recruited 2,359 clinically suspected patients from Heilongjiang Province, China. In all, 954 cases were identified as antibody-positive by immunoglobulin (IgG)-ELISA and 495 individuals were diagnosed as egg-positive by the Kato-Katz (KK) method. The seropositive and egg-negative individuals were re-examined by repeated egg counts and/or the number of KK slides and 18 (18.18%) cases were confirmed as clonorchiasis. The 40.44%, antibody-positive rate determined by IgG-ELISA was significantly higher (P<0.05) than the 21.75% egg-positive rate found by examination of feces. A Bayesian approach indicated that the prevalence of clonorchiasis in this region was 22.27% and that the sensitivity, specificity, positive predictive value and negative predictive value of IgG-ELISA were 98.7%, 76.53%, 54.66% and 99.52%, respectively. The agreement between the two methods was moderate (kappa value = 0.564). The clonorchiasis patients lived mainly along the Songhua River. The risk factors, except for ethnic factors, were estimated effectively by both methods.
The present study suggested that clonorchiasis was widely distributed in Heilongjiang Province, China. The missing diagnosis rate was high using the KK technique alone. The combination of immunological methods and parasitological techniques could improve diagnostic accuracy and reduce the missing diagnosis rate. ELISA used as an auxiliary diagnostic method was realistic and practical for a large-scale screening test, monitoring the prevalence and assessing the risk factors of clonorchiasis.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Analysis</subject><subject>Animals</subject><subject>Bayesian analysis</subject><subject>Biology</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>China - epidemiology</subject><subject>Clonorchiasis - diagnosis</subject><subject>Clonorchiasis - epidemiology</subject><subject>Clonorchiasis - parasitology</subject><subject>Clonorchiasis - prevention & control</subject><subject>Clonorchis sinensis</subject><subject>Clonorchis sinensis - physiology</subject><subject>Diagnosis</subject><subject>Diagnostic systems</subject><subject>Disease control</subject><subject>Endemic Diseases - prevention & control</subject><subject>Enzyme-linked immunosorbent assay</subject><subject>Enzyme-Linked Immunosorbent Assay - methods</subject><subject>Enzymes</subject><subject>Ethnic factors</subject><subject>Feces</subject><subject>Female</subject><subject>Fluke infections</subject><subject>Health aspects</subject><subject>Humans</subject><subject>Immunoglobulin G</subject><subject>Immunology</subject><subject>Infections</subject><subject>Laboratories</subject><subject>Light microscopy</subject><subject>Male</subject><subject>Medical diagnosis</subject><subject>Medical research</subject><subject>Medicine</subject><subject>Methods</subject><subject>Middle Aged</subject><subject>Parasites</subject><subject>Parasitic diseases</subject><subject>Parasitology</subject><subject>Patients</subject><subject>Risk analysis</subject><subject>Risk factors</subject><subject>Rivers</subject><subject>Rivers - parasitology</subject><subject>Sensitivity and Specificity</subject><subject>Tropical diseases</subject><subject>Young Adult</subject><issn>1932-6203</issn><issn>1932-6203</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>DOA</sourceid><recordid>eNqNk12L1DAUhoso7rr6D0QDgig4Yz6apL0RhmHVwYEFV70NSZtOM7TJmKSL-utNZ7rLjOyFDbTl5Hnfk5zkZNlzBOeIcPR-6wZvZTffOavnEOas5PxBdo5KgmcMQ_Lw6P8sexLCFkJKCsYeZ2eYQMpozs-zuACV65WxMhpngWtAbDX4IqObpdcf0OvYujoAaWtwuV5dL0B0wPQ77270Hq2N3FgXTBi1Vees81Vr5BgwNsmAtrXuTQWk1_IdWLYp1dPsUSO7oJ9N34vs-8fLb8vPs_XVp9VysZ5VnBZxpilRiuYFqzWDCClICtxgWSqGi7JEGBHJeKmUbspc55QpjCnBUuka1ooVnFxkLw--u84FMRUsCEQwo7RkJUzE6kDUTm7Fzpte-t_CSSP2Aec3Qvpoqk4LUpaSFDzHjapzUknJKKu4LnVNmhzlOHl9mLINqtd1pW30sjsxPZ2xphUbdyNIzhji43LfTAbe_Rx0iKI3odJdJ612Q1p3egpGOKcJffUPev_uJmoj0waMbVzKW42mYkFzksACk0TN76HS2J9bul2NSfETwdsTQWKi_hU3cghBrK6__j979eOUfX3Etlp2sQ2uG8abGU7B_ABW3oXgdXNXZATF2By31RBjc4ipOZLsxfEB3Yluu4H8BbjkCDo</recordid><startdate>20121008</startdate><enddate>20121008</enddate><creator>Han, Su</creator><creator>Zhang, Xiaoli</creator><creator>Wen, Jingshan</creator><creator>Li, Yihong</creator><creator>Shu, Jing</creator><creator>Ling, Hong</creator><creator>Zhang, Fengmin</creator><general>Public Library of Science</general><general>Public Library of Science (PLoS)</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>IOV</scope><scope>ISR</scope><scope>3V.