title: Diagnosis of cystic echinococcosis, central Peruvian Highlands.
abstract: We evaluated prevalence of cystic echinococcosis (CE) in a central Peruvian Highland district by using 4 diagnostic methods: ultrasonography for 949 persons, radiography for 829, and 2 serologic tests for 929 (2 immunoblot formats using bovine hydatid cyst fluid [IBCF] and recombinant EpC1 glutathione S-transferase [rEpC1-GST] antigens). For the IBCF and rEpC1-GST testing, prevalence of liver and pulmonary CE was 4.7% and 1.1% and seropositivity was 8.9% and 19.7%, respectively. Frequency of seropositive results for IBCF and rEpC1-GST testing was 35.7% and 16.7% (all hepatic cysts), 47.1% and 29.4% (hepatic calcifications excluded), and 22.2% and 33.3% (lung cysts), respectively. Weak immune response against lung cysts, calcified cysts, small cysts, and cysts in sites other than lung and liver might explain the poor performance of the serodiagnostic tests. We confirm that CE is highly endemic to Peru and emphasize the limited performance of available serologic assays in the field.
authors.affiliation: Universidad Nacional Mayor de San Marcos, San Borja, Lima, Peru. cgavidia@jhsph.edu
authors.forename: Cesar M
authors.initials: CM
authors.lastname: Gavidia
authors.forename: Armando E
authors.initials: AE
authors.lastname: Gonzalez
authors.forename: Wenbao
authors.initials: W
authors.lastname: Zhang
authors.forename: Donald P
authors.initials: DP
authors.lastname: McManus
authors.forename: Luis
authors.initials: L
authors.lastname: Lopera
authors.forename: Berenice
authors.initials: B
authors.lastname: Ninaquispe
authors.forename: Hector H
authors.initials: HH
authors.lastname: Garcia
authors.forename: Silvia
authors.initials: S
authors.lastname: Rodríguez
authors.forename: Manuela
authors.initials: M
authors.lastname: Verastegui
authors.forename: Carmen
authors.initials: C
authors.lastname: Calderon
authors.forename: William K Y
authors.initials: WK
authors.lastname: Pan
authors.forename: Robert H
authors.initials: RH
authors.lastname: Gilman
mesh_terms: D000328:Adult; D000818:Animals; D000909:Antibodies, Helminth / Q000097:blood*; D000947:Antigens, Helminth / Q000276:immunology; D002675:Child, Preschool; D004444:Echinococcosis, Hepatic / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000453:epidemiology; D004445:Echinococcosis, Pulmonary / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000453:epidemiology; D004446:Echinococcus / Q000276:immunology; D019353:Endemic Diseases; D005260:Female; D006801:Humans; D015151:Immunoblotting; D008099:Liver / Q000000981:diagnostic imaging; D008168:Lung / Q000000981:diagnostic imaging; D008297:Male; D010568:Peru / Q000453:epidemiology; D015995:Prevalence; D011859:Radiography; D012424:Rural Population; D014463:Ultrasonography
chemical_list: D000909:Antibodies, Helminth; D000947:Antigens, Helminth