Diagnostic Performance of Mini Parasep^® for the Detection of Intestinal Parasitic Infections: A Systematic Review and...

Background and Objectives: Accurate diagnosis of intestinal parasitic infections remains essential for patient management, surveillance, and control programs. The Mini Parasep^® and Mini Parasep^® Solvent-Free (SF) fecal parasite concentrators were developed to improve laboratory safety and simplify stool processing; however, their diagnostic performance has not been comprehensively synthesized. This systematic review and meta-analysis evaluated the diagnostic sensitivity of Mini Parasep^® for detecting intestinal parasites in human stool specimens. Materials and Methods: A systematic literature search was conducted in Ovid, Embase, Scopus, PubMed, Nursing & Allied Health Premium, and Google Scholar from database inception to the final search date. Studies evaluating Mini Parasep^® or Mini Parasep^® SF in human stool samples and reporting sufficient data to calculate diagnostic sensitivity were eligible. A composite reference standard, defined as positivity by any diagnostic method used within each study, was accepted as the reference standard. Pooled sensitivity estimates and 95% confidence intervals (CIs) were calculated using random-effects models. Subgroup analyses were performed according to parasite species, study design, geographic region, country, and participant characteristics. Results: Eleven studies met the inclusion criteria. Overall, Mini Parasep^® demonstrated good sensitivity for detecting any intestinal parasitic infection, with a pooled sensitivity of 82.4% (95% CI: 61.0-93.4%, I² = 95.3%, 6 studies). Among pathogenic protozoa, pooled sensitivities were 78.9% (95% CI: 39.3-95.6%, I² = 43.7%, 4 studies) for Entamoeba histolytica, 76.3% (95% CI: 34.8-95.1%, I² = 71.1%, 4 studies) for Giardia duodenalis, and 74.4% (95% CI: 60.4-84.7%, I² = 0%, 2 studies) for Blastocystis spp. Among soil-transmitted helminths, sensitivity was highest for Ascaris lumbricoides (92.8%; 95% CI: 88.4-95.7%, I² = 0%, 2 studies), followed by Strongyloides stercoralis (73.7%; 95% CI: 50.2-88.6%, I² = 0%; 3 studies), hookworm (53.6%; 95% CI: 33.3-72.8%, I² = 23.1%, 5 studies), and Trichuris trichiura (39.4%; 95% CI: 8.6-81.8%, I² = 74.8%; 3 studies). High sensitivities were observed for Taenia spp. (89.0%; 95% CI: 74.0-95.8%, I² = 0%; 3 studies) and Schistosoma mansoni (92.8%; 95% CI: 86.9-96.1%, I² = 0%, 2 studies), whereas sensitivity for Opisthorchis viverrini was moderate (56.8%; 95% CI: 35.1-76.1%, I² = 88.8%, 7 studies). High heterogeneity was observed for several parasite-specific analyses. Conclusions: Mini Parasep^® demonstrates good overall diagnostic sensitivity and performs particularly well for A. lumbricoides, S. mansoni, and Taenia spp. However, diagnostic performance varies substantially across parasite species, with lower sensitivity observed for hookworm, T. trichiura, and O. viverrini. Mini Parasep^® represents a practical alternative to conventional concentration techniques for routine stool examination, although complementary diagnostic approaches may be required when detecting low-intensity infections or parasites with lower recovery rates.