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Background: Equine piroplasmosis is a tick-borne disease affecting equids caused by protozoa belonging to two genus named Theileria and Babesia, causing losses in the horse industry and constraint to the international movement. In endemic areas, clinical diagnosis is difficult because signs are not pathognomonic. Identifying the associated risks factors and the most suitable laboratory analyses are required to prevent the disease, confirm the diagnosis and assess therapy. Methods: A total of 438 horse and donkey samples were collected by practitioners during their clinical activities. The anamnestic information were collected by a standardized form. The samples were screened for piroplasmosis and other infectious diseases in differential diagnosis and haemato-biochemical parameters, and thus assigned to three groups: confirmed cases of T. equi, unconfirmed suspects and controls. Statistical analysis was performed to detect differences among groups regarding anamnestic data and haemato-biochemical parameters. Results: Among anamnestic variables, only age (> 6 years) increases the probability of infection compared to the controls, while ectoparasitic treatments seem to have a protective effect. A decrease in platelet count was the only haemato-biochemical parameter associated with T. equi infection. Conclusions: This study confirms the diagnosis of T. equi infection as an issue, for similarities regarding anamnesis and laboratory findings with other diseases. Moreover, it focuses the attention on prevention measures and good management practices that can reduce the spread of the disease, together with regular laboratory checks, useful to early detect the parasite and assess and monitor the therapy.

Background: Equine piroplasmosis is a tick-borne disease affecting equids caused by protozoa Theileria equi and Babesia caballi, causing losses in the horse industry for impaired performance and constraint to the international movement. In endemic areas, clinical diagnosis is difficult because the most frequent form is the asymptomatic carrier status and even in symptomatic cases, signs are not pathognomonic. Laboratory analyses are required to confirm the diagnosis and assess therapy.Methods: A total of 438 horse and donkey samples were collected by practitioners during their routine activities and for clinical suspicion of piroplasmosis. The anamnestic information as signs, individual data and management practises were collected by a standardized form. The samples were screened for piroplasmosis and other infectious diseases in differential diagnosis and haemato-biochemical parameters, and thus assigned to three groups: confirmed cases, unconfirmed suspects and controls. Univariate logistic regressions were performed using groups as outcome and anamnestic data as independent variables. Differences in haemato-biochemical parameters among groups were evaluated by Kruskal-Wallis H-test, followed, when significant (P < 0,05), by Bonferroni correction for multiple comparisons. Results: Nineteen confirmed T. equi cases and one B. caballi were detected, thus the study was focused only on the former parasite. Among anamnestic variables, only age (> 6 years) increases the probability of infection compared to the controls, while ectoparasiticide treatments seem to have a protective effect. A decrease in platelet count was the only haemato-biochemical parameter associated with T. equi infection. Comparing with healthy subjects, total and direct bilirubin, monocytes, basophils, MCH and gamma protein fraction showed higher values whereas CK, eosinophils, RBC, HGB, HCT, RDW, albumin and A/G ratio showed lower values, despite being mostly within physiological range. These findings resulted common to T. equi and other affections with similar signs. Conclusions: This study confirms the diagnosis of T. equi infection as an issue, for similarities regarding anamnesis and laboratory findings with other diseases; but still providing the practitioners with data useful for the laboratory results interpretation. Moreover, it focuses the attention on prevention measures, as external antiparasitic treatments and good management practices that, with regular laboratory checks, can reduce the spread of the disease.

Equine piroplasmosis (EP) is a disease of equids caused by Theileria equi and Babesia caballi, members of the order Piroplasmida, transmitted by several species of ticks. As the disease is endemic in many countries, a clinical examination or a serological test are required prior to movement of horses to prove freedom from infection and to avoid the introduction of EP with its sanitary and economic impact, especially in areas where it is absent. Currently, numerous diagnostic PCR protocols are available, some of which are recommended by the World Organisation for Animal Health (OIE). In order to adopt this diagnostic method, the Italian National Reference Centre for Equine Diseases (NRC-ED) conducted a preliminary comparison between an end-point PCR, nested PCR, real-time PCR, and commercial real-time PCR, for the detection of T. equi and B. caballi, respectively. One hundred and three field samples, collected during spring-summer 2013 in Latium and Tuscany regions, were employed for the study, and results discordant between detection assays were confirmed by sequencing. The reference assay was defined as that showing the highest sensitivity, and the relative sensitivity (rSe) and specificity (rSp) of the other methods were estimated referring to this assay. Agreement between methods was estimated by calculating the concordance between each pair of methods. Although no statistical differences were detected among PCR-based methods, the non-commercial real-time PCR assays seemed to be the most suitable for detection of T. equi and B. caballi, respectively. An important advantage of direct PCR detection of the pathogen, in comparison to indirect detection using serological methods, is that it allows specific treatment against the causative pathogen species responsible of the infection as well as for the definition of the infectious status of an animal for international movement.