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Comparison among FLOTAC, Kato-Katz and formalin ether concentration techniques for diagnosis of intestinal parasitic infections in school children in an Egyptian rural setting

Published online by Cambridge University Press:  10 September 2020

Amal Farahat Allam Open the ORCID record for Amal Farahat Allam [Opens in a new window] ,
Hoda Fahmy Farag ,
Wael Lotfy ,
Hayam Hussien Fawzy ,
Heba Elhadad  and
Amel Youssef Shehab
Amal Farahat Allam*
Affiliation:
Department of Parasitology, Medical Research Institute, University of Alexandria, Alexandria, Egypt
Hoda Fahmy Farag
Affiliation:
Department of Parasitology, Medical Research Institute, University of Alexandria, Alexandria, Egypt
Wael Lotfy
Affiliation:
Faculty of Nursing, Matrouh University, Matrouh, Egypt
Hayam Hussien Fawzy
Affiliation:
Department of Parasitology, Medical Research Institute, University of Alexandria, Alexandria, Egypt
Heba Elhadad
Affiliation:
Department of Parasitology, Medical Research Institute, University of Alexandria, Alexandria, Egypt
Amel Youssef Shehab
Affiliation:
Department of Parasitology, Medical Research Institute, University of Alexandria, Alexandria, Egypt
*
Author for correspondence: Amal Farahat Allam, E-mail: [email protected]
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Abstract

The study aimed to compare the diagnostic performance of the Kato-Katz, formalin ether concentration method (FECM) and FLOTAC using Sheather's sugar solution (FS1), saturated sodium chloride (FS2) and zinc sulfate (FS7) for the diagnosis of intestinal parasites among school children, focusing on Schistosoma mansoni. Ninety fecal samples were examined using the above mentioned techniques. The overall infection rate was 87.7%. Concerning protozoa, FLOTAC (FS1 and FS2) and FECM detected nearly equal infection rates (43.3% and 44.4%, respectively) with very good agreement. Kato-Katz diagnosed the highest helminthic infection rate (57.8%) followed by FLOTAC FS7 (44.4%) and FECM showed the lowest helminthic infection rate (27.7%). As for S. mansoni, Kato-Katz showed an infection rate of 38.8% vs FLOTAC (22.2%) and FECM (11.1%). The three techniques detected the same infection rate (11.1%) with egg counts more than 72 eggs/gram of feces. The FLOTAC sensitivity and accuracy for the diagnosis of protozoa were 97% and 99%, respectively. Regarding helminths diagnosis, FLOTAC technique showed higher sensitivity (77%) and accuracy (87%) compared to FECM (48% sensitivity and 70% accuracy). Therefore, FLOTAC can be used synchronously or in replacement to other diagnostic techniques. This can strategically impact future control programmes of intestinal parasitic infections in limited resources settings.

Keywords

FLOTACformalin ether concentration methodhelminthsKato-KatzprotozoaS. mansoni
Type
Research Article
Information
Parasitology , Volume 148 , Issue 3 , March 2021 , pp. 289 - 294
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Copyright
Copyright © The Author(s), 2020. Published by Cambridge University Press

