A meta-analysis of Entamoeba histolytica/dispar in Iraq Khder Niazi Chalabi* Department of Biology

A meta-analysis of Entamoeba histolytica/dispar in Iraq
Khder Niazi Chalabi*
Department of Biology, College of Education, Salahaddin University-Erbil, Erbil, Iraq
* Corresponding author
E-mail: [email protected] (KC)
Abstract
Background
Amebiasis is a major health problem caused by the protozoan parasite Entamoeba histolytica with a worldwide distribution, especially in developing countries. The aim of this systematic review and meta-analysis was to estimate the proportion prevalence of E. histolytica/dispar in human in Iraq.

Methodology/Principal Findings
Published studies on human infection with E. histolytica/dispar in Iraq were searched in electronic databases using Google scholar, Iraqi Academic Scientific Journals (IASJ), PubMed, ScienceDirect and WHO Global Health Library (GHL). Eligible studies were cross-sectional and used fecal and/or serological methods to diagnose E. histolytica/dispar infection in human in Iraq, and published between 1970 and July 2017. The pooled prevalence was calculated using random effect model meta-analyses with 95% confidence interval (CI). Ninety nine studies were eligible for the meta-analysis that included 117694 individuals. The pooled proportion for E. histolytica/dispar infection in Iraq was estimated at 20.61% with a 95% confidence interval (CI) of 17.83, 23.53. A high level of heterogeneity was found among the studies. The prevalence among Iraqi population ranged between 1.66 and 90.5% per study (mean: 22.36%). The pooled prevalence of infection was 58.43% (95% CI: 54.71%?62.1%) and 43.10% (95% CI: 39.66%?46.6%) for males and females respectively. Parasite screening using microscopy did not differentiate between the pathogenic and nonpathogenic species of Entamoeba resulted in higher proportion prevalence than PCR proportion prevalence, (20.32%, 95% CI: 17.80%?22.96%) (17.57%, 95% CI: 8.07%?29.75%) respectively. Hospital based studies recorded the highest prevalence of E. histolytica/dispar infection at 22.69% (95% CI: 19.55%?25.99%). The prevalence decreased into 18.46 (95% CI: 14.28%–23.04%) between 2010 and 2017.

We Will Write a Custom Essay Specifically
For You For Only $13.90/page!


order now

Conclusions/Significance
Although there was a reduction in prevalence of amebiasis since 2010, the prevalence of amebiasis is still considerable in population of Iraq. Therefore, prevention strategies of fecal contamination are required to reduce the infection.

Author summary
Amebiasis is the infection with Entamoeba histolytica an invasive parasite dwelling the intestine or other organs such as liver, lungs, or skin of human. Infection with this parasite could be acquired by consumption of contaminated water, vegetables, and fruits with feces of infected human. The infection may be asymptomatic or symptomatic causing dysentery. We performed this meta-analysis to estimate the prevalence of amebiasis in the population of Iraq between 1970 and 2017. Ninety nine published studies were identified and the data were extracted from them to use in our meta-analysis and the total included individuals were 117694. The prevalence of population infection in Iraq was evaluated at 20.61%. The infection prevalence was higher in males than in females. The infection prevalence decreased during the period 2010 to 2017 in Iraqi population. This level of infection needs further efforts to eradicate amebiasis, these efforts begin with the prevention of the disease transmission through water and food and treatment of infected people. So awareness of simple hygienic principles can control the disease by boiling water and washing vegetables and fruits thoroughly.
Introduction
Amebiasis is a human infection caused by the intestinal protozoan parasite Entamoeba histolytica, with a cosmopolitan distribution. It is considered as third parasitic cause of human mortality after malaria and schistosomiasis, especially in developing countries with poor sanitations. The infection with amebiasis is estimated to be more than 50 million cases throughout the world and 40,000–110,000 deaths annually ADDIN CSL_CITATION { “citationItems” : { “id” : “ITEM-1”, “itemData” : { “DOI” : “10.1038/srep13613”, “ISBN” : “2045-2322 (Electronic)\r2045-2322 (Linking)”, “ISSN” : “20452322”, “PMID” : “26346926”, “abstract” : “The parasite Entamoeba histolytica kills human cells resulting in ulceration, inflammation and invasion of the colonic epithelium. We used the cytotoxic properties of ameba to select a genome-wide RNAi library to reveal novel host factors that control susceptibility to amebic killing. We identified 281 candidate susceptibility genes and bioinformatics analyses revealed that ion transporters were significantly enriched among susceptibility genes. Potassium (K(+)) channels were the most common transporter identified. Their importance was further supported by colon biopsy of humans with amebiasis that demonstrated suppressed K(+) channel expression. Inhibition of human K(+) channels by genetic silencing, pharmacologic inhibitors and with excess K(+) protected diverse cell types from E. histolytica-induced death. Contact with E. histolytica parasites triggered K(+) channel activation and K(+) efflux by intestinal epithelial cells, which preceded cell killing. Specific inhibition of Ca(2+)-dependent K(+) channels was highly effective in preventing amebic cytotoxicity in intestinal epithelial cells and macrophages. Blockade of K(+) efflux also inhibited caspase-1 activation, IL-1beta secretion and pyroptotic death in THP-1 macrophages. We concluded that K(+) channels are host mediators of amebic cytotoxicity in multiple cells types and of inflammasome activation in macrophages.”, “author” : { “dropping-particle” : “”, “family” : “Marie”, “given” : “Chelsea”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Verkerke”, “given” : “Hans P.”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Theodorescu”, “given” : “Dan”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Petri”, “given” : “William A.”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” } , “container-title” : “Scientific Reports”, “id” : “ITEM-1”, “issue” : “September”, “issued” : { “date-parts” : “2015” }, “page” : “1-18”, “publisher” : “Nature Publishing Group”, “title” : “A whole-genome RNAi screen uncovers a novel role for human potassium channels in cell killing by the parasite <i>Entamoeba histolytica</i>”, “type” : “article-journal”, “volume” : “5” }, “uris” : “http://www.mendeley.com/documents/?uuid=d3b1376c-5453-443e-875e-110f69096d27” }, { “id” : “ITEM-2”, “itemData” : { “DOI” : “10.1016/s0140-6736(03)12830-9”, “PMID” : “12660071”, “author” : { “dropping-particle” : “”, “family” : “Stanley SL Jr”, “given” : “”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” } , “container-title” : “The Lancet”, “id” : “ITEM-2”, “issue” : “9362”, “issued” : { “date-parts” : “2003” }, “page” : “1025 – 1034”, “title” : “Amoebiasis”, “type” : “article-journal”, “volume” : “361” }, “uris” : “http://www.mendeley.com/documents/?uuid=eca1471e-5fd4-4bed-af89-6c85ba3a1723” } , “mendeley” : { “formattedCitation” : “1,2”, “plainTextFormattedCitation” : “1,2”, “previouslyFormattedCitation” : “1,2” }, “properties” : { “noteIndex” : 0 }, “schema” : “https://github.com/citation-style-language/schema/raw/master/csl-citation.json” }1,2. E. histolytica is endemic in most tropical and subtropical countries ADDIN CSL_CITATION { “citationItems” : { “id” : “ITEM-1”, “itemData” : { “author” : { “dropping-particle” : “”, “family” : “Blessmann”, “given” : “J”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Van”, “given” : “L P”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Nu”, “given” : “P A”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Thi”, “given” : “H D”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Muller-Myhsok”, “given” : “B”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Buss”, “given” : “H”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Tannich”, “given” : “E”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” } , “container-title” : “Am J Trop Med Hyg”, “id” : “ITEM-1”, “issue” : “5”, “issued” : { “date-parts” : “2002” }, “page” : “578u2013583”, “title” : “Epidemiology of amebiasis in a region of high incidence of amebic liver abscess in central Vietnam”, “type” : “article-journal”, “volume” : “66” }, “uris” : “http://www.mendeley.com/documents/?uuid=42674af7-4d60-4260-a972-503eafb5d261” } , “mendeley” : { “formattedCitation” : “3”, “plainTextFormattedCitation” : “3”, “previouslyFormattedCitation” : “3” }, “properties” : { “noteIndex” : 0 }, “schema” : “https://github.com/citation-style-language/schema/raw/master/csl-citation.json” }3. Infection with amebiasis can be intestinal and extraintestinal especially in liver; intestinal amebiasis varies widely from asymptomatic infection to dysentery ADDIN CSL_CITATION { “citationItems” : { “id” : “ITEM-1”, “itemData” : { “DOI” : “10.1093/clinids/8.2.228”, “author” : { “dropping-particle” : “”, “family” : “Walsh”, “given” : “Julia A.”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” } , “container-title” : “Reviews of Infectious Diseases”, “id” : “ITEM-1”, “issue” : “2”, “issued” : { “date-parts” : “1986” }, “page” : “228u2013238”, “title” : “Problems in recognition and diagnosis of amebiasis: estimation of the global magnitude of morbidity and mortality”, “type” : “article-journal”, “volume” : “8” }, “uris” : “http://www.mendeley.com/documents/?uuid=4e4aa3aa-99d0-4540-964d-4a5c7ea69143” } , “mendeley” : { “formattedCitation” : “4”, “plainTextFormattedCitation” : “4”, “previouslyFormattedCitation” : “4” }, “properties” : { “noteIndex” : 0 }, “schema” : “https://github.com/citation-style-language/schema/raw/master/csl-citation.json” }4. The common route for infection of the host with amebiasis is by the ingestion of E. histolytica cysts in water or food, which are contaminated with feces ADDIN CSL_CITATION { “citationItems” : { “id” : “ITEM-1”, “itemData” : { “DOI” : “10.1086/600298”, “ISBN” : “1537-6591 (Electronic)\r1058-4838 (Linking)”, “ISSN” : “1058-4838”, “PMID” : “19580413”, “abstract” : “BACKGROUND: Transmission of Entamoeba histolytica generally occurs by fecal excretion of cysts followed by oral ingestion of contaminated food or water. However, fecal-oral transmission may occur within households and long-term care institutions, and sexual transmission occurs among men who have sex with men. Epidemiologically linked clusters of E. histolytica infection are rare in industrialized countries. We report such a sexually linked cluster in Canada. METHODS: An index case involving a young female with an amebic liver abscess led to an epidemiological investigation of sexual contacts. Anti-amebic serological analysis, stool specimen examinations, and abdominal ultrasounds were done for the contacts. Enzyme-linked immunosorbent assay was done for stool antigen specific to E. histolytica. Genotyping and phylogenetic analysis was performed on 1 stool isolate. RESULTS: By tracing sexual contacts related to the index case, we uncovered a cluster of 7 cases of amebiasis (3 with liver abscesses). Oral-anal sex was common in the group; the 5 female individuals were bisexual (4) or homosexual (1). The outbreak strain was genotyped, and cluster analysis indicated that this virulent strain differed substantially from asymptomatic or diarrheal E. histolytica isolates. CONCLUSIONS: E. histolytica can be transmitted by heterosexual activity as well as male and female homosexual activity. Patients with amebiasis should be counselled about possible sexual transmission.”, “author” : { “dropping-particle” : “”, “family” : “Salit”, “given” : “Irving E.”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Khairnar”, “given” : “Krishna”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Gough”, “given” : “Kevin”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Pillai”, “given” : “Dylan R.”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” } , “container-title” : “Clinical Infectious Diseases”, “id” : “ITEM-1”, “issue” : “3”, “issued” : { “date-parts” : “2009” }, “page” : “346-353”, “title” : “A possible cluster of sexually transmitted <i>Entamoeba histolytica</i>: genetic analysis of a highly virulent strain”, “type” : “article-journal”, “volume” : “49” }, “uris” : “http://www.mendeley.com/documents/?uuid=051b4e4d-8ae4-4769-bc85-ee5e7f3434b4” } , “mendeley” : { “formattedCitation” : “5”, “plainTextFormattedCitation” : “5”, “previouslyFormattedCitation” : “5” }, “properties” : { “noteIndex” : 0 }, “schema” : “https://github.com/citation-style-language/schema/raw/master/csl-citation.json” }5. E. histolytica has been reclassified into Entamoeba complex that include pathogenic E. histolytica and two nonpathogenic species (E. dispar and E. moshkovskii), the three species are morphologically indistinguishable ADDIN CSL_CITATION { “citationItems” : { “id” : “ITEM-1”, “itemData” : { “DOI” : “10.1371/journal.pntd.0004225”, “ISSN” : “19352735”, “PMID” : “26633890”, “abstract” : “BACKGROUND Epidemiological studies carried out using culture or microscopy in most of the amoebiasis endemic developing countries, yielded confusing results since none of these could differentiate the pathogenic Entamoeba histolytica from the non-pathogenic Entamoeba dispar and Entamoeba moshkovskii. The Northeastern part of India is a hot spot of infection since the climatic conditions are most conducive for the infection and so far no systemic study has been carried out in this region. METHODOLOGY/PRINCIPAL FINDINGS Following a cross-sectional study designed during the period 2011-2014, a total of 1260 fecal samples collected from the Northeast Indian population were subjected to microscopy, fecal culture and a sensitive and specific DNA dot blot screening assay developed in our laboratory targeting the Entamoeba spp. Further species discrimination using PCR assay performed in microscopy, culture and DNA dot blot screening positive samples showed E. histolytica an overall prevalence rate of 11.1%, 8.0% and 13.7% respectively. In addition, infection rates of nonpathogenic E. dispar and E. moshkovskii were 11.8% (95% CI = 10.2, 13.8) and 7.8% (95% CI = 6.4, 9.4) respectively. The spatial distributions of infection were 18.2% (107/588) of Assam, 11.7% (23/197) of Manipur, 10.2% (21/207) of Meghalaya, and 8.2% (22/268) of Tripura states. Association study of the disease with demographic features suggested poor living condition (OR = 3.21; 95% CI = 1.83, 5.63), previous history of infection in family member (OR = 3.18; 95% CI = 2.09, 4.82) and unhygienic toilet facility (OR = 1.79; 95% CI = 1.28, 2.49) as significant risk factors for amoebiasis. Children in age group <15 yr, participants having lower levels of education, and daily laborers exhibited a higher infection rate. CONCLUSIONS/SIGNIFICANCE Despite the importance of molecular diagnosis of amoebiasis, molecular epidemiological data based on a large sample size from endemic countries are rarely reported in the literature. Improved and faster method of diagnosis employed here to dissect out the pathogenic from the nonpathogenic species would help the clinicians to prescribe the appropriate anti-amoebic drug.”, “author” : { “dropping-particle” : “”, “family” : “Nath”, “given” : “Joyobrato”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Ghosh”, “given” : “Sankar Kumar”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Singha”, “given” : “Baby”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Paul”, “given” : “Jaishree”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” } , “container-title” : “PLoS Neglected Tropical Diseases”, “id” : “ITEM-1”, “issue” : “12”, “issued” : { “date-parts” : “2015” }, “page” : “1-19”, “title” : “Molecular epidemiology of amoebiasis: a cross-sectional study among North East Indian population”, “type” : “article-journal”, “volume” : “9” }, “uris” : “http://www.mendeley.com/documents/?uuid=757ea281-bab4-47ce-bade-cfd1fcc469e0” } , “mendeley” : { “formattedCitation” : “6”, “plainTextFormattedCitation” : “6”, “previouslyFormattedCitation” : “6” }, “properties” : { “noteIndex” : 0 }, “schema” : “https://github.com/citation-style-language/schema/raw/master/csl-citation.json” }6.

To our knowledge, there is no study which has determined the overall prevalence of E. histolytica infection of human in Iraq. Therefore, the objectives of this study were to determine the prevalence of E. histolytica infection and related data (age, sex and study setting) of humans in Iraq, by using meta-analytical methods. The data of the current study can be used to eliminate or reduce the human infection with amebiasis in Iraq through providing more targeted programs for prevention and control.
Methods
The study was conducted based on the PRISMA guideline (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) ADDIN CSL_CITATION { “citationItems” : { “id” : “ITEM-1”, “itemData” : { “DOI” : “10.1371/journal.pmed.1000097”, “ISBN” : “0031-9023”, “ISSN” : “15491277”, “PMID” : “19621072”, “abstract” : “Systematic reviews provide clinical practice recommendations that are based on evaluation of primary evidence. When systematic reviews with the same aims have different conclusions, it is difficult to ascertain which review reported the most credible and robust findings. This study examined five systematic reviews that have investigated the effectiveness of Pilates exercise in people with chronic low back pain. A four-stage process was used to interpret findings of the reviews. This process included comparison of research questions, included primary studies, and the level and quality of evidence of systematic reviews. Two independent reviewers assessed the level of evidence and the methodological quality of systematic reviews, using the National Health and Medical Research Council hierarchy of evidence, and the Revised Assessment of Multiple Systematic Reviews respectively. Any disagreements were resolved by a third researcher. A high level of consensus was achieved between the reviewers. Conflicting findings were reported by the five systematic reviews regarding the effectiveness of Pilates in reducing pain and disability in people with chronic low back pain. Authors of the systematic reviews included primary studies that did not match their questions in relation to treatment or population characteristics. A total of ten primary studies were identified across five systematic reviews. Only two of the primary studies were included in all of the reviews due to different inclusion criteria relating to publication date and status, definition of Pilates, and methodological quality. The level of evidence of reviews was low due to the methodological design of the primary studies. The methodological quality of reviews varied. Those which conducted a meta-analysis obtained higher scores. There is inconclusive evidence that Pilates is effective in reducing pain and disability in people with chronic low back pain. This is due to the small number and poor methodological quality of primary studies. The Revised Assessment of Multiple Systematic Reviews provides a useful method of appraising the methodological quality of systematic reviews. Individual item scores, however, should be examined in addition to total scores, so that significant methodological flaws of systematic reviews are not missed, and results are interpreted appropriately. (348 words)”, “author” : { “dropping-particle” : “”, “family” : “Moher”, “given” : “David”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Liberati”, “given” : “Alessandro”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Tetzlaff”, “given” : “Jennifer”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Altman”, “given” : “Douglas G.”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Altman”, “given” : “Doug”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Antes”, “given” : “Gerd”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Atkins”, “given” : “David”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Barbour”, “given” : “Virginia”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Barrowman”, “given” : “Nick”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Berlin”, “given” : “Jesse A.”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Clark”, “given” : “Jocalyn”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Clarke”, “given” : “Mike”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Cook”, “given” : “Deborah”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “D’Amico”, “given” : “Roberto”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Deeks”, “given” : “Jonathan J.”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Devereaux”, “given” : “P. J.”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Dickersin”, “given” : “Kay”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Egger”, “given” : “Matthias”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Ernst”, “given” : “Edzard”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Gu00f8tzsche”, “given” : “Peter C.”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Grimshaw”, “given” : “Jeremy”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Guyatt”, “given” : “Gordon”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Higgins”, “given” : “Julian”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Ioannidis”, “given” : “John P.A.”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Kleijnen”, “given” : “Jos”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Lang”, “given” : “Tom”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Magrini”, “given” : “Nicola”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “McNamee”, “given” : “David”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Moja”, “given” : “Lorenzo”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Mulrow”, “given” : “Cynthia”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Napoli”, “given” : “Maryann”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Oxman”, “given” : “Andy”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Pham”, “given” : “Bu00e1”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Rennie”, “given” : “Drummond”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Sampson”, “given” : “Margaret”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Schulz”, “given” : “Kenneth F.”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Shekelle”, “given” : “Paul G.”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Tovey”, “given” : “David”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Tugwell”, “given” : “Peter”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” } , “container-title” : “PLoS Medicine”, “id” : “ITEM-1”, “issue” : “7”, “issued” : { “date-parts” : “2009” }, “title” : “Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement”, “type” : “article-journal”, “volume” : “6” }, “uris” : “http://www.mendeley.com/documents/?uuid=dc982df6-ef35-45f8-b941-d392740bb7fa” } , “mendeley” : { “formattedCitation” : “7”, “plainTextFormattedCitation” : “7”, “previouslyFormattedCitation” : “7” }, “properties” : { “noteIndex” : 0 }, “schema” : “https://github.com/citation-style-language/schema/raw/master/csl-citation.json” }7. The PRISMA checklist was used to ensure inclusion of relevant information in the analysis (S1 Checklist).

Search strategy
The literature search was conducted in the following electronic databases: Google scholar, Iraqi Academic Scientific Journals (IASJ), PubMed, ScienceDirect and WHO Global Health Library (GHL). The electronic search was limited to studies published in English or Arabic between 1970 and July 2017.
For searching, Boolean operators OR and/or AND were used for combination of terms. The following terms were used in the electronic database search: “amebiasis”, “amoebiasis”, “Entamoeba histolytica”, “Entamoeba dispar”, “Iraq”, “human”, “prevalence” and “Infection”.

Study selection
The process of study selection was performed by identifying relevant publications about human amebiasis in Iraq. The selection of articles was based on their titles and then their abstracts, which were relevant to the outcomes of interest. The search results were imported into Mendeley, for management of articles, to exclude duplicate publications. Then articles were screened, they were excluded if did not meet the eligibility criteria. A study was eligible if it fulfilled the following eligibility criteria: (i) full text and published in English or Arabic; (ii) cross-sectional; (iii) carried out on humans; (iv) conducted in Iraq; (v) used coprological and/or serological methods for diagnosis; (vi) sample size ? 35; (vii) clarity of results. If more than one study presented the same data, the study with data that are more complete were included.

Data extraction
From each study included, the following data were extracted: the first author, year of publication, year of study, province, method of detection, sample size, positive samples, prevalence, sex, age group and study setting.
If the data values were not clearly mentioned in the text, the information was extracted from available data tables.
Data analysis
Proportion meta-analyses had been conducted for data analysis. For each study, the proportions of the prevalence of amebiasis were calculated, and then the pooled proportions were derived with 95% confidence intervals (CIs). Freeman-Tukey transformation (arcsine square root transformation) was used for calculation of the weighted summary proportion for the random effects model (DerSimonian and Laird).

If a study did not record the year of data collection, the year of publication was used as the year of data collection. If detailed data were available, we stratified the prevalence of amebiasis by sex (male and female), by method of detection (Microscopy and PCR), by setting (hospital, hospital/primary schools pupils, primary school pupils, foodhandlers, village and nursery schools/children from some houses), by Year of study (less than 1990, 1990-1999, 2000-2009 and 2010-2018) and by province (Al-Anbar, Al-Najaf, Babylon, Baghdad, Basrah, Diwaniya, Diyala, Duhok, Erbil, Karbala, Kirkuk, Ninevah, Saladin, Sulaimani, Thi-Qar and Wasit).

