Real Time PCR Assay in differentiating Entamoeba histolytica and Entamoeba dispar infections in patients fecal samples attending St Camille hospital in Ouagadougou, Burkina Faso

Abstract

Amoebiasis is a parasitic infection caused by Entamoeba histolytica. The diagnosis of amoebic infections, based on microscopic stool examination does not differentiate between E. histolytica and E. dispar, the commensal species because these two species are morphologically indistinguishable. The re-description of these species in 1993 and the exclusive pathogenicity recognized to E. histolytica have stimulated reassessment of the epidemiology of amebiasis using molecular techniques. This study aimed to diagnose and differentiate E. histolytica and E. dispar in feces for a first time in Burkina Faso. Fecal samples from 413 patients suffering from gastrointestinal disorders, attending the Saint Camille Hospital in Ouagadougou were collected and processed by direct microscopic examination for the presence of Entamoeba species and other intestinal parasites. A real-time PCR was then developed and assessed for the detection and the differentiation of E. histolytica and E. dispar. Based on single fecal sample examination, the overall prevalence of E. histolytica/E. dispar was 22.5 % (93/413) with 84.9 % (79/93) in infected adults and 15.1 % (14/93) in children under 5 years. Fourteen (14) samples of 93 (15.05 %) E. histolytica/E. dispar microscopy positive samples were PCR positive. E. dispar was the most common, with a prevalence of 71.4 % (10/14) against 21.4 % (3/14) for E. histolytica. One case of mixed infection was recorded. We showed for the first time in Burkina Faso, that real-time PCR is an excellent tool in the re-definition of the epidemiology of E. histolytica according to WHO recommendation and also for proper management of this tropical neglected disease.