Evaluation of excretory / secretory fasciola [Fhes] antigen in diagnosis of human fascioliasis

The parasitological diagnosis of human fascioliasis based on the demonstrations of the eggs in stool, duodenal contents or bile is usually unsatisfactory due to false passage of eggs, ectopic fascioliasis and failure of immature worm to maturation. So, ELISA- Fhes antigen [Fasciola hepatica excretory/secretory] and IHAT were evaluated in the immunodiagnosis of parasitologically proven cases of human fascioliasis compared with proven cases of human Schistosomiasis mansoni and parasite-free individuals. ELISA-Fhes gave 100% sensitivity and 100% specificity. On the other hand, IHAT was less sensitive and less specific

review on fascioliasis in Egypt

In this study, two clinical stages in human fascioliasis were recognized. An acute stage coincided with the larval migration and worm maturation in the hepatic tissue and a chronic stage coincided with the persistence of Fasciola worms in the bile ducts. Human infection with fascioliasis was very sporadic until the last three decades where the clinical cases and outbreaks were reported. The total estimated number of people infected with fascioliasis is 2.4 million in 61 countries and that the number of people who are at risk is more than 180 million all over the world. Human fascioliasis has to be differentially diagnosed from some diseases as acute hepatitis, infection with other liver flukes as schistosomiasis, visceral toxocariasis, biliary tract diseases and hepatic amoebiasis

Clinico-epidemiological study of human fascioliasis in an endemic focus in Dakahlia governorate, Egypt

Human fascioliasis is increasing in the Nile Delta particularly in Dakahlia Governorate, where it reached 7.47%. In this study, the tetrad of fascioliasis was established as high eosinophilia [100%] fever [85.6%], painful hepatomegaly [81.93%] and anaemia [100%]. The laboratory results showed ESR accelerated in 87%, ALT elevated in 21.5%. AST elevated in 21.9%. S. bilirubin elevated in 16.5%, gamma GT elevated in 80.6% and SAP elevated in 76.4%. Abdominal ultrasonography showed variable findings, as hepatomegaly, splenomegaly, periportal fibrosis, thickened wall of gall bladder, dilated common bile duct, dilated biliary radicals [partial], dilated common bile duct and biliary radicals [total], Fasciola worms in gall bladder, Fasciola worms in common bile duct, stones in gall bladder, stones in bile duct, cystic lesions in the liver, focal lesions in the liver and ascitis. The highest was hepatomegaly in 81.93% of fascioliasis patients and the lowest was biliary dilated radicles [partial] in 0.26%