Staining blindly: an update on coloring techniques for fecal smears in parasitology: a scoping review.

Dye application for parasite highlighting in the Ova and Parasite exam is a common practice in parasitology diagnosis. Methods: A scoping review investigated how staining solutions interact with parasite structures. After screening 1334 papers, 35 met eligibility criteria. Results: Differentiating background from foreground in the fecal smear under light microscopy is the core of the research on this topic. Refractivity, unevenness of staining, size and temperature were explored to enhance staining protocols. Cryptosporidium spp. and Microsporidia were the main studied species. Conclusion: Studies on diagnostic efficacy outperform those that elucidate the physical-chemical interaction between dyes and parasites. An alternative approach involves technicians using computational tools to reduce subjectivity in fecal smear interpretation, deviating from conventional methods.

What is this article about? Coloring parasites during fecal exams has been widely used to find parasites in human feces. We searched for articles that could help us to answer the question: 'How do dyes give color to parasites?'. Then, we filtered the information from a total of 1334 articles to 35. What were the results? Cryptosporidium spp. and Microsporidia are microbes that can be seen only through a microscope. Researchers were interested in these two species in the last 40 years. Differentiating parasites from dirt on a glass slide is the main problem researchers are trying to solve. The way the light goes through parasites under a microscope, variation of staining, size and temperature of dyes have been explored to identify what gives better results in coloring protocols. What do the results of the study mean? Little is known about the chemical interaction between dyes and parasites. On the other hand, there are many studies on how good coloring methods are and comparing protocols. An alternative to the conventional approaches in staining parasites is the use of computational tools to reduce doubt in the exam interpretation by technicians.

Toward automating the diagnosis of gastrointestinal parasites in cats and dogs.

Diagnosing gastrointestinal parasites by microscopy slide examination often leads to human interpretation errors, which may occur due to fatigue, lack of training and infrastructure, presence of artifacts (e.g., various types of cells, algae, yeasts), and other reasons. We have investigated the stages in automating the process to cope with the interpretation errors. This work presents advances in two stages focused on gastrointestinal parasites of cats and dogs: a new parasitological processing technique, named TF-Test VetPet, and a microscopy image analysis pipeline based on deep learning methods. TF-Test VetPet improves image quality by reducing cluttering (i.e., eliminating artifacts), which favors automated image analysis. The proposed pipeline can identify three species of parasites in cats and five in dogs, distinguishing them from fecal impurities with an average accuracy of 98,6%. We also make available the two datasets with images of parasites of dogs and cats, which were obtained by processing fecal smears with temporary staining using TF-Test VetPet.

Detection of intestinal parasites in human faecal samples using dissolved air flotation.

OBJECTIVE: Ova and parasite (O&P) examination is recommended for the laboratory diagnosis of agents causing parasitic infections; however, this exam requires scientific and technological improvements to enhance its diagnostic validity. Dissolved air flotation (DAF) is an efficient technical principle separating suspended solids in a liquid medium. We aimed to develop and validate a new procedure for intestinal parasite detection with DAF. METHODS: In this study, we collected samples from 500 volunteers, screened them by direct examination, and transferred the material to tubes using the Three Faecal Test (TF-Test) for triplicate DAF tests. We evaluated physical-chemical parameters and DAF prototype components through quantifying parasites recovered from floated and non-floated regions of the flotation column. The DAF operation protocol was validated with the gold standard results. RESULTS: The 10% saturated volume proportion and cationic surfactant showed regularity and high parasite recovery (80%). Modifications of the needle device did not influence parasite recovery (p > 0.05). Sensitivity, specificity, accuracy and kappa agreement obtained with the DAF protocol were 91%, 100%, 93% and substantial (k = 0.64), respectively. CONCLUSION: The DAF principle could be used to process faecal samples in routine laboratory exams, enabling intestinal parasite detection.

Dissolved air flotation as potential new mechanism for intestinal parasite diagnosis in feces.

The parasitological examination of feces is recommended for the laboratory diagnosis of intestinal parasites due to its practicality, low-cost, and moderate diagnostic sensitivity. Dissolved Air Flotation (DAF) is an efficient technical principle used in other areas to separate dispersed solids. This study sought the preliminary evaluation of a proof-of-concept prototype as a tool for detecting species of parasites by adjusting DAF. Two DAF prototype units were developed to evaluate microbubbles' generation amidst fecal suspension and parasites' capture. For this evaluation, samples were screened and processed by the TF-Test technique (Control) and simultaneously by DAF device. The dimensional and attachment characteristics in the formation of the microbubbles were evaluated, and the percentage of parasitic recovery in floated and not-floated regions compared by Student's t-test. The second prototype unit proved to be more efficient in forming microbubbles with diameters between 34 and 170µm. The flotation tests showed a recovery of 73.27%, 58.12%, 37.85%, and 91.89% for Ascaris lumbricoides, Hymenolepis diminuta, Giardia duodenalis, and Strongyloides stercoralis, respectively. This study confirmed the selective interaction between microbubbles and parasite eggs and larvae during the flotation process using the DAF principle for the first time through imaging.

