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  • Title: The use of rectal tubes for stool collection.
    Journal: EPI Newsl; 1992 Feb; 14(1):5. PubMed ID: 12285226.
    Abstract:
    Besides verifying the absence of wild poliovirus transmission in children with acute flaccid paralysis, the ICCPE also advocates verifying the absence of wild poliovirus transmission in the environment. This can be done either by community stool surveys of normal children or by sampling sewage. In developed countries, the sampling of sewage tends not be a constraint since adequate sewage systems exist. In developing countries where such systems do not always exist, or, if they do, they do not always operate, community stool surveys are preferable, especially in remote rural areas. In April 1991, staff from PAHO and the Ministry of Health of Colombia conducted a community survey of 242 5 year old children living in a high risk area of Cartagena, Colombia to compare the effectiveness of the traditional cup technique of collecting stool samples with the polyethylene rectal tube in screening normal children 5 years old. They chose this area of Cartagena because it has had several confirmed cases of polio. The rectal tube was to be inserted 66-75% of its length into the rectum. More children had their stools collected via the traditional cup technique than the rectal tube technique (67% vs. 36%; p.001). Isolation rates for enterovirus including poliovirus were similar for the 2 techniques. Thus the probability of getting stool samples from children 5 years old was 3 times greater with the traditional cup technique than the rectal tube technique. In fact, the collection rate for the rectal tube was so low, staff could not accurately evaluate the possibility of silent transmission among high risk children. PAHO advises then that health workers not use the rectal tube in the polio eradication program in the Americas until further research has been conducted.
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