Data analysis was performed using MedCalc Statistical Software (version 17.9.2) (MedCalc Software bvba, Ostend, Belgium; http://www.medcalc.org; 2017) and Microsoft Office Excel 2013.

Forest plot was generated to display the results of each study and the heterogeneity among studies. Heterogeneity between studies was assessed by the Cochran’s Q test and inverse variance index (I2). The I2 index indicates that the variation between studies that is due to heterogeneity rather than chance. I2 values greater than 75% were considered as high heterogeneity ADDIN CSL_CITATION { “citationItems” : { “id” : “ITEM-1”, “itemData” : { “DOI” : “10.1136/bmj.327.7414.557”, “ISBN” : “1468-5833 (Electronic)\r0959-535X (Linking)”, “ISSN” : “1756-1833”, “PMID” : “12958120”, “abstract” : “Cochrane Reviews have recently started including the quantity I 2 to help readers assess the consistency of the results of studies in meta-analyses. What does this new quantity mean, and why is assessment of heterogeneity so important to clinical practice?”, “author” : { “dropping-particle” : “”, “family” : “Higgins”, “given” : “Julian P T”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Thompson”, “given” : “Simon G”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Deeks”, “given” : “Jonathan J”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Altman”, “given” : “Douglas G”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” } , “container-title” : “BMJ: British Medical Journal”, “id” : “ITEM-1”, “issue” : “7414”, “issued” : { “date-parts” : “2003” }, “page” : “557-560”, “title” : “Measuring inconsistency in meta-analyses”, “type” : “article-journal”, “volume” : “327” }, “uris” : “http://www.mendeley.com/documents/?uuid=d1d1de88-5704-4263-9189-a63d4a403d86” } , “mendeley” : { “formattedCitation” : “8”, “plainTextFormattedCitation” : “8”, “previouslyFormattedCitation” : “8” }, “properties” : { “noteIndex” : 0 }, “schema” : “https://github.com/citation-style-language/schema/raw/master/csl-citation.json” }8. A funnel plot was used to visually investigate the across study bias.

