Epidemiology of intestinal parasitosis in Italy between 2005 and 2008: diagnostic techniques and methodologies

Aim of the study was to keep a real and actual photo relating to 2005-2008 regarding to diagnostic techniques and methodologies for intestinal parasites; so it would be possible to know specific epidemiology and suggest more rational and efficacious guide-lines. All members of AMCLI were involved in the proposal of a retrospective study regarding bowel parasites, helminths and protozoa.To engaged laboratories we asked how O&P was performed, if a specifical research for E. vermicularis and S. stercoralis was performed, if for the identification of D. fragilis, Entamoeba histolytica/dispar and Cryptosporidum spp were performed recommended specific permanent stains. 23 laboratories gave assent; but for an inferior number was possible to use the data for analysis and evaluation. Relating O&P only some laboratories performed permanent stains: Giemsa for D. fragilis, antigen and/or Trichrome stain for E. histolytica/dispar, antigen and/or acid fast stain for Cryptosporidium spp.Not all laboratories research specifically S. stercoralis. So the epidemiology is differentiated and related more to adequate or not adequate techniques than cohorts of examined populations. The overall positivity for parasites ranged from 0% to18.7%,for protozoa (pathogens or not) were from 0% to 14.7%; for nematodes from 0% to 3.7%; for cestodes from 0% to 1.0%; for trematodes from 0% to 1.0%.Among helminths, E. vermicularis, followed by S. stercoralis, also in O&P, is the most frequent.The specific research of S. stercoralis gave a positivity from 0% to 33.3%; the cellophane tape test was positive for E. vermicularis from 0% fo 21.9% of cases.Among pathogen protozoa, D. fragilis, when permanent stain were applied, prevailed from 0% to 16.6%; G. duodenalis from 0.8% to 4.3%; E. histolytica/dispar, using a permanent stain or research of antigen, was identified from 0% to 20.6%. Coccidia were very rare, with Cryptosporidium spp observed from 0% to 5.2%. These are our conclusions: many laboratories need for a critical revision of own technical procedures and diagnostic methodologies.