The present study was conducted to compare stool antigen detection with PCR for the diagnosis of Entamoeba sp. infection in asymptomatic cyst passers from Iran. Entamoeba dispar and, in one case, E. moshkovskii were the Entamoeba spp. found in the amebic cyst passers. There was a 100% correlation between the results from the TechLab E. histolytica II stool antigen kit and those from nested PCR. We concluded that E. dispar is much more common in asymptomatic cyst passers in Iran and that antigen detection and PCR are comparable diagnostic modalities.Entamoeba histolytica, E. dispar, and E. moshkovskii are morphologically identical but biochemically and genetically different. These parasites colonize the human gut, but only E. histolytica is thought to be capable of causing disease. Amebiasis, defined as asymptomatic, invasive intestinal or extraintestinal disease due to E. histolytica infection, is one of the most common parasitic infections worldwide, infecting about 50 million people, frequently in developing countries, resulting in 40,000 to 100,000 deaths per annum (21). Asymptomatic cyst passage is the most frequent manifestation of intestinal Entamoeba infection. All E. dispar and E. moshkovskii infections and 90% of E. histolytica infections are asymptomatic (21). The studies conducted to date that have used methods capable of differentiating between the two species suggest that, in general, E. dispar is much more prevalent than E. histolytica (9,10,11) and that only a small proportion of individuals specifically infected with E. histolytica will progress to having amebic disease (8). The necessity to identify and treat asymptomatic carriers of E. histolytica is emphasized by the observation that 10% of them develop invasive amebiasis in due course (6). Additionally, asymptomatic carriers are more likely to spread the disease than symptomatic persons with invasive diseases, as the latter individuals seek medical attention (12).In nearly all of the studies of asymptomatic amebic cyst passers in which the distribution of the two species has been investigated (1,3,5,11,16,18), E. dispar has been found to be much more prevalent than E. histolytica; however, in a few studies, including two from Mexico (14, 15) and one targeting mentally retarded individuals in Japan (20), either E. histolytica occult infections were more common than E. dispar infections or E. histolytica was the sole Entamoeba sp. found.Several microscopy-based epidemiological studies in Iran have shown Entamoeba sp. infection rates of 2.2% to 30% (13, 17). The current study, therefore, was designed to address the distribution of E. histolytica and E. dispar in regions of Iran where previous microscopy-based studies showed a high prevalence of infection and to compare the commercially available TechLab E. histolytica II kit to PCR.A total of 1,037 single fresh stool samples were collected from apparently healthy persons in rural and semirural settings of western (Luristan), northwestern (West Azerbaijan), and northeastern (Golestan) Iran, where...