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Added value of antigen ELISA in the diagnosis of neurocysticercosis in resource poor settings

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dc.contributor.author Gabriël, S.
dc.contributor.author Blocher, J.
dc.contributor.author Dorny, P.
dc.contributor.author Abatih, E. N.
dc.contributor.author Schmutzhard, E.
dc.contributor.author Ombay, M.
dc.contributor.author Mathias, B.
dc.contributor.author Winkler, A. S.
dc.date.accessioned 2012-12-14T10:18:06Z
dc.date.available 2012-12-14T10:18:06Z
dc.date.issued 2012
dc.identifier.issn 1935-2727
dc.identifier.doi http://dx.doi.org/10.1371/journal.pntd.0001851
dc.identifier.other ITG-B1B
dc.identifier.other ITG-B3A
dc.identifier.other ITG-B4B
dc.identifier.other DBM
dc.identifier.other U-VHELM
dc.identifier.other U-VEPID
dc.identifier.other JIF
dc.identifier.other DOI
dc.identifier.other FTA
dc.identifier.other E-only
dc.identifier.other Abstract
dc.identifier.other UPD53
dc.identifier.uri http://hdl.handle.net/10390/7256
dc.description.abstract BACKGROUND: Neurocysticercosis (NCC) is the most common cause of acquired epilepsy in Taenia solium endemic areas, primarily situated in low-income countries. Diagnosis is largely based upon the "Del Brutto diagnostic criteria" using the definitive/probable/no NCC diagnosis approach. Neuroimaging and specific T. solium cysticercosis antibody detection results are at the mainstay of this diagnosis, while antigen detection in serum has never been included. This study aimed at evaluating the addition of antigen detection as a major diagnostic criterion, especially in areas where neuroimaging is absent. METHODS: The B158/B60 monoclonal antibody-based enzyme-linked immunosorbent assay (ELISA) for the detection of circulating cysticercus antigen was carried out retrospectively on serum samples collected during a hospital-based study from 83 people with epilepsy (PWE) in an endemic area. RESULTS: The addition of antigen results as a major criterion allowed the correct diagnosis of definitive NCC in 10 out of 17 patients as opposed to 0/17 without antigen results in the absence of neuroimaging. A sensitivity of 100% and a specificity of 84% were determined for the diagnosis of active NCC using antigen ELISA. While the use of a higher cutoff improves the specificity of the test to 96%, it decreases its sensitivity to 83%. CONCLUSIONS: In areas where neuroimaging is absent, NCC diagnosis according to the existing criteria is problematic. Taking into account its limitations for diagnosis of inactive NCC, antigen detection can be of added value for diagnosing NCC in PWE by supporting diagnostic and treatment decisions. Therefore, we recommend a revision of the "Del Brutto diagnostic criteria" for use in resource poor areas and suggest the inclusion of serum antigen detection as a major criterion. en
dc.language English en
dc.subject Animal diseases en
dc.subject Helminthic diseases en
dc.subject Zoonoses en
dc.subject Neurocysticercosis en
dc.subject Taenia solium en
dc.subject Epilepsy en
dc.subject Diagnosis en
dc.subject Evaluation en
dc.subject Comparison en
dc.subject Clinical examination en
dc.subject CT-scanning en
dc.subject Antibody detection en
dc.subject Serum en
dc.subject Antigen detection en
dc.subject ELISA en
dc.subject Specificity en
dc.subject Sensitivity en
dc.subject Neuroimaging en
dc.subject Cysts en
dc.subject Tanzania en
dc.subject Africa, East en
dc.title Added value of antigen ELISA in the diagnosis of neurocysticercosis in resource poor settings en
dc.type Article-E en
dc.citation.issue 10 en
dc.citation.jtitle PLoS Neglected Tropical Diseases en
dc.citation.volume 6 en
dc.citation.pages e1851 en
dc.identifier.pmid http://www.ncbi.nlm.nih.gov/pubmed/23094118
dc.citation.jabbreviation PLoS Negl Trop Dis en


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