Performance evaluation of Baermann techniques: the quest for developing a microscopy reference standard for the diagnosis of Strongyloides stercoralis

Autores
Gelaye, Woyneshet; Williams, Nana Aba; Kepha, Stella; Messa Junior, Augusto; Fleitas, Pedro Emanuel; Marti Soler, Helena; Damtie, Destaw; Menkir, Sissay; Krolewiecki, Alejandro Javier; Van Lieshout, Lisette; Enbiale, Wendemagegn
Año de publicación
2021
Idioma
inglés
Tipo de recurso
artículo
Estado
versión publicada
Descripción
Background: Soil-transmitted helminths (STH) are common in low and middle income countries where there is lack of access to clean water and sanitation. Effective diagnosis and treatment are essential for the control of STH infections. However, among STH parasites, Strongyloides stercoralis is the most neglected species, both in diagnostics and control strategies. Diagnostic methods cover different approaches, each with different sensitivities and specificities, such as serology, molecular techniques and microscopy based techniques. Of the later, the Baermann technique is the most commonly used procedure. In the literature, several ways have been described to perform the Baermann method, which illustrates the overall lack of a ‘(gold) reference standard’ method for the diagnosis of S. stercoralis infection. In this study we have evaluated the performance of three Baermann techniques in order to improve the reference standard for the microscopic diagnosis of S. stercoralis infection thereby facilitating individual case detection, mapping of the disease and proper evaluation of treatment responses. Methods/Principal findings: A community based cross sectional study was conducted at Zenzelima, Bahir Dar Zuria Ethiopia. A total of 437 stool samples were collected and analyzed by the following procedures: conventional Baermann (CB), modified Baermann (MB), and modified Baermann with charcoal pre-incubation (MBCI). The diagnostic sensitivity and Negative Predictive Value (NPV) of each technique was calculated using the combination of all the three techniques as a composite reference standard. Our result indicated that larvae of S. stercoralis were detected in 151 (34.6%) stool samples. The prevalence of S. stercoralis infection based on the three diagnostic methods was 9.6%, 8.0%, and 31.3% by CB, MB, and MBCI respectively. The sensitivity and NPV for CB, MB, and MBCI were 26.7% and 70.8%, 22.1% and 69.6%, and 87.0% and 93.2%, respectively. The MBCI showed significant difference (P- value = <0.001) in the sensitivity and NPV values when compared with CB and MB values. The agreement between CB, MB, and MBCI with the composite reference standard was 31.8%, 26.7%, 89.6%, respectively. Conclusion/Significance: Our results suggest the superior performance of MBCI. It is relatively easy to implement, simple to perform and comparatively cheaper. The CB is by far the commonly used method in routine diagnostic although this technique significantly underestimates the true burden of the disease and thereby contributing to the exclusion of S. stercoralis from the control strategies. Therefore, MBCI is recommended as a routine microscopy-based diagnostic test for S. stercoralis infection, particularly in settings where molecular procedures are not available.
