Gastrointestinal parasites diagnoses at the primary health care units: a comparative analysis of diagnostic abilities of parasitology staff technicians versus medical parasitologists in Ismailia, Egypt

Background: This study aims to compare parasitology technicians (ParaTechs) with medical staff parasitologists (MedParas) in terms of diagnostic ability and to assess the actual occurrence of gastrointestinal parasites in selected faecal samples from primary health care units (PHCUs). Methods: The study included five PHCU ParaTechs in the El-Kassassin rural area, evaluated using a scoring system for their knowledge, skills, practices and parasitology laboratory facilities. Seventy-five faecal samples previously examined for ova and parasites by ParaTechs were chosen for re-evaluation by MedParas. Results: The most deficient ParaTechs-related factor was the parasitological knowledge, which scored 23.9% of the maximum score, while ParaTechs had acceptable levels of skills and practices, scored 60% and 61%, respectively. Compared with MedParas, false positive ParaTech diagnoses made up 8.8% of all negative samples, while false negative diagnoses made up 85.4% of all positive samples. ParaTechs underestimated the count or misidentified the type of parasites in one-third of the true positive samples. The overall rate of misdiagnosis among ParaTechs was 53.3% of all samples. Conclusions: Regular ParaTech training, including culture and staining at parasitology labs, and collaboration between the Ministry of Health and Population and academic institutions are essential to increase ParaTechs diagnostic abilities.