STANDARDIZATION OF BLASTOCYSTIS HOMINIS DIAGNOSIS USING DIFFERENT STAINING TECHNIQUES
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Keywords
Blastocystis hominis, trichrome stain, iron hematoxylin, diagnostic accuracy, stool microscopy, parasitology.
Abstract
Background: Blastocystis hominis is one of the most frequently encountered intestinal protozoa worldwide, yet its diagnosis remains challenging due to its pleomorphic nature and lack of standardized detection methods.
Objective: The primary objective of this study was to evaluate and standardize different staining techniques for the detection of Blastocystis hominis in stool samples.
Methodology: This cross-sectional analytical study was conducted on 85 patients presenting with gastrointestinal complaints. Stool samples were collected and examined using multiple staining techniques, including trichrome, iron hematoxylin, Giemsa, and modified Ziehl–Neelsen stains. Results were compared against a composite reference standard, defined as positivity by at least one staining method.
Results: Out of 85 samples, Blastocystis hominis was detected in 34 (40.0%) cases by at least one staining method. Trichrome stain demonstrated the highest detection rate (36.5%), followed by iron hematoxylin (32.9%), Giemsa (28.2%), and modified Ziehl–Neelsen (11.8%). Diagnostic accuracy analysis showed trichrome to have a sensitivity of 91.2% and specificity of 96.1%, while iron hematoxylin had 82.3% sensitivity and 96.1% specificity. Inter-observer agreement was strong across all stains, with kappa values ranging from 0.86 to 0.91. No statistically significant association was observed between gastrointestinal symptoms and Blastocystis positivity.
Conclusion: It is concluded that trichrome staining is the most sensitive and practical method for routine detection of Blastocystis hominis, while iron hematoxylin remains a reliable but technically demanding alternative. Giemsa provided moderate results, whereas modified Ziehl–Neelsen was unsuitable for routine diagnosis.
References
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Naglaa M Shalaby
Department of Medical parasitology Faculty of Medicine , Mansoura University , Mansoura City 35516, Egypt, Department of Microbiology Faculty of Medicine , Northern Border University, Arar 91431,Saudi Arabia.
Madiha Mahmood
Liaquat College of Medicine & Dentistry, Karachi, Pakistan
Fatima Fatima Hamadain Alnourain Hamed
Community Medicine, Najran University –Faculty of Medicine.
Naglaa Ahmed Abdellatif Ginawi
Accademic Affairs hail Health Cluster_quality Department , Hail
Manal zayed Alshammary
Pediatric endocrinologist, , College of medicine University of Hail
Nowayer suhyeman Al shammari
Supervisor of clinical skills lab, University of Hail
Hiba Mahgoub Ali Osman
Department of Medical Laboratory Sciences, College of Applied Medical Sciences, University of Bisha,P.O. Box 551, Bisha 61922, Saudi Arabia
Dr Husham O. Elzein
Medical Laboratory Technology, Applied Medical Sciences, Northern border University, Arar, Saudi Arabia
Rawabi Mohammed ALjohani
Medical student ,College of Medicine , University of Ha’il
Elryah I Ali
Department of Medical Laboratory Technology, College of Applied Medical Sciences, Northern Border University, Arar, Saudi Arabia
Maha Mahmoud Abdul-Latif
Assistant professor Opthalmology , Faculty of Medicine Northern Border University
EhabEhab Ezzat Abdellatif
Department of General Courses - Faculty of Humanities and Social Sciences- Northern Border University, Arar, Saudi Arabia