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. 2022 Nov 17;23(1):284.
doi: 10.1186/s12875-022-01888-4.

A simple parasitological technique to increase detection of Strongyloides stercoralis in Bolivian primary health care system

Ivana Camacho-Alvarez  1 , Elia M Chavez-Mamani  2 , Goyens Philippe  3 , Jenny M Luizaga-López  4 , Mary Cruz Torrico  5 , Laurent Gétaz  6 , Frédérique Jacobs  7
Affiliations

A simple parasitological technique to increase detection of Strongyloides stercoralis in Bolivian primary health care system

Ivana Camacho-Alvarez et al. BMC Prim Care. .

Abstract

Background: Strongyloides stercoralis is widespread; however, there is limited information on its prevalence owing to laboratory underestimation and low clinical manifestations. The Baermann method and agar culture stand out among the parasitological techniques. Strongyloides stercoralis is present in Bolivia, but its prevalence in children remains unknown. The objective of this study was to estimate the applicability of simple parasitological techniques to increase the detection of this parasite in children living in the tropics.

Methods: This cross-sectional study was conducted in a tropical village in Cochabamba, Bolivia. Participants were 304 children aged 5 - 12 years who provided stool samples for different parasitological analyses (direct examination, Ritchie, Baermann, and Dancescu techniques), and their parents provided informed consent.

Results: Up to 64.8% of pathogenic parasites were detected using the modified Ritchie method. The Baermann technique identified 17.8% of Strongyloides stercoralis cases, and a high sensitivity with respect to the Baermann technique was only for the Dancescu technique (75.9%) that is also specific for Strongyloides stercoralis, followed by 66.7% for the modified Ritchie technique, which is used in second-line care.

Discussion: The Baermann technique is the best parasitological option for improving Strongyloides stercoralis diagnosis in the first-line care of the Primary Health Care System. A particular cycle of reinfection, combined with the environment and some other risk factors are related with persistence. Control is difficult without a proper diagnosis, and the Baermann technique is an approach to the solution. We conclude that with a high suspicion of the presence of Strongyloides stercoralis, the use of the Baermann technique is strongly recommended as support for direct examination in primary health care systems especially in tropical areas.

Keywords: Baermann Technique; Diagnosis; Neglected Tropical Disease; Primary Health Care; Strongyloides Stercoralis.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Field sample processing replicating first-line care laboratory conditions 1._Preparation of sample for Baermann technique and direct examination; 2. Preparation of plates for Dancescu technique; 3. Adaptation of Baermann technique for first level in the fieldwork and 4. On-site sample analysis
Fig. 2
Fig. 2
Detection of intestinal parasites using four parasitological techniques in primary health care in children from Bolivian tropical areas. *Specific methods for Strongyloides stercoralis. **PP: Pathogenic parasite
Fig. 3
Fig. 3
Detection of Strongyloides stercoralis by four parasitological techniques, in primary health care in children from Bolivian tropical areas. * Specific methods for Strongyloides stercoralis
See this image and copyright information in PMC

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