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Wang Z, Wu M, Liu Q, Wang X, Yan C, Song T. Multiclassification of Hepatic Cystic Echinococcosis by Using Multiple Kernel Learning Framework and Ultrasound Images. ULTRASOUND IN MEDICINE & BIOLOGY 2024:S0301-5629(24)00151-0. [PMID: 38679514 DOI: 10.1016/j.ultrasmedbio.2024.03.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 03/10/2024] [Accepted: 03/30/2024] [Indexed: 05/01/2024]
Abstract
To properly treat and care for hepatic cystic echinococcosis (HCE), it is essential to make an accurate diagnosis before treatment. OBJECTIVE The objective of this study was to assess the diagnostic accuracy of computer-aided diagnosis techniques in classifying HCE ultrasound images into five subtypes. METHODS A total of 1820 HCE ultrasound images collected from 967 patients were included in the study. A multi-kernel learning method was developed to learn the texture and depth features of the ultrasound images. Combined kernel functions were built-in Support Vector Machine (MK-SVM) for the classification work. The experimental results were evaluated using five-fold cross-validation. Finally, our approach was compared with three other machine learning algorithms: the decision tree classifier, random forest, and gradient boosting decision tree. RESULTS Among all the methods used in the study, the MK-SVM achieved the highest accuracy of 96.6% on the fused feature set. CONCLUSION The multi-kernel learning method effectively learns different image features from ultrasound images by utilizing various kernels. The MK-SVM method, which combines the learning of texture features and depth features separately, has significant application value in HCE classification tasks.
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Affiliation(s)
- Zhengye Wang
- Center for Disease Control and Prevention, Xinjiang Production and Construction Corps, Urumqi, China; Ultrasound Department, State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Disease in Central Asia, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Miao Wu
- College of Medical Engineering and Technology, Xinjiang Medical University, Urumqi, China
| | - Qian Liu
- Basic Medical College, Xinjiang Medical University, Urumqi, China
| | - Xiaorong Wang
- Ultrasound Department, State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Disease in Central Asia, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Chuanbo Yan
- College of Medical Engineering and Technology, Xinjiang Medical University, Urumqi, China
| | - Tao Song
- Ultrasound Department, State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Disease in Central Asia, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China.
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Rizwanullah, Salcedo YE, Reddy Kayeetha V, Shah M, Owais Haseeb S. Seronegative Bilateral Pulmonary Hydatid Cysts in a 15-Year-Old Boy From Pakistan: Report of a Rare Case. Cureus 2024; 16:e57958. [PMID: 38741845 PMCID: PMC11090377 DOI: 10.7759/cureus.57958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/10/2024] [Indexed: 05/16/2024] Open
Abstract
Hydatid disease, attributed to the tapeworm Echinococcus granulosus, poses a significant health threat in regions where it is endemic. Here, we present a case involving a 15-year-old boy from rural Pakistan who initially sought medical attention due to a persistent cough and hemoptysis. Despite initially testing negative for serological markers, imaging studies revealed well-defined cysts in both lungs. Confirmation of the diagnosis was achieved through histopathological examination. Management includes albendazole therapy and surgical excision of the cyst. Our case underscores the diagnostic challenges associated with seronegative cases and underscores the importance of considering hydatid disease in endemic regions, irrespective of typical serological markers. This report enhances understanding regarding the clinical presentation, diagnostic approach, and management strategies for pulmonary hydatid cysts.
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Affiliation(s)
- Rizwanullah
- Internal Medicine, Hayatabad Medical Complex Peshawar, Peshawar, PAK
| | | | | | - Mudassir Shah
- Pediatric Medicine, Hayatabad Medical Complex Peshawar, Peshawar, PAK
| | - Syed Owais Haseeb
- Internal Medicine, Hayatabad Medical Complex Peshawar, Peshawar, PAK
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Yang SK, Zhang W, Zhu N, McManus DP, Gray DJ, Clements ACA, Cadavid Restrepo AM, Williams GM, Zhang T, Ma GR, Yang YH, Yang YR. Serological Comparison of Native Antigen ELISAs with Rapid ICT Test Kits for the Diagnosis of Human Alveolar and Cystic Echinococcosis in China. Trop Med Infect Dis 2024; 9:44. [PMID: 38393133 PMCID: PMC10893119 DOI: 10.3390/tropicalmed9020044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 01/31/2024] [Accepted: 02/02/2024] [Indexed: 02/25/2024] Open
Abstract
BACKGROUND The aim of this study was to compare the diagnostic performance of native antigen ELISAs and ADAMU-AE/CE commercial ICT test kits in subjects either exposed to Echinococcus infection or with clinically diagnosed alveolar (AE) or cystic (CE) echinococcosis. METHODS A total of 370 subjects with a previous clinical confirmation of CE or AE from northwestern China were recruited. Serum samples were also obtained from 3923 children/teenagers during a community survey. All sera were tested using native antigen ELISAs. The ADAMU-AE/CE test kits were subsequently used for the serology of the 370 clinically confirmed individuals and of 251 children/teenagers that were ELISA antibody-positive for both Echinococcus species but ultrasound-negative during baseline survey. An analysis of the association between the serological tests and ultrasound classification was carried out amongst 89 AE and 164 CE cases. A Kappa consistency analysis was undertaken to compare the diagnostic performance of the native antigen ELISAs and the ADAMU kits and the ultrasound imaging results. The χ² test was also used for a comparison of the different seropositivity rates between the groups. FINDINGS There was poor consistency (Kappa = 0.26 and 0.28 for AE and CE respectively) between the native antigen ELISAs and the ADAMU kits for the diagnosis of AE and CE among the cases and the surveyed children/teenagers, but a relatively good consistency (Kappa = 0.63) between the ADAMU-AE kit and ultrasound observations for the AE cases. Additionally, of the 251 teenagers co-positive for both AE and CE antibodies by the native antigen ELISAs, only one was found positive by the ADAMU-AE kit, verified as a new AE case on subsequent ultrasound follow-up. The remainder (N = 250) were negative by serology using the ADAMU-AE/CE kits and by ultrasound examination. The two native antigen ELISAs did not discriminate well between cases of clinically diagnosed AE and CE. In contrast, ADAMU-AE and ADAMU-CE commercial ICT test kits readily differentiated cases of AE from CE with specificities of 99% for AE and 100% for CE. CONCLUSIONS The ADAMU-AE/CE kits proved reliable, accurate, and amenable diagnostic tools in the clinical setting for confirmation of suspected AE/CE cases. The native antigen ELISAs tests can provide useful information on the level of human exposure to Echinococcus infection.
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Affiliation(s)
- Shu-Kun Yang
- Department of Radiology, The Second Affiliated Hospital of Ningxia Medical University, The First People’s Hospital of Yinchuan City, Yinchuan 750001, China;
| | - Wei Zhang
- Department of Pathogenic Biology & Medical Immunology, School of Basic Medical Science, Ningxia Medical University, Yinchuan 750004, China; (W.Z.); (N.Z.); (G.-R.M.); (Y.-H.Y.)
| | - Na Zhu
- Department of Pathogenic Biology & Medical Immunology, School of Basic Medical Science, Ningxia Medical University, Yinchuan 750004, China; (W.Z.); (N.Z.); (G.-R.M.); (Y.-H.Y.)
| | - Donald P. McManus
- Molecular Parasitology Laboratory, Global Health & Tropical Medicine, QIMR Berghofer Medical Research Institute, Brisbane, QLD 4006, Australia (D.J.G.)
| | - Darren J. Gray
- Molecular Parasitology Laboratory, Global Health & Tropical Medicine, QIMR Berghofer Medical Research Institute, Brisbane, QLD 4006, Australia (D.J.G.)
- Department of Global Health, Research School of Population Health, Australian National University, Acton, ACT 2600, Australia;
- Infectious Disease Epidemiology Unit, School of Public Health, University of Queensland, Brisbane, QLD 4006, Australia; (A.M.C.R.); (G.M.W.)
| | - Archie C. A. Clements
- Department of Global Health, Research School of Population Health, Australian National University, Acton, ACT 2600, Australia;
- Faculty of Health Sciences, Curtin University, Perth, WA 6102, Australia
| | - Angela M. Cadavid Restrepo
- Infectious Disease Epidemiology Unit, School of Public Health, University of Queensland, Brisbane, QLD 4006, Australia; (A.M.C.R.); (G.M.W.)
| | - Gail M. Williams
- Infectious Disease Epidemiology Unit, School of Public Health, University of Queensland, Brisbane, QLD 4006, Australia; (A.M.C.R.); (G.M.W.)
| | - Ting Zhang
- NHC Key Laboratory of Parasite and Vector Biology, National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research), Shanghai 200025, China
| | - Guo-Rong Ma
- Department of Pathogenic Biology & Medical Immunology, School of Basic Medical Science, Ningxia Medical University, Yinchuan 750004, China; (W.Z.); (N.Z.); (G.-R.M.); (Y.-H.Y.)
| | - Yan-Hui Yang
- Department of Pathogenic Biology & Medical Immunology, School of Basic Medical Science, Ningxia Medical University, Yinchuan 750004, China; (W.Z.); (N.Z.); (G.-R.M.); (Y.-H.Y.)
| | - Yu-Rong Yang
- Department of Pathogenic Biology & Medical Immunology, School of Basic Medical Science, Ningxia Medical University, Yinchuan 750004, China; (W.Z.); (N.Z.); (G.-R.M.); (Y.-H.Y.)
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Hogea MO, Ciomaga BF, Muntean MM, Muntean AA, Popa MI, Popa GL. Cystic Echinococcosis in the Early 2020s: A Review. Trop Med Infect Dis 2024; 9:36. [PMID: 38393125 PMCID: PMC10891927 DOI: 10.3390/tropicalmed9020036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Revised: 01/14/2024] [Accepted: 01/30/2024] [Indexed: 02/25/2024] Open
Abstract
Cystic echinococcosis (CE) is a zoonosis caused by metacestodes, the larval stage of Echinococcus granulosus. Although the World Health Organization (WHO) has defined CE as a neglected disease, it is the second most important foodborne parasitic disease, and it remains an important public health issue, considering its zonal endemicity and potential morbidity. The control and prevention of CE is a relevant WHO target, especially from a One Health perspective, as the disease affects not only animals and humans but also the food chain. Since not all countries have a CE surveillance strategy or reporting system and specific management guidelines, recent epidemiological data are relatively scarce, and research concerning the specific geographical distribution of the disease is ongoing. To add new information to the subject, we have analyzed and collected data from national guidelines and several medical databases. Out of the 751 research articles that were originally identified, only 52 were included in the investigation after applying specific inclusion and exclusion criteria. Notable international projects that have provided significant contributions and had a positive impact are presented. The available data were correlated with WHO recommendations on the subject, thus showcasing the measures taken and those that are still needed to properly control the disease's spread.
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Affiliation(s)
- Mihai-Octav Hogea
- Department of Microbiology II, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania; (M.-O.H.); (B.-F.C.); (M.-M.M.); (A.-A.M.); (M.I.P.)
| | - Bogdan-Florin Ciomaga
- Department of Microbiology II, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania; (M.-O.H.); (B.-F.C.); (M.-M.M.); (A.-A.M.); (M.I.P.)
| | - Mădălina-Maria Muntean
- Department of Microbiology II, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania; (M.-O.H.); (B.-F.C.); (M.-M.M.); (A.-A.M.); (M.I.P.)
| | - Andrei-Alexandru Muntean
- Department of Microbiology II, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania; (M.-O.H.); (B.-F.C.); (M.-M.M.); (A.-A.M.); (M.I.P.)
- Department of Microbiology, Cantacuzino National Military Medical Institute for Research and Development, 050096 Bucharest, Romania
| | - Mircea Ioan Popa
- Department of Microbiology II, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania; (M.-O.H.); (B.-F.C.); (M.-M.M.); (A.-A.M.); (M.I.P.)
