ABSTRACT
BACKGROUND: Intestinal parasitic infections can harm health by causing malnutrition, anemia, impaired growth and cognitive development, and alterations in microbiota composition and immune responses. Therefore, it is crucial to examine stool samples to diagnose parasitic infections. However, the traditional microscopic detection method is time-consuming, labor-intensive, and dependent on the expertise and training of microscopists. Hence, there is a need for a low-complexity, high-throughput, and cost-effective alternative to labor-intensive microscopic examinations. METHODS: This study aimed to compare the performance of a fully automatic digital feces analyzer, Orienter Model FA280 (People's Republic of China) with that of the formalin-ethyl acetate concentration technique (FECT). We assessed and compared the agreement between the FA280 and the FECT for parasite detection and species identification in stool samples. The first part of the study analyzed 200 fresh stool samples for parasite detection using the FECT and FA280. With the FA280, the automatic feces analyzer performed the testing, and the digital microscope images were uploaded and automatically evaluated using an artificial intelligence (AI) program. Additionally, a skilled medical technologist conducted a user audit of the FA280 findings. The second set of samples comprised 800 preserved stool samples (preserved in 10% formalin). These samples were examined for parasites using the FECT and FA280 with a user audit. RESULTS: For the first set of stool samples, there was no statistically significant difference in the pairwise agreements between the FECT and the FA280 with a user audit (exact binomial test, P = 1). However, there were statistically significant differences between the pairwise agreements for the FECT and the FA280 with the AI report (McNemar's test, P < 0.001). The agreement for the species identification of parasites between the FA280 with AI report and FECT showed fair agreement (overall agreement = 75.5%, kappa [κ] = 0.367, 95% CI 0.248-0.486). On the other hand, the user audit for the FA280 and FECT showed perfect agreement (overall agreement = 100%, κ = 1.00, 95% CI 1.00-1.00). For the second set of samples, the FECT detected significantly more positive samples for parasites than the FA280 with a user audit (McNemar's test, P < 0.001). The disparity in results may be attributed to the FECT using significantly larger stool samples than those used by the FA280. The larger sample size used by the FECT potentially contributed to the higher parasite detection rate. Regarding species identification, there was strong agreement between the FECT and the FA280 with a user audit for helminths (κ = 0.857, 95% CI 0.82-0.894). Similarly, there was perfect agreement for the species identification of protozoa between the FECT and the FA280 with user audit (κ = 1.00, 95% CI 1.00-1.00). CONCLUSIONS: Although the FA280 has advantages in terms of simplicity, shorter performance time, and reduced contamination in the laboratory, there are some limitations to consider. These include a higher cost per sample testing and a lower sensitivity compared to the FECT. However, the FA280 enables rapid, convenient, and safe stool examination of parasitic infections.
Subject(s)
Parasites , Parasitic Diseases , Animals , Artificial Intelligence , Feces , FormaldehydeABSTRACT
We conducted a survey of canine microfilaraemia in 768 dogs in Chanthaburi, Samut Sakhon, and Narathiwat provinces of Thailand using a novel semi-automated, microfluidic device that is easy and rapid to perform. Microfilariae species were identified using High Resolution Melting real-time PCR (HRM real-time PCR). The prevalence of canine microfilaremia was 16.2% (45/278) in Chanthaburi and 5.5% (12/217) in Samut Sakhon. The prevalence of canine microfilaremia in Narathiwat was 22.7% (67/273). Brugia pahangi and Dirofilaria immitis were the predominant species of filariae found in the infected dogs from Chanthaburi and Narathiwat, respectively. The low prevalence of canine microfilaremia of Samut Sakhon may reflect the success of the Soi Dog foundation's efforts and the establishment of veterinary control programs. An effective disease control and prevention strategies is needed in Chanthaburi and Narathiwat to reduce the risks of zoonotic transmission of the parasites. An appropriate drug treatment should be given to infected dogs and prophylactic drugs are suggested to be given to dogs age ≤1-year-old to prevent filarial infection. The novel microfluidic device could be implemented for surveillance of filariae infection in other animals.