Results
Study selection
A total of 164 studies were found of which 16 were duplicates and were excluded, resulting in 148 records (Fig 1). After screening the title and abstract of 148 records, 17 records were excluded because the abstracts and the full-texts of eight and nine studies were not accessible, respectively. Out of 131 full-text reports were assessed for eligibility, 32 were excluded because: 2 studies did not use coprological and/or serological methods for diagnosis of amebiasis; 2 studies had the same data by the same author; 4 studies were not epidemiological; 2 studies presented the data of infection with amebiasis as a combined infection with other parasite; 19 studies did not provide data of prevalence; 2 studies were conducted on the samples of fingernails; 1 study was carried out on infectious agents in stool samples of children with nosocomial diarrhea. Finally, 99 entries were included in the meta-analysis ADDIN CSL_CITATION { “citationItems” : { “id” : “ITEM-1”, “itemData” : { “author” : { “dropping-particle” : “”, “family” : “Al-Sorchee”, “given” : “Sawsan M Abdullah”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Rabat”, “given” : “Abbas A”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Juma”, “given” : “Intisar M”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” } , “container-title” : “Journal of Al-Nahrain University”, “id” : “ITEM-1”, “issue” : “3”, “issued” : { “date-parts” : “2013” }, “page” : “19-29”, “title” : “Microbial causatives of diarrhea in children in Erbil city”, “type” : “article-journal”, “volume” : “16” }, “uris” : “http://www.mendeley.com/documents/?uuid=aa4bd3fd-9653-43af-9cd6-26ab207a5452” }, { “id” : “ITEM-2”, “itemData” : { “author” : { “dropping-particle” : “”, “family” : “Al-Mosawi”, “given” : “Rabab”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” } , “container-title” : “International Journal of Sciences: Basic and Applied Research (IJSBAR)”, “id” : “ITEM-2”, “issue” : “1”, “issued” : { “date-parts” : “2016” }, “page” : “180-185”, “title” : “Detection of intestinal parasitic among people infection with diarrhea in Al-Fhood district in Thi-Qar province, Iraq”, “type” : “article-journal”, “volume” : “28” }, “uris” : “http://www.mendeley.com/documents/?uuid=549cc731-613a-4060-8578-4633773a4bfe” }, { “id” : “ITEM-3”, “itemData” : { “author” : { “dropping-particle” : “”, “family” : “Amin”, “given” : “Hersh Ahmad”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Ali”, “given” : “Shahnaz Abdulkader”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” } , “container-title” : “International Journal of Current Microbiology and Applied Sciences”, “id” : “ITEM-3”, “issue” : “5”, “issued” : { “date-parts” : “2015” }, “page” : “991-996”, “title” : “Evaluation of different techniques of stool examination for intestinal parasitic infections in Sulaimani city – Iraq”, “type” : “article-journal”, “volume” : “4” }, “uris” : “http://www.mendeley.com/documents/?uuid=513a6e28-2621-48eb-9f2e-c14bfacd1f87” }, { “id” : “ITEM-4”, “itemData” : { “author” : { “dropping-particle” : “”, “family” : “Salman”, “given” : “Yahya Jirjees”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Salih”, “given” : “Luqman Ali”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” } , “container-title” : “Journal of Kirkuk medical college”, “id” : “ITEM-4”, “issue” : “1”, “issued” : { “date-parts” : “2013” }, “page” : “53-61”, “title” : “Detection of some microbial infectious agents among children aging below two years in Kirkuk city”, “type” : “article-journal”, “volume” : “1” }, “uris” : “http://www.mendeley.com/documents/?uuid=1958ec39-8e4e-4b34-9d02-d2515dd75a8c” }, { “id” : “ITEM-5”, “itemData” : { “ISSN” : “1450202X”, “author” : { “dropping-particle” : “”, “family” : “Al-Kaissi”, “given” : “E. N.”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Makki”, “given” : “M.”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Al-Khoja”, “given” : “M.”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” } , “container-title” : “European Journal of Scientific Research”, “id” : “ITEM-5”, “issue” : “3”, “issued” : { “date-parts” : “2006” }, “page” : “359-371”, “title” : “Aetiology and epidemiology of sever infantile diarrhoea in Baghdad, Iraq”, “type” : “article-journal”, “volume” : “14” }, “uris” : “http://www.mendeley.com/documents/?uuid=5ef2b69d-ad81-4cc8-ab43-0fa4f9dd0e48” }, { “id” : “ITEM-6”, “itemData” : { “abstract” : “This study was carried out in Al Haweeja General Hospital/Kirkuk, Iraq from June2013to February2014. A total of 207 Patients of both sexes from all ages were eligible for this study. The chosen patients had single infection either with Entamoeba histolytica or Giardia lamblia.Entamoeba histolytica was diagnosedin 84 (40.5%) stool samples from the total number examined. No significant differences was appeared between males (43.8%) and females (37%) infected with E. histolytica. Age group 1-10 years had significantly higher rate of infection (60%) followed by 11-20 years with rate of 34%. The lower rate was for 41-50 (16%). High rates of the E. histolytica positive samples contained trophozoite and cyst(47.6%), followed by cystic stage (27%), while trophozoite stage was found in 25% of samples.G. lamblia prevalence was significantly lower compared with E. histolytica. It was diagnosed in 15 (7.2%) stool samples of 207 samples examined. No significant differences were recorded between the females (8%) and the males (6%). Also no significant differences appeared between the different age groups. G. lamblia was more prevalent as trophozoite (46.6%), trophozoite and cystic (40%) than cystic stage alone (13.3%). The samples containing trophozoite and cystic stages of E. histolytica had the most apparent significant effect on all hematological parameters , and the highest rate of abnormality was seen in HB levels, followed by these samples having E. histolytica cyst alone , also significantly high rate of abnormality was for PCV levels. The lowest rate was for samples containing G. lamblia stages. Eosinophil showed significantly high rate with G. lamblia trophozoite compared with the control. Lymphocyte showed significantly high rate with E.histolytica (trophozoite+cyst) compared with the control. No significant differences were noted with the other types of WBCs (neutrophil, monocyte, basophil) inall cases of infections compared with the control.”, “author” : { “dropping-particle” : “”, “family” : “Obaid”, “given” : “Hiro Mohammad”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” } , “container-title” : “Journal of Natural Sciences Research”, “id” : “ITEM-6”, “issue” : “12”, “issued” : { “date-parts” : “2014” }, “page” : “44-48”, “title” : “The effect of Entamoeba histolytica and ;i;Giardia lamblia;/i; infection on some human hematological parameters”, “type” : “article-journal”, “volume” : “4” }, “uris” : “http://www.mendeley.com/documents/?uuid=3f07913e-9371-42b6-badd-fe653aa6f9f0” }, { “id” : “ITEM-7”, “itemData” : { “author” : { “dropping-particle” : “”, “family” : “Jarallah”, “given” : “Hind Mahdi”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” } , “container-title” : “Journal of Basrah Researches ((Sciences))”, “id” : “ITEM-7”, “issue” : “2”, “issued” : { “date-parts” : “2012” }, “page” : “40-43”, “title” : “Intestinal parasitic infections among rural villages in Basrah marshes regions”, “type” : “article-journal”, “volume” : “38” }, “uris” : “http://www.mendeley.com/documents/?uuid=e485d2fb-0b0f-48f7-b28c-90ba6ac87bfc” }, { “id” : “ITEM-8”, “itemData” : { “ISBN” : “0127-5720 (Print)\r0127-5720 (Linking)”, “ISSN” : “0127-5720 (Print)”, “PMID” : “25382477”, “abstract” : “Parasitic diarrhea among children is a significant health problem worldwide. This cross sectional study described the burden of parasitic diarrhea among children. The objectives of this study were to evaluate the impact of risk factors on the parasitic diarrhea, and to determine the parasitic profile among children in Baghdad-Iraq, during the period extending from September 2003 to June 2004. A total number of 2033 cases were included in the study. The estimated prevalence rate of parasitic diarrhea was 22%. We identified the following major diarrhea determinants were large households size, residential location, water source, low socioeconomic status, and low parent education. Giardia lamblia was found to be the most prevalent parasite with an infection rate of 45.54% followed by Entamoeba histolytica 23.44%, Enterobius vermicularis 12.7%, Hymenolepis nana 9.82%, Trichuris trichiura 5.4%, and Ascaris lumbricoides 2.2%. In conclusion, this study demonstrates that poor sanitation, inadequate environmental conditions, and low socioeconomic status are the main determining factors that predispose children to parasitic diarrhea. Mass deworming programs are recommended for school children, as this population is easily accessible.”, “author” : { “dropping-particle” : “”, “family” : “Al-Kubaisy”, “given” : “Waqar”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Al-Talib”, “given” : “Hassanain”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Al-Khateeb”, “given” : “Alyaa”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Shanshal”, “given” : “Mohammad Mazin”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” } , “container-title” : “Tropical Biomedicine”, “id” : “ITEM-8”, “issue” : “3”, “issued” : { “date-parts” : “2014” }, “page” : “499-506”, “title” : “Intestinal parasitic diarrhea among children in Baghdad – Iraq”, “type” : “article-journal”, “volume” : “31” }, “uris” : “http://www.mendeley.com/documents/?uuid=bae6b318-d8f4-41bf-8de8-aecd1d965ea0” }, { “id” : “ITEM-9”, “itemData” : { “DOI” : “http://dx.doi.org/10.18203/2320-6012.ijrms20151174”, “author” : { “dropping-particle” : “”, “family” : “Mero”, “given” : “Wijdan M S”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Jameel”, “given” : “Ahmed Y”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Amidy”, “given” : “Kaveen S Kh”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” } , “container-title” : “International Journal of Research in Medical Sciences”, “id” : “ITEM-9”, “issue” : “11”, “issued” : { “date-parts” : “2015” }, “page” : “3266-3273”, “title” : “Microorganisms and viruses causing diarrhea in infants and primary school children and their relation with age and sex in Zakho city, Kurdistan Region, Iraq”, “type” : “article-journal”, “volume” : “3” }, “uris” : “http://www.mendeley.com/documents/?uuid=926508c3-ed92-4e5e-b248-09ffe352adbf” }, { “id” : “ITEM-10”, “itemData” : { “author” : { “dropping-particle” : “”, “family” : “Al-Azawi”, “given” : “Athmar K Abass”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” } , “container-title” : “Iraqi Journal of Veterinary Medicine”, “id” : “ITEM-10”, “issue” : “1”, “issued” : { “date-parts” : “2009” }, “page” : “155-160”, “title” : “Incidence of entamoebiasis among children in Abu-Ghraib area Baghdad”, “type” : “article-journal”, “volume” : “33” }, “uris” : “http://www.mendeley.com/documents/?uuid=44b3a775-ae7e-4d5e-99fd-c4463f27c25b” }, { “id” : “ITEM-11”, “itemData” : { “author” : { “dropping-particle” : “”, “family” : “Saeed”, “given” : “Bushra H.”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Gazal”, “given” : “Farah M.”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Nori”, “given” : “Hanan S.”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” } , “container-title” : “Rafidain Journal of Science”, “id” : “ITEM-11”, “issue” : “7”, “issued” : { “date-parts” : “2005” }, “page” : “191-206”, “title” : “Epidemiological study of diarrhoea in Al-Rashedia village in Ninava in Iraq”, “type” : “article-journal”, “volume” : “16” }, “uris” : “http://www.mendeley.com/documents/?uuid=f93b881d-a3cf-4a63-bceb-420cea8b57fd” }, { “id” : “ITEM-12”, “itemData” : { “author” : { “dropping-particle” : “”, “family” : “Abdullah”, “given” : “Ibraheem A.”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Al-Shirifi”, “given” : “Hider M.”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” } , “container-title” : “Rafidain Journal of Science”, “id” : “ITEM-12”, “issue” : “8”, “issued” : { “date-parts” : “2005” }, “page” : “83-89”, “title” : “The role of housing type and drinking water in prevalence of intestinal parasites among pupils of a number of primary schools in rural area of Al-Taamem Province-Iraq”, “type” : “article-journal”, “volume” : “16” }, “uris” : “http://www.mendeley.com/documents/?uuid=d11c85b1-059a-4738-9779-449ed821a242” }, { “id” : “ITEM-13”, “itemData” : { “author” : { “dropping-particle” : “”, “family” : “Abdullah”, “given” : “Ibraheem A.”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Al-Shirifi”, “given” : “Hider M.”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” } , “container-title” : “Rafidain Journal of Science”, “id” : “ITEM-13”, “issue” : “7”, “issued” : { “date-parts” : “2005” }, “page” : “13-21”, “title” : “Prevalence of intestinal parasites amongest foodhandlers in Kirkuk city, Al-Taamu2019em province, Iraq”, “type” : “article-journal”, “volume” : “16” }, “uris” : “http://www.mendeley.com/documents/?uuid=7cb50e0f-6719-43ac-b545-4128a693ef37” }, { “id” : “ITEM-14”, “itemData” : { “author” : { “dropping-particle” : “”, “family” : “Al-Taie”, “given” : “Hydar Hamza Ibraheem”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Al-Mosa”, “given” : “Ahmed Hadi A.”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” } , “container-title” : “Al-Taqani”, “id” : “ITEM-14”, “issue” : “1”, “issued” : { “date-parts” : “2006” }, “page” : “134-141”, “title” : “Prevalence rate of intestinal parasite associated with diarrhea”, “type” : “article-journal”, “volume” : “19” }, “uris” : “http://www.mendeley.com/documents/?uuid=5ac9e093-5820-4bdb-b02a-66983227ed03” }, { “id” : “ITEM-15”, “itemData” : { “author” : { “dropping-particle” : “”, “family” : “Al-Tikrity”, “given” : “Ilham Ayed Asaad”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Al-Jubory”, “given” : “Abdul-khaliq Alwan”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Al-Tikrity”, “given” : “Ali Hussain Altaif”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” } , “container-title” : “Tikrit Journal of Pure Science”, “id” : “ITEM-15”, “issue” : “2”, “issued” : { “date-parts” : “2009” }, “page” : “189-196”, “title” : “Prevalence of ;i;Entamoeba histolytica;/i; in Baiji province and the effect of ;i;Punica granatum;/i; rind extract on the parasite in culture”, “type” : “article-journal”, “volume” : “14” }, “uris” : “http://www.mendeley.com/documents/?uuid=8b8f0bdc-0e42-4edc-a815-8970b699c12e” }, { “id” : “ITEM-16”, “itemData” : { “author” : { “dropping-particle” : “”, “family” : “Al-Warid”, “given” : “Harith Sa’eed”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” } , “container-title” : “Journal of Al-Nahrain University”, “id” : “ITEM-16”, “issue” : “2”, “issued” : { “date-parts” : “2012” }, “page” : “121-125”, “title” : “Some factors influencing the prevalence of <i>Giardia lamblia</i> and <i>Entamoeba histolytica</i> in a sample of patients in north of Baghdad”, “type” : “article-journal”, “volume” : “15” }, “uris” : “http://www.mendeley.com/documents/?uuid=499b9285-622a-476a-8b3d-04f0a68d5b05” }, { “id” : “ITEM-17”, “itemData” : { “author” : { “dropping-particle” : “”, “family” : “Jaeffer”, “given” : “Harith Saeed”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” } , “container-title” : “Journal of University of Anbar for Pure Science”, “id” : “ITEM-17”, “issue” : “2”, “issued” : { “date-parts” : “2011” }, “page” : “6-10”, “title” : “Prevalence of <i>Giardia lamblia</i> and <i>Entamoeba histolytica/Entamoeba dispar</i> infections among Children in Al-Shulaa and Al-Khadimya-Baghdad-Iraq”, “type” : “article-journal”, “volume” : “5” }, “uris” : “http://www.mendeley.com/documents/?uuid=abcfd105-38de-42cf-a466-08dbd2f3441d” }, { “id” : “ITEM-18”, “itemData” : { “author” : { “dropping-particle” : “”, “family” : “Saael”, “given” : “Yhia Karem”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” } , “container-title” : “Al-Taqani”, “id” : “ITEM-18”, “issue” : “2”, “issued” : { “date-parts” : “2009” }, “page” : “A32-A37”, “title” : “Prevalence of intestinal parasites in children in Baghdad city”, “type” : “article-journal”, “volume” : “22” }, “uris” : “http://www.mendeley.com/documents/?uuid=e036538d-1634-40da-8244-4d7965dc6e98” }, { “id” : “ITEM-19”, “itemData” : { “author” : { “dropping-particle” : “”, “family” : “Al-Kaisi”, “given” : “Aroub Abdul Rahman”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” } , “container-title” : “The Iraqi Postgraduate Medical Journal”, “id” : “ITEM-19”, “issue” : “1”, “issued” : { “date-parts” : “2007” }, “page” : “80-83”, “title” : “Intestinal parasitosis in Samarrau2019a city”, “type” : “article-journal”, “volume” : “6” }, “uris” : “http://www.mendeley.com/documents/?uuid=b9d68af3-e30d-47a0-9379-9e0854280ebc” }, { “id” : “ITEM-20”, “itemData” : { “author” : { “dropping-particle” : “”, “family” : “Ftohe”, “given” : “Zohair I.”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Al-Zako”, “given” : “Sagida S.”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Mahfoth”, “given” : “Najwa”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” } , “container-title” : “Rafidain Journal of Science”, “id” : “ITEM-20”, “issue” : “2”, “issued” : { “date-parts” : “2008” }, “page” : “37-50”, “title” : “Study on intestinal parasites as a causative of diarrhea and some effectors on them in children of Neinavah governorate”, “type” : “article-journal”, “volume” : “19” }, “uris” : “http://www.mendeley.com/documents/?uuid=493df594-ab1a-42bb-9d33-27df47ca0546” }, { “id” : “ITEM-21”, “itemData” : { “author” : { “dropping-particle” : “”, “family” : “Al-Marzoqi”, “given” : “Ali Hussain M.”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Kadhim”, “given” : “Raad A.”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” } , “container-title” : “Medical Journal of Babylon”, “id” : “ITEM-21”, “issue” : “3-4”, “issued” : { “date-parts” : “2008” }, “page” : “501-506”, “title” : “Parasitic etiology of newborn gastroenteritis in Babylon governorate”, “type” : “article-journal”, “volume” : “5” }, “uris” : “http://www.mendeley.com/documents/?uuid=1fb2c5b4-6101-4765-9ed2-2437bb8cf6fe” }, { “id” : “ITEM-22”, “itemData” : { “author” : { “dropping-particle” : “”, “family” : “Nayyef”, “given” : “Hanan J.”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Majeed”, “given” : “Laheeb J.”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Abdul Al-Wahab”, “given” : “Eftkhar”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” } , “container-title” : “Journal of Al-Nahrain University – Science”, “id” : “ITEM-22”, “issue” : “3”, “issued” : { “date-parts” : “2011” }, “page” : “57-63”, “title” : “A study of epidemiology of intestinal protozoa in human in Baghdad city”, “type” : “article-journal”, “volume” : “14” }, “uris” : “http://www.mendeley.com/documents/?uuid=1391ae13-6c28-4ab6-b1c7-0b204778b26b” }, { “id” : “ITEM-23”, “itemData” : { “author” : { “dropping-particle” : “”, “family” : “Al-Dulaimi”, “given” : “Fadel Hassan Aloan”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” } , “container-title” : “Scientific Journal of Karbala University”, “id” : “ITEM-23”, “issue” : “4”, “issued” : { “date-parts” : “2007” }, “page” : “566-570”, “title” : “Prevalence of infection with intestinal parasites in outpatients of two hospitals in Babylon province”, “type” : “article-journal”, “volume” : “5” }, “uris” : “http://www.mendeley.com/documents/?uuid=3244e6e3-3694-4349-a3b2-984008644925” }, { “id” : “ITEM-24”, “itemData” : { “author” : { “dropping-particle” : “”, “family” : “Al-Mosa”, “given” : “Ahmed Hadi A.”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Al-Taie”, “given” : “Hydar Hamza Ibraheem”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” } , “container-title” : “Al-Taqani”, “id” : “ITEM-24”, “issue” : “1”, “issued” : { “date-parts” : “2007” }, “page” : “1-7”, “title” : “Effect of infection with intestinal parasites on blood picture”, “type” : “article-journal”, “volume” : “20” }, “uris” : “http://www.mendeley.com/documents/?uuid=79e65879-b217-4cd1-9b70-5340adf4c25b” }, { “id” : “ITEM-25”, “itemData” : { “author” : { “dropping-particle” : “”, “family” : “Al-Jabouri”, “given” : “Damiaa Ibrahim Alwan”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” } , “container-title” : “Scientific Journal of Karbala University”, “id” : “ITEM-25”, “issue” : “4”, “issued” : { “date-parts” : “2007” }, “page” : “80-86”, “title” : “Survey of intestinal parasites in some health centers in Karbala city”, “type” : “article-journal”, “volume” : “5” }, “uris” : “http://www.mendeley.com/documents/?uuid=22300b08-0747-4fd7-a928-996985bca85a” }, { “id” : “ITEM-26”, “itemData” : { “author” : { “dropping-particle” : “”, “family” : “Jasim”, “given” : “Thamer Mutleg”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Al-Mugdadi”, “given” : “Suhad Faisal Hatem”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” } , “container-title” : “Iraqi Journal of Community Medicine”, “id” : “ITEM-26”, “issue” : “1”, “issued” : { “date-parts” : “2011” }, “page” : “17-19”, “title” : “The incidence of <i>Entamoeba histolytica</i> & <i>Giardia lamblia</i> associated with diarrhea among children in lbn Al-Balady hospital in Baghdad”, “type” : “article-journal”, “volume” : “24” }, “uris” : “http://www.mendeley.com/documents/?uuid=84315e17-12b8-4c95-8f98-2406d6f63b05” }, { “id” : “ITEM-27”, “itemData” : { “author” : { “dropping-particle” : “”, “family” : “Ibrahim”, “given” : “Basim M”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” } , “container-title” : “Journal of the Faculty of Medicine”, “id” : “ITEM-27”, “issue” : “3”, “issued” : { “date-parts” : “2012” }, “page” : “218-222”, “title” : “Isolation of some microbial agents that cause acute gastroenteritis in children”, “type” : “article-journal”, “volume” : “54” }, “uris” : “http://www.mendeley.com/documents/?uuid=ac445816-bac6-4527-8241-6e3fac54bc5f” }, { “id” : “ITEM-28”, “itemData” : { “author” : { “dropping-particle” : “”, “family” : “Al-Kubaisy”, “given” : “Ali Husain Makky”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Ramadan”, “given” : “Mohammed”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Abdalsajad”, “given” : “Qaiser”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Mahdi”, “given” : “Alaa Hussein”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Abdulmajeed”, “given” : “Muhammad Naufal”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Alrushdi”, “given” : “Ahmad Ali Kadim”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” } , “container-title” : “Scientific Journal of Karbala University”, “id” : “ITEM-28”, “issue” : “4”, “issued” : { “date-parts” : “2007” }, “page” : “6-10”, “title” : “Survey of intestinal parasites which causing the diarrhea in Al-Heindia/Kerbala”, “type” : “article-journal”, “volume” : “5” }, “uris” : “http://www.mendeley.com/documents/?uuid=4a157836-3209-476a-8c57-b71f4e0a49ad” }, { “id” : “ITEM-29”, “itemData” : { “author” : { “dropping-particle” : “”, “family” : “Kadum”, “given” : “Samah Ahmed”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” } , “container-title” : “Scientific Journal of Karbala University”, “id” : “ITEM-29”, “issue” : “1”, “issued” : { “date-parts” : “2007” }, “page” : “37-44”, “title” : “Contamination role in the prevalence of intestinal parasites among the people of Al-Kufel town in Babylon province”, “type” : “article-journal”, “volume” : “5” }, “uris” : “http://www.mendeley.com/documents/?uuid=03d085b6-045b-451e-8281-0fc6ee46805d” }, { “id” : “ITEM-30”, “itemData” : { “author” : { “dropping-particle” : “”, “family” : “Hamad”, “given” : “Narmin Rafiq”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Ahmed”, “given” : “Rezan Kamal”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” } , “container-title” : “Journal of Education and Science”, “id” : “ITEM-30”, “issue” : “4”, “issued” : { “date-parts” : “2011” }, “page” : “79-86”, “title” : “Intestinal parasites among patients attending general central public health laboratory in Erbil city-Iraq during 1998-2004”, “type” : “article-journal”, “volume” : “24” }, “uris” : “http://www.mendeley.com/documents/?uuid=38177d84-4b96-4872-bd0f-a24cd5249121” }, { “id” : “ITEM-31”, “itemData” : { “author” : { “dropping-particle” : “”, “family” : “Al-Shaheen”, “given” : “Zuhair”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Al-Maki”, “given” : “Ayad Kassim”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Hussein”, “given” : “Kassim”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” } , “container-title” : “Basrah Journal of Veterinary Research”, “id” : “ITEM-31”, “issue” : “2”, “issued” : { “date-parts” : “2007” }, “page” : “30-36”, “title” : “A study on prevalence of <i>Entamoeba histolytica</i> & <i>Giardia lamblia</i> infection among patient attending Qurna hospital in Basrah”, “type” : “article-journal”, “volume” : “6” }, “uris” : “http://www.mendeley.com/documents/?uuid=f565112a-a2c2-4511-ae96-10d2e891b0ef” }, { “id” : “ITEM-32”, “itemData” : { “author” : { “dropping-particle” : “”, “family” : “Kadhum”, “given” : “Iman Jabbar”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” } , “container-title” : “Kufa Medical Journal”, “id” : “ITEM-32”, “issue” : “1”, “issued” : { “date-parts” : “2011” }, “page” : “76-80”, “title” : “Epidemiological study of acute diarrhea in breast fed infants”, “type” : “article-journal”, “volume” : “14” }, “uris” : “http://www.mendeley.com/documents/?uuid=15d99640-b336-47cb-a87a-bd0a389efb32” }, { “id” : “ITEM-33”, “itemData” : { “author” : { “dropping-particle” : “”, “family” : “Raddam”, “given” : “Khlabus Kh”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Hasson”, “given” : “Ali Jarin”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” } , “container-title” : “Kufa Medical Journal”, “id” : “ITEM-33”, “issue” : “1”, “issued” : { “date-parts” : “2008” }, “page” : “15-24”, “title” : “The epidemiological aspects of infection with <i>Entamoeba histolytica</i> in acute diarrhea in Thi-Qar governorate during the year 2006”, “type” : “article-journal”, “volume” : “11” }, “uris” : “http://www.mendeley.com/documents/?uuid=9d489a33-0334-441f-89e4-5f8539ae7d65” }, { “id” : “ITEM-34”, “itemData” : { “author” : { “dropping-particle” : “”, “family” : “Ali”, “given” : “Majidah Abdul Khaliq”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Hameed”, “given” : “Shaima’a Shakir”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Kasim”, “given” : “Mohammed”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” } , “container-title” : “Wasit Journal for Science ; Medicine”, “id” : “ITEM-34”, “issue” : “8”, “issued” : { “date-parts” : “2010” }, “page” : “87-91”, “title” : “Prevalence of amoebic dysentery among population of Wasit province”, “type” : “article-journal”, “volume” : “3” }, “uris” : “http://www.mendeley.com/documents/?uuid=a43a82ae-64d9-4bf8-8498-18ac2566fc9d” }, { “id” : “ITEM-35”, “itemData” : { “author” : { “dropping-particle” : “”, “family” : “Al-Najar”, “given” : “Sabah. A.”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” } , “container-title” : “The Iraqi Postgraduate Medical Journal”, “id” : “ITEM-35”, “issue” : “1”, “issued” : { “date-parts” : “2006” }, “page” : “42-45”, “title” : “The role of ;i;Dientamoeba fragilis;/i; in children with gastrointestinal illness”, “type” : “article-journal”, “volume” : “5” }, “uris” : “http://www.mendeley.com/documents/?uuid=2c1add20-5c35-4241-b8ac-972d772e8761” }, { “id” : “ITEM-36”, “itemData” : { “author” : { “dropping-particle” : “”, “family” : “Al-Kubaisy”, “given” : “Ali Husain Makky”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” } , “container-title” : “Scientific Journal of Karbala University”, “id” : “ITEM-36”, “issue” : “2”, “issued” : { “date-parts” : “2008” }, “page” : “187-193”, “title” : “Survey study of intestinal parasites in Awofy and Al-Twmazy area/Babylon province”, “type” : “article-journal”, “volume” : “6” }, “uris” : “http://www.mendeley.com/documents/?uuid=4f0b7d44-bbd3-4a92-991b-1d56846ad939” }, { “id” : “ITEM-37”, “itemData” : { “author” : { “dropping-particle” : “”, “family” : “Rahi”, “given” : “Abdulsadah A.”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Mutlak”, “given” : “Enas M.”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” } , “container-title” : “Wasit Journal for Science ; Medicine”, “id” : “ITEM-37”, “issue” : “2”, “issued” : { “date-parts” : “2011” }, “page” : “54-57”, “title” : “Prevalence of ;i;Entamoeba histolytica;/i; among population at Wasit province”, “type” : “article-journal”, “volume” : “4” }, “uris” : “http://www.mendeley.com/documents/?uuid=a04e78b7-5d78-4c50-963f-e9ef14560ec7” }, { “id” : “ITEM-38”, “itemData” : { “author” : { “dropping-particle” : “”, “family” : “Rahi”, “given” : “Abdulsadah A.”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” } , “container-title” : “Wasit Journal for Science ; Medicine”, “id” : “ITEM-38”, “issue” : “2”, “issued” : { “date-parts” : “2011” }, “page” : “1-7”, “title” : “Haematological variables of patients with amoebic dysentery”, “type” : “article-journal”, “volume” : “4” }, “uris” : “http://www.mendeley.com/documents/?uuid=3bbe4ad6-4444-43fa-a0ae-e8ce8b120c67” }, { “id” : “ITEM-39”, “itemData” : { “author” : { “dropping-particle” : “”, “family” : “Thhaib”, “given” : “Faal N.”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Jeaz”, “given” : “Ebtesam T.”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Jaber”, “given” : “Shrook H.”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” } , “container-title” : “Al-Qadisiya Journal of Pure Science”, “id” : “ITEM-39”, “issue” : “2”, “issued” : { “date-parts” : “2008” }, “page” : “1-14”, “title” : “Study of role rotavirus and some pathogenic agents in diarrhea infections of the infants and children in Al-Diwaniya city”, “type” : “article-journal”, “volume” : “13” }, “uris” : “http://www.mendeley.com/documents/?uuid=a27ece9a-7d3b-4121-bdfa-f7ce8fe36fc9” }, { “id” : “ITEM-40”, “itemData” : { “author” : { “dropping-particle” : “”, “family” : “Al-Reikaby”, “given” : “Rahman L.”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Abood”, “given” : “Meethaq S.”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Hamid”, “given” : “Ruaa Ghanim”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” } , “container-title” : “Journal of Univesity of Thi-Qar”, “id” : “ITEM-40”, “issue” : “Special”, “issued” : { “date-parts” : “2010” }, “page” : “128-137”, “title” : “The epidemiological investigation of the causatives of intestinal diseases in Al-Nasiriya city”, “type” : “article-journal”, “volume” : “5” }, “uris” : “http://www.mendeley.com/documents/?uuid=06bd980f-7a8e-477b-b063-e1059e123957” }, { “id” : “ITEM-41”, “itemData” : { “author” : { “dropping-particle” : “”, “family” : “Al-Yasari”, “given” : “Hadi F.”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Hamza”, “given” : “Lena Fadhil”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Al-Hassnawi”, “given” : “Huda H.”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Jabar”, “given” : “Samira S.”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” } , “container-title” : “Journal of Kerbala University”, “id” : “ITEM-41”, “issue” : “2”, “issued” : { “date-parts” : “2009” }, “page” : “212-218”, “title” : “Isolation of some intestinal parasites from individuals suffering from intestinal disorders in Al-Mahaweel district”, “type” : “article-journal”, “volume” : “7” }, “uris” : “http://www.mendeley.com/documents/?uuid=da17a5a6-0e0b-4025-9682-f0ff67c22d4b” }, { “id” : “ITEM-42”, “itemData” : { “abstract” : “In this study we collect 1520 stool samples during the period from September to December 2010 from children whom their ages between 1 month -12 years. The results showed that the total infection of Entamoeba histolytica was 9.80% , and Giardia lamblia was 1.77%. And the male ratio that infected with Entamoeba histolytica was 9.83% , while the female ratio was 9.74%; and the male infected with Giardia lamblia was 1.51% , while the female ratio was 2.18%. The result showed that the high average of infection with Entamoeba histolytica and Giardia lamblia in age group from 1 month to 2 years. And there is no significance difference between gender and infectivity rate of Entamoeba histolytica and Giardia lamblia under Pu22640.05. Also it showed that there were significant relation between Age group and infectivity rate of Entamoeba histolytica and Giardia lamblia.”, “author” : { “dropping-particle” : “”, “family” : “Ibrahim”, “given” : “Amjed Qays”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” } , “container-title” : “The Iraqi Journal of Veterinary Medicine”, “id” : “ITEM-42”, “issue” : “1”, “issued” : { “date-parts” : “2012” }, “page” : “32-36”, “title” : “Prevalence of ;i;Entamoeba histolytica;/i; and ;i;Giardia lamblia;/i; in children in Kadhmiyah hospital”, “type” : “article-journal”, “volume” : “36” }, “uris” : “http://www.mendeley.com/documents/?uuid=f0f8aed7-c79f-4228-aadf-81d45de167c2” }, { “id” : “ITEM-43”, “itemData” : { “author” : { “dropping-particle” : “”, “family” : “Ibraheem”, “given” : “Mohammad F.”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Ali”, “given” : “Zainab A.”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Saeed”, “given” : “Dhiaa H.”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” } , “container-title” : “The Iraqi Postgraduate Medical Journal”, “id” : “ITEM-43”, “issue” : “1”, “issued” : { “date-parts” : “2010” }, “page” : “10-15”, “title” : “Shigella gastroenteritis in children with acute diarrhea in children welfare teaching hospital”, “type” : “article-journal”, “volume” : “9” }, “uris” : “http://www.mendeley.com/documents/?uuid=913440f4-061d-4ea7-850e-dafe2ff015de” }, { “id” : “ITEM-44”, “itemData” : { “author” : { “dropping-particle” : “”, “family” : “Yousif”, “given” : “Adeba”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” } , “container-title” : “Journal of Al-Qadisiyah for Pure Science”, “id” : “ITEM-44”, “issue” : “1”, “issued” : { “date-parts” : “2011” }, “page” : “16-19”, “title” : “The prevalence of some intestinal parasites in Al-Ubaidy region/Baghdad province”, “type” : “article-journal”, “volume” : “16” }, “uris” : “http://www.mendeley.com/documents/?uuid=fcc1c1da-e72a-4197-be9f-f366353d9e45” }, { “id” : “ITEM-45”, “itemData” : { “author” : { “dropping-particle” : “”, “family” : “Ali”, “given” : “Fatimah Mohammed”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Ali”, “given” : “Shahnaz Abdul Kader”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Abdullah”, “given” : “Sham Jamil”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” } , “container-title” : “International Journal of Medical Research ; Health Sciences”, “id” : “ITEM-45”, “issue” : “3”, “issued” : { “date-parts” : “2016” }, “page” : “77-84”, “title” : “Detection of ;i;Cyclospora cayetanensis;/i; infections among diarrheal children attending pediatric teaching hospital in Sulaimani city”, “type” : “article-journal”, “volume” : “5” }, “uris” : “http://www.mendeley.com/documents/?uuid=c6762d20-08d0-481a-a545-537ce67ec85e” }, { “id” : “ITEM-46”, “itemData” : { “author” : { “dropping-particle” : “”, “family” : “Al-Morshidy”, “given” : “Kassim Abdulla”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” } , “container-title” : “Journal of University of Babylon”, “id” : “ITEM-46”, “issue” : “1”, “issued” : { “date-parts” : “2007” }, “page” : “179-185”, “title” : “Prevalence of intestinal pathogenic parasites infections in Hilla city, Babylon province, Iraq”, “type” : “article-journal”, “volume” : “14” }, “uris” : “http://www.mendeley.com/documents/?uuid=2f8e0343-09e2-4f01-8b38-242726f266b0” }, { “id” : “ITEM-47”, “itemData” : { “author” : { “dropping-particle” : “”, “family” : “Abid”, “given” : “A.M.”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Daoud”, “given” : “I. S.”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Al-Assie”, “given” : “A. H.”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” } , “container-title” : “Second Scientific Conference u2013 Science College u2013 Tikrit University”, “id” : “ITEM-47”, “issued” : { “date-parts” : “2012” }, “page” : “96-100”, “title” : “Diagnostic study of some species of genus ;i;Entamoeba;/i; by PCR technique in city Tikrit”, “type” : “paper-conference” }, “uris” : “http://www.mendeley.com/documents/?uuid=bd9f13b9-decc-4ab1-a0de-5227a911cfc3” }, { “id” : “ITEM-48”, “itemData” : { “author” : { “dropping-particle” : “”, “family” : “Badry”, “given” : “Awaz H. H.”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Jameel”, “given” : “Ahmed Y.”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Mero”, “given” : “Wijdan M. S.”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” } , “container-title” : “Journal of University of Zakho”, “id” : “ITEM-48”, “issue” : “2 (A)”, “issued” : { “date-parts” : “2014” }, “page” : “266-275”, “title” : “Pathogenic microorganisms associated with diarrhea in infants and children in Duhok province, Kurdistan Region/Iraq”, “type” : “article-journal”, “volume” : “2” }, “uris” : “http://www.mendeley.com/documents/?uuid=9f7edd66-4228-4a72-962d-c44ac820cd33” }, { “id” : “ITEM-49”, “itemData” : { “author” : { “dropping-particle” : “”, “family” : “Al-Joudi”, “given” : “F. S.”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Ghazal”, “given” : “A. M.”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” } , “container-title” : “Bulletin of Pharmaceutical Sciences, Assiut University”, “id” : “ITEM-49”, “issue” : “2”, “issued” : { “date-parts” : “2005” }, “page” : “277-281”, “title” : “The prevalence of intestinal parasites in Ramadi, Iraq”, “type” : “article-journal”, “volume” : “28” }, “uris” : “http://www.mendeley.com/documents/?uuid=50db6eba-d5bb-4315-8017-e169b5042d9d” }, { “id” : “ITEM-50”, “itemData” : { “author” : { “dropping-particle” : “”, “family” : “Shebib”, “given” : “Z. A.”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Abdul Ghanii”, “given” : “Z. G.”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Mahdi”, “given” : “L. Kh.”