- Department of Microbiology, Cantacuzino National Military Medical Institute for Research and Development, 050096 Bucharest, Romania
| | - Gabriela Loredana Popa
- Parasitic Disease Department, Colentina Clinical Hospital, 020125 Bucharest, Romania
- Department of Microbiology, Faculty of Dentistry, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania
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Wang Z, Kuerban K, Zhou Z, Hailati M, Aihematiniyazi R, Wang X, Yan C. HCEs-Net: Hepatic cystic echinococcosis classification ensemble model based on tree-structured Parzen estimator and snap-shot approach. Med Phys 2023. [PMID: 37183479 DOI: 10.1002/mp.16444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 02/15/2023] [Accepted: 04/18/2023] [Indexed: 05/16/2023] Open
Abstract
BACKGROUND Hepatic cystic echinococcosis (HCE) still has a high misdiagnosis rate, and misdiagnosis may lead to wrong treatments seriously harmful for the patients. Precise diagnosis of HCE relies heavily on the experience of clinical experts with auxiliary diagnostic tools using medical images. PURPOSE This paper intends to improve the diagnostic accuracy for HCE by employing a method which combines deep learning with ensemble method. METHODS We proposed a method, namely HCEs-Net, for classification of five HCE subtypes using ultrasound images. It takes first the snap-shot strategy to obtain sub-models from the pre-trained VGG19, ResNet18, ViT-Base, and ConvNeXt-T models, then a stacking process to ensemble those sub-models. Afterwards, it uses the tree-structured Pazren estimator (TPE) to optimize the hyperparameters. The experiments were evaluated by the five-fold cross-validation process. RESULTS A total of 3083 abdominal ultrasound images from 972 patients covering five subtypes of HCE were utilized in this study. The experiments were conducted to predict the HCE subtype, and results of modeling performance evaluation were reported in terms of precision, recall, F1-score, and AUC. The stacking model based on three ConvNeXt-T sub-models showed the best performance, with precision 85.9%, recall 85.5%, F1-score 85.7%, and AUC 0.971 which are higher than the compared state-of-the-art models. CONCLUSION The stacking model of three ConvNeXt-T sub-models shows comparable or superior performance to the other methods, including VGG19, ResNet18 and ViT-Base. It has the potential to enhance clinical diagnosis for HCE.
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Affiliation(s)
- Zhengye Wang
- College of Public Health, Xinjiang Medical University, Urumqi, China
| | - Kadiliya Kuerban
- College of Public Health, Xinjiang Medical University, Urumqi, China
| | - Zihang Zhou
- School of Computer Science and Engineering, Beihang University, Beijing, China
| | | | | | - Xiaorong Wang
- The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
- State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asia, Department of Abdominal Ultrasound, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Chuanbo Yan
- College of Medical Engineering Technology, Xinjiang Medical University, Urumqi, China
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Arega G, Kebede RA, Woldeselassie HG, Lingerh T, Yayeh T. Bilateral Large Pulmonary Hydatid Cyst: A Rare Presentation in a Young Child from Ethiopia. Pediatric Health Med Ther 2022; 13:279-282. [PMID: 35983161 PMCID: PMC9380727 DOI: 10.2147/phmt.s374091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 08/02/2022] [Indexed: 11/26/2022] Open
Abstract
Hydatidosis is a parasitic disease caused by Echinococcus granulosus, which is endemic in many parts of the world. Hydatid cysts can occur in any organ of the human body and the lung is the most common site in children, primarily related to higher lung tissue elasticity. Bilateral pulmonary hydatid cyst is a rare clinical phenomenon in young children. Here, we report on a 3-year-old boy diagnosed with bilateral pulmonary hydatid cyst after he came with four months history of dry cough and progressive worsening of shortness of breath. Computed tomography of the chest revealed large bilateral thick-walled pulmonary cystic mass lesions, with bilateral perihilar extension and pressure effect on the diaphragm with surrounding atelectatic changes. The patient underwent left posterolateral thoracotomy and cyst excision was done for the left hydatid cyst. Two months after the first surgical cyst excision, right posterolateral thoracotomy and cystectomy was done for the right lung hydatid cyst. He recovered well post-operatively.
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Affiliation(s)
- Gashaw Arega
- Addis Ababa University, School of Medicine, Department of Pediatrics and Child Health, Addis Ababa, Ethiopia
- Correspondence: Gashaw Arega, Addis Ababa University, School of Medicine, Department of Pediatrics and Child Health, P.O.Box: 9080, Addis Ababa, Ethiopia, Tel +251911417235, Email
| | - Rahel Argaw Kebede
- Addis Ababa University, School of Medicine, Department of Pediatrics and Child Health, Addis Ababa, Ethiopia
| | | | - Temesgen Lingerh
- Addis Ababa University, School of Medicine, Department of Pediatrics and Child Health, Addis Ababa, Ethiopia
| | - Tadele Yayeh
- Addis Ababa University, School of Medicine, Department of Pediatrics and Child Health, Addis Ababa, Ethiopia
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Pfeil J, Bialek R, Heininger U, Liese J, Simon A, Stich A, Assaad K, von Both U, Janda A, Kitz C, Kobbe R, Kunze M, Lindert J, Ritz N, Trapp S, Fressle R, Hufnagel M. Aktualisierte Empfehlungen zur infektiologischen Versorgung von Flüchtlingen im Kindes- und Jugendalter in Deutschland (Stand 30. März 2022), angemeldet als S1-Leitlinie (AWMF-Register Nr. 048-017). Monatsschr Kinderheilkd 2022; 170:632-647. [PMID: 35645410 PMCID: PMC9130691 DOI: 10.1007/s00112-022-01499-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/20/2022] [Indexed: 11/08/2022]
Abstract
Hintergrund Mit etwa 190.000 Asylanträgen im Jahr 2021 ist Deutschland das wichtigste Aufnahmeland von Asylsuchenden in Europa. Die vorliegenden Handlungsempfehlungen sollen eine Grundlage für eine evidenzbasierte und zielgerichtete infektiologische Versorgung minderjähriger Flüchtlinge schaffen. Ziele Die Handlungsempfehlungen sollen medizinisches Personal in der Versorgung minderjähriger Flüchtlinge unterstützen, um 1. einen unvollständigen Impfschutz frühzeitig zu erkennen und zu vervollständigen; 2. übliche Infektionskrankheiten zu diagnostizieren und zu behandeln; 3. in Deutschland seltene Infektionskrankheiten frühzeitig zu erkennen und zu therapieren. Material und Methoden Die Handlungsempfehlungen wurden als AWMF-Leitlinie Stufe 1 verfasst. Entsprechend wurden die Empfehlungen durch eine repräsentativ zusammengesetzte Expertengruppe der beteiligten Fachgesellschaften im informellen Konsens erarbeitet und final von den Vorständen der Fachgesellschaften offiziell verabschiedet. Ergebnisse Es werden Empfehlungen ausgesprochen, für den Umfang der Anamnese und der körperlichen Untersuchung minderjähriger Flüchtlinge. Für alle minderjährigen Flüchtlinge werden die Bestimmung eines Differenzialblutbildes sowie Untersuchungen auf Tuberkulose und Hepatitis B empfohlen. Je nach Herkunft und Alter werden weitere gezielte Untersuchungen z. B. auf Hepatitis C, HIV oder Schistosomiasis empfohlen. Zur raschen Vervollständigung des Impfstatus wird eine alters- und indikationsbezogene Priorisierung einzelner Impfungen vorgenommen. Diskussion Angesichts anhaltend hoher Flüchtlingszahlen ist eine weitere Professionalisierung der medizinischen Versorgung minderjähriger Flüchtlinge notwendig. Hierzu sollten die notwendigen strukturellen und personellen Rahmenbedingungen geschaffen werden.
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Wu M, Yan C, Wang X, Liu Q, Liu Z, Song T. Automatic Classification of Hepatic Cystic Echinococcosis Using Ultrasound Images and Deep Learning. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2022; 41:163-174. [PMID: 33710638 DOI: 10.1002/jum.15691] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 02/22/2021] [Accepted: 02/24/2021] [Indexed: 05/11/2023]
Abstract
BACKGROUND Hepatic cystic echinococcosis is the main form of hepatic echinococcosis, which is a life-threatening liver disease caused by parasites that requires a precise diagnosis and proper treatment. OBJECTIVE This study focuses on the automatic classification system of five different subtypes of hepatic cystic echinococcosis based on ultrasound images and deep learning algorithms. METHODS Three popular deep convolutional neural networks (VGG19, Inception-v3, and ResNet18) with and without pretrained weights were selected to test their performance on the classification task, and the experiments were followed by a 5-fold cross-validation process. RESULTS A total of 1820 abdominal ultrasound images covering five subtypes of hepatic cystic echinococcosis from 967 patients were used in the study. The classification accuracy for the models with pretrained weights (fine-tuning) ranged from 88.2 to 90.6%. The best accuracy of 90.6% was obtained by VGG19. For comparison, the models without pretrained weights (from scratch) achieved a lower accuracy, ranging from 69.4 to 75.1%. CONCLUSION Deep convolutional neural networks with pretrained weights are capable of recognizing different subtypes of hepatic cystic echinococcosis from ultrasound images, which are expected to be applied in the computer-aided diagnosis systems in future work.
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Affiliation(s)
- Miao Wu
- College of Biomedical Engineering and Instrumental Science, Zhejiang University, Hang Zhou, China
- College of Medical Engineering and Technology, Xinjiang Medical University, Urumqi, China
| | - Chuanbo Yan
- College of Medical Engineering and Technology, Xinjiang Medical University, Urumqi, China
| | - Xiaorong Wang
- Ultrasonography Department, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Qian Liu
- Basic Medical College, Xinjiang Medical University, Urumqi, China
| | - Zhihua Liu
- College of Medical Engineering and Technology, Xinjiang Medical University, Urumqi, China
| | - Tao Song
- Ultrasonography Department, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
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Mutwiri T, Magambo J, Zeyhle E, Muigai AWT, Alumasa L, Amanya F, Fèvre EM, Falzon LC. Findings of a community screening programme for human cystic echinococcosis in a non-endemic area. PLOS GLOBAL PUBLIC HEALTH 2022; 2:e0000235. [PMID: 36962714 PMCID: PMC10022381 DOI: 10.1371/journal.pgph.0000235] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Accepted: 07/01/2022] [Indexed: 11/19/2022]
Abstract
Cystic Echinococcosis (CE) is a zoonosis caused by infection with the larval stages of the taeniid cestodes of the species complex Echinococcus granulosus sensu lato. It is prevalent among transhumant communities in East Africa, including those residing in northern Kenya. The movement of livestock from these regions of high incidence to areas of low incidence creates an indirect risk of disease spill-over to humans. To assess possible establishment of the CE life cycle outside known endemic regions, we used a portable ultrasound scanner to screen for the presence of human CE in Bungoma County of western Kenya, an area which imports substantial numbers of cattle for slaughter from neighbouring pastoralist regions. Eight sentinel sites were purposively selected based on their proximity to slaughterhouses handling animals introduced from pastoralist regions, and necessary permissions to conduct the study were sought. Regression analyses were conducted to identify risk factors associated with the presence of abdominal and cystic lesions (CL). In total, 1002 participants were screened; of these, 654 (65.3%) were female and the median age was 43. Farming (n = 403; 43.4%) was the most frequent occupation, followed by professional (i.e. on regular salary) (n = 215; 23.1%), and business (n = 207; 22.3%) categories. Sixty-seven participants (6.7%) had abnormal ultrasound findings, of these, 7 (1.1%) had simple liver cysts/CL, as per WHO classification. As such, their outcome was inconclusive and they were not put on treatment but advised to attend follow-up investigations in a referral health facility. Other abnormal findings included splenomegaly (n = 14), ovarian cysts (n = 14), uterine fibroids (n = 10), polycystic kidneys (n = 6), and benign prostatic hyperplasia (n = 6). Age was unconditionally associated with the presence of presumptive CL. These results contribute to CE baseline data while providing insights on the implementation of ultrasound diagnosis in the field, as recommended by the WHO for targeted control of echinococcosis by 2030.
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Affiliation(s)
- Titus Mutwiri
- Jomo Kenyatta University of Agriculture and Technology, Nairobi, Kenya
- International Livestock Research Institute, Nairobi, Kenya
- Kenya Methodist University, Nairobi, Kenya
| | | | | | - Anne W T Muigai
- Jomo Kenyatta University of Agriculture and Technology, Nairobi, Kenya
| | - Lorren Alumasa
- International Livestock Research Institute, Nairobi, Kenya
| | | | - Eric M Fèvre
- International Livestock Research Institute, Nairobi, Kenya
- Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, United Kingdom
| | - Laura C Falzon
- International Livestock Research Institute, Nairobi, Kenya
- Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, United Kingdom
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Khan H, Ahmed H, Afzal MS, Awan UA, Khurram M, Simsek S, Cao J. Detection of Anti- Echinococcus granulosus Antibodies in Humans: An Update from Pakistan. Pathogens 2021; 11:pathogens11010029. [PMID: 35055977 PMCID: PMC8781053 DOI: 10.3390/pathogens11010029] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2021] [Revised: 12/18/2021] [Accepted: 12/20/2021] [Indexed: 11/16/2022] Open
Abstract
Human cystic echinococcosis (CE) is a zoonotic disease caused by the larval stage of Echinococcus granulosus sensu lato that causes economic losses by affecting livestock and also poses a public health threat worldwide. The present study is the first retrospective report on the seroprevalence of anti-E. granulosus antibodies in humans in Pakistan. The study used data from 93 blood analysis reports of patients suspected of having CE from different medical centers in Lahore, Pakistan. Out of 93 sera samples, 20 (21.5%) were seropositive, and higher seropositivity (17.2%) was recorded with the indirect hemagglutination test (IHA) than with enzyme-linked immunosorbent assay (ELISA). The findings indicated that age, gender, and year had no significant relationship with the seropositivity of CE. The current study provides directions towards the management of the disease in the near future in Pakistan.
