title: A mass screening survey of cystic echinococcosis by ultrasonography, Western blotting, and ELISA among university students in Manisa, Turkey.
abstract: Cystic echinococcosis (CE) is one of the most important zoonotic diseases in a wide geographic area, including Turkey. In the present project, a total of 4275 students from Celal Bayar University, Manisa, Turkey, were screened by ultrasonography (US) and specific antibodies for CE were examined by Western blotting (WB) and ELISA in finger prick blood samples of 2034 of 4275 volunteered students. We aimed to report the apparent prevalence of CE based on different diagnostic procedures and to compare WB and ELISA with US in diagnosis of CE in a mass screening setting. Six new cases were diagnosed as CE by US during the survey. In addition to these cases, three students were also detected to have been previously operated and pathologically confirmed for hepatic CE. US revealed parenchymal changes in these cases in concordance with their operation history; so, the prevalence of CE by US was calculated as 0.21% (9/4275) (95%CI, 0.11-0.39%) among university students in Manisa. Bands were detected at 8, 28, 32, 38, 42, 47, 70 and 90kDa by WB and the cases were considered to be positive for CE when at least three of the bands were seen together. Apparent prevalence of CE by ELISA and WB were found to be 2.11% (43/2034) (95%CI, 1.57-2.83%) and 0.25% (5/2034) (95%CI, 0.10-0.57%), respectively. Of the six US positive cases, WB was positive in only one case with two cysts in the liver. All of four cases with liver involvement were positive by ELISA. The high prevalence of CE among university students in Manisa indicated that CE is a major health problem in this area of Turkey. Our results supported that WB is rather difficult and not feasible as a mass screening test and may not be effective for confirmation especially in asymptomatic cases. As a result, we recommend US to be used initially in mass screening surveys for CE followed by confirmation by ELISA for suspected cases. Further examination primarily by chest X-ray followed by computed tomography and/or magnetic resonance imaging, if needed, should be recommended for US negative, ELISA and WB positive individuals who may have non-abdominal cysts.
authors: Department of Parasitology, Faculty of Medicine, Celal Bayar University, Manisa, Turkey. Electronic address: ali.kilimcioglu@yahoo.com.tr.
authors: Ali Ahmet
authors: AA
authors: Kilimcioğlu
authors: Nogay
authors: N
authors: Girginkardeşler
authors: Metin
authors: M
authors: Korkmaz
authors: Mine
authors: M
authors: Özkol
authors: Fatih
authors: F
authors: Düzgün
authors: Ipek
authors: I
authors: Östan
authors: Yüksel
authors: Y
authors: Pabuşcu
authors: Gönül
authors: G
authors: Dinç
authors: Ulgen Zeki
authors: UZ
authors: Ok
mesh_terms: D000293:Adolescent; D000328:Adult; D000909:Antibodies, Helminth / Q000097:blood; D015153:Blotting, Western / Q000379:methods*; D004443:Echinococcosis / Q000175:diagnosis* / Q000276:immunology / Q000473:pathology; D004797:Enzyme-Linked Immunosorbent Assay / Q000379:methods; D005260:Female; D064368:Healthy Volunteers; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods*; D015995:Prevalence; D013334:Students; D014421:Turkey / Q000453:epidemiology; D014463:Ultrasonography / Q000379:methods*; D014495:Universities; D055815:Young Adult
chemical_list: D000909:Antibodies, Helminth
keywords: Cystic echinococcosis; ELISA; Epidemiology; Mass screening; Ultrasonography; Western blotting