Long shelf-life of antigen-sensitised erythrocytes by double aldehyde stabilisation for the serodiagnosis of amoebiasis by indirect haemagglutination.
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Biomedical subjects
Publications and source records attributed to S C Parija.
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A serological survey was carried out to determine the frequency of distribution of hydatid antibodies in Pondicherry during 1981 to 1984. 1325 apparently normal sera and 109 sera from clinically suspected hydatid disease cases were screened by the indirect haemagglutination (IHA) test. Results showed a diagnostic titre of 1:128 or higher in 6 normal sera and 27 sera of suspected hydatid cases. An antibody titre of 1:64 was observed in 8.17 per cent of the sera screened by this test.
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An indirect haemagglutination (IHA) test was performed with chick red blood cells (RBC) on sera from 26 confirmed cases of echinococcosis and 45 control sera. The results were compared with those obtained in an IHA test with sheep RBC on the same batches of sera; both tests were equally sensitive. The chick cells settled quickly and the results could be determined within 30-45 min. Heterophilic antigen was not a problem. This study also showed that chick cells stabilised by the double-aldehyde method, could be sensitised with the antigen and then stored at 4 degrees C for up to 31 days before use in the IHA test without loss of sensitivity. The use of sensitised double-aldehyde stabilised (DAS) chick cells in IHA tests provides a rapid diagnostic test in echinococcosis.
A modification of the indirect haemagglutination test is described for the serodiagnosis of echinococcosis. In the modified test the Cowan I strain of Staphylococcus aureus, which contains protein A, was used to enhance haemagglutination of sensitised red cells. The test was performed in parallel with the indirect haemagglutination test on 31 sera from surgically-confirmed cases of hydatid disease and on 45 sera from healthy blood donors. Use of S. aureus protein A enhanced the sensitivity of the test and greatly increased the titres obtained with most of the sera. None of the sera from healthy blood donors exhibited a titre greater than 64, whereas all but two of the sera from cases of hydatid disease exhibited titres greater than 128. The immunoassay is simple, inexpensive and requires little technical skill. It has the potential for wide application in the serodiagnosis of echinococcosis.
We have evaluated the use of sheep red-blood cells stabilised in various ways in indirect haemagglutination tests on the sera of 21 surgically confirmed cases of echinococcosis, and on control sera. Tests with Double-Aldehyde-Stabilised cells-treated sequentially with pyruvic aldehyde, tannic acid and glutaraldehyde-were more sensitive than tests with the cells treated only with formaldehyde, glutaraldehyde or pyruvic aldehyde, and subsequently tanned.
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An analysis of hospital and laboratory records for the period of 1971-1979 revealed 45 confirmed cases of hydatid disease. The majority were young adult (21-30 years) labourers. The commonest site of lesion was lower lobe of the left lung with the liver occupying second place. A few uncommon sites of involvement were also observed. Casoni's test was positive in 48% of cases. Eosinophilia was a usual associated finding. This report shows Pondicherry to be endemic for hydatid disease.
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Neurocysticercosis (NCC) is an important zoonotic infection, and a significant cause of morbidity and mortality in India. Immunodiagnosis plays an important role in the early, rapid, and specific diagnosis of the condition. The aim of the present study was to detect specific cysticercal antigen excreted in the urine for the diagnosis of NCC. The objective was to develop and evaluate staphylococcal Co-agglutination (Co-A) test for the detection of urinary cysticercal antigen. In the present study, urine samples were collected from 9 cases of clinically suspected NCC, 8 cases of CT/MRI proven cases of NCC, 11 of non-cysticercal CNS infection controls, and 25 healthy control subjects. Polyclonal antisera raised in rabbits against porcine complete cysticercus homogenate antigen, was used in the Co-A test to detect cysticercal antigen. The Co-A detected excreted cysticercal antigen in the urine of five of nine (55.5%) clinically diagnosed NCC and in five of eight (62.5%), CT/MRI proven cases of NCC. A false positive reaction was observed with 1 of 11 (9%) of control urine specimens from non-cysticercal CNS infection controls. No false positivity was demonstrated with 25 urine samples collected from healthy controls. Results of the present study shows that the Co-A test can be employed as a moderately sensitive and specific test for detection of urinary antigen in the diagnosis of NCC in poorly equipped laboratories.
The co-agglutination (Co-A) procedure was standardized and evaluated to detect hydatid antigen in fluid samples aspirated from hydatid cysts. Samples were collected from 14 hydatid cysts in different organs (liver, 7; lung, 5; multiple abdominal cysts, 1; and kidney, 1) by surgery. Echinococcus granulosus scolices and hooklets were seen in only 6 (42.85%) samples by routine microscopy. In contrast, hydatid antigen was demonstrated in all the samples by Co-A (100% sensitivity). Co-A could be employed as a simple and rapid diagnostic procedure, as an alternative to microscopy, to confirm the hydatid aetiology of a suspected cyst.
The clinical features and surgical management of 240 cases of liver abscess admitted during a period of five years are presented. Incidence of liver abscess was 0.20 per cent of hospital admissions. A peak age incidence in the 4th decade, male preponderance, pain and fever were the striking features. The majority of the abscesses were localised to a single lobe (90.0%). The abscess was sited in the right lobe in 75.1 per cent, in the left lobe in 18.3 per cent and in both lobes in 6.7 per cent. Elevation and limitation of movement of the right dome of the diaphragm was present in 89.5 per cent of cases. Depending upon therapeutic response, aspiration or/and surgical drainage was undertaken. Aspiration was done in 169 patients and surgical drainage in 63 patients. Management of pyogenic liver abscess included early operative intervention preceded by appropriate antibiotic therapy. Surgical intervention is required less often in amoebic abscess and is recommended only after amoebicidal therapy. Open drainage is recommended for the cases associated with complications, left lobe abscess and big abscess.
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