Serological Assays for Alveolar and Cystic Echinococcosis—A Comparative Multi-Test Study in Switzerland and Kyrgyzstan
Philipp A. Kronenberg,
Ansgar Deibel,
Bruno Gottstein,
Felix Grimm,
Beat Müllhaupt,
Cordula Meyer zu Schwabedissen,
Sezdbek Aitbaev,
Rakhatbek A. Omorov,
Kubanychbek K. Abdykerimov,
Gulnara Minbaeva,
Jumagul Usubalieva,
Mar Siles-Lucas,
Paola Pepe,
Laura Rinaldi,
Markus Spiliotis,
Junhua Wang,
Norbert Müller,
Paul R. Torgerson,
Peter Deplazes
Affiliations
Philipp A. Kronenberg
Institute of Parasitology, Vetsuisse and Medical Faculty, University of Zurich, 8075 Zurich, Switzerland
Ansgar Deibel
Clinics of Hepatology and Gastroenterology, University Hospital Zurich, 8091 Zurich, Switzerland
Bruno Gottstein
Laboratory of Parasitology, Institute for Infectious Diseases, Medical Faculty, University of Bern, 3001 Bern, Switzerland
Felix Grimm
Institute of Parasitology, Vetsuisse and Medical Faculty, University of Zurich, 8075 Zurich, Switzerland
Beat Müllhaupt
Clinics of Hepatology and Gastroenterology, University Hospital Zurich, 8091 Zurich, Switzerland
Cordula Meyer zu Schwabedissen
Clinics of Hepatology and Gastroenterology, University Hospital Zurich, 8091 Zurich, Switzerland
Sezdbek Aitbaev
City Clinical Hospital #1, Surgical Department, Faculty of Surgery of the Kyrgyz State Medical Academy, Bishkek 720054, Kyrgyzstan
Rakhatbek A. Omorov
City Clinical Hospital #1, Surgical Department, Faculty of Surgery of the Kyrgyz State Medical Academy, Bishkek 720054, Kyrgyzstan
Kubanychbek K. Abdykerimov
Section of Epidemiology, Vetsuisse Faculty, University of Zurich, 8057 Zurich, Switzerland
Gulnara Minbaeva
Government Sanito-Epidemiology Unit, Kyrgyz Ministry of Health, Bishkek 720033, Kyrgyzstan
Jumagul Usubalieva
Government Sanito-Epidemiology Unit, Kyrgyz Ministry of Health, Bishkek 720033, Kyrgyzstan
Mar Siles-Lucas
Instituto de Recursos Naturales y Agrobiologia (IRNASA-CSIC), 37008 Salamanca, Spain
Paola Pepe
Unit of Parasitology and Parasitic Diseases, Department of Veterinary Medicine and Animal Production, University of Naples Federico II, 80138 Naples, Italy
Laura Rinaldi
Unit of Parasitology and Parasitic Diseases, Department of Veterinary Medicine and Animal Production, University of Naples Federico II, 80138 Naples, Italy
Markus Spiliotis
Laboratory of Parasitology, Institute for Infectious Diseases, Medical Faculty, University of Bern, 3001 Bern, Switzerland
Junhua Wang
Laboratory of Parasitology, Institute for Infectious Diseases, Medical Faculty, University of Bern, 3001 Bern, Switzerland
Norbert Müller
Institute of Parasitology, Vetsuisse Faculty, University of Bern, 3012 Bern, Switzerland
Paul R. Torgerson
Section of Epidemiology, Vetsuisse Faculty, University of Zurich, 8057 Zurich, Switzerland
Peter Deplazes
Institute of Parasitology, Vetsuisse and Medical Faculty, University of Zurich, 8075 Zurich, Switzerland
Both 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).
