Prevalence of Entamoeba histolytica/dispar and Giardia lamblia infections and their associated factors among schoolchildren in the Amhara region, Northwest Ethiopia

Abstract

Globally, intestinal protozoa E. histolytica/dispar and Giardia lamblia are the cause of amoebiasis and giardiasis, respectively. Despite their important medical importance and common occurrence in Ethiopia, they are minimally addressed in terms of their prevalence, sensitive diagnostic methods, and associated risk factors. Infections with E. histolytica/dispar and G. lamblia are often misdiagnosed and underreported in impoverished countries. Thus, the purpose of this study was to ascertain the prevalence of Giardia lamblia and E. histolytica/dispar infections as well as related variables among schoolchildren in the Amhara region. A cross-sectional study was conducted among 844 schoolchildren in the Amhara region from April to December 2019. A stool sample was collected from each study participant and processed via the formol ether concentration technique (FECT) and spontaneous tube sedimentation techniques (STST). Data were entered in EpiData and analysed by SPSS statistical software. The prevalence of E. histolytica and G. lamblia infections using each diagnostic method and composite reference was determined by descriptive statistics. The association of risk factors with E. histolytica/dispar and G. lamblia infections was analysed by logistic regression and variables with p < 0.05 were considered to have statistical significance. From the total, 243 (28.8%) schoolchildren were found to be infected by at least one of E. histolytica/dispar or G. lamblia. The prevalence of E. histolytica/dispar and G. lamblia infections was 201 (23.8%) and 62 (7.3%), respectively. The co-infection prevalence with both E. histolytica/dispar and G. lamblia was 22 (2.6%). The sensitivity (78.6%) and negative predictive value of STST (19.6%) were higher than FECT sensitivity (65.4%) and negative predictive value (13.1%). Children in 10-14 years of age (AOR = 1.66;95%CI: 1.16-2.38), lived in the rural (AOR = 1.97;95%CI: 1.12-3.49), used latrine improperly (AOR = 1.49;95%CI: 1.04-2.13), did not wash hands before meal (AOR = 2.10; 95%CI:1.08-4.10), and after latrine (AOR = 1.51;95%CI: 1.05-2.19), ate unwashed raw vegetables (AOR = 1.85;95%CI:1.26-2.70), and played with soil (AOR = 1.48;95%CI:1.06-2.06) were associated with E. histolytica/dispar and G. lamblia infection. These findings revealed high prevalence of E. histolytica/dispar and G. lamblia infections was high in the Amhara region. Therefore, proper implementation of water, sanitation and hygiene should be advocated at the community and school levels to mitigate the disease burden.

Keywords: Amhara region; Entamoeba histolytica; Ethiopia; Giardia lamblia; Prevalence; Protozoa; Schoolchildren.