Human toxocariasis is a zoonotic infection with global and regional impacts. Worldwide it is underestimated and clinically overlooked. Medical practitioners are generally unaware of the extent of the resulting disease spectrum. The objective of the study was to assess knowledge and disease awareness among medical practitioners in Aseer, south-western Saudi Arabia. A questionnaire addressing knowledge about the parasite, its visceral larva migrans and the disease spectrum generated was used to interview participants. The study included 285 participants. In answer to the question what is toxocara, only 27%, answered correctly that it is a nematode, paediatricians being the majority. With regard to years of experience among participants, 56.8% of those who answered correctly had less than 5-year experience, as opposed to 35.4% for those with more than 10-year experience. The cumulative awareness about the disease manifestations and spectrum, i.e. those who knew, was less than 30% across specialties and years of experiences. Lack of awareness regarding Toxocara infection and the disease spectrum it can generate is evident. The consequence for such lack of knowledge within our practising medical community is simply unacceptable as it might translate into misdiagnosis and consequently misguided treatment.

Donated blood must be evaluated for the presence of transfusion transmitted infections (TTIs). In this study, we aimed to determine the prevalence of TTIs among blood donors in order to study the epidemiology of these organisms in the study population. We retrospectively reviewed the records of all subjects who donated blood at the Central Blood Bank in Abha, Saudi Arabia, during 2017, 2018 and 2019. All TTIs in these subjects were recorded by year and determined if they were a normal blood donor or someone donating blood for a friend or family member. The lab tests recorded to detect TTIs were: antibodies against hepatitis B virus core antigen (anti-HBc), antibodies against hepatitis B surface antigen (anti-HBsAg), antibodies against hepatitis C virus (anti-HCV), antibodies against human immune deficiency virus types 1 and 2 (anti-HIV1&2), antibodies against human T-lymphotropic virus types 1 and 2 (anti-HTLV-1&2), hepatitis B surface antigen (HBsAg), Treponema pallidum hemagglutination test (TPHA) to detect syphilis and a malarial antigen (Malaria Ag) rapid detection test. A total of 25,253 subjects were included in the study; 99.39% (n = 25,098) male; 10.98% of subjects (n = 2,772) had a positive TTI test, of whom 47.01% (n = 1,303) were voluntary blood donors and 52.99% (n = 1,469) were replacement donors. The prevalences of positive TTI tests were: 5.91% (n = 1,492) for Anti-HBC, 4.56% (n = 1,151) for Anti-HBsAg, 0.48% (n = 121) for HBsAg, 0.01% (n = 3) for Anti-HCV, 0.01% (n = 2) for Anti-HIV1&2, <0.01% (n = 1) for Anti-HTLVI&2, <0.01% (n = 2) for TPHA and 0.0% (n = 0) for Malaria Ag. The prevalence of an abnormal test for hepatitis B was 10.54% (n = 2,664) of the total subjects and the prevalence of the other TTIs was 0.03% (n = 8). There were no significant differences by year in the prevalences of TTIs and there was no significant difference between usual blood donors and blood replacement donors in the prevalence of TTIs. In summary, the prevalence of TTIs did not show any significant correlation between age, gender, nationality or donor status in the three-year observation.

Background: Human cytomegalovirus (HCMV) infection spreads easily by interpersonal contact. Objective: This study determined the prevalence of seropositivity of cytomegalovirus immunoglobulin G (IgG) in the Asir Region, Kingdom of Saudi Arabia. Methods: The study evaluated the seropositivity for cytomegalovirus-specific IgG in 460 females. Collected samples were processed and tested using enzyme-linked immunosorbent assay and specific HCMV IgG. Results: The study showed that all the respondents aged 15–20 years were seropositive for the HCMV. HCMV seropositive status was recorded in 99.2% of the older patients (>40 years of age). In the remaining age groups, the rate of seropositivity ranged from 95.7 (age range 20–25 years) to 98.9% (age range 30 years). Conclusions: In all age groups of females tested, the prevalence of seropositive for HCMV was high, i.e., in the range of 95.7–100%.

