Immunological study of Entamoeba histolytica and association with Entamoeba coli, Shigella, and Rotavirus among diarrheic children

Background: Entamoeba histolytica poses a significant public health challenge across various nations, recognized as one of the primary contributors to diarrhea. Aims: This study profiles IgM and IgE antibodies in patients infected with Entamoeba histolytica, as well as to investigate the association with Escherichia coli, Shigella and Rota virus in diarrheic children. Methods: A study was conducted between 2024 and 2025 at Al-Batool and Baqubah Teaching Hospital. Seventy stool samples were collected from patients diagnosed with diarrheal; E. histolytica was identified through microscopic examination. Cultural methods and chromatographic immunoassay were utilized to investigate the presence of E. coli and Shigella, whereas the ELISA test was employed for the detection of Rotavirus, 70 serum samples were collected from both patients with amoebiasis and healthy control to assess IgM and IgE levels using the prepared kits. Results: Entamoeba histolytica was identified in 40 out of 70 children with diarrhea, representing 57.14% of the cases. Highly significant differences were observed (t = 10.24, p < 0.001) in the levels of both IgM and IgE among patients with amoebiasis, with mean values of 298.33 (SD = 92.02) and 229.80 (SD = 70.17), respectively, when compared to the control group, which had mean values of 102.00 (SD = 58.12) and 44.00 (SD = 13.22).Infections caused by Entamoeba histolytica were observed in 25 males (60.97%) and 15 females (51.72%) . The highest infection rate observed was 16, accounting for 64% within the 2-5 years age group. The bacterial culture and immunochromatography tests indicated the presence of E. coli at 34.28% and Shigella at 17.14%, whereas the ELISA test revealed Rotavirus at 30%. The analysis of the four pathogens revealed that 24 out of 40 cases, 60% exhibited co-infection. The findings indicated a correlation between E. histolytica cases and E. coli, with 10 cases (25%) observed, alongside E. histolytica co-occurring with Rotavirus in 8 cases (20%). Additionally, there were 6 cases (15%) of co-infection involving E. histolytica and shigella among patients. Conclusions: All diarrheic children infected with E. histolytica produced IgM and IgE antibodies, which are involved in the immune response against amoebiasis. It also contributes to a better understanding of the mechanisms that reduce amebic infection. The identification of various intestinal pathogens in mixed infections in this study heightens concerns regarding public health.