Comparison of three copromicroscopic methods to assess albendazole efficacy against soil-transmitted helminth infections in school-aged children on Pemba Island

Background The diagnostic accuracy of three faecal egg count techniques (Kato-Katz, McMaster and FLOTAC) to assess albendazole efficacy against soil-transmitted helminth (STH) infections was compared. Methods The study is registered with Current Controlled Trials [identifier: ISRCTN90088840]. During September-November 2009, 304 school-aged children on Pemba Island, Tanzania, were screened and those infected with Ascaris lumbricoides, hookworm or Trichuris trichiura were treated with a single dose of albendazole (400 mg). Twenty-one days post-treatment, children provided a single stool sample which was examined using the same diagnostic methods. All stool samples were divided into two aliquots and one was fixed in 5% formalin and examined using FLOTAC and McMaster approximately 6 months after collection. Results Using fresh stool samples, comparable prevalences were demonstrated for the three methods at baseline (90-92.2% for T. trichiura, 41.1-52.8% for hookworm, 32.9-37.2% for A. lumbricoides); FLOTAC was the most sensitive method at baseline and follow-up. Albendazole showed high cure rate (CR) against A.lumbricoides (90-97%), moderate CR against hookworm (63-72%) and very low CR against T.trichiura (6-9%), regardless of the technique used. Egg counts (eggs per gram) at baseline were similar for A. lumbricoides and for hookworm among the three methods, and higher using McMaster and Kato-Katz compared with FLOTAC for T. trichiura. All methods were similar for hookworm and A. lumbricoides egg reduction rate (ERR) estimation, but Kato-Katz indicated a significantly higher ERR than McMaster and FLOTAC for T. trichiura. Preserved stool samples revealed consistently lower FECs at baseline and follow-up for all STHs. Conclusion Further development and validation of standard protocols for anthelminthic drug efficacy evaluation must be pursue

Ancylostoma caninum : calibration and comparison of diagnostic accuracy of flotation in tube, McMaster and FLOTAC in faecal samples of dogs

We performed a calibration of flotation in tube, McMaster and FLOTAC to determine the optimal flotation solution (FS) and the influence of faecal preservation for the diagnosis of Ancylostoma caninum in dogs, and compared the accuracy of the three copromicroscopic techniques. Among nine different FS, sodium chloride and sodium nitrate performed best for detection and quantification of A.caninum eggs. Faecal samples, either fresh or preserved in formalin 5%, resulted in higher A.caninum egg counts, compared to frozen samples or preserved in formalin 10% or sodium acetate-acetic acid-formalin. FLOTAC consistently resulted in higher A.caninum eggs per gram of faeces (EPG) and lower coefficient of variation (CV) than McMaster and flotation in tube. The best results in terms of mean faecal egg counts (highest value, i.e. 117.0 EPG) and CV (lowest value, i.e. 4.8%) were obtained with FLOTAC using sodium chloride and faecal samples preserved in formalin 5%. Our findings suggest that the FLOTAC technique should be considered for the diagnosis of A.caninum in dog