Prevalence of Echinococcus granulosus in Southern Libya: (Immuno-epidemiological Study)

Abstract

Human cystic hydatidosis due to infection with the larval stage of Echinococcus granulosus is a serious public health problem in many countries. The disease is highly endemic in Libya, with previous studies that concentrated on the north-east, north-central and north-west. This is cross-sectional and community-based study aimed at determining the prevalence of Echinococcus granulosus in Murzuk province in southern Libya. Following informed consent a total of 1274 individuals from 25 villages in the province were interviewed and screened serologically. ELISA (Gold-standard) and a devised Latex agglutination (devised) techniques were used to detect anti-echinococcal antibodies. Biochemical profiles of the sera were examined using Reflotron Machine (Blood dry chemistry). Demographic and laboratory data were entered, checked and verified using the EpiInfo 2004 software package. Twenty nine individuals (29/1274; 2.3%) were sero-reactive using ELISA techniques. The seroprevalence was significantly different between different areas of the province and ranged from 1.9% to 4.1% (p=0.0006). The Latex agglutination technique was positive in 28/1274 individuals. Females constituted 68.0% of sero-reactive group [Female:Male=20:9] (p=0.008). Sero-reactive individuals has normal urea, creatinine (p>0.05). AST, ALT and alkaline phosphatase were universally increased (p=0.0000). The seroprevalence was commonly seen in the age group 7-50 years (p=0.006). The sensitivity, specificity, positive predictive value and negative predictive value of the Latex were 96.6%, 99.9%, 95.8% and 99.9% respectively. In conclusion: Echinococcus granulosus infection is prevalent in Southern Libya with a prevalence that ranges from 1.9% to 4.1%. The devised Latex agglutination is easy to prepare and cheap test showed high sensitivity, specificity, positive predictive and negative predictive values. The exposure rates was 6.8%.