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” } , “container-title” : “Eastern Mediterranean Health Journal”, “id” : “ITEM-50”, “issue” : “1-2”, “issued” : { “date-parts” : “2003” }, “page” : “159-166”, “title” : “First report of ;i;Escherichia coli;/i; 0157 among Iraqi children”, “type” : “article-journal”, “volume” : “9” }, “uris” : “http://www.mendeley.com/documents/?uuid=a958967f-af72-4fd0-b6a8-6fb7e103990c” }, { “id” : “ITEM-51”, “itemData” : { “DOI” : “10.3823/1603”, “ISSN” : “17557682”, “abstract” : “Introduction: Diarrhoea is a preventable and treatable disease; however it is still a major public health problem particularly in the developing world. Bloody diarrhoea in young children is usually a sign of invasive enteric infection that carries risk of serious morbidity and death. In Iraq, diarrhoea is the second common cause of mortalities among children. Objective: To determine the prevalence and associated factors of bloody diarrhoea among children less than 10 years old, in Baghdad. Material and methods: A hospital based prospective cross-sectional study was conducted in two Paediatric hospitals: AL-Manseur Paediatric Teaching Hospital and The Central Paediatric Teaching Hospital. A total of 1500 children (;10 years) with diarrhoea were included. Mothers were interviewed to obtain the necessary information. A Clinical examination and stool laboratory tests were performed for all children. Results: The prevalence of bloody diarrhoea was 28%. Bloody diarrhoea was significantly higher among children aged 7-9 years, those living in rural areas and on exclusive bottle feeding, with illiterate mother, and where river water is a household source. Gender of child and working mother were not significant. Entamoeba Histolytica was a main causative agent especially amongst children in age group 1-3years. Salmonella and Shigella were common in the age group 4-6 years old. Conclusion: The prevalence of bloody diarrhoea was high. Entamoeba Histolytica was the main causative agent. Poor sanitary condition and low socio-economic status may contribute to bloody diarrhoea among children in Iraq.”, “author” : { “dropping-particle” : “”, “family” : “Al-Kubaisy”, “given” : “Waqar”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Badre”, “given” : “Amer”, “non-dropping-particle” : “Al”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Al-Naggar”, “given” : “Redhwan Ahmed”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Nik Ibrahim”, “given” : “Nik Shamsidah”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” } , “container-title” : “International Archives of Medicine”, “id” : “ITEM-51”, “issue” : “4”, “issued” : { “date-parts” : “2015” }, “page” : “1-9”, “title” : “Epidemiological study of bloody diarrhoea among children in Baghdad, Iraq”, “type” : “article-journal”, “volume” : “8” }, “uris” : “http://www.mendeley.com/documents/?uuid=1fa90953-ef7f-4883-9047-22be0b8d2932” }, { “id” : “ITEM-52”, “itemData” : { “author” : { “dropping-particle” : “”, “family” : “Mero”, “given” : “Wijdan. M. S.”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Hussein”, “given” : “Jehan. N.”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” } , “container-title” : “Journal of University of Zakho”, “id” : “ITEM-52”, “issue” : “1”, “issued” : { “date-parts” : “2013” }, “page” : “189-199”, “title” : “Prevalence of intestinal parasites among children in various localities of Duhok city and nearby villages”, “type” : “article-journal”, “volume” : “1 (A)” }, “uris” : “http://www.mendeley.com/documents/?uuid=514e9876-8f0e-47f9-91db-2b099f6d3b18” }, { “id” : “ITEM-53”, “itemData” : { “ISBN” : “1020-3397 (Print)\r1020-3397”, “ISSN” : “10203397”, “PMID” : “15339123”, “abstract” : “Stool samples were obtained from individuals admitted to three hospitals in Basra during November 1997-May 1998. Of 40 patients with sickle-cell anaemia, 25 (62.5%) had parasitic infections. In the apparently healthy comparison group, 26 of 175 individuals (14.8%) had intestinal parasitic infections, a statistically significant difference. The most common intestinal parasites isolated in the sickle-cell patients were Blastocystis hominis (36%) and Giardia lamblia (28%). The isolation rate of Cryptosporidium species in sickle-cell patients (5%) was not significantly different from that in apparently healthy individuals (1.14%). We report for the first time the isolation of Isospora belli from a sickle-cell patient in Iraq and the Mediterranean region.”, “author” : { “dropping-particle” : “”, “family” : “Mahdi”, “given” : “N. K.”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Ali”, “given” : “N. H.”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” } , “container-title” : “Eastern Mediterranean Health Journal”, “id” : “ITEM-53”, “issue” : “2-3”, “issued” : { “date-parts” : “2002” }, “page” : “345-349”, “title” : “Intestinal parasites, including ;i;Cryptosporidium;/i; species, in Iraqi patients with sickle-cell anaemia”, “type” : “article-journal”, “volume” : “8” }, “uris” : “http://www.mendeley.com/documents/?uuid=072a9ad2-ed2c-4104-adf9-1ddd701427b8” }, { “id” : “ITEM-54”, “itemData” : { “author” : { “dropping-particle” : “”, “family” : “Ali”, “given” : “Fadel Saba”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Al-Kubaisy”, “given” : “Ali Husain Makky”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” } , “container-title” : “Journal of University of Babylon”, “id” : “ITEM-54”, “issue” : “1”, “issued” : { “date-parts” : “2017” }, “page” : “57-68”, “title” : “Molecular identification of ;i;Entamoeba histolytica;/i; parasite in the middle Euphrates region”, “type” : “article-journal”, “volume” : “25” }, “uris” : “http://www.mendeley.com/documents/?uuid=dc6879db-475f-4453-8c0c-68549fac37a0” }, { “id” : “ITEM-55”, “itemData” : { “author” : { “dropping-particle” : “”, “family” : “Al-Khalidi”, “given” : “Khadeeja Abees Hmood”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” } , “container-title” : “Journal of Al-Qadisiyah for Pure Science”, “id” : “ITEM-55”, “issue” : “2”, “issued” : { “date-parts” : “2016” }, “page” : “27-35”, “title” : “Detection of ;i;Entamoeba histolytica;/i; in patients an infected infants with diarrhea in born and children’s hospital by classic methods and real-time polymerase chain reaction”, “type” : “article-journal”, “volume” : “21” }, “uris” : “http://www.mendeley.com/documents/?uuid=72db8316-2001-4752-a7f9-b9c7a522a388” }, { “id” : “ITEM-56”, “itemData” : { “author” : { “dropping-particle” : “”, “family” : “Kadir”, “given” : “Mohammed A.”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Salman”, “given” : “Yahya G.”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” } , “container-title” : “Annals of the College of Medicine, Mosul”, “id” : “ITEM-56”, “issue” : “1 & 2”, “issued” : { “date-parts” : “1999” }, “page” : “94-98”, “title” : “Prevalence of intestinal parasites among primary school children in Al-Taameem province, Iraq”, “type” : “article-journal”, “volume” : “25” }, “uris” : “http://www.mendeley.com/documents/?uuid=921188e0-f0ad-40d8-be92-cdebffe95eff” }, { “id” : “ITEM-57”, “itemData” : { “author” : { “dropping-particle” : “”, “family” : “Shlash”, “given” : “Shaimaa A.”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” } , “container-title” : “Kufa Journal for Nursing Sciences”, “id” : “ITEM-57”, “issue” : “3”, “issued” : { “date-parts” : “2016” }, “page” : “102-110”, “title” : “Impact of <i>Entamoeba histolytica</i> infection on some haematological and immunological parameters among children in Najaf governorate”, “type” : “article-journal”, “volume” : “6” }, “uris” : “http://www.mendeley.com/documents/?uuid=ae1b3fe7-083f-4773-8442-29d67b8c6773” }, { “id” : “ITEM-58”, “itemData” : { “author” : { “dropping-particle” : “”, “family” : “Al-Moussawi”, “given” : “Ahmed M.”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” } , “container-title” : “Medical Journal of Babylon”, “id” : “ITEM-58”, “issue” : “4”, “issued” : { “date-parts” : “2005” }, “page” : “491-498”, “title” : “Prevalence of intestinal parasites among rural population in Babylon province”, “type” : “article-journal”, “volume” : “2” }, “uris” : “http://www.mendeley.com/documents/?uuid=1ba76da8-a67b-4c44-91f0-b6c7dc60ba53” }, { “id” : “ITEM-59”, “itemData” : { “author” : { “dropping-particle” : “”, “family” : “Shaker”, “given” : “Mohammed Jasim”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Hussein”, “given” : “Rawaa Abdulkhaleq”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” } , “container-title” : “Diyala Journal for Pure Sciences”, “id” : “ITEM-59”, “issue” : “1”, “issued” : { “date-parts” : “2016” }, “page” : “133-142”, “title” : “The relationship between the infection with <i>Entamoeba histolytica</i> and some blood parameters”, “type” : “article-journal”, “volume” : “12” }, “uris” : “http://www.mendeley.com/documents/?uuid=0fad3e6e-509e-4f4e-9e7d-525c80998689” }, { “id” : “ITEM-60”, “itemData” : { “author” : { “dropping-particle” : “”, “family” : “Atiyah”, “given” : “Amal Hasan”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Almwsawi”, “given” : “Haider Qasim Hamood”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” } , “container-title” : “Medical Journal of Babylon”, “id” : “ITEM-60”, “issue” : “4”, “issued” : { “date-parts” : “2016” }, “page” : “862-873”, “title” : “The most detective protozoal infections in correlation with radiological findings in Wasit governorate hospitals during 2015”, “type” : “article-journal”, “volume” : “13” }, “uris” : “http://www.mendeley.com/documents/?uuid=45619d59-949c-4788-b950-92c64e98d69f” }, { “id” : “ITEM-61”, “itemData” : { “author” : { “dropping-particle” : “”, “family” : “Hussein”, “given” : “Khwam R.”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Dahis”, “given” : “Hayat N.”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Mshhwt”, “given” : “Abdul-Kareem A.”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” } , “container-title” : “Journal of Thi-Qar University”, “id” : “ITEM-61”, “issue” : “4”, “issued” : { “date-parts” : “2016” }, “page” : “134-142”, “title” : “Parasitic infections causing diarrhoea among children less than six years at Al-Nasiriyah province”, “type” : “article-journal”, “volume” : “11” }, “uris” : “http://www.mendeley.com/documents/?uuid=d7d5348c-4e77-47fa-bf68-36aa1998fc72” }, { “id” : “ITEM-62”, “itemData” : { “author” : { “dropping-particle” : “”, “family” : “Racine”, “given” : “Safaa”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” } , “container-title” : “Journal of Al-Qadisiyah for Pure Science”, “id” : “ITEM-62”, “issue” : “2”, “issued” : { “date-parts” : “2014” }, “page” : “33-39”, “title” : “Epidemiology survey on the prevalence of infections intestinal parasites in workers in restaurants and food shop in the province of Diwaniyah”, “type” : “article-journal”, “volume” : “19” }, “uris” : “http://www.mendeley.com/documents/?uuid=0884d721-c2a4-48aa-b1e1-96dfe23931d9” }, { “id” : “ITEM-63”, “itemData” : { “author” : { “dropping-particle” : “”, “family” : “Alshawi”, “given” : “Abdul-Razzak Jabbar”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Abbas”, “given” : “Nibras Khudhur”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Al-Taie”, “given” : “Lazim H. K.”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” } , “container-title” : “Al-Yarmouk Journal”, “id” : “ITEM-63”, “issue” : “1”, “issued” : { “date-parts” : “2014” }, “page” : “103-116”, “title” : “The prevalence of intestinal parasite among sample of Iraqi peoples in Baghdad city”, “type” : “article-journal” }, “uris” : “http://www.mendeley.com/documents/?uuid=808cd490-8b62-4790-bebd-ec05c795ec11” }, { “id” : “ITEM-64”, “itemData” : { “author” : { “dropping-particle” : “”, “family” : “Al-Bayati”, “given” : “Mostafa Hadi J.”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Al-Hassany”, “given” : “Najim Abd-Alwahid”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” } , “container-title” : “Journal of Al-Qadisiyah for Pure Science”, “id” : “ITEM-64”, “issue” : “1”, “issued” : { “date-parts” : “2014” }, “page” : “1-16”, “title” : “Epidemiological and diagnostic study for some intestinal parasites that infect children in Diwaniya province”, “type” : “article-journal”, “volume” : “19” }, “uris” : “http://www.mendeley.com/documents/?uuid=3ee89b20-dd3f-4b65-85fb-4e8a42e85fe5” }, { “id” : “ITEM-65”, “itemData” : { “author” : { “dropping-particle” : “”, “family” : “Aljanabi”, “given” : “Marwan A. H.”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Altikrity”, “given” : “Ilham A. A.”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” } , “container-title” : “Iraqi Journal of Science”, “id” : “ITEM-65”, “issue” : “3”, “issued” : { “date-parts” : “2014” }, “page” : “979-985”, “title” : “The spread of <i>Entamoeba histolytica</i> infection among children attended the central child hospital in Baghdad city”, “type” : “article-journal”, “volume” : “55” }, “uris” : “http://www.mendeley.com/documents/?uuid=03238e2e-1783-4fcd-a455-01955e4ee45f” }, { “id” : “ITEM-66”, “itemData” : { “abstract” : “Malnutrition and infection with intestinal parasites are widespread in almost all developing countries, high rate of people in the world are infected with protozoal and helminthes parasites. Most of cases are asymptomatic but some intestinal parasites can cause severe diarrhea and malnutrition problems. Four hundred and thirty children (257 male and 173 female) whom attended the parasitology section of Kirkuk General Pediatric and Azady Teaching Hospitals, were chosen for this study. Their ages were < 1-12 years. The weight and the height of each children were recorded. Stool samples were taken from them and examined microscopically for parasitic finding. The frequency of malnutrition was significantly more in males (29.9%) than in females (15.6%). The most age group which were more malnourished in both males and females were 8-11years. Although the number of inpatients (336) was higher than outpatients (94), but malnutrition showed no significant differences between them. The total malnourished children were 24%. Most of the normal malnourished children had body mass index (BMI) range of 13-16.9, while most of the moderate malnourished had BMI range of 13-14.9 and the sever malnourished BMI were 8-12.9.The most prevalent parasite in both sexes were Entamoeba histolytica followed by Giardia lamblia, Hymenolepis nana, Enterobius vermicularis and Cryptosporidium parvum, and the lowest rate was for Ascaris lumbricoides. The most malnourished children were infected C. parvum with a rate of 60%, followed by E. histolytica and G. lamblia with rate of 18.7, 10.4% respectively, no malnutrition degree were noted with other parasites. A significantly high rate of malnourished children had parasitic infection (30%) comparing with the total malnourished number (104). Diarrhea was significantly related with malnutrition degree and with parasites. 60% of the total moderatelymalnourished children had diarrhea and 84% of them had parasite with diarrhea, while in the total sever malnourished children, 87% had diarrhea and 100% had parasitic infection with diarrhea.”, “author” : { “dropping-particle” : “”, “family” : “Obaid”, “given” : “Hiro M.”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” } , “container-title” : “Kirkuk University Journal /Scientific Studies”, “id” : “ITEM-66”, “issue” : “1”, “issued” : { “date-parts” : “2015” }, “page” : “191-206”, “title” : “Malnutrition in relation to some intestinal parasitic infection in children of Kirkuk city-Iraq”, “type” : “article-journal”, “volume” : “10” }, “uris” : “http://www.mendeley.com/documents/?uuid=6b32de3b-76bc-4813-b5fd-42a48d556dc3” }, { “id” : “ITEM-67”, “itemData” : { “author” : { “dropping-particle” : “”, “family” : “Al-Garawi”, “given” : “Ali Karim Hassan”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” } , “container-title” : “Journal of Kerbala University”, “id” : “ITEM-67”, “issue” : “1”, “issued” : { “date-parts” : “2015” }, “page” : “50-56”, “title” : “Study of prevalence of intestinal parasites infection among children in & attending to Karbala teaching hospital for children”, “type” : “article-journal”, “volume” : “13” }, “uris” : “http://www.mendeley.com/documents/?uuid=db6bed6b-addd-4ed9-b458-ce42a3327251” }, { “id” : “ITEM-68”, “itemData” : { “author” : { “dropping-particle” : “”, “family” : “Abed”, “given” : “Farah Amer”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Younis”, “given” : “Fekri N.”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Al-Naddawi”, “given” : “Mahjoob Naffil”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” } , “container-title” : “Journal of Biotechnology Research Center”, “id” : “ITEM-68”, “issue” : “1”, “issued” : { “date-parts” : “2015” }, “page” : “17-20”, “title” : “Prevalence and laboratory diagnosis of intestinal protozoa in children under 10 years (amoebiasis and giardiasis) in Al-Mansor general hospital for pediatric/Baghdad”, “type” : “article-journal”, “volume” : “9” }, “uris” : “http://www.mendeley.com/documents/?uuid=ff1ab541-bac6-4393-b64d-57e360553525” }, { “id” : “ITEM-69”, “itemData” : { “author” : { “dropping-particle” : “”, “family” : “Raof”, “given” : “Sh. A.”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” } , “container-title” : “Al-Qadisiyah Journal of Veterinary Medicine Sciences”, “id” : “ITEM-69”, “issue” : “1”, “issued” : { “date-parts” : “2012” }, “page” : “8-14”, “title” : “Prevalence of <i>Entamoeba histolytica/E. dispar</i> in three regions of south-east Baghdad”, “type” : “article-journal”, “volume” : “11” }, “uris” : “http://www.mendeley.com/documents/?uuid=6dc71c6d-070c-4030-9978-17a961b99baa” }, { “id” : “ITEM-70”, “itemData” : { “author” : { “dropping-particle” : “”, “family” : “Hussein”, “given” : “Talib Abdullah”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Abdul-Jabbar”, “given” : “Doa’a Baha”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” } , “container-title” : “The Iraqi Journal of Veterinary Medicine”, “id” : “ITEM-70”, “issue” : “2”, “issued” : { “date-parts” : “2014” }, “page” : “19-26”, “title” : “Epidemiological study for intestinal parasites in Abu Ghraib and Amiriyah regions”, “type” : “article-journal”, “volume” : “38” }, “uris” : “http://www.mendeley.com/documents/?uuid=8ddb613c-8717-4a56-92c8-fe31c38fef44” }, { “id” : “ITEM-71”, “itemData” : { “author” : { “dropping-particle” : “”, “family” : “Al-Jebory”, “given” : “Abdlullah H.”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Al-Tikrity”, “given” : “Elham A. A.”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Al-Baitha”, “given” : “Shujan R. H.”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” } , “container-title” : “Tikrit Journal of Pure Science”, “id” : “ITEM-71”, “issue” : “3”, “issued” : { “date-parts” : “2012” }, “page” : “108-115”, “title” : “Epidemiological study for intestinal protozoan parasites in Al-Tous province and study the histopathological effect on intestine of mice infected with ;i;Giardia lamblia;/i;”, “type” : “article-journal”, “volume” : “17” }, “uris” : “http://www.mendeley.com/documents/?uuid=d4b2e7f1-d335-4dbb-95a4-a1c1140e0607” }, { “id” : “ITEM-72”, “itemData” : { “author” : { “dropping-particle” : “”, “family” : “Hussan”, “given” : “Basim M.”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” } , “container-title” : “Al-Qadisiah Medical Journal”, “id” : “ITEM-72”, “issue” : “14”, “issued” : { “date-parts” : “2012” }, “page” : “163-176”, “title” : “Determination of the prevalence of viral aetiology of diarrhea in children less than 5 years of age in Baghdad province”, “type” : “article-journal”, “volume” : “8” }, “uris” : “http://www.mendeley.com/documents/?uuid=c11b61be-ae81-4b75-883a-8bdacfbd4fef” }, { “id” : “ITEM-73”, “itemData” : { “author” : { “dropping-particle” : “”, “family” : “Guirges”, “given” : “Sami Y.”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” } , “container-title” : “Al-Mustansiriyah Journal of Science”, “id” : “ITEM-73”, “issue” : “4”, “issued” : { “date-parts” : “2006” }, “page” : “1-10”, “title” : “Intestinal parasites in patients attending medical city teaching hospital in Baghdad”, “type” : “article-journal”, “volume” : “17” }, “uris” : “http://www.mendeley.com/documents/?uuid=dfc2110a-3e04-4169-9a80-bf49c6061828” }, { “id” : “ITEM-74”, “itemData” : { “author” : { “dropping-particle” : “”, “family” : “Al-Hameedawi”, “given” : “Jameel Jerri Yousif”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” } , “container-title” : “Kufa Journal for Nursing sciences”, “id” : “ITEM-74”, “issue” : “2”, “issued” : { “date-parts” : “2014” }, “page” : “48-55”, “title” : “Molecular identification of ;i;Entamoeba histolytica;/i; parasite by using actin and amebapore-A genes”, “type” : “article-journal”, “volume” : “4” }, “uris” : “http://www.mendeley.com/documents/?uuid=ffb61209-97ba-4714-bc27-05d87ec1a5b1” }, { “id” : “ITEM-75”, “itemData” : { “author” : { “dropping-particle” : “”, “family” : “Hussein”, “given” : “Zainab Ali”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Hamady”, “given” : “Haiytham Mohamed”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” } , “container-title” : “Kufa Journal for Nursing Sciences”, “id” : “ITEM-75”, “issue” : “3”, “issued” : { “date-parts” : “2013” }, “page” : “190-196”, “title” : “Real-Time PCR for detection CP1 ; CP5 virulence factors of ;i;Entamoeba histolytica;/i; in patients stool samples in Al-Najaf Al-Ashraf province”, “type” : “article-journal”, “volume” : “3” }, “uris” : “http://www.mendeley.com/documents/?uuid=5027a64d-9258-435b-8a48-3c3250f7b9e7” }, { “id” : “ITEM-76”, “itemData” : { “author” : { “dropping-particle” : “”, “family” : “Zaidan”, “given” : “Ali Awad”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Jiboory”, “given” : “Riyadh KL”, “non-dropping-particle” : “Al”, “parse-names” : false, “suffix” : “” } , “container-title” : “Al-Kindy College Medical Journal”, “id” : “ITEM-76”, “issue” : “2”, “issued” : { “date-parts” : “2013” }, “page” : “35-39”, “title” : “Occurrence of amoebic versus bacillary dysentery among children under five years of age in Baghdad city”, “type” : “article-journal”, “volume” : “9” }, “uris” : “http://www.mendeley.com/documents/?uuid=f1c6840f-e819-4524-b44f-9d925baf3e01” }, { “id” : “ITEM-77”, “itemData” : { “author” : { “dropping-particle” : “”, “family” : “Al-Aboody”, “given” : “B.A.”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” } , “container-title” : “Journal of Thi-Qar Science”, “id” : “ITEM-77”, “issue” : “2”, “issued” : { “date-parts” : “2010” }, “page” : “59-64”, “title” : “Epidemiological study on intestinal protozoa ;i;Entamoeba histolytica;/i; ; ;i;Giardia lamblia;/i; in Al-Batha ; Al-Gharraf cities of Thi-Qar governorate”, “type” : “article-journal”, “volume” : “2” }, “uris” : “http://www.mendeley.com/documents/?uuid=aae4e8dd-90e5-46ee-94c6-02c5edfaed25” }, { “id” : “ITEM-78”, “itemData” : { “author” : { “dropping-particle” : “”, “family” : “Kadir”, “given” : “Mohammed A.”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Daoud”, “given” : “Ibrahim S.”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Al-Bayati”, “given” : “Zaid”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” } , “container-title” : “Tikrit Journal of Pharmaceutical Sciences”, “id” : “ITEM-78”, “issue” : “1”, “issued” : { “date-parts” : “2013” }, “page” : “122-129”, “title” : “Differentiation between ;i;Entamoeba histolytica;/i; and ;i;E. dispar;/i; using enzyme-linked immunosorbent assay and wet mount method”, “type” : “article-journal”, “volume” : “9” }, “uris” : “http://www.mendeley.com/documents/?uuid=f1bf20cb-0b00-4533-b662-dee2a9e76250” }, { “id” : “ITEM-79”, “itemData” : { “author” : { “dropping-particle” : “”, “family” : “Al-Zigibi”, “given” : “Ihsan Mohamed Salbi”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” } , “container-title” : “Journal of Kerbala University”, “id” : “ITEM-79”, “issue” : “3”, “issued” : { “date-parts” : “2011” }, “page” : “170-174”, “title” : “Isolation of parasitic causes of digestive system infection from primary rural school in a Reghala village in Babylon City”, “type” : “article-journal”, “volume” : “9” }, “uris” : “http://www.mendeley.com/documents/?uuid=31f1727f-09a9-43d0-a304-c78cc3e62718” }, { “id” : “ITEM-80”, “itemData” : { “author” : { “dropping-particle” : “”, “family” : “Al-Jeburi”, “given” : “Damiaa Ibrahim Alwan”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” } , “container-title” : “Journal of Kerbala University”, “id” : “ITEM-80”, “issue” : “1”, “issued” : { “date-parts” : “2010” }, “page” : “180-186”, “title” : “Epidemiology of intestinal parasites which causing the diarrhea in health center of Jidedat Al-Shat/Diala”, “type” : “article-journal”, “volume” : “8” }, “uris” : “http://www.mendeley.com/documents/?uuid=d0f8f263-0c2c-4457-831c-45a5df0c2056” }, { “id” : “ITEM-81”, “itemData” : { “author” : { “dropping-particle” : “”, “family” : “Al-Tae”, “given” : “Abdul-Rahman A.”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Al-Mufragi”, “given” : “Sumaiah E.”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” } , “container-title” : “Tikrit Medical Journal”, “id” : “ITEM-81”, “issue” : “2”, “issued” : { “date-parts” : “2008” }, “page” : “179-182”, “title” : “Epidemiological study of the intestinal parasites in patients attending two hospitals in Baghdad”, “type” : “article-journal”, “volume” : “14” }, “uris” : “http://www.mendeley.com/documents/?uuid=6bcfad26-a104-4f86-b72f-bc655c62a26c” }, { “id” : “ITEM-82”, “itemData” : { “author” : { “dropping-particle” : “”, “family” : “Jasim”, “given” : “Thamer Mutlek”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” } , “container-title” : “Al-Kindy College Medical Journal”, “id” : “ITEM-82”, “issue” : “1”, “issued” : { “date-parts” : “2009” }, “page” : “78-82”, “title” : “Bloody diarrhoea among children under five years of age in Tikirit teaching hospital”, “type” : “article-journal”, “volume” : “5” }, “uris” : “http://www.mendeley.com/documents/?uuid=3b82b9b0-8276-42a5-a2c7-319085572390” }, { “id” : “ITEM-83”, “itemData” : { “author” : { “dropping-particle” : “”, “family” : “Al-Azzawi”, “given” : “Dawood Salman Hameed”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” } , “container-title” : “Tikrit Medical Journal”, “id” : “ITEM-83”, “issue” : “2”, “issued” : { “date-parts” : “2010” }, “page” : “60-66”, “title” : “Prevalence of amoebic dysentery among children with diarrhea in Diyala governorate during 2009”, “type” : “article-journal”, “volume” : “16” }, “uris” : “http://www.mendeley.com/documents/?uuid=94bccf13-bc38-4b41-89e8-608a6a517598” }, { “id” : “ITEM-84”, “itemData” : { “author” : { “dropping-particle” : “”, “family” : “Al-Zigibi”, “given” : “Ihsan Mohamed Salbi”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Abid-Alhasan”, “given” : “Maysaa Taqi”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Al-Jubouri”, “given” : “Damiaa Ibrahim Alwan”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” } , “container-title” : “Journal of Kerbala University”, “id” : “ITEM-84”, “issue” : “4”, “issued” : { “date-parts” : “2011” }, “page” : “147-152”, “title” : “Study of the relationship between intestinal parasitic infection and the yeast infection with Candida in the digestive system of human in the Karbala governorate”, “type” : “article-journal”, “volume” : “9” }, “uris” : “http://www.mendeley.com/documents/?uuid=b4415f0b-4540-4d3b-91f5-5819da7b7d53” }, { “id” : “ITEM-85”, “itemData” : { “author” : { “dropping-particle” : “”, “family” : “Mohammed”, “given” : “Z. A.”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” } , “container-title” : “Journal of College of Education for Pure Science”, “id” : “ITEM-85”, “issue” : “1”, “issued” : { “date-parts” : “2010” }, “page” : “153-146”, “title” : “An epidemiological study of some intestinal parasitic infections of patients of Al-Hussein teaching hospital in the city of Nasiriyah”, “type” : “article-journal”, “volume” : “1” }, “uris” : “http://www.mendeley.com/documents/?uuid=82d04ec2-410c-463f-9bc0-6e781ed6f224” }, { “id” : “ITEM-86”, “itemData” : { “author” : { “dropping-particle” : “”, “family” : “Muhsin”, “given” : “Zainab Abid”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Iliwii”, “given” : “Abid Al-Karim”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Al-Quraishi”, “given” : “Maher Ali”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” } , “container-title” : “Al-Kufa University Journal for Biology”, “id” : “ITEM-86”, “issue” : “2”, “issued” : { “date-parts” : “2016” }, “page” : “393-400”, “title” : “Prevalence and seasonal frequency and pattern of ;i;Giardia lamblia;/i; and ;i;Entamoeba histolytica;/i; infection in children”, “type” : “article-journal”, “volume” : “8” }, “uris” : “http://www.mendeley.com/documents/?uuid=1e19eab4-53c9-4564-89af-4ee1bf57a3ff” }, { “id” : “ITEM-87”, “itemData” : { “author” : { “dropping-particle” : “”, “family” : “Al-Ammash”, “given” : “Maroof S. Juma”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” } , “container-title” : “Kufa Journal for Veterinary Medical Sciences”, “id” : “ITEM-87”, “issue” : “2”, “issued” : { “date-parts” : “2015” }, “page” : “194-204”, “title” : “Study on prevalence of ;i;Entameoba histolytica;/i; ; ;i;Giardia;/i; lamblia in Samarra city”, “type” : “article-journal”, “volume” : “6” }, “uris” : “http://www.mendeley.com/documents/?uuid=6f3440af-cbc2-451a-8a40-a412b19ed714” }, { “id” : “ITEM-88”, “itemData” : { “abstract” : “Out of 492 patients attending Al-Emam Ali hospital, examined during the peroid from beginning of June/2013 to the end of may/2014, 79 (16.05%) were infected with G. lamblia and 115 (23.37%) were infected with E. histolytica. Highest rate of infection with giardiasis was in July and March (20.93%, 20.51% respectively), while the lower infection was found in December (8.51%). Amoebiasis show high rate of infection in September (41.93%) and low rate of infection in May (14.06%). Prevalence of giardinsis and amoebiasis in rural areas (16.8%, 26.3% respectively) were found higher than urban areas (15.3%, 20.3%), but with out significant differences. Also no significant differences were found between infected males and females patients. The infection of both parasites was found increased with advancing ages of patients. Mixed stages (trophozoites and cysts) was the most apparent in posative cases of amoebiasis, while trophozoites stage was found apparent in posative cases of giardiasis.”, “author” : { “dropping-particle” : “”, “family” : “Ali”, “given” : “J. K.”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” } , “container-title” : “Kufa Journal for Veterinary Medical Sciences”, “id” : “ITEM-88”, “issue” : “1”, “issued” : { “date-parts” : “2015” }, “page” : “30-34”, “title” : “Prevalence of ;i;Entamoeba histolytica;/i; and ;i;Giardia lamblia;/i; parasites among patients attending Al-Emam Ali hospital in Al-Mashrooh / Babylon province”, “type” : “article-journal”, “volume” : “6” }, “uris” : “http://www.mendeley.com/documents/?uuid=b721b1dc-f8d5-4f19-bc8a-2aa44b001986” }, { “id” : “ITEM-89”, “itemData” : { “author” : { “dropping-particle” : “”, “family” : “Nasser”, “given” : “Noor Ismeal”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” } , “container-title” : “Kufa Journal for Nursing Sciences”, “id” : “ITEM-89”, “issue” : “3”, “issued” : { “date-parts” : “2014” }, “page” : “169-175”, “title” : “Frequency of parasitic, bacterial and fungal enteropathogens among children and adults patients with diarrhea and association affecting factors”, “type” : “article-journal”, “volume” : “4” }, “uris” : “http://www.mendeley.com/documents/?uuid=c6abe7e4-0f06-4a58-b7c5-271aa4a49d9e” }, { “id” : “ITEM-90”, “itemData” : { “author” : { “dropping-particle” : “”, “family” : “Jamil”, “given” : “Gassan Hamdan”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Sulltan”, “given” : “Amaar Ahmed”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” } , “container-title” : “Journal of Research Diyala humanity”, “id” : “ITEM-90”, “issued” : { “date-parts” : “2008” }, “page” : “98-106”, “title” : “Factors Affecting the epidemiology of the parasite ;i;Entamoeba histolytica;/i; and the parasite ;i;Giardia;/i; lamblia among residents of Al-Khalis and Baladruz districts”, “type” : “article-journal”, “volume” : “27” }, “uris” : “http://www.mendeley.com/documents/?uuid=1e3c3237-a184-41f9-9acf-a07d2517ed4e” }, { “id” : “ITEM-91”, “itemData” : { “DOI” : “10.20546/ijcmas.2016.501.076”, “author” : { “dropping-particle” : “”, “family” : “Salman”, “given” : “Yahya Jirjees”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Al-Taee”, “given” : “Abdul-Rahman Aziz”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Abid”, “given” : “Ali Mohammed”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” } , “container-title” : “International Journal of Current Microbiology and Applied Sciences”, “id” : “ITEM-91”, “issue” : “1”, “issued” : { “date-parts” : “2016” }, “page” : “753-760”, “title” : “Prevalence of ;i;Giardia lamblia;/i; among Iraqi displaced peoples in Kirkuk province”, “type” : “article-journal”, “volume” : “5” }, “uris” : “http://www.mendeley.com/documents/?uuid=009bca20-f4a2-4eaf-b704-1920827d242f” }, { “id” : “ITEM-92”, “itemData” : { “author” : { “dropping-particle” : “”, “family” : “Hamad”, “given” : “Narmin Rafik”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Ramzy”, “given” : “Isra Anmar”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” } , “container-title” : “Journal of Research in Biology”, “id” : “ITEM-92”, “issue” : “1”, “issued” : { “date-parts” : “2012” }, “page” : “57-62”, “title” : “Epidemiology of ;i;Entamoeba histolytica;/i; among children in Erbil province, Kurdistan Region-Iraq”, “type” : “article-journal”, “volume” : “2” }, “uris” : “http://www.mendeley.com/documents/?uuid=12d653b6-68aa-4c4e-aa48-1a9aa3f5f2f6” }, { “id” : “ITEM-93”, “itemData” : { “author” : { “dropping-particle” : “”, “family” : “Faraj”, “given” : “Abbas Mohamed”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Koyee”, “given” : “Qaraman Mamakhidr”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” } , “container-title” : “Duhok Medical Journal”, “id” : “ITEM-93”, “issued” : { “date-parts” : “2012” }, “page” : “1-12”, “title” : “Epidemiology of intestinal parasites among food handlers in Erbil city”, “type” : “article-journal”, “volume” : “6” }, “uris” : “http://www.mendeley.com/documents/?uuid=5b766516-f2e7-4d22-abf8-5c63800ce1f1” }, { “id” : “ITEM-94”, “itemData” : { “author” : { “dropping-particle” : “”, “family” : “Al-Fahdawi”, “given” : “Suad Shallal”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” } , “container-title” : “Journal of university of Anbar for pure science”, “id” : “ITEM-94”, “issue” : “3”, “issued” : { “date-parts” : “2007” }, “page” : “35-42”, “title” : “Prevalence of intestinal parasites infection in some areas of Al-Quim / Al-Anbar governorate”, “type” : “article-journal”, “volume” : “1” }, “uris” : “http://www.mendeley.com/documents/?uuid=46b8f939-0894-42d6-a985-537391983107” }, { “id” : “ITEM-95”, “itemData” : { “author” : { “dropping-particle” : “”, “family” : “Hussein”, “given” : “Rawaa Abdulkhaleq”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Shaker”, “given” : “Mohammed Jasim”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Majeed”, “given” : “Hadeel A.”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” } , “container-title” : “Journal of the College of Basic Education”, “id” : “ITEM-95”, “issue” : “71”, “issued” : { “date-parts” : “2011” }, “page” : “139-147”, “title” : “Prevalence of intestinal parasitic infections among children in Baghdad city”, “type” : “article-journal”, “volume” : “17” }, “uris” : “http://www.mendeley.com/documents/?uuid=cce856f4-ae4e-44ab-a198-5ee238f98097” }, { “id” : “ITEM-96”, “itemData” : { “author” : { “dropping-particle” : “”, “family” : “Mahfoth”, “given” : “Najwa”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” } , “container-title” : “College of Basic Education Researches Journal”, “id” : “ITEM-96”, “issue” : “2”, “issued” : { “date-parts” : “2010” }, “page” : “493-512”, “title” : “The distribution of parasitic intestinal infection and its relation with the type of food in the children of two nursery schools in Mosul city”, “type” : “article-journal”, “volume” : “9” }, “uris” : “http://www.mendeley.com/documents/?uuid=02f7ffb5-6072-46ec-900f-eaaa583afd7a” }, { “id” : “ITEM-97”, “itemData” : { “author” : { “dropping-particle” : “”, “family” : “Hussein”, “given” : “Rawaa Abdulkhaleq”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Al-Mayah”, “given” : “Qasim Sharhan”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Merdaw”, “given” : “Maysoon Abdul-zahra”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Al-Bashier”, “given” : “Nada Taha”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Al-Abbas”, “given” : “Areej Abd”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Jasem”, “given” : “Ilham Ahmed”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” } , “container-title” : “International Journal of Advanced Research”, “id” : “ITEM-97”, “issue” : “9”, “issued” : { “date-parts” : “2015” }, “page” : “782-788”, “title” : “Evaluation of multiplex real-time PCR and ELISA in detection of intestinal protozoan parasites from children with diarrheal disease”, “type” : “article-journal”, “volume” : “3” }, “uris” : “http://www.mendeley.com/documents/?uuid=d6c7803c-c2d3-45f1-9279-f0fcc8843a2a” }, { “id” : “ITEM-98”, “itemData” : { “author” : { “dropping-particle” : “”, “family” : “Rabatti”, “given” : “Abbass A.”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Rasheed”, “given” : “Nazdar Ezzaddin”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” } , “container-title” : “Al-Kindy College Medical Journal”, “id” : “ITEM-98”, “issue” : “6”, “issued” : { “date-parts” : “2008” }, “page” : “19-24”, “title” : “Etiology of bloody diarrhea among children admitted to maternity and childrenu2019s hospital-Erbil”, “type” : “article-journal”, “volume” : “4” }, “uris” : “http://www.mendeley.com/documents/?uuid=365882ab-bb89-46af-ab21-3ccc1c609c6b” }, { “id” : “ITEM-99”, “itemData” : { “author” : { “dropping-particle” : “”, “family” : “Khudair”, “given” : “Mohammed Khalifa”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Jawad”, “given” : “Shaba Jassim”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Nazal”, “given” : “Maha Flah”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” } , “container-title” : “Baghdad Science Journal”, “id” : “ITEM-99”, “issue” : “4”, “issued” : { “date-parts” : “2011” }, “page” : “887-890”, “title” : “Study the causes of parasitic diarrhea in children in Al-Ahded village, Dyala governorate”, “type” : “article-journal”, “volume” : “8” }, “uris” : “http://www.mendeley.com/documents/?uuid=5ab594c2-d8d0-4153-a0b9-03d7c8c9bf11” } , “mendeley” : { “formattedCitation” : “9,10,19u201328,11,29u201338,12,39u201348,13,49u201358,14,59u201368,15,69u201378,16,79u201388,17,89u201398,18,99u2013107”, “manualFormatting” : “9-107”, “plainTextFormattedCitation” : “9,10,19u201328,11,29u201338,12,39u201348,13,49u201358,14,59u201368,15,69u201378,16,79u201388,17,89u201398,18,99u2013107”, “previouslyFormattedCitation” : “9,10,19u201328,11,29u201338,12,39u201348,13,49u201358,14,59u201368,15,69u201378,16,79u201388,17,89u201398,18,99u2013107” }, “properties” : { “noteIndex” : 0 }, “schema” : “https://github.com/citation-style-language/schema/raw/master/csl-citation.json” }9-107.

