Lisette van Lieshout1, Jaco J Verweij. 1. Department of Parasitology, Leiden University Medical Center, Leiden, The Netherlands. lvanlieshout@lumc.nl
Abstract
PURPOSE OF REVIEW: To update the reader on the latest developments in the laboratory diagnosis of intestinal protozoa. RECENT FINDINGS: Correct identification of a diarrhoea causing pathogens is essential for the choice of treatment in an individual patient as well as to map the aetiology of diarrhoea in a variety of patient populations. Classical diagnosis of diarrhoea causing protozoa by microscopic examination of a stool sample lacks both sensitivity and specificity. Alternative diagnostic platforms are discussed. SUMMARY: Recent literature on the diagnosis of intestinal protozoa has focused mainly on nucleic acid-based assays, in particular the specific detection of parasite DNA in stool samples using real-time PCR. In addition, the trend has been moving from single pathogen detection to a multiplex approach, allowing simultaneous identification of multiple parasites. Different combinations of targets can be used within a routine diagnostic setting, depending on the patient population, such as children, immunocompromised individuals and those who have been travelling to tropical regions. Large-scale monitoring and evaluation of control strategies become feasible due to automation and high-throughput facilities. Improved technology also has become available for differentiating protozoa subspecies, which facilitates outbreak investigations and extensive research in molecular epidemiology.
PURPOSE OF REVIEW: To update the reader on the latest developments in the laboratory diagnosis of intestinal protozoa. RECENT FINDINGS: Correct identification of a diarrhoea causing pathogens is essential for the choice of treatment in an individual patient as well as to map the aetiology of diarrhoea in a variety of patient populations. Classical diagnosis of diarrhoea causing protozoa by microscopic examination of a stool sample lacks both sensitivity and specificity. Alternative diagnostic platforms are discussed. SUMMARY: Recent literature on the diagnosis of intestinal protozoa has focused mainly on nucleic acid-based assays, in particular the specific detection of parasite DNA in stool samples using real-time PCR. In addition, the trend has been moving from single pathogen detection to a multiplex approach, allowing simultaneous identification of multiple parasites. Different combinations of targets can be used within a routine diagnostic setting, depending on the patient population, such as children, immunocompromised individuals and those who have been travelling to tropical regions. Large-scale monitoring and evaluation of control strategies become feasible due to automation and high-throughput facilities. Improved technology also has become available for differentiating protozoa subspecies, which facilitates outbreak investigations and extensive research in molecular epidemiology.
Authors: Pavitra Pillay; Myra Taylor; Siphosenkosi G Zulu; Svein G Gundersen; Jaco J Verweij; Pytsje Hoekstra; Eric A T Brienen; Elisabeth Kleppa; Eyrun F Kjetland; Lisette van Lieshout Journal: Am J Trop Med Hyg Date: 2014-01-27 Impact factor: 2.345
Authors: Femkje A M Jonker; Job C J Calis; Kamija Phiri; Eric A T Brienen; Harriet Khoffi; Bernard J Brabin; Jaco J Verweij; Michael Boele van Hensbroek; Lisette van Lieshout Journal: PLoS Negl Trop Dis Date: 2012-03-06
Authors: Sören L Becker; Jürg Vogt; Stefanie Knopp; Marcus Panning; David C Warhurst; Katja Polman; Hanspeter Marti; Lutz von Müller; Cedric P Yansouni; Jan Jacobs; Emmanuel Bottieau; Moussa Sacko; Suman Rijal; Fransiska Meyanti; Michael A Miles; Marleen Boelaert; Pascal Lutumba; Lisette van Lieshout; Eliézer K N'Goran; François Chappuis; Jürg Utzinger Journal: BMC Infect Dis Date: 2013-01-24 Impact factor: 3.090
Authors: Benjamin Speich; Hanspeter Marti; Shaali M Ame; Said M Ali; Isaac I Bogoch; Jürg Utzinger; Marco Albonico; Jennifer Keiser Journal: Parasit Vectors Date: 2013-01-04 Impact factor: 3.876