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Introduction: Soil-transmitted helminthiasis (STH) remains a major public health problem in school children in Ethiopia. Although direct wet mount microscopy (DWMM) is the means to diagnose parasitic diseases in health care facilities in Ethiopia, it remains unclear what its diagnostic performance is for STH. Methodology: A cross-sectional study was performed in Jimma Town (Ethiopia) and included 600 children from 10 primary schools. The diagnostic sensitivity of DWMM was compared to a composite reference standard (CRS) consisting of Kato-Katz, McMaster and Mini-FLOTAC. We also explored the impact of intensity of infection (the highest faecal egg counts (FECs; expressed as eggs per gram of stool (EPG)) across the CRS) on the diagnostic sensitivity of DWMM. Results: Based on the CRS, there were 210 Ascaris (35.0%), 312 Trichuris (52.0%) and 102 hookworm cases (17.0%). The median intensity of infections equalled 2,057 EPG for Ascaris, 200 EPG for Trichuris and 110 EPG for hookworms. The sensitivity of DWMM was 73.8% for Ascaris, but was around 17% for both Trichuris and hookworms. The sensitivity significantly increased with intensity of STH. For Ascaris, the odds for detecting an infection intensity of 1,000 EPG was 6.2 times higher than detecting an infection of 100 EPG. For Trichuris and hookworms, these odds ratios were 7.1 and 14. Conclusions: The diagnostic sensitivity of DWMM is low for STH, but it is able to detect those subjects that are in the highest need of treatment, and hence contributes to the global goal to eliminate STH as a public health problem.

We have compared the searching of the presence of \"honeycomb\" structures by direct microscopy on wet mount preparations with the direct immunofluorescence (DIF) for the diagnosis of Pneumocystis carinii pneumonia (PCP) in 115 bronchoalveolar (BAL) fluids. The samples belonged to 115 AIDS patients; 87 with presumptive diagnosis of PCP and 28 with presumptive diagnosis other than PCP. The obtained results were coincident in 114 out of 115 studied samples (27 were positive and 87 negative) with both techniques. A higher percentage of positive results (32.18%) among patients with presumptive diagnosis of PCP with respect to those with presumptive diagnosis other than PCP (3.57%) was observed. One BAL fluid was positive only with DIF, showed scarce and isolated P. carinii elements and absence of typical \"honeycomb\" structures. The searching for \"honeycomb\" structures by direct microscopy on wet mount preparations could be considered as a cheap and rapid alternative for diagnosis of PCP when other techniques are not available or as screening test for DIF. This method showed a sensitivity close to DIF when it was applied to BAL fluids of AIDS patients with poor clinical condition and it was performed by an experienced microscopist. Comparamos a presença de estruturas com aspecto de \"favo de mel\" através da microscopia a fresco e imunofluorescência direta (IFD) no diagnóstico de pneumocistose pulmonar (P. carinii) (PCP) em secreções do aparelho respiratório obtidas através do lavado bronco-alveolar (BAL) de 115 pacientes com AIDS. Oitenta e sete amostras pertenciam a pacientes com diagnóstico presuntivo de PCP e 28 a pacientes com outros diagnósticos diferentes de PCP. Os resultados obtidos foram coincidentes em 114 das 115 amostras pesquisadas (27 foram positivas e 87 negativas) com porcentagem mais elevada de resultados positivos entre os pacientes com diagnóstico presuntivo de PCP (32,18%) do que entre aqueles com outros diagnósticos presuntivos (3,57%). Um BAL (1,14%) foi positivo somente com a IFD que revelou poucas formas isoladas de P. carinii e ausência das estruturas típicas com aspecto de \"favo de mel\". A pesquisa de estruturas com aspecto de \"favo de mel\" através da microscopia a fresco poderia ser considerada como um método alternativo, econômico e rápido, para o diagnóstico de PCP, quando outras técnicas não estiverem disponíveis ou como prova de \"screening\" prévia antes do DIF. Esse método demonstrou sensibilidade semelhante a DIF aplicada em secreções do aparelho respiratório obtidas através do BAL em pacientes com AIDS com más condições clínicas quando executada por um microscopista experiente.