Dr. Murai Éva szerk.: Parasitologia Hungarica 11. (Budapest, 1978)

at least one species-specific component for E. granulosus has been isolated (BOUT et al., 1974). Of all the serologic procedures used, all but the ELISA test have been evaluated by several groups in different endemic areas. The sensitivity of diagnostic tests increases when more than one procedure is used. The tests currently recommended for the diagnosis of hydatid disease are either IHAT or LAT as the primary test and IEP, DDG, or CEP as the confirming test. For evaluating the efficiacy of operation in the removal of hydatid cysts, the CFT and IFT are best, and if sequential sera are available, the IEP can be used. The IDT, when carefully used with adjusted antigens in a standardized test, may also serve as an effective epidemiologic tool. For best results, however, both skin and serologic tests should be done. Table 1 Complement Fixation Test (CFT) BRADSTREET (1969) Reviewed 10 years of experience inEngland with the CFT and the intradermal test (IDT) between 1957 and 1967. Evaluating 101 proven cases of hydatid disease, the CFT was 93% sensitive at a titer of 1:2 or greater; the specificity of the test, however, was only 84% since 14 of 90 normal individuals had titers of 1:2 or greater. The CFT diminished to negative after 5 years in most of the 37 patients followed. On some patients, titers in the CFT persisted for 8 to 10 years. MOCHMANN, HERING (1970) Employed the CFT for diagnosis between 1951 and 1962. Among 2 000 specimens tested 18 of 40 from known cases were positive. A number of cases are described in detail. GARABEDIAN (1971) Evaluated whole scolex antigen initially developed for CFT in the IHAT. The antigen was more sensitive in the IHAT (83%) than in the CFT (66-74%). LITTLE (1976) In a review of cases in Australia over a ten year period the sensitivity of the CFT was 52% and the IDT, 67%. HESS, ECKERT, FRÖHLICH (1974) Compared the CFT, IHAT, and IFT in 36 proven cases of E. granulosus (Eg) and 16 proven cases of E. multilocularis (Em) infections. The sensitivity of the CFT for Eg was 77% and for Em 36%; for IHAT, 94% and 100%; and for IFT, 89% and 100%. Nonspecific reaction in normal individuals was 2% in the CFT, 1% in the IHAT, and 6% in the IFT. Table 2 Indirect hemagglutination Test (IHA) de ROSA, PUCCINI, SIMONE (1970) Testing sheep sera, found a sensitivity of 70% and a specificity of 88%. APT, KNIERIM (1970) Evaluated the IHAT and IDT on 208 patients with hydatid infection. The IHAT had the higher sensitivity and specificity. WILLIAMS, PREZIOSO (1971) Employed gluteraldehyde treated cells. PAULUZZI, de ROSA, DOTTORINI (1971) Correlated 120 samples of human and animal cyst fluid for reactivity in the IHAT with protein content. In general, the higher the protein content in the cyst fluid, the more antigenic in the test. MATOSSIAN, KANE (1971) After stabilizing human or sheep erythrocytes with pyruvic aldehyde and sensitizing them with hydatid antigen, found the cells could be stored by lyophilization. KNIERIM, ESKUCH (1971) Evaluated a rapid slide hemagglutination procedure. KNIERIM, MUNOZ, ESCUCHE, SANDOVAL, RAMIREZ (19 71) Compared a rapid slide IHAT, a tube IHAT, and a bentonité flocculation test. Specificity ranged from 64 to 72% and nonspecificity from 3 to 8%. STEPANKOVSKAIA (1972) Compared IHAT with the LAT. The IHAT was superior.