Comparison of the Sensitivity and Specificity of Liver Fluke Screening using OV-RDT and Modified Kato-Katz technique in the Pathumrat District Community

Abstract

Purposes: To compare the sensitivity and specificity of liver fluke screening for Opisthorchis viverrini infection using OV-RDT and Modified Kato-Katz technique (MKKT).

Study design: Quasi-Experimental research.

Materials and methods: The study population consisted of 450 individuals at risk for liver fluke infection, aged 15-75 years, from 15 villages in the Pathumrat District Community under the responsibility of Pathumrat Hospital. Stool and urine collection containers were distributed to participants, and specimens were collected at scheduled appointments. Specimens were analyzed using both OV-RDT and MKKT screening methods, and results were recorded on risk screening forms. Data were analyzed using descriptive statistics including gender, age, and occupation, as well as inferential statistics including frequencies, percentages, 95% confidence intervals, p-values, and difference values.

Main finding: The prevalence of liver fluke infection was 48.22%, with 42.00% detected by one method only and 6.22% detected by both methods. The sensitivity of OV-RDT was 94.97%, while MKKT demonstrated a sensitivity of 84.85% (p = .001), indicating that OV-RDT had significantly higher sensitivity than MKKT. Regarding specificity, OV-RDT showed a specificity of 92.00%, whereas MKKT achieved a specificity of 100.00% (p < .001), demonstrating that MKKT had significantly higher specificity. MKKT also showed superior performance with a positive predictive value of 100%, negative predictive value of 97.86%, and accuracy of 98.01%. Additionally, the OV-RDT method required significantly less testing time (10 minutes) compared to the MKKT method (45 minutes).

Conclusions and recommendations: Both methods demonstrated different effectiveness in liver fluke screening. The OV-RDT method showed higher sensitivity, required less time, and was more convenient for sample collection but had higher costs. In contrast, the Modified Kato-Katz technique demonstrated higher specificity and positive predictive value but required more time. The selection of testing methods should consider objectives, urgency, available resources, and context of use.