Prevalence and Incidence of Entamoeba histolytica Infection in South Africa and Egypt

There are little data on the true prevalence and incidence of Entamoeba histolytica infection in Africa. This is due to the inability, historically, to differentiate Entamoeba histolytica from the more common, but non-pathogenic, Entamoeba dispar. In addition, newer studies have demonstrated that the previous gold standard, culture with zymodeme analysis, is insensitive in detecting the presence of infection, especially when compared to PCR. Recent published articles as well as data from the authors' previous work are reviewed and summarized to elucidate what is known about prevalence and incidence of Entamoeba histolytica in Africa. The majority of data on asymptomatic infection are published from South Africa, Egypt and Cote d'Ivoire. Egypt has high rates of asymptomatic infection detected in the stool (>21%), whereas South Africa and Cote d'Ivoire rates range between 0 and 2%. Seroprevalence estimates the rate of recent infection, because anti-amebic antibodies generally persist for