Fil: Gelaye, Woyneshet. Bahir Dar University. College Of Medicine And Health; Etiopía
Fil: Williams, Nana Aba. Universidad de Barcelona; España
Fil: Kepha, Stella. Kenya Medical Research Institution; Kenia
Fil: Messa Junior, Augusto. Centro de Investigação em Saúde de Manhiça; Mozambique
Fil: Fleitas, Pedro Emanuel. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Salta; Argentina. Universidad Nacional de Salta. Sede Regional Orán. Instituto de Investigación de Enfermedades Tropicales; Argentina
Fil: Marti Soler, Helena. Universidad de Barcelona; España
Fil: Damtie, Destaw. Bahir Dar University. College of Science. Department of Biology; Etiopía
Fil: Menkir, Sissay. Bahir Dar University. College of Science. Department of Biology; Etiopía
Fil: Krolewiecki, Alejandro Javier. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Salta; Argentina. Universidad de Barcelona; España. Universidad Nacional de Salta. Sede Regional Orán. Instituto de Investigación de Enfermedades Tropicales; Argentina
Fil: Van Lieshout, Lisette. Leiden University. Leiden University Medical Center; Países Bajos
Fil: Enbiale, Wendemagegn. Bahir Dar University, College Of Medicine And Health; Etiopía
Materia
BAERMANM
STRONGYLOIDES STERCORALIS
DIAGNOSTIC
Nivel de accesibilidad
acceso abierto
Condiciones de uso
https://creativecommons.org/licenses/by/2.5/ar/
Repositorio
CONICET Digital (CONICET)
Institución
Consejo Nacional de Investigaciones Científicas y Técnicas
OAI Identificador
oai:ri.conicet.gov.ar:11336/159143

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network_name_str CONICET Digital (CONICET)
spelling Performance evaluation of Baermann techniques: the quest for developing a microscopy reference standard for the diagnosis of Strongyloides stercoralisGelaye, WoyneshetWilliams, Nana AbaKepha, StellaMessa Junior, AugustoFleitas, Pedro EmanuelMarti Soler, HelenaDamtie, DestawMenkir, SissayKrolewiecki, Alejandro JavierVan Lieshout, LisetteEnbiale, WendemagegnBAERMANMSTRONGYLOIDES STERCORALISDIAGNOSTIChttps://purl.org/becyt/ford/3.3https://purl.org/becyt/ford/3Background: Soil-transmitted helminths (STH) are common in low and middle income countries where there is lack of access to clean water and sanitation. Effective diagnosis and treatment are essential for the control of STH infections. However, among STH parasites, Strongyloides stercoralis is the most neglected species, both in diagnostics and control strategies. Diagnostic methods cover different approaches, each with different sensitivities and specificities, such as serology, molecular techniques and microscopy based techniques. Of the later, the Baermann technique is the most commonly used procedure. In the literature, several ways have been described to perform the Baermann method, which illustrates the overall lack of a ‘(gold) reference standard’ method for the diagnosis of S. stercoralis infection. In this study we have evaluated the performance of three Baermann techniques in order to improve the reference standard for the microscopic diagnosis of S. stercoralis infection thereby facilitating individual case detection, mapping of the disease and proper evaluation of treatment responses. Methods/Principal findings: A community based cross sectional study was conducted at Zenzelima, Bahir Dar Zuria Ethiopia. A total of 437 stool samples were collected and analyzed by the following procedures: conventional Baermann (CB), modified Baermann (MB), and modified Baermann with charcoal pre-incubation (MBCI). The diagnostic sensitivity and Negative Predictive Value (NPV) of each technique was calculated using the combination of all the three techniques as a composite reference standard. Our result indicated that larvae of S. stercoralis were detected in 151 (34.6%) stool samples. The prevalence of S. stercoralis infection based on the three diagnostic methods was 9.6%, 8.0%, and 31.3% by CB, MB, and MBCI respectively. The sensitivity and NPV for CB, MB, and MBCI were 26.7% and 70.8%, 22.1% and 69.6%, and 87.0% and 93.2%, respectively. The MBCI showed significant difference (P- value = <0.001) in the sensitivity and NPV values when compared with CB and MB values. The agreement between