Fig 1. Flow diagram of study selection process for meta-analysis.

Study characteristics
Table 1 shows the characteristics of the studies included in the meta-analysis, which covered 16 provinces in Iraq. The studies included 24383 positive cases out of 117694 individuals. Most of the studies used microscopy method (95 studies) followed by PCR method (3 studies) for detection of E. histolytica/dispar in stool, one study did not mention the method. There was no study used serological methods for detection of E. histolytica/dispar. The studies have been carried out from 1988 to 2016 and published between 1999 and 2017. The studies included in the meta-analyses were undertaken in subjects of all ages, ranging from less than 1 year to 90 years, 47 studies included only children and 45 studies included both children and adults, seven studies did not specify the age groups. The sample sizes of the eligible studies ranged from 70 to 18450. The prevalence of infection with E. histolytica/dispar ranged from 1.66 to 90.5% (mean: 22.36%). In the selected articles, 84 studies were hospital based, 3 studies were conducted in individuals from hospitals / primary schools, 3 studies in pupils of primary schools, 3 studies in foodhandlers, 2 studies in individuals from villages, 1 study in children from nursery schools / some houses, 3 studies did not specify the sources of stool samples.

Table 1. Characteristics of studies included in the meta-analysis.

First author Year of publication Year of study Province Detection method in stool Sample size Positive cases Prevalence % Male No (%) Female No (%) Age in years Study setting
Al-Mosawi2016 2015 Thi-QarMicroscopy 200 35 17.5 hospital
Al-Sorchee2013 2007 Erbil Microscopy 500 175 35 1-10 hospital
Rabatti2008 2002 Erbil Microscopy 116 70 60.34 0-12 hospital
Khudair2011 2008-2009 DiyalaMicroscopy 975 93 9.54 0-10 hospital
Nasser 2014 2013-2014 WasitMicroscopy 596 100 16.78 <5-?46 hospital
Ali 2015 2013-2014 Babylon Microscopy 492 115 23.37 0 -<30 hospital
Al-Ammash2015 2014-2015 Saladin Microscopy 304 55 18.09 35 (63.64) 20 (36.36) 0-50 hospital
Muhsin2016 2012 Karbala Microscopy 5670 332 5.86 193 (58.13) 139 (41.87) ?12 hospital
Mahfoth2010 2007-2008 NinevahMicroscopy 1220 347 28.44 ?5 nursery schools / children from some houses
Hussein 2011 2009 Baghdad Microscopy 730 103 14.11 40 (38.83) 63 (61.17) 0-18 hospital
Al-Fahdawi2007 2004-2005 Al-Anbar Microscopy 896 237 26.45 120 (50.63) 117 (49.37) 1-71 hospital
Jamil 2008 2006 DiyalaMicroscopy 220 155 70.45 ?1-?41 hospital
Al-Zigibi (a) 2011 2009-2010 Karbala Microscopy 776 61 7.86 29 (47.54) 32 (52.46) 0-70 hospital
Al-Jeburi2010 2007-2008 DiyalaMicroscopy 161 43 26.71 23 (53.49) 20 (46.51) ?1-70 hospital
Al-Zigibi (b) 2011 Babylon Microscopy 250 34 13.6 19 (55.88) 15 (44.12) primary school pupils
AL-Aboody2010 2009 Thi-QarMicroscopy 1000 249 24.9 1-?16 hospital
Mohammed 2010 2008 Thi-QarMicroscopy 960 392 40.83 210 (53.57) 182 (46.43) ?10-? 51 hospital
Al-Tae 2008 2000-2001 Baghdad Microscopy 354 103 29.10 1-?70 hospital
Al-Azzawi2010 2009 DiyalaMicroscopy 18450 2640 14.31 1490 (56.44) 1150 (43.56) 0-15 hospital
Jasim2009 2001 Saladin Microscopy 133 57 42.86 0-5 hospital
Al-Kaisi2007 2002 Saladin Microscopy 1050 140 13.33 82 (58.57) 58 (41.43) 0-81 hospital
Saael2009 2005 Baghdad Microscopy 1268 394 31.07 204 (51.78) 190 (48.22) 1-12 hospital
Al-Warid2012 2009-2010 Baghdad Microscopy 737 27 3.66 various ages hospital
Al-Tikrity2009 2006-2007 Saladin Microscopy 218 154 70.64 78 (50.65) 76 (49.35) 1-?25 hospital
Al-Marzoqi2008 2008 Babylon Microscopy 173 40 23.12 ?1 hospital
Al-Mosa2007 2004-2005 Babylon Microscopy 540 91 16.85 various ages hospital
Ftohe2008 2005-2006 NinevahMicroscopy 600 139 23.17 82 (58.99) 57 (41.01) ?6 hospital
Nayyef2011 2008 Baghdad Microscopy 800 317 39.63 163 (51.42) 154 (48.58) 0-90 hospital
Al-Taie2006 2003-2004 Babylon Microscopy 865 146 16.88 1-?50 hospital
Abdullah (a) 2005 1998-1999 Kirkuk Microscopy 806 75 9.31 6-13 primary school pupils
Abdullah (b) 2005 1998-1999 Kirkuk Microscopy 325 12 3.69 325 9-79 foodhandlers
Saeed 2005 NinevahMicroscopy 754 67 8.89 1-69 hospital
Jaeffer2011 2009-2010 Baghdad Microscopy 513 15 2.92 7 (46.67) 8 (53.33) 0-12 hospital
Thhaib2008 2005-2006 DiwaniyaMicroscopy 75 8 10.67 0-2 hospital
Al-Yasari2009 2008 Babylon Microscopy 115 6 5.22 5-50 hospital
Al-Morshidy2007 2003-2004 Babylon Microscopy 243 68 27.98 hospital
Yousif2011 Baghdad Microscopy 722 12 1.66 1-?18 Ibraheem2010 2007-2008 Baghdad Microscopy 316 64 20.25 0-10 hospital
Al-Reikaby2010 2007 Thi-Qar4006 2470 61.66 ?1-?45 hospital
Al-Kubaisy2008 2006-2007 Babylon Microscopy 1224 222 18.14 135 (60.81) 87 (39.19) ?1-?45 hospital
Kadhum2011 2009-2010 Al-Najaf Microscopy 70 3 4.29 ?1 hospital
Al-Najar2006 2001 Baghdad Microscopy 125 51 40.8 0-12 hospital
Ali 2010 2009-2010 WasitMicroscopy 600 60 10 34 (56.67) 26 (43.33) 0-50 hospital
Ibrahim (a) 2012 2010 Baghdad Microscopy 1520 149 9.80 91 (61.07) 58 (38.93) 0-12 hospital
Rahi (a) 2011 2009-2010 WasitMicroscopy 424 68 16.04 38 (55.88) 30 (44.12) 0-50 hospital
Rahi (b) 2011 WasitMicroscopy 78 13 16.67 10 (76.92) 3 (23.08) 0-60 hospital
Raddam2008 2006 Thi-QarMicroscopy 3600 1400 38.89 725 (51.79) 675 (48.21) 0-12 hospital
Kadum2007 2005-2006 Babylon Microscopy 1312 228 17.38 1-?50 hospital / primary schools pupils
Al-Kubaisy2007 2005-2006 Karbala Microscopy 2052 554 27 359 (64.80) 195 (35.20) various ages hospital
Al-Jabouri2007 2006-2007 Karbala Microscopy 557 286 51.35 157 (54.90) 129 (45.10) ?1-70 hospital
Al-Dulaimi2007 2005 Babylon Microscopy 515 48 9.32 1-?30 hospital
AL-Shaheen2007 2005 BasrahMicroscopy 7537 2203 29.23 1374 (62.37) 829 (37.63) 1-?45 hospital
Hamad2011 1998-2004 Erbil Microscopy 5768 711 12.33 430 (60.48) 281 (39.52) hospital
Jasim2011 2009 Baghdad Microscopy 2177 377 17.32 206 (54.64) 171 (45.36) Children hospital
Ibrahim (b) 2012 2010 Baghdad Microscopy 223 43 19.28 0-5 hospital
Guirges2006 Baghdad Microscopy 3564 938 26.32 0-70 hospital
Al-Jebory2012 2010-2011 Saladin Microscopy 1500 188 12.53 119 (63.30) 69 (36.70) 0-70 hospital
Hussan2012 Baghdad Microscopy 250 22 8.8 ?5 hospital
Raof2012 2009-2010 Baghdad Microscopy 300 67 22.33 41 (61.19) 26 (38.81) ?1-?19 hospital
Hussein 2013 2012-2013 Al-Najaf Microscopy 678 162 23.89 1-70 hospital
Kadir2013 2008-2009 Kirkuk Microscopy 600 154 25.67 ?1-60 hospital
Zaidan2013 2005 Baghdad Microscopy 400 362 90.5 211 (58.29) 151 (41.71) ?5 hospital
Al-Hameedawi2014 2013 Al-Najaf PCR 104 25 24.04 1-58 hospital
Aljanabi2014 2011-2012 Baghdad Microscopy 1712 270 15.77 169 (62.59) 101 (37.41) 0-15 hospital
Alshawi2013 2010 Baghdad Microscopy 1356 331 24.41 186 (56.19) 145 (43.81) 1-?50 hospital
Al-Bayati2014 2011-2012 DiwaniyaMicroscopy 1057 149 14.1 0-12 hospital
Racine 2014 DiwaniyaMicroscopy 220 13 5.91 15-45 foodhandlersHussein 2014 2011-2012 Baghdad Microscopy 2449 453 18.5 hospital
Abed 2015 2007 Baghdad Microscopy 200 55 27.5 0-10 hospital
Al-Garawi2015 2013 Karbala Microscopy 2036 410 20.14 253 (61.71) 157 (38.29) ?1-12 hospital
Obaid2015 Kirkuk Microscopy 430 123 28.6 <1-12 hospital
Shaker 2016 2014 Baghdad Microscopy 320 60 18.75 1-50 hospital
Shlash2016 2015-2016 Al-Najaf Microscopy 120 90 75 32 (35.56) 58 (64.44) <6-14 hospital
Ali 2017 2013-2014 Karbala, Babylon & Al-Najaf Microscopy 1350 203 15.04 1-?60 hospital
Al-Khalidi2016 2014 DiwaniyaPCR 170 39 22.94 0-2 hospital
Atiyah2016 2015 WasitMicroscopy 3550 1780 50.14 1447 (81.29) 333 (18.71) 0-45 hospital
Hussein 2016 2008 Thi-QarMicroscopy 780 49 6.28 0-6 hospital
Al-Moussawi2005 2002-2003 Babylon Microscopy 681 69 10.13 1-?30 village
Kadir1999 1988-1989 Kirkuk Microscopy 1681 130 7.73 6-12 primary school pupils
Al-Joudi2005 1992-1997 Al-Anbar Microscopy 6330 509 8.04 1-67 hospital
Ali 2016 2014 SulaimaniMicroscopy 300 31 10.33 0-14 hospital
Abid2012 2009-2010 Saladin Microscopy 317 54 17.03 hospital
Badry2014 2012-2013 DuhokMicroscopy 522 134 25.67 0-14 hospital
Mero2013 2008-2009 DuhokMicroscopy 1132 121 10.69 0-13 hospital / primary schools pupils
Al-Kubaisy2015 Baghdad Microscopy 1500 351 23.4 ?10 hospital
Mahdi 2002 1997-1998 BasrahMicroscopy 215 5 2.33 2 (40) 3 (60) ?6-65 Shebib2003 1999-2000 Baghdad Microscopy 200 50 25 hospital
Salman 2013 2010 Kirkuk Microscopy 221 44 19.91 ?2 hospital
Al-Kaissi2006 Baghdad Microscopy 200 4 2 0-2 hospital
Amin 2015 2014 SulaimaniMicroscopy 300 110 36.67 1-50 hospital
Obaid2014 2013-2014 Kirkuk Microscopy 207 84 40.58 46 (54.76) 38 (45.24) ?1-50 hospital
Mero2015 2013-2014 DuhokMicroscopy 600 158 26.33 <2-12 hospital / primary schools pupils
Al-Azawi2009 2006-2007 Baghdad Microscopy 600 195 32.5 2-11 hospital
Al-Kubaisy2014 2003-2004 Baghdad Microscopy 2033 105 5.16 ?15 hospital
Jarallah2012 2011 BasrahMicroscopy 294 80 27.21 47 (58.75) 33 (41.25) <1-14 village
Hussein 2015 2014-2015 Baghdad PCR 100 7 7 0-18 hospital
Hamad2012 2010-2011 Erbil Microscopy 200 60 30 32 (53.33) 28 (46.67) <1-12 hospital
Faraj2012 2005-2006 Erbil Microscopy 587 75 12.78 75 (100) ?10-?50 foodhandlersSalman 2016 2014-2015 Kirkuk Microscopy 417 7 1.68 ?1-60 Prevalence and heterogeneity
The random effect pooled prevalence of E. histolytica/dispar infection was 20.61% (95% CI: 17.83%?23.53%) in Iraq. The prevalence estimates of E. histolytica/dispar are shown in a forest plot (Fig 2). The results of Cochran’s Q test and inverse variance index (I2) among studies included in the meta-analysis were 14169.34 and 99.31%, respectively.
Fig 2. Forest plot of the proportion prevalence of E. histolytica/dispar in Iraq.