A historical review of the techniques of recovery of parasites for their detection in human stools.

Since the early 20th century, the detection of intestinal parasites has improved with the development of several techniques for parasitic structures recovery and identification, which differ in sensitivity, specificity, practicality, cost, and infrastructure demand. This study aims to review, in chronological order, the stool examination techniques and discuss their advantages, limitations, and perspectives, and to provide professionals and specialists in this field with data that lays a foundation for critical analysis on the use of such procedures. The concentration procedures that constitute the main techniques applied in routine research and in parasitological kits are a) spontaneous sedimentation; b) centrifugation-sedimentation with formalin-ethyl acetate; and c) flotation with zinc sulfate solution. While selecting a technique, one should consider the purpose of its application and the technical-operational, biological, and physicochemical factors inherent in the procedures used in stool processing, which may restrict its use. These intrinsic limitations may have undergone procedural changes driven by scientific and technological development and by development of alternative methods, which now contribute to the improvement of diagnostic accuracy.

A historical review of the techniques of recovery of parasites for their detection in human stools

Abstract Since the early 20th century, the detection of intestinal parasites has improved with the development of several techniques for parasitic structures recovery and identification, which differ in sensitivity, specificity, practicality, cost, and infrastructure demand. This study aims to review, in chronological order, the stool examination techniques and discuss their advantages, limitations, and perspectives, and to provide professionals and specialists in this field with data that lays a foundation for critical analysis on the use of such procedures. The concentration procedures that constitute the main techniques applied in routine research and in parasitological kits are a) spontaneous sedimentation; b) centrifugation-sedimentation with formalin-ethyl acetate; and c) flotation with zinc sulfate solution. While selecting a technique, one should consider the purpose of its application and the technical-operational, biological, and physicochemical factors inherent in the procedures used in stool processing, which may restrict its use. These intrinsic limitations may have undergone procedural changes driven by scientific and technological development and by development of alternative methods, which now contribute to the improvement of diagnostic accuracy.

Use of the aqueous biphasic system as an alternative for concentration of Ascaris lumbricoides eggs, with non-toxic separation of faecal residues and fats.

OBJECTIVES: Human enteroparasites are considered a serious public health problem in underdeveloped countries located in world regions with tropical, subtropical and equatorial climates. These parasites are commonly diagnosed by the Parasitological Examination of Faeces (PEF), performed by conventional techniques and/or commercial kits that result in tests with low-to-moderate sensitivity, due to the use of destructive chemical solvents to parasite structures, and to present excess adipose substance and digestive residues in their microscopic slides. In order to improve the efficacy of these tests/examinations, this study aimed to investigate a new alternative for the PEF, with the use of Aqueous Biphasic System (ABS). METHODS: For this, four ABSs containing poly (ethylene glycol), PEG (PEG-4000 and PEG-6000), dipotassium phosphate and sodium citrate at different concentrations in the biphasic systems were evaluated with faecal samples containing eggs of Ascaris lumbricoides. RESULTS: The ABS consisting of PEG-4000 and dipotassium phosphate, at concentrations of 55% w/w and 20% w/w, respectively, achieved 100% satisfactory results compared to the conventional TF-Test technique in terms of preservation and concentration of A. lumbricoides eggs, with adequate separation of digestive residues, without using a centrifuge or chemical solvents that may cause harm to the parasites. CONCLUSIONS: This study presents ABS as a new low-cost technical principle for the detection of parasite eggs in PEF. The new technique is simple, fast, non-toxic, not harmful to the parasite and does not require a centrifuge.

UTILISATION DU SYSTÈME BIPHASIQUE AQUEUX COMME ALTERNATIVE À LA CONCENTRATION DES ŒUFS D'ASCARIS LUMBRICOIDES, AVEC SÉPARATION NON TOXIQUE DES RÉSIDUS FÉCAUX ET DES GRAISSES: OBJECTIFS: Les entéroparasites humains sont considérés comme un sérieux problème de santé publique dans les pays sous-développés situés dans des régions du monde aux climats tropicaux, subtropicaux et équatoriaux. L'examen parasitologique des matières fécales (EPMF) permet généralement de diagnostiquer ces parasites, à l'aide de techniques classiques et/ou de kits commerciaux, conduisant à des tests de sensibilité faible à modérée, dus à l'utilisation de solvants chimiques destructeurs pour les structures du parasite et résultant en excès de substances adipeuses et de résidus digestifs dans leurs lames microscopiques. Afin d'améliorer l'efficacité de ces tests/examens, cette étude visait à étudier une nouvelle alternative à l'EPMF, avec l'utilisation du Système Biphasique Aqueux (SBA). MÉTHODES: Pour cela, quatre SBA contenant du poly (éthylène glycol), du PEG (PEG-4000 et PEG-6000), du phosphate dipotassique et du citrate de sodium à différentes concentrations ont été évalués avec des échantillons de matières fécales contenant des œufs d'Ascaris lumbricoides. RÉSULTATS: Le SBA constitué de PEG-4000 et de phosphate dipotassique, à des concentrations respectives de 55% poids/poids et 20% poids/poids, a obtenu des résultats satisfaisants à 100% par rapport à la technique conventionnelle du TF-Test, en termes de préservation et de concentration des œufs de A. lumbricoides, avec une séparation adéquate des résidus digestifs, sans utiliser de centrifugeuse ni de solvants chimiques pouvant détruire les parasites. CONCLUSIONS: Cette étude présente le SBA comme un nouveau principe technique peu coûteux pour la détection des œufs de parasites dans l'EPMF. La nouvelle technique est simple, rapide, non toxique, n'endommage pas le parasite et ne nécessite pas de centrifugeuse.