CB, MB, and MBCI with the composite reference standard was 31.8%, 26.7%, 89.6%, respectively. Conclusion/Significance: Our results suggest the superior performance of MBCI. It is relatively easy to implement, simple to perform and comparatively cheaper. The CB is by far the commonly used method in routine diagnostic although this technique significantly underestimates the true burden of the disease and thereby contributing to the exclusion of S. stercoralis from the control strategies. Therefore, MBCI is recommended as a routine microscopy-based diagnostic test for S. stercoralis infection, particularly in settings where molecular procedures are not available.Fil: Gelaye, Woyneshet. Bahir Dar University. College Of Medicine And Health; EtiopíaFil: Williams, Nana Aba. Universidad de Barcelona; EspañaFil: Kepha, Stella. Kenya Medical Research Institution; KeniaFil: Messa Junior, Augusto. Centro de Investigação em Saúde de Manhiça; MozambiqueFil: Fleitas, Pedro Emanuel. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Salta; Argentina. Universidad Nacional de Salta. Sede Regional Orán. Instituto de Investigación de Enfermedades Tropicales; ArgentinaFil: Marti Soler, Helena. Universidad de Barcelona; EspañaFil: Damtie, Destaw. Bahir Dar University. College of Science. Department of Biology; EtiopíaFil: Menkir, Sissay. Bahir Dar University. College of Science. Department of Biology; EtiopíaFil: Krolewiecki, Alejandro Javier. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Salta; Argentina. Universidad de Barcelona; España. Universidad Nacional de Salta. Sede Regional Orán. Instituto de Investigación de Enfermedades Tropicales; ArgentinaFil: Van Lieshout, Lisette. Leiden University. Leiden University Medical Center; Países BajosFil: Enbiale, Wendemagegn. Bahir Dar University, College Of Medicine And Health; EtiopíaPublic Library of Science2021-03info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttp://purl.org/coar/resource_type/c_6501info:ar-repo/semantics/articuloapplication/pdfapplication/pdfhttp://hdl.handle.net/11336/159143Gelaye, Woyneshet; Williams, Nana Aba; Kepha, Stella; Messa Junior, Augusto; Fleitas, Pedro Emanuel; et al.; Performance evaluation of Baermann techniques: the quest for developing a microscopy reference standard for the diagnosis of Strongyloides stercoralis; Public Library of Science; Neglected Tropical Diseases; 15; 2; 3-2021; 1-131935-2735CONICET DigitalCONICETenginfo:eu-repo/semantics/altIdentifier/url/https://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0009076info:eu-repo/semantics/altIdentifier/doi/10.1371/journal.pntd.0009076info:eu-repo/semantics/openAccesshttps://creativecommons.org/licenses/by/2.5/ar/reponame:CONICET Digital (CONICET)instname:Consejo Nacional de Investigaciones Científicas y Técnicas2025-09-03T10:00:58Zoai:ri.conicet.gov.ar:11336/159143instacron:CONICETInstitucionalhttp://ri.conicet.gov.ar/Organismo científico-tecnológicoNo correspondehttp://ri.conicet.gov.ar/oai/requestdasensio@conicet.gov.ar; lcarlino@conicet.gov.arArgentinaNo correspondeNo correspondeNo correspondeopendoar:34982025-09-03 10:00:58.995CONICET Digital (CONICET) - Consejo Nacional de Investigaciones Científicas y Técnicasfalse
dc.title.none.fl_str_mv Performance evaluation of Baermann techniques: the quest for developing a microscopy reference standard for the diagnosis of Strongyloides stercoralis
title Performance evaluation of Baermann techniques: the quest for developing a microscopy reference standard for the diagnosis of Strongyloides stercoralis
spellingShingle Performance evaluation of Baermann techniques: the quest for developing a microscopy reference standard for the diagnosis of Strongyloides stercoralis
Gelaye, Woyneshet
BAERMANM
STRONGYLOIDES STERCORALIS
DIAGNOSTIC
title_short Performance evaluation of Baermann techniques: the quest for developing a microscopy reference standard for the diagnosis of Strongyloides stercoralis
title_full Performance evaluation of Baermann techniques: the quest for developing a microscopy reference standard for the diagnosis of Strongyloides stercoralis
title_fullStr Performance evaluation of Baermann techniques: the quest for developing a microscopy reference standard for the diagnosis of Strongyloides stercoralis
