Detection of the Carcinogenic Liver Fluke Opisthorchis viverrini Using a Mini Parasep SF Faecal Parasite Concentrator

  • Kaewpitoon, Soraya J (Parasitic Disease Research Unit, Suranaree University of Technology) ;
  • Rujirakul, Ratana (Parasitic Disease Research Unit, Suranaree University of Technology) ;
  • Tongtawee, Taweesak (Suranaree University of Technology Hospital) ;
  • Matrakul, Likit (Suranaree University of Technology Hospital) ;
  • Panpimanmas, Sukij (Suranaree University of Technology Hospital) ;
  • Wakkuwattapong, Parichart (Parasitic Disease Research Unit, Suranaree University of Technology) ;
  • Loyd, Ryan A (School of Family Medicine and Community Medicine, Suranaree University of Technology) ;
  • Kaewpitoon, Natthawut (Parasitic Disease Research Unit, Suranaree University of Technology)
  • Published : 2016.02.05


The Mini Parasep SF fecal parasite concentrator (MPSFC) is a new modification of the closed concentration system, which can easily be adopted in any routine clinical pathology laboratory. Here we describe our experience with the system in diagnosing Opisthorchis viverrini. A total of 199 fecal samples was submitted for routine examination in the clinical pathology laboratory of Suranaree University of Technology hospital, Nakhon Ratchasima province, Thailand, during August to October 2015. Out of all samples examined, 10 (5.03%) were positive with intestinal parasites including O. viverrini (2.01%), followed by Strongyloided stercoralis (1.51%), Hookworm (0.5%), Taenia spp. (0.5%), and Entamoeba coli (0.5%). Regarding the distribution of intestinal parasites in relation to the methods used, and found that 4 samples (2.01%) were positive using the direct wet smear method while 10 (5.03%) were positive with the Mini Parasep SF method; the difference was statistically significant ($X^2$-test = 116.506, p-value =0.001). Mean time for processing using the Parasep system was 6.03 min/sample, the conventional direct wet smear method at 0.3 min/sample. Cost per test, conventional direct wet smear method costing less than the Parasep method at USD 0.74/sample versus USD 1.47/sample. This first report of O. viverrini detection using MPSFC indicates that Parasep concentration test is useful in the routine laboratory, increasing the yield of parasites as compared to direct microscopy, but with greater processing time and cost. Further comparisons between the Parasep concentration test and common methods for O. viverrini detection are required, particularly concerning use in epidemiological surveys.


Detection;carcinogenic liver fluke;Opisthorchis viverrini;mini parasep SF faecal parasite concentrator


Supported by : Suranaree University of Technology (SUT), Higher Education Commission


  1. Chaiputcha K, Promthet S, Bradshaw P (2015). Prevalence and risk factors for infection by Opisthorchis viverrini in an urban area of Mahasarakham province, northeast Thailand. Asian Pac J Cancer Prev, 16, 4173-6.
  2. Chudthaisong N, Promthet S, Bradshaw P (2015). Risk factors for Opisthorchis viverrini infection in Nong Khai province, Thailand. Asian Pac J Cancer Prev, 16, 4593-6.
  3. Harinasuta C, Vajrasthira S (1960). Opisthorchiasis in Thailand. Am J Trop Med Hyg, 54, 100-5.
  4. Harinasuta T, Riganti M, Bunnag D (1984). Opisthorchis viverrini infection: pathogenesis and clinical features. Arzneimittelforschung, 34, 1167-9.
  5. IARC. (1994). Infection with liver flukes (Opisthorchis viverrini, Opisthorchis felineus and Clonrochis sinensis). IARC Monogr Eval Carcinog Risks Hum, 61, 121-75.
  6. Jongsuksuntigul P, Imsomboon T (2003). Opisthorchiasis control in Thailand. Acta Trop, 88, 229-32.
  7. Kaewpitoon N, Kaewpitoon SJ, Pengsaa P (2008). Opisthorchiasis in Thailand: review and current status. World J Gastroenterol, 14, 2297-302.
  8. Kaewpitoon SJ, Rujirakul R, Ueng-Arporn N, et al (2012). Community-based cross-sectional study of carcinogenic human liver fluke in elderly from Surin province, Thailand. Asian Pac J Cancer Prev, 13, 4285-8.
  9. Kaewpitoon SJ, Rujirakul R, Kaewpitoon N (2012). Prevalence of Opisthorchis viverrini infection in Nakhon Ratchasima province, Northeast Thailand. Asian Pac J Cancer Prev, 13, 5245-9.
  10. Levecke B, De Wilde N, Vandenhoute E, et al (2009). Field validity and feasibility of four techniques for the detection of trichuris in simians: a model for monitoring drug efficacy in public Health? PLoS Negl Trop Dis, 3, 366.
  11. Saez AC, Manser MM, Andrews N, et al (2011). Comparison between the midi parasep and midi parasep solvent free (SF) faecal parasite concentrators. J Clin Pathol, 64, 901-4.
  12. Saengsawang P, Promthet S, Bradshaw P (2013). Infection with Opisthorchis viverrini and use of praziquantel among a working-age population in northeast Thailand. Asian Pac J Cancer Prev, 14, 2963-6.
  13. Sithithaworn P, Pipitgool V, Srisawangwong T, et al (1997). Seasonal variation of Opisthorchis viverrini infection in cyprinoid fish in north-east Thailand: implications for parasite control and food safety. Bull WHO, 75, 125-31.
  14. Sithithaworn P, Andrews RH, Nguyen VD, et al (2012). The current status of opisthorchiasis and clonorchiasis in the Mekong Basin. Parasitol International, 61, 10-6.
  15. Sripa B, Kaewkes S, Intapan PM, et al (2010). Food-borne trematodiases in Southeast Asia: epidemiology, pathology, clinical manifestation and control. Adv Parasitol, 72, 305-50.
  16. Sripa B, Pairojkul C (2008). Cholangiocarcinoma: lessons from Thailand. Curr Opin Gastroenterol, 24, 349-56.
  17. Suwannahitatorn P, Klomjit S, Naaglor T, et al (2013). A follow-up study of Opisthorchis viverrini infection after the implementation of control program in a rural community, central Thailand. Parasit Vectors, 6, 188.
  18. Thamavit W, Bhamarapravati N, Sahaphong S, et al (1978). Effects of dimethylnitrosamine on induction of cholangiocarcinoma in Opisthorchis viverrini-infected Syrian golden hamsters. Cancer Res, 38, 4634-9.
  19. Useh MF, Asuquo AE, Otu-Bassey IB, OL Ubi (2011). Evaluation of the efficacy of the mini parasep sf faecal parasite concentrator; a new technique against the direct smear and formol ether concentration technique for the detection of intestinal parasites in Stool. J Med Lab Sci, 20, 37-43.
  20. Zeeshan M, Zafar A, Saeed Z, et al (2011). Use of Parasep filter fecal concentrator tubes” for the detection of intestinal parasites in stool samples under routine conditions. Indian J Pathol Microbiol, 54, 121-3.
  21. Yeoh KW, Promthet S, Sithithaworn P, et al (2015). Reexamination of Opisthorchis viverrini infection in northeast Thailand. Asian Pac J Cancer Prev, 16, 3413-8.

Cited by

  1. Prevalence and Factors Associated with Opisthorchis viverrini Infection in Khammouane Province, Lao PDR vol.17, pp.3, 2016,
  2. Health Behavior Regarding Liver Flukes among Rural People in Nakhon Ratchasima, Thailand vol.17, pp.4, 2016,