epidemiology of helminthes and diagnosis of fasciola...
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• Stool exam• ELISA• Fast-ELISA• Dig-ELISA• IFA• EITB or Western Blot• CIEP• ِ◌DOT-ELISA• IHA• And so on…..
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Fasciola hepatica
Sensitivity Specificity Somatic 100% 97% E/S 100% 98.5% CP 100% 98.5% CL1 100% 99%
Rokni et al
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Fas2-ELISA in the detection of human infection by Fasciola hepatica.
• Fas2-ELISA exhibited 95% sensitivity and 100% specificity.
• The high antigenicity of Fas2 is suggested by the fact that antibodies to Fas2 rise rapidly by 1-2 weeks of infection.
SpinosaSpinosa et alet al……..
i3
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Slide 8
i3 Espinoza JR, Timoteo O, Herrera-Velit P.
Molecular Biotechnology Unit, Laboratories for Research and Development, Faculty of Science and Philosophy, Universidad Peruana Cayetano Heredia, Lima 100, Peru. [email protected], 5/1/2007
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Kesmat Maher (92)ELISA (Homogenate Ag)
IgG1 IGg4 Sensitivity 100% 100% Specificity 56.2% 97%
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Fast-ELISA
• Sensitivity : 96%• Specificity: > 95%
• Rokni et al…(Unpublished)
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CIEP
• Arc2 from homogenate Ag• Specificity= high• Sensitivity= so so
• (43)
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DOT-ELISA
• 1.5 µg/µl of antigen per dot, serum dilution of 1:320, and dilution conjugate of 1:500 along with 1:3000 were found optimal.
• The sensitivity, specificity, positive and negative predictive values were 96.8%, 96.1%, 96.8% and 96.1%, respectively.
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• Recombinant CL1 using ELISA• Sensitivity = 100%• Specificity= 100%
• O’Neill (114)
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Detection of Fasciola-specific excretory/ secretory (E/S) protein fraction band (49.5 kDa)
• Using (EITB), Fasciola-specific E/ S protein fraction band (49.5 kDa) was determined and electroeluted.
• The sensitivity, specificity and diagnostic accuracy of EITB were 45.2%, 100% and 70.7%, respectively,
• while those of CIEP were 38.7%, 100% and 67.2%, respectively.
Arfah et al…
i5
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Slide 19
i5 1: J Egypt Soc Parasitol. 1999;29(3):911-26Arafa MS, Abaza SM, El-Shewy KA, Mohareb EW, El-Moamly AA. Department of Parasitology, Faculty of Medicine, Suez Canal University, Ismailia, Egypt.ijph, 5/1/2007
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Cysteine protease
Sensitivity 97.5% Specificity 98.8% Positive predictive value
98.7%
Negative predictive value
97.7%
Rokni et al…
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EITB using E/S Ag for 27kDa band
• Sensitivity: 100%• Specificity: 98%• P.P.Value: 66.7%• N.P.Value: 100%
• Pew Pan M Intapan et al
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• Two weeks after treatment, 87 kDa band in western blot test was disapeared (Hillyer et al-55). Also it was detected that 17 kDa band is a good marker to differentiate the acute and chronic phases.
• Using circulating antigens, 1,3 and 6 months after treaetmentwith TCB, ELISA test was
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ارزیابی درمان
بررسي آنتي ژن ھاي چرخشي توسط الایزا ي یك در•مستقیم ، یك ھفتھ پس ار آلودگي تست مثبت بود در
)14 (. ھفتھ پس از درمان تست منفي گردید 4حالیكھ
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ارزیابی
از تست دات Castroدر بررسي دیگري توسط • ترشحي جھت –الایزا و آنتي ژن مواد دفعي –
.(35)ارزیابي تست پس از درمان استفاده شد ھفتھ پس از آلودگي گاوھا در مزرعھ آلوده بھ 4 تا 2 •
.قابل تشخیص بود IgGمتاسركر، آنتي بادي 15پس از درمان گاوھا با تریكلابندازول با دوزاژ•
mg/kg ، ماه بعد تست منفي 6تا 4سھ بار در ھفتھ . پیدایش تخم یك ماه بعد از درمان اول منفي بود . شد
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•Hammouda نشان دادند كھ (75)و ھمكاران الایزابا پس از درمان بیماران با تریكلا بندازول تست
منفي بوده و لذا تشخیص استفاده از آنتي ژن چرخشيآنتي ژن چرخشي مي تواند بعنوان ابزاري در جھت
. ارزیابي درمان مورد استفاده قرار گیرد
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مشخص گردید كھ متوسط (60)در یك بررسي جالب •است ng/ml 250غلظت آنتي ژن در مدفوع انسان
دو ماه پس . ده برابر میزان آن در سرم است " كھ تقریبااز درمان با بیتینول تمام بیماران شفا یافتھ از نظر وجود
Ag این روش در كوبا . در مدفوع منفي بوده اند. بصورت تجارتي مورد استفاده قرار گرفتھ است
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• Patients treated unsuccessfully with
praziquantel retain high levels of antibodies 147 weeks post-treatment.
