埃塞俄比亚德布雷马尔科斯综合专科医院粪便检查湿片法和浓缩技术用于肠道寄生虫鉴定的评估
Evaluation of Wet Mount and Concentration Techniques of Stool Examination for Intestinal Parasites Identification at Debre Markos Comprehensive Specialized Hospital, Ethiopia.
作者信息
Demeke Gebreselassie, Fenta Abebe, Dilnessa Tebelay
机构信息
Department of Medical Laboratory Science, Health Science College, Debre Markos University, Debre Markos, Ethiopia.
出版信息
Infect Drug Resist. 2021 Apr 9;14:1357-1362. doi: 10.2147/IDR.S307683. eCollection 2021.
BACKGROUND
Intestinal parasitic infection has serious medical and public health impacts in developing countries. Intestinal parasites were under reported via direct wet mount method due to its poor sensitivity. So, the selection of a more sensitive and reliable diagnostic method is essential.
OBJECTIVE
The aim of the study was to evaluate the diagnostic performance of wet mount and concentration techniques of stool examination for intestinal parasites identification.
METHODS
A cross-sectional study among 797 pregnant women was conducted from October 2018 to February 2019 at Debre Markos Comprehensive Specialized Hospital. The study participants were selected by using a systematic random sampling technique. Stool sample was processed by using Wet Mount (WM) and Formol-Ether Concentration (FEC) techniques. Data was entered into Epi-data version 3.1 and analysis using SPSS version 20.0. The sensitivity, specificity, positive predictive value, and negative predictive value were determined against the combined result as "Gold" standard. Kappa value was determined to estimate the agreement of the diagnostic methods.
RESULTS
The overall prevalence of intestinal parasites (IP) was 35.2% with a combined method. By using WM and FEC the prevalence of IP was 13.1% and 25.7%, respectively. The sensitivity and negative predictive value of WM method were 37.1% and 74.6%, and for FEC method 73.5% and 87.5%, respectively. Test efficiency of direct WM and FEC were 77.9% and 90.7%, respectively. The agreement of WM and FEC techniques with combined technique were moderate (κ=0.434) and perfect (κ=0.783), respectively.
CONCLUSION
The prevalence of intestinal parasites was under-reported by wet mount technique. The diagnostic performance of FEC technique for the diagnosis of intestinal parasites in pregnant women was notably high as compared to WM technique in the present study. Therefore, the WM and FEC combined method should be used as a routine diagnostic technique for the diagnosis of intestinal parasites identification.
背景
肠道寄生虫感染在发展中国家具有严重的医学和公共卫生影响。由于直接涂片法敏感性较差，肠道寄生虫的报告率较低。因此，选择一种更敏感、可靠的诊断方法至关重要。
目的
本研究旨在评估粪便检查的涂片法和浓缩技术在肠道寄生虫鉴定中的诊断性能。
方法
2018年10月至2019年2月在德布雷马科斯综合专科医院对797名孕妇进行了一项横断面研究。采用系统随机抽样技术选取研究参与者。粪便样本采用直接涂片法（WM）和甲醛乙醚浓缩法（FEC）进行处理。数据录入Epi-data 3.1版本，并使用SPSS 20.0版本进行分析。以联合结果作为“金”标准，确定敏感性、特异性、阳性预测值和阴性预测值。计算kappa值以评估诊断方法的一致性。
结果
联合方法检测肠道寄生虫（IP）的总体患病率为35.2%。采用WM和FEC法检测IP的患病率分别为13.1%和25.7%。WM法的敏感性和阴性预测值分别为37.1%和74.6%，FEC法分别为73.5%和87.5%。直接WM法和FEC法的检测效率分别为77.9%和90.7%。WM和FEC技术与联合技术的一致性分别为中等（κ=0.434）和完美（κ=0.783）。
结论
直接涂片法低估了肠道寄生虫的患病率。在本研究中，与WM技术相比，FEC技术对孕妇肠道寄生虫的诊断性能显著更高。因此，WM和FEC联合方法应用于肠道寄生虫鉴定的常规诊断技术。
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