{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,5]],"date-time":"2026-11-05T20:50:36Z","timestamp":1793911836374,"version":"4.8.0"},"reference-count":25,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2021,4,15]],"date-time":"2021-04-15T00:00:00Z","timestamp":1618444800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["TropicalMed"],"abstract":"<jats:p>Intestinal helminth infections are the most prevalent neglected tropical diseases, predominantly affecting rural and marginalised populations. The mainstay of diagnosis is the microscopic examination of faecal samples to detect parasites in the form of eggs, larvae and cysts. In an effort to improve the standard of care, the comparative accuracy in detecting helminth infections of the hitherto used formalin-based concentration method (FC) was compared to a previously developed formalin ethyl-acetate-based concentration technique (FECT), prior to the systematic deployment of the latter at a research and humanitarian unit operating on the Thailand\u2013Myanmar border. A total of 693 faecal samples were available for the comparison of the two diagnostic methods. The FECT was superior in detecting hookworm, Trichuris trichiura and small liver flukes. Interestingly, there was no significant difference for Ascaris lumbricoides, possibly due to the high observed egg density. Despite the minor increase in material cost and the fact that the FECT is somewhat more time consuming, this method was implemented as the new routine technique.<\/jats:p>","DOI":"10.3390\/tropicalmed6020051","type":"journal-article","created":{"date-parts":[[2021,4,15]],"date-time":"2021-04-15T21:35:13Z","timestamp":1618522513000},"page":"51","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Improved Detection of Intestinal Helminth Infections with a Formalin Ethyl-Acetate-Based Concentration Technique Compared to a Crude Formalin Concentration Technique"],"prefix":"10.3390","volume":"6","author":[{"given":"Tobias","family":"Brummaier","sequence":"first","affiliation":[{"name":"Shoklo Malaria Research Unit, Mahidol\u2013Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, P.O. Box 46, 68\/30 Bann Thung Road, Mae Sot 63100, Thailand"},{"name":"Swiss Tropical and Public Health Institute, P.O. Box, CH-4002 Basel, Switzerland"},{"name":"University of Basel, P.O. Box, CH-4003 Basel, Switzerland"},{"name":"Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford OX3 7LG, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laypaw","family":"Archasuksan","sequence":"additional","affiliation":[{"name":"Shoklo Malaria Research Unit, Mahidol\u2013Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, P.O. Box 46, 68\/30 Bann Thung Road, Mae Sot 63100, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dorn","family":"Watthanakulpanich","sequence":"additional","affiliation":[{"name":"Faculty of Tropical Medicine, Department of Helminthology, Mahidol University, 420\/6 Ratchawithi Road, Ratchathewi, Bangkok 10400, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4743-5987","authenticated-orcid":false,"given":"Daniel H.","family":"Paris","sequence":"additional","affiliation":[{"name":"Swiss Tropical and Public Health Institute, P.O. Box, CH-4002 Basel, Switzerland"},{"name":"University of Basel, P.O. Box, CH-4003 Basel, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u00fcrg","family":"Utzinger","sequence":"additional","affiliation":[{"name":"Swiss Tropical and Public Health Institute, P.O. Box, CH-4002 Basel, Switzerland"},{"name":"University of Basel, P.O. Box, CH-4003 Basel, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1621-3257","authenticated-orcid":false,"given":"Rose","family":"McGready","sequence":"additional","affiliation":[{"name":"Shoklo Malaria Research Unit, Mahidol\u2013Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, P.O. Box 46, 68\/30 Bann Thung Road, Mae Sot 63100, Thailand"},{"name":"Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford OX3 7LG, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4201-5473","authenticated-orcid":false,"given":"Stephane","family":"Proux","sequence":"additional","affiliation":[{"name":"Shoklo Malaria Research Unit, Mahidol\u2013Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, P.O. Box 46, 68\/30 Bann Thung Road, Mae Sot 