Improved Detection of Intestinal Helminth Infections with a Formalin Ethyl-Acetate-Based Concentration Technique Compared to a Crude Formalin Concentration Technique.

Tobias Brummaier,François Nosten,Daniel H Paris,Laypaw Archasuksan,Rose Mcgready,Jürg Utzinger,Dorn Watthanakulpanich,Stephane Proux

doi:10.3390/tropicalmed6020051

Abstract

Intestinal helminth infections are the most prevalent neglected tropical diseases, predominantly affecting rural and marginalised populations. The mainstay of diagnosis is the microscopic examination of faecal samples to detect parasites in the form of eggs, larvae and cysts. In an effort to improve the standard of care, the comparative accuracy in detecting helminth infections of the hitherto used formalin-based concentration method (FC) was compared to a previously developed formalin ethyl-acetate-based concentration technique (FECT), prior to the systematic deployment of the latter at a research and humanitarian unit operating on the Thailand–Myanmar border. A total of 693 faecal samples were available for the comparison of the two diagnostic methods. The FECT was superior in detecting hookworm, Trichuris trichiura and small liver flukes. Interestingly, there was no significant difference for Ascaris lumbricoides, possibly due to the high observed egg density. Despite the minor increase in material cost and the fact that the FECT is somewhat more time consuming, this method was implemented as the new routine technique.

Highlights

Helminths, which are widespread across various populations mostly in tropical and subtropical regions, are the most common infectious agents worldwide [1]
Contrary to their vast distribution, helminth infections were included in the list of neglected tropical diseases since the establishment of this denomination in 2005 and still retain a position in the most recent portfolio of neglected tropical diseases put forward by the World Health Organization (WHO) [2,3]
Their importance as a public health issue in some regions is underlined by the fact that about 1.5 billion people are estimated to be infected with soil-transmitted helminths (i.e., Ascaris lumbricoides, the two hookworm species Ancylostoma duodenale and Necator americanus and Trichuris trichiura), causing an estimated global burden of 2 million disability-adjusted life years (DALYs) [4,5]

Summary

Introduction

Helminths, which are widespread across various populations mostly in tropical and subtropical regions, are the most common infectious agents worldwide [1] Contrary to their vast distribution, helminth infections were included in the list of neglected tropical diseases since the establishment of this denomination in 2005 and still retain a position in the most recent portfolio of neglected tropical diseases put forward by the World Health Organization (WHO) [2,3]. While tropical regions carry the highest burden of intestinal helminth infections, they mostly rely on microscopy as the sole diagnostic tool as molecular-based methods are usually not available because of financial and human resources constraints

Methods

Results

Conclusion