Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Mar 29:23:e00122.
doi: 10.1016/j.fawpar.2021.e00122. eCollection 2021 Jun.

Entamoeba species infection in patients seeking treatment for diarrhea and abdominal discomfort in Mukuru informal settlement in Nairobi, Kenya

Erastus Mulinge  1 , Cecilia Mbae  1 , Benjamin Ngugi  1 , Tabitha Irungu  1 , Elizabeth Matey  1 , Samuel Kariuki  1
Affiliations

Entamoeba species infection in patients seeking treatment for diarrhea and abdominal discomfort in Mukuru informal settlement in Nairobi, Kenya

Erastus Mulinge et al. Food Waterborne Parasitol. .

Abstract

Entamoeba histolytica is the only pathogenic species of the Entamoeba genus and is morphologically identical to E. dispar/E. moshkovskii (Entamoeba complex) hence cannot be microscopically differentiated. The other Entamoeba spp. found in humans (E. hartmanni, E. polecki, and E. coli) can be differentiated morphologically from this Entamoeba complex. However, some of their morphologic features overlap making differential diagnosis difficult. This study aimed at determining the occurrence of Entamoeba spp. in patients seeking treatment for diarrhea and/or abdominal discomfort at two clinics in Mukuru informal settlement in Nairobi, Kenya. Faecal samples were collected from 895 patients, examined microscopically following direct wet smear and formal-ether concentration methods. Entamoeba spp. positive faecal samples were subjected to DNA extraction and species-specific nested polymerase chain reaction of the 18S ribosomal RNA (rRNA). By microscopy, Entamoeba spp. cysts or trophozoites were detected in 114/895 (12.7%, 95% Confidence Interval (CI) 10.6-15.1) faecal samples. By nested PCR, the prevalence was: E. histolytica (7.5%, 95% CI 5.9-9.4, 67/895) and E. dispar (8.2%, 95% CI 6.5-10.2, 73/895). Among the Entamoeba spp. complex positive samples, nested PCR detected E. coli and E. hartmanni DNA in 63/114 (55.3%) and 37/114 (32.5%), samples respectively. Among the E. histolytica/E. dispar PCR negative samples (32.5%), 21 (18.4%) contained cysts of either E. coli (19) or E. hartmanni (2) by nested PCR. Entamoeba spp. infections were most common among participants aged 21-30 years; however it was not significant (P = 0.7). Entamoeba spp. infections showed an inverse relationship with diarrhea being most common among participants without diarrhea (P = 0.0). The difference was significant for E. histolytica (P = 0.0) but not significant for E. dispar (P = 0.1). Only E. dispar infections were significantly associated with sex (P = 0.0). This study highlights the need for differentiation of E. histolytica from other Entamoeba spp. by molecular tools for better management of amoebiasis.

Keywords: Abdominal discomfort; Diarrhea; Entamoeba species; Kenya; Mukuru informal settlement; Nairobi.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
A map of Mukuru informal settlement showing the Reuben Centre and Medical Missionaries of Mary clinics.
See this image and copyright information in PMC

References

    1. Al-Areeqi M.A., Sady H., Al-Mekhlafi H.M., Anuar T.S., Al-Adhroey A.H., Atroosh W.M., Dawaki S., Elyana F.N., Nasr N.A., Ithoi I., Lau Y.L., Surin J. First molecular epidemiology of Entamoeba histolytica, E. dispar and E. moshkovskii infections in Yemen: different species-specific associated risk factors. Tropical Med. Int. Health. 2017;22:493–504. - PubMed
    1. Ali I.K., Hossain M.B., Roy S., Ayeh-Kumi P.F., Petri W.A., Jr., Haque R., Clark C.G. Entamoeba moshkovskii infections in children. Bangladesh. Emerg. Infect. Dis. 2003;9:580–584. - PMC - PubMed
    1. Ali I.K., Clark C.G., Petri W.A., Jr. Molecular epidemiology of amebiasis. Infect. Genet. Evol. 2008;8:698–707. - PMC - PubMed
    1. APHRC . African Population and Health Research Center; Nairobi: 2014. Population and Health Dynamics in Nairobi's Informal Settlements: Report of the Nairobi Cross-Sectional Slums Survey (NCSS) 2012.
    1. Aribodor D., Anidebe A., Eneanya O., Emelummadu O. Entamoeba histolytica infection in children aged 0-12 years in rural communities in Anambra state, Nigeria. Nigerian J. Parasitol. 2012;33

LinkOut - more resources