Field Performance of a Rapid Diagnostic Test for the Serodiagnosis of Abdominal Cystic Echinococcosis in the Peruvian Highlands

Crucial role of biosensors in the detection of helminth biomarkers in public health programmes

Helminthiases are highly prevalent but neglected infections that affect more than 1·5 billion people worldwide. Considering the worldwide prevalence of helminthiases, WHO has declared them a public health concern since 2001, necessitating rigorous control and elimination efforts. However, only a few reliable point-of-care diagnostic tests are available for assessing the effectiveness of public health interventions targeting helminthiases, thus increasing the risk of suboptimal outcomes, misallocation of resources, and emergence of drug-resistant helminths. This Review provides an introduction on helminthiases and strategies to achieve control, elimination, interruption in transmission, and eradication of these infections. The Review then comprehensively details the existent biosensors that can be used to detect these infections in human samples, focusing on their target biomarkers, the bioreceptors used, and the sensing readouts. The Review concludes with an in-depth discussion on the persistent challenges related to helminthiases, aiming to encourage the development of much-needed diagnostics specific to these neglected infections.

Ultrasound diagnosis of cystic echinococcosis: updates and implications for clinical management

The diagnosis of cystic echinococcosis (CE) is based on imaging. Detection of a focal lesion with morphological characteristics of Echinococcus granulosus sensu lato metacestode is the starting point for the diagnostic workup. In organs explorable with ultrasound (US), this is the method of choice for both aetiological diagnosis of CE and staging of the CE cyst. Staging in terms of lesion morphology is also needed when serology is added to the diagnostic workflow when imaging alone is inconclusive. Finally, staging guides the clinical management of uncomplicated CE, especially in the liver. This commentary provides an overview of the most up-to-date evidence backing the above-mentioned role of US in the diagnosis and clinical management of CE. Finally, we outline future perspectives for the improvement of CE diagnosis.

'No cyst, no echinococcosis': a scoping review update on the diagnosis of cystic echinococcosis after the issue of the WHO-IWGE Expert Consensus and current perspectives

PURPOSE OF REVIEW

In 2010, the WHO-Informal Working Group on Echinococcosis (IWGE) published an Expert Consensus on the diagnosis and treatment of echinococcal infections. We provide an update on the diagnosis of cystic echinococcosis through a scoping review of the literature published after the release of the WHO-IWGE document.

RECENT FINDINGS

Ultrasound accurately and reliably depicts the pathognomonic signs of cystic echinococcosis (CE) stages compared with other imaging techniques. Among these, T2-wighted MRI is to be preferred to computed tomography, which has poor performance for the etiological diagnosis of CE. A negative serology cannot exclude the diagnosis of CE, while a positive serology, applied after the visualization of a CE-compatible lesion, may confirm a CE diagnosis. Serology alone must not be used to define 'CE' nor as 'screening' tool for infection. Other imaging and laboratory techniques did not show clinically applicable performances.

SUMMARY

In the absence of a focal lesion compatible with a CE cyst, no diagnosis of CE should be attempted. There is urgent need to achieve univocal CE case definitions and consensus diagnostic algorithm, as well as standardization of diagnostic methods and issue of a Target Product Profile of CE diagnostics, as advocated by the WHO in the 2021-2030 roadmap for neglected tropical diseases (NTDs).

Detection of Echinococcus granulosus sensu lato cysts and seroprevalence of cystic echinococcosis in cattle and camels in Maiduguri Abattoir

Cystic echinococcosis (CE) is a zoonotic disease of great importance worldwide. This study was conducted to determine the prevalence and antigenic profile of Echinococcus cysts (CE cysts) in camels and cattle. The lungs, livers, hearts, and kidneys of 560 animals, comprising 304 camels and 256 cattle slaughtered in the Maiduguri abattoir, were examined for CE. Blood samples were collected for serology. Protein profiles of CE fluids were analyzed using indirect Enzyme Linked Immunosorbent Assay while Sodium Dodecyl Sulphate Polyacrylamide Gel Electrophoresis (SDS-PAGE) was used to characterize the electrophoretic pattern of different CE cyst fluid samples. The overall prevalence of CE was 8.4%, 14.14% (95% CI = 10.65-18.54%) in camels and 1.60% (95% CI = 0.46-4.09%) in cattle. Adult camels 41 (16.21%) (95% CI = 12.15-21.27%) had a higher prevalence than the young camels 2 (3.92%) (95% CI = 0.33-13.97%) (p = 0.038). In cattle, only adults 4 (2.0%) had cysts. Higher prevalence of CE was recorded in male 22 (16.42%) (95% CI = 11.03-23.68%) than female 21 (12.35%) (95% CI = 8.16-18.21%) camels [p = 0.399] while only female cattle 3 (2.2%) had cysts. Higher prevalence of CE was recorded in the livers of 34 (11.18%) (95% CI = 8.08-15.25%) than in the lungs 25 (8.22%) (95% CI = 5.59-11.90%) of camels [p = 0.273]. Of the 47 cysts collected, 43 (91.49%) and 4 (8.51%) were from camels and cattle, respectively. A total of 18 (38.30%) fertile, 17 (36.17%) non-fertile, and 12 (25.53%) calcified cysts were recovered in animals. Overall seroprevalence of 52.63% (95% CI = 47.02-58.18%) and 35.55% (95% CI = 29.93-41.59%) were observed in camels and cattle in this study. The SDS-PAGE of camel CE cyst fluids revealed protein bands at 64kda, 91kda, 160kda, and 200kda molecular units while the purified cyst fluids revealed bands at 64kda, 91kda, 120kda, 160kda, and 200kda. Regular meat inspections and the exclusion of dogs from abattoir premises are strongly encouraged. Investigation into local prevailing factors encouraging transmission should be carried out.

Comparison and evaluation of analytic and diagnostic performances of four commercial kits for the detection of antibodies against Echinococcus granulosus and multilocularis in human sera

Cystic echinococcosis (CE) is a disease caused by Echinococcus granulosus sensu lato (s.l.), an ubiquitous worldwide zoonotic agent affecting humans and animals. Diagnosis of CE in humans is usually performed by imagine techniques along with immunoassays. The aim of our study was to evaluate and compare four commercial diagnostic kits, based on the detection of IgG antibodies against E. granulosus and E. multilocularis. The study was performed on a total of 259 sera: the positive (n = 74) and the negative (n = 185) group. The following analytic and diagnostic performances of the four kits were evaluated: operator skills, specificity, sensitivity, repeatability, reproducibility, accuracy, positive and negative predictive values. Based on the parameters evaluated, all four tests demonstrated excellent quality and proved to be reliable diagnostic tools to support the clinical evaluation of human patients suspected of having CE. The four commercial assays, in our hands, presented altogether, a range of performances from good to excellent, being immunoblotting (IB) the most reliable, used as gold standard, followed by the immunochromatographic test (ICT) and finally the two enzyme linked immunosorbent assay (ELISAs).