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Affiliation(s)
- Huma Khan
- Department of Biosciences, COMSATS University Islamabad (CUI), Islamabad 45550, Pakistan
| | - Haroon Ahmed
- Department of Biosciences, COMSATS University Islamabad (CUI), Islamabad 45550, Pakistan
| | - Muhammad Sohail Afzal
- Department of Life Sciences, School of Science, University of Management & Technology (UMT), Lahore 54700, Pakistan
| | - Usman Ayub Awan
- Department of Medical Laboratory Technology, The University of Haripur, Haripur 22620, Pakistan
| | - Muhammad Khurram
- Department of Life Sciences, School of Science, University of Management & Technology (UMT), Lahore 54700, Pakistan
| | - Sami Simsek
- Department of Parasitology, Faculty of Veterinary Medicine, University of Firat, Elazig 23119, Turkey
| | - Jianping Cao
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research), NHC Key Laboratory of Parasite and Vector Biology, WHO Collaborating Centre for Tropical Diseases, National Center for International Research on Tropical Diseases, Shanghai 200025, China
- The School of Global Health, Chinese Center for Tropical Diseases Research, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
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11
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Rogers MJ, McManus DP, Muhi S, Gordon CA. Membrane Technology for Rapid Point-of-Care Diagnostics for Parasitic Neglected Tropical Diseases. Clin Microbiol Rev 2021; 34:e0032920. [PMID: 34378956 PMCID: PMC8404699 DOI: 10.1128/cmr.00329-20] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Parasitic neglected tropical diseases (NTDs) affect over one billion people worldwide, with individuals from communities in low-socioeconomic areas being most at risk and suffering the most. Disease management programs are hindered by the lack of infrastructure and resources for clinical sample collection, storage, and transport and a dearth of sensitive diagnostic methods that are inexpensive as well as accurate. Many diagnostic tests and tools have been developed for the parasitic NTDs, but the collection and storage of clinical samples for molecular and immunological diagnosis can be expensive due to storage, transport, and reagent costs, making these procedures untenable in most areas of endemicity. The application of membrane technology, which involves the use of specific membranes for either sample collection and storage or diagnostic procedures, can streamline this process, allowing for long-term sample storage at room temperature. Membrane technology can be used in serology-based diagnostic assays and for nucleic acid purification prior to molecular analysis. This facilitates the development of relatively simple and rapid procedures, although some of these methods, mainly due to costs, lack accessibility in low-socioeconomic regions of endemicity. New immunological procedures and nucleic acid storage, purification, and diagnostics protocols that are simple, rapid, accurate, and cost-effective must be developed as countries progress control efforts toward the elimination of the parasitic NTDs.
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Affiliation(s)
- Madeleine J. Rogers
- School of Chemistry and Molecular Biosciences, University of Queensland, Brisbane, Queensland, Australia
- Molecular Parasitology Laboratory, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | - Donald P. McManus
- Molecular Parasitology Laboratory, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | - Stephen Muhi
- Victorian Infectious Diseases Service, The Royal Melbourne Hospital, Parkville, Victoria, Australia
| | - Catherine A. Gordon
- Molecular Parasitology Laboratory, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
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12
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Örsten S, Baysal İ, Yabanoglu-Ciftci S, Ciftci T, Ünal E, Akıncı D, Akyön Y, Akhan O. Can parasite-derived microRNAs differentiate active and inactive cystic echinococcosis patients? Parasitol Res 2021; 121:191-196. [PMID: 34811587 DOI: 10.1007/s00436-021-07382-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Accepted: 11/11/2021] [Indexed: 11/28/2022]
Abstract
Cystic Echinococcosis (CE) is a neglected zoonotic disease caused by the metacestode form of Echinococcus granulosus sensu lato. Non-invasive imaging techniques, especially ultrasound, are primarily used for CE diagnosis. MicroRNAs (miRNAs) are small, non-coding RNA molecules that act as post-transcriptional regulators in various biological processes. After identification of parasite-derived miRNAs, these miRNAs are considered to be potential biomarkers for diagnosis and follow-up. The focus of this research is to compare the expression profiles of certain parasite-derived miRNAs in CE patients with active and inactive cysts as well as healthy controls. Parasite-derived miRNAs, egr-let-7-5p, egr-miR-71a-5p, and egr-miR-9-5p, of inactive CE patients were found to be differentially expressed with 3.74-, 2.72-, and 20.78-fold change (p < 0.05), respectively, when compared with active CE patients. In this study, we evaluated for the first time the expression profile of three parasite-derived miRNAs in the serum of CE patients to determine their potential to distinguish between active and inactive CE. It was concluded that serum levels of parasite-derived miRNAs, egr-let-7-5p and egr-miR-9-5p, could be promising new potential biomarkers for stage-specific diagnosis of CE. Further studies are needed with larger sample set to validate discriminating potential of these miRNAs.
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Affiliation(s)
- Serra Örsten
- Vocational School of Health Services, Hacettepe University, Ankara, Turkey.
| | - İpek Baysal
- Vocational School of Health Services, Hacettepe University, Ankara, Turkey
| | | | - Türkmen Ciftci
- Department of Radiology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Emre Ünal
- Department of Radiology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Devrim Akıncı
- Department of Radiology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Yakut Akyön
- Department of Medical Microbiology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Okan Akhan
- Department of Radiology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
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13
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Ciftci TT, Yabanoglu-Ciftci S, Unal E, Akinci D, Baysal I, Yuce G, Dogrul AB, Orsten S, Akhan O, Nemutlu E. Metabolomic profiling of active and inactive liver cystic echinococcosis. Acta Trop 2021; 221:105985. [PMID: 34048790 DOI: 10.1016/j.actatropica.2021.105985] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 04/26/2021] [Accepted: 05/19/2021] [Indexed: 01/10/2023]
Abstract
Cystic Echinococcosis (CE) is one of the life-threatening diseases worldwide. It is a parasitic zoonosis caused by tapeworms of the species Echinococcus granulosus sensu lato (s.l). The treatment options of CE vary from simple "watch and wait" approach to invasive treatment, based on the type and especially the nature of the cyst (active/inactive). Serological tests are inadequate to distinguish between active and inactive CE. A diagnostic reference that can determine whether the cyst is active or inactive can easily guide the treatment strategy. We aimed to test whether gas chromatography-mass spectrometry (GC-MS) and liquid chromatography-quadropole time of flight mass spectrometry (LC-qTOF-MS) based metabolomics can establish a plasma metabolic fingerprint of CE patients and identify a diagnostic reference to discriminate active and inactive CE cysts. Metabolite concentrations were measured in plasma samples of 36 active CE patients, 17 inactive CE patients and 31 healthy controls. Multivariate statistical analysis on 232 identified metabolites obtained from two analytical platforms was performed by using principle component analysis (PCA) and partial least square-discriminant analysis (PLS-DA) methods. The PLS-DA scores plot of the combined data set demonstrated a good separation between the groups. Compared to the healthy control group, decreased levels of squalene and increased levels of glyceric acid, 3-phosphoglycerate, glutamic acid, palmitoleic acid and oleic acid were determined in the CE patients. However, decreased levels of 3-phosphoglycerate and increased levels of 4-hydroxyphenylacetylglutamine, docosahexanoic acid were determined in active CE patients compared to the inactive CE patients. Determination of differences in metabolites may provide detailed understandings of potential metabolic process associated with active and inactive CE patients, and altered specific metabolic changes may provide some clues to obtain diagnostic reference for CE. This study has certain limitations: a. various factors affecting results of metabolomic studies such as lifestyle and dietary habits of the patients could not be fully controlled b. other infectious or malignant diseases of the liver should also be included as a positive control to evaluate the specificity of the diagnostic references.
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Affiliation(s)
- Turkmen T Ciftci
- Hacettepe University, Faculty of Medicine, Department of Radiology, Ankara 06100, Turkey.
| | - Samiye Yabanoglu-Ciftci
- Hacettepe University, Faculty of Pharmacy, Department of Biochemistry, Ankara 06100, Turkey.
| | - Emre Unal
- Hacettepe University, Faculty of Medicine, Department of Radiology, Ankara 06100, Turkey.
| | - Devrim Akinci
- Hacettepe University, Faculty of Medicine, Department of Radiology, Ankara 06100, Turkey.
| | - Ipek Baysal
- Hacettepe University, Faculty of Pharmacy, Department of Biochemistry, Ankara 06100, Turkey.
| | - Gokhan Yuce
- Ministry of Health, Ankara City Hospital, Department of Radiology, Ankara, Turkey.
| | - Ahmet Bulent Dogrul
- Hacettepe University, Faculty of Medicine, Department of General Surgery, Ankara, Turkey
| | - Serra Orsten
- Hacettepe University, Vocational School of Health Services, Ankara, Turkey.
| | - Okan Akhan
- Hacettepe University, Faculty of Medicine, Department of Radiology, Ankara 06100, Turkey.
| | - Emirhan Nemutlu
- Hacettepe University, Faculty of Pharmacy, Department of Analytical Chemistry, Ankara 06100, Turkey; Hacettepe University, Faculty of Pharmacy, Bioanalytic and Omics Laboratory, Ankara 06100, Turkey.
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14
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Vola A, Mariconti M, Lissandrin R, Cuzzocrea F, Bortolotto C, Sammarchi L, Vercelli A, Rinaldi P, Maestri M, Manciulli T, Brunetti E. Prospective collection of clinical data on cystic echinococcosis: experience with the European Registry of Cystic Echinococcosis in Pavia, Italy. Trans R Soc Trop Med Hyg 2021; 116:157-162. [PMID: 34323274 DOI: 10.1093/trstmh/trab097] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Revised: 02/28/2021] [Accepted: 06/18/2021] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Cystic echinococcosis (CE) is a chronic, complex and neglected infection that may cause serious disease in humans. Given its peculiar epidemiologic and clinical features, collection of clinical data is challenging. Notification systems, when available, fail to record important clinical features, available data are mostly retrospectively collected and no prospectively enrolled uniform surveillance systems exist. The European Register of Cystic Echinococcosis database (ERCE) is the first systematic attempt to address these issues. METHODS Here, we describe the demographics and clinical characteristics of 436 patients who accessed the CE clinic at the University of Pavia-San Matteo Hospital Foundation, in Pavia, Italy, from March 2012 to February 2020. RESULTS Overall, 436 patients, consisting of 204 (46.8%) males and 232 (53.2%) females were enrolled; the mean age at enrollment was 50 (range 4-88) y. Of the 436 patients, 248 (56.9%) were born in Italy while 188 (43.1%) were foreign-born. In total, 638 CE cysts were counted, most of them in the CE4 (230; 36.1%) and CE3b (131; 20.5%) stages. CONCLUSIONS This is the largest cohort of CE patients with detailed clinical and demographic data published to date. We strongly encourage colleagues caring for CE patients in the European Union to join the ERCE.
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Affiliation(s)
- Ambra Vola
- Unit of Molecular Virology, Microbiology and Virology Department, IRCCS San Matteo Hospital Foundation, Viale Taramelli 5, 27100, Pavia, Italy
| | - Mara Mariconti
- Infectious Diseases and Immunology, IRCCS San Matteo Hospital Foundation, Viale Taramelli 5, 27100, Pavia, Italy
| | - Raffaella Lissandrin
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Viale Brambilla 74, 27100, Pavia, Italy
| | - Fabrizio Cuzzocrea
- Unit of Orthopedic Surgery and Traumatology, IRCCS San Matteo Hospital Foundation, Viale Taramelli 5, 27100, Pavia, Italy
| | - Chandra Bortolotto
- Unit of Orthopedic Surgery and Traumatology, IRCCS San Matteo Hospital Foundation, Viale Taramelli 5, 27100, Pavia, Italy
| | - Luigi Sammarchi
- Unit of Radiology, IRCCS San Matteo Hospital Foundation, Viale Taramelli 5, 27100, Pavia, Italy
| | - Alessandro Vercelli
- Department of Radiology, Istituto di Cura, Città di Pavia, Via Parco Vecchio, 27, 27100 Pavia, Italy
| | - Pietro Rinaldi
- Unit of Thoracic Surgery, IRCCS San Matteo Hospital Foundation, Viale Taramelli 5, 27100, Pavia, Italy
| | - Marcello Maestri
- Unit of General Surgery, IRCCS San Matteo Hospital Foundation, Viale Taramelli 5, 27100, Pavia, Italy
| | - Tommaso Manciulli
- Infectious Diseases and Immunology, IRCCS San Matteo Hospital Foundation, Viale Taramelli 5, 27100, Pavia, Italy.,Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Viale Brambilla 74, 27100, Pavia, Italy.,Unit of Radiology, IRCCS San Matteo Hospital Foundation, Viale Taramelli 5, 27100, Pavia, Italy
| | - Enrico Brunetti
- Infectious Diseases and Immunology, IRCCS San Matteo Hospital Foundation, Viale Taramelli 5, 27100, Pavia, Italy.,Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Viale Brambilla 74, 27100, Pavia, Italy
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15
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Bharadwaj M, Bengtson M, Golverdingen M, Waling L, Dekker C. Diagnosing point-of-care diagnostics for neglected tropical diseases. PLoS Negl Trop Dis 2021; 15:e0009405. [PMID: 34138846 PMCID: PMC8211285 DOI: 10.1371/journal.pntd.0009405] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Inadequate and nonintegrated diagnostics are the Achilles' heel of global efforts to monitor, control, and eradicate neglected tropical diseases (NTDs). While treatment is often available, NTDs are endemic among marginalized populations, due to the unavailability or inadequacy of diagnostic tests that cause empirical misdiagnoses. The need of the hour is early diagnosis at the point-of-care (PoC) of NTD patients. Here, we review the status quo of PoC diagnostic tests and practices for all of the 24 NTDs identified in the World Health Organization's (WHO) 2021-2030 roadmap, based on their different diagnostic requirements. We discuss the capabilities and shortcomings of current diagnostic tests, identify diagnostic needs, and formulate prerequisites of relevant PoC tests. Next to technical requirements, we stress the importance of availability and awareness programs for establishing PoC tests that fit endemic resource-limited settings. Better understanding of NTD diagnostics will pave the path for setting realistic goals for healthcare in areas with minimal resources, thereby alleviating the global healthcare burden.