Objectives:To investigate the presence of toxoplasmosis, rubella, cytomegalovirus, and herpes (TORCH) infections in women attending at the antenatal care clinic in Abha, Kingdom of Saudi Arabia (KSA).Methods:A total of 190 blood samples were collected from Abha maternity hospital in Aseer region, KSA, from February 2018 to May 2019 and screened with the TORCH panel (toxoplasmagondii [IgG/IgM], cytomegalovirus [CMV] [IgG/IgM], rubella [IgG/IgM], and herpes simplex type 1 and 2 [IgG/IgM]).Results:The mean age was 31.42±6.514 years and gestational age was 32.48±6.168 weeks. Serum IgG was positive for Toxoplasma gondii (T. gondii) (27.4%), herpes simplex type 1 (HSV-1) (94.7%), herpes simplex type 2 (HSV-2) (0.5%), CMV (100%), and rubella (88.9%). Serum IgM was positive only for CMV (9.5%). Though, there was an association between abortions from previous pregnancies (26.5%), intrauterine death (5.8%), premature labor (3.2%), microcephaly (1.6%), other congenital diseases (1.6%) and low birth weight (0.5%) with current IgG positivity for TORCH infections, the results were not statistically significant.Conclusion:Seropositivity for IgG antibodies correlate with TORCH-associated pregnancy complications in Abha, KSA; however, IgM positive CMV pregnant cases warrant further systematic investigation to understand the implications of CMV on outcomes during pregnancy.

Objective: To investigate the prevalence and risk factors of brucellosis in human and animal’s communities in southern Saudi Arabia. Methods: A cross-sectional sero-epidemiological study was conducted in Aseer and Jazan, Saudi Arabia (October 2017-October 2018). Human serum samples (n=339) were initially screened for Brucella antibodies and positive samples were further titrated for Brucella antibodies by immunocapture assay (titer of ⩾1:320 as positive). Animal samples (n=828) were screened using the Rose Bengal test. Relationship status was dichotomized to measure and predict independent contributions to variations in human using univariate and multivariate stepwise binary logistic regression model. Results: The rate of brucellosis among the 339 human samples in the two regions was 33.9%, and the rate of acute brucellosis was 12.4%. The rate of brucellosis in animals was 4.7%. Human brucellosis among the target groups was higher in northwestern Aseer (53.3%) compared to Southeastern Aseer (25.9%) and Jazan region (20.6%). The disease was more prevalent among non-Saudi nationals (35.2%) compared to Saudis (30.5%). The rate of brucellosis among butchers and shepherds was 37.5% and 37.2%, respectively. The rate of brucellosis was 37.8% in people over 30 years of age. Our univariate analysis showed that residing in Aseer region (OR: 2.60, 95% CI: 1.50-4.40), especially residing in northwestern Aseer region (OR: 4.40, 95% CI: 2.40-7.90), frequent consumption of raw meat (OR: 2.90, 95% CI: 1.50-5.50), shepherds (OR: 2.10, 95% CI: 0.80-5.30), owning sheep (OR: 2.20, 95% CI: 1.10-4.40), daily contact with animals (OR: 2.10, 95% CI: 0.75-5.80), and those > 30-year-old (OR: 1.50, 95% CI: 1.00-2.40) were significantly associated with increased risks of brucellosis. Our multivariate analysis further showed that residing in northwestern Aseer (OR: 9.16, 95% CI: 3.39-24.76) and having sheep (OR: 1.16, 95% CI: 1.00-1.35) were significant and independent risks of brucellosis while residing in agricultural region (OR: 0.28, 95% CI: 0.10-0.78) was a significant and independent protector against brucellosis. Conclusions: The study concluded that residing in northwestern Aseer area and having animals (sheep) are associated with significantly increased risks of brucellosis.