HILLYER G V, SOLER DE GALANES M. Identification of a 17-kilodalton Fasciola hepaticaimmunodiagnostic antigen by enzyme-linked immunoelectrotransfer blot technique.
J Clin Microbiol 1988; 26: 2048-53.
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neglected tropical diseases (NTDs)• ascariasis , hookworm infection
, trichuriasis , lymphatic filariasis (LF) , onchocerciasis , schistosomiasis
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dracunculiasis
• Ethiopia, Ghana and Mali are expected to interrupt transmission by 2010.
• Interrupting transmission in Sudan, which reported 2733 cases in 2009, is likely to take a few years longer.
• WHO has certified 187 countries and territories as dracunculiasis-free.
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hydatidosis
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ALVEOLAR echinococcosisALVEOLAR echinococcosisIranIran
ØØBetween 1946 and 1993, just 28 Between 1946 and 1993, just 28 female and nine male cases of female and nine male cases of alveolar echinococcosis were alveolar echinococcosis were recorded in Iran.recorded in Iran.ØØMost of these cases were middleMost of these cases were middle--
aged (31aged (31––45 years) and most were 45 years) and most were farmers (38%) or shepherds (33%).farmers (38%) or shepherds (33%).ØØ All the cysts detected were either in All the cysts detected were either in
the liver(92.3%) or, more rarely, in the liver(92.3%) or, more rarely, in the lung (7.6%).the lung (7.6%).
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DPUVDPUVDPUV
PREVALENCESPREVALENCESHUMAN FASCIOLIASISHUMAN FASCIOLIASIS
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DPUVDPUVDPUV
RELATIONSHIPS WITH GENDERRELATIONSHIPS WITH GENDERHUMAN FASCIOLIASISHUMAN FASCIOLIASIS
-- = not analysed-- = not analysed sign. = only noted when statistically significant differences were foundsign. = only noted when statistically significant differences were found
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DPUVDPUVDPUV
Intensities(epg in
coprology)
Intensities(epg in
coprology)decrease with age
higher epg in 5-9higher epg in 6-11
--
no sign.diff.peak 7-10, prec.girls
increase with age
higher adults 30-50
higher adults 30-50
--
--
--
decrease with age
higher epg in 5-9higher epg in 6-11
--
no sign.diff.peak 7-10, prec.girls
increase with age
higher adults 30-50
higher adults 30-50
--
--
--
RELATIONSHIPS WITH AGERELATIONSHIPS WITH AGE HUMAN FASCIOLIASISHUMAN FASCIOLIASIS
-- = not analysed-- = not analysedsign. = only when statistical significance tests appliedsign. = only when statistical significance tests applied
Trans.Trans.
AZ
AZAZAZ
AZ
Z
ZZ
(AZ)
Z
Z
AZ
AZAZAZ
AZ
Z
ZZ
(AZ)
Z
Z
AZ = antropozoonotic transmissionAZ = antropozoonotic transmissionZ = zoonotic transmissionZ = zoonotic transmission
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Schistosomiasis
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•• urinary schistosomiasis, was common in the western urinary schistosomiasis, was common in the western province of Khuzestan until the1980s (Then 11.3%).province of Khuzestan until the1980s (Then 11.3%).
•• By 1976, however, the prevalence of human infection had By 1976, however, the prevalence of human infection had fallen to 0.7%, and by 1995, it was only 0.02%.fallen to 0.7%, and by 1995, it was only 0.02%.
•• The prevalence of infection fell from 0.653% in 1980 to much The prevalence of infection fell from 0.653% in 1980 to much lower values in 1988 (0.021%) and 1989 (0.042%).lower values in 1988 (0.021%) and 1989 (0.042%).
•• In Khuzestan province although 1158 cases were recorded In Khuzestan province although 1158 cases were recorded throughout the province between 1981 and 1990, only 98 throughout the province between 1981 and 1990, only 98 were reported between 1991 and 2000, and no cases were were reported between 1991 and 2000, and no cases were detected in 2001.detected in 2001.
•• No Iranian cases of human schistosomiasis have been No Iranian cases of human schistosomiasis have been reported since 2001.reported since 2001.
SchistosomiasisSchistosomiasis
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Soil Transmitted Helminthiases
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Trichinella aspiralis
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فقط یک مورد انسانی با روش سرولوژی در سال •. گزارش شده است1345
در یک خانواده در شمال •در خوک وحشی ، گراز، موش خرما ، خرس قھوه •
.ای، شغال و گربھ وحشی نیز گزارش شده است
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وحشی ، شکار و شکارچی حیوانات: وحشیسیکل•انسان ، خوک و موش : اھلی سیکل•. وجوددارد دنیا در اکثر نقاط استرالیابجز دانمارک و •.میشود دیدهو اروپای شرقی ) 40-50( % در آلاسکا بیشتر•. در آمده استاپیدمی بصورت و ژاپن چیندر •
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• 9 cases of pentastomiasis (all caused by Linguatula),
• 12 cases of dirofilariasis,• 1 case of gongylonemiasis,• 3 cases of moniliformiasis
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