ORIGINAL ARTICLES

The role of a recombinant hybrid protein based ELISA for the serodiagnosis of Onchocerca volvulus

J A Andrews¹, W J Bligh¹, P L Chiodini¹, J E Bradley², P N Nde³ and R Lucius⁴

¹ Department of Clinical Parasitology, The Hospital for Tropical Diseases, Mortimer Market, London WC1E 6AU, UK
² Department of Parasitology, University of Nottingham, Nottingham, UK
³ Department of Microbial Pathogenesis and Immune Response, Meharry Medical College, Nashville, Tennessee, USA
⁴ Department of Molecular Parasitology, Humboldt University, Berlin, Germany

Correspondence to:
Dr Julie Andrews, 9 The Deerings, Harpenden AL5 2PF, UK; julie.andrews{at}whittington.nhs.uk

Aims: Onchocerca volvulus infection is traditionally diagnosed by examination of skin snips for the presence of microfilariae. A disadvantage of this method is the low sensitivity particularly with light or prepatent infection. Serodiagnosis using recombinant-antigen-based assays may provide a more sensitive diagnostic test. An ELISA based on a recombinant antigen OvH3 has previously been validated using sera from endemic areas. This study investigated the role of this ELISA-based assay for use in the serodiagnosis of onchocerciasis in non-endemic areas.

Methods: The ELISA-based assay was tested on sera from untreated patients with known onchocerciasis and on untreated and treated patients with definite or probable onchocerciasis identified from a hospital diagnostic database. The assay was also tested on sera from patients with other helminthic infections to determine the sensitivity and specificity of this assay in a tertiary referral laboratory dealing with sera from a variety of patients.

Results: The sensitivity and specificity of the OvH3 assay were 93.2% and 93.5%, respectively, when tested on non-endemic patients with clinical diagnosis of onchocerciasis.

Conclusions: This study demonstrates the potential role of the assay as a sensitive and specific test for use in the serodiagnosis of onchocerciasis in a reference laboratory dealing with sera from patients in non-endemic setting.

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