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. 2016 Nov 3;10(11):e0004818. doi: 10.1371/journal.pntd.0004818

Table 3. Diagnostic challenges encountered during the NIDIAG study on persistent digestive disorders and proposed solutions.

Diagnostic test Problem Possible reason Solution
RDT for Cryptosporidium and Giardia Faintly positive test line that is hard to interpret as either a positive or negative test result An inaccurate volume of stool sample may have been used While an exact amount of liquid stool could easily be taken via pipettes, this was less standardized for solid samples. All positive or faintly positive RDT results were documented by photography, and results should be compared to subsequent microscopic and molecular diagnostics
RDT for Cryptosporidium and Giardia During internal quality control, a Cryptosporidium-positive stool sample led to inconsistent results upon RDT application False-negative results were exclusively observed on expired or nearly expired RDTs Strict adherence to the indicated expiration dates of RDTs in clinical studies and routine diagnostics
Formalin-ether concentration Difficult microscopic reading of stool samples following formalin-ether concentration Questionable quality of the locally obtained ether Identify alternative provider for ether and other chemical products required for analysis (proved to be difficult in some study countries)
Mini-FLOTAC Leakage of one flotation chamber The utilized Mini-FLOTAC apparatus can be reused after disinfection. However, the washing procedure may influence the stability of the flotation chambers Apply vaseline on the septum or partition of the Mini-FLOTAC to prevent leakage