title_full_unstemmed Performance evaluation of Baermann techniques: the quest for developing a microscopy reference standard for the diagnosis of Strongyloides stercoralis
title_sort Performance evaluation of Baermann techniques: the quest for developing a microscopy reference standard for the diagnosis of Strongyloides stercoralis
dc.creator.none.fl_str_mv Gelaye, Woyneshet
Williams, Nana Aba
Kepha, Stella
Messa Junior, Augusto
Fleitas, Pedro Emanuel
Marti Soler, Helena
Damtie, Destaw
Menkir, Sissay
Krolewiecki, Alejandro Javier
Van Lieshout, Lisette
Enbiale, Wendemagegn
author Gelaye, Woyneshet
author_facet Gelaye, Woyneshet
Williams, Nana Aba
Kepha, Stella
Messa Junior, Augusto
Fleitas, Pedro Emanuel
Marti Soler, Helena
Damtie, Destaw
Menkir, Sissay
Krolewiecki, Alejandro Javier
Van Lieshout, Lisette
Enbiale, Wendemagegn
author_role author
author2 Williams, Nana Aba
Kepha, Stella
Messa Junior, Augusto
Fleitas, Pedro Emanuel
Marti Soler, Helena
Damtie, Destaw
Menkir, Sissay
Krolewiecki, Alejandro Javier
Van Lieshout, Lisette
Enbiale, Wendemagegn
author2_role author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv BAERMANM
STRONGYLOIDES STERCORALIS
DIAGNOSTIC
topic BAERMANM
STRONGYLOIDES STERCORALIS
DIAGNOSTIC
purl_subject.fl_str_mv https://purl.org/becyt/ford/3.3
https://purl.org/becyt/ford/3
dc.description.none.fl_txt_mv Background: Soil-transmitted helminths (STH) are common in low and middle income countries where there is lack of access to clean water and sanitation. Effective diagnosis and treatment are essential for the control of STH infections. However, among STH parasites, Strongyloides stercoralis is the most neglected species, both in diagnostics and control strategies. Diagnostic methods cover different approaches, each with different sensitivities and specificities, such as serology, molecular techniques and microscopy based techniques. Of the later, the Baermann technique is the most commonly used procedure. In the literature, several ways have been described to perform the Baermann method, which illustrates the overall lack of a ‘(gold) reference standard’ method for the diagnosis of S. stercoralis infection. In this study we have evaluated the performance of three Baermann techniques in order to improve the reference standard for the microscopic diagnosis of S. stercoralis infection thereby facilitating individual case detection, mapping of the disease and proper evaluation of treatment responses. Methods/Principal findings: A community based cross sectional study was conducted at Zenzelima, Bahir Dar Zuria Ethiopia. A total of 437 stool samples were collected and analyzed by the following procedures: conventional Baermann (CB), modified Baermann (MB), and modified Baermann with charcoal pre-incubation (MBCI). The diagnostic sensitivity and Negative Predictive Value (NPV) of each technique was calculated using the combination of all the three techniques as a composite reference standard. Our result indicated that larvae of S. stercoralis were detected in 151 (34.6%) stool samples. The prevalence of S. stercoralis infection based on the three diagnostic methods was 9.6%, 8.0%, and 31.3% by CB, MB, and MBCI respectively. The sensitivity and NPV for CB, MB, and MBCI were 26.7% and 70.8%, 22.1% and 69.6%, and 87.0% and 93.2%, respectively. The MBCI showed significant difference (P- value = <0.001) in the sensitivity and NPV values when compared with CB and MB values. The agreement between CB, MB, and MBCI with the composite reference standard was 31.8%, 26.7%, 89.6%, respectively. Conclusion/Significance: Our results suggest the superior performance of MBCI. It is relatively easy to implement, simple to perform and comparatively cheaper. The CB is by far the commonly used method in routine diagnostic although this technique significantly underestimates the true burden of the disease and thereby contributing to the exclusion of S. stercoralis from the control strategies. Therefore, MBCI is recommended as a routine microscopy-based diagnostic test for S. stercoralis infection, particularly in settings where molecular procedures are not available.
