Diagnosis of amoebic colitis by antigen capture ELISA in patients presenting with acute diarrhoea in Cairo, Egypt


Jonathan I. Ravdin Department of Medicine, University of Minnesota, 420 Delaware Street SE, Minneapolis, MN 55455, USA. Fax: +1 612 626 3055; E-mail: ravdi001@tc.umn.edu


We studied 84 consecutive patients presenting with acute diarrhoea (less than 1 week in duration) at an outpatient tropical medicine clinic in Cairo, Egypt. The diagnosis of amoebic colitis was established by the presence of Entamoeba histolytica galactose-inhibitable lectin antigen and the presence of occult blood in stool. Controls were 182 healthy regional people and 64 patients complaining of prolonged diarrhoea lasting more than 1 week. Entamoeba histolytica infection was found more frequently in patients with acute diarrhoea (57.1%) than in healthy controls (21.4%) or patients with prolonged diarrhoea (25%) (P < 0.001). There was a higher prevalence of Entamoeba dispar infection in the two control groups (24.2 and 20.3%, respectively, P=0.004 and 0.061) compared with those with acute diarrhoea (8.3%). Of the 84 patients with acute diarrhoea 32 had amoebic colitis (38%), and of these, 31 (97%) had at least one positive assay for serum amoebic antibodies (P < 0.001 compared with control groups). In summary, as determined by antigen-detection enzyme-linked immunosorbent assay, there is an unexpectedly high prevalence of amoebic colitis among patients presenting with acute diarrhoea to a tropical disease clinic in Cairo, Egypt.