○ Collect urine at midday on three consecutive days; peak Schistosoma egg excretion occurs between 12:00 and 3:00pm. Preferably collect the last portion voided.
○ Collect 1 stool specimen per day (1 Yellow top and 1 White top container) for 3 days in each vial for a total of six (6) specimens per patient with suspected parasitic infection.
○ Ensure patient avoids anti-diarrheal medications, radiological dye (barium) and antibiotics prior to producing the specimen as they may interfere with parasite detection.
○ Please provide appropriate clinical information on the requisition (e.g. travel history or country of origin if refugee, returned traveller or recent immigrant, consumption of certain food products, eosinophilia, HIV, immunocompromise, critical illness, admitted to ICU or previous parasite infection. The foreign country MUST be identified on the requisition.
○ Please indicate any specific organisms suspected on the requisition ○ Microscopy is the gold standard diagnostic test for schistosomiasis and should be requested whenever testing is indicated. Serologic testing is an adjunct to microscopy for individuals with clinical or epidemiologic risk factors of schistosomiasis, particularly for individuals with low parasite burden when microscopy is negative.
○ Urine: Sterile container (min volume 30 mL) ○ Stool: Parasitology Kit (3 each of SAF yellow top vial, white top sterile vial) ○ Whole blood/serum: serum separator tube (clotted blood) (min volume 5 mL)
Urine ○ Collect last portion of voided urine two hours before and after midday in sterile container
Stool ○ Collect stool immediately after bowel movement in a dry, clean container (e.g. Chamber pot, wide-mouth jar, pie plate, newspaper, or saran wrap on toilet seat). Follow instructions below to add specimen to BOTH yellow and white capped containers. Specimen should not be contaminated with urine or toilet water. Container 1 SAF (Yellow top) vial: ○ Use plastic spork attached to lid to add sample (from beginning, middle and end of stool) to yellow capped bottle so that the preservative fluid level is approximately ¾ full. Mix thoroughly by shaking. Ratio should be 1 part solid stool to 3 parts SAF or 1 part liquid faeces to 1 part SAF.
Container 2 Sterile (White top) vial: ○ Using plastic spork, Add stool directly to sterile white capped container. Whole blood/serum Decontaminate skin with 70% alcohol followed by iodine or chlorhexidine, collect at least 5 mL of blood into appropriate container
Refer to section Sample Processing / Delivery
PHOL
○ Up to 2 days for urine
416-586-4800 extension 4607
NO
○ Label specimen container. Place specimens in biohazard bag and seal..
○ Specimens should be stored at room temperature (20-25˚C) or refrigeration temperature for serology (2-8˚C) and transported to the UHN/SH Microbiology Laboratory ASAP after collection. For stool, keep Yellow top tube (SAF vial) at room temperature while the White-top vial should be refrigerated (2-8˚C) prior to transport.
○ The specimen will be referred to the Public Health Ontario Laboratory for testing