title: FLOTAC for the diagnosis of Hymenolepis spp. infection: proof-of-concept and comparing diagnostic accuracy with other methods.
abstract: Hymenolepis nana is the most common cestode parasitizing humans, yet it is under-diagnosed. We determined the optimal flotation solution (FS) for the diagnosis of this intestinal parasite with the FLOTAC method, and compared its diagnostic accuracy with an ether-concentration technique and the Kato-Katz method. Zinc sulphate (specific gravity 1.20) proved to be the best-performing FS. Using this FS, we detected 65 H. nana infections among 234 fixed fecal samples from Tajik and Sahrawi children (prevalence 27.8 %). The ether-concentration technique detected 40 infections (prevalence 17.1 %) in the same samples. Considering the combined results as a reference, the sensitivities of FLOTAC and ether-concentration were 95.6 % and 58.8 %, respectively. The Kato-Katz method resulted in a prevalence of only 8.7 %. In terms of eggs per gram of stool, a significantly (P <0.05) higher value was obtained with the FLOTAC and Kato-Katz techniques compared to ether-concentration. In another study carried out in China, the FLOTAC method detected six Hymenolepis diminuta infections in 302 fecal samples, whereas five samples were found positive with the Kato-Katz technique. We conclude that FLOTAC is an accurate coprodiagnostic technique for H. nana and H. diminuta, two species which join a growing list of intestinal parasites that can be reliably diagnosed by this technique.
authors.affiliation: Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Socinstrasse 57, P.O. Box, 4002 Basel, Switzerland. peter.steinmann@unibas.ch
authors.forename: Peter
authors.initials: P
authors.lastname: Steinmann
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Cringoli
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Bruschi
authors.forename: Barbara
authors.initials: B
authors.lastname: Matthys
authors.forename: Laurent K
authors.initials: LK
authors.lastname: Lohourignon
authors.forename: Barbara
authors.initials: B
authors.lastname: Castagna
authors.forename: Maria P
authors.initials: MP
authors.lastname: Maurelli
authors.forename: Maria E
authors.initials: ME
authors.lastname: Morgoglione
authors.forename: Jürg
authors.initials: J
authors.lastname: Utzinger
authors.forename: Laura
authors.initials: L
authors.lastname: Rinaldi
mesh_terms: D000349:Africa; D000818:Animals; D002590:Cestode Infections / Q000175:diagnosis*; D002648:Child; D005243:Feces / Q000469:parasitology; D005260:Female; D006801:Humans; D006926:Hymenolepis / Q000302:isolation & purification*; D008297:Male; D010270:Parasite Egg Count / Q000379:methods*; D012680:Sensitivity and Specificity; D013620:Tajikistan