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Simultaneous detection of Entamoeba histolytica/dispar, Giardia duodenalis and cryptosporidia by immunochromatographic assay in stool samples from patients living in the Greater Cairo Region, Egypt

Abstract

Gastrointestinal infection due to intestinal parasites is an enormous health problem in developing countries and its reliable diagnosis is demanding. Therefore, this study aimed at evaluating a commercially available immunochromatographic assay (ICA) for the detection of cryptosporidia, Giardia duodenalis, and Entamoeba histolytica/dispar for its usefulness in the Greater Cairo Region, Egypt. Stool samples of 104 patients who presented between October 2012 and March 2013 with gastrointestinal symptoms or for the exclusion of parasites at Kasr-Al-Ainy University Medical School were examined by light microscopy of wet mounts and the triple ICA. Microscopy revealed in 20 % of the patients [95 % confidence interval (CI), 13.5–29.0 %] parasites with Hymenolepis nana, E. histolytica/dispar and Blastocystis hominis being the most frequent ones, but was not able to detect G. duodenalis and cryptosporidia, whereas ICA was positive in 21 % (95 % CI, 14.3–30.0 %) and detected E. histolytica/dispar in 12.5 % (95 % CI, 7.3–20.4 %), cryptosporidia in 6.7 % (95 % CI, 3.1–13.5 %) and G. duodenalis in 15.4 % (95 % CI, 9.6–23.6 %) of the patients. Detection of one or more pathogens was associated with access to water retrieved from a well or pump (p = 0.01). Patients between 20 and 29 years of age (p = 0.08) and patients with symptoms of 5 days or longer (p = 0.07) tended to have a higher risk to be infected than patients of other age groups or with shorter-lasting symptoms. In conclusion, the ICA was easy to perform and timesaving. Importantly, it enabled the detection of cryptosporidia, which cannot be found microscopically in unstained smears, demonstrated a higher sensitivity for the detection of G. duodenalis than microscopy, and was more specific for distinguishing E. histolytica/dispar from apathogenic amoeba.

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References

  1. Abdel Hameed DM, Elwakil HS, Ahmed MA (2008) A single-step immunochromatographic lateral-flow assay for detection of Giardia lamblia and Cryptosporidium parvum antigens in human fecal samples. J Egypt Soc Parasitol 38:797–804

    Google Scholar 

  2. Abdel-Hafeez EH, Ahmad AK, Ali BA, Moslam FA (2012) Opportunistic parasites among immunosuppressed children in Minia district, Egypt. Korean J Parasitol 50:57–62

    Article  Google Scholar 

  3. Alyousefi NA, Mahdy MAK, Mahmud R, Lim YAL (2011) Factors associated with high prevalence of intestinal protozoan infections among patients in Sana’a city Yemen. PLoS One 6:1–7

    Article  Google Scholar 

  4. Antonios SN, Tolba OA, Orthman AA, Saad MA (2010) A preliminary study on the prevalence of parasitic infections in immunocompromised children. J Egypt Soc Parasitol 40:617–630

    Google Scholar 

  5. Badawy AA, Gneidy MR, Ghoniemy AE (2012) Acute diarrhea among military recruits. J Egypt Soc Parasitol 42:309–320

    Article  Google Scholar 

  6. Baiomy AM, Mohamed KA, Ghannam MA, Shahat SA, Al-Saadawy AS (2010) Opportunistic parasitic infections among immunocompromised Egyptian patients. J Egypt Soc Parasitol 40:97–808

    Google Scholar 

  7. Bhaskar S, Singh S, Sharma M (1996) A single-step immunochromatographic test for the detection of Entamoeba histolytica antigen in stool samples. J Immunol Methods 196:193–198

    CAS  Article  Google Scholar 

  8. Costache CA, Calosi IA, Colosi HA (2009) Immunochromatography versus microscopy for the identification of Giardia lamblia and Cryptosporidium parvum in human feces. Scient Parasit 1–2:26–31