</scope><scope>7QG</scope><scope>7QL</scope><scope>7QO</scope><scope>7RV</scope><scope>7SN</scope><scope>7SS</scope><scope>7T5</scope><scope>7TG</scope><scope>7TM</scope><scope>7U9</scope><scope>7X2</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABJCF</scope><scope>ABUWG</scope><scope>AEUYN</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>ATCPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>D1I</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB.</scope><scope>KB0</scope><scope>KL.</scope><scope>L6V</scope><scope>LK8</scope><scope>M0K</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>M7P</scope><scope>M7S</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PATMY</scope><scope>PDBOC</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PTHSS</scope><scope>PYCSY</scope><scope>RC3</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope></search><sort><creationdate>20121008</creationdate><title>A combination of the Kato-Katz methods and ELISA to improve the diagnosis of clonorchiasis in an endemic area, China</title><author>Han, Su ; Zhang, Xiaoli ; Wen, Jingshan ; Li, Yihong ; Shu, Jing ; Ling, Hong ; Zhang, Fengmin</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c758t-e53bb5486de6011b0382f2a9b628991213a679bbef94e456b22532abed0db6873</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Analysis</topic><topic>Animals</topic><topic>Bayesian analysis</topic><topic>Biology</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>China - epidemiology</topic><topic>Clonorchiasis - diagnosis</topic><topic>Clonorchiasis - epidemiology</topic><topic>Clonorchiasis - parasitology</topic><topic>Clonorchiasis - prevention & control</topic><topic>Clonorchis sinensis</topic><topic>Clonorchis sinensis - physiology</topic><topic>Diagnosis</topic><topic>Diagnostic systems</topic><topic>Disease control</topic><topic>Endemic Diseases - prevention & control</topic><topic>Enzyme-linked immunosorbent assay</topic><topic>Enzyme-Linked Immunosorbent Assay - methods</topic><topic>Enzymes</topic><topic>Ethnic factors</topic><topic>Feces</topic><topic>Female</topic><topic>Fluke infections</topic><topic>Health aspects</topic><topic>Humans</topic><topic>Immunoglobulin G</topic><topic>Immunology</topic><topic>Infections</topic><topic>Laboratories</topic><topic>Light microscopy</topic><topic>Male</topic><topic>Medical diagnosis</topic><topic>Medical research</topic><topic>Medicine</topic><topic>Methods</topic><topic>Middle Aged</topic><topic>Parasites</topic><topic>Parasitic diseases</topic><topic>Parasitology</topic><topic>Patients</topic><topic>Risk analysis</topic><topic>Risk factors</topic><topic>Rivers</topic><topic>Rivers - 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Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Han, Su</au><au>Zhang, Xiaoli</au><au>Wen, Jingshan</au><au>Li, Yihong</au><au>Shu, Jing</au><au>Ling, Hong</au><au>Zhang, Fengmin</au><au>Bejon, Philip</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A combination of the Kato-Katz methods and ELISA to improve the diagnosis of clonorchiasis in an endemic area, China</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2012-10-08</date><risdate>2012</risdate><volume>7</volume><issue>10</issue><spage>e46977</spage><epage>e46977</epage><pages>e46977-e46977</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>Examination of feces by light microscopy is widely used for specific parasitological diagnosis of clonorchiasis. However, the true incidence of infection is underestimated owing to the high missing diagnosis rate of this method. The enzyme-linked immunosorbent assay (ELISA) is widely used for the detection and control of clonorchiasis but the practicality of this method is unclear. The purpose of this study was to evaluate the effect of ELISA as a supplementary method for the diagnosis of clonorchiasis.
