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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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Factors associated with detecting pathogenic intestinal parasites in multiple stool microscopy samples: a
Thareerat Ananchaisarp1, Wisarut Srisintorn1, Pirun Saelue2
1Division of Family and Preventive Medicine, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, 90110, Thailand.
Parasitology Research
|October 23, 2025
Summary
Collecting multiple stool samples significantly improves the detection of intestinal parasites. A third stool examination can achieve a 100% detection rate, especially for certain parasites in immunocompetent individuals.
Area of Science:
- Medical Parasitology
- Diagnostic Accuracy
- Public Health
Background:
- Accurate detection of intestinal parasites is vital for effective treatment.
- Previous research on the optimal number of stool samples for diagnosis yielded conflicting results.
- Understanding factors influencing parasite detection across multiple samples is needed.
Purpose of the Study:
- To determine the diagnostic yield of multiple stool examinations for pathogenic intestinal parasites.
- To identify factors associated with the detection of parasites in sequential stool samples.
Main Methods:
- Retrospective cross-sectional study at a tertiary care hospital outpatient clinic.
- Inclusion of patients submitting three stool samples between 2012 and 2021 with at least one positive result.
- Analysis of diagnostic yields for one, two, and three stool specimens; ordinal logistic regression for associated factors.
Main Results:
- Cumulative parasite detection rates increased with each additional stool specimen, reaching 100% with three samples.
- Single-sample screening missed over half of Trichuris trichiura and all Isospora belli infections.
- Immunocompetent hosts were more likely to have parasites detected in later samples (aOR=3.94).
Conclusions:
- Collecting multiple stool specimens enhances the likelihood of detecting pathogenic intestinal parasites.
- A second or third stool sample is recommended, particularly for immunocompetent patients, to maximize diagnostic yield.
- Current single-sample screening protocols may lead to underdiagnosis of certain parasitic infections.