The pooled estimates by subgroup are summarised in Table 2. Of the 99 studies, 39 provided information on the gender of individuals investigated (38 studies presented data from both males and females, 1 study presented data from just males). The pooled prevalence of E. histolytica/dispar in males (58.43%, 95% CI: 54.71%?62.1%) was higher than in females (43.10%, 95% CI: 39.66%?46.6%).
Table 2. Pooled prevalence of E. histolytica/dispar in Iraq stratified by subgroups
Characteristics Number of studies Proportion % 95% CI heterogeneity
Q P-value I2 % 95% CI for I2
Overall 99 20.61 17.83?23.53 14169.34 P < 0.0001 99.31 99.26 ? 99.35
Sex Male 39 58.43 54.71?62.1 686.28 P < 0.0001 94.46 93.24 ? 95.47
Female 38 43.10 39.66?46.6 568.85 P < 0.0001 93.50 91.95 ? 94.74
Detection method in stool Microscopy 95 20.32 17.80?22.96 10813.55 P < 0.0001 99.13 99.07 ? 99.19
PCR 3 17.57 8.07?29.75 15.81 P = 0.0004 87.35 64.15 ? 95.53
Study setting hospitals 84 22.69 19.55?25.99 12965.76 P < 0.0001 99.36 99.32 ? 99.40
hospitals / primary schools pupils 3 17.66 10.34?26.43 68.38 P < 0.0001 97.08 94.14 ? 98.54
primary school pupils 3 9.68 7.17?12.52 8.89 P = 0.0118 77.49 26.97 ? 93.06
foodhandlers3 7.79 1.36?18.83 24.08 P < 0.0001 95.85 88.14 ? 98.55
villages 2 17.85 4.59?37.25 41.60 P < 0.0001 97.60 94.09 ? 99.02
nursery schools / children from some houses 1 Year of study <1990 1 >=1990?<=1999 4 5.98 3.72?8.73 25.73 P < 0.0001 88.34 72.63 ? 95.03
>=2000?<=2009 46 26.68 22.12?31.51 8143.53 P < 0.0001 99.45 99.40 ? 99.49
>=2010?<=2017 38 18.46 14.28?23.04 3758.65 P < 0.0001 99.02 98.89 ? 99.12
Province Al-Anbar 2 16.15 2.72?37.73 200.94 P < 0.0001 99.50 99.14 ? 99.71
Al-Najaf 5 26.80 11.96?44.98 175.82 P < 0.0001 97.73 96.39 ? 98.56
Babylon 12 15.98 13.24?18.93 109.12 P < 0.0001 89.92 84.33 ? 93.52
Baghdad 27 19.51 14.49?25.07 2867.75 P < 0.0001 99.09 98.96 ? 99.21
Basrah3 17.29 4.43?36.19 142.09 P < 0.0001 98.59 97.55 ? 99.19
Diwaniya4 13.08 7.46?19.97 25.59 P < 0.0001 88.28 72.46 ? 95.01
Diyala4 28.02 13.28?45.72 361.20 P < 0.0001 99.17 98.78 ? 99.43
Duhok3 20.32 10.05?33.07 92.35 P < 0.0001 97.83 95.92 ? 98.85
Erbil 5 28.34 15.89?42.76 287.69 P < 0.0001 98.61 97.94 ? 99.06
Karbala 6 19.43 9.07?32.54 1121.22 P < 0.0001 99.55 99.43 ? 99.65
Kirkuk 8 14.88 7.69?23.92 411.34 P < 0.0001 98.30 97.66 ? 98.76
Ninevah3 19.43 8.63?33.27 128.04 P < 0.0001 98.44 97.23 ? 99.12
Saladin 6 27.33 14.91?41.87 365.82 P < 0.0001 98.63 98.06 ? 99.04
Sulaimani2 22.16 3.04?51.980 62.21 P < 0.0001 98.39 96.43 ? 99.28
Thi-Qar6 30.12 15.47?47.22 1467.28 P < 0.0001 99.66 99.58 ? 99.73
Wasit5 20.92 5.71?42.370 756.71 P < 0.0001 99.47 99.30 ? 99.60
The proportion of E. histolytica/dispar infection was higher in studies used microscopic detection method (20.32%, 95% CI: 17.80%?22.96%) compared to studies used PCR method (17.57%, 95% CI: 8.07%?29.75%).

Most of the studies were hospital based studies reported a prevalence of E. histolytica/dispar of 22.69% (95% CI: 19.55%?25.99%). The estimated prevalence across the hospitals / primary schools pupils-based studies was 17.66% (95% CI: 10.34%?26.43%). The pooled prevalence in primary school pupils and residents of villages was 9.68% (95% CI: 7.17%?12.52%) and 17.85% (95% CI: 4.59%?37.25%), respectively. Foodhandlers showed the lowest proportion of infection (7.79%, 95% CI: 1.36%?18.83%). There was one nursery schools / children from some houses-based study.

According to the subgroup of study year, there was one study conducted before 1990, the pooled prevalence was 5.98% (95% CI: 3.72%–8.73%) between 1990 and 1999, then increased into 26.68% (95% CI: 22.12%–31.51%) between 2000 and 2009, lastly, decreased into 18.46 (95% CI: 14.28%–23.04%) between 2010 and 2017.

On the basis of provinces, the highest pooled prevalence was observed in the province of Thi-Qar (30.12%, 95% CI: 15.47%?47.22%), while the lowest pooled prevalence was in the province of Diwaniya (13.08%, 95% CI: 7.46%?19.97%).

Fig 3. Funnel plots of the proportion prevalence of E. histolytica/dispar in Iraq.

Discussion
This the first systematic review and meta-analysis to estimate the nationwide prevalence of E. histolytica/dispar in Iraq. The findings of this study could have important implications to develop prevention and control strategies for amebiasis.

This study showed that the overall prevalence of E. histolytica/dispar in Iraq was 20.61%. The E. histolytica/dispar prevalence in Iraq is higher than that reported in the United States and Australia which were 7% and 2.9% respectively ADDIN CSL_CITATION { “citationItems” : { “id” : “ITEM-1”, “itemData” : { “ISBN” : “0002-9637”, “ISSN” : “0002-9637”, “PMID” : “12224595”, “abstract” : “One-third of 5,792 fecal specimens from 2,896 patients in 48 states and the District of Columbia tested positive for intestinal parasites during the year 2000. Multiple infections with 2-4 parasitic species constituted 10% of 916 infected cases. Blastocystis hominis infected 662 patients (23% or 72% of the 916 cases). Its prevalence appears to be increasing in recent years. Eighteen other species of intestinal parasites were identified. Cryptosporidium parvum and Entamoeba histolytica/E. dispar ranked second and third in prevalence, respectively. Prevalence of infection was lowest (22-27%) in winter, gradually increased during the spring, reached peaks of 36-43% between July and October, and gradually decreased to 32% in December. A new superior method of parasite detection using the Proto-fix-CONSED system for fixing, transport, and processing of fecal specimens is described. In single infections, pathogenic protozoa caused asymptomatic subclinical infections in 0-31 % of the cases and non-pathogenic protozoa unexpectedly caused symptoms in 73-100% of the cases. The relationship between Charcot-Leyden crystals and infection with four species of intestinal parasites is examined and the list of provoking parasitic causes is expanded.”, “author” : { “dropping-particle” : “”, “family” : “Amin”, “given” : “Omar”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” } , “container-title” : “The American Journal of Tropical Medicine and Hygiene”, “id” : “ITEM-1”, “issue” : “6”, “issued” : { “date-parts” : “2002” }, “page” : “799-803”, “title” : “Seasonal prevalence of intestinal parasites in the United States during 2000.”, “type” : “article-journal”, “volume” : “66” }, “uris” : “http://www.mendeley.com/documents/?uuid=25d0b702-51c2-4ded-865c-dd4d5de3ca50” }, { “id” : “ITEM-2”, “itemData” : { “DOI” : “10.1128/JCM.02144-06”, “ISBN” : “0095-1137 (Print)\r0095-1137 (Linking)”, “ISSN” : “00951137”, “PMID” : “17229864”, “abstract” : “This study investigated the presence of Entamoeba histolytica, Entamoeba dispar, and Entamoeba moshkovskii in stool samples from a patient population in Sydney, Australia. Stool samples were tested by microscopy and PCR. Five patients were found with E. histolytica infections, while E. dispar and E. moshkovskii were observed in 63 (70.8%) and 55 (61.8%) patients, respectively, by PCR. This is the first study in Australia using molecular techniques to determine the presence of E. histolytica, E. dispar, and E. moshkovskii.”, “author” : { “dropping-particle” : “”, “family” : “Fotedar”, “given” : “R.”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Stark”, “given” : “D.”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Beebe”, “given” : “N.”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Marriott”, “given” : “D.”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Ellis”, “given” : “J.”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Harkness”, “given” : “J.”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” } , “container-title” : “Journal of Clinical Microbiology”, “id” : “ITEM-2”, “issue” : “3”, “issued” : { “date-parts” : “2007” }, “page” : “1035-1037”, “title” : “PCR detection of ;i;Entamoeba histolytica;/i;, ;i;Entamoeba dispar;/i;, and ;i;Entamoeba moshkovskii;/i; in stool samples from Sydney, Australia”, “type” : “article-journal”, “volume” : “45” }, “uris” : “http://www.mendeley.com/documents/?uuid=d6d49ec8-48b7-433e-ab72-cec510e930e2” } , “mendeley” : { “formattedCitation” : “108,109”, “plainTextFormattedCitation” : “108,109”, “previouslyFormattedCitation” : “108,109” }, “properties” : { “noteIndex” : 0 }, “schema” : “https://github.com/citation-style-language/schema/raw/master/csl-citation.json” }108,109. The prevalence of E. histolytica/dispar in Iraq is closer to the prevalence of 23.1% in Pakistan ADDIN CSL_CITATION { “citationItems” : { “id” : “ITEM-1”, “itemData” : { “author” : { “dropping-particle” : “”, “family” : “Zeb”, “given” : “Aurang”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Qureshi”, “given” : “Asma”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Khan”, “given” : “Luqman”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Mansoor”, “given” : “Abu”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Ullah”, “given” : “Sami”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Irfan”, “given” : “Muhammad”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” } , “container-title” : “Journal of Entomology and Zoology Studies”, “id” : “ITEM-1”, “issue” : “1”, “issued” : { “date-parts” : “2018” }, “page” : “185-188”, “title” : “Prevalence of ;i;Entamoeba histolytica;/i; in district Buner Khyber Pakhtunkhwa, Pakistan”, “type” : “article-journal”, “volume” : “6” }, “uris” : “http://www.mendeley.com/documents/?uuid=39d51c3c-0f8c-4f1f-b1aa-ad43f3667c78” } , “mendeley” : { “formattedCitation” : “110”, “plainTextFormattedCitation” : “110”, “previouslyFormattedCitation” : “110” }, “properties” : { “noteIndex” : 0 }, “schema” : “https://github.com/citation-style-language/schema/raw/master/csl-citation.json” }110 and 19.2% in United Arab Emirates ADDIN CSL_CITATION { “citationItems” : { “id” : “ITEM-1”, “itemData” : { “DOI” : “10.2478/s11686-013-0128-8”, “ISBN” : “1896-1851 (Electronic)\r1230-2821 (Linking)”, “ISSN” : “12302821”, “PMID” : “23666654”, “abstract” : “Amoebiasis is one of the most important infectious diseases afflicting mainly tropical and subtropical countries. This study was carried out in the Sharjah Emirate, UAE in order to accurately detect and differentiate Entamoeba histolytica, Entamoeba dispar and E. moshkovskii in fecal samples collected from the Sharjah municipality public health clinic by ELISA and nested polymerase chain reaction (PCR). One hundred and twenty specimens were examined and the PCR was positive for E. histolytica, E. dispar and E. moshkovskii (collectively referred to as Entamoeba complex) in 19.2% (23 out of 120). Of those, 10% (12/120) were mono u2014 infection with E. histolytica; 2.5% (3/120) with E. dispar; and 2.5% (3/120) E. moshkovskii. The nested PCR also detected mixed infections by both E. histolytica and E. dispar in 3.3% (4/120) and E. dispar and E. moshkovskii in 0.8% (1/120). The TechLab ELISA kit failed to detect E. histolytica in any of the E. histolytica PCR positive samples. Overall, the percentage of E. histolytica including those found in mixed infections was 13.3% (16/120). Compared to nested PCR, microscopy was found to have an overall sensitivity of 52.2% and a specificity of 75.2% for detection of Entamoeba complex. The present study indicates that E. histolytica is present in the UAE with an average incidence rate of 13.3%. However, larger studies need to be conducted in order to confirm these findings. We propose the use of PCR in both the routine diagnosis of amoebiasis and epidemiological survey in the UAE.”, “author” : { “dropping-particle” : “”, “family” : “ElBakri”, “given” : “Ali”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Samie”, “given” : “Amidou”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Ezzedine”, “given” : “Sinda”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Abu Odeh”, “given” : “Raed”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” } , “container-title” : “Acta Parasitologica”, “id” : “ITEM-1”, “issue” : “2”, “issued” : { “date-parts” : “2013” }, “page” : “185-190”, “title” : “Differential detection of ;i;Entamoeba histolytica;/i;, ;i;Entamoeba dispar;/i; and ;i;Entamoeba moshkovskii;/i; in fecal samples by nested PCR in the United Arab Emirates (UAE)”, “type” : “article-journal”, “volume” : “58” }, “uris” : “http://www.mendeley.com/documents/?uuid=c3712de5-b995-4e72-958b-80db870b191e” } , “mendeley” : { “formattedCitation” : “111”, “plainTextFormattedCitation” : “111”, “previouslyFormattedCitation” : “111” }, “properties” : { “noteIndex” : 0 }, “schema” : “https://github.com/citation-style-language/schema/raw/master/csl-citation.json” }111, but lower than the estimated prevalence in two neighboring countries, Turkey and Iran which were 1.5% and 1.0% respectively ADDIN CSL_CITATION { “citationItems” : { “id” : “ITEM-1”, “itemData” : { “DOI” : “10.5152/tpd.2011.02”, “ISBN” : “2146-3077 (Electronic)\r1300-6320 (Linking)”, “ISSN” : “13006320”, “PMID” : “21618183”, “abstract” : “OBJECTIVE: Humans may be infected with three morphologically identical Entamoeba species; pathogenic E. histolytica, commensal E. moshkowskii and E. dispar. The aim of the present study was to determine the true prevalence of the E. histolytica using native lugol, trichrome staining and a monoclonal antigen detection kit (ELISA kit E. histolytica-II; Techlab, Inc., Blacksburg, VA) among primary school children living in the rural areas around Sivas.\n\nMETHODS: A total of 1449 stool samples were examined by native lugol and Trichrome staining, and 312 (22%) samples were positive for one or more parasite species. Additionally, 22 (1.5%) stool samples were found to be positive for the presence of E. histolytica/dispar cysts, and these samples were further examined by E. histolytica specific antigen based ELISA.\n\nRESULTS: As a result, ELISA test gave negative reactions for all the samples. Also, there was no cross reaction with other luminal protozoa such as E. coli, G. intestinalis, B. hominis and I. butschlii.\n\nCONCLUSION: The data reveals that E. histolytica prevalence may be lower than estimated.”, “author” : { “dropping-particle” : “”, “family” : “Malatyali”, “given” : “Erdogan”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Ozcelik”, “given” : “Semra”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Celiksoz”, “given” : “Ali”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” } , “container-title” : “Turkish Journal of Parasitology”, “id” : “ITEM-1”, “issue” : “1”, “issued” : { “date-parts” : “2011” }, “page” : “6-9”, “title” : “The investigation of ;i;Entamoeba histolytica;/i; prevalence in some villages of Sivas by ELISA method”, “type” : “article-journal”, “volume” : “35” }, “uris” : “http://www.mendeley.com/documents/?uuid=f27c4022-1e6d-4f96-b703-9380aa1f1a14” }, { “id” : “ITEM-2”, “itemData” : { “author” : { “dropping-particle” : “”, “family” : “Sayyari”, “given” : “A”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Imanzadeh”, “given” : “F”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Bagheri Yazdi”, “given” : “S”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Karami”, “given” : “H”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Yaghoobi”, “given” : “M”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” } , “container-title” : “Eastern Mediterranean Health Journal”, “id” : “ITEM-2”, “issue” : “3”, “issued” : { “date-parts” : “2005” }, “page” : “377-383”, “title” : “Prevalence of intestinal parasitic infections in the Islamic Republic of Iran”, “type” : “article-journal”, “volume” : “11” }, “uris” : “http://www.mendeley.com/documents/?uuid=50e29486-366c-48ed-aae3-6f216103581c” } , “mendeley” : { “formattedCitation” : “112,113”, “plainTextFormattedCitation” : “112,113”, “previouslyFormattedCitation” : “112,113” }, “properties” : { “noteIndex” : 0 }, “schema” : “https://github.com/citation-style-language/schema/raw/master/csl-citation.json” }112,113.

