Screening for intestinal helminth infestation in a semi-urban cohort of HIV-infected people in Uganda: a combination of techniques may enhance diagnostic yield in the absence of multiple stool samples


Brown, M; Bukusuba, J; Hughes, P; Nakiyingi, J; Watera, C; Elliott, A; Whitworth, J; (2003) Screening for intestinal helminth infestation in a semi-urban cohort of HIV-infected people in Uganda: a combination of techniques may enhance diagnostic yield in the absence of multiple stool samples. Tropical doctor, 33 (2). pp. 72-6. ISSN 0049-4755

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Abstract

Intestinal helminth prevalence is best determined by using multiple stool samples from each subject, but this may be difficult in the clinic or hospital setting. We used a range of well-established parasitological techniques in a study of interactions between helminth infestation and HIV in a cohort of 412 HIV-infected people in Entebbe, Uganda. Analysis of a single stool sample underestimated helminth prevalence, especially of low-intensity infections, but a combination of Kato-Katz smear, formol-ether concentration (FEC), charcoal culture for Strongyloides and a serum enzyme-linked immunosorbent assay for Schistosoma mansoni antigen (CAA) increased diagnostic yield. Helminths were diagnosed in 23% patients by FEC alone, 35% by FEC and Kato-Katz, 39% by FEC, Kato-Katz and charcoal culture and 49% by a combination of all three tests plus CAA. Performing a range of techniques on a single sample may enhance the detection of parasites. Techniques vary in their sensitivity for different helminths so the appropriate choice of techniques depends on which parasite species are being sought.

Item Type: Article
Keywords: Schistosoma-mansoni, strongyloides-stercoralis, egg counts, excretion, vaccine, Cohort Studies, Feces, parasitology, HIV Infections, complications, Helminthiasis, diagnosis, Human, Intestinal Diseases, Parasitic, diagnosis, Mass Screening, methods, Parasitology, methods, Uganda, epidemiology, Urban Population
Faculty and Department: Faculty of Infectious and Tropical Diseases > Dept of Clinical Research
Faculty of Epidemiology and Population Health > Dept of Infectious Disease Epidemiology
Research Centre: Centre for Global Non-Communicable Diseases (NCDs)
PubMed ID: 12680536
Web of Science ID: 181893700004
URI: http://researchonline.lshtm.ac.uk/id/eprint/16703

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