Objective: Vascular endothelial growth factor (VEGF) is regulated by hypoxia that is essential for placental development. It is antagonized by a soluble form of its receptor (sFlt-1). The purpose of this study was to measure these factors in the maternal and the cord bloods, at low and high altitude. Methods: Samples were collected from full term births normal pregnant women. Free (unbound) VEGF and sFlt-1 levels were measured in plasma samples from cord and maternal blood for each subject by enzyme-linked immunosorbent assay (ELISA) using commercially available kits from R&D systems, UK (Cat # DVE00 and Cat # SVR100B, respectively). Results: At high altitude, the average maternal free VEGF in pg/ml was significantly (p < 0.001) lower than that of the cord level (71.30 +/- 282.14 and 431.35 +/- 424.31, respectively). On the other hand, the average maternal sFlt-1 was significantly (p < 0.001) higher than that of the cord level (8205.41 +/- 6244.72 and 1811.74 +/- 3469.30, respectively). At low altitude, the average maternal free VEGF was significantly lower than that of the cord level (0.47 +/- 0.89 and 483.44 +/- 457.31, respectively, p < 0.001). On the other hand, the average maternal sFlt-1 was significantly higher than that of the cord level (9267.82 +/- 6345.68 and 958.66 +/- 1359.92, respectively, p < 0.001). There were no significant differences by altitude. Conclusion: Secretion of sFlt-1 appears to be polarized, in that concentrations are higher in the maternal compartment than on the fetal side at both high and low altitudes. This may be a normal physiological phenomenon to permit angiogenesis in the placenta and fetus while protecting the mother. Chronic exposure to hypobaric hypoxia at high altitude does not affect these distributions.

PURPOSE:To compare the performance of two indirect enzyme-linked immunosorbent assays (ELISA) detecting Helicobacter pylori (HP)-specific IgG antibodies in serum and saliva with endoscopic observations and histologic findings of biopsies from dyspeptic patients, in an area of high HP prevalence.MATERIALS AND METHODS:Sera, saliva and antral biopsies were obtained from 55 dyspeptic patients. IgG antibodies against HP were assayed in sera and saliva utilizing two indirect ELISAs. Biopsies were processed according to standard procedures in order to detect histological changes and the presence or absence of Helicobacter pylori. Laboratory data thus obtained were compared and statistically analyzed.RESULTS:Forty-two (76.36%) biopsies were positive for HP. The organisms were detected in 4 of 16 (25%) cases with normal endoscopic findings, in all 16 cases of gastritis and in 22 of the 23 (95.6%) cases of duodenal ulcers (DU). Serum and saliva HP-specific IgG antibodies were detected in 4 normal cases with positive biopsies, in 12 and 14 cases of gastritis, respectively, and in all 22 (100%) biopsy positive cases of DU. The sensitivities of the serum and saliva tests were 90.5% and 95%, respectively, while the specificities were 84.5% and 70%, respectively.CONCLUSION:Due to their high sensitivity and specificity in diagnosing HP-associated DU and gastritis, serum and saliva antibody testing seems to offer a valuable alternative to invasive procedures especially in areas of high HP prevalence such as ours; saliva antibody testing is simple and practical especially in children and in difficult patients who resent venipuncture.

Objective. To investigate the concentrations of free plasma vascular endothelial growth factor (VEGF) in the maternal and foetal circulations of normal term pregnancies. Methods. Free plasma VEGF was measured from plasma of umbilical cord and maternal blood by ELISA for each of 20 normal pregnancies delivering at term at an altitude of 3100 m. Spearman's correlation coefficient was used to test for correlation between values and clinical maternal and neonatal data. Student's 't' test was used to test for differences between samples from male and female neonates. Results. Free plasma VEGF was undetectable from maternal samples, but it was detectable in the cord blood (mean, 560.3775 pg/ml, median, 145.84 pg/ml, range, 22.56–2653.5). No differences were found between neonates sex, and no correlation was found with clinical maternal and neonatal data. Conclusion. Circulating VEGF is usually bound to the soluble form of its receptor 1 (sFlt-1). High levels of sFlt-1 are secreted by the syncytiotrophoblast during pregnancy, and so free plasma VEGF is undetectable in the maternal circulation. In contrast, our findings are the first to show free plasma VEGF in the umbilical circulation. We speculate that this free VEGF may promote angiogenesis in the foetus and placenta. Our data imply that sFlt-1 is not present in the cord blood, and that secretion by the syncytiotrophoblast is polarised to its apical surface. Further investigations are required to test this hypothesis.

