Methylene blue vital staining for Trypanosoma cruzi trypomastigotes and epimastigotes

The morphological identification of Trypanosoma cruzi is currently considered to have a high specificity, but its sensitivity, which depends on the volume of the sample examined, is rather low. Trypanosome developmental stages suspended in blood, reduviid feces, and culture media are routinely searched for by means of fresh film examination (about 2 æL). High speed centrifugation of blood samples separates the buffy coat, where most trypomastigotes concentrate. As the parasites are transparent and colorless, their detection is mostly dependent on their motility. The fluorescent vital stain acridine orange has been used to enhance image contrast, as exemplified by the QBC (Quantitative Buffy Coat) technique. Staining blood, buffy coat, reduviid feces, and culture media samples with methylene blue (also a vital dye) is a means of producing sharp, well contrasted images of motile or non-motile T. cruzi developmental stages, only standard laboratory microscopes being required. Slides previously coated with a thin layer of methylene blue are used to stain fresh blood films. Photomicrographs exemplify the results of methylene blue staining applied to living and fixed parasites.

A identificação morfológica de Trypanosoma cruzi tem alta especificidade, segundo é geralmente aceito; entretanto, sua sensibilidade, dependente do volume da amostra examinada, é baixa. Formas evolutivas de T. cruzi suspensas em sangue, fezes de reduviídeos e meios de cultura são rotineiramente pesquisadas em esfregaços a fresco (cerca de 2 æL). Centrifugação de amostras de sangue a altas velocidades produz a separação do creme leucocitário, onde se concentram as formas tripomastigotas. Em preparações a fresco, a motilidade das formas tripomastigotas e epimastigotas de T. cruzi, protozoário transparente e incolor, facilita sua detecção. Laranja de acridina, corante vital fluorescente, tem sido usada para acentuar o contraste das imagens de parasitas. Disto é exemplo a técnica QBC (Quantitative Buffy Coat). A coloração por meio de azul de metileno (também um corante vital), de amostras de sangue, de fezes de reduviídeos ou de meios de cultura permite obter imagens nítidas e contrastadas de formas evolutivas de T. cruzi com ou sem motilidade. Microscópios de uso geral em laboratórios permitem o exame dos parasitas corados. Uma camada bem delgada de azul de metileno colocada sobre a parte central da lâmina limpa (por meio da evaporação de solução diluída do corante) é usada para corar as preparações a fresco. O aspecto dos parasitas corados em materiais frescos ou previamente fixados pode ser observado em fotomicrografias.

Methylene blue vital staining for Trypanosoma cruzi trypomastigotes and epimastigotes.

The morphological identification of Trypanosoma cruzi is currently considered to have a high specificity, but its sensitivity, which depends on the volume of the sample examined, is rather low. Trypanosome developmental stages suspended in blood, reduviid feces, and culture media are routinely searched for by means of fresh film examination (about 2 microL). High speed centrifugation of blood samples separates the buffy coat, where most trypomastigotes concentrate. As the parasites are transparent and colorless, their detection is mostly dependent on their motility. The fluorescent vital stain acridine orange has been used to enhance image contrast, as exemplified by the QBC (Quantitative Buffy Coat) technique. Staining blood, buffy coat, reduviid feces, and culture media samples with methylene blue (also a vital dye) is a means of producing sharp, well contrasted images of motile or non-motile T. cruzi developmental stages, only standard laboratory microscopes being required. Slides previously coated with a thin layer of methylene blue are used to stain fresh blood films. Photomicrographs exemplify the results of methylene blue staining applied to living and fixed parasites.

Refractive index matching applied to fecal smear clearing

Os esfregaços espessos de fezes humanas podem tornar-se adequados para a identificação de ovos e larvas de helmintos por meio da busca de homogeneidade de índices de refração. Embora seja possível obter esse efeito por meio de simples espalhamento de um fragmento de fezes sobre uma lâmina de microscopia, uma solução de glicerol tem sido usada rotineiramente para este fim. Visando à praticabilidade, elaborou-se uma técnica quantitativa em que é usada uma solução de sacarose (Índice de refração = 1,49) para reduzir o efeito da difusão da luz produzido por material particulado. O volume da amostra fecal a examinar em uma lâmina corresponde ao da cavidade cilíndrica da placa medidora (38,5 mm2). Avaliações de sensibilidade e contagens de ovos tornam-se, portanto, de fácil execução.

