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An In-Depth Analysis of a Piece of Shit: Distribution of Schistosoma mansoni and Hookworm Eggs in Human Stool

BACKGROUND: 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 a...

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Autores principales: Krauth, Stefanie J., Coulibaly, Jean T., Knopp, Stefanie, Traoré, Mahamadou, N'Goran, Eliézer K., Utzinger, Jürg
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2012
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3527364/
https://www.ncbi.nlm.nih.gov/pubmed/23285307
http://dx.doi.org/10.1371/journal.pntd.0001969
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author Krauth, Stefanie J.
Coulibaly, Jean T.
Knopp, Stefanie
Traoré, Mahamadou
N'Goran, Eliézer K.
Utzinger, Jürg
author_facet Krauth, Stefanie J.
Coulibaly, Jean T.
Knopp, Stefanie
Traoré, Mahamadou
N'Goran, Eliézer K.
Utzinger, Jürg
author_sort Krauth, Stefanie J.
collection PubMed
description BACKGROUND: 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. METHODOLOGY: 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. PRINCIPAL FINDINGS: 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<0.005). CONCLUSIONS/SIGNIFICANCE: Our findings have important implications for helminth diagnosis at the individual patient level and for epidemiological surveys, anthelmintic drug efficacy studies and monitoring of control programs. Specifically, homogenization of fecal samples is recommended for an accurate detection of S. mansoni eggs, while keeping collected stool samples cool and moist delayed the disintegration of hookworm eggs.
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spelling pubmed-35273642013-01-02 An In-Depth Analysis of a Piece of Shit: Distribution of Schistosoma mansoni and Hookworm Eggs in Human Stool Krauth, Stefanie J. Coulibaly, Jean T. Knopp, Stefanie Traoré, Mahamadou N'Goran, Eliézer K. Utzinger, Jürg PLoS Negl Trop Dis Research Article BACKGROUND: 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. METHODOLOGY: 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. PRINCIPAL FINDINGS: 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<0.005). CONCLUSIONS/SIGNIFICANCE: Our findings have important implications for helminth diagnosis at the individual patient level and for epidemiological surveys, anthelmintic drug efficacy studies and monitoring of control programs. Specifically, homogenization of fecal samples is recommended for an accurate detection of S. mansoni eggs, while keeping collected stool samples cool and moist delayed the disintegration of hookworm eggs. Public Library of Science 2012-12-20 /pmc/articles/PMC3527364/ /pubmed/23285307 http://dx.doi.org/10.1371/journal.pntd.0001969 Text en © 2012 Krauth et al http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited.
spellingShingle Research Article
Krauth, Stefanie J.
Coulibaly, Jean T.
Knopp, Stefanie
Traoré, Mahamadou
N'Goran, Eliézer K.
Utzinger, Jürg
An In-Depth Analysis of a Piece of Shit: Distribution of Schistosoma mansoni and Hookworm Eggs in Human Stool
title An In-Depth Analysis of a Piece of Shit: Distribution of Schistosoma mansoni and Hookworm Eggs in Human Stool
title_full An In-Depth Analysis of a Piece of Shit: Distribution of Schistosoma mansoni and Hookworm Eggs in Human Stool
title_fullStr An In-Depth Analysis of a Piece of Shit: Distribution of Schistosoma mansoni and Hookworm Eggs in Human Stool
title_full_unstemmed An In-Depth Analysis of a Piece of Shit: Distribution of Schistosoma mansoni and Hookworm Eggs in Human Stool
title_short An In-Depth Analysis of a Piece of Shit: Distribution of Schistosoma mansoni and Hookworm Eggs in Human Stool
title_sort in-depth analysis of a piece of shit: distribution of schistosoma mansoni and hookworm eggs in human stool
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3527364/
https://www.ncbi.nlm.nih.gov/pubmed/23285307
http://dx.doi.org/10.1371/journal.pntd.0001969
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