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. 2022 Jun 27;15(1):234.
doi: 10.1186/s13071-022-05338-z.

Performance of Mini Parasep® SF stool concentrator kit, Kato-Katz, and formalin-ethyl acetate concentration methods for diagnosis of opisthorchiasis in Northeast Thailand

Kulthida Y Kopolrat  1   2 , Seri Singthong  3 , Narong Khuntikeo  2   4 , Watcharin Loilome  2   5 , Chanika Worasith  2   6 , Chutima Homwong  2 , Chompunoot Wangboon  7 , Patiwat Yasaka  8 , Chatanun Eamudomkarn  6 , Opal Pitaksakulrat  6 , Krisnakorn Tonkhamhak  2 , Arunee Paeyo  2 , Thomas Crellen  9   10 , Jiraporn Sithithaworn  11 , Paiboon Sithithaworn  12   13
Affiliations

Performance of Mini Parasep® SF stool concentrator kit, Kato-Katz, and formalin-ethyl acetate concentration methods for diagnosis of opisthorchiasis in Northeast Thailand

Kulthida Y Kopolrat et al. Parasit Vectors. .

Abstract

Background: Control and elimination of the liver fluke (Opisthorchis viverrini) is a primary preventive strategy against cholangiocarcinoma in Southeast Asia. A sensitive parasitological diagnostic method is required to facilitate a surveillance and control program. In this study, we evaluated the performance of Mini Parasep® SF stool concentrator kit (stool kit) compared with Kato-Katz (KK) and the quantitative formalin-ethyl acetate concentration technique (FECT) for detection of O. viverrini and co-endemic parasitic infections.

Methods: A cross-sectional survey for parasitic infection in residents aged > 15 years in a community in Kalasin province, Northeast Thailand, was conducted in 2018. Fecal samples were collected and screened by KK method, and a subset of samples was further examined by the stool kit and FECT methods. The results were analyzed for prevalence of parasitic infections in addition to the diagnostic performance of the methods for qualitative and quantitative detection of helminthiases.

Results: The initial survey of parasitic infection determined by the KK method (n = 567) showed the prevalence of O. viverrini was 32.63%, followed by Taenia 2.65%, echinostomes 1.76%, hookworms 1.41%, Trichuris trichiura 0.53% and Strongyloides stercoralis 0.53%. Within a subset of samples tested with multiple diagnostics (n = 150), the detection rates of O. viverrini by the stool kit, FECT and KK methods were 27.3%, 30.7% and 28.7%, respectively. The diagnostic sensitivity for opisthorchiasis was similar for FECT (75.5%), KK(66.0%) and the stool kit (67.3%). For other parasitic infections, FECT and stool kit methods performed better than KK, particularly in detecting minute intestinal flukes (MIF), S. stercoralis and coinfections. When measuring the intensity of O. viverrini infection (fecal egg counts), the stool kit results showed a significant positive correlation with KK and FECT (P < 0.05).

Conclusions: As the stool kit is simple to use and shows a comparable performance to FECT, it may serve as an alternative method of fecal examination for screening of helminthiasis including opisthorchiasis.

Keywords: Diagnostic performance; Formalin-ethyl acetate concentration technique; Helminthiasis; Kato-Katz; Mini Parasep® SF stool concentrator kit; Opisthorchiasis; Opisthorchis viverrini.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Map of the study area showing an overview of an endemic area for opisthorchiasis in Na Mon district, Kalasin province, northeast Thailand
Fig. 2
Fig. 2
Age-sex prevalence (a) and age-sex intensity (b) profiles of O. viverrini determined by Kato-Katz method (n = 567)
Fig. 3
Fig. 3
Flow diagram of study participants and sample collection. Data shown for age are mean ± SD, where n is the sample size
Fig. 4
Fig. 4
Relationship between log eggs per gram of feces of O. viverrini measured by Mini Parasep® SF kit (stool kit) and formalin-ethyl acetate concentration technique (FECT) (a), stool kit and Kato-Katz (KK) (b) and FECT and KK methods (c). The dots shown are observed data and a solid line represented a linear regression equation. R2 is the correlation coefficient and P-value
See this image and copyright information in PMC

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