Retrospective Determination of the Prevelense of Anti-Echinococcus granulosus Antibodies in Cystic Echinococcosis Pre-diagnosed Patients at Erciyes University Faculty of Medicine

OBJECTIVE

Cystic echinococcosis (CE) is a parasitic disease that has been known for years in helminth diseases and it is important as human and animal health problem in many parts of the world and in our country due to economic losses. In this study, it was aimed to retrospectively evaluate the distribution of anti-E. granulosus-IgG antibodies in patients with pre-diagnosis of CE that referred to parasitology laboratory between January 2013-December 2018.

METHODS

Commercial kit was used for indirect hemaglutination (IHA), indirect fluorescent antibody test (IFAT) and Western blot (WB) methods using sera from patient samples was applied according to the kit proposal. In addition, patient materials for CAM, CSF and blood for which polymerase chain reaction (PCR)/QPCR tests were requested were examined.

RESULTS

Sera of the patients who were tested with at least one of the IHA, IFAT and WB methods or a combination of these methods, and 443 cases out of 2.283 cases were found to be E. granulosus seropositive. It was determined that 369 (62.03%) of 443 positive patients were female and 330 (37.97%) were male patients. Among these patients, 87 patients whose IFAT and/or IHA tests were negative were found to have positive results with the WB method. IFAT or IHA test results of 13 patients with negative WB tests were found to be positive. Four patients were identified with both tests positive but WB test results negative. In addition, 36 of 72 patients who underwent PCR/QPCR tests were found to be positive.

CONCLUSION

As a result of a six-year retrospective screening, 22% of the cases were found to be positive, and it was concluded that the prevalence of CE is high and the use of a single test may be insufficient in the diagnosis of CE, therefore, test combinations will increase the sensitivity and reliability in reaching the correct diagnosis.

Seropozitifity of Anti-Echinococcus granulosus in Patients with of Clinical Prediagnosis Cystic Echinococcosis at Kafkas University Health Research and Application Hospital

OBJECTIVE

Cystic echinococcosis (CE) is a common zoonotic disease in the world, which is caused by the larval form of Echinococcus granulosus settling in various organs in both animals and humans. It is common in livestock breeding areas and rural areas. This study was conducted to determine anti-E. granulosus seropositivity in patients with clinical pre-diagnosis/suspected CE in Kafkas University Health Research and Application Hospital in the Eastern Anatolia region of Turkey.

METHODS

Study material; between January 2018 and December 2020, 498 blood samples were sent to the Parasitology Laboratory from patients with clinical pre-diagnosis of CE, who applied to Kafkas University Health Research and Application Hospital for three years. The obtained serum samples were analyzed by indirect hemagglutination method.

RESULTS

Anti-Echinococcus granulosus antibodies were detected in 74 (14.9%) of 498 patients with clinical pre-diagnosis of hydatid cyst. Of the positive cases, 53 (71.6%) were observed in women, and 21 (28.4%) in men (p<0.05). Anti-E. granulosus antibodies were most commonly detected in the 16-30 age group (32.9%) (p<0.05), and 19.3% in the 16-60 age group.

CONCLUSION

Although the study data do not cover the entire Eastern Anatolia region of Turkey, it has been concluded that KE maintains its importance as a public health problem in the region.

Determining the Frequency of Cystic Echinococcosis among Suspected Cases Referred to Health Centers Southwest Iran, and Post-Treatment Serologic Follow-up

Background:

This study was designed to determine the frequency of hydatidosis in Khuzestan Province, Iran and to evaluate the antibody changes in infected individuals after treatment.

Methods:

Overall, 454 sera were collected from health centers of Khuzestan Province, southern Iran (from 2013 to 2018). Demographic data such as age, gender and history of disease were recorded. Serum samples were investigated for antibody against CE by ELISA using antigen B. Thirty six of cases were followed up after treatment.

Results:

Among the 454 evaluated cases, antibody against CE was detected in 184 (40.52%) including 115 (62.5%) females and 69 (37.5%) males. Age distribution was from 8–97 yr, the highest prevalence of hydatid cyst was observed in age group 40–49 years. Liver was the most infected organ (76.63%). Relapse of CE occurred in 23 of patients. In the majority of patients the antibody decreased, whereas in some cases increased CE antibody observed during post-treatment follow up.

Conclusion:

Current study indicated the high prevalence of hydatidosis and rate of relapse after treatment among suspected patients. Therefore, long periods and regular follow-up of patients after treatment is necessary and for these monitoring, antibody assay can be an appropriate method.

The Availability of Echinococcus IgG ELISA for Diagnosing Pulmonary Hydatid Cysts

Objective

In this study, we researched the availability of Echinococcus IgG ELISA in pulmonary hydatid cysts.