TF-Test Quantified: a new technique for diagnosis of Schistosoma mansoni eggs.

OBJECTIVES: Laboratory diagnosis of Schistosoma mansoni eggs is routinely performed by conventional quantitative techniques through the parasitological examination of human faeces. However, the diagnostic sensitivity of this type of exam varies from low to moderate. We aimed to develop a new parasitological technique called TF-Test Quantified (TFT-Quant), for the quantitative detection of S. mansoni eggs in human faeces. METHODS: Four study stages were performed using 43 mice infected by S. mansoni cercariae. These experiments allowed the definition of an operational protocol for TFT-Quant and a comparison of this new technique to the conventional Helm-Teste technique. RESULTS: The results show a good diagnostic efficacy of TFT-Quant, which reached 100% in sensitivity and specificity, indicating an 'Almost Perfect' Kappa (k) agreement. CONCLUSIONS: This new technique provided a quantitative gain in the detection of S. mansoni eggs, largely free of faecal debris. The next stage of this study is the field validation of the TFT-Quant technique with the use of human faecal samples from an endemic region for mansonic schistosomiasis in Brazil (Microregion Jequitinhonha, State of Minas Gerais). In parallel to this validation, computational algorithms will be developed to allow the automated quantitative diagnosis of S. mansoni eggs.

OBJECTIFS: Le diagnostic en laboratoire des œufs de Schistosoma mansoni est systématiquement effectué à l'aide de techniques quantitatives conventionnelles faisant appel à l'examen parasitologique de selles humaines. Cependant, la sensibilité diagnostique de ce type d'examen varie de faible à modérée. Nous avons voulu développer une nouvelle technique parasitologique appelée TF-Test Quantified (TFT-Quant), pour la détection quantitative des œufs de S. mansoni dans les selles humaines. MÉTHODES: Quatre étapes de l'étude ont été réalisées sur 43 souris infectées par des cercaires de S. mansoni. Ces expériences ont permis de définir un protocole opérationnel pour TFT-Quant et de comparer cette nouvelle technique à la technique classique Helm-Teste. RÉSULTATS: Les résultats montrent une bonne efficacité diagnostique de TFT-Quant, dont la sensibilité et la spécificité ont atteint 100%, ce qui indique une concordance kappa (k) «presque parfaite¼. CONCLUSIONS: Cette nouvelle technique a permis un gain quantitatif dans la détection des œufs de S. mansoni, largement exempts de débris fécaux. La prochaine étape de cette étude est la validation sur le terrain de la technique TFT-Quant avec l'utilisation d'échantillons de selles humaines provenant d'une région endémique pour la schistosomiase mansonique au Brésil (Microregion Jequitinhonha, dans l'Etat de Minas Gerais). Parallèlement à cette validation, des algorithmes informatiques de calcul seront développés pour permettre le diagnostic quantitatif automatisé des œufs de S. mansoni.

A study of intestinal parasites in children of an urban region with excellent sanitary condition reveals high occurrence of Blastocystis spp

Intestinal parasites are among the major causative agents of diseases that affect animals and humans, especially children. In view of this, the current study evaluated the occurrence of these parasitic agents in 737 children in an urban region with excellent sanitation condition of the city of Pedreira, São Paulo, Brazil. Fecal samples from the children were processed with the use of a technique of high diagnostic efficiency (TF-Test®). The diagnosis of these samples resulted in the detection of 557 parasitic structures among eleven genera of parasites, and of 46.4% (342/737) infected children. Blastocystis spp. was found in 69.6% (238/342) of the positive samples and the monoparasitism was accompanied by symptoms in 44 children. Furthermore, 67.8% (232/342) of the infected children had close contact with pets, suggesting a possible zoonotic transmission. Lastly, this study allowed to perform health education to the children, aiming the reduction of new intestinal parasitic infections.