63100, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fran\u00e7ois","family":"Nosten","sequence":"additional","affiliation":[{"name":"Shoklo Malaria Research Unit, Mahidol\u2013Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, P.O. Box 46, 68\/30 Bann Thung Road, Mae Sot 63100, Thailand"},{"name":"Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford OX3 7LG, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,4,15]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1311","DOI":"10.1172\/JCI34261","article-title":"Helminth infections: The great neglected tropical diseases","volume":"118","author":"Hotez","year":"2008","journal-title":"J. Clin. Investig."},{"key":"ref_2","first-page":"w13727","article-title":"Neglected tropical diseases: Diagnosis, clinical management, treatment and control","volume":"142","author":"Utzinger","year":"2012","journal-title":"Swiss Med. Wkly."},{"key":"ref_3","unstructured":"WHO World Health Organization (2021, March 02). Accelerating Work to Overcome the Global Impact of Neglected Tropical Diseases a Roadmap for Implementation. Available online: https:\/\/apps.who.int\/iris\/handle\/10665\/70809."},{"key":"ref_4","unstructured":"WHO World Health Organization (2019, October 04). Soil-Transmitted Helminth Infections (Fact Sheet). Available online: https:\/\/Www.Who.Int\/News-Room\/Fact-Sheets\/Detail\/Soil-Transmitted-Helminth-Infections."},{"key":"ref_5","unstructured":"DALYs and HALE Collaborators Global (2018). Global, regional, and national disability-adjusted life-years (DALYs) for 359 diseases and injuries and healthy life expectancy (HALE) for 195 countries and territories, 1990\u20132017: A systematic snalysis for the global burden of disease study 2017. Lancet, 392, 1859\u20131922."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"301","DOI":"10.1002\/jhbp.62","article-title":"Roles of liver fluke infection as risk factor for cholangiocarcinoma","volume":"21","author":"Sithithaworn","year":"2014","journal-title":"J. Hepatobiliary Pancreat. Sci."},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Brummaier, T., Tun, N.W., Min, A.M., Gilder, M.E., Archasuksan, L., Proux, S., Kiestra, D., Charunwatthana, P., Utzinger, J., and Paris, D.H. (2021). Burden of soil-transmitted helminth infection in pregnant refugees and migrants on the Thailand-Myanmar border: Results from a retrospective cohort. PLoS Negl. Trop. Dis., 15.","DOI":"10.1371\/journal.pntd.0009219"},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Boel, M., Carrara, V.I., Rijken, M., Proux, S., Nacher, M., Pimanpanarak, M., Paw, M.K., Moo, O., Gay, H., and Bailey, W. (2010). Complex interactions between soil-transmitted helminths and malaria in pregnant women on the Thai-Burmese border. PLoS Negl. Trop. Dis., 4.","DOI":"10.1371\/journal.pntd.0000887"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"852","DOI":"10.1128\/jcm.10.6.852-853.1979","article-title":"Ethyl acetate as a substitute for diethyl ether in the formalin-ether sedimentation technique","volume":"10","author":"Young","year":"1979","journal-title":"J. Clin. Microbiol."},{"key":"ref_10","unstructured":"WHO World Health Organization (2021, January 04). Guideline: Preventive Chemotherapy to Control Soil-Transmitted Helminth Infections in At-risk Population Groups. Available online: https:\/\/www.who.int\/nutrition\/publications\/guidelines\/deworming\/en\/."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"595","DOI":"10.1128\/CMR.15.4.595-612.2002","article-title":"History of human parasitology","volume":"15","author":"Cox","year":"2002","journal-title":"Clin. Microbiol. Rev."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1510","DOI":"10.1055\/s-0028-1135692","article-title":"Eine Methode zur Erleichterung der Auffindung von Parasiteneiern in den Faeces","volume":"34","author":"Telemann","year":"1908","journal-title":"DMW\u2014Deutsche Med. Wochenschr."},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Xu, B., Gordon, C.A., Hu, W., McManus, D.P., Chen, H.-G., Gray, D.J., Ju, C., Zeng, X.