Prevalence of Entamoeba histolytica and Giardia lamblia infection among diabetic and non diabetic patients of Bangladesh

Abstract

The present study was conducted on 697 diabetic and 603 non-diabetic peoples (aged 25-75 years) in the Immunology Laboratory, Institute of Health Science (BIHS) Hospital, Mirpur, in Dhaka to investigate their association with protozoan infestation. The use of appropriate technique plays an important role in the detection of the parasitic infections. ELISA with blood samples, formol-ether concentration technique (F-ECT) and zinc sulphate method (Z-SFM) were applied to faecal samples for the detection of prevalence of Entamoeba histolytica and Giardia lamblia. Out of 697 diabetic patients, by ELISA 15.93% and 17.65% were found infected by E. histolytica and G. lamblia; while out of 603 non-diabetic individuals, 27.53% and 28.03% were infected by E. histolytica and G. lamblia; respectively. According to the results of F-ECT on diabetic patients, 26.83% and 28.41%; 34.66% and 34.99% were found among non-diabetic individuals infected by E. histolytica and G. lamblia; respectively. According to the results of Z-SFM, on diabetic patients 12.05% and 13.34%; 15.09% and 16.09% were found among non-diabetic individuals infected by E. histolytica and G. lamblia respectively. A specimen was considered positive for E. histolytica and G. lamblia if either cysts or trophozoites or both stages were present. Double parasitic infestation (8.03%) was found in diabetic patients and 13.10% was found in non-diabetic individuals. By these methods (ELISA, F-ECT and Z-SFM techniques), it reveals that, males were more infected than females. It was also observed that prevalence was higher among 25-45 years than old aged group (above 55 years). By ELISA method, out of 697 diabetic blood samples, 18.68% of symptomatic types and 12.91% of asymptomatic types were positive for E. histolytica antibody. Similarly, 31.45% of non-diabetic symptomatic types and 21.21% of asymptomatic types were positive for E. histolytica antibody. Out of 697 diabetic blood samples, 21.15% was positive in symptomatic types and 13.8% in asymptomatic types for G. lamblia antibody, 31.18% of non-diabetic symptomatic types and 22.94% of asymptomatic types were positive for G. lamblia antibody. By F-EC technique, 31.87% of diabetic symptomatic types and 21.32% of asymptomatic types were positive for E. histolytica. Similarly, 37.63% of non-diabetic symptomatic types and 29.87% of asymptomatic types were positive for E. histolytica. Among diabetic 30.49% of symptomatic types and 26.13% of asymptomatic types were positive for G. lamblia. Among non-diabetic individuals, 38.71% of symptomatic types and 29% of asymptomatic types were positive for G. lamblia. By Z-SF method, 13.46% of symptomatic diabetic patients and 10.51% of asymptomatic types were positive for E. histolytica. Similarly, 19.35% of non-diabetic symptomatic types and 8.23% of asymptomatic types were positive for E. histolytica. Among diabetic patients, 14.56% of symptomatic and 12.01% of asymptomatic types was positive for G. lamblia. Similarly, 20.16% of non-diabetic symptomatic types and 9.12% of asymptomatic types were positive for G. lamblia. Considering the age groups, in non-diabetic individuals, the highest prevalence of E. histolytica was 38.05% in the age group of 25-35 and in the case of G. lamblia, it was 40.13% found in the age group of 35-45 years detected by F-ECT. In comparison of three techniques of blood and faecal samples, in single and double parasitic infections, the prevalence always found higher among the non-diabetes than the diabetic patients. The seasonal variation of parasitic infestation was higher during rainy season and lower in winter. It revealed that, F-ECT is most suitable method for detection of single and as well as double protozoan infections and is recommended as the best technique to get the concentration of the parasites present in faeces. Z-SFM used to diagnose infection with E. histolytica and G. lamblia, which is a quick and comparatively simpler examination and gives a precise and reliable diagnosis. The ELISA technique is the best of all techniques, which represents the present infection as well as the recent infection of amebiasis and giardiasis.