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Affiliation(s)
- Mitasha Bharadwaj
- Department of Bionanoscience, Kavli Institute of Nanoscience Delft, Delft University of Technology, Delft, The Netherlands
| | - Michel Bengtson
- Department of Bionanoscience, Kavli Institute of Nanoscience Delft, Delft University of Technology, Delft, The Netherlands
| | - Mirte Golverdingen
- Department of Bionanoscience, Kavli Institute of Nanoscience Delft, Delft University of Technology, Delft, The Netherlands
| | - Loulotte Waling
- Department of Bionanoscience, Kavli Institute of Nanoscience Delft, Delft University of Technology, Delft, The Netherlands
| | - Cees Dekker
- Department of Bionanoscience, Kavli Institute of Nanoscience Delft, Delft University of Technology, Delft, The Netherlands
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16
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Manciulli T, Enríquez-Laurente R, Tamarozzi F, Lissandrin R, Elizalde M, Sedano C, Bardales K, Vola A, De Silvestri A, Tinelli C, Brunetti E, Santivanez S, Mariconti M. Field Performance of a Rapid Diagnostic Test for the Serodiagnosis of Abdominal Cystic Echinococcosis in the Peruvian Highlands. Am J Trop Med Hyg 2021; 105:181-187. [PMID: 34029208 PMCID: PMC8274789 DOI: 10.4269/ajtmh.21-0045] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Accepted: 02/11/2021] [Indexed: 11/07/2022] Open
Abstract
We evaluated the performance of a commercial rapid diagnostic test (RDT) in a field setting for the diagnosis of abdominal cystic echinococcosis (CE) using sera collected during an ultrasound population screening in a highly endemic region of the Peruvian Andes. Abdominal CE was investigated by ultrasonography. Sera collected from individuals with abdominal CE (cases) and age- and gender-matched volunteers with no abdominal CE (controls) were tested independently in two laboratories (Peru and Italy) using the VIRapid® HYDATIDOSIS RDT and RIDASCREEN® Echinococcus IgG enzyme-linked immunosorbent assay. Performance indexes of single and serially combined tests were calculated and applied to hypothetical screening and clinical scenarios. Test concordance was also evaluated. Prevalence of abdominal CE was 6.00% (33 of 546) by ultrasound. Serum was obtained from 33 cases and 81 controls. The VIRapid test showed similar sensitivity (76% versus 74%) and lower specificity (79% versus 96%) than results obtained in a hospital setting. RDTs showed better performance when excluding subjects reporting surgery for CE and if weak bands were considered negative. Concordance between tests was moderate to very good. In hypothetical screening scenarios, ultrasound alone or confirmed by RDTs provided more reliable prevalence figures than serology alone, which overestimated it by 5 to 20 times. In a simulation of case diagnosis with pre-test probability of CE of 50%, positive and negative post-test probabilities of the VIRapid test were 78% and 22%, respectively. The application of the VIRapid test alone would not be reliable for the assessment of population prevalence of CE, but could help clinical decision making in resource-limited settings.
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Affiliation(s)
- Tommaso Manciulli
- PhD School of Experimental Medicine, University of Pavia, Pavia, Italy
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
| | | | - Francesca Tamarozzi
- Department of Infectious-Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar, Verona, Italy
| | - Raffaella Lissandrin
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
| | - Maira Elizalde
- Instituto Peruano de Parasitologia Clinica y Experimental, Lima, Peru
| | - Cesar Sedano
- Instituto Peruano de Parasitologia Clinica y Experimental, Lima, Peru
| | - Karina Bardales
- Instituto Peruano de Parasitologia Clinica y Experimental, Lima, Peru
| | - Ambra Vola
- Unit of Infectious and Tropical Diseases, IRCCS San Matteo Hospital Foundation, Pavia, Italy
| | - Annalisa De Silvestri
- Unit of Epidemiology and Biostatistics, IRCCS San Matteo Hospital Foundation, Pavia, Italy
| | - Carmine Tinelli
- Unit of Epidemiology and Biostatistics, IRCCS San Matteo Hospital Foundation, Pavia, Italy
| | - Enrico Brunetti
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
- Unit of Infectious and Tropical Diseases, IRCCS San Matteo Hospital Foundation, Pavia, Italy
| | - Saul Santivanez
- Instituto Peruano de Parasitologia Clinica y Experimental, Lima, Peru
| | - Mara Mariconti
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
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17
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Tamarozzi F, Silva R, Fittipaldo VA, Buonfrate D, Gottstein B, Siles-Lucas M. Serology for the diagnosis of human hepatic cystic echinococcosis and its relation with cyst staging: A systematic review of the literature with meta-analysis. PLoS Negl Trop Dis 2021; 15:e0009370. [PMID: 33909640 PMCID: PMC8081258 DOI: 10.1371/journal.pntd.0009370] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Accepted: 04/07/2021] [Indexed: 01/13/2023] Open
Abstract
Background The diagnosis of cystic echinococcosis (CE) is primarily based on imaging, while serology should be applied when imaging is inconclusive. CE cyst stage has been reported among the most important factors influencing the outcome of serodiagnosis. We performed a systematic review and meta-analysis of the relation between cyst stage of hepatic CE and diagnostic sensitivity of serological tests, to evaluate whether their relation is a consistent finding and provide guidance for the interpretation of results of serological tests. Methodology/Principal findings MEDLINE, EMBASE, CENTRAL, and Lilacs databases were searched on December 1st 2019. Original studies published after 2003 (year of publication of the CE cyst classification), reporting sensitivity of serological tests applied to the diagnosis of human hepatic CE, as diagnosed and staged by imaging, were included. The quality of studies was assessed using the Newcastle-Ottawa Scale. Data from 14 studies were included in the meta-analysis. Summary estimates of sensitivities and 95% confidence intervals were obtained using random effects meta-analysis. Overall, test sensitivity was highest in the presence of CE2 and CE3 (CE3a and/or CE3b), and lowest in the presence of CE5 and CE4 cysts. ELISA, ICT and WB showed the highest sensitivities, while IHA performed worst. Conclusions/Significance The results of our study confirm the presence of a clear and consistent relation between cyst stage and serological tests results. Limitations of evidence included the heterogeneity of the antigenic preparations used, which prevented to determine whether the relation between cyst stage and sensitivity was influenced by the type of antigenic preparation, the paucity of studies testing the same panel of sera with different assays, and the lack of studies assessing the performance of the same assay in both field and hospital-based settings. Our results indicate the absolute need to consider cyst staging when evaluating serological results of patients with hepatic CE. Cystic echinococcosis is a neglected zoonosis induced by the development of parasitic cysts in intermediate hosts, including humans, mostly in the liver. The diagnosis of CE is based on imaging. As CE cysts may assume different aspects (stages), the range of differential diagnoses is broad, from harmless simple cysts to neoplasms. Serological assays for the detection of serum antibodies are applied when imaging is inconclusive, but their performance depend on a number of factors, among which cyst stage has been reported as important. If this was a robust finding, it would be absolutely required to interpret serological findings in the light of CE cyst staging. The results of our systematic review and meta-analysis of the relation between cyst stage of hepatic CE and diagnostic sensitivity of serological tests confirmed that such relation is clear and consistent, and indicate the absolute need to consider cyst staging when evaluating serology results of patients with hepatic CE.
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Affiliation(s)
- Francesca Tamarozzi
- Department of Infectious-Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar, Verona, Italy
- * E-mail:
| | - Ronaldo Silva
- Department of Infectious-Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar, Verona, Italy
| | - Veronica Andrea Fittipaldo
- Department of Infectious-Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar, Verona, Italy
| | - Dora Buonfrate
- Department of Infectious-Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar, Verona, Italy
| | - Bruno Gottstein
- Institute of Infectious Diseases, Faculty of Medicine, University of Bern, Bern, Switzerland
| | - Mar Siles-Lucas
- Instituto de Recursos Naturales y Agrobiología de Salamanca (IRNASA-CSIC), Salamanca, Spain
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18
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Khan A, Ahmed H, Khan H, Saleem S, Simsek S, Brunetti E, Afzal MS, Manciulli T, Budke CM. Cystic Echinococcosis in Pakistan: A Review of Reported Cases, Diagnosis, and Management. Acta Trop 2020; 212:105709. [PMID: 32956637 DOI: 10.1016/j.actatropica.2020.105709] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 09/12/2020] [Accepted: 09/12/2020] [Indexed: 02/07/2023]
Abstract
Cystic echinococcosis (CE) is a zoonotic disease that occurs in humans and ungulates due to infection with the larval stage of the taeniid cestode Echinococcus granulosus sensu lato. It has been estimated that approximately one million people are infected annually, resulting in US$3 billion in human and livestock-associated direct and indirect losses per year. CE is a serious public health concern in many parts of the world, including Pakistan. This review discusses the causative agent as well as the epidemiology, diagnosis, and treatment of CE in Pakistan.
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19
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Noordin R, Khanbabaie S, Hafiznur Yunus M, Marti H, Nickel B, Fasihi Harandi M, Nasibi S. Evaluation of the Diagnostic Performance of Recombinant Antigen B1 for Detection of Cystic Echinococcosis Using Lateral Flow Dipstick Test. IRANIAN JOURNAL OF PARASITOLOGY 2020; 15:290-298. [PMID: 33082792 PMCID: PMC7548468 DOI: 10.18502/ijpa.v15i3.4191] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Background Human echinococcosis is a neglected zoonotic disease distributed worldwide. It comprises cystic and alveolar forms, the former being the more prevalent disease. Imaging techniques are the first choice for diagnosis of cystic echinococcosis and serology is used as an additional diagnostic technique in doubtful cases or as the sole test in low-resource settings. Rapid diagnostic tests are useful and convenient for immunodiagnosis of cystic echinococcosis in endemic areas, where medical facilities often struggle with limited resources. Methods Recently, we have developed Hyd Rapid™, an IgG4 lateral flow dipstick test using recombinant antigen B1 for detection of cystic echinococcosis. This study was performed between 2016 until 2018 at the Institute for Research in Molecular Medicine, Universiti Sains Malaysia. The diagnostic performance of Hyd Rapid™ was tested in-house and at two international laboratories in Switzerland and Iran. Results The overall diagnostic sensitivity for detection of cystic and alveolar echinococcosis was 95% (56/59). Meanwhile, the diagnostic specificity, with and without exclusion of cysticercosis and fascioliasis, was 100% (n=48) and 88% (63/72), respectively. Conclusion Hyd Rapid™ detected cystic echinococcosis as well as probable cases of alveolar echinococcosis. Therefore, Hyd Rapid™ showed good potential as a serological tool for echinococcosis, and merits further evaluation.
