BANCROFTIAN FILARIASIS: DIAGNOSTIC TOOLS
Manal Z.M. Abdel-Latif1, Tarek K.H. Zaalouk2, Gamal A. Abosheashaa2, Mohamed S. El-Faramawy2 and Mohamoud Abdel –Aziz3
Departments of Parasitology, Faculties of Medicine, Minia1, Al-Azhar2 Universities Department of Tropical Medicine, Mansoura University3
Background: Human filariasis constitutes one of the public health problems in Egypt with highest incidence in the Eastern part of Nile Delta. The most common method of diagnosis by night blood film for microfilaraemia, but this method is not sensitive since microfilaraemia may not be present in the early and late stages of the disease. With recent advances in immunology, a number of immunodiagnostic tests utilizing homologous and heterologous antigens are used in diagnosis of filariasis. Aim: The aim of this work was to study the role of molecular and immunological diagnosis of bancroftian filariasis regarding sensitivity and specificity. Metholodolgy: Serodiagnosis to detect antifilarial antibodies and filarial antigenaemia and Polymerase chain raction (PCR) for detection of filarial DNA Conclusion: There was significant relation between PCR and IgG, IgM, OD, Lymphoedema and Microfilariae. There was significant relation between age and Microfilariae/ml. IgG and antigenaemia were significantly higher in Lymphoedema patients. The antigen detection recorded a sensitivity of 59.3%, while PCR recorded a sensitivity of 33.3% and microfilariae recorded a sensitivity of 20.4%. Specificity was equal for all the three tests (100.0%). It means that all tests had a good negative index, i.e. any of them can exclude negative cases, while the antigen detection had the better ability to discover the positive cases up to 59.3% Recommendations The recent use of assays to detect circulating filarial antigen has shown that active infection may be much more common in children. So, they must be considered as an important target during any control programmers. Use of real time PCR in diagnosis is more accurate than other measures. Transmission control programmes protect future generations from the consequence of lymphatic filariasis . However, morbidity control in persons who are currently infected and at risk of developing (or already developed) a wide range of debilitating disease syndromes associated with lymphatic damage is also very important.
December 2011