Comparison of helminth egg analysis (The Netherlands)

The study evaluated different helminths eggs analysis methodologies on the applicability to be used in a humanitarian context. Unlike fresh faeces, environmental samples such as faecal sludge, compost of manure, require larger sample size and pre-processing (i) to recover eggs attached to organic, silica and soil particles, and (ii) to remove large particles and reduce size of the sample. After evaluating and analysing different commonly used soil- helminths egg analysis methodologies, a decision-making framework to guide the selection of a helminths egg analysis methodology for use in humanitarian context was proposed. The framework recommends adopting a universal sample pre-processing procedure: washing/desorption followed by filtration. Thereafter, the availability of skills determines the choice of the suitable analysis methodology. For example, if the skills are available on site, MINI- FLOTAC, Kato-Katz protocols can be used. In the absence of skills onsite, pre- processed samples can be packaged and transported to central laboratories for AMBIC-UKZN analysis. Either an optical and digital microscope can be used for egg counts, although for the modified Kato-Katz thick smear a digital microscope is recommended. If improved and adopted, this research will contribute towards sustainable control of soil-transmitted helminths transmission and provision of safe sanitation in humanitarian context.