Abstract:
BACKGROUND፡ Accurate diagnosis of Giardia lamblia and
Entamoeba histolytica is important since these intestinal parasites
account for a significant proportion of morbidity and mortality
globally. Microscopy is the key diagnostic test used for diagnosis
of the two parasites. Other tests including rapid diagnostic tests
and polymerase chain reaction have been developed to improve
the detection of these parasites. Most of these newer tests are not
affordable in resource limited settings, hence the over reliance on
microscopy. The objective of this study was to determine the
reliability of microscopy in a resource limited setting in Western
Kenya, a region endemic for the two intestinal parasites.
METHODS: Polymerase chain reaction, the gold standard test,
was performed on stool samples suspected for G. lamblia and E.
histolytica. Microscopy was then performed on the same samples
and the two tests compared.
RESULTS: Microscopy was found to be 64.4% sensitive, 86.6%
specific for the detection of G. lamblia. Additionally, this test was
64.2% sensitive and 83.6% specific for the diagnosis of E.
histolytica. Cohen’s kappa values of 0.51 and 0.47 were
determined for microscopy for G. lamblia and E. histolytica
respectively. McNemar’s test revealed a significant difference
between the two tests, P<0.001.
CONCLUSION: This study found microscopy to be a reliable
diagnostic test in this resource limited setting.
