Abstract
ObjectiveThe aim of this study was to evaluate the diagnostic performance of direct wet mount microscopy compared to formalin ether concentration (FEC) technique in detecting intestinal helminths in pregnant women.ResultsThe total prevalence of intestinal helminths was 18.8% (70/372) by direct wet mount microscopy and 24.7% (92/372) by FEC technique (P < 0.001). The sensitivity, negative predictive value (NPV) and test efficiency (TE) of direct wet mount microscopy in diagnosing intestinal helminths was 76, 92.7 and 94%, respectively. The sensitivity of direct wet mount microscopy was very low in detecting ova of Hymenolepis nana. The two methods showed excellent agreement in detecting ova of Hook worm and Ascaris lumbricoides (Kappa > 0.81) but they fairly agreed in detecting ova of Hymenolepis nana (Kappa = 0.39). Intestinal helminths were underdiagnosed and the total diagnostic performance of direct wet mount microscopy was significantly poor in detecting intestinal helminths as compared to FEC technique. Routine use of FEC method is recommended for the diagnosis of intestinal helminths in pregnant women.
Highlights
Intestinal parasitic infections, especially due to helminths, increase anemia in pregnant women
The findings of the present study showed that direct wet mount microscopy has showed lower prevalence rate of intestinal helminths when compared to the formol-ether concentration technique (FEC) method (18.8% versus 24.7%) (P < 0.001) which is similar to a study done in Nigeria [15]
Our findings showed that direct wet mount microscopy exhibited low sensitivity for the detection of intestinal helminths as compared to the FEC technique which is similar with another study done in Ethiopia [18]
Summary
Intestinal parasitic infections, especially due to helminths, increase anemia in pregnant women. The results of this are low pregnancy weight gain and intra uterine growth retardation, followed by low birth weight, with its associated greater risks of infection and higher prenatal mortality rates. Several diagnostic tools are available to diagnose intestinal helminths, direct wet mount microscopy is commonly used for the diagnosis of intestinal parasitic infections generally in Africa and in Ethiopia [2–5]. Low sensitivity of the direct wet mount technique has been reported to have poor performance in the detection of low intensity infection elsewhere which shows that the use of direct wet mount microscopy will significantly increase misdiagnosis of intestinal helminthic infections [6]. Different studies showed that formol-ether concentration technique (FEC) is more sensitive than the conventional direct wet mount microscopy. The employment of FEC techniques as a confirmatory test in routine laboratory examination of stool will significantly
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