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KMID : 0383919670040000160
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Report of National Institute of Health
1967 Volume.4 No. 0 p.160 ~ p.161
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Epidemiological studies of Clonorchis sinensis in Korea (Ⅲ)
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Abstract
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Reliability of intradermal test for diagnosis using VBS (Veronal Buffered Saline) antigen of Clonorchis sinenisis was determined with epidemiological considerations.
VBS antigen was prepared by alightly modifying Chaffee´s method in extracting lipoids in ethylether by Soxhlet apparatus for 48 hours. Paragonimus antigen and the buffered saline merthiolated control solution were also injected in order to eliminate cross reaction with paragonimiasis and possible false reaction. The antigens and control solution, 0.02ml respectively, were injected intradermally in the front forearm and the area of the ensuing wheal was measured 15 minutes after injection by measuring plate in mm^(2).
Determination of positive judgements was based on the following reactions: (1) when the wheal produced by Clonorchis antigen was 60mm^(2) or over while the wheal of the other antigen was smaller than 60mm^(2), (2) when both wheals were 60mm^(2) or over provided the wheal of Clonorchis antigen was of the same size or larger than the wheal of the other antigen. In principle, if the control solution produces a wheal of 60mm^(2) or over, the test should be disregarded.
The skin test was applied as a survey measure in the epidemiological studies in Kimhae Gun, high endemic area and in Koyang Gun, low endemic area. The results of the skin test were compared with those obtained by the stool examination.
In Kimhae Gun, of the 915 skin test positive cases, 93.9% were found positive with Clonorchis eggs and the remaining 6.1% were negative. In the 658 skin test negative cases, 12.3% (81) of them were found to be the egg positive and 87.8% were negative.
Among 940 cases with Clonorchis eggs, 91.4% reacted positive in the skin test, but 8.6% were false negative. Out of 633 egg negative cases, 8.6%(56) reacted positive in skin reaction and 91.2% were negative.
On the other hand in Koyang Gun, of the 189 skin test positive cases, 83.6% were found positive with Clonorchis eggs and the remaining 16.4% were negative.
On the other hand in Koyang Gun, of the 189 skin test positive cases, 83.6% were found positive with Clonorchis eggs and the remaining 16.4% were negative. Among the 728 skin test negative cases, 1.8% (13) were found to be the egg positive and 98.2% were were negative.
Of the 171 egg positive cases, 92.4% of them reacted positive with skin test and 7.6% were false negative; of the 746 egg negative cases, 4.2% of them reacted positive with skin test and 95.8% were negative.
The reliability of the intradermal test for diagnosis with VBS antigen of clonorchiasis cases was 91.4-92.4%. Among the egg positive cases of Clonorchis, 7.6-8.6% were found negative by the skin test.
In mass survey by skin test for incidence of infection, egg positive rates among those who reacted positive varies depending on the endemic rate in the particular area of survey, namely, 93.9% in Kimhae a high endemic area and 83.6% in Koyang a low endemic area.
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KEYWORD
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