AJTMH Transactions of the Royal Society of Tropical Medicine and Hygiene
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Am. J. Trop. Med. Hyg., 35(6), 1986, pp. 1140-1145
Copyright © 1986 by The American Society of Tropical Medicine and Hygiene

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Protozoal Enteric Infections Among Expatriates in Bangladesh

Peter Speelman AND Inger Ljungström
International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B), GPO Box 128, Dhaka-2, Bangladesh, and National Bacteriological Laboratory, S-105 21 Stockholm, Sweden

In order to study the prevalence, incidence, and symptoms of infections with Giardia lamblia and Entamoeba histolytica, we followed 251 expatriates in Bangladesh over a 1-year period. Microscopic examination of fecal specimens was performed upon enrollment, at 3-month intervals, and during episodes of diarrhea. Specimens were cultured for bacteria and samples of serum and saliva were collected for antibody studies (IgG and SIgA).

The prevalence of G. lamblia infections was 5.2% and the incidence 11.8%. Children aged ≤10 years and newcomers were most frequently infected (P < 0.02). Symptoms were present in 37% of the subjects infected with G. lamblia. A systemic antibody response was observed in 57% of symptomatic patients and 35% of asymptomatic subjects during the first 2 months of infection.

The prevalence and the incidence of E. histolytica infection were 3.2% and 8.6%, respectively. Infections with E. histolytica were correlated with the duration of stay in Bangladesh; <1 year 7% vs. >3 years 26% (P < 0.01). Most expatriates infected with E. histolytica were asymptomatic (90%). Three adult patients, who were resident in Bangladesh for <1 year, were symptomatic but none of them developed dysentery or a serological response. Four of 25 asymptomatic subjects had significant antibody titers. Three of these people were seropositive for ameba at the beginning of the study.

The local immune response, reflected by specific secretory IgA in saliva samples, correlated poorly with both E. histolytica and G. lamblia infections.

Accepted for publication June 11, 1986.






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Copyright © 1986 by the American Society of Tropical Medicine and Hygiene.