2020; 2(1): 8-16PublishedOnline:01/10/2020 (https://journals.unza.zm/index.php?journal=medicine) DOI: 10.21617/jprm2020.213ISSN: 2415-038X (Print)Received: 14August2020Accepted: 16August 2020Published: 1October2020RESEARCH ARTICLEOpen AccessComparison of Serologic Diagnosis of Taeniosis and Cysticercosis in Field Samples from Eastern Zambia

Background:Neurocysticercosis is a leading cause of epilepsy in Taenia soliumendemic regions of the world accounting for about 30% of all epileptic cases. The main aim of this study was to do aComparison of Serologic Diagnosis of Taeniosis and Cysticercosis in Field Samples from Eastern Zambia.Methods: Retrospectively collectedSamples through community-based cross sectional and longitudinal studies which looked at the prevalence and incidence of human T. solium infections, respectively, and described in earlier reports were selected for this laboratory based study. Samples, with coproantigen ELISA and serum antigen ELISA which the results were known were randomly selected for this study.Results: A total of 886 serum samples were analyzed. The rT24 /rES33 EITB detected a taeniosis and cysticercosis prevalence of 5.9% and 9.5%, respectively. On performance the Kappa statistics revealed a fair agreement of rT4/rES33 EITB (Kappa value of 0.2781-0.2117) compared to coproantigen ELISA and serum antigen ELISA. Although there is not a good agreement between the antibody and antigen test.Conclusion: This study found that the performance of rT4/rES33 EITB compared to copro antigen ELISA and serum antigen ELISA were fair and because the agreement was not good between the antibody and antigen test the, selection of a test must be carefully made, with consideration of what is needed. Keywords:Taenia solium diagnosis; coproantigen ELISA; immunodiagnosis; Ag-ELISA; recombinant T24/ES33 EITB

A113 COST SAVINGS OF SEROLOGIC VERSUS BIOPSY PROVEN DIAGNOSIS OF PEDIATRIC CELIAC DISEASE

Background Celiac disease (CD) affects approximately one percent of the population in Canada and the United States. At present, endoscopic diagnosis (ED) of CD remains the gold standard in North America, despite mounting evidence and validated European guidelines for serologic diagnosis (SD). Within publicly funded healthcare systems there is pressure to ensure optimal resource utilization and cost efficiency, including for endoscopic services. At Stollery Children’s Hospital, Edmonton, Canada, we have adopted serologic diagnosis as routine practice since 2016. Aims The aim of this study is to estimate cost savings, i.e. hard dollar savings and capacity improvements, to the health care system as well as impacts on families in regard to reduced work days lost and missing child school days for SD versus ED. Initial cost saving data is presented. Methods Micro-costing methods were used to determine health care resource use in patients undergoing ED or SD from 2017–2018. SD testing included anti-tissue glutaminase antibody (aTTG) ≥200IU/mL (on two occasions), human leukocyte antigen (HLA) DQA5/DQ2, blood sampling, transport and laboratory costs. ED diagnosis included gastroenterologist, anesthetist, OR equipment, staff, overhead and histopathology. Cost of each unit of resource was obtained from the schedule of medical benefits (Alberta) and reported average ambulatory cost for day hospital endoscopy for Stollery Children’s Hospital determined in 2016; reported in CAN$. Results Between March 2017-December 2018, 473 patients were referred for diagnosis of CD; 233 had ED and 127 SD. Estimated cost for ED was $1240 per patient; for SD was $85 per patient (6.8% of ED cost). Based on 127 patients not requiring endoscopy and a cost saving of $1155 per patient there was a total cost savings of $146,685 over 22 months. Conclusions A SD approach presents a significant cost savings to the public health care system. It also frees up valuable endoscopic resources, and limits exposure of children to the immediate and long-term risks associated with anesthesia and biopsy. SD also decreases time to diagnosis and the cost of the process to families (lost days of school/work, travel costs etc.). Our costing data can be used in combination with mounting evidence on the test performance of SD versus ED to determine cost-effectiveness of serological diagnosis for pediatric CD. Given the potential for cost saving and more efficient operating room utilization, SD for pediatric CD warrants further investigation in North America. Funding Agencies None