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Journal article
Diagnostic sensitivity of formalin-fixed faecal microscopy for the detection of soil-transmitted helminths
Transactions of the Royal Society of Tropical Medicine and Hygiene, Vol.119(6), pp.596-605
2025
PMID: 39921402
Abstract
Background
Faecal microscopy is the mainstay of soil-transmitted helminth diagnosis and commonly completed on formalin-fixed samples when resources are insufficient to analyse fresh samples. This study assessed the diagnostic sensitivity of microscopic techniques using formalin-fixed samples.
Methods
Formalin-fixed faecal samples from 574 individuals were tested by the formalin-ethyl acetate concentration technique (FECT), Malachite smear, McMaster and McMaster2 methods. Agreement between tests was assessed by Kappa. Bayesian latent class models and a composite reference standard estimated the diagnostic sensitivity of each test.
Results
Moderate-to-good agreement between tests was observed for A. lumbricoides. Agreement was poorer for hookworm and Trichuris trichiura. The FECT (72.70%, credible interval [CrI]: 68.92–76.56%) and McMaster2 method (67.93%, 95% CrIs: 62.41–73.31%) had the highest sensitivities for A. lumbricoides. For hookworm, the McMaster2 method (70.56%, 95% CrIs: 64.10–76.96%) was more sensitive than all other tests. For T. trichiura, the McMaster (90.10%, 95% CrIs: 83.29–94.67%) and McMaster2 (89.3%, 95% CrIs: 82.28–94.52%) methods were the most sensitive.
Conclusions
The McMaster2 method is a viable alternative to FECT and provides important information on the intensity of infection. The effect of formalin-fixation on test performance may not be as great as previously assumed. This study reports formalin-fixed sensitivities similar to previous estimates using fresh samples.
Details
- Title
- Diagnostic sensitivity of formalin-fixed faecal microscopy for the detection of soil-transmitted helminths
- Authors/Creators
- Andrew Larkins - Murdoch University, School of Medical, Molecular and Forensic SciencesBoualay Keokhamphavanh - Murdoch UniversityBreanna Knight - Murdoch UniversityKelly Taggart - Murdoch UniversitySarah Keatley - Murdoch UniversityBounnaloth Insisiengmay - Ministry of HealthAmanda Ash - Murdoch University, Centre for Biosecurity and One Health
- Publication Details
- Transactions of the Royal Society of Tropical Medicine and Hygiene, Vol.119(6), pp.596-605
- Publisher
- Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene.
- Number of pages
- 10
- Grant note
- LS/2014/055 / Australian Centre for International Agricultural Research
- Identifiers
- 991005743944307891
- Copyright
- © The Author(s) 2025.
- Murdoch Affiliation
- Centre for Biosecurity and One Health; School of Medical, Molecular and Forensic Sciences
- Language
- English
- Resource Type
- Journal article
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