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Diagnosis of Oesophagostomum bifurcum and hookworm infection in humans: day-to-day and within-specimen variation of larval counts

Published online by Cambridge University Press:  01 March 1999

D. S. S. PIT
Affiliation:
Department of Parasitology, Leiden University Medical Centre, PO Box 9605, 2300 RC Leiden, The Netherlands
W. DE GRAAF
Affiliation:
Department of Parasitology, Leiden University Medical Centre, PO Box 9605, 2300 RC Leiden, The Netherlands
H. SNOEK
Affiliation:
Department of Parasitology, Leiden University Medical Centre, PO Box 9605, 2300 RC Leiden, The Netherlands
S. J. DE VLAS
Affiliation:
Department of Public Health, Faculty of Medicine Erasmus University Rotterdam, The Netherlands
S. M. BAETA
Affiliation:
Département de Gynécologie, Centre Hospitalier Universitaire, Université du Benin, Lomé, Togo
A. M. POLDERMAN
Affiliation:
Department of Parasitology, Leiden University Medical Centre, PO Box 9605, 2300 RC Leiden, The Netherlands

Abstract

Oesophagostomum bifurcum, as well as hookworm infections are hyperendemic among humans in northern Togo and Ghana. For parasite-specific diagnosis a coproculture is obligatory, because only the infective larvae, and not the eggs, can be distinguished morphologically. The sensitivity of duplicate coprocultures from a single stool sample was found to be above 90% in comparison to a gold standard of 10 coprocultures made from a single stool specimen. Prevalence of infection with O. bifurcum and hookworm further increased with the number of coprocultures made from each individual stool. Notwithstanding the high sensitivity, intensity of infection per individual varied considerably from day-to-day and the number of larvae found in different samples out of 1 stool also varied highly, both showing a heterogeneous distribution. Surprisingly, daily fluctuation and within-specimen variation could not be differentiated from each other, probably because of the variation created by the coproculture technique. To estimate the intensity of infection, it is sufficient to make repeated coprocultures from only 1 individual stool sample. Laborious collection of stool samples on subsequent days does not give better estimates of the individual infection status.

Type
Research Article
Copyright
1999 Cambridge University Press

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