Diagnosis and Differentiation of Entamoeba Infection in Makkah Al Mukarramah Using Microscopy and Stool Antigen Detection Kits

Entamoeba histolytica infection is one of the significantly common pathogenic protozoa encountered in Saudi Arabia. Previous reports did not distinguish between E. histolytica and E. dispar as differential diagnosis is essential both for treatment decision and public health knowledge. Studies suggested that stool antigen assays are more sensitive and specific than microscopy for the diagnosis of E. histolytica infection. This study intended to determine the prevalence of E. histolytica and E. dispar by microscopy and two stool antigen detection kits: Triage parasite panel and TechLab E. histolytica. Stool specimens were collected from diarrhoeic patients in Makkah Al Mukarramah city. Parasite detection was performed by microscopy, Triage parasite panel and TechLab E. histolytica II. Differentiation between E. histolytica and E. dispar was performed using Tech Lab. Out of the 156 samples collected, 76.9% were infected. Microscopic examination revealed that, 64.8% were positive for E. histolytica/E. dispar, Giardia lamblia 1.9%, Cryptosporidium spp. 1.9% and other parasites 8.3%. 112 samples were found to be infected using Triage. 59.6% were infected with E. histolytica/ E. dispar, 1.9% was infected with Giardia lamblia and 1.9% with Cryptosporidium spp. Differentiation between E. histolytica and E. dispar performed by ELISA showed that 2.6%, samples were positive for E. histolytica antigen. The infection rate of E. histolytica/E. dispar was high and the Triage parasite panel kit was less sensitive than microscopy. The high incidence of Entamoeba infections are mainly of E. dispar. Also, E. histolytica-specific ELISA showed to be a sensitive, specific and fast method for the rapid differentiation of the two species.