Brief ReportsThe Rapid Manual ParaSight™-F Test for Diagnosing Plasmodium Falciparum Malaria in Saudi Arabia Mohamed S. Omar, DSc Gaafar M. Malik, MRCP(UK) Omar M. Al-Amari, PhD Salah E. Abdalla, and BSc Riyad A. MoosaMSc Mohamed S. Omar From the Departments of Clinical Microbiology and Parasitology, College of Medicine, King Saud University, Abha, Saudi Arabia , Gaafar M. Malik Address reprint requests and correspondence to Dr. Malik: College of Medicine, King Saud University, P.O. Box 641, Abha, Saudi Arabia. From the Department of Medicine, College of Medicine, King Saud University, Abha, Saudi Arabia , Omar M. Al-Amari From the Departments of Clinical Microbiology and Parasitology, College of Medicine, King Saud University, Abha, Saudi Arabia , Salah E. Abdalla From the Departments of Clinical Microbiology and Parasitology, College of Medicine, King Saud University, Abha, Saudi Arabia , and Riyad A. Moosa From the Departments of Clinical Microbiology and Parasitology, College of Medicine, King Saud University, Abha, Saudi Arabia Published Online:1 Mar 1999https://doi.org/10.5144/0256-4947.1999.159SectionsPDF ToolsAdd to favoritesDownload citationTrack citations ShareShare onFacebookTwitterLinked InRedditEmail AboutIntroductionCurrently, about 1.6 million people live in areas of Saudi Arabia where malaria is transmitted. In the southwestern region of the Asir lowlands (Tihama), Plasmodium falciparum is the predominant species, accounting for over 90% of all malaria infections.1 The peak of malaria transmission in the Asir lowlands is between October and April, and coincides with the rainy season (550 mm/year).In the malarious areas of Asir, two categories of population are at risk of contracting the infection: 1) permanent residents of the foothills and lowlands of Tihama and the coastal plain along the Red Sea; and 2) residents of the non-malarious areas in the highlands (Sarawat), who frequently travel for recreational activities to the endemic lowland areas during the transmission season. The latter group is especially prone to severe infection and a high degree of parasitemia, as they have little or no resistance to malaria.In the rural areas of Saudi Arabia, management of human malaria at the primary health care level is based on clinical diagnosis of febrile patients before institution of chloroquine therapy. The absence of specific diagnostic criteria and supportive laboratory confirmation of parasitemia mostly leads to inaccurate diagnosis and overtreatment. In regional referral hospitals, where appropriate facilities for better diagnosis and light microscopy are present, examination of blood slides for malaria is the cornerstone for early diagnosis and prompt treatment. However, the sensitivity of the standard thick-blood examination and microscopy has many limitations.2In recent years, the antigen detection ParaSight™-F rapid dipstick capture assay for the diagnosis of Falciparum malaria (Beckton Dickson Company, USA) has been extensively evaluated in endemic and non-endemic areas of the world.3 The method detects parasites, with limits of detection equal to or better than those provided by light microscopy, with matching specificity and sensitivity of around 90%.3,4In the present study, we conducted a laboratory evaluation of the ParaSight™-F test versus the standard thick-blood film examination for malaria diagnosis. The comparison was made between two study populations in the Asir region during periods of high malaria transmission.PATIENTS AND METHODSThe ParaSight™-F test was evaluated in a total of 89 subjects during the malaria transmission seasons of 1996-1998. The study population comprised two groups: 1) patients with febrile or other commonly associated malaria symptoms (n=38) who presented to an outpatient clinic at a primary health care center (PHCC) in Maraba, in lowland Tihamat Asir, located 50 km south of Abha, and 2) malaria inpatients admitted to Asir Central Hospital (ACH) in Abha (n=51) and suffering from acute uncomplicated or severe malaria. The study was approved by the College Research Center ethics committee. The demographic characteristics of the populations under study are summarized in Table 1.Table 1. Demographic characteristics of the patient population at the PHCC, Maraba, and at the ACH, Abha, Saudi Arabia.Table 1. Demographic characteristics of the patient population at the PHCC, Maraba, and at the ACH, Abha, Saudi Arabia.From each patient, 2 mL of venous blood was withdrawn