Abstract
BackgroundThe endemic countries are in a diagnostic dilemma concerning Schistosoma japonicum with increasing difficulties in diagnosing the infected individuals. The formol-ethyl acetate sedimentation concentration technique is preferred by many clinical microbiology laboratories for the detection of parasites in stool samples. It is potentially more sensitive than the diagnostic methods traditionally used.Methodology/Principal FindingsWe evaluated the technique for detection of low-intensity S. japonicum infections in 106 stool samples from China and used a commercial kit, Parasep Midi Faecal Parasite Concentrator. One stool sample and one serum sample were collected from each person. As reference standard we used persons positive by indirect hemagglutination in serum and positive by Kato-Katz thick smear microscopy (three slides from a single stool), and/or the hatching test. We found the sedimentation technique to have a sensitivity of only 28.6% and specificity of 97.4%.Conclusion/SignificanceThis study indicates that the sedimentation technique has little to offer in the diagnosis of low-intensity S. japonicum infections, at least when only a single stool sample is examined.
Highlights
Schistosomiasis japonica is still a major public health problem, especially in China, despite great achievements during the past 50 years in controlling this parasitic disease
Conclusion/Significance: This study indicates that the sedimentation technique has little to offer in the diagnosis of lowintensity S. japonicum infections, at least when only a single stool sample is examined
Formol-ethyl acetate sedimentation concentration is a technique for detecting eggs in stool by microscopy, but has not to our knowledge been evaluated for S. japonicum
Summary
Schistosomiasis japonica is still a major public health problem, especially in China, despite great achievements during the past 50 years in controlling this parasitic disease. Especially formol (formalin)-ether or formol-ethyl acetate sedimentation concentration is the preferred method for detection of helminth eggs and protozoa cysts in many clinical parasitology laboratories [7,8,9], to a lesser extent in Africa and Asia. The primary aim of this study was to assess whether the sedimentation technique could be a sensitive alternative to the tests traditionally used in the endemic areas, and potentially play a role in a diagnostic algorithm of the control programs. The formol-ethyl acetate sedimentation concentration technique is preferred by many clinical microbiology laboratories for the detection of parasites in stool samples. It is potentially more sensitive than the diagnostic methods traditionally used
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