Serodiagnosis of human cysticercosis for epidemiological studies in low-income countries is the ELISA "screening" strategy accurate
Résumé
Background: Serodiagnosis of cysticercosis uses two serological tests, ELISA and Western blot, which are carried on sequentially.
Only the samples positive in Elisa are confirmed with Western blot. The objective of this study was to assess the agreement between
the ELISA and Western blot to evaluate false negative generate by ELISA alone. Methods: This is a retrospective study conducted
on samples randomly drawn at random from a serum bank constituted during two cross-sectional surveys carried out in the
departments of Dabou and Agboville, in the south of Côte d'Ivoire. These two sero-epidemiological studies were conducted on
randomly selected asymptomatic subjects. The sera selected for this ancillary study were all tested using both native antigen Elisa
and western blot methods. Western blot (EITB) was used as reference test. Sensitivity, specificity, false positive and false negative
rates of the Elisa test were determined against EITB results. Results: A total of 594 sera (297 positives / 297 negatives in ELISA),
were tested by Western blot. The sensitivity and specificity of the ELISA were 82.6% and 79.5%, respectively. The false negative
and false positive rates of ELISA were 16.5% and 21.6%, respectively. A strong agreement was observed between these two tests
with a Cohen's Kappa value equal to 0.62. Conclusion: These data reveal that the Elisa test alone is not sufficient for the
serodiagnosis of cysticercosis. When used for diagnosis in symptomatic patient, ELISA alone is not sufficient to avoid the
diagnostic. Elisa-negative patient who presents a critical clinical picture must be tested by Western blot.
Domaines
Parasitologie
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