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Affiliation(s)
- Rahmah Noordin
- Institute for Research in Molecular Medicine (INFORMM), Universiti Sains Malaysia, 11800 USM, Pulau Pinang, Malaysia
| | - Sam Khanbabaie
- Institute for Research in Molecular Medicine (INFORMM), Universiti Sains Malaysia, 11800 USM, Pulau Pinang, Malaysia
| | - Muhammad Hafiznur Yunus
- Institute for Research in Molecular Medicine (INFORMM), Universiti Sains Malaysia, 11800 USM, Pulau Pinang, Malaysia
| | - Hanspeter Marti
- Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | - Beatrice Nickel
- Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | - Majid Fasihi Harandi
- Research Center for Hydatid Disease in Iran, School of Medicine, Kerman University of Medical Sciences, Kerman, Iran
| | - Saeid Nasibi
- Research Center for Hydatid Disease in Iran, School of Medicine, Kerman University of Medical Sciences, Kerman, Iran
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20
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Wang X, Dai G, Li M, Jia W, Guo Z, Lu J. Prevalence of human alveolar echinococcosis in China: a systematic review and meta-analysis. BMC Public Health 2020; 20:1105. [PMID: 32664905 PMCID: PMC7362549 DOI: 10.1186/s12889-020-08989-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Accepted: 05/26/2020] [Indexed: 12/14/2022] Open
Abstract
Background Human alveolar echinococcosis (HAE), caused by the larvae of Echinococcus multilocularis, is a severe parasitic disease that is a major public health concern. New HAE cases in China account for 91% of the global HAE burden every year. Although there are a few studies and systematic reviews (SRs) on the prevalence of HAE in China, trends in the prevalence have not been estimated. This study aims to describe the overall variation in the trend of HAE prevalence in China, and provide evidence for preventive measures in the future. Methods Thirty-five eligible studies were retrieved from PubMed, Web of Science, EMBASE, CNKI, Wanfang Data, and VIP, and included in the SR and meta-analysis. An adjusted Agency for Healthcare Research and Quality checklist was used to evaluate study quality. The arcsine transformation was used to adjust the individual reported prevalence, and the pooled HAE prevalence was calculated. Heterogeneity was evaluated using the chi-square test and I2 statistic. Forest plots were generated for the meta-analysis, and publication bias of the studies was assessed using the Egger’s test and funnel plots. We conducted subgroup analyses, sensitivity analyses, and meta-regression analyses to analyze the source of heterogeneity and factors potentially influencing the prevalence of HAE. Results The meta-analysis indicated that the pooled HAE prevalence in China was 0.96% (95% CI: 0.71 to 1.25%). Factors potentially influencing HAE prevalence were female sex (OR = 1.60, 95% CI: 1.35 to 1.91, P<0.01), being ≥30 years old (OR = 4.72, 95% CI: 2.29 to 9.75, P<0.01), and being farmers and/or herdsmen (OR = 2.54, 95% CI: 1.60 to 4.02, P<0.01). The results of the meta-regression analysis (R2 = 38.11%, P < 0.01) indicated that HAE prevalence is on a downward trend. Conclusions HAE prevalence has decreased over time and maintained low levels after 2005 in China. This decline was influenced by the utilization of One Health strategies as intervention measures. Therefore, these One Health strategies should be used as references to formulate future programs for HAE control. More high-quality epidemiological investigations and surveillance programs should be conducted in order to improve HAE control in the future.
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Affiliation(s)
- Xuanzhuo Wang
- School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong Province, China.,State Key Laboratory of Veterinary Etiological Biology, Key Laboratory of Veterinary Parasitology of Gansu Province, Lanzhou Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Lanzhou, Gansu Province, China
| | - Guodong Dai
- State Key Laboratory of Veterinary Etiological Biology, Key Laboratory of Veterinary Parasitology of Gansu Province, Lanzhou Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Lanzhou, Gansu Province, China
| | - Min Li
- State Key Laboratory of Veterinary Etiological Biology, Key Laboratory of Veterinary Parasitology of Gansu Province, Lanzhou Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Lanzhou, Gansu Province, China
| | - Wanzhong Jia
- State Key Laboratory of Veterinary Etiological Biology, Key Laboratory of Veterinary Parasitology of Gansu Province, Lanzhou Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Lanzhou, Gansu Province, China
| | - Zhongmin Guo
- Experimental Animal Center, Sun Yat-sen University, Guangzhou, Guangdong Province, China.
| | - Jiahai Lu
- School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong Province, China. .,Key Laboratory for Tropical Diseases Control of Ministry of Education, Sun Yat-sen University, Guangzhou, Guangdong Province, China. .,One Health Research Centre, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong Province, China.
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21
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Vola A, Manciulli T, De Silvestri A, Lissandrin R, Mariconti M, Siles-Lucas M, Brunetti E, Tamarozzi F. Diagnostic Performances of Commercial ELISA, Indirect Hemagglutination, and Western Blot in Differentiation of Hepatic Echinococcal and Non-Echinococcal Lesions: A Retrospective Analysis of Data from a Single Referral Centre. Am J Trop Med Hyg 2020; 101:1345-1349. [PMID: 31674293 DOI: 10.4269/ajtmh.19-0556] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
The diagnosis of cystic echinococcosis (CE) is based on imaging. Serology supports imaging in suspected cases, but no consensus exists on the algorithm to apply when imaging is inconclusive. We performed a retrospective analysis of serology results of patients with untreated hepatic CE and non-CE lesions, seen from 2005 to 2017, to evaluate their accuracy in the differential diagnosis of hepatic CE. Serology results of three seroassays for echinococcosis (ELISA RIDASCREEN, indirect hemagglutination (IHA) Cellognost, and Western blot LDBIO) and clinical characteristics of eligible patients were retrieved. Patients were grouped as having active or inactive CE and liquid or solid non-CE lesions. Sensitivity, specificity, and diagnostic accuracy were compared between scenarios encompassing different test combinations. Eligible patients included 104 patients with CE and 257 with non-CE lesions. Sensitivity and diagnostic accuracy of Western blot (WB) were significantly higher than those of the following: 1) IHA or ELISA alone, 2) IHA+ELISA interpreted as positive if both or either tests positive, and 3) IHA+ELISA confirmed by WB if discordant. The best performances were obtained when WB was applied on discordant or concordant negative IHA+ELISA. Analyses performed within "active CE (n = 52) versus liquid non-CE (n = 245)" and "inactive CE (n = 52) versus solid non-CE (n = 12)" groups showed similar results. Specificity was high for all tests (0.99-1.00) and did not differ between test combination scenarios. WB may be the best test to apply in a one-test approach. Two first-level tests confirmed by WB seem to provide the best diagnostic accuracy. Further studies should be performed in different settings, especially where lower test specificity is likely.
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Affiliation(s)
- Ambra Vola
- Unit of Infectious and Tropical Diseases, San Matteo Hospital Foundation, Pavia, Italy
| | - Tommaso Manciulli
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
| | - Annalisa De Silvestri
- Clinical Epidemiology and Biometric Unit, San Matteo Hospital Foundation, Pavia, Italy
| | - Raffaella Lissandrin
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy.,Unit of Infectious and Tropical Diseases, San Matteo Hospital Foundation, Pavia, Italy
| | - Mara Mariconti
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy.,Unit of Infectious and Tropical Diseases, San Matteo Hospital Foundation, Pavia, Italy
| | - Mar Siles-Lucas
- Instituto de Recursos Naturales y Agrobiología de Salamanca, Consejo Superior de Investigaciones Científicas, Salamanca, Spain
| | - Enrico Brunetti
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy.,Unit of Infectious and Tropical Diseases, San Matteo Hospital Foundation, Pavia, Italy
| | - Francesca Tamarozzi
- Department of Infectious Diseases, WHO Collaborating Centre for the Epidemiology, Detection and Control of Cystic and Alveolar Echinococcosis, Istituto Superiore di Sanità, Rome, Italy
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22
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Review of Cystic Echinococcosis in Nigeria: A Story of Neglect. Acta Parasitol 2020; 65:1-10. [PMID: 31552582 PMCID: PMC7223537 DOI: 10.2478/s11686-019-00124-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Accepted: 09/14/2019] [Indexed: 12/28/2022]
Abstract
Purpose Cystic echinococcosis (CE) caused by Echinococcus granulosus sensu lato is a widespread zoonotic disease of global concern. In Nigeria, the exact picture/status of CE is unclear, as most of the states are largely uninvestigated. Yet, as with every parasitic zoonosis, the first step towards planning a comprehensive management and control programme involves assessment of available national/regional prevalence data, host range, and risk factors at play in the transmission dynamics.
Methods Published articles on echinococcosis were searched on PubMed and Africa Journal Online (AJOL) databases. Inclusion criteria were based on studies reporting prevalence of echinococcosis in animals and humans (including case reports) from 1970 to 2018. Results In this study, we evaluated and summarized cystic echinococcosis reports in Nigeria and found that post 1970–80s, studies on cystic echinococcosis have remained sparse regardless of the high prevalence recorded in the early years of CE investigation. In addition, information on the genetic population structure and the role of wildlife in CE transmission is still lacking. Conclusions This study appraises the prevalence and distribution of CE in Nigeria and identified areas where surveillance and control efforts should be focused and intensified.
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23
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Isolated Pulmonary Hydatid Cyst: A Rare Presentation in a Young Maasai Boy from Northern Tanzania. Case Rep Surg 2019; 2019:5024724. [PMID: 31662940 PMCID: PMC6791237 DOI: 10.1155/2019/5024724] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2019] [Accepted: 09/06/2019] [Indexed: 11/17/2022] Open
Abstract
Introduction Hydatidosis is a parasitic manifestation caused by Echinococcus granulosus. It is characterized by cystic lesions in the liver and lungs. Diagnosis is based on typical history and radiological measures. Case presentation A four-year-old boy presented with a one-year history of dry cough and difficulty in breathing which was of gradual progression. Computed tomography of the chest revealed a large 11.7 cm × 8.6 cm × 11.0 cm cyst in the right hemithorax. The patient underwent thoracotomy and recovered well post procedure. Conclusion This case report highlights that large hydatid cysts can be surgically removed with good outcome and the importance of realizing that the disease is a burden to the public health and is much neglected.
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Ohiolei JA, Yan HB, Li L, Magaji AA, Luka J, Zhu GQ, Isaac C, Odoya ME, Wu YT, Alvi MA, Muku RJ, Fu BQ, Jia WZ. Cystic echinococcosis in Nigeria: first insight into the genotypes of Echinococcus granulosus in animals. Parasit Vectors 2019; 12:392. [PMID: 31391113 PMCID: PMC6686243 DOI: 10.1186/s13071-019-3644-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Accepted: 07/25/2019] [Indexed: 11/10/2022] Open
Abstract
Background Cystic echinococcosis (CE) is a zoonosis caused by cestodes of Echinococcus granulosus (sensu lato) complex. In Nigeria, reports on the prevalence of CE, although limited, have been found to vary with location and host with higher prevalence and fertility rate observed in camels than other livestock. Until now, information regarding the molecular characteristics, genetic population structure, and genotypes of Echinococcus is lacking. Therefore, this study was aimed at addressing these gaps in knowledge. Methods We describe the genetic status of 31 Echinococcus isolates collected from slaughtered livestock (camels, cattle and goats) based on the full-length mitochondrial cytochrome c oxidase subunit 1 (cox1) and NADH dehydrogenase subunit 1 (nad1) genes. Results The resulting nucleotide sequences via the NCBI BLAST algorithm and Bayesian phylogeny of cox1 and cox1–nad1 genes using MrBayes v.3.1.2 showed that all isolates were clearly E. canadensis (G6/G7) and were 99–100% identical to previously reported G6/G7 haplotypes across Europe, Asia, North and East Africa. Conclusions Although, the G1 genotype is believed to be responsible for the majority of global CE burden, reports from a number of West African countries including Nigeria suggest that E. canadensis G6/G7 genotype could be the major causative agent of CE in the subregion. This study provides for the first time insight into the genetic population structure of Echinococcus species as well as implications for CE control in Nigeria. Electronic supplementary material The online version of this article (10.1186/s13071-019-3644-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- John Asekhaen Ohiolei
- State Key Laboratory of Veterinary Etiological Biology/National Professional Laboratory of Animal Hydatidosis, Lanzhou Veterinary Research Institute, CAAS, Lanzhou, 730046, Gansu, P. R. China.,Department of Zoology, Faculty of Life Sciences, Ambrose Alli University, Ekpoma, Nigeria
| | - Hong-Bin Yan
- State Key Laboratory of Veterinary Etiological Biology/National Professional Laboratory of Animal Hydatidosis, Lanzhou Veterinary Research Institute, CAAS, Lanzhou, 730046, Gansu, P. R. China
| | - Li Li
- State Key Laboratory of Veterinary Etiological Biology/National Professional Laboratory of Animal Hydatidosis, Lanzhou Veterinary Research Institute, CAAS, Lanzhou, 730046, Gansu, P. R. China
| | - Abdullahi Alhaji Magaji
- Department of Veterinary Public Health and Preventive Medicine, Faculty of Veterinary Medicine, Usmanu Danfodiyo University, Sokoto, Nigeria
| | - Joshua Luka
- Department of Veterinary Parasitology and Entomology, Faculty of Veterinary Medicine, University of Maiduguri, Maiduguri, Nigeria
| | - Guo-Qiang Zhu
- State Key Laboratory of Veterinary Etiological Biology/National Professional Laboratory of Animal Hydatidosis, Lanzhou Veterinary Research Institute, CAAS, Lanzhou, 730046, Gansu, P. R. China
| | - Clement Isaac
- Department of Zoology, Faculty of Life Sciences, Ambrose Alli University, Ekpoma, Nigeria
| | - Manfred Ebube Odoya
- Department of Zoology, Faculty of Life Sciences, Ambrose Alli University, Ekpoma, Nigeria
| | - Yan-Tao Wu
- State Key Laboratory of Veterinary Etiological Biology/National Professional Laboratory of Animal Hydatidosis, Lanzhou Veterinary Research Institute, CAAS, Lanzhou, 730046, Gansu, P. R. China
| | - Mughees Aizaz Alvi
- State Key Laboratory of Veterinary Etiological Biology/National Professional Laboratory of Animal Hydatidosis, Lanzhou Veterinary Research Institute, CAAS, Lanzhou, 730046, Gansu, P. R. China
| | - Rosline James Muku
- State Key Laboratory of Veterinary Etiological Biology/National Professional Laboratory of Animal Hydatidosis, Lanzhou Veterinary Research Institute, CAAS, Lanzhou, 730046, Gansu, P. R. China
| | - Bao-Quan Fu
- State Key Laboratory of Veterinary Etiological Biology/National Professional Laboratory of Animal Hydatidosis, Lanzhou Veterinary Research Institute, CAAS, Lanzhou, 730046, Gansu, P. R. China
| | - Wan-Zhong Jia
- State Key Laboratory of Veterinary Etiological Biology/National Professional Laboratory of Animal Hydatidosis, Lanzhou Veterinary Research Institute, CAAS, Lanzhou, 730046, Gansu, P. R. China.
