title: Prevalence and risk factors associated with Entamoeba histolytica/dispar/moshkovskii infection among three Orang Asli ethnic groups in Malaysia.
abstract: BACKGROUND
  Entamoeba histolytica/Entamoeba dispar/Entamoeba moshkovskii infection is still prevalent in rural Malaysia especially among Orang Asli communities. Currently, information on prevalence of this infection among different ethnic groups of Orang Asli is unavailable in Malaysia. To contribute to a better comprehension of the epidemiology of this infection, a cross-sectional study aimed at providing the first documented data on the prevalence and risk factors associated with E. histolytica/E. dispar/E. moshkovskii infection was carried out among three Orang Asli ethnic groups (Proto-Malay, Negrito, and Senoi) in selected villages in Negeri Sembilan, Perak, and Pahang states, Malaysia.
  
  
  RESULTS
  Faecal samples were examined by formalin-ether sedimentation and trichrome staining techniques. Of 500 individuals, 8.7% (13/150) of Proto-Malay, 29.5% (41/139) of Negrito, and 18.5% (39/211) of Senoi were positive for E. histolytica/E. dispar/E. moshkovskii, respectively. The prevalence of this infection showed an age-dependency relationship, with higher rates observed among those aged less than 15 years in all ethnic groups studied. Multivariate analysis confirmed that not washing hands after playing with soils or gardening and presence of other family members infected with E. histolytica/E. dispar/E. moshkovskii were significant risk factors of infection among all ethnic groups. However, eating with hands, the consumption of raw vegetables, and close contact with domestic animals were identified as significant risk factors in Senoi.
  
  
  CONCLUSIONS
  Essentially, the findings highlighted that E. histolytica/E. dispar/E. moshkovskii parasites are still prevalent in Malaysia. Further studies using molecular approaches to distinguish the morphologically identical species of pathogenic, E. histolytica from the non-pathogenic, E. dispar and E. moshkovskii are needed. The establishment of such data will be beneficial for the public health authorities in the planning and implementation of specific prevention and control strategies of this infection in different Orang Asli ethnic groups in Malaysia.
authors.affiliation: Department of Parasitology and Medical Entomology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia.
authors.forename: Tengku
authors.initials: T
authors.lastname: Shahrul Anuar
authors.forename: Hesham
authors.initials: H
authors.lastname: M Al-Mekhlafi
authors.forename: Mohamed Kamel
authors.initials: MK
authors.lastname: Abdul Ghani
authors.forename: Emelia
authors.initials: E
authors.lastname: Osman
authors.forename: Azlin
authors.initials: A
authors.lastname: Mohd Yasin
authors.forename: Anisah
authors.initials: A
authors.lastname: Nordin
authors.forename: Siti
authors.initials: S
authors.lastname: Nor Azreen
authors.forename: Fatmah
authors.initials: F
authors.lastname: Md Salleh
authors.forename: Nuraffini
authors.initials: N
authors.lastname: Ghazali
authors.forename: Mekadina
authors.initials: M
authors.lastname: Bernadus
authors.forename: Norhayati
authors.initials: N
authors.lastname: Moktar
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D004747:Entamoeba / Q000378:metabolism*; D004748:Entamoeba histolytica / Q000378:metabolism*; D004749:Entamoebiasis / Q000175:diagnosis / Q000453:epidemiology* / Q000469:parasitology*; D005006:Ethnicity; D005260:Female; D006801:Humans; D007223:Infant; D008296:Malaysia; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors