Parasite detection efficiencies of five stool concentration systems

Fresh fecal material that was free of ova and parasites was pooled with 10% Formalin in a 1:4 ratio to prepare a standard specimen. Portions of 100 ml of this specimen were individually seeded with Cryptosporidium oocysts, Entamoeba coli, Entamoeba histolytica, and Giardia lamblia cysts; ova of Necator americanus; and Strongyloides larvae. Appropriate volumes of each parasite suspension were used to evaluate the Fecal Concentrator Kit (Remel, Lenexa, Kans.), Fecal Parasite Concentrator (Evergreen Scientific, Los Angeles, Calif.), Para-Pak Macro-Con (Meridian Diagnostics, Inc., Cincinnati, Ohio), and Trend FeKal CON-Trate (Trend Scientific, Inc., St. Paul, Minn.). A standardized gauze filtration method was used as the reference procedure. Tests were performed in triplicate with each individual parasite-concentrator combination, with three slides examined from each sediment. All of the systems effectively concentrated parasites compared with direct examination of unconcentrated fecal material. The Fecal Concentrator Kit provided the best overall performance. Clarity of sediment, lack of debris, and uniformity of background material were found to be important considerations for microscopic detection of parasites in concentrated specimens.