Annals of Clinical Microbiology (Ann Clin Microbiol) 2003 December Volume 6, Issue 2, pages 139-143.
Evaluation of Diagnostic Utility of Intradermal Test for the Diagnosis of Clonorchis sinensis Infestation
Jae-Cheol Choi, Seung-Hwan Oh, Hae Jin Jeong*, Junghwan Shin**, Ki Hyung Park***, Eun Yup Lee, and Chulhun Ludgerus Chang
Departments of Laboratory Medicine, and Parasitology,* College of Medicine, Pusan National University; Department of Laboratory Medicine,** Busan Paik Hospital, Inje University College of Medicine; Department of Laboratory Medicine,*** Pusan City Medical Center
Abstract
Background :The intradermal test for the screening of Clonorchis sinensis is difficult to interpret because the sensitivity and persistence rates of reactions after treatment are not well known.
Methods : Stool egg examinations and intradermal tests for C. sinensis and Paragonimus westermani were performed for 1,207 persons who lived in endemic areas of C. sinensis infestation, and epidemiologic data were also surveyed.
Results :The infestation rate of C. sinensis was 12% (male 14%, female 9%). It was higher in Southeastern area of Gyungsang Namdo Province and Ulsan (22%) than in Busan (10%), whereas much higher in Gangseo/Buk/Sasang (28%) than in other areas of Busan. The performance of C. sinensis intradermal test was as belows; sensitivity 45%, specificity 80.8%, positive predictive value 24%, negative predictive value 92%, and diagnostic efficiency 77%. Positive C. sinensis intradermal reaction persisted for longer than 40 years after treatment of C. sinensis infestation in at least 30% of patients. C. sinensis intradermal reaction turned to be positive within 4 months after intake of raw fish in more than half the patients.
Conclusion :The infestation rate of C. sinensis was still very high in inhabitants around Nakdong River, an endemic area. We think that C. sinensis intradermal test is inadequate to diagnose current clonorchiasis. (Korean J Clin Microbiol 2003;6(2):139-143)