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Al-Abodi HR, Al-Shadeedi SMJ, K Z K AA, Ghasemian A. Zataria Multiflora bois as an auspicious therapeutic approach against Echinococcus granulosus: Current status and future perspectives. Comp Immunol Microbiol Infect Dis 2019; 66:101335. [PMID: 31437681 DOI: 10.1016/j.cimid.2019.101335] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Revised: 07/04/2019] [Accepted: 07/19/2019] [Indexed: 02/07/2023]
Abstract
Hydatidosis caused by Echinococcus granulosus is a major zoonotic diseases. In addition to imposing heavy economic losses, the disease is a public health problem worldwide. The larval stage of the parasite (hydatid cyst) is formed in a wide range of domestic, wild and human beings as intermediate hosts. On the other, its recurrence has been reported anywhere as a reemerging disease. Although the cysts have some evading mechanisms, both human TH1 and TH2 cells subsets are stimulated. Because of increasing resistance and adverse effects of medications such as abnormalities of liver and other organs functions and abdominal pain, seeking alternative therapeutic approaches to be inexpensive, easy available, with low side effects and toxicity seems essential. However, the lack of information on the social and economic welfares of herbal medicines for the industrial scale application is a limitation. Zataria Multiflora bois (ZMB) has exhibited huge advantages and tremendous protoscolicidal effects as demonstrated by numerous studies and its combination therapies with anti-parasitic drugs have exerted desirable outcomes in vitro and in vivo. Noticeably, the compound confers negligible side effects or toxicity even at high concentrations. ZMB has exhibited promising inhibitory effects against hydatid cyst, particularly when combined with chemical drugs and in formulations of nanoemulsions. Its immunomodulatory effects include increase of nitric oxide production (NO) and protection of hepatic cells (Kupffer cells, fat-storing cells, and endothelial cells), enhancement of macrophages and T cells and increase of cytokines production. This study aimed at assessment of ZMB traits for application against hydatid cyst protoscolices.
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Affiliation(s)
| | | | - Al-Alo K Z K
- Department of Veterinary Clinical Sciences, Faculty of Veterinary Medicine, University of Kufa, Iraq
| | - Abdolmajid Ghasemian
- Department of Biology, Central Tehran Branch, Islamic Azad University, Tehran, Iran.
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26
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Mubanga C, Mwape KE, Phiri IK, Trevisan C, Zulu G, Chabala C, van Damme I, Schmidt V, Dorny P, Gabriël S. Progress on the development of rapid diagnostic tests for foodborne neglected zoonotic helminthiases: A systematic review. Acta Trop 2019; 194:135-147. [PMID: 30946810 DOI: 10.1016/j.actatropica.2019.03.030] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2018] [Revised: 02/15/2019] [Accepted: 03/31/2019] [Indexed: 12/22/2022]
Abstract
BACKGROUND Foodborne Neglected Zoonotic Helminths (FNZH) are parasites of both economic and public health importance. They include Taenia solium, Echinococcus granulosus sensu lato, Echinococcus multilocularis and Foodborne trematodes (FBT). FNZH are earmarked for major interventions for control, elimination and eradication. This systematic review highlights the progress towards development of rapid tests for the diagnosis of FNZH since 2010 when they were listed as neglected tropical diseases. METHODOLOGY A systematic search was conducted in three databases, World of Science, Embase and PubMed using the same search phrase. The search produced 480 hits. Three studies from back referencing were included. Only 22 of these met the inclusion criteria. Data was extracted from these and presented qualitatively. RESULTS Twenty-five rapid diagnostic tests were found to have been developed since 2010, eight for diagnosis of T. solium infections, eight for echinococcosis and nine for FBT infections. The rapid tests for diagnosing T. solium infections included six antibody detecting and two antigen detecting tests. They constitute a combination among them, with some tests providing qualitative, others quantitative results. Similarly, seven out of the eight rapid tests developed for Echinococcus infections were antibody detecting tests save for one loop mediated isothermal amplification test. All of them were qualitative tests. For FBT infections, nine rapid tests were described; two antibody and one nucleic acid detecting test for diagnosis of Fascioliasis; three nucleic acid detecting tests for Opisthorchiasis; one antibody detecting test for Paragonimiasis; and for Clonorchiasis, one antibody and one nucleic acid detecting test. The FBT infection rapid tests were all qualitative in nature. Most of these tests have not undergone field evaluation in endemic areas where they will be used most. CONCLUSION This review describes the development and evaluation of rapid diagnostic tests, while highlighting the need for in depth validations of the tools to determine how well they can perform in endemic areas.
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Affiliation(s)
- Chishimba Mubanga
- Department of Clinical Studies, School of Veterinary Medicine, University of Zambia, Lusaka, Zambia.
| | - Kabemba E Mwape
- Department of Clinical Studies, School of Veterinary Medicine, University of Zambia, Lusaka, Zambia
| | - Isaac K Phiri
- Department of Clinical Studies, School of Veterinary Medicine, University of Zambia, Lusaka, Zambia
| | - Chiara Trevisan
- Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Gideon Zulu
- Provincial Medical Office, Ministry of Health, Kasama, Zambia
| | - Chishala Chabala
- Children's Hospital, University Teaching Hospitals, Lusaka, Zambia
| | - Inge van Damme
- Department of Veterinary Public Health and Food Safety, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - Veronika Schmidt
- Centre for Global Health, Department of Neurology, Klinikum rechts der Isar, Technical University Munich, Munich, Germany; Centre for Global Health, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Pierre Dorny
- Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Sarah Gabriël
- Department of Veterinary Public Health and Food Safety, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
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Khanbabaie S, Riazi M, Chang CH, Yunus MH, Noordin R. Lateral flow dipstick antigen assay for human cystic echinococcosis. Acta Trop 2019; 190:171-176. [PMID: 30458123 DOI: 10.1016/j.actatropica.2018.11.018] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2018] [Revised: 10/06/2018] [Accepted: 11/16/2018] [Indexed: 12/15/2022]
Abstract
Cystic echinococcosis (CE) is a neglected zoonotic disease with a worldwide distribution and is a major public health problem in some areas. Diagnosis of CE is mainly based on clinical symptoms, imaging and serological testing, however, improvement in serodiagnosis is still needed. This study was aimed at detecting circulating Echinococcus antigen in CE patients using a lateral flow dipstick (LFD) assay. Three types of hydatid antigens i.e. hydatid cyst fluid (HCF), native antigen B (nAgB) and recombinant antigen B (rAgB) were prepared and polyclonal rabbit antiserum was raised against each antigen. Purified IgG fractions were prepared and a portion was conjugated to gold nanoparticles. After a series of optimizations, a final antigen detection LFD assay was developed using a combination of anti-nAgB-IgG and gold-conjugated anti-HCF-IgG. Evaluation of the assay showed that 27 out of 35 (77%) serum samples from CE patients gave positive results. Meanwhile, the test showed a diagnostic specificity of 82% when tested with sera from 38 healthy individuals and 13 patients with other parasitic diseases. In conclusion, the antigen detection LFD assay seemed to be useful for diagnosis of CE and possibly for post-treatment follow-up, and merit further evaluation studies. We foresee that it may improve serodiagnosis of CE when used in tandem with an antibody detection test.
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Affiliation(s)
- Sam Khanbabaie
- Institute for Research in Molecular Medicine (INFORMM), Universiti Sains Malaysia, Penang, Malaysia.
| | - Mehdi Riazi
- School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, Malaysia.
| | - Chiat Han Chang
- Institute for Research in Molecular Medicine (INFORMM), Universiti Sains Malaysia, Penang, Malaysia.
| | - Muhammad Hafiznur Yunus
- Institute for Research in Molecular Medicine (INFORMM), Universiti Sains Malaysia, Penang, Malaysia.
| | - Rahmah Noordin
- Institute for Research in Molecular Medicine (INFORMM), Universiti Sains Malaysia, Penang, Malaysia.
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Hernández-González A, Sánchez-Ovejero C, Manzano-Román R, González Sánchez M, Delgado JM, Pardo-García T, Soriano-Gálvez F, Akhan O, Cretu CM, Vutova K, Tamarozzi F, Mariconti M, Brunetti E, Vola A, Fabiani M, Casulli A, Siles-Lucas M. Evaluation of the recombinant antigens B2t and 2B2t, compared with hydatid fluid, in IgG-ELISA and immunostrips for the diagnosis and follow up of CE patients. PLoS Negl Trop Dis 2018; 12:e0006741. [PMID: 30188936 PMCID: PMC6143278 DOI: 10.1371/journal.pntd.0006741] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Revised: 09/18/2018] [Accepted: 08/08/2018] [Indexed: 12/28/2022] Open
Abstract
Cystic echinococcosis (CE) is one of the most widespread helminthic zoonoses and is caused by the tapeworm Echinococcus granulosus complex. CE diagnosis and monitoring primarily rely on imaging techniques, complemented by serology. This is usually approached by the detection of IgG antibodies against hydatid fluid (HF), but the use of this heterogeneous antigenic mixture results in a variable percentage of false positive and negative results, and has shown to be useless for follow-up due to the long persistence of anti-HF antibodies in cured patients. To improve test performances and standardization, a number of recombinant antigens mainly derived from HF have been described, among them the B2t and 2B2t antigens. The performance of these antigens in the diagnosis and follow up of patients with CE has been so far evaluated on a limited number of samples. Here, we evaluated the performances of tests based on B2t and 2B2t recombinant antigens compared to HF in IgG-ELISA and immunochromatography (IC) for the diagnosis and follow-up of patients with CE in a retrospective cohort study. A total of 721 serum samples were collected: 587 from 253 patients with CE diagnosed by ultrasonography (US), 42 from patients with alveolar echinococcosis and 92 from healthy donors from Salamanca (Spain). The highest overall sensitivity was obtained with HF in ELISA (85.5%), followed by IC containing HF and 2B2t-HF (83.0% and 78.2%, respectively). The lowest sensitivity was obtained with B2t and 2B2t in ELISA (51.8%). The highest specificity was obtained with IC containing 2B2t-HF (100%), and the lowest with HF-ELISA (78.0%). The lowest cross-reactivity with sera from patients with alveolar echinococcosis was detected with the recombinant antigens in ELISA (9.5% - 16.7%) and the highest with the HF-IC (64.3%). The results of B2t and 2B2t-ELISA were influenced by cyst stage, as classified by US according to the WHO-Informal Working Group on Echinococcosis (WHO-IWGE), with low sensitivity for inactive (CE4 and CE5) cysts, and by the drug treatment, with higher sensitivity in patients after drug treatment compared with patients not subjected to drug treatment. The two recombinant antigens in ELISA provided promising results for monitoring patients in follow-up, although their use is limited to patients with positive serology against them at the beginning of the follow-up. Potential biological reasons behind the low sensitivity of the recombinant antigens and possible strategies to enhance the performance of CE serology are discussed. Cystic echinococcosis (CE) is a helminthic zoonosis caused by Echinococcus granulosus sensu lato. CE diagnosis and monitoring is of paramount importance for the clinical management of patients and primarily rely on imaging techniques, complemented by serology. CE serology is usually based on the detection of antibodies against hydatid fluid (HF), but the use of this heterogeneous antigenic mixture shows several drawbacks, including false positive and negative results, unsatisfied predictive values, and long persistence of detectable antibody levels in cured patients. As an alternative, to improve test performances and standardization, several recombinant antigens have been described, but these have been so far evaluated only on a limited number of samples. Here, two recombinant antigens derived from one of the immunodominant HF antigens (antigen B2) have been tested in enzyme-linked immunosorbent assay (ELISA) and in immunochromatographic strips (IC) against 721 serum samples. Although more specific than the HF, the recombinant antigens in ELISA showed low sensitivity for patients with inactive (CE4 and CE5) cysts and for patients not subjected to drug treatment. This limited their use for follow-up, although promising, to those patients with positive serology at the beginning of the follow-up period. These results will aid in the future development of a serological test with enhanced performance in the diagnosis and follow-up of patients with CE.
