Oesophagostomum bifurcum, as well as hookworm infections
are hyperendemic among humans in northern Togo and Ghana.
For parasite-specific diagnosis a coproculture is obligatory, because only
the infective larvae, and not the eggs, can be
distinguished morphologically. The sensitivity of duplicate coprocultures
from a single stool sample was found to be above
90% in comparison to a gold standard of 10 coprocultures made from a single
stool specimen. Prevalence of infection with
O. bifurcum and hookworm further increased with the number of
coprocultures made from each individual stool.
Notwithstanding the high sensitivity, intensity of infection per individual
varied considerably from day-to-day and the
number of larvae found in different samples out of 1 stool also varied
highly, both showing a heterogeneous distribution.
Surprisingly, daily fluctuation and within-specimen variation could not
be differentiated from each other, probably
because of the variation created by the coproculture technique. To estimate
the intensity of infection, it is sufficient to
make repeated coprocultures from only 1 individual stool sample. Laborious
collection of stool samples on subsequent
days does not give better estimates of the individual infection status.