in heparinized tubes and transported on ice to the Parasitology Laboratory of the Abha College of Medicine within 4 hours of collection. In the laboratory, two thick and one thin blood films were prepared from each sample. The microscopical examination of the standard Giemsa-stained blood films was performed by a microscopist experienced in malaria diagnosis and checked by a consultant. Smears were examined with 100x magnification under oil-immersion objectives. Parasites were counted against 1000 white blood cells (WBCs) or until a count of 500 asexual parasites (trophozoites) had been reached. The parasite density was estimated assuming 8000 WBC/μL of blood.5 Parasite species' determination was made by examination of both thick and thin blood smears.The ParaSight™-F dipstick assay was performed on the day of collection according to the manufacturer's instructions,6 although testing was extended for several hours after blood collection for some specimens. Four levels of reactivity were assessed, based on the intensity of the color reaction, as follows: no reaction (0); faint (1); clear (2); and strong (3). The results were read by two investigators. The presence of microscopically detectable parasitemia using thick blood film was taken as the reference standard to determine sensitivity and specificity of the ParaSight™-F test.The current treatment of uncomplicated Falciparum malaria at PHCC is based on presumptive diagnosis and utilizes standard chloroquine regimen as the first-line drug. In ACH, treatment of malarial patients started immediately after positive diagnosis. Acute uncomplicated P. falciparum infections were treated with the standard chloroquine regimen (10 mg/kg start, 5 mg/kg after 6 hours, and then 5 mg/kg daily for 2 days),5 or a single dose of Fansidar (sulfadoxine + pyrimethamine) for patients who did not respond to chloroquine. Oral quinine (10 mg/kg every 8 hours for 7 days), or parenteral quinine at the same dose, was used in cases of complicated disease, including cerebral malaria.Data were analyzed using SPSS software (Norusis NJ/SPSS Inc. 1993). Correlation between the intensity of the color reaction of the ParaSight™-F test grade and the level of parasitemia was estimated by applying the Spearman rank correlation coefficient and the significance was considered at 0.05 level. Mann-Whitney rank sum test was used for comparing the mean parasitemia between the two populations studied. Also, the level of agreement between the ParaSight™-F test and thick blood-film examination results was determined by the calculation of the kappa coefficient.RESULTSThe results of the field study (PHCC) and hospital inpatient (ACH) groups are compared in Table 2. Of the 89 subjects whose blood was examined, 58 (65.2%) were infected with P. falciparum and two (2.3%) with P. vivax, as revealed by microscopy (Table 1). No mixed infections were recorded. Table 2 shows the number of specimens that were positive by both blood-film examination and ParaSight™-F test. The mean admission parasite density for patients in ACH was significantly higher (75,193± 109,037.8) than that of those presenting with fever at the outpatient clinic of the PHCC (7476.3±13,288) (95% CI for the difference between means 34,512:100,922, with P=0.0004). The intensity of the ParaSight™-F test readings was significantly and positively correlated with peripheral blood parasitemia. (Spearman rank correlation coefficient between the grade of the test strip and level of parasitemia is equal to 0.90, P<0.0001). At ACH, twoParaSight™-F test false-negative results were due to samples containing P. vivax and were excluded from the analysis (Table 2), because the test does not detect antigen of this species.Table 2. Comparison of the ParaSight™-F test with thick blood film examination in the outpatient clinics of the PHCC and ACH.Table 2. Comparison of the ParaSight™-F test with thick blood film examination in the outpatient clinics of the PHCC and ACH.In the two studies, 55 of the specimens (69.6%) had matching ParaSight™-F test and blood-film results. In the field study, the thick blood film and ParaSight™-F test were discrepant in three cases, with the latter giving three false-negative results. All three false-negatives had relatively low parasite counts of 16-48 parasites per μL (Table 2). With higher levels of parasitemia (>50/μL), both the thick blood-film examination and the ParaSight™-F methods were 100% sensitive (Tables 2 and 3). Table 3 