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目的通过旋毛虫病、弓形虫病血清学检测,探讨了混合血清检测(混检)在寄生虫病血清流行病学调查中的应用及对成本-效果的影响。方法根据二项分布原理,探讨混合血清检测的可行性。旋毛虫病或弓形虫病血清学检测,采用3、5、10份等三种混检方法。同时对血清样品逐一检测和混合检测进行了成本．效果评价。结果只要混有1份弱阳性血清,旋毛虫病或弓形虫病的三种混检都呈阳性结果。如果混合的血清全部是阴性,旋毛虫病3、5、10份阴性血清样品混合各检测24组,全部呈阴性；弓形虫病3、5份阴性血清样品混合,检测12组,都呈阴性,10份阴性血清样品混合,检测18组中16组呈阴性,2组呈阳性。旋毛虫病或弓形虫病混检显示,混检效率与待检寄生虫血清学阳性率有关,血清学阳性率在10%时,4份混检效率较高,血清学阳性率在1%时,以10份混检效率较高,而当血清阳性率在0．1%时,增加混检样品数可明显减少检测次数,但前提条件是要保证混检样品中只要有1份阳性样品,混检时都能测出阳性,而且若全部是阴性样品混检,也不出现阳性。结论运用卫生经济学成本-效果分析,表明寄生虫病血清流行病学调查,混检成本低,尤其是对预期血清学阳性率较低(≤1%)的调查,混检可节省大量成本。
OBJECTIVE: To investigate the serological detection of trichinellosis and toxoplasmosis, and to explore the application of mixed serum detection (mixed detection) in the investigation of serological epidemiology of parasitic diseases and its impact on cost-effectiveness. Methods Based on binomial distribution principle, the feasibility of mixed serum detection was explored. Trichinellosis or toxoplasmosis serological testing, using 3, 5,10 copies of three mixed detection methods. At the same time, the cost of the serum samples one by one and the mixed detection is carried out. Evaluation. As long as the results mixed with a weak positive serum, Trichinella or Toxoplasmosis were three mixed positive test results. If the mixed sera were all negative, 3,5 and 10 samples of negative serotypes of Trichinellosis were mixed for 24 tests in each group, all of them were negative. Toxoplasmosis and 3,5 negative serum samples were mixed and tested in 12 groups, all of which were negative. Ten negative serum samples were mixed, 16 of the 18 tested groups were negative, two groups were positive. Toxoplasmosis or toxoplasmosis mixed inspection showed that the mixing efficiency and parasites seroprevalence to be tested positive serological positive rate of 10%, 4 copies of the high rate of mixed, serological positive rate of 1% , 10 mixed screening efficiency is higher, and when the serum positive rate of 0.1%, increasing the number of mixed samples can significantly reduce the number of tests, but the premise is to ensure that as long as there is a mixed sample of positive samples, Mixed tests can detect positive, and if all negative samples mixed, nor positive. Conclusion Using the cost-effectiveness analysis of health economics, it is indicated that the serological epidemiological survey of parasitic diseases and the low cost of mixed examination, especially for the survey with low expected positive serological rate (≤1%), can save a lot of costs.