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首页> 外文期刊>The Internet Journal of Tropical Medicine >The Need For A Better Method: Comparison Of Direct Smear And Formol-Ether Concentration Techniques In Diagnosing Intestinal Parasites
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The Need For A Better Method: Comparison Of Direct Smear And Formol-Ether Concentration Techniques In Diagnosing Intestinal Parasites

机译：需要更好的方法：直接涂片法和甲酚-醚浓缩技术在诊断肠道寄生虫中的比较

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The study compared results of one direct smear and one formol-ether concentration examination executed on each of 103 stool samples from patients attending a hospital and a medical diagnostic laboratory in Owerri. Formol-ether concentration technique detected 65.26% of positive specimens for one or more intestinal parasites. Direct smear was 34.74% effective. A significant number of the infected population was missed by direct smear method. This accounts for the prevalence of intestinal parasites in the studied population, part of which is ensuing from misdiagnosis. Soft stool exposed most of the intestinal parasites encountered in the study more than other consistency types. Hookworm bears the highest occurrence (15.79%) in soft stools and in the entire study (24.21%) as revealed by concentration method. This study furthermore showed that the age group (9-13) has the highest prevalence for intestinal parasites. Formol-ether detected 23.16% prevalence in this age group while direct smear found 14.74%. Introduction Parasitic diseases caused by intestinal parasites are a major public health problem in developing countries of Africa [1]. Majority of these infections with parasites results from low standard of living associated with poor socioeconomic status, poor sanitation, and misdiagnosis of parasitic infections.In the diagnosis of intestinal parasites a lot of techniques can be employed. Selection of a particular technique will depend on its affordability, easy to carry out, its effectiveness and level of professionalism involved. Some of these methods are DNA probes, PCR, and direct fluorescent antibody methods [2], which offer high sensitivity, but are expensive for use in the developing world. Direct stool smear, formol-ether, and salt floatation techniques in the form of stool microscopy offers many advantages over other diagnostic methods for detecting intestinal parasites. If performed correctly, it is sensitive, simple, and economical [2].A high choice of direct stool [3] and modified formol-ether concentration [4] methods in diagnosing intestinal parasites by hospitals and researchers in developing countries, Nigeria in particular is as a result of its affordability, simplicity and sensitivity. Though each has a preference over another in certain aspects.Due to low density of the parasites in the faeces, direct smear method is useful for the observation of motile protozoan trophozoites and the examination of cellular exudates, but is not recommended solely for the routine examination of suspected parasitic infections [5]. Therefore there is need for increased probability of finding the parasites in faecal samples to allow for an accurate diagnosis, hence there is need to concentrate. Though direct stool smear technique is quick to prepare, and is inexpensive when compared with modified formol-ether concentration method, it can miss parasites (ova, cysts, and larvae) if concentration is too low or if too much debris or fat is present. Sand, seeds, or other faecal debris can make opposition of coverslip onto slide difficult. Most diagnostic centers in Nigeria show high preference to this method, owing to the fact that it is inexpensive and non-time-consuming thereby disregarding the consequences of misdiagnosis, which has led to high prevalence of parasitic diseases and morbid conditions in Nigeria. Such complications resulting from misdiagnosis has been described [6]The concentration procedure as described by Allen and Ridley [4] used in hospitals requires the use of ether or ethyl acetate as a lipid removing agent and formalin as a fixative. The advantages of this method are that it will recover most ova, cysts and larvae and retain their morphology, thereby facilitating identification. There is less risk of infection from bacteria and viruses because they may not be able to survive the concentration process involved. Knight et al., [7] indicated that the concentration technique has additional advantage by allowing fo
机译：该研究比较了对来自Owerri的一家医院和医学诊断实验室的103名粪便样本中的每项样本进行的一次直接涂片检查和一次甲醛甲醚浓度检查的结果。甲醚-醚浓缩技术检测出65.26％的阳性样本中一种或多种肠道寄生虫。直接涂片有效率为34.74％。直接涂片法漏掉了大量感染人群。这解释了所研究人群中肠道寄生虫的患病率，其中一部分是由于误诊所致。软粪便暴露了研究中遇到的大多数肠道寄生虫，而不是其他稠度类型。浓缩方法显示，钩虫在软便中的发生率最高（15.79％），在整个研究中占24.21％。这项研究进一步表明，年龄段（9-13岁）的肠道寄生虫患病率最高。在该年龄组中，甲酚醚检出率为23.16％，而直接涂片检出率为14.74％。引言由肠道寄生虫引起的寄生虫病是非洲发展中国家的主要公共卫生问题[1]。这些寄生虫感染的主要原因是生活水平低，社会经济状况差，卫生条件差以及对寄生虫感染的误诊。在肠道寄生虫的诊断中可以使用许多技术。特定技术的选择将取决于其可负担性，易于实施，其有效性和所涉及的专业水平。其中一些方法是DNA探针，PCR和直接荧光抗体方法[2]，它们具有很高的灵敏度，但在发展中国家使用起来很昂贵。粪便显微镜检查形式的直接粪便涂片，甲酚-醚和盐浮选技术相对于检测肠道寄生虫的其他诊断方法具有许多优势。如果正确执行，它将是灵敏，简单且经济的[2]。发展中国家的医院和研究人员，尤其是尼日利亚的医院和研究人员，可以选择直接粪便[3]和改良的甲醚浓度[4]来诊断肠道寄生虫。这是由于其价格适中，简单和敏感。尽管每个人在某些方面都比其他人更偏爱。由于粪便中的寄生虫密度低，直接涂片法可用于观察活动性原生动物滋养体和检查细胞渗出液，但不建议仅用于常规检查疑似寄生虫感染的发生[5]。因此，需要增加在粪便样品中发现寄生虫的可能性，以进行准确的诊断，因此需要集中精力。尽管直接粪便涂片技术制备起来很迅速，并且与改良的甲酚-醚浓缩法相比便宜，但是如果浓度太低或碎片或脂肪过多，它可能会漏掉寄生虫（卵，囊肿和幼虫）。沙子，种子或其他粪便残渣可能会使盖玻片在玻片上难以对置。尼日利亚大多数诊断中心对这种方法表示高度偏爱，原因是该方法便宜且不费时，从而无视误诊的后果，从而导致了尼日利亚寄生虫病和病态的高发。已经描述了由于误诊而导致的此类并发症[6]医院使用的Allen和Ridley [4]所述的浓缩程序需要使用乙醚或乙酸乙酯作为脂质去除剂，并使用福尔马林作为固定剂。该方法的优点是它将恢复大多数卵，囊肿和幼虫并保留其形态，从而便于鉴定。由于细菌和病毒可能无法在涉及的浓缩过程中幸存下来，因此感染细菌和病毒的风险较小。 Knight等人，[7]指出，浓缩技术具有以下优点：

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