PLOS ONE2014-01-05 12:51 AM

An In-Depth Analysis of a Piece of Shit: Distribution of Schistosoma mansoni and Hookworm Eggs in Human Stool 对一泡屎的深入研究:曼氏血吸虫和钩虫卵在人类粪便中的分布

Abstract Background An accurate diagnosis of helminth infection is important to improve patient management. However, there is considerable intra- and inter-specimen variation of helminth egg counts in human feces. Homogenization of stool samples has been suggested to improve diagnostic accuracy, but there are no detailed investigations. Rapid disintegration of hookworm eggs constitutes another problem in epidemiological surveys. We studied the spatial distribution of Schistosoma mansoni and hookworm eggs in stool samples, the effect of homogenization, and determined egg counts over time in stool samples stored under different conditions. 背景 对蠕虫感染的一个正确的诊断对提高病患管理是非常重要的。 然而,人类粪便的蠕虫卵数目在样本内和跨样本间具有非常大的差异。 虽然保证粪便样本同质化已被建议以提高诊断正确性,但是对此还没有详细的调查。 钩虫卵的快速衰变也带来了一个流行病学调查的问题。 我们学习了粪便样本中曼氏血吸虫和钩虫卵的空间分布, 同质化效果,并且确定了一段时间内保存于不同状态下的粪便样本的蠕虫卵数目。 Methodology Whole-stool samples were collected from 222 individuals in a rural part of south Côte d'Ivoire. Samples were cut into four pieces and helminth egg locations from the front to the back and from the center to the surface were analyzed. Some samples were homogenized and fecal egg counts (FECs) compared before and after homogenization. The effect of stool storing methods on FECs was investigated over time, comparing stool storage on ice, covering stool samples with a water-soaked tissue, or keeping stool samples in the shade. 方法 全粪便样本是从科特迪瓦南部一个农村的222个人收集的。 样本被切割成了四份以保证前后左右内外位置的蠕虫卵都得到了分析。 一些样本被同质化了并且对同质化之前和之后的粪便虫卵计数(FECs)也进行了比较。 粪便储存的方法对粪便虫卵计数(FECs)的影响也在一段时间内进行了调查。我们比较了将粪便保存于冰中,将粪便样本用一块湿纸巾包裹,或者将粪便样本存放于阴凉处这一些不同的保存方法。 Principal Findings We found no clear spatial pattern of S. mansoni and hookworm eggs in fecal samples. Homogenization decreased S. mansoni FECs (p = 0.026), while no effect was observed for hookworm and other soil-transmitted helminths. Hookworm FECs decreased over time. Storing stool samples on ice or covered with a moist tissue slowed down hookworm egg decay (p<0.005). 主要发现 我们没有在粪便样本中发现曼氏血吸虫和钩虫虫卵有明显的空间分布模式。 同质化降低了曼氏血吸虫的粪便虫卵计数(FECs) (p = 0.026), 但是对钩虫和其他土壤传播的蠕虫么有影响。 钩虫的粪便虫卵计数(FECs)随着时间下降。 保存于冰中以及用湿纸巾包裹的粪便降低了钩虫卵的衰减 (p<0.005)。 Conclusions/Significance Our findings have important implications for helminth diagnosis at the individual patient level and for epidemiological surveys, anthelmintic drug efficacy studies and monitoring of control programs. Specifically, homogenization of fecal samples is recommended for an accurate detection of S. mansoni eggs, while keeping collected stool samples cool and moist delayed the disintegration of hookworm eggs. 结果/意义 我们的发现对于个体患者的蠕虫诊断,流行病学调查,驱虫药效率研究和监测控制项目上都有重要意义。 具体来说,同质化粪便样本被建议用来正确检测曼氏血吸虫卵,而将粪便样本保存于湿润凉爽的的状态可以降低钩虫卵的衰变。

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