RESUMO
The basic strategy for development of hydatid struggle programs is in the actuality: Primary Attention of Health. In the present work and in this instance, it's arm a precocious detection system of hydatid disease, fixed in immunologic diagnostic by means of ELISA technical beginning with blood capillary samples, taken in filter paper by teachers and sanitary agents from official services of Rio Negro Province. 177 teachers and 45 sanitary agents were trained, correspondent to 25 schools, 3 lodging schools and 9 Hospitals all of them from rural area. 890 blood samples during the training were obtained. Lastly, the trained personal armed the system and they obtained 728 samples in the beginning of the Program. It hadn't statistical differences in the reactivity of both samples. The serological prevalence found was 1.32%. The activity displayed by teachers and sanitary agents permitted to detect 21 new cases it was the 20% of new cases diagnosed in this area in the period of work. The viability and the importance of the incorporation of non traditional effectors into the Hydatid Control Programs is discussed.
Assuntos
Participação da Comunidade , Equinococose/diagnóstico , Ensaio de Imunoadsorção Enzimática , Humanos , Atenção Primária à SaúdeRESUMO
The specificity and sensitivity of the enzyme immunoassay (EIA), presently used in South America areas where hydatidosis caused by Echinococcus granulosus is endemic, was compared to two alternative EIA. One of these uses an hydatid antigen of different preparation and the other vesicular fluid of Taenia crassiceps cisticerci (VFCC). The effect of previous neutralization in the serum sample of antibodies antinormal ovine or murine sera and antiphosphorylcholine on the diagnostic efficiency of these EIA was studied. The frequency of distribution of the titers obtained with normal sera, hydatid sera positive to DD5 test and hydatid sera negative to DD5 test in three EIA systems was analyzed. Results showed a significant decrease of sensitivity of the EIA using VFCC when compared to these EIA using hydatid antigens. This makes inconvenient the use of VFCC for the immunodiagnosis of hydatid disease. No significant differences between the two EIA using hydatid antigens were observed. SDS-PAGE analysis showed remarkable differences between the VFCC and the hydatid antigens composition and some differences among these latters probably due to manufacturing procedures.
Assuntos
Antígenos de Helmintos , Equinococose/diagnóstico , Animais , Feminino , Humanos , Técnicas Imunoenzimáticas , Masculino , Sensibilidade e Especificidade , Taenia/imunologiaRESUMO
Una de las actividades que realizan los programas de control de hidatidosis causada por Echinococcus granulosus en la Republica Argentina es la busqueda de portadores asintomaticos de quistes hidatidicos entre la poblacion general que habita las areas de risco, mediante un ensayo inmunoenzimatico (EIE) con antigeno de liquido hidatidico total (EIE-ALHT) que selecciona los posibles portadores. En base a la experiencia recogida se ha observado que dependiendo de la prevalencia del area, entre el 10 por cento y el 30 por cento de las personas seleccionadas por el EIE con valores de densidad optica (DO * DO + 4S no presentan imagens compatibles con quistes hidatidicos. El proposito del estudio fue mejorar la especificidad de la prueba. Con ese fin, se evaluo la influencia de la modificacion de la oferta antigenica y el efecto de la absorcion de los anticuerpos anti-componentes sericos ovinos y anti-fosforilcolina de los sueros en estudios, 114 sueros no hidatidicos seleccionados por su alto nivel de reacciones cruzadas en EIE-ALHTy 118 sueros hidatidicos se estudiaron frente a 4 fracciones antigenicas de liquido hidatidico ovino. El EIE que empleo la fraccion antigenica S2B conjuntamente con la absorcion previa de los sueros (EIE-S2B/A) fue el sistema que mejor discrimino los sueros hidatidicos de los no hidatidicos
Assuntos
Humanos , Equinococose/diagnóstico , Equinococose/epidemiologia , Equinococose/imunologia , Testes Sorológicos , Técnicas Imunoenzimáticas/métodos , Anticorpos Monoclonais/imunologia , Reações Antígeno-Anticorpo , Antígenos/imunologia , Argentina , Equinococose/cirurgia , Eletroforese em Gel de PoliacrilamidaRESUMO
An enzymoimmunoassay (EIE) as a screening test to select potential asymptomatic cyst carriers among the general population of areas under risk is being used in programs for the control of hydatic diseases caused by Echinococcus granulosus in Argentina. The experience obtained up to date, applying this assay in population surveys, indicates that depending on the prevalence in the area 10% to 30% of the individuals selected did not show images compatible with hydatic cysts. The purpose of the present study was to improve the specificity of the test. To this purpose, the influence of the modification of the antigenic availability and the effect of the absorption from the serum samples of antibodies anti-normal ovine sera and anti-phosphorylcholine was evaluated. One hundred and fourteen non hydatic sera selected because of their high cross reactivity in EIE using the whole hydatid antigen (WHA) and 118 hydatid sera, were studied with four fractions of ovine hydatid cyst fluid. The EIE employing the S2B antigenic fraction with previous absorption of the sera (EIE-S2B/A) was the system that discriminated better hydatid sera from non hydatid sera with high levels of cross reactivity. The replacement of the EIE employing WHA by the EIE-S2B/A system, for the active search of asymptomatic cyst carriers in field conditions, is proposed. The four antigenic fractions were analyzed by double diffusion and SDS-PAGE. The S2B fraction revealed a high content of parasitic components of less than 30 Kd which probably includes antigen B and subunits or fragments of antigen 5.
