ArticleParasites & vectors2019
Improving diagnostic performance of the Kato-Katz method for Clonorchis sinensis infection through multiple samples.
Article in Parasites & vectors, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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Who cites it
14 citing papers in PubMed, 22 citations in OpenAlex.
- Trial
- First Local Cluster of Clonorchiasis Caused by Consumption of Raw Freshwater Fish - Zhengzhou City, Henan Province, China, 2026.China CDC weekly · 2026Article
- Current knowledge on the prevalence and detection techniques ofFrontiers in veterinary science · 2025Review
- Clonorchiasis and opisthorchiasis: epidemiology, transmission, clinical features, morbidity, diagnosis, treatment, and control.Clinical microbiology reviews · 2024Review
- Formalin-fixed stool improves the performance of the Kato-Katz method.Veterinary world · 2024Article
- Evaluation of Kato-Katz and multiplex quantitative polymerase chain reaction performance for clinical helminth infections in Thailand using a latent class analysis.Philosophical transactions of the Royal Society of London. Series B, Biological sciences · 2023Article
- Global prevalence of 4 neglected foodborne trematodes targeted for control by WHO: A scoping review to highlight the gaps.PLoS neglected tropical diseases · 2023Article
- Clonorchis sinensis infection modulates key cytokines for essential immune response impacted by sex.PLoS neglected tropical diseases · 2022Article
- Performance of Mini ParasepParasites & vectors · 2022Article
- Multiple biochemical indices and metabolomics of Clonorchis sinensis provide a novel interpretation of biomarkers.Parasites & vectors · 2022Article
- Molecular Techniques as Alternatives of Diagnostic Tools in China as Schistosomiasis Moving towards Elimination.Pathogens (Basel, Switzerland) · 2022Review
- Cost yield of different treatment strategies against Clonorchis sinensis infection.Infectious diseases of poverty · 2021Article
- Severe hepatobiliary morbidity is associated with Clonorchis sinensis infection: The evidence from a cross-sectional community study.PLoS neglected tropical diseases · 2021Article
- Risk Factors forFrontiers in public health · 2021Article
Corrections and comments
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Authors and funding
6 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundClonorchiasis is caused by eating of raw or undercooked freshwater fish containing the larvae of Clonorchis sinensis; the Kato-Katz method is widely applied in diagnosis. The improvement of repeated Kato-Katz smears from multiple stool samples has been well illuminated in many helminths other than C. sinensis.
methodsA cross-sectional investigation was implemented to capture the epidemiology and risk factors of clonorchiasis among middle school students in Qiyang county, China. Students with complete data of six Kato-Katz thick smears from two stool samples were included in this analysis. Data on the habits of eating raw freshwater fish were also collected and compared.
resultsAltogether, 397 students had complete information of six smears, out of which 394 reported the information on eating habits. According to the 'gold' standard by six smears, 77 students (19.4%) were detected with C. sinensis. However, only 45 (11.3%) were detected using a single smear, with an underestimation of 41.6% compared to the 'gold' standard. However, the geometric mean of eggs per gram of feces in detected cases was 126.4 in a single smear, overestimated by 105.2% compared to 61.6 by the 'gold' standard. The linear relationship between prevalence and infection intensity of detected cases based on different smears was significantly negative. The habits of eating raw freshwater fish in the false negative cases was similar to those in the detected cases, but these two groups had significantly higher levels for habits of eating raw freshwater fish than negative individuals.
conclusionsIn low endemicity situations, underestimation of C. sinensis infection could not be avoided based on a limited number of Kato-Katz smears. Thus, repeated smears from at least two stool samples should be considered when an individual eats raw freshwater fish, drug efficacy is evaluated or elimination of C. sinensis is verified. Additionally, when logistics are insufficient for multiple samples to be taken for diagnosis for survey and surveillance in the areas or populations of low endemicity, prevalence accuracy needs to be corrected.
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