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Diagnosis and Identification of Blastocystis Subtypes in Primary School Children in Jakarta
Ika P Sari1, Martwinny R Benung1,2, Sri Wahdini1
1Department of Parasitology, Faculty of Medicine, Universitas Indonesia, Jakarta 10430, Indonesia.
Abstract:
Blastocystis hominis is an enteric protozoan with many subtypes. It is frequently found in children and may cause chronic diarrhea. This study revealed Blastocystis subtypes among primary school children and comparison of molecular technique and culture method in Blastocystis diagnosis. A total of 141 stools were collected, examined microscopically, selected into the Blastocystis and negative parasite groups, for diagnostic comparison between culture and 18S rRNA polymerase chain reaction (PCR) methods. Positive PCR amplicons were subsequently sequenced for subtyping. The PCR results revealed 89%, 78%, 80% and 88% sensitivity, specificity and positive and negative predictive values, respectively, in comparison with the culture method (McNemar, p > 0.05). Sixteen PCR samples were successfully sequenced and resulted in three Blastocystis subtypes 1, 3 and 4. In conclusion, PCR was sensitive enough and can be used to exclude Blastocystis infection up to 88% of the cases. Subtypes 3 and 1 were the main subtypes found in apparently healthy school children in Jakarta.
Insights
Blastocystis hominis infection is common in children. Polymerase chain reaction (PCR) is a sensitive method for diagnosing Blastocystis infection, identifying subtypes 1, 3, and 4 in school children.
Area of Science:
- Medical Parasitology
- Molecular Diagnostics
- Pediatric Infectious Diseases
Background:
- Blastocystis hominis is a common enteric protozoan parasite.
- Infections are frequently observed in children and can lead to chronic diarrhea.
- Understanding Blastocystis subtypes and diagnostic methods is crucial for effective management.
Purpose of the Study:
- To identify Blastocystis subtypes in primary school children.
- To compare the diagnostic accuracy of polymerase chain reaction (PCR) with the culture method.
- To determine the prevalence of different Blastocystis subtypes in a pediatric population.
Main Methods:
- Stool samples from 141 primary school children were collected.
- Microscopic examination, culture method, and 18S rRNA gene-based PCR were employed for diagnosis.
- Positive PCR amplicons were sequenced for subtyping.
Main Results:
- PCR demonstrated high diagnostic values: 89% sensitivity, 78% specificity, 80% positive predictive value, and 88% negative predictive value compared to culture.
- Three Blastocystis subtypes (1, 3, and 4) were identified through sequencing.
- Subtypes 3 and 1 were the predominant subtypes found in apparently healthy school children in Jakarta.
Conclusions:
- Polymerase chain reaction (PCR) is a sensitive and reliable method for Blastocystis diagnosis.
- PCR can effectively exclude Blastocystis infection in up to 88% of cases.
- Subtypes 1 and 3 are the most prevalent Blastocystis subtypes among healthy school children in Jakarta.
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