학술논문

Simple Fecal Flotation Is a Superior Alternative to Guadruple Kato Katz Smear Examination for the Detection of Hookworm Eggs in Human Stool.
Document Type
Article
Source
PLoS Neglected Tropical Diseases. 12/18/2014, Vol. 8 Issue 12, p1-6. 6p.
Subject
*HOOKWORMS
*EGGS
*FLOTATION
*SODIUM nitrate
Language
ISSN
1935-2727
Abstract
Background: Microscopy-based identification of eggs in stool offers simple, reliable and economical options for assessing the prevalence and intensity of hookworm infections, and for monitoring the success of helminth control programs. This study was conducted to evaluate and compare the diagnostic parameters of the Kato-Katz (KK) and simple sodium nitrate flotation technique (SNF) in terms of detection and quantification of hookworm eggs, with PCR as an additional reference test in stool, collected as part of a baseline cross-sectional study in Cambodia. Methods/Principle Findings: Fecal samples collected from 205 people in Dong village, Rovieng district, Preah Vihear province, Cambodia were subjected to KK, SNF and PCR for the detection (and in case of microscopy-based methods, quantification) of hookworm eggs in stool. The prevalence of hookworm detected using a combination of three techniques (gold standard) was 61.0%. PCR displayed a highest sensitivity for hookworm detection (92.0%) followed by SNF (44.0%) and quadruple KK smears (36.0%) compared to the gold standard. The overall eggs per gram feces from SNF tended to be higher than for quadruple KK and the SNF proved superior for detecting low egg burdens. Conclusion/Significance: As a reference, PCR demonstrated the higher sensitivity compared to SNF and the quadruple KK method for detection of hookworm in human stool. For microscopic-based quantification, a single SNF proved superior to the quadruple KK for the detection of hookworm eggs in stool, in particular for low egg burdens. In addition, the SNF is cost-effective and easily accessible in resource poor countries. Author Summary: Hookworm infection is widespread in resource-poor countries worldwide. Detection of hookworm eggs in human feces can be done by the Kato Katz technique (KK), sodium nitrate flotation technique (SNF) or PCR. This study was conducted to evaluate and compare the diagnostic parameters of the KK and simple SNF in terms of detection and quantification of hookworm eggs, with PCR as an additional reference test in stool, collected as part of a baseline cross-sectional study in Cambodia. PCR demonstrated the highest sensitivity for hookworm detection. By microscopy, SNF of a single stool sample proved superior for the detection of hookworm eggs in feces than quadruple Kato Katz smears. Hookworm egg counts were higher by SNF than those obtained using Kato Katz. Thus, the SNF proved superior to the quadruple Kato-Katz smears for the detection of low egg burdens and for the quantification of egg intensities. We propose the simple SNF is a superior alternative to the Kato-Katz for detection and quantification of hookworm infection in resource poor counties. The test is cost-effective and easily accessible. [ABSTRACT FROM AUTHOR]