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Khwam Reissan Hussein 1 Article
The epidemiology of amoebiasis in Thi-Qar Province, Iraq (2015-2020): differentiation of Entamoeba histolytica and Entamoeba dispar using nested and real-time polymerase chain reaction
Mohammed Hassan Flaih, Ruaa Majid Khazaal, Manar Karem Kadhim, Khwam Reissan Hussein, Falah Abd Bashir Alhamadani
Epidemiol Health. 2021;43:e2021034.   Published online May 6, 2021
DOI: https://doi.org/10.4178/epih.e2021034
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Abstract
OBJECTIVES
The objective of this study was to evaluate the present status of amoebiasis in Thi-Qar Province in southern Iraq, and to determine the presence of Entamoeba histolytica and Entamoeba dispar with nested and real-time polymerase chain reaction (PCR).
METHODS
Epidemiological data were obtained from the public health department of the Thi-Qar Health Office (2015-2020). Eighty stool samples were also randomly collected from patients ≤12 year of age with diarrhea at 2 hospitals between the beginning of February 2020 and the end of October 2020. These samples were selected after microscopy to identify the 18S rRNA gene in Entamoeba DNA.
RESULTS
Of the 341,554 cases of intestinal parasitic infections, 38,004 (11.1%) individuals were recorded as having amoebiasis, which accounted for the highest proportion of infections in 2015 (26.1%) and the lowest in 2020 (8.1%). Amoebiasis was distributed among all age groups, with the age group of 5-14 years accounting for the highest proportion (27.3%). In molecular testing, 42 (52.5%) out of 80 samples were positive for the 18S rRNA gene (888 bp). Using nested PCR, E. histolytica (439 bp) was detected in 25 (31.3%) samples and E. dispar (174 bp) in 14 (17.5%), while using real-time PCR, E. histolytica and E. dispar were detected in 28 (35.0%) and 15 (18.8%) samples, respectively.
CONCLUSIONS
Epidemiological data confirmed that amoebiasis is endemic in this province, and is not limited to certain months. Our study confirms the applicability of molecular identification to detect pathogenic and non-pathogenic Entamoeba to prescribe the appropriate drug.
Summary
Korean summary
Key Message
Our study conducted an epidemiologic evaluation of amoebiasis (2015-2020). Amoebiasis is considered a health burden and uncontrolled disease, is endemic in Thi-Qar Province, and is not related with certain months. This study suggests that molecular diagnosis is necessary before the treatment. Both Nested and RT PCR assays are beneficial to diagnose Entamoeba spp.

Epidemiol Health : Epidemiology and Health