Role of Serology in Diagnosis of Human Hydatidosis: Experience from a Tertiary Care Hospital

Abstract

Hydatid disease is an important emerging neglected disease worldwide, with significant geographic variation in seroprevalance. The disease is commonly diagnosed on basis of clinical suspicion, imaging and serology. This study was conducted to evaluate our experience with serology in diagnosing hydatid disease in terms of identifying the numbers of patients testing positive for antibodies against Echinococcus, and to study their clinical profile. This retrospective study included all patients who tested for anti-Echinococcus IgG antibodies by ELISA in the years 2014-2015. The clinical characteristics of seropositive patients were contrasted with seronegative patients, and the test results were correlated with radiological findings and, where performed, with histopathological studies. Analysis was performed on SPSS (IBM, Inc). Chi-square test was used to statistically compare between patient groups. Out of 54 patients evaluated by serology for Echinococcosis during the study period, Fourteen (26%) were seropositive. The two groups were comparable with respect to age, gender and most hematological parameters, excepting eosinophilia, which was more frequent among seropositive patients (28.6% vs. 2.5%; p=0.01). Alkaline phosphatase also tended to be higher among seropositives (42.9% vs 20%; p=0.09). Liver was the most frequent site involved (12 patients; 86%). Of the 29 patients who also underwent biopsy, all the seven patients with positive biopsy were seropositive, suggesting 100% sensitivity. The specificity was 81.8%, but this might be a lower estimate due to potentially high rate of false-negative biopsies, as all the seropositive patients also had imaging features suggestive of disease. The positive and negative predictive values were 63.6% and 100%, respectively. ELISA for detection of anti-Echinococcus antibodies is a simple serological test that helps in correlation with imaging finding in the diagnosis and subsequent management of hydatid disease.

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

“…In this study, antibody against CE was detected in the sera of 454 CE suspected subjects and the results indicated that 40% of cases had antibody against CE. In Behan et al study 15.03% of CE suspected subjects had ( 12 ) and in Netherland it was detected in sera 26% of CE suspected subjects ( 13 ).…”

Human Hydatidosis: A Negliged Zoonosis and Underdeclared at the University Hospital Center of Tlemcen, Algeria: 16 Years of Registration from 2003 to 2018

“…Also, predominance of the disease in women might be due to the fact that females are more frequently exposed to the infection than males due to being engaged more in domestic activities including feeding of dogs and preparing food for the family [19]. Other studies did not find difference by sex [21,23].…”

“…In India [21], the mean age of 54 patients suffering from hydatid disease was 43.9 years (range: 10-98 years). Highest numbers of cases were seen among age group of 40-49 years.…”

“…Many studies have shown that the high infection rate was recorded in liver: Sudan [15], Egypt [16], Yemen [18], Iraq [19], Ethitopia [20], India [21] and Iran [23].…”