An indirect immunofluorescence antibody test employing whole eggs as the antigen for the diagnosis of abdominal angiostrongyliasis

Abstract

Abdominal angiostrongyliasis is a potentially fatal zoonotic disease with a broad geographical distribution throughout Central and South America. This study assessed the performance of Angiostrongylus costaricensis eggs as the antigen in an indirect immunofluorescence assay for the determination of parasite-specific IgG and IgG1 antibodies. For prevalence studies, an IgG antibody titre ≥ 16 was identified as the diagnostic threshold with the best performance, providing 93.7% sensitivity and 84.6% specificity. Cross reactivity was evaluated with 65 additional samples from patients with other known parasitic infections. Cross reactivity was observed only in samples from individuals infected with Strongyloides stercoralis. For clinical diagnosis, we recommend the determination of IgG only as a screening test. IgG1 determination may be used to increase the specificity of the results for patients with a positive screening test.

Proteolytic activity in the adult and larval stages of the human roundworm parasite Angiostrongylus costaricensis

“…This parasitic disease has been reported throughout Central and South America (Morera & Cespedes 1971, Incani et al 2007, Palominos et al 2008. In endemic areas, such as the southern region of Brazil, epidemiological and clinical features are used as diagnostic indications of AA (Agostini et al 1983, 1984, Ayala 1987, Graeff-Teixeira et al 1991, Bender et al 2003, Mesen-Ramirez et al 2008, Ben et al 2010, Abrahams-Sandi et al 2011. However, AA is a disease with unspecified clinical manifestations.…”

Angiostrongylus costaricensisinfection in Martinique, Lesser Antilles, from 2000 to 2017

“…In the absence of parasites, histopathological findings can help the diagnosis when they show granulomatous reactions with massive eosinophilic and giant cell infiltration in the intestinal wall and regional lymph nodes and/or eosinophilic vasculitis of arteries, veins, and lymph vessels [ 19 ]. In subclinical forms not requiring laparotomy or surgery, diagnosis may be established when IgG anti-crude adult worm antigens are found by ELISA-based serological analysis, but such analyses are available in only a few laboratories worldwide [ 1 , 3 , 15 , 48 , 67 ]. Serodiagnosis of A. costaricensis is somewhat unsatisfactory because of cross-reactions with A. cantonensis, Strongyloides stercoralis , and Gnathostoma spinigerum [ 47 ].…”

Angiostrongyliasis in the Americas

“…Palpation of the tumoral mass in the lower right abdominal quadrant, vomiting and anorexia suggest parasitism, but definitive diagnosis is only confirmed by observation of the worms inside the arteries after histological examination of biopsy material (Graeff-Teixeira et al, 1991). Laboratory diagnosis includes the serological latex agglutination test (Morera & Amador, 1998), enzyme-linked immunosorbent assay (ELISA) Graeff-Teixeira et al, 1997) and indirect immunofluorescence assay (Abrahams-Sandi et al, 2011). Nevertheless, the choice of the antigen and specificity of the tests need improvement.…”