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A novel kit for enrichment of fecal helminth eggs

  • Eunsol Lee (Division of Vectors and Parasitic Diseases, Korea Diseases Control and Prevention Agency) ;
  • Seon-Ok Back (Division of Vectors and Parasitic Diseases, Korea Diseases Control and Prevention Agency) ;
  • Young-Ju Lee (Division of Vectors and Parasitic Diseases, Korea Diseases Control and Prevention Agency) ;
  • Jung-Won Ju (Division of Vectors and Parasitic Diseases, Korea Diseases Control and Prevention Agency) ;
  • Hee-Il Lee (Division of Vectors and Parasitic Diseases, Korea Diseases Control and Prevention Agency) ;
  • Myoung-Ro Lee (Division of Vectors and Parasitic Diseases, Korea Diseases Control and Prevention Agency)
  • Received : 2024.03.18
  • Accepted : 2024.07.22
  • Published : 2024.08.31

Abstract

We developed a new concentration kit, called the ParaEgg (PE), for easy detection trematode eggs from fecal samples in endemic areas of clonorchiasis and metagonimiasis in Korea. To create a standard of detection efficiency, 120 fecal samples were examined using the water-ether concentration method (WECM). The PE kit and Mini ParaSep (PS) kit were used to compare the detection sensitivity of 100 egg-positive and 20 egg-negative samples in WECM. Additionally, stool samples, which were intentionally spiked with 10, 20, and 30 Clonorchis sinensis eggs, were evaluated to assess the sensitivity in low-infection cases. The PE and PS kits showed detection rates of 100% and 92%, respectively, from 100 egg-positive samples in WECM. Meanwhile, eggs were detected in 3 (PE) and 2 (PS) out of 20 egg-negative samples in WECM. The PE kit detected the highest number of eggs per gram of feces (727 on average), followed by the WECM (524) and PS kit (432). In fecal samples that were intentionally spiked with 10, 20, and 30 C. sinensis eggs, PE only detected eggs 2 out of 5 samples in 10 eggs spiked (40%), and the detection rates were 80% and 100%, respectively. The PE kit enabled a more accurate identification of trematode eggs because of the clearance of small fecal debris in the microscopic field. In conclusion, the PE kit is obviously helpful to detect and identify trematode eggs in stool examinations especially in endemic areas of clonorchiasis and metagonimiasis.

Keywords

Acknowledgement

This work was supported by a grant (6331-311-210-13, 2023) from the Korea Disease Control and Prevention Agency (KDCA), Korea.