shows the distribution of positive thick blood film and ParaSight™-F test results, and the corresponding sensitivities stratified according to parasite level when results from both studies were combined. The sensitivity of the ParaSight™-F test was greater with increasing peripheral parasitemia, giving a sensitivity of 95%-100%, a specificity of 100% and positive and negative predictive values of 100% and 91%, respectively. The kappa index of agreement was 92% between the ParaSight™-F test and the conventional thick blood-film examination.Table 3. Performance of ParaSight™-F test at various levels of P. falciparum parasitemia in all subjects tested.Table 3. Performance of ParaSight™-F test at various levels of P. falciparum parasitemia in all subjects tested.Of the 38 patients enrolled in the field study (PHCC), all presenting with fever, only 12 (31.6%) had positive blood films, and the ParaSight™-F tests were positive in 9 cases (23.7%), showing a low correlation between the presence of fever and positive diagnosis. The 26 patients who were finally diagnosed as negative by both the thick blood film examination of 1000 WBCs and ParaSight™-F test were unnecessarily treated with chloroquine by the clinic's staff.DISCUSSIONThe ParaSight™-F test is based on the detection of the trophozoite-specific histidine-rich protein II antigen, and has been shown to give a constant specificity and sensitivity of around 90%, compared to the standard thick blood-film examination.3 In our study, we found the threshold parasitemia for detection by theParaSight™-F test to be 16-48 asexual parasites per μL blood. In previous reports, false-negative results appeared to be associated with parasitemia below 60 parasites per μL.3,7,8 In this report, the 95% sensitivity of the ParaSight™-F test was due to three false-negative results observed in patients with parasitemia below 50 parasites per μL, whereas the endpoint sensitivity reached 100% when parasitemia exceeded that level. It has been suggested that malaria cases with relatively low parasite counts may be early infections which may not have produced sufficient antigenemia to be detected by the ParaSight™-F test.8,9 The absence of false positives among the study population may merely reflect the fact that patients were clinically symptomatic on admission and had viable parasites in their peripheral blood before treatment. In contrast to previous reports,4,10 however, there was a positive correlation between the test strip readings and parasitemia levels (P<0.0001).Parasite density is usually high in non-immune subjects, whereas those living in endemic areas who have acquired high levels of immunity usually have a low-density parasitemia.2 The significantly high difference in the degree of parasitemia (P=0.0004) between patients of the lowlands (semi-immune) and those in the highlands (non-immune) is probably related to differences in the immune status of the two populations.In the field study group, only about one-third (31.6%) of persons presumptively diagnosed with malaria as they were admitted to the PHCC and sequentially treated with chloroquine were found to have positive results. The ParaSight™-F test could be of particular use in such situations where, in the absence of microscopical diagnosis, better clinical management of malarial patients can be made, reducing unwanted drug pressure. This is particularly important in Saudi Arabia, where evidence of diminishing sensitivity to chloroquine and clinical resistance to the drug in indigenously transmitted Falciparum malaria has been on the rise in recent years.11–14 Apart from autochthonous malaria, the ParaSight™-F test could be used in the rapid screening of imported cases of multidrug-resistant P. falciparummalaria among frequent travelers and highly mobile expatriate workers returning from malarious countries with known resistance.15Based on present and previous published reports, the ParaSight™-F test and the standard thick blood-film examination were equal as diagnostic tools forFalciparum malaria. The test is simple, quick and can give accurate diagnosis of patients with low as well as high parasitemia under laboratory and field conditions. It is highly recommended to be introduced at the primary health care level, especially in remote endemic areas of the Kingdom, where early diagnosis and treatment of Falciparum malaria is needed, and referral to the next level of health facility is not feasible.ARTICLE REFERENCES:1. Al-Seghayer