Serological diagnosis in hydatidosis: Searching standardized antigenic support. Systematic review and meta-analysis

Abstract

Background: Hydatidosis is a worldwide distributed parasitic zoonosis caused by Echinococcus granulosus s.l. In humans, the diagnosis is based on epidemiological nexus, clinical findings, ultrasound images, and second-line serology. Hydatid fluid is the most widely used source of antigens in serology, but it shows high variability. This review analyzes the diagnostic utility of serology for the diagnosis of hydatidosis, particularly ELISA and Western Blot techniques. Material and methods: Systematic review and meta-analysis of studies with data of diagnostic validity. The reference diagnosis was ultrasound and / or parasitological medical finding. The reproducibility in the studies selection and data extraction was guaranteed, the quality was evaluated according to the QUADAS-2 guide, global results and SROC were obtained under a random effects model in Meta-Disc1.4. Results: Forty-one articles published between 1981 and 2019 were included. Elisa was performed in 33 articles; Western Blot was performed in 14 articles and some of the articles included both techniques. The included articles presented high heterogeneity. The SROC parameters were AUC = 0.9511 and Q=0.8919 for ELISA and AUC=0.9693 and Q = 0.9186 for Western Blot. Conclusion: ELISA and Western Blot have good diagnostic accuracy.