    Google Scholar 

  9. Current WL, Garcia LS (1991) Cryptosporidiosis. Clin Microbiol Rev 4:325–358

    CAS  Google Scholar 

  10. Curtale F, Nabil M, El Wakeel A, Shamy MY (1998) Anaemia and intestinal parasitic infections among school age children in Behera Governorate, Egypt. Behera Survey Team. J Trop Pediatr 44:323–328

    CAS  Article  Google Scholar 

  11. Den Hartoq J, Rosenbaum L, Wood Z, Burt D Jr, Petri WA (2013) Diagnosis of multiple enteric protozoan infections by enzyme-linked immunosorbent assay in the Guatemalan highlands. Am J Trop Med Hyg 88:167–171

    Article  Google Scholar 

  12. El-Hamshary EM, El-Sayed HF, Hussein EM, Rayan HZ, Soliman RH (2008) Comparison of polymerase chain reaction, immunochromatographic assay and staining techniques in diagnosis of Cryptosporidiosis. PUJ 1:77–86

    Google Scholar 

  13. El-Helaly NA, Mona MA, Samar SA (2012) Detection of Cryptosporidium infection among children with diarrhoea. N Y Sci J 5:68–76

    Google Scholar 

  14. El-Kadi MA, Ahmad OD, Shoukry NM (2006) Patients with gastrointestinal complaints due to enteric parasites, with reference to Entamoeba histolytica/dispar as detected by ELISA E. histolytica adhesion in stool. J Egypt Soc Parasitol 36:53–64

    Google Scholar 

  15. El-Moamly AAR, El-Sweify MA (2012) ImmunoCard STAT! cartridge antigen detection assay compared to microplate enzyme immunoassay and modified Kinyoun’s acid-fast staining technique for detection of Cryptosporidium in fecal specimens. Parasitol Res 110:1037–1041

    Article  Google Scholar 

  16. El-Mohammady H, Mansour A, Shaheen HI, Henien NH, Motawea MS, Rafaat I, Moustafa M, Adip-Messih I, Seben PJ, Young SYN et al (2012) Increase in the detection rate of viral and parasitic enteric pathogens among Egyptian children with acute diarrhoea. J Infect Dev Ctries 6:774–781

    Google Scholar 

  17. El-Naggar SM, El-Bahy MM, Abd Elaziz J, El-Dardiry MA (2006) Detection of protozoal parasites in the stools of diarrhoeic patients using different techniques. J Egypt Soc Parasitol 36:7–22

    Google Scholar 

  18. Elsafi SH, Al-Maqati TN, Hussein MI, Adam AA, Abu Hassan MM, Al Zahrani EM (2013) Comparison of microscopy, rapid immunoassay, and molecular techniques for the detection of Giardia lamblia and Cryptosporidium parvum. Parasitol Res 112:1641–1646

    Article  Google Scholar 

  19. El-Sherbini GT, Abosdera MM (2013) Risk factors associated with intestinal parasitic infections among children. J Egypt Soc Parasitol 43:287–294

    Article  Google Scholar 

  20. Fawzi M, El-Sahn AA, Ibrahim HF, Shehata AI (2004) Vegetable-transmitted parasites among inhabitants of El-Prince, Alexandria and its relation to housewives’ knowledge and practices. J Egypt Public Health Assoc 79:13–29

    Google Scholar 

  21. Gaafar RM (2011) Evaluation of enzyme immunoassay techniques for diagnosis of the most common intestinal protozoa in fecal samples. Int J Infect Dis 15:541–544

    Article  Google Scholar 

  22. Garcia LS, Garcia JP (2006) Detection of Giardia lamblia antigens in human fecal specimens by a solid-phase qualitative immunochromatographic assay. J Clin Microbiol 44:4587–4588

    CAS  Article  Google Scholar 

  23. Goñi P, Martin B, Villacampa M, Garcia A, Seral C, Castillo FJ, Clavel A (2012) Evaluation of an immunochromatographic dip strip test for simultaneous detection of Cryptosporidium spp., Giardia duodenalis, and Entamoeba histolytica antigens in human faecal samples. Eur J Clin Microbiol Infect Dis 31:2077–2082