SM. "Malaria control in the Kingdom of Saudi Arabia" . Saudi Epidemiol Bull. 1996; 3: 4. Google Scholar2. Trape JF. "Rapid evaluation of malaria parasite density and standardization of thick smear examination for epidemiological investigations" . Trans Roy Soc Trop Med Hyg. 1985; 79: 181–4. Google Scholar3. WHO. "A rapid dipstick antigen capture assay for the diagnosis of Falciparum malaria" . Bull Wld Hlth Org. 1996; 74: 47–54. Google Scholar4. Kodisinghe HM, Perera KRL, Premawnsa S, Nootunne TS, Wickramasinghe AR, Mendis KN. "The ParaSight™-F dipstick test as a routine diagnostic tool for malaria in Sri Lanka" . Trans Roy Soc Med Hyd. 1997; 91: 398–402. Google Scholar5. WHO. Management of uncomplicated malaria and the use of antimalarial drugs for the protection of travellers. Report of an informal consultation. Geneva18-21September1995. WHO/MAL/96;1075: 98. Google Scholar6. Shiff CJ, Premji Z, Minjas JN. "The rapid manual ParaSight™-F test: a new diagnostic tool for Plasmodium falciparum infection" . Trans Roy Soc Trop Med Hyg. 1993; 87: 646–8. Google Scholar7. Beadle C, Long GW, Weiss WR, McElroy PD, Maret SM, Oloo AJ, et al. "Diagnosis of malaria by detection of Plasmodium falciparum HRP-2 antigen with a rapid dipstick antigen capture assay" . Lancet. 1994; 343: 564–8. Google Scholar8. Banchongaksorn T, Yomokgul P, Panyim S, Rooney W, Wickers P. "A field trial of the ParaSight™-F test for the diagnosis of Plasmodium falciparum" . Trans Roy Soc Trop Med Hyg. 1996; 90: 244–5. Google Scholar9. Karbwang J, Tasanor O, Kanda T, Wattanagoon Y, Ibrahim M, Na-Bangchong K, et al. "ParaSight™-F test for the detection of treatment failure in multidrug resistant Plasmodium falciparum malaria" . Trans Roy Soc Trop Med Hyg. 1996; 90: 513–5. Google Scholar10. Dietze R, Perkins M, Boulos M, Luz F, Relier B, Corey R. "The diagnosis of Plasmodium falciparum infection using a new antigen detection system" . Am J Trop Med Hyg. 1995; 32: 45–9. Google Scholar11. Warrell DA. "Leishmaniasis, malaria and schistosomiasis in Saudi Arabia" . Saudi Med J. 1993; 14: 203–8. Google Scholar12. Malik GM, Khan AM, Abdalla SEA. "No response to chloroquine therapy in a case of Saudi Falciparum malaria" . Saudi Med J. 1997; 18: 99–100. Google Scholar13. Alrajhi AR, Frayha HH. "Chloroquine-resistant Plasmodium falciparum: is it our turn? (editorial)" . Ann Saudi Med. 1997; 17: 151–3. Google Scholar14. Manohar S, Baker A, Pawar AR, Oridota T. "Chloroquine-resistant Plasmodium falciparum malaria in a pregnant woman" . Ann Saudi Med. 1997; 17: 247–9. Google Scholar15. Freeman JD. "Multiple drug resistant Plasmodium falciparum: a threat to the Arabian Peninsula" . Saudi Med J. 1984; 5: 267–71. Google Scholar Previous article Next article FiguresReferencesRelatedDetails Volume 19, Issue 2March 1999 Metrics History Received5 July 1998Accepted29 November 1998Published online1 March 1999 ACKNOWLEDGEMENTSThe authors would like to thank the staff of the clinic at the Primary Health Care center in Maraba, Asir region, for their cooperation. Thanks are also due to Professor Mostafa A. Abolfotouh, Department of Community and Family Medicine, who carried out the statistical analysis of the data.InformationCopyright © 1999, Annals of Saudi MedicinePDF download

A total of 2182 serum samples from 38 patients with surgically confirmed unilocular hydatidosis, 19 clinically assessed patients, 15 patients with parasitic infections other than hydatidosis, 104 hospital outpatients, and 2006 normal Jordanians were serodiagnosed for the presence of IgG antibodies against hydatid fluid, circulating immune complexes (CIC), and/or hydatid circulating antigen (CA). Anti-hydatid IgG antibodies were detected in the sera of 77.4% of patients with hydatid discase and persiste for very long periods postsurgery. As many as 54.1% of patients with hydatidosis had positive levels of CIC, and 16.1% had circulating antigen in their sera. The search for circulating antigen and CIC decreased the number of false-negative hydatid cases from seven to three, and the combined sensitivity of the assays thus increased from 77.4% to 90.3%. Using the immunoblot technique, 16- and <14.4-kDaEchinococcus granulosus-specific bands were detected in sera from 54.1% and 61.5% of patients with hydatid disease who were tested before and after surgery, respectively. The seropositivity rate for anti-hydatid IgG antibodies was 2.4% for the general Jordanian population and 5.8% for hospital outpatients.