Abstract
Diagnosis of cystic echinococcosis (CE) in sheep is essentially based on necropsy findings. Clinical symptoms can be easily overlooked, while the use of immunological tests is still not recommended for an intra vitam diagnosis. This study assessed the performances of three post-mortem laboratory methods in the diagnosis of ovine CE. In the absence of a single and accurate test as a gold standard, the results of multiple analytical tests can be combined to estimate diagnostic performance based on a Bayesian statistical approach. For this purpose, livers (n = 77), and lungs (n = 79) were sampled from adult sheep and examined using gross pathology, histopathology and molecular analyses. Data from the three diagnostic methods were analyzed using a Bayesian latent class analysis model to evaluate their diagnostic accuracy in terms of sensitivity (Se), specificity (Sp), positive predictive value (PPV) and negative predictive value (NPV). The gross pathology examination revealed excellent diagnostic capabilities in diagnosing ovine CE with an Se of 99.7 (96.7–99.8), Sp of 97.5 (90.3–99.8), PPV of 97.6 (90.5–100), and NPV of 99.7 (96.5–100). The experimental design used in this work could be implemented as a validation protocol in a quality assurance system.
Highlights
Cystic echinococcosis (CE) is a globally-distributed zoonosis caused by the larval form of Echinococcus granulosus sensu lato (s.l.)
GP, gross pathology; H, histopathology; Molecular Analysis (MA), molecular analysis. * Histopathology (H) was assumed to be negative since it was not performed on samples negative on gross pathology
This study aimed to evaluate the diagnostic performance of three post-mortem laboratory methods in the diagnosis of cystic echinococcosis (CE) in sheep
Summary
Cystic echinococcosis (CE) is a globally-distributed zoonosis caused by the larval form of Echinococcus granulosus sensu lato (s.l.). Due to its severe clinical implications, human CE is considered a public health concern worldwide. The E. granulosus s.l. life cycle includes definitive (wild and domestic carnivores) and intermediate hosts (wild and domestic ungulates). Definitive hosts cause environmental contamination with parasite eggs shed in the feces, which are ingested by intermediate hosts and develop into larvae or metacestodes (hydatids). Metacestode encystment within infected organs can cause clinical problems associated with the growth and localization of the hydatid cysts, most frequently occurring in the liver and lungs. Humans are considered aberrant intermediate hosts, acquiring the infection by accidental ingestion of eggs.
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