Table 4 Diagnostic tests for important helminths that may cause persistent digestive disorders
Infectious pathogen | Diagnostic method | ||||
|---|---|---|---|---|---|
| Â | Microscopy | Stool culture | Immunology | Molecular biology (PCR) | Reference(s) |
Cestodes | |||||
Diphyllobothrium latum | Stool microscopy: identification of eggs or proglottids | - | - | PCR and sequencing for species differentiation (for epidemiological purpose) | |
|  | · Wet preparation |  |  |  |  |
|  | · Ethyl-acetate or formalin-ether-based concentration techniques |  |  |  |  |
|  | · Sedimentation techniques |  |  |  |  |
Hymenolepis spp. | Stool microscopy | - | - | PCR in research settings (for epidemiological purpose) | [79] |
|  | · Kato-Katz method |  |  |  |  |
|  | · Ethyl-acetate or formalin-ether-based concentration techniques |  |  |  |  |
|  | · Sedimentation techniques |  |  |  |  |
|  | · FLOTAC |  |  |  |  |
Taenia spp. | Stool microscopy | - | · Coproantigen EIA | PCR for species differentiation | [80] |
|  | · Perianal egg detection |  | · Serology: detection of specific circulating antibodies against T. solium |  |  |
|  | · (Graham’s test applying adhesive tape) |  |  |  |  |
|  | · Examination of tapeworms from purges |  |  |  |  |
Nematodes | |||||
Ascaris lumbricoides | Stool microscopy: egg detection | - | - | PCR in research settings (for epidemiological purpose) | |
|  | · Kato-Katz method |  |  |  |  |
|  | · Ethyl-acetate or formalin-ether-based concentration techniques |  |  |  |  |
|  | · Sedimentation techniques |  |  |  |  |
|  | · FLOTAC |  |  |  |  |
Capillaria philippinensis | Stool microscopy: egg detection | - | - | - | |
|  | · Ethyl-acetate or formalin-ether-based concentration techniques |  |  |  |  |
|  | · Sedimentation techniques |  |  |  |  |
|  | · (Kato-Katz method: great care is indicated to distinguish between T. trichiura and C. philippinensis eggs) |  |  |  |  |
Hookworms (Ancylostoma duodenale, Necator americanus) | Stool microscopy: egg detection | Culture on Koga agar and subsequent microscopic identification of larvae | Â | PCR mainly applied in research settings (for epidemiological purpose) | |
|  | · Kato-Katz method |  |  |  |  |
|  | · Ethyl-acetate or formalin-ether-based concentration techniques |  |  |  |  |
|  | · Sedimentation techniques |  |  |  |  |
|  | · FLOTAC |  |  |  |  |
Strongyloides stercoralis | · Stool: microscopy following Baermann funnel concentration | Culture on Koga agar and subsequent microscopic identification of larvae | · ELISA tests detecting serum antibodies or faecal antigens | PCR applied in research settings (for epidemiological purpose) and increasingly used for individual patient management | |
|  | · Microscopy of sputum, bronchoalveolar lavage, duodenal aspirate, skin biopsy |  | · Indirect fluorescent antibody test |  |  |
Trichuris trichiura | Stool microscopy: egg detection | - | - | - | |
|  | · Kato-Katz method |  |  |  |  |
|  | · Ethyl-acetate or formalin-ether-based concentration techniques |  |  |  |  |
|  | · Sedimentation techniques |  |  |  |  |
|  | · FLOTAC |  |  |  |  |
Trematodes | |||||
Intestinal flukes | Stool microscopy: egg detection | - | ELISA to detect worm-specific antibodies or antigens in serum or stool | PCR applied in research settings (for epidemiological purpose) | [88] |
|  | · Kato-Katz method |  |  |  |  |
|  | · Ethyl-acetate or formalin-ether-based concentration techniques |  |  |  |  |
|  | · Stoll’s dilution |  |  |  |  |
|  | · Sedimentation techniques |  |  |  |  |
|  | · FLOTAC |  |  |  |  |
Intestinal blood flukes: Schistosoma mansoni, S. intercalatum, S. japonicum, S. mekongi | Stool microscopy: egg detection | - | - ELISA to detect serum antibodies or worm-specific antigens in serum or urine | PCR applied in research settings for epidemiological purpose and increasingly used for individual patient management | [89] |
|  | · Kato-Katz method |  | - RDT to detect CCA or CAA antigen in serum or urine (for S. mansoni) |  |  |
|  | · Ethyl-acetate or formalin-ether-based concentration techniques |  |  |  |  |
|  | · Stoll’s dilution |  |  |  |  |
|  | · Sedimentation techniques |  |  |  |  |
|  | · FLOTAC (first experiences for S. mansoni) |  |  |  |  |
| Â | Miracidium-hatching test from stool samples | Â | Â | Â | Â |