The infection with E. histolytica is acquired through the ingestion of cysts from fecally contaminated food or water. Therefore in developing countries, E. histolytica is a waterborne and foodborne parasitic protozoa. In Iraq, the most probable sources of E. histolytica infection may be due to the contamination of different sources of drinking water with human sewages, as a result of direct dumping of untreated sewage into rivers or leaking sewage pipes or septic tanks resulting in contaminated drinking water network and ground water. In Baghdad city, the capital of Iraq, the contamination proportion of tap water and sewage with E. histolytica were 10% and 30% respectively ADDIN CSL_CITATION { “citationItems” : { “id” : “ITEM-1”, “itemData” : { “abstract” : “From July 2006 to March 2007, 180 tap water sample and 90 sewage water sample from houses at (Al-Dura, Hi-Al- Maalf, Hi-Al-Jehad, Al-Shabab, and Al-Baya’a) were collected in Baghdad city. Sedimentation methods were performed on each specimens the total contamination rate in tap water was 17.2% and in sewage water was 60% with these parasites: Entamoeba histolytica, Ascaris lumbericoides ,Strongyloides stercoralis ,and Fasciola sp. Distribution of parasites as months of year that July was record the highest rate of contamination in both tap and swage water”, “author” : { “dropping-particle” : “”, “family” : “Hadi”, “given” : “A.”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Faraj”, “given” : “A.”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” } , “container-title” : “Al-Qadisiyah Journal of Veterinary Medicine Sciences”, “id” : “ITEM-1”, “issue” : “2”, “issued” : { “date-parts” : “2008” }, “page” : “33-36”, “title” : “Distribution of intestinal parasites in drinking water in some regions in Baghdad”, “type” : “article-journal”, “volume” : “7” }, “uris” : “http://www.mendeley.com/documents/?uuid=d96cf38a-0617-4f44-a30c-5449d4c79e31” } , “mendeley” : { “formattedCitation” : “114”, “plainTextFormattedCitation” : “114”, “previouslyFormattedCitation” : “114” }, “properties” : { “noteIndex” : 0 }, “schema” : “https://github.com/citation-style-language/schema/raw/master/csl-citation.json” }114.
This meta-analysis showed that the infection rate was higher in males than females in Iraq. This finding is consistent with a previous study of gender distribution in which the reports of invasive amebiasis and population-based studies demonstrated a higher proportion of men than women, whereas asymptomatic infection with E. histolytica is equally distributed between males and females ADDIN CSL_CITATION { “citationItems” : { “id” : “ITEM-1”, “itemData” : { “DOI” : “10.1111/j.1572-0241.2000.01525.x”, “ISBN” : “0002-9270 (Print)\r0002-9270 (Linking)”, “ISSN” : “00029270”, “abstract” : “OBJECTIVE: The majority of individuals infected by the protozoan parasite Entamoeba histolytica experience subclinical infections. However, a small proportion of parasitized individuals develop severe invasive disease such as amebic dysentery or amebic liver abscess. Invasive amebiasis affects predominantly men; the usual explanation for this has been that men have a higher rate of asymptomatic infections and therefore experience a higher rate of invasive disease. To date, there is no convincing evidence of an increased rate of asymptomatic infection of men as compared with women. The purpose of this study was to evaluate the evidence supporting the hypothesis that men have higher rates of asymptomatic infection and thus an increased frequency of invasive amebiasis. METHODS: We reviewed published reports of invasive amebiasis and population-based parasitological studies from 1929-1997 to compare the gender ratio of asymptomatic and symptomatic E. histolytica infection. Infections with E. histolytica were differentiated from the nonpathogenic E. dispar whenever possible. RESULTS: The reports of invasive amebiasis (dysentery, liver abscess, colonic perforation, peritonitis, appendicitis, and ameboma) showed a higher proportion of men than women (ratio, male:female = 3.2:1, p < 0.05). This contrasts with the epidemiological surveys, where the rate of asymptomatic infection with E. histolytica was the same (1:1) for both genders (p > 0.05). CONCLUSIONS: Asymptomatic E. histolytica infection is equally distributed between the genders. The high proportion of men with invasive amebiasis may be due to a male-related susceptibility to invasive disease. (C) 2000 by Am. Coll. of Gastroenterology.”, “author” : { “dropping-particle” : “”, “family” : “Acuna-Soto”, “given” : “R.”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Maguire”, “given” : “J. H.”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Wirth”, “given” : “D. F.”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” } , “container-title” : “The American Journal of Gastroenterology”, “id” : “ITEM-1”, “issue” : “5”, “issued” : { “date-parts” : “2000” }, “page” : “1277-1283”, “title” : “Gender distribution in asymptomatic and invasive amebiasis”, “type” : “article-journal”, “volume” : “95” }, “uris” : “http://www.mendeley.com/documents/?uuid=f0201fd4-a88d-4f07-9954-ed04ccdda955” } , “mendeley” : { “formattedCitation” : “115”, “plainTextFormattedCitation” : “115”, “previouslyFormattedCitation” : “115” }, “properties” : { “noteIndex” : 0 }, “schema” : “https://github.com/citation-style-language/schema/raw/master/csl-citation.json” }115. Another study indicated that serum from women had a higher ability to kill E. histolytica trophozoites than serum from men and this killing took place via complement ADDIN CSL_CITATION { “citationItems” : { “id” : “ITEM-1”, “itemData” : { “ISSN” : “00029637”, “PMID” : “18541770”, “abstract” : “Men are more than 7 times more likely to develop amebic liver abscess or amebic dysentery caused by Entamoeba histolytica than women. Because the complement system could play a key role in controlling amebiasis, we determined whether serum from men and women differ in the ability to kill amebic trophozoites. We found that serum from women was significantly more effective in killing E. histolytica trophozoites than serum from men, and this killing was complement dependent. Our results provide a possible explanation for the differential susceptibility of men and women to amebic liver abscess and amebic colitis.”, “author” : { “dropping-particle” : “”, “family” : “Snow”, “given” : “Margaret”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Chen”, “given” : “Minghe”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Guo”, “given” : “Jian”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Atkinson”, “given” : “John”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Stanley”, “given” : “Samuel L.”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” } , “container-title” : “American Journal of Tropical Medicine and Hygiene”, “id” : “ITEM-1”, “issue” : “6”, “issued” : { “date-parts” : “2008” }, “page” : “922-923”, “title” : “Short report: differences in complement-mediated killing of <i>Entamoeba histolytica</i> between men and women – an explanation for the increased susceptibility of men to invasive amebiasis?”, “type” : “article-journal”, “volume” : “78” }, “uris” : “http://www.mendeley.com/documents/?uuid=5b561e10-1d9e-4a3c-84c7-dfb67743b9ff” } , “mendeley” : { “formattedCitation” : “116”, “plainTextFormattedCitation” : “116”, “previouslyFormattedCitation” : “116” }, “properties” : { “noteIndex” : 0 }, “schema” : “https://github.com/citation-style-language/schema/raw/master/csl-citation.json” }116.

In terms of detection method in stool, the pooled prevalence of microscopy was higher than that of PCR, because microscopic examination of stools does not distinguish E. dispar from E. histolytica. PCR methods are used to differentiate E. histolytica from E. dispar. Hence, PCR methods have led to more reliable results compared to microscopy.

In the present study, the maximum prevalence rate of 22.69% occurred in hospital based studies. The hospital setting cases may have intestinal symptoms and require clinical examination in the clinic or hospital to diagnose the causes of these symptoms, and they were routinely to be tested for intestinal parasites compared with cases from the community setting.

Residents of villages presented high prevalence of E. histolytica (17.85%). This may reflect the shortages of purified water supplies and compromised sanitation in the villages of Babylon and Basrah provinces where the samples of stools were taken and examined. The contamination of drinking water with E. histolytica was reported to be 8% in Basrah marshes villages, south of Iraq ADDIN CSL_CITATION { “citationItems” : { “id” : “ITEM-1”, “itemData” : { “abstract” : “Human and animal are the main sources of water and environmental contamination. This study aims to discover and determine the prevalence of drinking water contamination with parasites. A total of 425 water samples were colleted from Basrah marshes villages south of Iraq, during the period of November 2012 to May 2013. Water samples were examined by direct method and by sedimentation and floatation methods. From 425 water samples 155(36.4%) were parasitic and 270 (63.5%) were no contaminated. Entamoeba histolytica is the most common parasites that was detected in 34(8%) water samples followed by Giardia lamblia 31(7.2%) and then other types of parasites but in lower rates. The examinations included study some of the effective factors on the growth of these parasites such as temperature and pH. Statistically, there are significant differences (p<0.01) among the contamination rates of water samples for all villages of Basrah marshes. Parasites are found in various water sources especially that found in rural villages of marshes land showed a higher prevalence of contamination can be explained by poor sanitation and personal hygiene, also Style life and environmental of marshes land, contamination water supply, lack of filtration and rottenness of water distributing pipes and warm climate in Basrah province.”, “author” : { “dropping-particle” : “”, “family” : “Jarallah”, “given” : “Hind Mahdi”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” } , “container-title” : “Journal of Babylon University/Pure and Applied Sciences”, “id” : “ITEM-1”, “issue” : “2”, “issued” : { “date-parts” : “2016” }, “page” : “370-376”, “title” : “Contamination of different drinking water sources with parasites in Basrah marshes villages, Iraq”, “type” : “article-journal”, “volume” : “24” }, “uris” : “http://www.mendeley.com/documents/?uuid=1c4736d4-7a47-4520-8637-30e0dbd57a21” } , “mendeley” : { “formattedCitation” : “117”, “plainTextFormattedCitation” : “117”, “previouslyFormattedCitation” : “117” }, “properties” : { “noteIndex” : 0 }, “schema” : “https://github.com/citation-style-language/schema/raw/master/csl-citation.json” }117.
The prevalence of E. histolytica in primary school pupils was 9.68% and this is due to the lack of purified water supplies and poor hygiene in both schools and pupils. This can be explained by the fact that out of the three studies conducted only on primary schoolchildren, two studies were carried out among schoolchildren in rural areas ADDIN CSL_CITATION { “citationItems” : { “id” : “ITEM-1”, “itemData” : { “author” : { “dropping-particle” : “”, “family” : “Al-Zigibi”, “given” : “Ihsan Mohamed Salbi”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” } , “container-title” : “Journal of Kerbala University”, “id” : “ITEM-1”, “issue” : “3”, “issued” : { “date-parts” : “2011” }, “page” : “170-174”, “title” : “Isolation of parasitic causes of digestive system infection from primary rural school in a Reghala village in Babylon City”, “type” : “article-journal”, “volume” : “9” }, “uris” : “http://www.mendeley.com/documents/?uuid=31f1727f-09a9-43d0-a304-c78cc3e62718” }, { “id” : “ITEM-2”, “itemData” : { “author” : { “dropping-particle” : “”, “family” : “Abdullah”, “given” : “Ibraheem A.”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Al-Shirifi”, “given” : “Hider M.”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” } , “container-title” : “Rafidain Journal of Science”, “id” : “ITEM-2”, “issue” : “8”, “issued” : { “date-parts” : “2005” }, “page” : “83-89”, “title” : “The role of housing type and drinking water in prevalence of intestinal parasites among pupils of a number of primary schools in rural area of Al-Taamem Province-Iraq”, “type” : “article-journal”, “volume” : “16” }, “uris” : “http://www.mendeley.com/documents/?uuid=d11c85b1-059a-4738-9779-449ed821a242” } , “mendeley” : { “formattedCitation” : “20,87”, “plainTextFormattedCitation” : “20,87”, “previouslyFormattedCitation” : “20,87” }, “properties” : { “noteIndex” : 0 }, “schema” : “https://github.com/citation-style-language/schema/raw/master/csl-citation.json” }20,87 and one study with samples from rural and low socioeconomic urban areas ADDIN CSL_CITATION { “citationItems” : { “id” : “ITEM-1”, “itemData” : { “author” : { “dropping-particle” : “”, “family” : “Kadir”, “given” : “Mohammed A.”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Salman”, “given” : “Yahya G.”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” } , “container-title” : “Annals of the College of Medicine, Mosul”, “id” : “ITEM-1”, “issue” : “1 & 2”, “issued” : { “date-parts” : “1999” }, “page” : “94-98”, “title” : “Prevalence of intestinal parasites among primary school children in Al-Taameem province, Iraq”, “type” : “article-journal”, “volume” : “25” }, “uris” : “http://www.mendeley.com/documents/?uuid=921188e0-f0ad-40d8-be92-cdebffe95eff” } , “mendeley” : { “formattedCitation” : “64”, “plainTextFormattedCitation” : “64”, “previouslyFormattedCitation” : “64” }, “properties” : { “noteIndex” : 0 }, “schema” : “https://github.com/citation-style-language/schema/raw/master/csl-citation.json” }64.
Relatively the lowest prevalence (7.79%) has been observed among foodhandlers, this can be attributed to the routine mandatory screening and treatment of registered foodhandlers by the ministry of health. However, the prevalence of E. histolytica infection was much higher than in the neighboring countries Jordan and Turkey (0.11% and 0.3% respectively) ADDIN CSL_CITATION { “citationItems” : { “id” : “ITEM-1”, “itemData” : { “DOI” : “10.1016/j.jmii.2013.06.001”, “ISBN” : “1995-9133 (Electronic)\r1684-1182 (Linking)”, “ISSN” : “19959133”, “PMID” : “23933293”, “abstract” : “BACKGROUND/PURPOSE: Intestinal parasitic and bacterial infections constitute a major health issue in developing countries. The present study investigates and assesses infection rates among food handlers with intestinal parasites and microbial agents in luxurious hotels in the Dead Sea area of Jordan. METHODS: A total of 901 stool samples were collected from food handlers (35 females and 866 males) employed in four main hotels in the Dead Sea area. Fecal samples were examined microscopically for intestinal parasites. Standard culture and biochemical techniques were used for the isolation and identification of Salmonella and Shigella spp. in stool samples. RESULTS: Five species of protozoan (Blastocystis hominis, Giardia intestinalis, Entamoeba coli, Entamoeba histolytica, and Endolimax nana), one helminth (Hymenolepis nana), and one cylindrical worm (Enterobius vermicularis) were recovered with an overall infection rate of 3.7%. G. intestinalis was the most prevalent parasitic infection with infection rate of 2.44%. All samples were negative for both Salmonella and Shigella. CONCLUSION: Findings highlight the important role of food handlers in the transmission of intestinal parasites to high-class clients accommodated in luxury hotels, and stress the urgent need for regular health and parasitologic examination of food handlers.”, “author” : { “dropping-particle” : “”, “family” : “Abdel-Dayem”, “given” : “Muna”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Zou’bi”, “given” : “Renad”, “non-dropping-particle” : “Al”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Hani”, “given” : “Rehan Bani”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Amr”, “given” : “Zuhair Sami”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” } , “container-title” : “Journal of Microbiology, Immunology, and Infection”, “id” : “ITEM-1”, “issue” : “5”, “issued” : { “date-parts” : “2014” }, “page” : “377-380”, “publisher” : “Elsevier Taiwan LLC”, “title” : “Microbiological and parasitological investigation among food handlers in hotels in the Dead Sea area, Jordan”, “type” : “article-journal”, “volume” : “47” }, “uris” : “http://www.mendeley.com/documents/?uuid=f7ff86be-6584-4872-8110-44cd43fb17bb” }, { “id” : “ITEM-2”, “itemData” : { “DOI” : “10.1097/PHH.0b013e3181aa2814”, “ISBN” : “1078-4659”, “ISSN” : “10784659”, “PMID” : “19823157”, “abstract” : “Objectives: Food-borne diseases represent a persistent global health burden, and food handlers play a major role in their transmission. Staphylococcus aureus carriage and intestinal parasitism are important risk factors for the contamination of food and water. This study was undertaken to determine the prevalence of Staphylococcus aureus and intestinal parasites among food handlers working in Sanliurfa, Southeastern Anatolia. Methods: In this cross-sectional study, 299 food handlers selected randomly were enrolled. Nasal swabs, throat cultures, and stool samples were examined. Results: The mean age of participants was 26.7 (+/- 9.6) years. Only 33.6 percent of food handlers had education beyond the elementary school level. Within this group, 50.8 percent had never previously received a carrier examination and only 31.4 percent received regular examinations. We found that 52.2 percent of food handlers carried intestinal parasites including Giardia intestinalis (26.8%), Ascaris lumbricoides (10.7%), Tenya saginata (10.0%), and Staphylococcus aureus (23.1%). None of the food handlers was positive for Salmonella sp and Shigella sp. Conclusions: These findings necessitate improvements in regional carrier detection, infection control, and food hygiene. Subsequent to this study, researchers from the Department of Public Health, Harran University, instituted a series of interventions aimed at improving infection control. These included establishment of an evidence-based carrier control system, training of municipal food controllers and health professionals, creation of electronic outbreak records and follow-up procedures, and development of a source eradication system for Sanliurfa’s primary healthcare center staff.”, “author” : { “dropping-particle” : “”, “family” : “Simsek”, “given” : “Zeynep”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Koruk”, “given” : “Ibrahim”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Copur”, “given” : “Aysegul Cicek”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” }, { “dropping-particle” : “”, “family” : “Gu00fcrses”, “given” : “Gulcan”, “non-dropping-particle” : “”, “parse-names” : false, “suffix” : “” } , “container-title” : “Journal of Public Health Management and Practice”, “id” : “ITEM-2”, “issue” : “6”, “issued” : { “date-parts” : “2009” }, “page” : “518-523”, “title” : “Prevalence of <i>Staphylococcus aureus</i> and intestinal parasites among food handlers in Sanliurfa, Southeastern Anatolia”, “type” : “article-journal”, “volume” : “15” }, “uris” : “http://www.mendeley.com/documents/?uuid=8a727c85-838a-4e99-a46f-339018e0e1d8” } , “mendeley” : { “formattedCitation” : “118,119”, “plainTextFormattedCitation” : “118,119”, “previouslyFormattedCitation” : “118,119” }, “properties” : { “noteIndex” : 0 }, “schema” : “https://github.com/citation-style-language/schema/raw/master/csl-citation.json” }118,119.

The majority of included studies were published online after 2003 since there was no internet access before that in Iraq. The prevalence of E. histolytica increased from 5.98% in 1990?1999 to 26.68% in 2000?2009. The small number of published researches in 1990?1999 could be the reason for the lower prevalence. The highest prevalence of E. histolytica was related to the years 2000?2009, this can be due to the sectarian violence during 2006-2008 in Iraq that led to the emigration and internal displacement of millions and this was associated with poor sanitation and limited access to health services. The overall prevalence E. histolytica in Iraq has reported a decrease (18.46%) in 2010?2017 compared to 26.68% in 2000?2009. This relative decrease could be an indicator of improvement in the sanitation and water supplies quality. In spite of that, this may suggest that E. histolytica is still considered as a health issue in Iraq.
The prevalence of E. histolytica varied among the provinces. The highest prevalence was observed in Thi-Qar province (30.12%). This may be because only individuals from hospitals were analyzed and this increased the rate of prevalence. The largest fraction of identified studies (27 of the 99 included studies) were carried out in Baghdad, the province with the highest density of population in Iraq and a population of more than 7 million, the estimated pooled prevalence of E. histolytica was 19.51%, this represents a challenge for health workers. The lowest pooled prevalence (13.08%) of E. histolytica in the country was reported from Diwaniya province. This may be because of the low number of studies from this province and the studies were conducted in individuals from hospitals (one of them used PCR for detection of E. histolytica) and foodhandlers, the group with the lowest rate of infection. Even if the disease is known to be prevalent to Iraq, no study was reported from provinces of Maysan and Muthanna in the south of Iraq.

There was high heterogeneity in prevalence infection with E. histolytica in Iraq among the included studies. This is revealing the variations that could have been due to population of the study, detection method, province and year of study.
Limitations
The study has some limitations. Most of the studies did not report the gender of the persons infected with E. histolytica/dispar, thus making it difficult to evaluate the effect of this important factor on the prevalence of infection with E. histolytica/dispar in Iraq. In addition, most surveys used microscopic diagnosis, which could not differentiate the pathogenic E. histolytica from the nonpathogenic E. dispar and these studies may have overestimated the rates of the prevalence. In this meta-analysis, there were few studies that assessed the prevalence of E. histolytica/dispar in community populations, most of the studies were hospital based which increased the risk of bias. Another limitation of this study is that all provinces of the country have not been covered in the eligible studies, therefore the pooled prevalence of two provinces have not been estimated and this could affect the overall pooled prevalence of infection with E. histolytica/dispar in Iraq.
In conclusion, the overall prevalence of infection with E. histolytica/dispar was 20.61% in the population of Iraq and the prevalence of the disease has dropped since 2010. Therefore, in order to reduce the infections of amebiasis in humans, preventive measures including educational programs, proper sanitation, monitoring of foodhandlers and preventing fecal contamination of water, vegetable and fruits should be recommended. Further studies are needed for the molecular diagnosis of intestinal E. histolytica to differentiate the pathogenic from nonpathogenic Entamoeba species. Also diagnosis of extraintestinal amebiasis in patients is required to estimate the epidemiology of the disease at a national level.