    Article  Google Scholar 

  24. Hassanein SM, Abd-El-Latif MM, Hassanin OM, Abd-El-Latif LM, Ramadan NI (2012) Cryptosporidium gastroenteritis in Egyptian children with acute lymphoblastic leukemia: magnitude of the problem. Infection 40:279–284

    CAS  Article  Google Scholar 

  25. Helmy YA, Krücken J, Nöckler K, von Samson-Himmelstjerna G, Zessin K-H (2014) Comparison between two commercially available serological tests and polymerase chain reaction in the diagnosis of Cryptosporidium in animals and diarrhoeic children. Parasitol Res 113:211–216

    Article  Google Scholar 

  26. Ignatius R, Gahutu JB, Klotz C, Musemakweri A, Aebischer T, Mockenhaupt FP (2014) Detection of Giardia duodenalis assemblage A and B by immunochromatography in stoolsamples from Rwandan children. CMI 20:O783–O785

    CAS  Google Scholar 

  27. Mahmud AM, Chappell C, Hossain MM, Habib M, Dupont HL (1995) Risk factors for development of first symptomatic Giardia infection among infants of birth cohort in rural Egypt. Am J Trop Med Hyg 53:84–88

    CAS  Google Scholar 

  28. Pawlowski SW, Warren CA, Guerrant R (2009) Diagnosis and treatment of acute or persistent diarrhea. Gastroenterol 136:1874–1886

    CAS  Article  Google Scholar 

  29. Sahagún J, Clavel A, Goñi P, Llorente MT, Castillo FJ, Capilla S, Arias A, Gómez-Lus R (2008) Correlation between the presence of symptoms and the Giardia duodenalis genotype. Eur J Clin Microbiol Infect Dis 27:81–83

    Article  Google Scholar 

  30. Selim S, Nassef N, Sharaf S, Badra G, Abdel Atty D (2009) Copro-antigen detection versus direct methods for the diagnosis of Giardia lamblia in patients from the National Liver Institute. J Egypt Soc Parasitol 39:575–583

    Google Scholar 

  31. Stark D, Al-Qassab E, Barratt JLN, Stanley K, Roberts T, Marriott D, Harkness J, Ellis JT (2010) Evaluation of multiplex tandem real-time PCR for detection of Cryptosporidium spp., Dientamoeba fragilis, Entamoeba histolytica, and Giardia intestinalis in clinical stool samples. J Clin Microbiol 49:257–262

    Article  Google Scholar 

  32. Stauffer W, Abd-Alla M, Ravdin JI (2006) Prevalence and incidence of Entamoeba histolytica infection in South-Africa and Egypt. Arch Med Res 37:266–269

    Article  Google Scholar 

  33. Taha HA, Soliman MI, Banjar SAN (2013) Intestinal parasitic infections among expatriate workers in Al-Madina Al-Munawarah, Kingdom of Saudi Arabia. Trop Biomed 30:78–88

    Google Scholar 

  34. Youssef FG, Mikhail EM, Mansour NS (1989) Intestinal capillariasis in Egypt, a case report. Am J Trop Med Hyg 40:195–196

    CAS  Google Scholar 

  35. Zaglool DA, Khodiari YA, Orthman RAM, Farooq MU (2011) Prevalence of intestinal parasites and bacteria among food handlers in a tertiary care hospital. Niger Med J 52:266–270

    CAS  Article  Google Scholar 

Download references

Acknowledgments

We are grateful to Renate Culley, Danijela Meister-Babić, Claudia Schubert and Antje Vincentz for their experienced help in microscopic diagnosis.

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Correspondence to Dagmar M. Banisch.

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Banisch, D.M., El-Badry, A., Klinnert, J.V. et al. Simultaneous detection of Entamoeba histolytica/dispar, Giardia duodenalis and cryptosporidia by immunochromatographic assay in stool samples from patients living in the Greater Cairo Region, Egypt. World J Microbiol Biotechnol 31, 1251–1258 (2015). https://doi.org/10.1007/s11274-015-1875-5

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Keywords

  • Entamoeba histolytica/dispar
  • Giardia duodenalis
  • Cryptosporidia
  • Immunochromatographic assay
  • Microscopy
  • Greater Cairo Region
  • Egypt