Comparison of microscopic and immunoassay examination in the diagnosis of intestinal protozoa of humans in Mansoura, Egypt

Abstract

Protozoal diseases are prevalent globally and especially in developing countries that have relatively lower socioeconomic populations such as Egypt. Direct microscopic examination (DME) is used for the detection and identification of protozoa but lacks sufficient reliability, and thus may be detrimental in obtaining accurate diagnostic or epidemiological data. In this study, we determine the prevalence of infections by Giardia intestinalis, Cryptosporidium sp., and Entamoeba histolytica in humans in Egypt. Furthermore, we determine the reliability of DME in determining infections caused by these protozoa and compare the results to enzyme linked Immunosorbent assays (ELISA). Our results indicate that the prevalence of giardiasis, cryptosporidiosis, and entamoebiasis is 38, 22, and 16 %, respectively. The sensitivity and specificity of DME for detection of G. intestinalis is 45 and 99 %, for Cryptosporidium 66 and 99 %, and for Entamoeba 45 and 100 %, respectively. Our findings demonstrate that ELISA is more reliable for diagnostic and epidemiologic study purposes.

Prevalence of Intestinal Parasites in Cancer Therapy Recipients with Concurrent Diarrhea

“…Also, prevalence of various protozoa was as follows among healthy individuals in another study from Egypt: E. histolytica 2%, G. lamblia 18%, Blastocystis hominis 10%, and Cryptosporidium 12% [24]. In Mansoura, results of the study conducted by Elswaif et al [25] revealed that the prevalence of protozoa among patients attending Mansoura University Hospital out-patient clinics presenting with diarrhea was 81% for Giardia 15% for Cryptosporidium and 14% for E. histolytica. Finally, a recent study in Egypt comprising patients complaining of diarrhea proved that Giardia was the most common parasite 30.5% as detected by microscopy while Cryptosporidium spp.…”

Prevalence and Clinical Manifestations of Giardia intestinalis and Other Intestinal Parasites in Children and Adults in Algeria

“…In our study, direct microscopy of fecal concentrates was used for detection and differentiation of intestinal protists, whereas a few previous studies 28,29,43,44 used a combination of or different examination and diagnostic tests, including microscopy of fecal concentrates, immunoassays, an immunofluorescence assay including 49,6-diamidine-2phenylindole-dihydrochloride, trichrome staining, and iodine staining, all of which may differ in terms of sensitivity with a consequence for the reported Giardia prevalence. This can be exemplified by a study carried out recently in Egypt, 43 where the prevalence of Giardia was 38% based on immunoassay results compared with 18% based on results from microscopy of fecal concentrates.…”

Systematic Review of Diagnostic Approaches for Human Giardiasis: Unveiling Optimal Strategies

“…This laborious nature arises from the intricate processes inherent to the chosen method, where each sample mandates individual scrutiny by the professional [31]. Literature corroborates that the experience and proficiency of the professional executing the technique are pivotal, necessitating the identification of cysts, trophozoites, and eggs within biological samples laden with extraneous material that could potentially obfuscate microorganism structures [25][26][27][28][29][30][31][32][33][34].…”

“…Light microscopy methods, renowned for their cost-effectiveness [32][33][34][35][36], harbor the added advantage of diagnosing a spectrum of intestinal parasites beyond giardiasis, including ascariasis, amoebiasis, taeniasis, and hookworm [12,34,36]. The Ritchie method emerges as the favored approach according to the data gleaned from selected articles.…”