Serological assays for alveolar and Cystic Echinococcosis-A comparative multi-test study in Switzerland and Kyrgyzstan

27 páginas, 9 tablasBoth alveolar (AE) and cystic echinococcosis (CE) are lacking pathognomonic clinical signs; consequently imaging technologies and serology remain the main pillars for diagnosis. The present study included 100 confirmed treatment-naïve AE and 64 CE patients that were diagnosed in Switzerland or Kyrgyzstan. Overall, 10 native Echinococcus spp. antigens, 3 recombinant antigens, and 4 commercial assays were comparatively evaluated. All native E. multilocularis antigens were produced in duplicates with a European and a Kyrgyz isolate and showed identical test values for the diagnosis of AE and CE. Native antigens and three commercial tests showed high diagnostic sensitivities (Se: 86-96%) and specificities (Sp: 96-99%) for the diagnosis of AE and CE in Swiss patients. In Kyrgyz patients, values of sensitivities and specificities were 10-20% lower as compared to the Swiss patients' findings. For the sero-diagnosis of AE in Kyrgyzstan, a test-combination of an E. multilocularis protoscolex antigen and the recombinant antigen Em95 appears to be the most suitable test strategy (Se: 98%, Sp: 87%). For the diagnosis of CE in both countries, test performances were hampered by major cross-reactions with AE patients and other parasitic diseases as well as by limited diagnostic sensitivities (93% in Switzerland and 76% in Kyrgyzstan, respectively).This research was partially funded by the Swiss National Science Foundation, grantnumber: 173131-“Transmission modelling of emergent echinococcosis in Kyrgyzstan” and by theproject “New sustainable tools and innovative actions to control cystic ECHINOcoccosis in sheepfarms in the MEDiterranean area: improvement of diagnosis and SAFEty in response to climaticchanges-ECHINO-SAFE-MED”, supported by PRIMA (Partnernship for research and innovation inthe Mediterranean areaPeer reviewe