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A COMPARISON OF METHODS FOR DETECTING THE EGGS OF ASCARIS, TRICHURIS, AND HOOKWORM IN INFANT STOOL, AND THE EPIDEMIOLOGY OF INFECTION IN ZANZIBARI INFANTS

This study compared five methods for detecting the eggs of the human parasitic geohelminths Ascaris, Trichuris, and hookworm in infant stool, and describes the epidemiology of infection in infants from a parasite-endemic area. A total of 424 infants 5–11 months old were enrolled from three villages on Pemba Island, Zanzibar. Methods used included the Kato-Katz technique, formol ethyl acetate sedimentation, modified formol ethyl acetate sedimentation, modified Wisconsin floatation, and simple gravity sedimentation. Of methods used alone, Wisconsin floatation and simple gravity sedimentation each provided the highest sensitivity for detecting eggs of these three geohelminths (89.6%). Of methods used in combination, the Kato-Katz technique/simple gravity sedimentation and Wisconsin floatation/simple gravity sedimentation each provided the highest sensitivity (99.0%). Prevalence of geohelminth infection was 26.5%. Between five and nine months of age the mean prevalence was 9.4%, while at 10 and 11 months of age the mean prevalence was 43.4%. Village prevalence varied from 3.6% to 43.8%. Infant geohelminth infection can occur at a high prevalence, and what method is best depends on research specifics.

Received January 27, 2005. Accepted for publication July 19, 2005.

Acknowledgments: We thank Dr. Clive Shiff for his help in developing the simple gravity sedimentation, as well as the excellent field and lab staff of the PHL-IdC, and the community of Pemba Island.

Financial support: This study was supported by a grant from the Wellcome Trust.

^* Address correspondence to David Goodman, Florida Department of Health, 4052 Bald Cypress Way, Bin #A13, Tallahassee, FL 32399. E-mail: dave_goodman{at}doh.state.fl.us

Authors’ addresses: David Goodman and James M. Tielsch, Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, Baltimore, MD 21205. Hamad J. Haji and Mahdi Ramsan, Pemba Public Health Laboratory, Ivo de Carneri, Box 122, Chake Chake, Pemba Island, Zanzibar, The United Republic of Tanzania. Quentin D. Bickle, Department of Infectious and Tropical Diseases London School of Hygiene and Tropical Medicine, Keppel Street, London, United Kingdom WC1E 7HT. Rebecca J. Stoltzfus, Division of Nutritional Sciences Cornell University, Savage Hall, Ithaca, NY 14853. Lorenzo Savioli and Marco Albonico, Division of Intestinal Parasites and Vector Control, World Health Organization, Geneva, Switzerland.