Abstract
This study was designed to determine the prevalence of intestinal parasites in relation to personal and environmental risk factors in Bursa province of Turkey and to compare wet mount + Lugol's iodine, formalin ethyl acetate concentration, trichrome staining and enzyme-linked immunosorbent assays (ELISA) methods used inEntamoeba histolytica/ Entamoeba dispar diagnosis. For this purpose a total of 176 faecal samples from people were randomly collected from regions of the Bursa City Centre, where crowded families of low socio-economic levels reside. All faecal samples were examined by wet mount + Lugol's iodine formalin ethyl acetate concentration, trichrome staining methods and ELISA. 66 faecal samples were infected with one or more parasite species and the overall prevalence rate was 37.5%. Nine species of intestinal parasites, including six protozoon and three helminth species were found. The most prevalent species was Blastocystis hominis (17.04%) and others were found with the following frequencies: 9.09% Enterobius vermicularis, 7.38% Giardia intestinalis, 5.68% Entamoeba coli, 2.27% E. histolytica/E.dispar, 1.13 % Entamoeba hartmani, 1.13% Taenia spp., 0.56% Hymenolepis nana. 6.2% of examined samples had mixed infections. Overall prevalence of the detected parasites did not differ significantly in different demographic groups. Except for B. hominis andG. intestinalis, there was no evidence for sex, age and other demographic-related differences in the prevalence of these parasites. Statistically, B. hominis and G. intestinalis were higher in 20 to 49 and in 1 to 19 year age groups, respectively than in any other age group. Microscopical examination and ELISA revealed that one sample (0.5%) was found to be positive using all 4 methods, and 162 samples (92%) were found to be negative with all 4 methods applied. E. histolytica/E. dispar complex was detected in 0.56% (1); in 0.56% (1), in 0.56% (1) and in 2.27% (4) of the fecal samples examined by wet mount + Lugol's iodine, formalin ethyl acetate concentration, with trichrome staining, and ELISA respectively. The wet mount + Lugol's iodine, formalin ethyl acetate and trichrome staining methods had a sensitivity of 25% each, a specificity of 94.1, 99.4 and 98.2%, compared to the results of the E. histolytica/E. dispar ELISA, respectively. Key words: Entamoeba histolytica/ Entamoeba dispar, enzyme-linked immunosorbent assays (ELISA), intestinal parasites, microscopy, prevalence.
Highlights
Amebiasis is a parasitic infection leading to various clinical manifestations, from asymptomatic colonization in humans by the protozoon Entamoeba histolytica to severe fulminant colitis and non-intestinal amebiasis
Intestinal amebiasis diagnosis is confirmed with the presence of E. histolytica/E. dispar cysts or trophozoites in feces, and tests examining ameba antigens in feces are reported to be useful (Haque, 2006)
This study aimed to: (i) determine the frequency of E. histolytica/E. dispar carriers in regions with a low socioeconomic level and inadequate sanitation conditions in three central districts of Bursa Province, located on the North-eastern part of Turkey; (ii) compare wet mount + Lugol's iodine, formalin ethyl acetate concentration, trichrome staining, and enzyme-linked immunosorbent assays (ELISA) methods used in E. histolytica/E. dispar diagnosis; and (iii) establish the relationship between the presence of the intestinal parasites and socio-demographic factors
Summary
Amebiasis is a parasitic infection leading to various clinical manifestations, from asymptomatic colonization in humans by the protozoon Entamoeba histolytica to severe fulminant colitis and non-intestinal amebiasis. Amebiasis can be transmitted through fresh food and drinks containing E. histolytica cysts with four nuclei (Pickering et al, 1986). In developed countries such as the United States of America and Japan, amebiasis is frequently seen among homosexuals and institutionalized patients (Phillips et al, 1981). It is estimated that more than 10% of the world’s population is colonized with E. histolytica and Entamoeba dispar, each year 50 million people develop invasive diseases, and that 40,000 to 100,000 people die from it each year (Ravdin, 2000). Intestinal amebiasis diagnosis is confirmed with the presence of E. histolytica/E. dispar cysts or trophozoites in feces, and tests examining ameba antigens in feces are reported to be useful (Haque, 2006). Microscopy remains the main method for the diagnosis of amebiasis and is used in most developing countries
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