Real-time PCR for detection of Strongyloides stercoralis in human stool samples from Côte d’Ivoire: Diagnostic accuracy, inter-laboratory comparison and patterns of hookworm co-infection

Becker, Sören L.; Piraisoody, Nivetha; Kramme, Stefanie; Marti, Hanspeter; Silué, Kigbafori D.; Panning, Marcus; Nickel, Beatrice; Kern, Winfried V.; Herrmann, Mathias; Hatz, Christoph; N’Goran, Eliézer K.; Utzinger, Jürg; Müller, Lutz von

doi:10.1016/j.actatropica.2015.07.019

Cited by 50 publications

(47 citation statements)

References 46 publications

(5 reference statements)

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“…On the other hand, this change entailed the lack of a third serology test, therefore patients with discordant results had to be classified as uncertain. PCR was not available at our Centre before 2014, hence we could not use this method, that showed good accuracy compared with APC and Baermann technique [27,28]. PCR is less cumbersome than the traditional faecal-based methods and the samples can be stored (either frozen or with ethanol), therefore it could have been a useful tool considering the high number of individuals screened.…”

Section: Discussionmentioning

confidence: 99%

Epidemiology of Strongyloides stercoralis in northern Italy: results of a multicentre case–control study, February 2013 to July 2014

Buonfrate

Baldissera

Abrescia³

et al. 2016

Eurosurveillance

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Strongyloides stercoralis is a soil-transmitted helminth widely diffused in tropical and subtropical regions of the world. Autochthonous cases have been also diagnosed sporadically in areas of temperate climate. We aimed at defining the epidemiology of strongyloidiasis in immigrants and Italians living in three northern Italian Regions. Screening for S. stercoralis infection was done with serology, confirmation tests were a second serological method or stool agar culture. A case–control approach was adopted and patients with a peripheral eosinophil count ≥ 500/mcL were classified as cases. Of 2,701 individuals enrolled here 1,351 were cases and 1,350 controls; 86% were Italians, 48% women. Italians testing positive were in 8% (97/1,137) cases and 1% (13/1,178) controls (adjusted odds ratio (aOR) 8.2; 95% confidence interval (CI): 4.5–14.8), while positive immigrants were in 17% (36/214) cases and in 2% (3/172) controls (aOR 9.6; 95% CI: 2.9–32.4). Factors associated with a higher risk of infection for all study participants were eosinophilia (p < 0.001) and immigration (p = 0.001). Overall, strongyloidiasis was nine-times more frequent in individuals with eosinophilia than in those with normal eosinophil count.

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Section: Discussionmentioning

confidence: 99%

Epidemiology of Strongyloides stercoralis in northern Italy: results of a multicentre case–control study, February 2013 to July 2014

Buonfrate

Baldissera

Abrescia³

et al. 2016

Eurosurveillance

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“…However, this test also can give a positive result in the setting of hookworm infection and can contribute to perceived false negatives and an overall low sensitivity seen in some studies using qPCR 26,61,62. However, in many epidemiologic surveys, qPCR has typically increased overall diagnostic yield by 2- to 8-fold when compared with a variety of microscopic techniques 12,19,27,45,51,63,73.…”

Section: Qpcr In the Detection Of Each Of The Major Sthmentioning

confidence: 99%

Molecular Diagnostics for Soil-Transmitted Helminths

O’Connell

Nutman

2016

The American Society of Tropical Medicine and Hygiene

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Abstract. Historically, the diagnosis of soil-transmitted helminths (STHs) (e.g., Strongyloides stercoralis, Trichuris trichiura, Ancylostoma duodenale, Necator americanus, and Ascaris lumbricoides) has relied on often-insensitive microscopy techniques. Over the past several years, there has been an effort to use molecular diagnostics, particularly quantitative polymerase chain reaction (qPCR), to detect intestinal pathogens. While some platforms have been approved by regulatory bodies (e.g., Food and Drug Administration) to detect intestinal bacteria, viruses, and protozoa, there are no approved tests currently available for STH. Although studies comparing qPCR to microscopy methods for STH are imperfect, due in large part to a lack of a sufficient gold standard, they do show a significant increase in sensitivity and specificity of qPCR compared with microscopic techniques. These studies, as well as the advantages and disadvantages of using qPCR for STH diagnosis, are discussed. Guidelines for those designing future studies utilizing qPCR are proposed for optimizing results, as is the proposition for using standardized molecular diagnostics routinely for STH in clinical laboratories and for field-based studies when possible.

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“…Its diagnosis relies on identification of larvae in stool, with the two most appropriate methods being the Baermann, Harada Mori and Koga agar plate culture techniques, even though their sensitivity is not optimal [13]. While highly sensitive molecular techniques have recently been developed [14, 15], there is still no gold standard. Accordingly, a combination of different techniques is the most useful approach for the detection of S. stercoralis larvae [7].…”

Section: Introductionmentioning

confidence: 99%

High prevalence of Strongyloides stercoralis in school-aged children in a rural highland of north-western Ethiopia: the role of intensive diagnostic work-up

et al. 2016

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BackgroundSoil-transmitted helminthiases (hookworms, Ascaris lumbricoides and Trichuris trichiura) are extremely prevalent in school-aged children living in poor sanitary conditions. Recent epidemiological data suggest that Strongyloides stercoralis is highly unreported. However, accurate data are essential for conducting interventions aimed at introducing control and elimination programmes.MethodsWe conducted a cross-sectional survey of 396 randomly selected school-aged children in Amhara region in rural area in north-western Ethiopia, to assess the prevalence of S. stercoralis and other intestinal helminths. We examined stools using three techniques: conventional stool concentration; and two S. stercoralis-specific methods, i.e. the Baermann technique and polymerase chain reaction. The diagnostic accuracy of these three methods was then compared.ResultsThere was an overall prevalence of helminths of 77.5%, with distribution differing according to school setting. Soil-transmitted helminths were recorded in 69.2%. Prevalence of S. stercoralis and hookworm infection was 20.7 and 54.5%, respectively, and co-infection was detected in 16.3% of cases. Schistosoma mansoni had a prevalence of 15.7%. Prevalence of S. stercoralis was shown 3.5% by the conventional method, 12.1% by the Baermann method, and 13.4% by PCR, which thus proved to be the most sensitive.ConclusionsOur results suggest that S. stercoralis could be overlooked and neglected in Ethiopia, if studies of soil-transmitted helminths rely on conventional diagnostic techniques alone. A combination of molecular and stool microscopy techniques yields a significantly higher prevalence. In view of the fact that current control policies for triggering drug administration are based on parasite prevalence levels, a comprehensive diagnostic approach should instead be applied to ensure comprehensive control of helminth infections.

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Real-time PCR for detection of Strongyloides stercoralis in human stool samples from Côte d’Ivoire: Diagnostic accuracy, inter-laboratory comparison and patterns of hookworm co-infection

Cited by 50 publications

References 46 publications

Epidemiology of Strongyloides stercoralis in northern Italy: results of a multicentre case–control study, February 2013 to July 2014

Epidemiology of Strongyloides stercoralis in northern Italy: results of a multicentre case–control study, February 2013 to July 2014

Molecular Diagnostics for Soil-Transmitted Helminths

High prevalence of Strongyloides stercoralis in school-aged children in a rural highland of north-western Ethiopia: the role of intensive diagnostic work-up

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