Fil: Gelaye, Woyneshet. Bahir Dar University. College Of Medicine And Health; Etiopía
Fil: Williams, Nana Aba. Universidad de Barcelona; España
Fil: Kepha, Stella. Kenya Medical Research Institution; Kenia
Fil: Messa Junior, Augusto. Centro de Investigação em Saúde de Manhiça; Mozambique
Fil: Fleitas, Pedro Emanuel. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Salta; Argentina. Universidad Nacional de Salta. Sede Regional Orán. Instituto de Investigación de Enfermedades Tropicales; Argentina
Fil: Marti Soler, Helena. Universidad de Barcelona; España
Fil: Damtie, Destaw. Bahir Dar University. College of Science. Department of Biology; Etiopía
Fil: Menkir, Sissay. Bahir Dar University. College of Science. Department of Biology; Etiopía
Fil: Krolewiecki, Alejandro Javier. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Salta; Argentina. Universidad de Barcelona; España. Universidad Nacional de Salta. Sede Regional Orán. Instituto de Investigación de Enfermedades Tropicales; Argentina
Fil: Van Lieshout, Lisette. Leiden University. Leiden University Medical Center; Países Bajos
Fil: Enbiale, Wendemagegn. Bahir Dar University, College Of Medicine And Health; Etiopía
description Background: Soil-transmitted helminths (STH) are common in low and middle income countries where there is lack of access to clean water and sanitation. Effective diagnosis and treatment are essential for the control of STH infections. However, among STH parasites, Strongyloides stercoralis is the most neglected species, both in diagnostics and control strategies. Diagnostic methods cover different approaches, each with different sensitivities and specificities, such as serology, molecular techniques and microscopy based techniques. Of the later, the Baermann technique is the most commonly used procedure. In the literature, several ways have been described to perform the Baermann method, which illustrates the overall lack of a ‘(gold) reference standard’ method for the diagnosis of S. stercoralis infection. In this study we have evaluated the performance of three Baermann techniques in order to improve the reference standard for the microscopic diagnosis of S. stercoralis infection thereby facilitating individual case detection, mapping of the disease and proper evaluation of treatment responses. Methods/Principal findings: A community based cross sectional study was conducted at Zenzelima, Bahir Dar Zuria Ethiopia. A total of 437 stool samples were collected and analyzed by the following procedures: conventional Baermann (CB), modified Baermann (MB), and modified Baermann with charcoal pre-incubation (MBCI). The diagnostic sensitivity and Negative Predictive Value (NPV) of each technique was calculated using the combination of all the three techniques as a composite reference standard. Our result indicated that larvae of S. stercoralis were detected in 151 (34.6%) stool samples. The prevalence of S. stercoralis infection based on the three diagnostic methods was 9.6%, 8.0%, and 31.3% by CB, MB, and MBCI respectively. The sensitivity and NPV for CB, MB, and MBCI were 26.7% and 70.8%, 22.1% and 69.6%, and 87.0% and 93.2%, respectively. The MBCI showed significant difference (P- value = <0.001) in the sensitivity and NPV values when compared with CB and MB values. The agreement between CB, MB, and MBCI with the composite reference standard was 31.8%, 26.7%, 89.6%, respectively. Conclusion/Significance: Our results suggest the superior performance of MBCI. It is relatively easy to implement, simple to perform and comparatively cheaper. The CB is by far the commonly used method in routine diagnostic although this technique significantly underestimates the true burden of the disease and thereby contributing to the exclusion of S. stercoralis from the control strategies. Therefore, MBCI is recommended as a routine microscopy-based diagnostic test for S. stercoralis infection, particularly in settings where molecular procedures are not available.
publishDate 2021
dc.date.none.fl_str_mv 2021-03
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
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info:ar-repo/semantics/articulo
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv http://hdl.handle.net/11336/159143
Gelaye, Woyneshet; Williams, Nana Aba; Kepha, Stella; Messa Junior, Augusto; Fleitas, Pedro Emanuel; et al.; Performance evaluation of Baermann techniques: the quest for developing a microscopy reference standard for the diagnosis of Strongyloides stercoralis; Public Library of Science; Neglected Tropical Diseases; 15; 2; 3-2021; 1-13
1935-2735
CONICET Digital
CONICET
url http://hdl.handle.net/11336/159143
identifier_str_mv Gelaye, Woyneshet; Williams, Nana Aba; Kepha, Stella; Messa Junior, Augusto; Fleitas, Pedro Emanuel; et al.; Performance evaluation of Baermann techniques: the quest for developing a microscopy reference standard for the diagnosis of Strongyloides stercoralis; Public Library of Science; Neglected Tropical Diseases; 15; 2; 3-2021; 1-13
1935-2735
CONICET Digital
CONICET
dc.language.none.fl_str_mv eng
language eng
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info:eu-repo/semantics/altIdentifier/doi/10.1371/journal.pntd.0009076
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