Related Experiment Video

Updated: Jan 15, 2026

Comparative Analysis of Automatic Fecal Analyzer versus Direct Wet Smear Microscopy for Detecting Parasitic Infections in Stool Samples
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Comparative Analysis of Automatic Fecal Analyzer versus Direct Wet Smear Microscopy for Detecting Parasitic Infections in Stool Samples

Published on: April 25, 2025

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Microscopic and molecular identification of diarrhoea-causing intestinal protozoa among children in Guinea-Bissau

Heidi B Bertelsen1, Signe V Vahlkvist1, Gitte N Hartmeyer2,3

  • 1Department of Pediatrics and Adolescent Medicine, Lillebaelt Hospital, DK-6000 Kolding, Denmark.

Transactions of the Royal Society of Tropical Medicine and Hygiene
|October 10, 2025
PubMed

Insights

Gastrointestinal parasitic infections like Giardia duodenalis are common in children in Bissau, often asymptomatic. Molecular testing (PCR) is more accurate than microscopy for diagnosing these infections.

Area of Science:

  • Infectious Diseases
  • Public Health
  • Molecular Diagnostics

Background:

  • Gastrointestinal parasitic infections represent a significant health challenge in low- and middle-income countries (LMICs).
  • Giardia duodenalis and Entamoeba species are common causes of parasitic infections.

Purpose of the Study:

  • To compare the diagnostic accuracy of microscopy and PCR for detecting gastrointestinal parasites in children.
  • To assess the prevalence and associations of parasitic infections with symptoms and water sources in children in Bissau.

Main Methods:

  • Examined 1238 fecal samples from children using microscopy and PCR for Giardia duodenalis, Entamoeba species, and Cryptosporidium spp.
  • Analyzed associations between symptoms, microscopy intensity, and PCR cycle threshold (Ct) values.
  • Matched children by age, gender, and residence.

Main Results:

  • Giardia duodenalis was highly prevalent (56.2%-63.0% by PCR), significantly more than detected by microscopy.
  • PCR demonstrated higher specificity than microscopy, which overestimated Entamoeba histolytica prevalence.
  • Parasite detection by PCR did not correlate with reported symptoms.

Conclusions:

  • Children in Bissau exhibit a substantial asymptomatic Giardia duodenalis burden.
  • PCR offers improved specificity over microscopy for diagnosing parasitic infections.
  • Selective molecular testing combined with clinical evaluation is recommended for effective treatment in resource-limited settings.
Abstract

Keywords:
Guinea-BissauPCRlow- and middle-income countriesparasitic infectionsparasitologyprotozoan infections

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