ISSN 2564-7784 | E-ISSN 2564-7040
Review
Basic Problems in Serological Diagnosis of Cystic Echinococcosis
1 Hitit University School of Medicine, Department of Medical Microbiology, Çorum, Turkey  
Eur J Ther ; : -
DOI: 10.5152/EurJTher.2019.18076
Key Words: Serological diagnosis, cystic echinococcosis, microbiology.
Abstract

Cystic echinococcosis (CE), which occurs in rural areas during most seasons, is an important public health problem in Turkey. Many challenges regarding both diagnosis and treatment of this disease have not yet been overcome, and despite significantly increasing patient care costs, surgical treatment remains the main option. Confirmation of diagnosis is usually carried out by serological tests based on the detection of serum antibodies against crude parasitic extracts (hydatid fluid, HF); however, HF contains cross-reactive antigens that lead to false positive results indicating other parasitic and nonparasitic diseases. Moreover, certain patients are serologically negative for HF, despite suffering from CE, likely due to cyst stage, number, and size. In recent years, the existing insensitive and nonspecific tests have been replaced with indirect haemagglutination tests (IHAT), enzyme-linked immunosorbent assays (ELISA), and immunoblotting (IB). As a result of the evident diagnostic problems, there exist the World Health Organization/World Animal Health Organization recommendations based on a sequential screening and confirmatory test model. For primary screening, the use of ELISA, IHAT, latex agglutination tests (LAT), immunofluorescence antibody tests (IFAT), and immunoelectrophoresis (IEP) is recommended. In Turkey, the accepted serological screening tests are IHAT, IFA, and ELISA; with the Turkish Ministry of Health, Public Health Agency recommending that at least two serological screening tests are used to diagnose CE patients followed by confirmation using IB. In the present review, the laboratory tests used in the diagnosis of CE and their limitations and diagnostic algorithms are explained with reference to the current literature.

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