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Affiliation(s)
- Ana Hernández-González
- Instituto de Salud Carlos III, Centro Nacional de Microbiología, Majadahonda, Madrid, Spain
| | - Carlos Sánchez-Ovejero
- Instituto de Recursos Naturales y Agrobiología de Salamanca (IRNASA-CSIC), Salamanca, Spain
| | - Raúl Manzano-Román
- Instituto de Recursos Naturales y Agrobiología de Salamanca (IRNASA-CSIC), Salamanca, Spain
| | - María González Sánchez
- Instituto de Recursos Naturales y Agrobiología de Salamanca (IRNASA-CSIC), Salamanca, Spain
| | | | | | | | - Okan Akhan
- Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Carmen M. Cretu
- University of Medicine and Pharmacy, Colentina Clinical Hospital - Parasitology, Bucharest, Romania
| | - Kamenna Vutova
- Specialised Hospital of Infectious and Parasitic Diseases "Prof. Ivan Kirov", Department of Infectious, Parasitic and Tropical Diseases, Medical University, Sofia, Bulgaria
| | - Francesca Tamarozzi
- Centre for Tropical Diseases, Sacro Cuore-Don Calabria Hospital, Negrar, Verona, Italy
| | - Mara Mariconti
- Department of Clinical Surgical Diagnostic and Paediatric Sciences, University of Pavia, Pavia, Italy
| | - Enrico Brunetti
- Department of Clinical Surgical Diagnostic and Paediatric Sciences, University of Pavia, and Division of Infectious and Tropical Diseases, San Matteo Hospital Foundation, Pavia, Italy
| | - Ambra Vola
- San Matteo Hospital Foundation, Pavia, Italy
| | - Massimo Fabiani
- Infectious Diseases Department, Istituto Superiore di Sanità, Rome, Italy
| | - Adriano Casulli
- WHO Collaborating Centre for the epidemiology, detection and control of cystic and alveolar echinococcosis, Istituto Superiore di Sanità, Rome, Italy
- European Reference Laboratory for Parasites (EURLP), Istituto Superiore di Sanità, Rome, Italy
| | - Mar Siles-Lucas
- Instituto de Recursos Naturales y Agrobiología de Salamanca (IRNASA-CSIC), Salamanca, Spain
- * E-mail:
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Performance of the commercially available SERION ELISA classic Echinococcus IgG test for the detection of cystic echinococcosis in clinical practice. J Helminthol 2018; 93:636-639. [PMID: 29950187 DOI: 10.1017/s0022149x18000536] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Diagnosis of cystic echinococcosis (CE) is at present mainly based on imaging techniques. Serology has a complementary role, partly due to the small number of standardized and commercially available assays. Therefore we examined the clinical performance of the SERION ELISA classic Echinococcus IgG test. Using 10 U/ml as a cut-off point, and serum samples from 50 CE patients and 105 healthy controls, the sensitivity and specificity were 98.0% and 96.2%, respectively. If patients with other infectious diseases were used as negative controls, the specificity decreased to 76.9%, which causes poor positive predictive values. However, if results between 10 and 15 U/ml are classified as indecisive, the specificity of positive results (≥15 U/ml) increased to 92.5% without greatly affecting the sensitivity (92.0%). Using this approach in combination with imaging studies, the SERION ELISA classic Echinococcosis IgG test can be a useful aid in the diagnosis of CE.
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Gao CH, Wang JY, Shi F, Steverding D, Wang X, Yang YT, Zhou XN. Field evaluation of an immunochromatographic test for diagnosis of cystic and alveolar echinococcosis. Parasit Vectors 2018; 11:311. [PMID: 29792228 PMCID: PMC5966859 DOI: 10.1186/s13071-018-2896-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Accepted: 05/14/2018] [Indexed: 12/28/2022] Open
Abstract
Background The larval stages of the tapeworms Echinocoocus granulosus and Echinococcus multilocularis are the causative agents of human cystic echinococcosis (CE) and human alveolar echinococcosis (AE), respectively. Both CE and AE are chronic diseases characterised by long asymptomatic periods of many years. However, early diagnosis of the disease is important if treatment and management of echinococcosis patients are to be successful. Methods A previously developed rapid diagnostic test (RDT) for the differential detection of CE and AE was evaluated under field conditions with finger prick blood samples taken from 1502 people living in the Ganzi Tibetan Autonomous Prefecture, China, a region with a high prevalence for both forms of human echinococcosis. The results were compared with simultaneously obtained abdominal ultrasonographic scans of the individuals. Results Using the ultrasonography as the gold standard, sensitivity and specificity, and the diagnostic accuracy of the RDT were determined to be greater than 94% for both CE and AE. For CE cases, high detection rates (95.6–98.8%) were found with patients having active cysts while lower detection rates (40.0–68.8%) were obtained with patients having transient or inactive cysts. In contrast, detection rates in AE patients were independent of the lesion type. The positive likelihood ratio of the RDT for CE and AE was greater than 20 and thus fairly high, indicating that a patient with a positive test result has a high probability of having echinococcosis. Conclusions The results suggest that our previously developed RDT is suitable as a screening tool for the early detection of human echinococcosis in endemic areas.
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Affiliation(s)
- Chun-Hua Gao
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, WHO Collaborating Centre for Tropical Diseases, National Center for International Research on Tropical Diseases, Ministry of Science and Technology, Key Laboratory of Parasite and Vector Biology, Ministry of Health, Shanghai, China
| | - Jun-Yun Wang
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, WHO Collaborating Centre for Tropical Diseases, National Center for International Research on Tropical Diseases, Ministry of Science and Technology, Key Laboratory of Parasite and Vector Biology, Ministry of Health, Shanghai, China.
| | - Feng Shi
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, WHO Collaborating Centre for Tropical Diseases, National Center for International Research on Tropical Diseases, Ministry of Science and Technology, Key Laboratory of Parasite and Vector Biology, Ministry of Health, Shanghai, China
| | - Dietmar Steverding
- Bob Champion Research & Education Building, Norwich Medical School, University of East Anglia, Norwich, UK.
| | - Xia Wang
- Bob Champion Research & Education Building, Norwich Medical School, University of East Anglia, Norwich, UK
| | - Yue-Tao Yang
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, WHO Collaborating Centre for Tropical Diseases, National Center for International Research on Tropical Diseases, Ministry of Science and Technology, Key Laboratory of Parasite and Vector Biology, Ministry of Health, Shanghai, China
| | - Xiao-Nong Zhou
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, WHO Collaborating Centre for Tropical Diseases, National Center for International Research on Tropical Diseases, Ministry of Science and Technology, Key Laboratory of Parasite and Vector Biology, Ministry of Health, Shanghai, China
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Vola A, Tamarozzi F, Noordin R, Yunus MH, Khanbabaie S, De Silvestri A, Brunetti E, Mariconti M. Preliminary assessment of the diagnostic performances of a new rapid diagnostic test for the serodiagnosis of human cystic echinococcosis. Diagn Microbiol Infect Dis 2018; 92:31-33. [PMID: 29776711 DOI: 10.1016/j.diagmicrobio.2018.04.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2017] [Revised: 03/29/2018] [Accepted: 04/10/2018] [Indexed: 11/29/2022]
Abstract
Rapid diagnostic tests for cystic echinococcosis (CE) are convenient to support ultrasound diagnosis in uncertain cases, especially in resource-limited settings. We found comparable diagnostic performances of the experimental Hyd Rapid Test and the commercial VIRapid HYDATIDOSIS Test, used in our diagnostic laboratory, using samples from well-characterized hepatic CE cases.
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Affiliation(s)
- Ambra Vola
- Division of Infectious Tropical Diseases, IRCCS San Matteo Hospital Foundation, 27100 Pavia, Italy
| | - Francesca Tamarozzi
- Center for Tropical Diseases, Sacro Cuore-Don Calabria Hospital, 37024 Negrar, Verona, Italy
| | - Rahmah Noordin
- Institute for Research in Molecular Medicine (INFORMM), Universiti Sains Malaysia, 11800 Penang, Malaysia
| | - Muhammad Hafiznur Yunus
- Institute for Research in Molecular Medicine (INFORMM), Universiti Sains Malaysia, 11800 Penang, Malaysia
| | - Sam Khanbabaie
- Institute for Research in Molecular Medicine (INFORMM), Universiti Sains Malaysia, 11800 Penang, Malaysia
| | - Annalisa De Silvestri
- SC Biometria e Statistica, Fondazione, IRCCS San Matteo Hospital Foundation, 27100 Pavia, Italy
| | - Enrico Brunetti
- Division of Infectious Tropical Diseases, IRCCS San Matteo Hospital Foundation, 27100 Pavia, Italy; Department of Clinical, Surgical, Diagnostic and Paediatric Science, University of Pavia, 27100 Pavia, Italy
| | - Mara Mariconti
- Department of Clinical, Surgical, Diagnostic and Paediatric Science, University of Pavia, 27100 Pavia, Italy.
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Tepe M, Boral Ö, Ayşan E, Dinçer M, İslim F, Yavuz E. Üç Farklı Ekinokokkozlu Hasta Grubunda ELISA İle Serum Sitokinlerinin Analizi. KOCAELI ÜNIVERSITESI SAĞLIK BILIMLERI DERGISI 2017. [DOI: 10.30934/kusbed.335266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Baraquin A, Zait H, Grenouillet FE, Moreau E, Hamrioui B, Grenouillet F. Large-scale evaluation of a rapid diagnostic test for human cystic echinococcosis. Diagn Microbiol Infect Dis 2017. [PMID: 28647066 DOI: 10.1016/j.diagmicrobio.2017.06.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Cystic echinococcosis (CE) is a neglected zoonotic disease, diagnosed through clinical findings, imaging techniques, and serology, for which many serological tests are available. Here we report a rapid unit assay, the immunochromatographic VIRapid® HYDATIDOSIS test (Vircell, Granada, Spain), potentially suitable for laboratories in low-prevalence or poorly equipped areas. This test was evaluated with a large retrospective cohort (224 sera), including patients suffering from CE or from other parasitic or liver diseases. The test was also assessed in routine conditions with a prospective cohort (115 sera) in areas where both cystic and alveolar echinococcoses have been diagnosed. Its performance (in terms of sensitivity, specificity, and both positive and negative likelihood ratios) was similar to an ELISA based on a crude antigen. Our study shows that this test performs adequately in the diagnostic process, when used with caution, especially regarding cross-reactivity with other parasitic diseases.
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Affiliation(s)
- Alice Baraquin
- Chrono-environnement, UMR UBFC/CNRS 6249 aff. INRA, University of Bourgogne/Franche-Comté, Besançon, France
| | - Houria Zait
- Parasitology & Mycology Department, Mustapha University Hospital, Algiers, Algeria
| | - Florence-Elisabeth Grenouillet
- Parasitology & Mycology Department, French National Reference Center for Alveolar Echinococcosis and WHO Collaborating Center for Prevention and Treatment of Human Echinococcosis, University Hospital, Besançon, France
| | - Elise Moreau
- Parasitology & Mycology Department, French National Reference Center for Alveolar Echinococcosis and WHO Collaborating Center for Prevention and Treatment of Human Echinococcosis, University Hospital, Besançon, France
| | - Boussad Hamrioui
- Parasitology & Mycology Department, Mustapha University Hospital, Algiers, Algeria
| | - Frédéric Grenouillet
- Chrono-environnement, UMR UBFC/CNRS 6249 aff. INRA, University of Bourgogne/Franche-Comté, Besançon, France; Parasitology & Mycology Department, French National Reference Center for Alveolar Echinococcosis and WHO Collaborating Center for Prevention and Treatment of Human Echinococcosis, University Hospital, Besançon, France.
