Newer diagnostic approaches to intestinal protozoa.
OBJECTIVE
To update the reader on the latest developments in the laboratory diagnosis of intestinal protozoa.


RESULTS
Correct identification of a diarrhoea causing pathogens is essential for the choice of treatment in an individual patient as well as to map the aetiology of diarrhoea in a variety of patient populations. Classical diagnosis of diarrhoea causing protozoa by microscopic examination of a stool sample lacks both sensitivity and specificity. Alternative diagnostic platforms are discussed.


CONCLUSIONS
Recent literature on the diagnosis of intestinal protozoa has focused mainly on nucleic acid-based assays, in particular the specific detection of parasite DNA in stool samples using real-time PCR. In addition, the trend has been moving from single pathogen detection to a multiplex approach, allowing simultaneous identification of multiple parasites. Different combinations of targets can be used within a routine diagnostic setting, depending on the patient population, such as children, immunocompromised individuals and those who have been travelling to tropical regions. Large-scale monitoring and evaluation of control strategies become feasible due to automation and high-throughput facilities. Improved technology also has become available for differentiating protozoa subspecies, which facilitates outbreak investigations and extensive research in molecular epidemiology.
van Lieshout
Lisette
L
Department of Parasitology, Leiden University Medical Center, Leiden, The Netherlands. lvanlieshout@lumc.nl
Verweij
Jaco J
JJ
D000818:Animals; D001331:Automation / Q000379:methods; D019411:Clinical Laboratory Techniques / Q000379:methods*; D003967:Diarrhea / Q000469:parasitology*; D005243:Feces / Q000469:parasitology; D006801:Humans; D007411:Intestinal Diseases, Parasitic / Q000175:diagnosis*; D008853:Microscopy; D021141:Nucleic Acid Amplification Techniques / Q000379:methods; D010271:Parasites / Q000302:isolation & purification*; D010274:Parasitology / Q000379:methods*; D012680:Sensitivity and Specificity