Comparison of İHA, ELISA and immunochrotographic methods in the diagnosis of patients with cystic echinococcis

Cystic echinococcosis is a zoonotic infection caused by E. granulosus, which is seen in countries where agriculture and animal husbandry are common. The disease is frequently encountered in Turkey, especially in the Eastern and Southeastern Regions and Central Anatolia. Radiological imaging methods such as ultrasonography and computed tomography are very successful in the diagnosis of cystic echinococcosis. The diagnosis of the disease is mainly based on these imaging techniques, which are confirmed by serological methods. In this thesis study, it was aimed to compare three different serological methods in patients who underwent radiological evaluation due to clinical suspicion. In the study, the data of the patients sent to Necmettin Erbakan University Faculty of Medicine Medical Microbiology laboratory with the suspicion of cystic echinococcosis were scanned through the automation system and those who were requested at least one of the radiological imaging methods such as simultaneous ultrasonography, computed tomography and/or magnetic resonance imaging were included in the study. Serum samples from a total of 80 patients were taken and examined by Indirect Hemagglutination Test (IHA), Enzyme-Linked Immunsorbent Assay (ELISA) and immunochromatographic methods, and the results of three different serological methods in the diagnosis of cystic echinococcosis and radiological imaging results were compared. In 80 patients included in the study, 77,5% positivity was found with radiological imaging methods, 80% positivity with ELISA, 58,8% positivity with IHA, 37,5% positivity with immunochromatographic method. While 30 of the patient samples were found positive by all three serological methods, 16 patients were found to be negative by all three serological methods. The consistency between the diagnostic methods used was statistically evaluated with the Cohen's kappa results. The highest level of agreement with the radiological assessment was found in the ELISA test and reported as 'significant agreement'. While the agreement between IHA and radiological evaluation was 'moderate agreement', the agreement between the immunochromatographic method and radiology was found to be 'poor agreement'. When we evaluated the serological diagnosis methods within themselves, IHA and ELISA were calculated as 'moderately compatible'. When radiological evaluation is taken as the reference method, the method with the highest sensitivity among serological methods is ELISA (93,6%), the method with the highest specificity is IHA and immunochromatographic test (72,2%). The ELISA method had the highest positive and negative predictive value (90,6% and 75%, respectively). In the results of the study, the serological method with the highest agreement with radiology was found to be the ELISA method. It was concluded that it would be appropriate to confirm the radiological findings with at least two serological methods in the diagnosis of cystic echinococcosis, especially in patients with high clinical suspicion. Keywords: Cystic echinococcosis, Echinococcus granulosus, ELISA, IHA