Lack of sensitive test for early diagnosis of echinococcosis.
In China, ultrasonography is the most frequently used test for echinococcosis diagnosis[79, 80]. Immunodiagnostic tests are also widely used in fieldwork. The kits used most widely are the ELISA-based serological tests, using either an Echinococcus granulosus hydatid cyst fluid antigen or an E. multilocularis crude vesicular fluid for primary screening. The sensitivity for hepatic cases of CE (Cystic echinococcosis) ranges from 85% to 98%. For AE (Alveolar echinococcosis), the use of purified or recombinant E. multilocularis antigens exhibit high diagnostic sensitivities ranging from between 91% and 100%, with overall specificities of 98%–100%. However, for echinococcosis formed in other organs except for liver, the specificities are less than 50%. DIGFA seems to be the current area of interest for research and development.
In general, more imaging procedures should be used in echinococcosis epidemic areas to diagnose patients. For Immunodiagnostic tests, the gap is to develop new serological tests with higher sensitivity and specificity (>95%) than those based on the use of hydatid fluid and then bring them to a world standard. The resulting drug should also be straightforward and cheap to produce, with the capacity to diagnose early stage echinococcosis and allow for early treatment.