An in-depth analysis of a piece of shit: distribution of Schistosoma mansoni and hookworm eggs in human stool

An accurate diagnosis of helminth infection is important to improve patient management. However, there is considerable intra- and inter-specimen variation of helminth egg counts in human feces. Homogenization of stool samples has been suggested to improve diagnostic accuracy, but there are no detail...

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Bibliographic Details
Published in:PLoS neglected tropical diseases 2012-12, Vol.6 (12), p.e1969-e1969
Main Authors: Krauth, Stefanie J, Coulibaly, Jean T, Knopp, Stefanie, Traoré, Mahamadou, N'Goran, Eliézer K, Utzinger, Jürg
Format: Article
Language:English
Subjects:
Adolescent
Adult
Ancylostomatoidea - isolation & purification
Animals
Awards & honors
Biology
Child
Child, Preschool
Cote d'Ivoire
Disease control
Egg (Biology)
Eggs
Epidemiology
Feces
Feces - parasitology
Female
Homogenization
Hookworm Infections - diagnosis
Hookworm Infections - parasitology
Hookworms
Humans
Identification and classification
Infections
Investigations
Male
Medicine
Middle Aged
Parasite Egg Count - methods
Parasites
Schistosoma mansoni - isolation & purification
Schistosomiasis mansoni - diagnosis
Schistosomiasis mansoni - parasitology
Specimen Handling - methods
Time Factors
Tropical diseases
Young Adult
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Summary:An accurate diagnosis of helminth infection is important to improve patient management. However, there is considerable intra- and inter-specimen variation of helminth egg counts in human feces. Homogenization of stool samples has been suggested to improve diagnostic accuracy, but there are no detailed investigations. Rapid disintegration of hookworm eggs constitutes another problem in epidemiological surveys. We studied the spatial distribution of Schistosoma mansoni and hookworm eggs in stool samples, the effect of homogenization, and determined egg counts over time in stool samples stored under different conditions. Whole-stool samples were collected from 222 individuals in a rural part of south Côte d'Ivoire. Samples were cut into four pieces and helminth egg locations from the front to the back and from the center to the surface were analyzed. Some samples were homogenized and fecal egg counts (FECs) compared before and after homogenization. The effect of stool storing methods on FECs was investigated over time, comparing stool storage on ice, covering stool samples with a water-soaked tissue, or keeping stool samples in the shade. We found no clear spatial pattern of S. mansoni and hookworm eggs in fecal samples. Homogenization decreased S. mansoni FECs (p = 0.026), while no effect was observed for hookworm and other soil-transmitted helminths. Hookworm FECs decreased over time. Storing stool samples on ice or covered with a moist tissue slowed down hookworm egg decay (p
ISSN:1935-2735
1935-2727
1935-2735
DOI:10.1371/journal.pntd.0001969