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References

Abdel-Gaffar, MM, Sadek, GS, Oshiba, SF and Esmail, ES (2018) Evaluation of feconomics and mini-flotac as recent stool preparation techniques for diagnosis of intestinal parasites. Journal of the Egyptian Society of Parasitology 48, 139–146.Google Scholar
Ashby, D (1991) Practical statistics for medical research. Douglas G. Altman, Chapman and Hall, London, 1991. No. of pages: 611. Price: £32.00. Statistics in Medicine 10, 1635–1636.CrossRefGoogle Scholar
Barda, B, Zepherine, H, Rinaldi, L, Cringoli, G, Burioni, R, Clementi, M and Albonico, M (2013) Mini-FLOTAC and Kato-Katz: helminth eggs watching on the shore of lake Victoria. Parasites & Vectors 6, 220.CrossRefGoogle ScholarPubMed
Bärenbold, O, Raso, G, Coulibaly, JT, N'Goran, EK, Utzinger, J and Vounatsou, P (2017) Estimating sensitivity of the Kato-Katz technique for the diagnosis of Schistosoma mansoni and hookworm in relation to infection intensity. PLoS Neglected Tropical Diseases 11, e0005953.CrossRefGoogle Scholar
Becker, SL, Lohourignon, LK, Speich, B, Rinaldi, L, Knopp, S, N'Gora, EK, Cringoli, G and Utzinger, J (2011) Comparison of the Flotac-400 dual technique and the formalin-ether concentration technique for diagnosis of human intestinal protozoon infection. Journal of Clinical Microbiology 49, 2183–2190.CrossRefGoogle ScholarPubMed
Booth, M, Vounatsou, P, N'Goran, EK, Tanner, M and Utzinger, J (2003) The influence of sampling effort and the performance of the Kato-Katz technique in diagnosing Schistosoma mansoni and hookworm co-infections in rural Côte d'Ivoire. Parasitology 127(Pt 6), 525–531.CrossRefGoogle ScholarPubMed
Cringoli, G (2006) FLOTAC, a novel apparatus for a multivalent faecal egg count technique. Parassitologia 48, 381–384.Google ScholarPubMed
Cringoli, G, Rinaldi, L, Veneziano, V, Capelli, G and Scala, A (2004) The influence of flotation solution, sample dilution and the choice of McMaster slide area (volume) on the reliability of the McMaster technique in estimating the faecal egg counts of gastrointestinal strongyles and Dicrocoelium dendriticum in sheep. Veterinary Parasitology 123, 121–131.CrossRefGoogle Scholar
Cringoli, G, Rinaldi, L, Maurelli, MP and Utzinger, J (2010) FLOTAC: new multivalent techniques for qualitative and quantitative copromicroscopic diagnosis of parasites in animals and humans. Nature Protocols 5, 503–515.CrossRefGoogle ScholarPubMed
Forson, AO, Arthur, I and Ayeh-Kumi, PF (2018) The role of family size, employment and education of parents in the prevalence of intestinal parasitic infections in school children in Accra. PLoS ONE 13, e0192303.CrossRefGoogle ScholarPubMed
Gadisa, E and Jote, K (2019) Prevalence and factors associated with intestinal parasitic infection among under-five children in and around Haro Dumal Town, Bale Zone, Ethiopia. BMC Pediatrics 19, 385.CrossRefGoogle ScholarPubMed
Garcia, LS, Arrowood, M, Kokoskin, E, Paltridge, GP, Pillai, DR, Procop, GW, Ryan, N, Shimizu, RY and Visvesvara, G (2018) Laboratory diagnosis of parasites from the gastrointestinal tract. Clinical Microbiology Reviews 31, e00025–e00017.CrossRefGoogle ScholarPubMed
Glinz, D, Silué, KD, Knopp, S, Lohourignon, LK, Yao, KP, Steinmann, P, Rinaldi, L, Cringoli, G, N'Goran, EK and Utzinger, J (2010) Comparing diagnostic accuracy of Kato-Katz, Koga agar plate, ether-concentration, and FLOTAC for Schistosoma mansoni and soil-transmitted helminths. PLoS Neglected Tropical Diseases 4, e754.CrossRefGoogle ScholarPubMed
Gualdieri, L, Rinaldi, L, Petrullo, L, Morgoglione, ME, Maurelli, MP, Musella, V, Piemonte, M, Caravano, L, Coppola, MG and Cringoli, G (2011) Intestinal parasites in immigrants in the city of Naples (southern Italy). Acta Tropica 117, 196–201.CrossRefGoogle Scholar
Hotez, PJ, Fenwick, A, Savioli, L and Molyneux, DH (2009) Rescuing the bottom billion through control of neglected tropical diseases. Lancet (London, England) 373, 1570–1575.CrossRefGoogle ScholarPubMed
Jeandron, A, Abdyldaieva, G, Usubalieva, J, Ensink, JH, Cox, J, Matthys, B, Rinaldi, L, Cringoli, G and Utzinger, J (2010) Accuracy of the Kato-Katz, adhesive tape and FLOTAC techniques for helminth diagnosis among children in Kyrgyzstan. Acta Tropica 116, 185–192.CrossRefGoogle ScholarPubMed
Knight, WB, Hiatt, RA, Cline, BL and Ritchie, LS (1976) A modification of the formol-ether concentration technique for increased sensitivity in detecting Schistosoma mansoni eggs. American Journal of Tropical Medicine and Hygiene 25, 818–823.CrossRefGoogle ScholarPubMed
