Strongyloidiasis in humans: diagnostic efficacy of four conventional methods and real-time polymerase chain reaction

Campo-Polanco, Laura Francisca; Sarmiento, José; Mesa, Mónica; Franco, Carlos Jaime Velásquez; López, Lucelly; Botero, Luz Elena; Builes, Lina Andrea Gutiérrez

doi:10.1590/0037-8682-0055-2018

Cited by 8 publications

(7 citation statements)

References 34 publications

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“…The sensitivity of APC, 28.0% which was found in the present study, is better than other larvae detection methods that are used for the diagnosis of S. stercoralis infection [ 38 ]. Our finding, 28.0%, is compared with 25% previous sensitivity report [ 41 ]. However, our finding is lower than earlier sensitivity reports, 100% [ 40 ] and 60% [ 12 ].…”

Section: Discussionsupporting

confidence: 57%

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Evaluation of five diagnostic methods for Strongyloides stercoralis infection in Amhara National Regional State, northwest Ethiopia

et al. 2022

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Background Strongyloides stercoralis is an intestinal parasite that can cause chronic infection, hyperinfection and/or a dissemination syndrome in humans. The use of techniques targeting ova fails to detect S. stercoralis, as only larvae of the parasite are excreted in faeces. Due to the absence of “Gold” standard diagnostic method for S. stercoralis, there is a paucity of reported data worldwide. Objective This study aimed to evaluate the performance of diagnostic methods of S. stercoralis infection by taking the composite reference as a “Gold” standard. Methods A cross-sectional study was conducted among 844 schoolchildren in Amhara Region, Ethiopia, from April to December 2019. Stool samples were collected and processed with formol-ether concentration technique (FECT), spontaneous tube sedimentation technique (STST), Baermann concentration technique (BCT), agar plate culture (APC) and real-time polymerase chain reaction (RT-PCR). Sensitivity, specificity, positive predictive value, and negative predictive value of each diagnostic method were computed against the composite reference. The agreements of diagnostic methods were evaluated by Kappa value at 95% CI. Results The composite detection rate of S. stercoralis by the five diagnostic methods was 39.0% (329/844). The detection rate of the parasite from stool samples by FECT, STST, BCT, APC and RT-PCR was 2.0% (17/844), 4.0% (34/844), 10.2% (86/844), 10.9% (92/844) and 28.8% (243/844), respectively. The highest detection rate (37.8%; 319/844) of S. stercoralis was recorded by a combination of BCT, APC, and RT-PCR followed by a combination of STST, BCT, APC and RT-PCR (37.3%; 315/844). The sensitivity of FECT, STST, BCT, APC and RT-PCR against the composite reference was 5.2%, 10.3%, 26.4%, 28.0% and 73.9%, respectively. The diagnostic agreements of RT-PCR, APC, BCT, STST and FECT with the composite reference in detection of S. stercoralis were substantial (0.775), fair (0.321), fair (0.305), slight (0.123), and slight (0.062), respectively. Conclusion RT-PCR detected the highest number of S. stercoralis infections. A combination of RT-PCR with APC and/or BCT better detected S. stercoralis from stool samples compared to other combinations or single diagnostic methods. Therefore, RT-PCR and combination of RT-PCR with APC and/or BCT diagnostic methods should be advocated for detection of S. stercoralis infection.

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Section: Discussionsupporting

confidence: 57%

“…The sensitivity of RT-PCR in this study was 73.9%, which is compared with 74.3% [ 12 ] and 75% previous sensitivity reports [ 41 ]. Our result is, however, higher than 64.6% [ 16 ] and 65.1% [ 31 ] previously reported by the same method, but it is lower than 93.8% [ 19 ].…”

Section: Discussioncontrasting

confidence: 45%

Evaluation of five diagnostic methods for Strongyloides stercoralis infection in Amhara National Regional State, northwest Ethiopia

et al. 2022

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“…Though cRDT and hsRDT performance within a single study site was basically equivalent, consistent differences were seen between surveys with both types of RDTs providing a lower sensitivity in Artibonite, but higher specificity. The Youden's J statistic (as a measure of a probability of making an informed decision with 1.0 being perfect decision making [17,32]) was strong for all scenarios with values of 0.86 or higher. In Grand Anse, multiple samples were positive by the HRP2 lab assay only, but an even higher number of persons were RDT+ only for both RDT types.…”

Section: Discussionmentioning

confidence: 96%

Conventional and High-Sensitivity Malaria Rapid Diagnostic Test Performance in Two Transmission Settings: Haiti 2017