Materials and Methods

Between January 2008 and December 2015, 93 successive cases, which were studied in preoperative Echinococcus IgG and histopathologically found to have pulmonary hydatid cysts, were retrospectively analyzed. Age and sex of the cases and the cyst's location, number, size, spread to other organs outside the lungs, and its condition as intact or ruptured were reviewed.

Results

Forty-seven (50.5%) patients were male and 46 (49.5%) patients were female; the mean age was 27.7±19.6 years. While in 56 (60.2%) cases, only lung cysts were detected, 32 (34.4%) cases presented with both lung and liver cysts. While lung cysts were single in 71 (76.3%), they were multiple in 22 (23.6%) cases (between 2 and 20 pieces). In 48 (51.6%) cases, cysts were in the right lung, and in 32 (34.4%) cases, they were in the left. In 13 (14%) cases, cysts presented in both the right and left lungs. The mean diameter of the pulmonary cysts was 6.4 cm (ranging from 2 to 19 cm). In 53 (57%) cases, hydatid cysts were ruptured, whereas in 40 (43%) cases, the cysts were intact. While general Echinococcus IgG was found to be positive in 53 (57%) cases, it was negative in 40 (43%) cases. There were 53 ruptured cases, and 48 (90.6%) of them were test-positive; however, the test was positive in only 5 (12.5%) out of the 40 cases where the cysts were intact (p<0.001). A statistically significant correlation has not been found between IgG and patient age, gender, cyst location, number of cysts, cyst diameter, and extrapulmonary involvement.

Conclusion

Our study demonstrated that the most important factor that affects the positivity of Echinococcus IgG is the rupture of cysts. When ruptured cysts become confusing, Echinococcus IgG can contribute toward a diagnosis.

The seroprevalence rate and population genetic structure of human cystic echinococcosis in the Middle East: A systematic review and meta-analysis

Cystic echinococcosis (CE) represents an increasing public health concern in many parts of the world, including the Middle East. The present study is the first systematic review and meta-analysis to assess the seroprevalence rate and population genetic structure of human CE in the eastern Mediterranean region. To estimate the population genetic structure, Echinococcus sequences of the cytochrome oxidase subunit 1 (cox1) gene isolated from countries from this geographical area were retrieved from the GenBank database. An electronic search for articles from 1990 until 2015 was performed using databases PubMed, ScienceDirect, and Scopus. A total of 53 articles reporting on CE seroprevalence and genotyping data met our eligibility criteria and were included in a meta-analysis. The overall CE seroprevalence rates in the general population and in individuals at high risk of infection were estimated using the random-effect model at 7.4% (95% CI = 4.8-10.6) and 10.7% (95% CI = 7.6-14.3), respectively. Risk factors including age group (P < 0.001), dog ownership (P = 0.03), residence area (P < 0.001), and educational level (P = 0.04) showed a statistically significant association with CE seroprevalence. A pairwise fixation index (Fst), used as an estimation of gene flow, suggested a moderate level of genetic differentiation between members of the E. granulosus sensu stricto (G1-G3) complex from Iranian and Turkish metapopulations (Fst = 0.171). The finding of common haplotypes may represent an ancestral transfer of alleles among populations probably during the early stages of animal domestication. The high CE seroprevalence rates found highlight the necessity of implementing appropriate public education for preventive and control strategies, particularly in individuals at high risk of infection; furthermore, our genetic findings reveal novel molecular data concerning microevolutionary events of Echinococcus isolates among Middle East countries.

Seroprevalence of cystic echinococcosis in blood donors in Fars province, southern Iran

Cystic echinococcosis (CE) is one of the most important zoonotic diseases in different geographical areas of the world including Iran. The current study aimed to assess the seroprevalence of human cystic echinococcosis (CE) in healthy blood donors in Fars province, southern Iran. A total of 1068 serum samples were collected from blood donors from five blood service centers of Fars province in south of Iran. Antigen B was prepared from sheep hydatid cyst fluid and collected sera were evaluated for anti-hydatid cyst antibodies, using antigen-B ELISA. Demographic features of the participants were also recorded during the sample collection. Anti hydatid cyst antibodies were detected in sera of 60 out of 1068 blood donors corresponding to overall seroprevalence of 5.6% in this population. Rate of seroprevalence was 6.7% in females and 5.5% in males. The highest rate of infection (8.3%) was found in age group of higher than 50 years old. There were no significant differences between seropositivity to CE and sex, age or place of residence of the participants (P > 0.05). Findings of this study showed that the rate of CE infection in Fars province, southern Iran, is relatively high. Some of these seropositive cases may have active hydatid cyst in their tissues without overt sign or symptoms.