Knopp, S, Speich, B, Hattendorf, J, Rinaldi, L, Mohammed, KA, Khamis, IS, Mohammed, AS, Albonico, M, Rollinson, D, Marti, H, Cringoli, G and Utzinger, J (2011) Diagnostic accuracy of Kato-Katz and FLOTAC for assessing anthelmintic drug efficacy. PLOS Neglected Tropical Diseases 5, e1036.CrossRefGoogle ScholarPubMed
Liao, C-W, Fu, C-J, Kao, C-Y, Lee, Y-L, Chen, P-C, Chuang, T-W, Naito, T, Chou, C-M, Huang, Y-C, Bonfim, I and Fan, C-K (2016) Prevalence of intestinal parasitic infections among school children in capital areas of the Democratic Republic of São Tomé and Príncipe, West Africa. African Health Sciences 16, 690–697.CrossRefGoogle ScholarPubMed
McHardy, IH, Wu, M, Shimizu-Cohen, R, Couturier, MR and Humphries, RM (2014) Detection of intestinal protozoa in the clinical laboratory. Journal of Clinical Microbiology 52, 712–720.CrossRefGoogle ScholarPubMed
Nematian, J, Gholamrezanezhad, A and Nematian, E (2008) Giardiasis and other intestinal parasitic infections in relation to anthropometric indicators of malnutrition: a large, population-based survey of schoolchildren in Tehran. Annals of Tropical Medicine and Parasitology 102, 209–214.CrossRefGoogle ScholarPubMed
Opara, KN, Udoidung, NI, Opara, DC, Okon, OE, Edosomwan, EU and Udoh, AJ (2012) The impact of intestinal parasitic infections on the nutritional status of rural and urban school-aged children in Nigeria. International Journal of MCH and AIDS 1, 73–82.CrossRefGoogle Scholar
Ouattara, M, N'Guéssan, NA, Yapi, A and N'Goran, EK (2010) Prevalence and spatial distribution of Entamoeba histolytica/dispar and Giardia lamblia among schoolchildren in Agboville area (Côte d'Ivoire). PLoS Neglected Tropical Diseases 4, e574.CrossRefGoogle Scholar
Qian, M-B, Yap, P, Yang, Y-C, Liang, H, Jiang, Z-H, Li, W, Utzinger, J, Zhou, X-N and Keiser, J (2013) Accuracy of the Kato-Katz method and formalin-ether concentration technique for the diagnosis of Clonorchis sinensis, and implication for assessing drug efficacy. Parasites & Vectors 6, 314.CrossRefGoogle Scholar
Sarhan, RM, Shaaban, YM, Hassan, AT and Salem, HS (2018) Mini-FLOTAC versus other copromicroscopic methods in diagnosis of intestinal parasitic infections. Research Journal of Parasitology 13, 36–46.Google Scholar
Sitotaw, B, Mekuriaw, H and Damtie, D (2019) Prevalence of intestinal parasitic infections and associated risk factors among Jawi primary school children, Jawi town, north-west Ethiopia. BMC Infectious Diseases 19, 341–341.CrossRefGoogle ScholarPubMed
Speich, B, Ali, SM, Ame, SM, Albonico, M, Utzinger, J and Keiser, J (2015) Quality control in the diagnosis of Trichuris trichiura and Ascaris lumbricoides using the Kato-Katz technique: experience from three randomised controlled trials. Parasites & Vectors 8, 82.CrossRefGoogle Scholar
Suwansaksri, J, Nithiuthai, S, Wiwanitkit, V, Soogarun, S and Palatho, P (2002) The formol-ether concentration technique for intestinal parasites: comparing 0.1 N sodium hydroxide with normal saline preparations. Southeast Asian Journal of Tropical Medicine and Public Health 33(Suppl 3), 97–98.Google ScholarPubMed
Tigabu, A, Taye, S, Aynalem, M and Adane, K (2019) Prevalence and associated factors of intestinal parasitic infections among patients attending Shahura Health Center, Northwest Ethiopia. BMC Research Notes 12, 333–341.CrossRefGoogle Scholar
Utzinger, J, Botero-Kleiven, S, Castelli, F, Chiodini, PL, Edwards, H, Köhler, N, Gulletta, M, Lebbad, M, Manser, M, Matthys, B, N'Goran, EK, Tannich, E, Vounatsou, P and Marti, H (2010) Microscopic diagnosis of sodium acetate-acetic acid-formalin-fixed stool samples for helminths and intestinal protozoa: a comparison among European reference laboratories. Clinical Microbiology and Infection 16, 267–273.CrossRefGoogle ScholarPubMed
World Health Organization (2012) Soil Transmitted Helminthiasis: Eliminating Soil Transmitted Helminthiasis as a Public Health Problem in Children; Progress Report 2001–2010 and Strategic Plan 2011–2020, 1st Edn. Geneva: World Health Organization, pp. 6–16.Google Scholar
Zenu, S, Alemayehu, E and Woldemichael, K (2019) Prevalence of intestinal parasitic infections and associated factors among street children in Jimma town; south West Ethiopia in 2019: a cross sectional study. BMC Public Health 19, 1731.CrossRefGoogle ScholarPubMed