Entamoeba histolytica infection in children in Accra: prevalence and risk factors

ABSTRACT

Background: Entamoeba histolytica causes amoebiasis in humans which is a major cause of morbidity and mortality in children in developing countries like Ghana where there are problems with sanitation. Studies conducted in Ghana have not placed much emphasis on the prevalence of this infection in both symptomatic and asymptomatic children in Accra. Thus, the aim of this study was to determine the prevalence of Entamoeba histolytica among children in Accra, and to identify some risk factors associated with infection.

Method: A cross sectional study was conducted involving two hundred and thirty-one (231) children of ages 1 day to 15 years in Accra. These included children with diarrhoea/dysentery presenting at Princess Marie Louise Children’s Hospital (PML); and supposedly healthy (asymptomatic) children from Wesley Methodist Basic School, De Youngsters International School and Agbogbloshie community. All the 231 samples collected were screened by microscopy. Ninety-two (92) out of the 231 samples were selected for ELISA analysis using Techlab E. histolytica II antigenic detection kit and 46 samples selected for PCR analysis.

Results: Two samples were positive for Entamoeba complex by microscopy. A prevalence of 0.9% was recorded. Another two samples were positive for E. histolytica by ELISA, giving a prevalence of 2.2%. For E. histolytica-specific PCR, amplification was achieved in four samples. A prevalence of 8.7% was obtained. Risk factors like age less than 5 years, the type of water drank and type of toilet facility were related to infection, although not statistically significant. Yeast cells and other enteric parasites like Entamoeba coli, Giardia lamblia, Hymenelopsis nana, Schistosoma mansoni and Taenia species were also identified by microscopy.

Conclusion: E. histolytica was detected among children in Accra, especially those under 5 years, using microscopy, ELISA and PCR.