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Letters to the Editor

Dear Sir:

Dr. Watt has questioned the use of a single stool examination to classify individuals as infected or uninfected in our studies on schistosomiasis japonica. As noted in previous published studies as well as our studies in the Philippines, examination of a single stool sample may miss a significant percentage of infected individuals. For example, when 38 subjects from the island of Leyte in the Philippines had four consecutive stool samples examined using duplicate Kato-Katz smears, Schistosoma japonica eggs were found in the initial stool examination in 53% of individuals, while 82% of subjects had eggs in their stools when four samples were examined. These data indicate that duplicate Kato-Katz smears performed on a single stool examination miss at least 35% of infected subjects. Thus, we agree with Dr. Watt that examination of a single stool sample is less than optimal for the detection of S. japonicum infection.