Abstract
Stool has multiple components, which include undigested food material, plant, animal products, normal intestinal microbiome, and parasites. Due to the existence of all the elements, stool parasite examination is cumbersome, especially with identification of the eggs of Ascaris lumbricoides. We examined 650 stool samples of pregnant women before anti-helminthic treatment. We found that the prevalence of Ascaris lumbricoides was 5.4% (95% CI 3.8–7.4, n = 35) by a single observer in microscopy, and the majority (33/35) were identified as decorticated fertilized eggs. The prevalence of Ascaris by molecular methods was 2.6% (95% CI 1.5–4.2%, n = 17). Five samples were positive by both methods. The prevalence of structures resembling Ascaris was 4.6% (95% CI 3.1–6.5, n = 30). Three of the positive samples were confirmed with sequencing. With the subjective nature of microscopy along with the naked eye examination, errors can happen. Hence adequate training and confirmation with molecular techniques for identification of Ascaris lumbricoides are advisable.
References
Ajjampur SSR et al (2021) Epidemiology of soil transmitted helminths and risk analysis of hookworm infections in the community: results from the DeWorm3 Trial in southern India. PLoS Negl Trop Dis 15(4):e0009338–e0009338. https://doi.org/10.1371/journal.pntd.0009338
Colmer-Hamood JA (2001) Fecal microscopy: artifacts mimicking ova and parasites. Lab Med 32(2):80–84. https://doi.org/10.1309/0VTA-YUXK-F20G-T20E
Cringoli G et al (2017) The Mini-FLOTAC technique for the diagnosis of helminth and protozoan infections in humans and animals. Nat Protoc 12(9):1723–1732. https://doi.org/10.1038/nprot.2017.067
Drake LJ et al (2015) Bihar’s pioneering school-based deworming programme: lessons learned in deworming over 17 million Indian school-age children in one sustainable campaign. PLoS Negl Trop Dis 9(11):e0004106. https://doi.org/10.1371/journal.pntd.0004106
Hedman J, Rådström P (2013) Overcoming inhibition in real-time diagnostic PCR. Methods Mol Biol (Clifton NJ) 943:17–48. https://doi.org/10.1007/978-1-60327-353-4_2
Incani RN et al (2017) Diagnosis of intestinal parasites in a rural community of Venezuela: advantages and disadvantages of using microscopy or RT-PCR. Acta Trop 167:64–70. https://doi.org/10.1016/j.actatropica.2016.12.014
Khurana S, Singh S, Mewara A (2021) Diagnostic techniques for soil-transmitted helminths–recent advances. Res Rep Trop Med 12:181–196. https://doi.org/10.2147/RRTM.S278140
Maurelli MP et al (2021) Ascaris lumbricoides eggs or artefacts? A diagnostic conundrum. Parasitology 148(13):1554–1559. https://doi.org/10.1017/S0031182021001256
Mogaji HO et al (2020) Distribution of ascariasis, trichuriasis and hookworm infections in Ogun State, Southwestern Nigeria. PLoS ONE 15(6):e0233423. https://doi.org/10.1371/journal.pone.0233423
Rijsman LH, Monkelbaan JF, Kusters JG (2016) Clinical consequences of polymerase chain reaction-based diagnosis of intestinal parasitic infections. J Gastroenterol Hepatol 31(11):1808–1815. https://doi.org/10.1111/jgh.13412
Szwabe K, Kurnatowski P (2012) ‘Comparative analysis of morphometric features of the eggs of selected alimentary tract parasites and of the plant pollens. Ann Parasitol 58(2):87–96
Ulaganeethi R et al (2023) Performance of microscopy compared to conventional PCR in identification of soil-transmitted helminth infections among antenatal women in a low-prevalence setting. Indian J Med Microbiol 46:100427. https://doi.org/10.1016/j.ijmmb.2023.100427
Van Gool T et al (2003) Triple faeces test: an effective tool for detection of intestinal parasites in routine clinical practice. Eur J Clin Microbiol Infect Dis Off Publ Eur Soc Clin Microbiol 22(5):284–290. https://doi.org/10.1007/s10096-003-0919-1
World Health Organization (2012) Soil-transmitted helminthiases: eliminating as public health problem soil-transmitted helminthiases in children: progress report 2001–2010 and strategic plan 2011–2020. World Health Organization, Geneva
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Jawaharlal Institute of Postgraduate Medical Education and Research (JIP/Res/Intramural/Phs2/2020–21).
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Ulaganeethi, R., Rajkumari, N., Ramachandrappa, V.K.S. et al. Are artefacts misleading the diagnosis of Ascaris lumbricoides in microscopy? Observations. J Parasit Dis (2024). https://doi.org/10.1007/s12639-024-01681-3
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DOI: https://doi.org/10.1007/s12639-024-01681-3