Rogier

Hamre

Joseph

et al. 2019

The Journal of Infectious Diseases

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Accurate malaria diagnosis is foundational for control and elimination, and Haiti relies on HRP2-based rapid diagnostic tests (RDTs) identifying Plasmodium falciparum in clinical and community settings. In 2017, one household and two easy-access group (EAG) surveys tested all participants (N=32,506) by conventional and high-sensitivity RDTs (cRDT/hsRDT). A subset of blood samples (n=1,154) were laboratory tested for HRP2 by bead-based immunoassay and for P. falciparum 18S rDNA by PET-PCR. Both RDT types detected low concentrations of HRP2 with sensitivity estimates between 2.6 and 14.6 ng/mL. Compared to the predicate HRP2 laboratory assay,, RDT sensitivity ranged from 86.3% to 96.0% between tests and settings, and specificity from 90.0% to 99.6%. In the household survey, the hsRDT provided a significantly higher number of positive tests, but this represented a very small proportion (<0.2%) of all participants. These data show an hsRDT may have limited utility in a malaria elimination setting like Haiti.

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“…The results of microscopy here (3.2% positive participants) are in line with a previous study reporting data on screening of 462 asylum seekers in Northern Italy [20], where 3.3% positive individuals were found with stool microscopy (with modified Ritchie's concentration method). In other studies, the screening of populations at risk resulted in a higher proportion of individuals positive to S. stercoralis detected by PCR than other parasitological methods [6,21,22].…”

Section: Discussionmentioning

confidence: 82%

“…Although its sensitivity was demonstrated to improve with the examination of multiple samples, it still remains disappointing [5]. Baermann method and agar plate culture have better performance but are seldom done because they are time-consuming and require parasitological skills that are not widely available in non-endemic settings [6]. Polymerase chain reaction (PCR) for S. stercoralis demonstrated good sensitivity and specificity, though it is not yet widely available outside referral laboratories [7].…”

Section: Introductionmentioning

confidence: 99%

Prevalence of Strongyloidiasis in a Cohort of Migrants in Italy and Accuracy of a Novel ELISA Assay for S. stercoralis Infection, a Cross-Sectional Study

Buonfrate

Marrone²,

Silva

et al. 2021

Microorganisms

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Strongyloides stercoralis infection is a life-threatening neglected tropical disease. Diagnostic issues have caused an underestimation of its global burden. The choice of appropriate diagnostic tests for the screening of populations at risk of the infection, such as migrants from endemic countries, is of paramount importance. From November 2017 to July 2018, all migrants presenting to the National Institute for Health Migration and Poverty (INMP) in Rome, Italy were offered screening tests for S. stercoralis infection. The study objective was to estimate the prevalence of strongyloidiasis in the study population and the accuracy of a novel ELISA assay. The following tests were carried out at the IRCCS Sacro Cuore Don Calabria hospital in Negrar, Verona: stool microscopy, real-time PCR for S. stercoralis, in-house immunofluorescence test (IFAT), a commercial ELISA assay (Bordier ELISA), and a novel ELISA assay (Euroimmun ELISA). A latent class analysis (LCA) model set up with test results, clinical variables, and eosinophilia indicated a prevalence around 7.5%, in line with previous findings. The sensitivity and the specificity of Euroimmun ELISA were 90.6% (95% CI 80.5–100) and 87.7% (95CI 84.5–91.0); these results indicate that the novel ELISA assay would be suitable for screening of migrants from endemic countries.

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Strongyloidiasis in humans: diagnostic efficacy of four conventional methods and real-time polymerase chain reaction

Abstract: The diagnostic sensitivity of qPCR to detect strongyloidiasis is analogous to that of conventional parasitology methods, with an additional advantage of being capable of identifying the parasite DNA at low sample concentrations.

Cited by 8 publications

References 34 publications

Evaluation of five diagnostic methods for Strongyloides stercoralis infection in Amhara National Regional State, northwest Ethiopia

Evaluation of five diagnostic methods for Strongyloides stercoralis infection in Amhara National Regional State, northwest Ethiopia

Conventional and High-Sensitivity Malaria Rapid Diagnostic Test Performance in Two Transmission Settings: Haiti 2017

Prevalence of Strongyloidiasis in a Cohort of Migrants in Italy and Accuracy of a Novel ELISA Assay for S. stercoralis Infection, a Cross-Sectional Study

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