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      Evaluation of the Diagnostic Performance of Recombinant Antigen B1 for Detection of Cystic Echinococcosis Using Lateral Flow Dipstick Test

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          Abstract

          Background:

          Human echinococcosis is a neglected zoonotic disease distributed worldwide. It comprises cystic and alveolar forms, the former being the more prevalent disease. Imaging techniques are the first choice for diagnosis of cystic echinococcosis and serology is used as an additional diagnostic technique in doubtful cases or as the sole test in low-resource settings. Rapid diagnostic tests are useful and convenient for immunodiagnosis of cystic echinococcosis in endemic areas, where medical facilities often struggle with limited resources.

          Methods:

          Recently, we have developed Hyd Rapid™, an IgG4 lateral flow dipstick test using recombinant antigen B1 for detection of cystic echinococcosis. This study was performed between 2016 until 2018 at the Institute for Research in Molecular Medicine, Universiti Sains Malaysia. The diagnostic performance of Hyd Rapid™ was tested in-house and at two international laboratories in Switzerland and Iran.

          Results:

          The overall diagnostic sensitivity for detection of cystic and alveolar echinococcosis was 95% (56/59). Meanwhile, the diagnostic specificity, with and without exclusion of cysticercosis and fascioliasis, was 100% (n=48) and 88% (63/72), respectively.

          Conclusion:

          Hyd Rapid™ detected cystic echinococcosis as well as probable cases of alveolar echinococcosis. Therefore, Hyd Rapid™ showed good potential as a serological tool for echinococcosis, and merits further evaluation.

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          Most cited references41

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          Expert consensus for the diagnosis and treatment of cystic and alveolar echinococcosis in humans.

          Enrico Brunetti, Peter Kern, Dominique Angèle Vuitton (2010)
          The earlier recommendations of the WHO-Informal Working Group on Echinococcosis (WHO-IWGE) for the treatment of human echinococcosis have had considerable impact in different settings worldwide, but the last major revision was published more than 10 years ago. Advances in classification and treatment of echinococcosis prompted experts from different continents to review the current literature, discuss recent achievements and provide a consensus on diagnosis, treatment and follow-up. Among the recognized species, two are of medical importance -Echinococcus granulosus and Echinococcus multilocularis - causing cystic echinococcosis (CE) and alveolar echinococcosis (AE), respectively. For CE, consensus has been obtained on an image-based, stage-specific approach, which is helpful for choosing one of the following options: (1) percutaneous treatment, (2) surgery, (3) anti-infective drug treatment or (4) watch and wait. Clinical decision-making depends also on setting-specific aspects. The usage of an imaging-based classification system is highly recommended. For AE, early diagnosis and radical (tumour-like) surgery followed by anti-infective prophylaxis with albendazole remains one of the key elements. However, most patients with AE are diagnosed at a later stage, when radical surgery (distance of larval to liver tissue of >2cm) cannot be achieved. The backbone of AE treatment remains the continuous medical treatment with albendazole, and if necessary, individualized interventional measures. With this approach, the prognosis can be improved for the majority of patients with AE. The consensus of experts under the aegis of the WHO-IWGE will help promote studies that provide missing evidence to be included in the next update. Copyright 2009 Elsevier B.V. All rights reserved.
          Article 0 comments Cited 276 times – based on 0 reviews     Review now
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            Global Distribution of Alveolar and Cystic Echinococcosis.

            P Deplazes, L. Rinaldi, C A Alvarez Rojas … (2017)
            Alveolar echinococcosis (AE) and cystic echinococcosis (CE) are severe helminthic zoonoses. Echinococcus multilocularis (causative agent of AE) is widely distributed in the northern hemisphere where it is typically maintained in a wild animal cycle including canids as definitive hosts and rodents as intermediate hosts. The species Echinococcus granulosus, Echinococcus ortleppi, Echinococcus canadensis and Echinococcus intermedius are the causative agents of CE with a worldwide distribution and a highly variable human disease burden in the different endemic areas depending upon human behavioural risk factors, the diversity and ecology of animal host assemblages and the genetic diversity within Echinococcus species which differ in their zoonotic potential and pathogenicity. Both AE and CE are regarded as neglected zoonoses, with a higher overall burden of disease for CE due to its global distribution and high regional prevalence, but a higher pathogenicity and case fatality rate for AE, especially in Asia. Over the past two decades, numerous studies have addressed the epidemiology and distribution of these Echinococcus species worldwide, resulting in better-defined boundaries of the endemic areas. This chapter presents the global distribution of Echinococcus species and human AE and CE in maps and summarizes the global data on host assemblages, transmission, prevalence in animal definitive hosts, incidence in people and molecular epidemiology.
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              Echinococcosis: a review.

              Pedro Moro, Peter M. Schantz (2009)
              Echinococcosis in humans occurs as a result of infection by the larval stages of taeniid cestodes of the genus Echinococcus. In this review we discuss aspects of the biology, life cycle, etiology, distribution, and transmission of the Echinococcus organisms, and the epidemiology, clinical features, treatment, and effect of improved diagnosis of the diseases they cause. New sensitive and specific diagnostic methods and effective therapeutic approaches against echinococcosis have been developed in the last 10 years. Despite some progress in the control of echinococcosis, this zoonosis continues to be a major public health problem in several countries, and in several others it constitutes an emerging and re-emerging disease.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Iran J Parasitol
                Journal ID (iso-abbrev): Iran J Parasitol
                Journal ID (publisher-id): IJPA
                Journal ID (pmc): IJPA
                Title: Iranian Journal of Parasitology
                Publisher: Tehran University of Medical Sciences
                ISSN (Print): 1735-7020
                ISSN (Electronic): 2008-238X
                Publication date (Print): Jul-Sep 2020
                Volume: 15
                Issue: 3
                Pages: 290-298
                Affiliations
                [1. ] Institute for Research in Molecular Medicine (INFORMM), Universiti Sains Malaysia, 11800 USM, Pulau Pinang, Malaysia
                [2. ] Swiss Tropical and Public Health Institute, Basel, Switzerland
                [3. ] University of Basel, Basel, Switzerland
                [4. ] Research Center for Hydatid Disease in Iran, School of Medicine, Kerman University of Medical Sciences, Kerman, Iran
                Author notes
                [* ] Correspondence Email: rahmah8485@ 123456gmail.com
                Article
                Publisher ID: IJPA-15-290
                DOI: 10.18502/ijpa.v15i3.4191
                PMC ID: 7548468
                SO-VID: bfdc3e7d-3754-43e6-9e9a-c0c0bd143702
                Copyright © Copyright© Iranian Society of Parasitology & Tehran University of Medical Sciences
                License:

                This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 06 September 2019
                Date accepted : 09 November 2019
                Categories
                Subject: Original Article

                ScienceOpen disciplines: Parasitology
                Keywords: rapid test,lateral flow,cystic and alveolar echinococcosis,evaluation,immunoglobulin g
                Data availability:
                ScienceOpen disciplines: Parasitology
                Keywords: rapid test, lateral flow, cystic and alveolar echinococcosis, evaluation, immunoglobulin g

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