Reference
ADDIN Mendeley Bibliography CSL_BIBLIOGRAPHY 1. Marie C, Verkerke HP, Theodorescu D, Petri WA. A whole-genome RNAi screen uncovers a novel role for human potassium channels in cell killing by the parasite Entamoeba histolytica. Sci Rep. Nature Publishing Group; 2015;5: 1–18. doi:10.1038/srep13613
2. Stanley SL Jr. Amoebiasis. Lancet. 2003;361: 1025–1034. doi:10.1016/s0140-6736(03)12830-9
3. Blessmann J, Van LP, Nu PA, Thi HD, Muller-Myhsok B, Buss H, et al. Epidemiology of amebiasis in a region of high incidence of amebic liver abscess in central Vietnam. Am J Trop Med Hyg. 2002;66: 578–583.
4. Walsh JA. Problems in recognition and diagnosis of amebiasis: estimation of the global magnitude of morbidity and mortality. Rev Infect Dis. 1986;8: 228–238. doi:10.1093/clinids/8.2.228
5. Salit IE, Khairnar K, Gough K, Pillai DR. A possible cluster of sexually transmitted Entamoeba histolytica: genetic analysis of a highly virulent strain. Clin Infect Dis. 2009;49: 346–353. doi:10.1086/600298
6. Nath J, Ghosh SK, Singha B, Paul J. Molecular epidemiology of amoebiasis: a cross-sectional study among North East Indian population. PLoS Negl Trop Dis. 2015;9: 1–19. doi:10.1371/journal.pntd.0004225
7. Moher D, Liberati A, Tetzlaff J, Altman DG, Altman D, Antes G, et al. Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement. PLoS Med. 2009;6. doi:10.1371/journal.pmed.1000097
8. Higgins JPT, Thompson SG, Deeks JJ, Altman DG. Measuring inconsistency in meta-analyses. BMJ Br Med J. 2003;327: 557–560. doi:10.1136/bmj.327.7414.557
9. Al-Sorchee SMA, Rabat AA, Juma IM. Microbial causatives of diarrhea in children in Erbil city. J Al-Nahrain Univ. 2013;16: 19–29.
10. Al-Mosawi R. Detection of intestinal parasitic among people infection with diarrhea in Al-Fhood district in Thi-Qar province, Iraq. Int J Sci Basic Appl Res. 2016;28: 180–185.
11. Amin HA, Ali SA. Evaluation of different techniques of stool examination for intestinal parasitic infections in Sulaimani city – Iraq. Int J Curr Microbiol Appl Sci. 2015;4: 991–996.
12. Salman YJ, Salih LA. Detection of some microbial infectious agents among children aging below two years in Kirkuk city. J Kirkuk Med Coll. 2013;1: 53–61.
13. Al-Kaissi EN, Makki M, Al-Khoja M. Aetiology and epidemiology of sever infantile diarrhoea in Baghdad, Iraq. Eur J Sci Res. 2006;14: 359–371.
14. Obaid HM. The effect of Entamoeba histolytica and Giardia lamblia infection on some human hematological parameters. J Nat Sci Res. 2014;4: 44–48.
15. Jarallah HM. Intestinal parasitic infections among rural villages in Basrah marshes regions. J Basrah Res. 2012;38: 40–43.
16. Al-Kubaisy W, Al-Talib H, Al-Khateeb A, Shanshal MM. Intestinal parasitic diarrhea among children in Baghdad – Iraq. Trop Biomed. 2014;31: 499–506.
17. Mero WMS, Jameel AY, Amidy KSK. Microorganisms and viruses causing diarrhea in infants and primary school children and their relation with age and sex in Zakho city, Kurdistan Region, Iraq. Int J Res Med Sci. 2015;3: 3266–3273. doi:http://dx.doi.org/10.18203/2320-6012.ijrms20151174
18. Al-Azawi AKA. Incidence of entamoebiasis among children in Abu-Ghraib area Baghdad. Iraqi J Vet Med. 2009;33: 155–160.
19. Saeed BH, Gazal FM, Nori HS. Epidemiological study of diarrhoea in Al-Rashedia village in Ninava in Iraq. Rafidain J Sci. 2005;16: 191–206.
20. Abdullah IA, Al-Shirifi HM. The role of housing type and drinking water in prevalence of intestinal parasites among pupils of a number of primary schools in rural area of Al-Taamem Province-Iraq. Rafidain J Sci. 2005;16: 83–89.
21. Abdullah IA, Al-Shirifi HM. Prevalence of intestinal parasites amongest foodhandlers in Kirkuk city, Al-Taam’em province, Iraq. Rafidain J Sci. 2005;16: 13–21.
22. Al-Taie HHI, Al-Mosa AHA. Prevalence rate of intestinal parasite associated with diarrhea. Al-Taqani. 2006;19: 134–141.
23. Al-Tikrity IAA, Al-Jubory AA, Al-Tikrity AHA. Prevalence of Entamoeba histolytica in Baiji province and the effect of Punica granatum rind extract on the parasite in culture. Tikrit J Pure Sci. 2009;14: 189–196.
24. Al-Warid HS. Some factors influencing the prevalence of Giardia lamblia and Entamoeba histolytica in a sample of patients in north of Baghdad. J Al-Nahrain Univ. 2012;15: 121–125.
25. Jaeffer HS. Prevalence of Giardia lamblia and Entamoeba histolytica/Entamoeba dispar infections among Children in Al-Shulaa and Al-Khadimya-Baghdad-Iraq. J Univ Anbar Pure Sci. 2011;5: 6–10.
26. Saael YK. Prevalence of intestinal parasites in children in Baghdad city. Al-Taqani. 2009;22: A32–A37.
27. Al-Kaisi AAR. Intestinal parasitosis in Samarra’a city. Iraqi Postgrad Med J. 2007;6: 80–83.
28. Ftohe ZI, Al-Zako SS, Mahfoth N. Study on intestinal parasites as a causative of diarrhea and some effectors on them in children of Neinavah governorate. Rafidain J Sci. 2008;19: 37–50.
29. Al-Marzoqi AHM, Kadhim RA. Parasitic etiology of newborn gastroenteritis in Babylon governorate. Med J Babylon. 2008;5: 501–506.
30. Nayyef HJ, Majeed LJ, Abdul Al-Wahab E. A study of epidemiology of intestinal protozoa in human in Baghdad city. J Al-Nahrain Univ – Sci. 2011;14: 57–63.
31. Al-Dulaimi FHA. Prevalence of infection with intestinal parasites in outpatients of two hospitals in Babylon province. Sci J Karbala Univ. 2007;5: 566–570.
32. Al-Mosa AHA, Al-Taie HHI. Effect of infection with intestinal parasites on blood picture. Al-Taqani. 2007;20: 1–7.
33. Al-Jabouri DIA. Survey of intestinal parasites in some health centers in Karbala city. Sci J Karbala Univ. 2007;5: 80–86.
34. Jasim TM, Al-Mugdadi SFH. The incidence of Entamoeba histolytica & Giardia lamblia associated with diarrhea among children in lbn Al-Balady hospital in Baghdad. Iraqi J Community Med. 2011;24: 17–19.
35. Ibrahim BM. Isolation of some microbial agents that cause acute gastroenteritis in children. J Fac Med. 2012;54: 218–222.
36. Al-Kubaisy AHM, Ramadan M, Abdalsajad Q, Mahdi AH, Abdulmajeed MN, Alrushdi AAK. Survey of intestinal parasites which causing the diarrhea in Al-Heindia/Kerbala. Sci J Karbala Univ. 2007;5: 6–10.
37. Kadum SA. Contamination role in the prevalence of intestinal parasites among the people of Al-Kufel town in Babylon province. Sci J Karbala Univ. 2007;5: 37–44.
38. Hamad NR, Ahmed RK. Intestinal parasites among patients attending general central public health laboratory in Erbil city-Iraq during 1998-2004. J Educ Sci. 2011;24: 79–86.
39. Al-Shaheen Z, Al-Maki AK, Hussein K. A study on prevalence of Entamoeba histolytica & Giardia lamblia infection among patient attending Qurna hospital in Basrah. Basrah J Vet Res. 2007;6: 30–36.
40. Kadhum IJ. Epidemiological study of acute diarrhea in breast fed infants. Kufa Med J. 2011;14: 76–80.
41. Raddam KK, Hasson AJ. The epidemiological aspects of infection with Entamoeba histolytica in acute diarrhea in Thi-Qar governorate during the year 2006. Kufa Med J. 2008;11: 15–24.
42. Ali MAK, Hameed SS, Kasim M. Prevalence of amoebic dysentery among population of Wasit province. Wasit J Sci Med. 2010;3: 87–91.
43. Al-Najar SA. The role of Dientamoeba fragilis in children with gastrointestinal illness. Iraqi Postgrad Med J. 2006;5: 42–45.
44. Al-Kubaisy AHM. Survey study of intestinal parasites in Awofy and Al-Twmazy area/Babylon province. Sci J Karbala Univ. 2008;6: 187–193.
45. Rahi AA, Mutlak EM. Prevalence of Entamoeba histolytica among population at Wasit province. Wasit J Sci Med. 2011;4: 54–57.
46. Rahi AA. Haematological variables of patients with amoebic dysentery. Wasit J Sci Med. 2011;4: 1–7.
47. Thhaib FN, Jeaz ET, Jaber SH. Study of role rotavirus and some pathogenic agents in diarrhea infections of the infants and children in Al-Diwaniya city. Al-Qadisiya J Pure Sci. 2008;13: 1–14.
48. Al-Reikaby RL, Abood MS, Hamid RG. The epidemiological investigation of the causatives of intestinal diseases in Al-Nasiriya city. J Univesity Thi-Qar. 2010;5: 128–137.
49. Al-Yasari HF, Hamza LF, Al-Hassnawi HH, Jabar SS. Isolation of some intestinal parasites from individuals suffering from intestinal disorders in Al-Mahaweel district. J Kerbala Univ. 2009;7: 212–218.
50. Ibrahim AQ. Prevalence of Entamoeba histolytica and Giardia lamblia in children in Kadhmiyah hospital. Iraqi J Vet Med. 2012;36: 32–36.
51. Ibraheem MF, Ali ZA, Saeed DH. Shigella gastroenteritis in children with acute diarrhea in children welfare teaching hospital. Iraqi Postgrad Med J. 2010;9: 10–15.
52. Yousif A. The prevalence of some intestinal parasites in Al-Ubaidy region/Baghdad province. J Al-Qadisiyah Pure Sci. 2011;16: 16–19.
53. Ali FM, Ali SAK, Abdullah SJ. Detection of Cyclospora cayetanensis infections among diarrheal children attending pediatric teaching hospital in Sulaimani city. Int J Med Res Heal Sci. 2016;5: 77–84.
54. Al-Morshidy KA. Prevalence of intestinal pathogenic parasites infections in Hilla city, Babylon province, Iraq. J Univ Babylon. 2007;14: 179–185.
55. Abid AM, Daoud IS, Al-Assie AH. Diagnostic study of some species of genus Entamoeba by PCR technique in city Tikrit. Second Scientific Conference – Science College – Tikrit University. 2012. pp. 96–100.
56. Badry AHH, Jameel AY, Mero WMS. Pathogenic microorganisms associated with diarrhea in infants and children in Duhok province, Kurdistan Region/Iraq. J Univ Zakho. 2014;2: 266–275.
57. Al-Joudi FS, Ghazal AM. The prevalence of intestinal parasites in Ramadi, Iraq. Bull Pharm Sci Assiut Univ. 2005;28: 277–281.
58. Shebib ZA, Abdul Ghanii ZG, Mahdi LK. First report of Escherichia coli 0157 among Iraqi children. East Mediterr Heal J. 2003;9: 159–166.
59. Al-Kubaisy W, Al Badre A, Al-Naggar RA, Nik Ibrahim NS. Epidemiological study of bloody diarrhoea among children in Baghdad, Iraq. Int Arch Med. 2015;8: 1–9. doi:10.3823/1603
60. Mero WMS, Hussein JN. Prevalence of intestinal parasites among children in various localities of Duhok city and nearby villages. J Univ Zakho. 2013;1 (A): 189–199.
61. Mahdi NK, Ali NH. Intestinal parasites, including Cryptosporidium species, in Iraqi patients with sickle-cell anaemia. East Mediterr Heal J. 2002;8: 345–349.
62. Ali FS, Al-Kubaisy AHM. Molecular identification of Entamoeba histolytica parasite in the middle Euphrates region. J Univ Babylon. 2017;25: 57–68.
63. Al-Khalidi KAH. Detection of Entamoeba histolytica in patients an infected infants with diarrhea in born and children’s hospital by classic methods and real-time polymerase chain reaction. J Al-Qadisiyah Pure Sci. 2016;21: 27–35.
64. Kadir MA, Salman YG. Prevalence of intestinal parasites among primary school children in Al-Taameem province, Iraq. Ann Coll Med Mosul. 1999;25: 94–98.
65. Shlash SA. Impact of Entamoeba histolytica infection on some haematological and immunological parameters among children in Najaf governorate. Kufa J Nurs Sci. 2016;6: 102–110.
66. Al-Moussawi AM. Prevalence of intestinal parasites among rural population in Babylon province. Med J Babylon. 2005;2: 491–498.
67. Shaker MJ, Hussein RA. The relationship between the infection with Entamoeba histolytica and some blood parameters. Diyala J Pure Sci. 2016;12: 133–142.
68. Atiyah AH, Almwsawi HQH. The most detective protozoal infections in correlation with radiological findings in Wasit governorate hospitals during 2015. Med J Babylon. 2016;13: 862–873.
69. Hussein KR, Dahis HN, Mshhwt A-KA. Parasitic infections causing diarrhoea among children less than six years at Al-Nasiriyah province. J Thi-Qar Univ. 2016;11: 134–142.
70. Racine S. Epidemiology survey on the prevalence of infections intestinal parasites in workers in restaurants and food shop in the province of Diwaniyah. J Al-Qadisiyah Pure Sci. 2014;19: 33–39.
71. Alshawi A-RJ, Abbas NK, Al-Taie LHK. The prevalence of intestinal parasite among sample of Iraqi peoples in Baghdad city. Al-Yarmouk J. 2014; 103–116.
72. Al-Bayati MHJ, Al-Hassany NA-A. Epidemiological and diagnostic study for some intestinal parasites that infect children in Diwaniya province. J Al-Qadisiyah Pure Sci. 2014;19: 1–16.
73. Aljanabi MAH, Altikrity IAA. The spread of Entamoeba histolytica infection among children attended the central child hospital in Baghdad city. Iraqi J Sci. 2014;55: 979–985.
74. Obaid HM. Malnutrition in relation to some intestinal parasitic infection in children of Kirkuk city-Iraq. Kirkuk Univ J /Scientific Stud. 2015;10: 191–206.
75. Al-Garawi AKH. Study of prevalence of intestinal parasites infection among children in ; attending to Karbala teaching hospital for children. J Kerbala Univ. 2015;13: 50–56.
76. Abed FA, Younis FN, Al-Naddawi MN. Prevalence and laboratory diagnosis of intestinal protozoa in children under 10 years (amoebiasis and giardiasis) in Al-Mansor general hospital for pediatric/Baghdad. J Biotechnol Res Cent. 2015;9: 17–20.
77. Raof SA. Prevalence of Entamoeba histolytica/E. dispar in three regions of south-east Baghdad. Al-Qadisiyah J Vet Med Sci. 2012;11: 8–14.
78. Hussein TA, Abdul-Jabbar DB. Epidemiological study for intestinal parasites in Abu Ghraib and Amiriyah regions. Iraqi J Vet Med. 2014;38: 19–26.
79. Al-Jebory AH, Al-Tikrity EAA, Al-Baitha SRH. Epidemiological study for intestinal protozoan parasites in Al-Tous province and study the histopathological effect on intestine of mice infected with Giardia lamblia. Tikrit J Pure Sci. 2012;17: 108–115.
80. Hussan BM. Determination of the prevalence of viral aetiology of diarrhea in children less than 5 years of age in Baghdad province. Al-Qadisiah Med J. 2012;8: 163–176.
81. Guirges SY. Intestinal parasites in patients attending medical city teaching hospital in Baghdad. Al-Mustansiriyah J Sci. 2006;17: 1–10.
82. Al-Hameedawi JJY. Molecular identification of Entamoeba histolytica parasite by using actin and amebapore-A genes. Kufa J Nurs Sci. 2014;4: 48–55.
83. Hussein ZA, Hamady HM. Real-Time PCR for detection CP1 ; CP5 virulence factors of Entamoeba histolytica in patients stool samples in Al-Najaf Al-Ashraf province. Kufa J Nurs Sci. 2013;3: 190–196.
84. Zaidan AA, Al Jiboory RK. Occurrence of amoebic versus bacillary dysentery among children under five years of age in Baghdad city. Al-Kindy Coll Med J. 2013;9: 35–39.
85. Al-Aboody BA. Epidemiological study on intestinal protozoa Entamoeba histolytica ; Giardia lamblia in Al-Batha ; Al-Gharraf cities of Thi-Qar governorate. J Thi-Qar Sci. 2010;2: 59–64.
86. Kadir MA, Daoud IS, Al-Bayati Z. Differentiation between Entamoeba histolytica and E. dispar using enzyme-linked immunosorbent assay and wet mount method. Tikrit J Pharm Sci. 2013;9: 122–129.
87. Al-Zigibi IMS. Isolation of parasitic causes of digestive system infection from primary rural school in a Reghala village in Babylon City. J Kerbala Univ. 2011;9: 170–174.
88. Al-Jeburi DIA. Epidemiology of intestinal parasites which causing the diarrhea in health center of Jidedat Al-Shat/Diala. J Kerbala Univ. 2010;8: 180–186.
89. Al-Tae A-RA, Al-Mufragi SE. Epidemiological study of the intestinal parasites in patients attending two hospitals in Baghdad. Tikrit Med J. 2008;14: 179–182.
90. Jasim TM. Bloody diarrhoea among children under five years of age in Tikirit teaching hospital. Al-Kindy Coll Med J. 2009;5: 78–82.
91. Al-Azzawi DSH. Prevalence of amoebic dysentery among children with diarrhea in Diyala governorate during 2009. Tikrit Med J. 2010;16: 60–66.
92. Al-Zigibi IMS, Abid-Alhasan MT, Al-Jubouri DIA. Study of the relationship between intestinal parasitic infection and the yeast infection with Candida in the digestive system of human in the Karbala governorate. J Kerbala Univ. 2011;9: 147–152.
93. Mohammed ZA. An epidemiological study of some intestinal parasitic infections of patients of Al-Hussein teaching hospital in the city of Nasiriyah. J Coll Educ Pure Sci. 2010;1: 153–146.
94. Muhsin ZA, Iliwii AA-K, Al-Quraishi MA. Prevalence and seasonal frequency and pattern of Giardia lamblia and Entamoeba histolytica infection in children. Al-Kufa Univ J Biol. 2016;8: 393–400.
95. Al-Ammash MSJ. Study on prevalence of Entameoba histolytica ; Giardia lamblia in Samarra city. Kufa J Vet Med Sci. 2015;6: 194–204.
96. Ali JK. Prevalence of Entamoeba histolytica and Giardia lamblia parasites among patients attending Al-Emam Ali hospital in Al-Mashrooh / Babylon province. Kufa J Vet Med Sci. 2015;6: 30–34.
97. Nasser NI. Frequency of parasitic, bacterial and fungal enteropathogens among children and adults patients with diarrhea and association affecting factors. Kufa J Nurs Sci. 2014;4: 169–175.
98. Jamil GH, Sulltan AA. Factors Affecting the epidemiology of the parasite Entamoeba histolytica and the parasite Giardia lamblia among residents of Al-Khalis and Baladruz districts. J Res Diyala Humanit. 2008;27: 98–106.
99. Salman YJ, Al-Taee A-RA, Abid AM. Prevalence of Giardia lamblia among Iraqi displaced peoples in Kirkuk province. Int J Curr Microbiol Appl Sci. 2016;5: 753–760. doi:10.20546/ijcmas.2016.501.076
100. Hamad NR, Ramzy IA. Epidemiology of Entamoeba histolytica among children in Erbil province, Kurdistan Region-Iraq. J Res Biol. 2012;2: 57–62.
101. Faraj AM, Koyee QM. Epidemiology of intestinal parasites among food handlers in Erbil city. Duhok Med J. 2012;6: 1–12.
102. Al-Fahdawi SS. Prevalence of intestinal parasites infection in some areas of Al-Quim / Al-Anbar governorate. J Univ Anbar pure Sci. 2007;1: 35–42.
103. Hussein RA, Shaker MJ, Majeed HA. Prevalence of intestinal parasitic infections among children in Baghdad city. J Coll Basic Educ. 2011;17: 139–147.
104. Mahfoth N. The distribution of parasitic intestinal infection and its relation with the type of food in the children of two nursery schools in Mosul city. Coll Basic Educ Res J. 2010;9: 493–512.
105. Hussein RA, Al-Mayah QS, Merdaw MA, Al-Bashier NT, Al-Abbas AA, Jasem IA. Evaluation of multiplex real-time PCR and ELISA in detection of intestinal protozoan parasites from children with diarrheal disease. Int J Adv Res. 2015;3: 782–788.
106. Rabatti AA, Rasheed NE. Etiology of bloody diarrhea among children admitted to maternity and children’s hospital-Erbil. Al-Kindy Coll Med J. 2008;4: 19–24.
107. Khudair MK, Jawad SJ, Nazal MF. Study the causes of parasitic diarrhea in children in Al-Ahded village, Dyala governorate. Baghdad Sci J. 2011;8: 887–890.
108. Amin O. Seasonal prevalence of intestinal parasites in the United States during 2000. Am J Trop Med Hyg. 2002;66: 799–803.
109. Fotedar R, Stark D, Beebe N, Marriott D, Ellis J, Harkness J. PCR detection of Entamoeba histolytica, Entamoeba dispar, and Entamoeba moshkovskii in stool samples from Sydney, Australia. J Clin Microbiol. 2007;45: 1035–1037. doi:10.1128/JCM.02144-06
110. Zeb A, Qureshi A, Khan L, Mansoor A, Ullah S, Irfan M. Prevalence of Entamoeba histolytica in district Buner Khyber Pakhtunkhwa, Pakistan. J Entomol Zool Stud. 2018;6: 185–188.
111. ElBakri A, Samie A, Ezzedine S, Abu Odeh R. Differential detection of Entamoeba histolytica, Entamoeba dispar and Entamoeba moshkovskii in fecal samples by nested PCR in the United Arab Emirates (UAE). Acta Parasitol. 2013;58: 185–190. doi:10.2478/s11686-013-0128-8
112. Malatyali E, Ozcelik S, Celiksoz A. The investigation of Entamoeba histolytica prevalence in some villages of Sivas by ELISA method. Turkish J Parasitol. 2011;35: 6–9. doi:10.5152/tpd.2011.02
113. Sayyari A, Imanzadeh F, Bagheri Yazdi S, Karami H, Yaghoobi M. Prevalence of intestinal parasitic infections in the Islamic Republic of Iran. East Mediterr Heal J. 2005;11: 377–383.
114. Hadi A, Faraj A. Distribution of intestinal parasites in drinking water in some regions in Baghdad. Al-Qadisiyah J Vet Med Sci. 2008;7: 33–36.
115. Acuna-Soto R, Maguire JH, Wirth DF. Gender distribution in asymptomatic and invasive amebiasis. Am J Gastroenterol. 2000;95: 1277–1283. doi:10.1111/j.1572-0241.2000.01525.x
116. Snow M, Chen M, Guo J, Atkinson J, Stanley SL. Short report: differences in complement-mediated killing of Entamoeba histolytica between men and women – an explanation for the increased susceptibility of men to invasive amebiasis? Am J Trop Med Hyg. 2008;78: 922–923.
117. Jarallah HM. Contamination of different drinking water sources with parasites in Basrah marshes villages, Iraq. J Babylon Univ Appl Sci. 2016;24: 370–376.
118. Abdel-Dayem M, Al Zou’bi R, Hani RB, Amr ZS. Microbiological and parasitological investigation among food handlers in hotels in the Dead Sea area, Jordan. J Microbiol Immunol Infect. Elsevier Taiwan LLC; 2014;47: 377–380. doi:10.1016/j.jmii.2013.06.001
119. Simsek Z, Koruk I, Copur AC, Gürses G. Prevalence of Staphylococcus aureus and intestinal parasites among food handlers in Sanliurfa, Southeastern Anatolia. J Public Heal Manag Pract. 2009;15: 518–523. doi:10.1097/PHH.0b013e3181aa2814

Supporting information
S1 Checklist. PRISMA checklist.

x

Hi!
I'm Kari!

Would you like to get a custom essay? How about receiving a customized one?

Check it out