Serological and Parasitological Detection of Amoebiasis in Immunocompromised Patients with Diarrhea
Nawfal Y Al-Dabbagh1* and Ma'ali Ibrahim Younis2
1Al-Kitab University, College of Medical Technology, Kirkuk, Iraq
2Department of Microbiology, College of Medicine, University of Mosul, Iraq
*Corresponding Author: Nawfal Y Al-Dabbagh, Al-Kitab University, College of Medical Technology, Kirkuk, Iraq.
February 28, 2023; Published: April 10, 2023
Objectives: To detect the presence of E. histolytica trophozoites and/or cysts by microscopical examination of fresh stool specimens obtained from cases and control groups. To detect the presence of E. histolytica cysts by using Zinc sulphate concentration method among negative stool samples. To detect the presence of E. histolytica specific antigen in stool samples of cases and controls by using ELISA technique. To detect the presence of anti- E. histolytica antibodies of IgG class in the serum of case and control groups. To evaluate other parameters including C-reactive protein, haematological and biochemical tests on the serum samples of both case and control groups.
Subjects and Methods: This study was carried out at Ibn-Al-Atheer Hospital, Ibn Sina Hospital and Hazim Al-Hafith Teaching Hospital. In Mosul city. Sixty immunocompromised patients with diarrhoea were studied. The collection of samples was done in the period from November 2009 to July 2010. The 60 cases included both leukaemic patients on chemo-therapy and patients with chronic renal failure on dialysis. Stool samples were examined for E. histolytica trophozoites or cysts directly by using a microscope, and the detection of parasitic antigens was done by using the ELISA technique. Serum samples were collected for the detection of anti- E. histolytica antibodies of IgG type. Thirty (apparently healthy) individuals with matched age and sex and suffering from diarrhoea were included in the study as a control group.
Results: Among the sixty cases and thirty control, 11.7% and 13.3% respectively were found to have E. histolytica infection by ELISA stool antigen test. Direct examination of fresh stool samples by saline and iodine together with the concentration technique shows a higher rate of infection at 26.7% and 10% in case and control groups respectively.
Examination of serum by ELISA detects anti-E-histolytica antibodies of IgG type in higher frequency 20% of cases and 33.3% of controls than those detected to have stool antigen positive.
Regarding age and sex, the incidence of infection was found to be higher below the age of 10 years old with no significant difference between age groups and also no significant difference in the incidence of infection related to sex.
The C-reactive protein test together with other biochemical and haematological tests was done to evaluate the level of immunity in case and control groups and significant differences were found, where the level of both humoral and cellular immunity in cases was lower than in controls.
Conclusion: Diagnosis of E. histolytica infection by ELISA for stool antigen has high sensitivity and specificity and is very useful to avoid overdiagnosis and treatment.
Keywords: Entamoeba histolytica; Stool Antigen; IgG Antibody; ELISA; Immunocompromised Patients
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