DIAGNOSIS OF DIENTAMOEBA FRAGILIS. ETIOPATHOGENIC ROLE IN GASTROINTESTINAL SYMPTOMS IN PAEDIATRIC PATIENTS

Background

Dientamoeba fragilis is a flagellated protozoa with a questioned role in gastrointestinal pathology but it is increasingly related to digestive symptoms with an unknown real prevalence. The use of molecular tests would improve its diagnosis.
Methods

We present a prospective cohort study on D. fragilis in children aged 1-17 years from October 2017 to February 2018 in the Hospital  Germans Trias i Pujol,Badalona, Spain. Stool samples from children with gastrointestinal symptoms (exposed) and without symptoms (not exposed) in whom other etiologies have been excluded were collected. A real-time PCR for D. fragilis (Viasure D.fragilis, Zaragoza, Spain) was performed. Data about diarrhea, abdominal pain, abdominal distension, weight loss, peripheral eosinophilia were recorded and have been analyzed for a plausible statistical association with D. fragilis infection.  

Results

A total of 44 samples were tested for the presence of D. fragilis. Out of the exposed group, 10 were positive (37%) and 17 were negative (63%). In the not exposed group, 5 were positive (29.4%) and 12 negative (70.6%). The relative risk of the exposed compared to the not exposed was 26%. Abdominal pain was the most frequent symptom (7/10) followed by meteorism (6/10). Diarrhea, abdominal distension and peripheral eosinophilia were present in 2 over 10. None of the patients had weight loss.

Conclusions

Detecting DNA of D. fragilis in stool samples using PCR is regarded as the gold standard diagnostic test. Although the small sample size, the results suggests that there is a positive tendency between intestinal symptoms and D. fragilis infection.  Treatments for the eradication of the parasites could be justified for the improvement of the symptoms in children. Further works are required to establish the ethiopathogenic role of D. fragilis in gastrointestinal disorders.