Abstract
BackgroundOur group has recently provided a proof-of-principle for the examination of pooled stool samples using McMaster technique as a strategy for the rapid assessment of intensity of soil-transmitted helminth infections (STH, Ascaris lumbricoides, Trichuris trichiura and hookworm). In the present study we evaluated this pooling strategy for the assessment of intensity of both STH and Schistosoma mansoni infections using the Kato-Katz technique.MethodsA cross-sectional survey was conducted in 360 children aged 5–18 years from six schools in Jimma Zone (southwest Ethiopia). We performed faecal egg counts (FECs) in both individual and pooled samples (pools sizes of 5, 10 and 20) to estimate the number of eggs per gram of stool (EPG) using the Kato-Katz technique. We also assessed the time to screen both individual and pooled samples.ResultsExcept for hookworms, there was a significant correlation (correlation coefficient = 0.53–0.95) between the mean of individual FECs and the FECs of pooled samples for A. lumbricoides, T. trichiura and S. mansoni, regardless of the pool size. Mean FEC were 2,596 EPG, 125 EPG, 47 EPG, and 41 EPG for A. lumbricoides, T. trichiura, S. mansoni and hookworm, respectively. There was no significant difference in FECs between the examination of individual and pooled stool samples, except for hookworms. For this STH, pools of 10 resulted in a significant underestimation of infection intensity. The total time to obtain individual FECs was 65 h 5 min. For pooled FECs, this was 19 h 12 min for pools of 5, 14 h 39 min for pools of 10 and 12 h 42 min for pools of 20.ConclusionsThe results indicate that pooling of stool sample holds also promise as a rapid assessment of infections intensity for STH and S. mansoni using the Kato-Katz technique. In this setting, the time in the laboratory was reduced by 70 % when pools of 5 instead of individual stool samples were screened.
Highlights
Our group has recently provided a proof-of-principle for the examination of pooled stool samples using McMaster technique as a strategy for the rapid assessment of intensity of soil-transmitted helminth infections (STH, Ascaris lumbricoides, Trichuris trichiura and hookworm)
These mass drug administration (MDA) programmes traditionally operate in resourceconstrained settings, and it is indispensable that programme managers and healthcare decision-makers have some flexibility to minimize both financial and technical resources, while assuring a reliable assessment of the progress made
A scale-up of MDA programmes to control the morbidity caused by Soil-transmitted helminths (STH) and S. mansoni infections is underway in various parts of Africa, Asia and South-America
Summary
Our group has recently provided a proof-of-principle for the examination of pooled stool samples using McMaster technique as a strategy for the rapid assessment of intensity of soil-transmitted helminth infections (STH, Ascaris lumbricoides, Trichuris trichiura and hookworm). The main strategy to control the morbidity caused by these helminthiasis is mass drug administration (MDA) programmes in which a single oral dose of benzimidazole drugs (soil-transmitted helminthiasis) and praziquantel (schistosomiasis) are periodically administered to school-aged children [2] These programmes have recently received increased political and scientific attention [3, 4], with which the World Health Organization (WHO) aims to increase the coverage of the children in need of anthelminthic drugs from the current 34 % for soil-transmitted helminthiasis [5] and 13 % for schistosomiasis [6] to at least 75 % by 2020, and to eliminate both diseases as a public health problem in children [7]. These MDA programmes traditionally operate in resourceconstrained settings, and it is indispensable that programme managers and healthcare decision-makers have some flexibility to minimize both financial and technical resources, while assuring a reliable assessment of the progress made
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