The present study recruited 2,359 clinically suspected patients from Heilongjiang Province, China. In all, 954 cases were identified as antibody-positive by immunoglobulin (IgG)-ELISA and 495 individuals were diagnosed as egg-positive by the Kato-Katz (KK) method. The seropositive and egg-negative individuals were re-examined by repeated egg counts and/or the number of KK slides and 18 (18.18%) cases were confirmed as clonorchiasis. The 40.44%, antibody-positive rate determined by IgG-ELISA was significantly higher (P<0.05) than the 21.75% egg-positive rate found by examination of feces. A Bayesian approach indicated that the prevalence of clonorchiasis in this region was 22.27% and that the sensitivity, specificity, positive predictive value and negative predictive value of IgG-ELISA were 98.7%, 76.53%, 54.66% and 99.52%, respectively. The agreement between the two methods was moderate (kappa value = 0.564). The clonorchiasis patients lived mainly along the Songhua River. The risk factors, except for ethnic factors, were estimated effectively by both methods.
The present study suggested that clonorchiasis was widely distributed in Heilongjiang Province, China. The missing diagnosis rate was high using the KK technique alone. The combination of immunological methods and parasitological techniques could improve diagnostic accuracy and reduce the missing diagnosis rate. ELISA used as an auxiliary diagnostic method was realistic and practical for a large-scale screening test, monitoring the prevalence and assessing the risk factors of clonorchiasis.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>23056547</pmid><doi>10.1371/journal.pone.0046977</doi><tpages>e46977</tpages><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; DOAJ Directory of Open Access Journals; Public Library of Science (PLoS); EZB-FREE-00999 freely available EZB journals; PubMed Central; Free Full-Text Journals in Chemistry |
| subjects | Adolescent Adult Aged Aged, 80 and over Analysis Animals Bayesian analysis Biology Child Child, Preschool China - epidemiology Clonorchiasis - diagnosis Clonorchiasis - epidemiology Clonorchiasis - parasitology Clonorchiasis - prevention & control Clonorchis sinensis Clonorchis sinensis - physiology Diagnosis Diagnostic systems Disease control Endemic Diseases - prevention & control Enzyme-linked immunosorbent assay Enzyme-Linked Immunosorbent Assay - methods Enzymes Ethnic factors Feces Female Fluke infections Health aspects Humans Immunoglobulin G Immunology Infections Laboratories Light microscopy Male Medical diagnosis Medical research Medicine Methods Middle Aged Parasites Parasitic diseases Parasitology Patients Risk analysis Risk factors Rivers Rivers - parasitology Sensitivity and Specificity Tropical diseases Young Adult |
| title | A combination of the Kato-Katz methods and ELISA to improve the diagnosis of clonorchiasis in an endemic area, China |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-08T15%3A22%3A05IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=A%20combination%20of%20the%20Kato-Katz%20methods%20and%20ELISA%20to%20improve%20the%20diagnosis%20of%20clonorchiasis%20in%20an%20endemic%20area,%20China&rft.jtitle=PloS%20one&rft.au=Han,%20Su&rft.date=2012-10-08&rft.volume=7&rft.issue=10&rft.spage=e46977&rft.epage=e46977&rft.pages=e46977-e46977&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0046977&rft_dat=%3Cgale_plos_%3EA543326823%3C/gale_plos_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1326559690&rft_id=info:pmid/23056547&rft_galeid=A543326823&rft_doaj_id=oai_doaj_org_article_399a38742fbd43caa656c7e9ed3f4142&rfr_iscdi=true |