Assuntos
Portador Sadio , Equinococose/diagnóstico , Animais , Anticorpos Monoclonais , Antígenos de Helmintos/análise , Equinococose/prevenção & controle , Echinococcus/imunologia , Eletroforese em Gel de Poliacrilamida , Humanos , Técnicas ImunoenzimáticasRESUMO
In South America programs to control hydatidosis caused by Echinococcus granulosus include the active search for asymptomatic patients through population surveys for the detection of antibodies against arc 5 antigens using the double diffusion arc 5 test (DD5). Though simple to perform and highly specific, DD5 is not practical for population studies due to the time lapse between testing and receiving results. This work evaluates the application of an enzyme immunoassay to screen sera for subsequent processing using DD5. The efficiency of an enzyme immunoassay screening/DD5 confirmation scheme vs. DD5 alone was compared within the framework of a control program. A total of 5,839 sera from residents of endemic areas was processed and 47 hydatid patients were detected by both schemes. The proposed enzyme immunoassay identified all sera having antibody activity against arc 5 antigens detectable by DD5 and ruled out 95.3% of sera which tested by DD5 would have produced negative results.
Assuntos
Anticorpos Anti-Helmínticos/análise , Equinococose/diagnóstico , Echinococcus/imunologia , Técnicas Imunoenzimáticas , Animais , Estudos de Avaliação como Assunto , Humanos , Soros Imunes/imunologia , Imunodifusão , Reprodutibilidade dos TestesRESUMO
Programmes for the control of hydatidosis caused by Echinococcus granulosus in Argentina use an enzyme immunoassay (EIA) as a screening test for population surveys aimed at detecting asymptomatic patients. Persons thus selected are referred to health centres for the arc 5 double diffusion test and imaging techniques. One of the most costly procedures of these surveys is the collection of blood samples under field conditions; the possibility of collecting dry blood samples on filter paper was therefore investigated. In a survey of 497 rural inhabitants of an endemic area, the same number of hydatidosis cases (22) were identified by EIA using (i) serum samples and (ii) capillary blood samples obtained by finger prick and collected on filter paper. The latter system was both simpler and cheaper.
Assuntos
Equinococose/diagnóstico , Animais , Antígenos de Helmintos/análise , Preservação de Sangue , Coleta de Amostras Sanguíneas , Equinococose/imunologia , Echinococcus/imunologia , Ensaio de Imunoadsorção Enzimática , Humanos , ImunodifusãoRESUMO
En el presente estudio se describe la aplicación de pruebas estandarizadas para el diagnóstico inmunológico de la hidatidosis humana en el Instituto de Medicina Tropical "Daniel A. Carrión", Universidad Nacional Mayor de San Marcos, Lima, Perú. Estas se emplearon para obtener la conformación prequirúrgica de la parasitosis en situaciones clínicas, y para la detección de portadores asintomáticos de quistes hidatídicos mediante encuestas. Los resultados se utilizaron como fuente de datos para evaluar la calidad de la información que sobre el número de casos de la afección en distintas áreas ecológicas, se obtiene a partir de los casos hospitalarios notificados a los niveles oficiales. Los resultados demuestran la utilidad que puede brindar la extensión de la cobertura de los servicios para el inmunodiagnóstico de la hidatidosis a las áreas endémicas del país con fines de atención primaria y vigilancia epidemiológica. Esto permitiría obtener mejor información sobre el impacto que la contaminación ambiental por los huevos de Echinococcus granulosus produce en la población humana y medir los cambios que resultarían de la efectiva aplicación de medidas de control.
Assuntos
Masculino , Feminino , Humanos , Equinococose , Estudos Soroepidemiológicos , Testes ImunológicosRESUMO
The sequential development of the hydatid immunodiagnostic activities of the control program of the Province of Neuquén, Argentina is described. Test results were used to obtain immunological confirmation of clinical cases and to detect asymptomatic cyst carriers amongst residents of rural endemic areas. The information was also valuable for improving the accuracy of prevalence estimates of human hydatidosis and the quality of surveillance data in different areas of the Province, characterized by varying degrees of environmental contamination by Echinococcus granulosus. In population groups examined by radiologic and immunologic methods, the latter detected more cases. When only immunodiagnostic surveys were carried out, mostly liver but also pulmonary hydatidosis cases were detected. This experience illustrates the advantages which may be obtained in endemic areas through the local application of hydatid immunodiagnosis based on arc 5 positivity.
Assuntos
Equinococose/diagnóstico , Imunodifusão , Imunoeletroforese , Adolescente , Adulto , Argentina , Portador Sadio/diagnóstico , Criança , Pré-Escolar , Equinococose/epidemiologia , Equinococose/prevenção & controle , Equinococose Hepática/diagnóstico , Equinococose Pulmonar/diagnóstico , Humanos , Lactente , Testes de Fixação do LátexRESUMO
More hydatidosis cases were detected in an immunodiagnostic survey of rural schoolchildren from an endemic area in Argentina by the arc 5 double diffusion (DD5) test than by indirect hemagglutination (IHA) and latex agglutination (LA) tests. Evidence of infection was obtained by clinical, radiologic, echographic, and/or computerized axial tomography examinations in only one of three DD5-negative individuals, and in 2 of 4 students showing a questionable reaction of identity with arc 5 in DD5, who were positive in LA and/or IHA. In contrast, cysts could be demonstrated in all DD5-positive cases, whether positive or negative in the agglutination procedures. These cysts in DD5-positive cases included the smallest cysts (1-1.2 cm wide) detected in surveys to date. Comparison of data obtained in the immunodiagnostic survey and in a review of hospital records was used to assess the relative contribution of each method in estimating the prevalence of infection. The findings are discussed in terms of the advantages and limitations of carrying out immunodiagnostic surveys of residents of endemic areas for purposes of primary medical care and surveillance.