{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T19:39:12Z","timestamp":1793302752765,"version":"4.5.0"},"reference-count":35,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2018,12,5]]},"abstract":"<jats:p>Current methods to identify the etiology of diarrhea require laboratory facilities for storage of pathogens, which is often challenging in low-resource settings. This study evaluated the efficacy of a low-cost method for preserving stool specimens for the detection of parasitic enteropathogens using Whatman 903 protein saver cards (Sigma-Aldrich, St. Louis, MO). Stool samples known to be positive by multiplex real-time polymerase chain reaction for <jats:italic>Giardia lamblia<\/jats:italic>, <jats:italic>Cryptosporidium<\/jats:italic> spp., and <jats:italic>Entamoeba histolytica<\/jats:italic> parasites were preserved on 232 Whatman cards. DNA was then extracted from cards using Chelex and Qiagen extraction protocols, and tested for these parasites using multiplex real-time PCR. We included stool samples known to have a higher parasite load (cycle threshold [ct]-value &lt; 30) and those with a lower parasite load (ct values 30\u201335). Sensitivities and specificities were determined using DNA extracted directly from whole stool samples using Qiagen kits (QIAGEN, Hilden, Germany). For whole stool samples with ct values &lt; 30, preserved directly on Whatman 903 protein saver cards for <jats:italic>Giardia<\/jats:italic> analysis, the sensitivity was 100% for both Qiagen and Chelex DNA extraction. For <jats:italic>E. histolytica<\/jats:italic>, this was 100% for sensitivity for Qiagen and 80% for Chelex DNA extractions, and for <jats:italic>Cryptosporidium<\/jats:italic>, this was 80% for Qiagen and 50% for Chelex DNA extraction. The specificity was 100% for all parasites for all extraction procedures. Given the high sensitivity for stool samples with higher parasite loads, we recommend the use of the Whatman 903 protein saver card for preserving fecal specimens for the analysis of <jats:italic>Giardia<\/jats:italic> and <jats:italic>E. histolytica<\/jats:italic> using Qiagen DNA extractions in low-resource settings.<\/jats:p>","DOI":"10.4269\/ajtmh.18-0538","type":"journal-article","created":{"date-parts":[[2018,11,6]],"date-time":"2018-11-06T07:00:23Z","timestamp":1541487623000},"page":"1613-1618","source":"Crossref","is-referenced-by-count":13,"title":["Whatman Protein Saver Cards for Storage and Detection of Parasitic Enteropathogens"],"prefix":"10.4269","volume":"99","author":[{"given":"Gayathri","family":"Natarajan","sequence":"first","affiliation":[{"name":"Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mamun","family":"Kabir","sequence":"additional","affiliation":[{"name":"International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jamie","family":"Perin","sequence":"additional","affiliation":[{"name":"Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Biplob","family":"Hossain","sequence":"additional","affiliation":[{"name":"International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amanda","family":"Debes","sequence":"additional","affiliation":[{"name":"Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rashidul","family":"Haque","sequence":"additional","affiliation":[{"name":"International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine Marie","family":"George","sequence":"additional","affiliation":[{"name":"Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2795","reference":[{"key":"b1","series-title":"Lancet","first-page":"1151","article-title":"Global, regional, and national age-sex specific mortality for 264 causes of death, 1980\u20132016: a systematic analysis for the Global Burden of Disease Study 2016","volume":"390","author":"GBD 2016 Causes of Death Collaborators","year":"2017"},{"key":"b2","series-title":"Lancet","first-page":"209","article-title":"Burden and aetiology of 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