Immunodiagnosis of hydatid disease with locally prepared elisa and latex kits

Echinococcus granulosus is one major species in medical and public health importance which causes hydatidosis.Hydatid disease is a chronic, cyst-forming, zoonotic disease of human and complex multicellular pathogen with multiantigens microorganism that,despite being under constant barrage by the immune system, are able to modulate antibodies immune responses and persist and flourish in humans. Hydatid cysts develop in internal organs(mainly liver and lungs) of humans as unilocular fluid-filled bladders.
Fifty patients infected with hydatidosis from different hospitals(28 patients at the AL-Kadhmiya teaching hospital,10 patients at the Medical city teaching hospital and 12 patients at the AL-Yarmok teaching hospital ) in Baghdad were included in this study. The 50 patients diagnosed with hydatid disease by clinically and radiologically.The study showed that the incidence of hydatidosis in females was the same as in the males.The youngest was 4 years and the oldest was 67years of age .The highest age distribution of hydatidosis patients was between(24-33) years.The percentage of liver hydatidosis was higher(44%) than any other organ. Twinty-two(22) cases in the liver(hepatic hydatid cyst),Eighteen(18) cases in the lung(pulmonary hydatid cyst),One(1) case in the kidneys(renal hydatid cyst),One(1) case in the Spine(cerebral hydatid cyst),Five (5) cases in the muscles under skin(subcutaneous hydatid cyst),One(1) case in the heart(cardiac hydatid cyst) and two(2) cases in the ovary(ovarian hydatid cyst). The size of the cysts range between (3.3x1 cm to 33x14 cm).Patients with large size cyst(62%) were more than those with small cyst(38%). The majority of patients (88%) had single cysts,whereas 12% had multiple cysts. The fertility rate of the hydatid cysts in humans 100%.A high percent(64%) of patients with hydatid cyst lived in urban areas while A low percent (36%) of patients with hydatid cyst lived in rural areas .This study also conducted one-hundred and seven relatives’ patients,(38) females and (69) males,their age range from (6 - 65)years old.Those were selected according to living in the same houses of the patients. All relatives apperantly healthy persons without previous history of hydatid disease. In rural area the seroprevalence were 12 male cases and 4 female cases ,While in urban area 5male cases,5 female cases,respectively.In rural area,out of the 16 positive cases,the highest rate,(7 cases) was found among age group 31-40 years.The lowest rate of infection,(1) case was recorded among age group under 20 years old.In urban area the 10 cases among the age –group above 51 years.There were no statistically significant differences in the frequency between both sexes(p=0.05)this may give no relation or independent between sex (male,female) and infection results. But a highly statistically significant differences (p=0.05) were shown between hydatidosis infected persons(serum positive,serum negative) in relation to area(urban area,rural area).On the other hand the Chi-square revealed no statistically significant difference in the frequency between ages (p=0.05)this may give no relation or independent between sex(male,female) and serum results in rural area.Also chi-square revealed no statistically significant differences (p=0.05) were shown between ages and serum results (serum positive,serum negative) in urban area.According to the occupation,In rural area, among 11 female,(all were house hold) only 4 were seropositive.In male,all the 23 male were farmers and 12 were seropositive. In urban area, among 27 females,20 were house hold,4 cases were seropositive.5 were student, one of them positive, while among 46 males,22 were workers,2cases were seropositive.11 were student, 2cases were seropositive. 14 were employer,one case was seropositive.
There were no significant differences in the rates seropositive case for different occupations(p=0.05);the number were highest among farmer and house hold both in rural area and urban area.Our results implied that the prevalence of hydatidosis had significant relationship with the level of education. Among 26 seropositive persons in rural area and urban area,16(61.53%)were illiterate, 5 (19.23%) had primary school education,and 4(15.38%)had intermediate school education while only 1(3.84%)had university education.
Thirty patients’ follow-up included in this study .The number of females follow-up was 15 (50%) and the number of males follow-up was 15 (50%) provided by retrospective post-surgical follow-up . The ages of patients’ follow-up studied were between 4 and 50 years old.The majority of cases which were found to be follow-up 9(69.2%)were the age group between 4 and 25 years . Four patients developed recurrences at 3-7 months postoperatively.Although the recurrence rate was reduced significantly in the radical surgery group.In this study new immunodiagnosis method were used, Nahrain -enzyme-linked immunosorbent assay(ELISA)kit and Nahrain -latex kit.Two types of antigens were prepared(Hydatid fluid antigen and Hydatid wall antigen).In this study all human samples were examined by sero immunodiagnosis of hydatidosis infection were conducted by preparing Two new kits( Nahrain -enzyme-linked immunosorbent assay(ELISA)kits and Nahrain – latex kit) , using two different types of antigens obtained from human lung cyst.(The crude human hydatid fluid antigen and crude human hydatid cyst wall antigen ).Both kits gave higher specificity(100%) and higher sensitivity (100%). Crude hydatid cyst fluid antigen and crude hydatid cyst wall antigen seem to have reasonable antigenic properties and hence could be employed for diagnosis and epidemiological surveillance of human hydatidosis.