Abstract: Objective　To evaluate the value of inquiry examinations for diagnosis of taeniasis in field investigations, so as to provide insights into improving the efficiency and accuracy of taeniasis control programmes.  Methods　Four taeniasis⁃endemic villages were sampled in Dali Bai Autonomous Prefecture, Yunnan Province in October 2023 as survey sites, and at least 305 permanent residents at ages of over 3 years were randomly sampled from each site. Face⁃to⁃face inquiries were performed with structured questionnaires to investigate participants' history and frequency of proglottids release during the past year, consumption of raw or undercooked meat products or pork liver during the past six months, history and time of deworming. Participants' stool samples were collected, and Taenia eggs were detected in stool samples using Kato⁃Katz technique (two slides of one stool sample). Egg⁃positive individuals or participants with a history of proglottids release during the past year were given diagnostic deworming with areca nuts and pumpkin seeds. The detection of Taenia eggs using Kato⁃Katz technique and release of Taenia worms or proglottids following diagnostic deworming served as a gold standard to evaluate the diagnostic efficiency of inquiry examinations for taeniasis. The receiver operating characteristic (ROC) curves of inquiry examinations for diagnosis of taeniasis were plotted, and the area under the curve (AUC) was calculated. In addition, Taenia worms or proglottids released following diagnostic deworming were subjected to multiplex PCR assay and Sanger sequencing for species identification.  Results　A total of 1 842 participants were included, and 1 842 valid questionnaires were recovered. A total of 1 533 stool samples were collected, among which 25 egg⁃positives were identified. Questionnaire surveys showed that 1 305 respondents had consumed raw or undercooked meat products during the past six months, and 42 respondents had a history of proglottids release during the past year. Diagnostic deworming was given to on the aforementioned 25 egg⁃positive individuals and 42 participants who self⁃reported a history of proglottids release during the past year, and 33 participants had a release of complete worms. Following exclusion of records of individuals receiving deworming during the past 3 months, during the past year, and all participants with a history of deworming, the AUCs were 0.767 (Z = 4.71, P < 0.001), 0.762 (Z = 4.51, P < 0.001), and 0.762 (Z = 4.52, P < 0.001) for diagnosis of Taenia infections with "self⁃reported history of proglottids release during the past year", respectively, and pairwise comparisons showed no statistically significant differences (D values, -0.005 to 0.328; all P values > 0.05). Following exclusion of records of individuals receiving deworming during the past 3 months, during the past year, and all participants with a history of deworming, the AUCs were 0.797 (Z = 4.71, P < 0.001), 0.835 (Z = 4.17, P < 0.001), and 0.847 (Z = 3.98, P < 0.001) for diagnosis of Taenia infections with "self⁃reported history of twice proglottids releases", respectively, and pairwise comparisons showed no statistically significant differences (D values, -0.43 to -0.10; all P values > 0.05). Following exclusion of records of all individuals receiving deworming, the diagnostic sensitivity and specificity of "self⁃reported history of twice proglottids releases" were 87.50% and 81.82%, respectively. Following exclusion of records of individuals receiving deworming at different intervals, the AUCs were 0.529 to 0.532 for diagnosis of Taenia infections with "self⁃reported consumption of raw or undercooked meat products or pork liver during the past 6 months" (all P values > 0.05). Among 33 individuals with releases of complete Taenia worms, 31 individuals were identified with T. asiatica infections (93.94%), with a mean worm burden of (1.39 ± 0.72) worms/person, and 2 were identified with T. saginata infections (6.06%), with one worm in each participant. Conclusions　A history of Taenia proglottids release during the past year as revealed by inquiry examinations exhibit a diagnostic value for taeniasis and may serve as an initial screening tool for field taeniasis screening. Increasing the frequency of Taenia proglottids release during inquiry examinations and exclusion of records of individuals receiving deworming during the analysis may improve the value for diagnosis of taeniasis. 

Key words: Taeniasis, Inquiry examination, Diagnostic efficiency, Receiver operating characteristic curve, Yunnan Province

摘要： 目的　评价现场调查中采用询检法诊断带绦虫病的价值，为进一步提升带绦虫病防控工作效率和精准度提供科学依据。方法　2023年10月，在云南省大理白族自治州选择有带绦虫病流行的4个村作为调查点，各调查点分别随机抽取3周岁以上常住居民开展调查，调查人数均≥ 305例。采用结构化问卷以面对面方式对调查对象开展询检，了解其近1年内排节片史和排节片次数，近半年内食用生肉及其制品、生猪肝等未熟肉制品和是否服驱虫药物及服用驱虫药时间等信息。收集调查对象粪便样本，采用改良加藤厚涂片法（1粪2检）检测粪便中带绦虫虫卵。对粪检阳性或自述近1年内有排节片史者采用槟榔⁃南瓜籽法进行诊断性驱虫治疗。以改良加藤厚涂片法检出带绦虫虫卵及诊断性驱虫治疗驱出虫体或节片作为“金标准”，评价询检法用于带绦虫病的诊断效能，绘制受试者工作特征（receiver operating characteristic，ROC）曲线并计算曲线下面积。此外，收集调查对象在诊断性驱虫治疗中排出的虫体或节片，采用多重PCR法及Sanger测序技术鉴定带绦虫虫种。结果　共纳入1 842例调查对象，收集1 842份有效问卷；共采集1 533份粪便样本，其中带绦虫虫卵阳性样本25份。问卷调查结果表明，自述近半年内食用生肉及其制品、生猪肝等未熟肉制品者1 305例，近1年内有排节片史者42例。对上述25例粪检阳性者及42例自述近1年内有排节片史者进行诊断性驱虫治疗，其中33例驱出完整虫体。 排除近3个月内、近1年内有服药史者及全部有服药史者记录后，“自述近1年内有排节片史”诊断带绦虫病的ROC曲线下面积分别为0.767（Z = 4.71，P < 0.001）、0.762（Z = 4.51，P < 0.001）、0.762（Z = 4.52，P < 0.001），两两比较显示差异均无统计学意义（D = -0.005 ~ 0.328，P均> 0.05）。 排除近3个月内、近1年内有服药史者及全部有服药史者记录后，“自述排节片次数为2次”诊断带绦虫病的ROC曲线下面积分别为0.797（Z = 4.71，P < 0.001）、0.835（Z = 4.17，P < 0.001）、0.847（Z = 3.98，P < 0.001），两两比较显示差异均无统计学意义（D = -0.43 ~ -0.10，P均> 0.05）；排除所有有服药史者记录后，“自述排节片次数为2次”的诊断灵敏度和特异度分别为87.50%和81.82%。在排除不同服药间隔者记录后，“自述近半年内食用生肉及其制品、生猪肝等未熟肉制品”诊断带绦虫病的ROC曲线下面积在0.529 ~ 0.532，但差异均无统计学意义（P均> 0.05）。经虫种鉴定，驱出虫体的33例调查对象中，31例（93.94%）感染亚洲带绦虫，平均感染度为（1.39 ± 0.72）条/例；2例（6.06%）感染牛带绦虫，感染度均为1条/例。结论　询检法对于带绦虫病诊断具有一定价值，可作为带绦虫病现场筛查的初筛工具。询检时进一步增加排节片次数等信息以及在分析过程中排除有服药史记录，均可提高诊断价值。

关键词: 带绦虫病, 询检法, 诊断效能, 受试者工作特征曲线, 云南省