Echinococcus multilocularis enfeksiyonu açısından yüksek risk altındaki bireylerde alveolar echinococcosis araştırılması
Küçük Resim Yok
Tarih
2003
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Ege Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/closedAccess
Özet
7. ÖZET Echinococcus multilocularis' \r\. metasestod evresinin insanlarda neden olduğu Alveolar Echinococcosis (AE) hastalığı ülkemizin en sık Doğu ve Güneydoğu Anadolu Bölgesi'nde görülmektedir. Güneydoğu Anadolu Bölgesi'nde bulunan Diyarbakır, Batman, Siirt ve Mardin illerine bağlı dağ köylerinde yaşayan 485 kişiyi ve Dicle Üniversitesi Tıp Fakültesi Kan Merkezi'ne başvuran 250 kan donörünü kapsayan çalışmamızda, Ekim 2001 - Ekim 2002 tarihleri arasında kişilerden alman kan örnekleri ELISA ve Western Blot yöntemleri kullanılarak anti-E. multilocularis antikorlarının varlığı yönünden araştırılmıştır. 485 kişiden 17'si (%3.5) Em2-ELISA ile pozitif olarak değerlendirilmiş ve kontrol grubunu oluşturan kan donörlerinde pozitiflik saptanmamıştır. İstatistiksel değerlendirmelerde aradaki fark anlamlı bulunmuştur (PO.05). Em2 -pozitif hastalardan yalmzca bir tanesi ayrıca EmII/3-10-ELISA testi ile pozitif olarak değerlendirilmiştir. EgHF-WB ve EmC-WB yöntemleri ile spesifik bantlarda pozitiflik saptanan olguda, görüntüleme yöntemleriyle karaciğer lezyonu ve beyin metastazı saptandı. Beyin metastazı nedeniyle öpere edilen hastanın tanısı histopatolojik olarak doğrulanmıştır. Çalışma ve kontrol grubundaki bireylerin, E. multilocularis yumurtaları ile kontaminasyon riskini artıran tilki ile temas, köpek sahipliği, yabani ot-meyva yeme alışkanlığı ve yaşam alam gibi faktörleri ile Em2-seropozitivitesi arasındaki ilişki araştırılmıştır. Tilki ile yüksek temasın Em2-pozitifliği ile anlamlı şekilde ilişkili olduğu bulunmuştur (PO.05). Diğer risk faktörlerinin çalışma grubundaki seropozitivite ile ilişkisi anlamlı değildi. Çalışma ve kontrol grubu beraber değerlendirildiğinde, tüm risk faktörlerinin istatistiksel olarak anlamlı olduğu bulunmuştur. Araştırmamızda kullanılan ELISA yöntemlerinin sensitivite ve spesifitesi değerlendirilmiş, EgHF-ELISA'mn en yüksek sensitivite (%100) ve en düşük spesifiteye (%67), Em2-ELISA'nın en yüksek spesifiteye (%96) sahip olduğu bulunmuştur. Em2-ELISA ve EmII/3-10-ELISA beraber değerlendirildiğinde spesifitenin %100 olduğu görülmüştür. Sonuç olarak; AE tanısında yüksek spesifite gösteren Em2-ELISA ve EmıI/3-10- ELISA'mn ülkemiz gibi AE açısından endemik olan bölgelerde güvenilir tam yöntemleri olarak kullanılabilir. 117
8. SUMMARY Alveolar Echinococcosis (AE), which is caused by the metacestode stage of Echinococcus multilocularis, is most prevalent in Eastern and South-Eastern Regions of our country. In our study, blood samples collected from 485 participants inhabiting in the villages of Diyarbakır, Batman, Siirt and Mardin provinces located in South-Eastern Regions and 250 blood donors appealed to the Blood Center of Dicle University School of Medicine between October 2001 -October 2002, were examined for the presence of anti-E.multilocularis antibodies by ELISA and Western Blotting. Seventeen out of 485 individuals were considered to be positive in Em2-ELISA and none of the blood donors in the control group showed positivity. The difference was statistically significant (PO.05). Among the Em2-ELISA positive subjects, one was also positive for EmII/3- 10-ELISA. This individual showed positivity in specific bands of EgHF-WB and EmC- WB and hepatic lesion with cranial methastasis were detected by imaging procedures. The patient was subsequently operated for cranial methastasis and the diagnosis was confirmed by histopathologic examination. The association between Em2-seropositivity and the potential factors increasing the contamination risk with E. multilocularis eggs, such as contact with the foxes, dog ownership, eating of wild berries and herbs and living in rural areas, were investigated. Contact with the foxes was found to be significantly related to Em2-seropositivity (PO.05). The relation of the other risk factors with seropositivity was not significant. The all risk factors were found to be significant when the study and the control group considered together. The sensitivity and specificities of ELISA tests used in our study were evaluated and EgHF-ELISA showed the highest sensitivity (%100) but the lowest specificity (67%), whereas Em2-ELISA has shown the the highest specificity (96%). When Em2- ELISA and EmII/3-10-ELISA were considered together, the specificity was found to be 100%. As a conclusion; Em2- and EmII/3-10-ELISAs, which represent the highest specificity in the diagnosis of AE, are reliable diagnostic tools in endemic areas such as our country. 118
8. SUMMARY Alveolar Echinococcosis (AE), which is caused by the metacestode stage of Echinococcus multilocularis, is most prevalent in Eastern and South-Eastern Regions of our country. In our study, blood samples collected from 485 participants inhabiting in the villages of Diyarbakır, Batman, Siirt and Mardin provinces located in South-Eastern Regions and 250 blood donors appealed to the Blood Center of Dicle University School of Medicine between October 2001 -October 2002, were examined for the presence of anti-E.multilocularis antibodies by ELISA and Western Blotting. Seventeen out of 485 individuals were considered to be positive in Em2-ELISA and none of the blood donors in the control group showed positivity. The difference was statistically significant (PO.05). Among the Em2-ELISA positive subjects, one was also positive for EmII/3- 10-ELISA. This individual showed positivity in specific bands of EgHF-WB and EmC- WB and hepatic lesion with cranial methastasis were detected by imaging procedures. The patient was subsequently operated for cranial methastasis and the diagnosis was confirmed by histopathologic examination. The association between Em2-seropositivity and the potential factors increasing the contamination risk with E. multilocularis eggs, such as contact with the foxes, dog ownership, eating of wild berries and herbs and living in rural areas, were investigated. Contact with the foxes was found to be significantly related to Em2-seropositivity (PO.05). The relation of the other risk factors with seropositivity was not significant. The all risk factors were found to be significant when the study and the control group considered together. The sensitivity and specificities of ELISA tests used in our study were evaluated and EgHF-ELISA showed the highest sensitivity (%100) but the lowest specificity (67%), whereas Em2-ELISA has shown the the highest specificity (96%). When Em2- ELISA and EmII/3-10-ELISA were considered together, the specificity was found to be 100%. As a conclusion; Em2- and EmII/3-10-ELISAs, which represent the highest specificity in the diagnosis of AE, are reliable diagnostic tools in endemic areas such as our country. 118
Açıklama
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Anahtar Kelimeler
Parazitoloji, Parasitology
