[高雄市小学生沙眼患病率再评估]。

H Z Wang, R K Tsai, J E Jeng, M M Sheu, W L Huang, C P Lin, C W Chen
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摘要

多年来,沙眼筛查一直是所有小学生健康检查计划的常规部分。本研究采用临床检查、免疫荧光单克隆抗体及McCoy细胞培养技术,对高雄市5所小学771名儿童进行沙眼检查,以了解小学生沙眼的现况。以McCoy细胞培养结果为判断标准,发现沙眼衣原体感染患儿118例(15.3%)。儿童的感染率在性别、年级和学校位置上差异均无统计学意义。118例感染儿童中,大多数无或轻度结膜炎症(96.6%)。仅有3例(0.4%)患儿出现结膜愈合并发症。这些结果表明,这些儿童的重复再感染很少。采用McCoy细胞培养对资深眼科医生的临床诊断结果进行检验。临床诊断敏感性为50%,预测阳性率为26.6%。提示仅凭临床观察对沙眼的诊断是不可靠的。免疫荧光素单克隆抗体检测结果显示,120例患儿(15.6%)发生沙眼感染。其敏感性为68.4%,特异性为91.7%。结果表明,实验室技术的质量控制应更加重视。结果显示:(1)高雄市小学生沙眼感染情况不严重;反复感染
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[The re-evaluation of the prevalence of trachoma in primary school children in Kaohsiung City].

For years, trachoma screening has been a routine part of the health examination program for all primary school children. In order to ascertain the current prevalence of trachoma in primary school children, we used clinical examination, immunofluorescein-monoclonal antibody and McCoy cell culture technique to examine 771 children from 5 primary schools in Kaohsiung City. Using the results of the McCoy cell culture as a judgement standard, we found that 118 children (15.3%) had chlamydia trachomatis infections. The infection rates of children were statistically insignificant for sex, grade and location of school of children. Among the 118 infected children, most had none or mild (96.6%) conjunctival inflammation. Only 3 children (0.4%) had conjunctival cicatrization complications. These results showed that the repeated reinfections among these children were quite few. The McCoy cell culture was used to test the result of clinical diagnosis made by the senior ophthalmologists. The sensitivity of the clinical diagnosis was 50% and the predictive positive rate was 26.6%. It revealed that the diagnosis of trachoma made by clinical observation only was unreliable. The results of immunofluorescein-monoclonal antibody test showed that 120 children (15.6%) had trachomatous infections. Its sensitivity was 68.4%, and specificity was 91.7%. It revealed that more care should be taken in quality control of laboratory techniques. From these results, we conclude: 1) the trachomatous infections of primary school children in Kaohsiung City are not serious; the repeated infections among

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