title: Entamoeba histolytica and Entamoeba dispar: epidemiology and comparison of diagnostic methods in a setting of nonendemicity.
abstract: Recent studies suggest that stool antigen assays are more sensitive and specific than microscopy for the diagnosis of Entamoeba histolytica infection. One hundred twelve patients presenting at 3 centers with symptoms or risk factors of E. histolytica infection were prospectively enrolled in this study to evaluate new diagnostic tests for infections with E. histolytica and Entamoeba dispar. Four ELISA-based stool antigen kits for detecting E. histolytica or E. dispar were blindly compared with stool microscopy. Amebic serology was assessed by indirect hemagglutination. When antigen assays were used as the reference standard, microscopy performed at referral centers was more specific (68.4% vs. 9.5%) but less sensitive (70.4% vs. 92.1%) than microscopy performed in community laboratories. Diagnosis with the E. histolytica test and Merlin Optimun S ELISA indicated that only 3 (4.2%) of 72 coproantigen-positive stools were positive for E. histolytica. Indirect hemagglutination was a good predictor of E. histolytica infection when titers of antibody to ameba were >/=1:512.
authors.affiliation: Tropical Disease Unit, Division of Infectious Diseases, Department of Medicine, Toronto Hospital and University of Toronto, Toronto, Ontario, M5G 2C4, Canda.
authors.forename: D R
authors.initials: DR
authors.lastname: Pillai
authors.forename: J S
authors.initials: JS
authors.lastname: Keystone
authors.forename: D C
authors.initials: DC
authors.lastname: Sheppard
authors.forename: J D
authors.initials: JD
authors.lastname: MacLean
authors.forename: D W
authors.initials: DW
authors.lastname: MacPherson
authors.forename: K C
authors.initials: KC
authors.lastname: Kain
mesh_terms: D000818:Animals; D000953:Antigens, Protozoan / Q000097:blood*; D004747:Entamoeba / Q000276:immunology / Q000302:isolation & purification*; D004748:Entamoeba histolytica / Q000276:immunology / Q000302:isolation & purification*; D004749:Entamoebiasis / Q000175:diagnosis*; D005243:Feces / Q000469:parasitology; D005260:Female; D006801:Humans; D008297:Male; D011446:Prospective Studies; D012015:Reference Standards; D012680:Sensitivity and Specificity
chemical_list: D000953:Antigens, Protozoan