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Molecular Characteristics and Serodiagnostic Potential of Dihydrofolate Reductase from Echinococcus granulosus. Sci Rep 2017; 7:514. [PMID: 28364125 PMCID: PMC5428777 DOI: 10.1038/s41598-017-00643-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2016] [Accepted: 03/07/2017] [Indexed: 02/02/2023] Open
Abstract
The larval stage of Echinococcus granulosus causes cystic echinococcosis (CE), a neglected tropical disease that leads to morbidity and mortality in humans and livestock worldwide. Here, we identified and characterized dihydrofolate reductase (Eg-DHFR) from E. granulosus, and evaluated its potential as a diagnostic antigen for sheep CE. Comparison between mammalian (host) DHFR and Eg-DHFR indicates that 45.7% of the 35 active site residues are different. Immunolocalisation analysis showed that native Eg-DHFR was widely distributed in all life-cycle stages of E. granulosus. Recombinant Eg-DHFR (rEg-DHFR) showed typical DHFR enzymatic parameters towards substrate, and was very sensitive to inhibition by methotrexate (IC50 = 27.75 ± 1.03 nM) and aminopterin (IC50 = 63.67 ± 6.76 nM). However, inhibition of DHFR exhibited little protoscolicidal effect in vitro. As there is no reliable method to monitor sheep CE, the immunogenicity of rEg-DHFR was detected, and we developed an indirect ELISA (iELISA) for CE serodiagnosis. The iELISA exhibited diagnostic specificity of 89.58%, diagnostic sensitivity of 95.83%, and the diagnostic accuracy was 91.67% compared with necropsy. Cross-reactivity assay showed analytical specificity of 85.7%. These suggest that rEg-DHFR is an effective antigen for the diagnosis of sheep CE.
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[Rapid diagnostic tests for the serodiagnosis of human cystic echinococcosis]. ACTA ACUST UNITED AC 2017; 110:20-30. [PMID: 28275967 DOI: 10.1007/s13149-017-0548-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2016] [Accepted: 11/29/2016] [Indexed: 12/15/2022]
Abstract
Cystic echinococcosis (CE) is a parasitic zoonosis especially affecting resource-poor populations in livestock raising areas. Imaging, in particular ultrasound (US), is crucial for the diagnosis, staging, and clinical management of abdominal CE in humans. Serology is a valuable complement to imaging, especially when ultrasound features of CE are absent or unclear. In rural endemic areas, where expertise in US is scant, and conventional serology techniques are unavailable due to lack of laboratory equipment, rapid diagnostic tests (RDTs) may be very useful. Several reports have described the performance of commercial and experimental RDTs in the diagnosis of CE, including a recent study by our group that compared the diagnostic performances of three commercial RDTs for the diagnosis of hepatic CE. To put RDTs for CE in context, we reviewed the available literature in English on this topic. Overall, RDTs appear to be useful in resourcepoor settings where they may replace conventional serodiagnostic tests. However, like other serodiagnostic tests, RDTs lack standardization and show unsatisfactory sensitivity and specificity. An important issue that needs to be addressed is that studies on the diagnostic performance of RDTs fail to take into account the variables known to influence results such as anatomical location and cyst stage.
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Folle AM, Kitano ES, Lima A, Gil M, Cucher M, Mourglia-Ettlin G, Iwai LK, Rosenzvit M, Batthyány C, Ferreira AM. Characterisation of Antigen B Protein Species Present in the Hydatid Cyst Fluid of Echinococcus canadensis G7 Genotype. PLoS Negl Trop Dis 2017; 11:e0005250. [PMID: 28045899 PMCID: PMC5234841 DOI: 10.1371/journal.pntd.0005250] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2016] [Revised: 01/13/2017] [Accepted: 12/12/2016] [Indexed: 12/23/2022] Open
Abstract
The larva of cestodes belonging to the Echinococcus granulosus sensu lato (s.l.) complex causes cystic echinococcosis (CE). It is a globally distributed zoonosis with significant economic and public health impact. The most immunogenic and specific Echinococcus-genus antigen for human CE diagnosis is antigen B (AgB), an abundant lipoprotein of the hydatid cyst fluid (HF). The AgB protein moiety (apolipoprotein) is encoded by five genes (AgB1-AgB5), which generate mature 8 kDa proteins (AgB8/1-AgB8/5). These genes seem to be differentially expressed among Echinococcus species. Since AgB immunogenicity lies on its protein moiety, differences in AgB expression within E. granulosus s.l. complex might have diagnostic and epidemiological relevance for discriminating the contribution of distinct species to human CE. Interestingly, AgB2 was proposed as a pseudogene in E. canadensis, which is the second most common cause of human CE, but proteomic studies for verifying it have not been performed yet. Herein, we analysed the protein and lipid composition of AgB obtained from fertile HF of swine origin (E. canadensis G7 genotype). AgB apolipoproteins were identified and quantified using mass spectrometry tools. Results showed that AgB8/1 was the major protein component, representing 71% of total AgB apolipoproteins, followed by AgB8/4 (15.5%), AgB8/3 (13.2%) and AgB8/5 (0.3%). AgB8/2 was not detected. As a methodological control, a parallel analysis detected all AgB apolipoproteins in bovine fertile HF (G1/3/5 genotypes). Overall, E. canadensis AgB comprised mostly AgB8/1 together with a heterogeneous mixture of lipids, and AgB8/2 was not detected despite using high sensitivity proteomic techniques. This endorses genomic data supporting that AgB2 behaves as a pseudogene in G7 genotype. Since recombinant AgB8/2 has been found to be diagnostically valuable for human CE, our findings indicate that its use as antigen in immunoassays could contribute to false negative results in areas where E. canadensis circulates. Furthermore, the presence of anti-AgB8/2 antibodies in serum may represent a useful parameter to rule out E. canadensis infection when human CE is diagnosed. Cystic echinococcosis (CE), a worldwide-spread zoonosis, affects livestock mammals and humans with significant economic and public health impact. It is caused by the infection with the larva of cestodes belonging to Echinococcus granulosus complex, a series of parasite species with preference for different hosts. Among them, Echinococcus canadensis larva uses mainly camels, goats and pigs as hosts. Species/genotypes belonging to E. canadensis are considered the second most common cause of human CE, but its contribution may be underestimated since causes asymptomatic or more benign infections than other E. granulosus complex species. The most relevant antigen for CE diagnosis is a lipoprotein called antigen B (AgB). AgB antigenicity is linked to its protein moiety that is encoded by several genes. One of these genes, AgB2, seems to be differentially expressed within E. granulosus complex. Using high sensitivity proteomic tools we analysed the composition of AgB obtained from E. canadensis larva, detecting the protein products of all AgB genes, except AgB2. Since AgB subunits have been widely used as antigens in immunoassays for human CE diagnosis, our results indicate that using AgB2 protein product in these assays may lead to false-negative results, particularly in geographical areas where E. canadensis species/genotypes circulate.
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Affiliation(s)
- Ana Maite Folle
- Cátedra de Inmunología, Facultad de Ciencias/Facultad de Química, Universidad de la República (UdelaR), Montevideo, Uruguay
| | - Eduardo S. Kitano
- Laboratório Especial de Toxinologia Aplicada, Center of Toxins, Immune-Response and Cell Signaling (CeTICS), Instituto Butantan São Paulo, Brazil
| | - Analía Lima
- Unidad de Bioquímica y Proteómica Analíticas, Instituto Pasteur de Montevideo, Montevideo, Uruguay
| | - Magdalena Gil
- Unidad de Bioquímica y Proteómica Analíticas, Instituto Pasteur de Montevideo, Montevideo, Uruguay
| | - Marcela Cucher
- Instituto de Investigaciones en Microbiología y Parasitología Médica, Facultad de Medicina, Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Gustavo Mourglia-Ettlin
- Cátedra de Inmunología, Facultad de Ciencias/Facultad de Química, Universidad de la República (UdelaR), Montevideo, Uruguay
| | - Leo K. Iwai
- Laboratório Especial de Toxinologia Aplicada, Center of Toxins, Immune-Response and Cell Signaling (CeTICS), Instituto Butantan São Paulo, Brazil
| | - Mara Rosenzvit
- Instituto de Investigaciones en Microbiología y Parasitología Médica, Facultad de Medicina, Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Carlos Batthyány
- Unidad de Bioquímica y Proteómica Analíticas, Instituto Pasteur de Montevideo, Montevideo, Uruguay
- Departamento de Bioquímica, Facultad de Medicina, Universidad de la República (UdelaR), Montevideo, Uruguay
| | - Ana María Ferreira
- Cátedra de Inmunología, Facultad de Ciencias/Facultad de Química, Universidad de la República (UdelaR), Montevideo, Uruguay
- * E-mail:
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Possenti A, Manzano-Román R, Sánchez-Ovejero C, Boufana B, La Torre G, Siles-Lucas M, Casulli A. Potential Risk Factors Associated with Human Cystic Echinococcosis: Systematic Review and Meta-analysis. PLoS Negl Trop Dis 2016; 10:e0005114. [PMID: 27820824 PMCID: PMC5098738 DOI: 10.1371/journal.pntd.0005114] [Citation(s) in RCA: 91] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2016] [Accepted: 10/17/2016] [Indexed: 02/06/2023] Open
Abstract
Background Scientific literature on cystic echinococcosis (CE) reporting data on risk factors is limited and to the best of our knowledge, no global evaluation of human CE risk factors has to date been performed. This systematic review (SR) summarizes available data on statistically relevant potential risk factors (PRFs) associated with human CE. Methodology/Principal Findings Database searches identified 1,367 papers, of which thirty-seven were eligible for inclusion. Of these, eight and twenty-nine were case-control and cross-sectional studies, respectively. Among the eligible papers, twenty-one were included in the meta-analyses. Pooled odds ratio (OR) were used as a measure of effect and separately analysed for the two study designs. PRFs derived from case-control studies that were significantly associated with higher odds of outcome were “dog free to roam” (OR 5.23; 95% CI 2.45–11.14), “feeding dogs with viscera” (OR 4.69; 95% CI 3.02–7.29), “slaughter at home” (OR 4.67; 95% CI 2.02–10.78) or at “slaughterhouses” (OR 2.7; 95% CI 1.15–6.3), “dog ownership” (OR 3.54; 95% CI 1.27–9.85), “living in rural areas” (OR 1.83; 95% CI 1.16–2.9) and “low income” (OR 1.68; 95% CI 1.02–2.76). Statistically significant PRFs from cross-sectional studies with higher odds of outcome were “age >16 years” (OR 6.08; 95% CI 4.05–9.13), “living in rural areas” (OR 2.26; 95% CI 1.41–3.61), “being female” (OR 1.38; 95% CI 1.06–1.8) and “dog ownership” (OR 1.37; 95% CI 1.01–1.86). Conclusions/Significance Living in endemic rural areas, in which free roaming dogs have access to offal and being a dog-owner, seem to be among the most significant PRFs for acquiring this parasitic infection. Results of data analysed here may contribute to our understanding of the PRFs for CE and may potentially be useful in planning community interventions aimed at controlling CE in endemic areas. Cystic echinococcosis (CE) is a chronic zoonotic disease causing serious global socio-economic losses in human and animal hosts. Two main aspects make it extremely difficult to study risk factors associated with human CE, the parasite’s unknown and apparently long incubation period which may last for several years, and the predominantly fecal-oral transmission route. This systematic review (SR) summarizes findings from relevant publications on this topic and provides a detailed list of potential risk factors (PRFs) associated with CE infection in humans. Free dog roaming, dogs having access to offal, being a dog-owner and slaughtering at home or using inadequately supervised slaughterhouses have all been shown to be highly statistically significant PRFs associated with the perpetuation of the parasite life cycle in endemic areas. The effect of other risk factors identified in this SR can vary between geographically different areas and societies and could reflect socio-cultural determinants of infection.
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Affiliation(s)
- Alessia Possenti
- Department of Infectious, Parasitic and Immunomediated Diseases, Istituto Superiore di Sanità (ISS), Rome, Italy
- European Reference Laboratory for Parasites (EURLP), ISS, Rome, Italy
| | - Raúl Manzano-Román
- Instituto de Recursos Naturales y Agrobiologia de Salamanca, IRNASA-CSIC, Salamanca, Spain
| | - Carlos Sánchez-Ovejero
- Instituto de Recursos Naturales y Agrobiologia de Salamanca, IRNASA-CSIC, Salamanca, Spain
| | - Belgees Boufana
- Department of Infectious, Parasitic and Immunomediated Diseases, Istituto Superiore di Sanità (ISS), Rome, Italy
- European Reference Laboratory for Parasites (EURLP), ISS, Rome, Italy
- World Health Organization Collaborating Centre for the epidemiology, detection and control of cystic and alveolar echinococcosis (in humans and animals), ISS, Rome, Italy
| | - Giuseppe La Torre
- Sapienza University of Rome, Department of Public health and Infectious Diseases, Rome, Italy
| | - Mar Siles-Lucas
- Instituto de Recursos Naturales y Agrobiologia de Salamanca, IRNASA-CSIC, Salamanca, Spain
| | - Adriano Casulli
- Department of Infectious, Parasitic and Immunomediated Diseases, Istituto Superiore di Sanità (ISS), Rome, Italy
- European Reference Laboratory for Parasites (EURLP), ISS, Rome, Italy
- World Health Organization Collaborating Centre for the epidemiology, detection and control of cystic and alveolar echinococcosis (in humans and animals), ISS, Rome, Italy
- * E-mail:
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