-J., Gobert, G.N., and Ge, J. (2012). A novel procedure for precise quantification of Schistosoma japonicum eggs in bovine feces. PLoS Negl. Trop. Dis., 6.","DOI":"10.1371\/annotation\/2c375f5c-78e4-4920-9498-014bf8d2aff3"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"159","DOI":"10.2307\/2529310","article-title":"The measurement of observer agreement for categorical data","volume":"33","author":"Landis","year":"1977","journal-title":"Biometrics"},{"key":"ref_15","unstructured":"Gamer, M., Lemon, J., and Singh, I.F.P. (2021, March 26). Irr: Various Coefficients of Interrater Reliability and Agreement. Available online: https:\/\/CRAN.R-project.org\/package=irr."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"f5605","DOI":"10.1136\/bmj.f5605","article-title":"Value of composite reference standards in diagnostic research","volume":"347","author":"Naaktgeboren","year":"2013","journal-title":"BMJ"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"344","DOI":"10.1007\/s10096-006-0135-x","article-title":"Differences in microscopic diagnosis of helminths and intestinal protozoa among diagnostic centres","volume":"25","author":"Bogoch","year":"2006","journal-title":"Eur. J. Clin. Microbiol. Infect. Dis."},{"key":"ref_18","unstructured":"Stevenson, M., Sergeant, E., Nunes, T., Heuer, C., Marshall, J., Sanchez, J., Thornton, R., Reiczigel, J., Robison-Cox, J., and Sebastiani, P. (2021, March 26). EpiR: Tools for the Analysis of Epidemiological Data; R package Version 2.0.19. Available online: https:\/\/CRAN.R-project.org\/package=epiR."},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Krauth, S.J., Coulibaly, J.T., Knopp, S., Traor\u00e9, M., N\u2019Goran, E.K., and Utzinger, J. (2012). An in-depth analysis of a piece of shit: Distribution of Schistosoma mansoni and hookworm eggs in human stool. PLOS Negl. Trop. Dis., 6.","DOI":"10.1371\/journal.pntd.0001969"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"330","DOI":"10.1016\/j.sapharm.2012.04.004","article-title":"Interrater agreement and interrater reliability: Key concepts, approaches, and applications","volume":"9","author":"Gisev","year":"2013","journal-title":"Res. Soc. Adm. Pharm."},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Bosch, F., Palmeirim, M.S., Ali, S.M., Ame, S.M., Hattendorf, J., and Keiser, J. (2021). Diagnosis of soil-transmitted helminths using the Kato-Katz technique: What is the influence of stirring, storage time and storage temperature on stool sample egg counts?. PLoS Negl. Trop. Dis., 15.","DOI":"10.1371\/journal.pntd.0009032"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"399","DOI":"10.1016\/j.ijpara.2009.09.003","article-title":"Estimating the sensitivity and specificity of Kato-Katz stool examination technique for detection of hookworms, Ascaris lumbricoides and Trichuris trichiura infections in humans in the absence of a \u2018Gold Standard\u2019","volume":"40","author":"Tarafder","year":"2010","journal-title":"Int. J. Parasitol."},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Gordon, C., Kurscheid, J., Williams, G., Clements, A., Li, Y., Zhou, X.-N., Utzinger, J., McManus, D., and Gray, D. (2019). Asian schistosomiasis: Current status and prospects for control leading to elimination. Trop. Med. Infect. Dis., 4.","DOI":"10.3390\/tropicalmed4010040"},{"key":"ref_24","unstructured":"WHO World Health Organization (2021, March 02). Ending the Neglect to Attain the Sustainable Development Goals a Road Map for Neglected Tropical Diseases 2021\u20132030. Available online: https:\/\/www.who.int\/neglected_diseases\/resources\/who-ucn-ntd-2020.01\/en\/."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1186\/s40249-020-0630-9","article-title":"Neglected tropical diseases: An effective global response to local poverty-related disease priorities","volume":"9","author":"Engels","year":"2020","journal-title":"Infect. Dis. Poverty"}],"container-title":["Tropical Medicine and Infectious Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2414-6366\/6\/2\/51\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T05:48:27Z","timestamp":1760161707000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2414-6366\/6\/2\/51"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,4,15]]},"references-count":25,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2021,6]]}},"alternative-id":["tropicalmed6020051"],"URL":"https:\/\/doi.org\/10.3390\/tropicalmed6020051","relation":{},"ISSN":["2414-6366"],"issn-type":[{"value":"2414-6366","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,4,15]]}}}