ABSTRACT
Among the four intestinal Entamoeba species, only E. histolytica causes disease and requires treatment regardless of symptomatic status. E. dispar is almost universally accepted as a non-pathogenic species. E. moshkovskii has been detected in both symptomatic and asymptomatic individuals. The pathogenicity of E. bangladeshi remains obscure as it has only been detected in very few individuals. Species-specific prevalence of different Entamoeba is not well understood as most studies still use methods that are non-specific.
This chapter discusses the current methods used in the diagnosis of human intestinal amebiasis, and emphasizes the importance of molecular-based methods. Species-specific detection of Entamoeba species is not only important to understand the true epidemiology and pathogenicity of these amebae, but also for treatment decisions. Simple stool antigen-based detection methods (e.g., ELISAs) are still needed for E. dispar, E. moshkovskii, and E. bangladeshi. Similarly, simple DNA-based detection methods (e.g., LAMP assay) that can easily be implemented in resource-poor settings are needed. Molecular diagnostic tests capable of simultaneously detecting three or more of these Entamoeba species in clinical samples are still scarce. High-throughput sequence-based methods utilizing clinical samples (e.g., stools) is needed to identify novel species of Entamoeba.
