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Limitations of the intradermal test for schistosomiasis mansoni: experience from epidemiologic studies in a Puerto Rican community.

The intradermal reaction with Schistosoma mansoni adult-worm antigen (35-40 microgram/ml nitrogen) was evaluated as an edpidemiologic tool in an endemic Puerto Rican community where the prevalence of S. mansoni infection was 36% and the geometric-mean egg count was 17.6 eggs/g. Subcutaneous injections of antigen were made in forearms, and stool specimens were examined for S. mansoni eggs by a formol-ether concentration method. Of 296 persons tested, 43% had positive intradermal reactions (greater than or equal to 1.0 cm 2 at least twice the area of the control wheal), compared to 48% positive stool examinations. However, sensitivity was low at 36% for children 14 yr old or less, and only 73% to 79% for adults. The test results were very specific for children (96%), but 32% of stool negative adults were positive. Mean wheal area was not directly related to intensity of infection as determined by egg counts in either children or adults, but did increase directly with age. Mean wheal areas were greater for males than females (both children and adults) at all intensities of infection. Because of unsatisfactory sensitivity and specificity the intradermal test may overestimate the prevalence of infection when rates are low, and underestimate prevalence of infection when rates are high. For its proper interpretation, complementary parasitologic data from stool surveys are required.

Adolescent↗

[Comparison of extracts of cockroaches, house dust and Dermatophagoides with intradermal tests in allergy patients].

In the order to know both the sensitivity and positivity between the allergenic extracts of cockroach (C), house dust (HDJ, and Dermatophagoides pteronyssinus (Dpt) we made a transversal study in 783 allergic patients who underwent intradermal skin tests with the antigens of C, HD and Dpt. Allergic asthma and rhinitis were the more frequent diagnosis. There was no significative difference between the sensitivity to C and HD (p = 0.1),-women were more sensitive to C than to HD (p < 0.05). We found a greater sensitivity to Dpt than C and HD (p < 001). There were more positive patients to C than to HD (p = 0.01) and although we observed more positive patients to Dpt than to C (p = 0.01) this difference was not significative for women (p = 0.05). We can conclude than cockroach, as an allergic source, has similar importance that house dust mite, and it is inadequate its substitution with house dust extracts in skin tests screening.

Adolescent↗

Intradermal test in the diagnosis of bovine cysticercosis (Cysticercus bovis).

The skin test was performed in cattle infected with C. bovis. The examination were carried out on naturally (23 head) and artificially infected animals (20 head) at different times after infection. Antigens prepared from T. saginata (B1, N0.1, C, Calk) and antigens extracted from activated oncospheres of T. saginata (OI and OII) were inoculated intradermally. The most active were the antigens B1, N0.1, and C prepared from T. saginata. In the majority of infected animals the antigens produced the immediate type of reaction developing the maximum intensity during 2 h post injection. It is worth mentioning that Arthus-type responses have often been observed. Uninfected animals when tested with the same antigens developed mild reaction, not exceeding 4 mm skin thickness. The second testing of the same animals after one or five months resulted in a more intensive reaction slightly resembling that one observed in infected animals. There is no correlation between titre of passive haemagglutination test and the skin test reaction in naturally infected animals. Neither the number of cysticerci with which the animal is infected has an influence on the degree of the skin edema.

Animals↗