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| Role of Serology and Histopathology in Diagnostic of Human Cystic Echinococcosis |
Adam Alfaki Mohammad Albadawi, Mohammad Baha Eldin Saad, Safaldin Mohammad Alzain, Nawal Tagelsir Mohammad Osman, Aida Hassan Gaber, Mawahb Abdelmonem, Hatim Babaker Osman , Mohammad Eltayeb A
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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 study included all patients who tested for anti-Echinococcus IgG antibodies by ELISA in the years 2011-2013. 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. Out of 31 patients evaluated by serology for Echinococcosis during the study period, 7 (22.58%) were seropositive. Liver was the most frequent site involved (24 patients; 77.77%). Second organ the lung 5(16.13%) bone 1(3.23%) and the optic 1(3.22%).Of the 29 patients who also underwent biopsy, all the seven patients with positive biopsy were seropositive, suggesting 100% sensitivity. The specificity was 83.33%, 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 77.77% and 90.90%, respectively. ELISA for detection of antiEchinococcus antibodies is a simple serological test that helps in correlation with imaging finding in the diagnosis and subsequent management of hydatid disease.
Material and methods: A cross sectional study was done on biological material (obtained from haptic and lung hydatid cysts). The viability criteria used were ovoid form invaginated scolices and intact calcareous corpuscles the presences of vibrating movements; and the absence of “vital” staining. The cysts were grouped according to diameter cysts from small cysts to very large size cysts. Descriptive statics for the collection of the prevalence of fertility; analytical statistics for comparison of groups, and multivariate analysis for examination of the association between cyst fertility and clinical variables. Is using to carried out by SPSS programme.
Result: Out of 31 patients evaluated by serology for Echinococcosis during the study period, 7 (22.58%) were seropositive. Liver was the most frequent site involved (24 patients; 77.77%). Second organ the lung 5(16.13%) bone 1(3.23%) and the optic 1(3.22%).Of the 29 patients who also underwent biopsy, all the seven patients with positive biopsy were seropositive, suggesting 100% sensitivity. The specificity was 83.33%, 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 77.77% and 90.90%, respectively.
Conclusion: Evaluation ELISA test in sensitivity and specificity, prevalence rates of the fertility of hydatid cysts and viability of protoscoleces and diversity sites location observed in human. And also the conformed diagnosis by histopathology.
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