References

  1. Hong ST, Yong TS. Review of successful control of parasitic infections in Korea. Infect Chemother 2020;52(3):427-440. https://doi.org/10.3947/ic.2020.52.3.427 
  2. World Health Organization. Communicable diseses: control of schistosomiasis and soil-transmitted helminth infections. Fifty-fourth World Health Assembly. 2001;WHA54(3):A54/10. 
  3. Jeong YI, Shin HE, Lee SE, Cheun HI, Ju JW, et al. Prevalence of Clonorchis sinensis infection among residents along 5 major rivers in the Republic of Korea. Korean J Parasitol 2016;54(2):215-219. https://doi.org/10.3347/kjp.2016.54.2.215 
  4. Yoo WG, Sohn WM, Na BK. Current status of Clonorchis sinensis and clonorchiasis in Korea: epidemiological perspectives integrating the data from human and intermediate hosts. Parasitology 2022;149(10):1296-1305. https://doi.org/10.1017/S0031182022000798 
  5. Lee MR, Shin HE, Back SO, Lee YJ, Lee HI, et al. Status of helminthic infections in residents around River Basins in the Republic of Korea for 10 years (2011-2020). Korean J Parasitol 2022;60(3):187-194. https://doi.org/10.3347/kjp.2022.60.3.187 
  6. Chai JY, Hong ST, Choi MH, Shin EH, Bae YM, et al. Clinical Parasitology. Seoul national University Press. Seoul, Korea. 2011, pp 358-368, 372-384.
  7. Kim HS, Nam HW, Ahn HJ, Kim D, Kim YH. Relationship between Clonorchis sinensis infection and cholangiocarcinoma in Korea. Korean J Parasitol 2022;60(4):261-271. https://doi.org/10.3347/kjp.2022.60.4.261 
  8. Bouvard V, Baan R, Straif K, Grosse Y, Secretan B, et al. A review of human carcinogens-part B: biological agents. Lancet Oncol 2009;10:321-322. https://doi.org/10.1016/s1470-2045(09)70096-8 
  9. Perry JL, Matthews JS, Miller GR. Parasite detection efficiencies of five stool concentration systems. J Clin Microbiol 1990; 28(6):1094-1097. https://doi.org/10.1128/jcm.28.6.1094-1097.1990 
  10. Barda BD, Rinaldi L, Ianniello D, Zepherine H, Salvo F, et al. Mini-FLOTAC, an innovative direct diagnostic technique for intestinal parasitic infections: experience from the field. PLoS Negl Trop Dis 2013;7(8):e2344. https://doi.org/10.1371/journal.pntd.0002344 
  11. Montresor A, Crompton DWT, Hall A, Bundy DAP, Savioll L. Guidelines for the Evaluation of Soil-Transmitted Helminthiasis and Schistosomiasis at Community Level. Guide for Managers of Control Programmes. World Health Organization, Geneva, Switzerland. 1998.
  12. Centers for Disease Control and Prevention. Stool Specimens - Specimen Processing [Internet]. Available from: https://www.cdc.gov/dpdx/diagnosticprocedures/stool/specimenproc.html
  13. Hong ST, Choi MH, Kim CH, Chung BS, Ji Z. The Kato-Katz method is reliable for diagnosis of Clonorchis sinensis infection. Parasitology 2003;47(1):345-347. https://doi.org/10.1016/s0732-8893(03)00113-5 
  14. Kaewpitoon SJ, Wakkhuwatapong P, Loyd RA, Sangwalee W, Kujapun J, et al. Detection of a carcinogenic liver fluke among migrant workers by three coprological concentration methods. Trop Biomed 2017;34(4):877-885. 
  15. Hussein AH, Rashed SM, El-Hayawan IA, Aly NSM, Abou Ouf EA, et al. Intestinal parasite infections and accuracy of direct thin and thick smear, formol-ether sedimentation, centrifugal flotation, and mini-flotac techniques among patients with gastrointestinal tract disorders from the Greater Cairo region, Egypt. Am J Trop Med Hyg 2017;96(3):589-594. https://doi.org/10.4269/ajtmh.16-0436 
  16. Won EJ, Kim J, Ryang DW. Evaluation of modified formalin-ether concentration method using Para Tube in clinical settings. Ann Lab Med 2015;35:445-448. https://doi.org/10.3343/alm.2015.35.4.445 
  17. Smith JW, Bartlett MS. Diagnostic parasitology: introduction and methods. In Lenette EH, Balows A, Hausler WJ Jr, Shadomy HJ, eds, Manual of Clinical Microbiology. 4th ed. American Society for Microbiology. Washington D.C., USA. 1985, pp 595-611.
  18. Saez AC, Manser MM, Andrews N, Chiodini PL. Comparison between the midi parasep and midi parasep solvent free (SF) faecal parasite concentrators. J Clin Pathol 2011;64(10):901-904. https://doi.org/10.1136/jcp.2011.090639 
  19. Couturier BA, Jensen R, Arias N, Heffron M, Gubler E, et al. Clinical and analytical evaluation of a single-bial stool collection device with formalin-free fixative for improved processing and comprehensive detection of gastrointestinal parasites. J Clin Microbiol 2015;53(8):2539-2548. https://doi.org/10.1128/JCM.00838-15 
  20. Charoensuk L, Subrungruang I, Mungthin M, Pinlaor S, Suwannabitatorn P. Comparison of stool examination techniques to detect Opisthorchis viverrini in low intensity infection. Acta Trop 2019;191:13-16. https://doi.org/10.1016/j.actatropica.2018.12.018 
  21. Adugna S, Kebede T, Mekonnen Z, Degarege A, Liang S, et al. Diagnostic performance of Mini Parasep® solvent-free faecal parasite concentrator relative to Kato-Katz and McMaster for the diagnosis of intestinal parasitic infections. Trans R Soc Trop Med Hyg 2017;111(12):572-578. https://doi.org/10.1093/trstmh/try010 
  22. Khanna V, Sagar S, Khanna R, Chawla K. A comparative study of formalin-ethyl acetate sedimentation technique and Mini Parasep® solvent-free method in the rapid diagnosis of intestinal parasites. Trop Parasitol 2018;8(1):29-32. https://doi.org/10.4103/tp.TP_44_17 
  23. Mewara A, Khurana S, Gupta S, Munda VS, Singh S, et al. Diagnostic performance of Mini Parasep® solvent-free foecal parasite concentrator for the diagnosis of intestinal parasitic infections. Indian J Med Microbiol 2019;37(3):381-386. https://doi.org/10.4103/ijmm.IJMM_19_44