Several and Ouattara et al., (27) (18.8%).

Several
researches conducted around the world have emphasized the significance of
food-handlers as threats in the transmission of parasitic infections (26).Present
study not only estimates the prevalence of some intestinal parasites among the
population of Al-Quwayiyah, Riyadh but also differentiates pathogenic E. histolytica
from non-pathogenic E. dispar.

This
study reports a low prevalence ( 6.4%) of 
intestinal parasite among the people of Al-Quwayiyah , and E. histolytica
was (5.7%) the most common  parasitic
infections among this population,  which
is similar (2.6%)to the study reported by Saeed et al., (20) , and Ouattara et
al., (27) (18.8%). Moreover,  our
study results about E. histolytica species were (5.7%) that correlate
with study results of Moustafa et al.,(28) and Wakid et al., (29) in which they
report a high prevalence rate of E. histolytica 20% and 4.1%
respectively than other intestinal parasites. In the previous study by Al-Braiken
et al., (30) the prevalence rate of E. histolytica was 8.3% than other
intestinal parasite which was  lower as
compared to our study.

The
low rate of intestinal parasites reported in this study area might be due to
adequate drainage system, selective disposal of sewage, sufficient potable
water, discriminated defecation, awareness and high standard of personal
hygiene among the people has improved comparatively than the previous year’s.
The studies conducted on the food handlers in Saudi Arabia showed a different
prevalence rates such as 17.7% in Riyadh (31), 45.38% in Hail (32), 27.2% in
Al-Ahsa (33) and 6.2% in Makkah (34) .The large variability of the prevalence
rates of parasitic infections might result from the difference in environmental
conditions, life style and health situations in the countries/province under
study.

In
this study prevalence of parasitic infections among Non -Saudies (9.3%) were
found to be higher than in Saudi (4.6%) patients. which is in accordance with
the study of Omar et al.,2016 (32) in their study expatriate shows a high
prevalence (51.22%) rate than Saudi (35.41%) patients. There is no significant
difference in the prevalence of parasitic infection between these two groups.
The   Non-Saudi patients are workers
coming mainly from Bangladesh, India, Pakistan, Sri Lanka, Philippine and Egypt
and all these courtiers are endemic for intestinal parasites (32, 44).

The
present study showed a higher prevalence of E. histolytica infection
among male (7.5%) than that of female (3.3%); this is correlated with study of Oti
B et al., (35) in which they show a high prevalence for male (30.5%) than
females (16%). The high prevalence of parasitic infection observed among male
than female may be due to their more involvement in outdoor activities (36)
such as playing football, farming, trucking, fishing, hunting and swimming in rivers
and ponds. These activities predispose them to more close to the infections (37,
36).On the other hand, females are more pre-occupied with house – hold
activities which limit their exposure to the infections(37).However, our
findings were in disagreement with the study of Nyenke et al., (38) from Degema
in which they state that females are more prone to infections than males.

This
study also shows a high prevalence rate for parasitic infections (6.45%) among
the adults than that of children’s (4.2%) aged between 3-18year.A similar
observation has been reported by Mergani et al., (39). Their study
reports (9.5%) prevalence rate for adults. But our finding shows dissimilarity
with studies of Oti B et al.,(35) that expressed a high prevalence rate (28.5%)
among the children aged between 6-10 years and followed by 11-14 years (22.7%).
The high prevalence rate in adults than children in our study could be due to
the adults are more adventurous than children and they prefer outside food. At
the same time, children mainly depend on homely food and mothers pay more
attention to their personal hygiene, such as, hand washing and discriminated
defecation.

The
Microscopic identification of Entamoeba species has been always a challenge for
clinical laboratory technicians; microscopy is usually used to diagnose
protozoa in stool samples. However, this method is unable to differentiate E.
histolytica from the morphologically identical non-pathogenic species such
as E. dispar. Therefore WHO recommends the development and application
of new methods for a specific diagnosis of E. histolytica infection (40,
41, 42).

In
the present study, Vitassay immunochromatographic test on stool samples shows 7
infections due to E. histolytica, while stool microscopy reports 9
cases, showing 2 wrongly diagnosed amoebic infections. These results were similar
to the findings of Tasleem etal., (43).In their study, ELISA stool test
verified 14 infections due to E. histolytica  while microscopy picked 36 cases.

Comparing
the specificity and sensitivity of Vitassay test with microscopic examination
on whole sample (140) Vitassay immunoassay shows a sensitivity of (77.8%) and specificity
of (99.23%). These results are almost identical with the study report of Mohammed
et al., (21) and Tasleem A et al., (43); their study reports show a sensitivity
of (88%), (71.4%) and specificity of (98%), (90.5%) for EIA test respectively.
The several researchers strongly recommend EIA test over microscopy in clinical
laboratory for the diagnosis of intestinal parasites. Also microscopy required
skillful and experienced technician for the identification of intestinal
parasites. Therefore, its results vary form study to study (43). At the same
time, EIA test doesn’t require skillful person and its procedures are simple
and quick. However,  the high cost and
lack of information about this test have reduced its use in diagnostic
laboratories in countries like Saudi Arabia (21).

 

Problems
and Suggestions:

1)      This
study included only in Al- Quwayiyah.  It
would have been better if it could include more hospitals in various regions of
Riyadh city to be a multicenter study.

2)      The
availability of E. histolytica QUIK
CHECK TM Tech Lab the Entamoeba Histolytica/ dispar differentiation kit.

3)      Parasite
prevalence always depends on climate changes; hence during winter season the
number of cases was comparatively less, expecting more cases during summer
season.

 

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