{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2023,9,11]],"date-time":"2023-09-11T20:39:13Z","timestamp":1694464753343},"reference-count":22,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2014,12,26]],"date-time":"2014-12-26T00:00:00Z","timestamp":1419552000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clinical Laboratory Analysis"],"published-print":{"date-parts":[[2016,3]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Current practices for ordering stool studies in patients with abdominal and gastrointestinal symptoms are not standardized. We hypothesized that an algorithm involving first\u2010line use of a <jats:italic>Cryptosporidium\/Giardia<\/jats:italic> combination antigen test and stricter use of ova and parasite (O&amp;P) examinations would be clinically and cost effective.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In this study, stool O&amp;P test results for pediatric patients in Dallas, Texas, were reviewed. All results obtained between 2009 and 2012 were included. Patient charts were reviewed to determine test results, symptoms, treatment, travel, and past medical history. Using these data, a retrospective modeling study was done to evaluate the utility of a diagnostic algorithm that limits O&amp;P testing to those patients who are immunocompromised or have travelled outside the United States.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Over the 3\u2010year period of this study, we found that the prevalence of gastrointestinal parasitic disease in children was 1.9%. Analysis of the diagnostic algorithm for the judicious use of stool O&amp;P showed that as much as 65% of testing may be unnecessary and could be eliminated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Our findings show that the prevalence of pediatric gastrointestinal parasitic disease in Texas may be lower than expected. In addition, these data show that a diagnostic algorithm limiting O&amp;P testing may be both clinically and cost effective in low\u2010prevalence settings. However, such an algorithm would miss a significant number of infections due to <jats:italic>Dientamoeba fragilis<\/jats:italic> and <jats:italic>Blastocystis hominis<\/jats:italic>.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jcla.21829","type":"journal-article","created":{"date-parts":[[2014,12,26]],"date-time":"2014-12-26T23:37:57Z","timestamp":1419637077000},"page":"155-160","source":"Crossref","is-referenced-by-count":0,"title":["Diagnostic Algorithm for the Diagnosis of Pediatric Parasitic Gastroenteritis"],"prefix":"10.1002","volume":"30","author":[{"given":"Stacy G.","family":"Beal","sequence":"first","affiliation":[{"name":"Department of Pathology University of Texas Southwestern Medical Center  Dallas Texas"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marc Roger","family":"Couturier","sequence":"additional","affiliation":[{"name":"Department of Pathology The University of Utah  Salt Lake City Utah"},{"name":"ARUP Laboratories  Salt Lake City Utah"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rita M.","family":"Gander","sequence":"additional","affiliation":[{"name":"Department of Pathology University of Texas Southwestern Medical Center  Dallas Texas"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher D.","family":"Doern","sequence":"additional","affiliation":[{"name":"Department of Pathology Virginia Commonwealth University Medical Center  Richmond Virginia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2014,12,26]]},"reference":[{"issue":"12","key":"e_1_2_8_2_1","first-page":"1","article-title":"Surveillance for waterborne disease outbreaks and other health events associated with recreational water\u2014United States, 2007\u20132008","volume":"60","author":"Hlavsa MC","year":"2011","journal-title":"MMWR Surveill Summ"},{"issue":"5","key":"e_1_2_8_3_1","first-page":"1","article-title":"Cryptosporidiosis surveillance \u2013 United States, 2009\u20132010","volume":"61","author":"Yoder JS","year":"2012","journal-title":"MMWR Surveill Summ"},{"issue":"5","key":"e_1_2_8_4_1","first-page":"13","article-title":"Centers for disease C, prevention. 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