Refractive index matching applied to fecal smear clearing.

Thick smears of human feces can be made adequate for identification of helminth eggs by means of refractive index matching. Although this effect can be obtained by simply spreading a fleck of feces on a microscope slide, a glycerol solution has been routinely used to this end. Aiming at practicability, a new quantitative technique has been developed. To enhance both sharpness and contrast of the images, a sucrose solution (refractive index = 1.49) is used, which reduces the effect of light-scattering particulates. To each slide a template-measured (38.5 mm3) fecal sample is transferred. Thus, egg counts and sensitivity evaluations are easily made.

Schistosomiasis mansoni in Bananal (State of São Paulo, Brazil): III. Seroepidemiological studies in the Palha District.

The Palha district, municipality of Bananal, State of São Paulo, Brazil, had 10.3% cases of Schistosoma mansoni diagnosed from 1994 to 2000 by coproscopy: about three times the municipality average. The immunofluorescent antibody test was used to assess gut-associated IgM antibody titers of samples from 452 inhabitants. It disclosed 129 (28.5%) positive cases. Subjects were classified according to age, sex, birthplace, and period of residence. Titers varied from 8 to 4,096 (geometric mean: 170.2). Seropositives were aged from 6 to 69 years (average: 24.5), 75% of them aged 34 or less, predominantly males (78 or 60.5%). Of all subjects, 65.7% were born and had been living in Bananal since; 24.2% came from neighboring municipalities and are residing in Bananal from two months to 89 years (average: 22.7 years). Further Kato-Katz coproscopy from 97 seropositives (geometric mean titer, 619) revealed S. mansoni eggs in 11 subjects (11.3%). Serology was deemed useful in screening subjects to be further investigated by coproscopy, considering that blood collection had better acceptance than supplying fecal samples. Higher than average serological titers may indicate new cases in endemic areas. Longitudinal studies associated with epidemiological investigation, including titer evolution are advised, as isolated data are difficult to interpret.

Schistosomiasis mansoni in Bananal (State of Säo Paulo, Brazil). III. Seroepidemiological studies in the Palha District

The Palha district, municipality of Bananal, State of Säo Paulo, Brazil, had 10.3 percent cases of Schistosoma mansoni diagnosed from 1994 to 2000 by coproscopy: about three times the municipality average. The immunofluorescent antibody test was used to assess gut-associated IgM antibody titers of samples from 452 inhabitants. It disclosed 129 (28.5 percent) positive cases. Subjects were classified according to age, sex, birthplace, and period of residence. Titers varied from 8 to 4,096 (geometric mean: 170.2). Seropositives were aged from 6 to 69 years (average: 24.5), 75 percent of them aged 34 or less, predominantly males (78 or 60.5 percent). Of all subjects, 65.7 percent were born and had been living in Bananal since; 24.2 percent came from neighboring municipalities and are residing in Bananal from two months to 89 years (average: 22.7 years). Further Kato-Katz coproscopy from 97 seropositives (geometric mean titer, 619) revealed S. mansoni eggs in 11 subjects (11.3 percent). Serology was deemed useful in screening subjects to be further investigated by coproscopy, considering that blood collection had better acceptance than supplying fecal samples. Higher than average serological titers may indicate new cases in endemic areas. Longitudinal studies associated with epidemiological investigation, including titer evolution are advised, as isolated data are difficult to interpret

Intestinal parasites among Karitiana Indians from Rondônia State, Brazil

Gravity sedimentation parasitological examinations were performed in stool samples from 111 Karitiana Indians from Rondônia State, Brazilian Amazon Basin. Intestinal parasites were found in 43 samples (38.7%). Ascaris lumbricoides was the most prevalent helminth species (18.9%). Egg counts in samples positive for Ascaris suggested an overdispersed distribution of worm burdens in the host population. Age-distribution pattern of intestinal parasites among Karitiana Indians was found to be rather unusual: the highest prevalence (60.0%) was detected in the 12- to 16-year-old age group