No association between abdominal pain and <i>Dientamoeba</i> in Dutch and Belgian children.

Abstract

To study the association between <i>Dientamoebafragilis</i> colonisation and faecal calprotectin to see whether the parasite is a harmless commensal or a gut pathogen. Cross-sectional study of previously collected stool samples. Two hundred stool samples originated from children aged 5-19 years with chronic abdominal pain and diarrhoea, who were seen in paediatric clinics in the Netherlands and Belgium and in whom somatic gastrointestinal disorders were excluded. Another 122 samples came from a healthy community-based reference population of the same age. All stool samples were analysed with real-time PCR for the detection of <i>D. fragilis</i> and with an ELISA for calprotectin-a biomarker of gastrointestinal inflammation. Prevalence of <i>D. fragilis</i> colonisation and results of stool calprotectin testing. <i>D. fragilis</i> was detected in 45% (95% CI 38% to 51%) of patients and in 71% (95% CI 63% to 79%) of healthy children. Median (IQR) concentrations of calprotectin in patients and healthy children with a positive PCR result were not different from those with a negative PCR result (40 (40-55) μg/g vs 40 (40-75) μg/g, respectively). Since <i>D. fragilis</i> colonisation is most prevalent in healthy children and is not associated with an increase in faecal calprotectin concentration, our data do not support the inference that <i>D. fragilis</i> is a pathogenic parasite. Routinely testing for <i>D. fragilis</i> in children with chronic abdominal pain should therefore be discouraged.