Detection and differentiation of Entamoeba histolytica from Entamoeba dispar among primary school children in Calabar using microscopy and ELISA techniques

Entamoeba histolytica is one of the common pathogenic protozoa encountered in Calabar, Nigeria. Differentiating it from the non-pathogenic species, Entamoeba dispar is not a routine practice in our medical laboratories leading to misdiagnosis, overdiagnosis and drug abuse. Studies suggested that stool antigen assays are more sensitive and specific than microscopy for the diagnosis of Entamoeba histolytica infection. This study was carried out to detect and differentiate E. histolytica from E. dispar, hence determining the actual prevalence of E. histolytica among primary school children in Calabar, Nigeria between February and July 2019. A total of 384 stool samples collected from public and private primary school children, aged 5-15years were examined. Direct stool microscopy and ELISA kit-abnova KA3201 were used for Entamoeba histolytica/dispar complex detection while differentiation between E. histolytica and E. dispar was performed using E. histolytica 11IgG ELISA Kit-abnova KA5130. Prevalence of E. histolytica/E. dispar by microscopy and ELISA were 15(3.91%) and 21(5.47%), respectively. The prevalence of Entamoeba histolytica and that of E. dispar after differentiation were 7(1.82%) and 14(3.65%), respectively. Children in public schools were more significantly infected with E. histolytica 6(3.13%) than their private school counterpart 1(0.52%), (P = 0.0211). Although there was no association between Entamoeba infection and gender, males had an insignificantly higher prevalence of E. histolytica and E. dispar 5(3.0%) and 10(6.2%), respectively than females 2(0.9%) and 4(1.8%), respectively (P = 0.1210). There was no association between Entamoeba infection and age but children between the age of 8-10years were more infected with E. histolytica 5(3.70%) and E. dispar 9(6.67%) than others (P =0.2358). Calabar South recorded an insignificantly higher prevalence for E. histolytica 4(2.08%) and E. dispar 8(4.17%) than Calabar municipal 3(1.56%) and 6(3.13%), respectively (P = 0.7029). To avoid andom treatments, the improved diagnostic technique (ELISA) should be included in our routine laboratory practice.