Epidemiology of clinically relevant Entamoeba spp. (E. histolytica/dispar/moshkovskii/bangladeshi): A cross sectional study from North India

Author summaryAmoebiasis, a neglected tropical disease, caused by Entamoeba sp., is one of the leading causes of death due to any parasitic disease worldwide and have a major impact on millions of people. There has been constant debate on the commensal and pathogen status of several Entamoeba spp., owing to sporadic reports of infections due to different Entamoeba species. In view of this, we conducted this study to provide detailed data of prevalence of the Entamoeba species through molecular method in different types of samples among the susceptible population in an endemic region. Despite the existence of specific and sensitive molecular techniques, microscopy because of its affordability and accessibility remains the diagnostic tool for the Entamoeba infections. Microscopy cannot differentiate other related species from Entamoeba histolytica. Thus, World Health Organization has recommended the use of advanced techniques in the diagnosis of Entamoeba infection. Further, the most common mode of Entamoeba infections is the ingestion of contaminated food and water. In this regard face to face interviews were carried out to know about the demographic details and household habits which can be a major force driving these infections. The establishment of such data clears the epidemiological status and conveys the proper control measures for better health care. BackgroundEntamoeba infections have major impact on millions of the people worldwide. Entamoeba histolytica has long been accepted as the only pathogenic species. However, recent reports of other Entamoeba spp. in symptomatic cases have raised questions on their pathogenicity. Methodology/Principal findingsTotal 474 stool samples and 125 liver aspirates from patients with intestinal and extra intestinal manifestations and from community were included. Sewage samples from the hospital and the city were also included. Microscopic examination and molecular detection were performed to detect presence of E. histolytica/ dispar/ moshkovskii/ bangladeshi. The associated demographic and socioeconomic factors were statistically analyzed with the presence of Entamoeba. Microscopy detected Entamoeba spp. in 5.4% stool and 6.4% liver aspirate samples. Through nested multiplex PCR, prevalence of Entamoeba spp. in intestinal and extra-intestinal cases was 6.6% (20/301) and 86.4% (108/125) respectively and in asymptomatic population was 10.5% (13/123). Sewage samples did not show presence of any Entamoeba spp. Uneducat