Molecular and Microscopic Diagnosis of Entamoeba histolytica in Human Stool Samples from Al-Kut, Iraq

الملخص

Entamoeba histolytica, a protozoan parasite, is responsible for amoebiasis, a significant public health issue, particularly in developing regions where sanitation and sanitary infrastructure are frequently insufficient. It is imperative to have a precise and expeditious diagnosis in order to effectively manage the patient and prevent the transmission of the infection. Our objective in this investigation was to assess and contrast the diagnostic efficacy of two methods for the detection of Entamoeba spp. in stool samples: conventional microscopic examination with Lugol's iodine staining and molecular identification via multiplex polymerase chain reaction (PCR) that targets the 18S rRNA gene. At the Al-Kut and Al-Karama hospitals in Wasit Province, Iraq, a total of 67 stool samples were obtained from patients who were experiencing gastrointestinal symptoms, particularly diarrhea. The positivity rate for Entamoeba spp. was 67.2%, as evidenced by the microscopic examination, which revealed spherical cysts with clearly defined nuclei. On the other hand, conventional PCR-based molecular analysis identified E. histolytica in 80% of the tested samples, indicating a greater diagnostic yield. Significant differences between the two methodologies were verified through statistical analysis (P ≤ 0.05). The findings emphasize the superior sensitivity and specificity of PCR for accurate detection and demonstrate the limitations of microscopy in differentiating morphologically similar species within the Entamoeba complex. This research advocates for the inclusion of molecular diagnostic methods, such as multiplex PCR, in routine parasitological screening, particularly in endemic regions. In addition, the results establish a basis for enhanced diagnostic strategies and public health interventions that are designed to manage amoebic infections.