Laboratory-Based Investigation of Entamoeba histolytica Infection and Its Association with Helicobacter pylori Co-Infection and Fecal Occult Blood Positivity

Abstract

This cross-sectional laboratory-based study investigated the prevalence of Helicobacter pylori and Entamoeba histolytica infections, their demographic associations, co-infection patterns, and fecal occult blood (FOB) positivity among 238 patients presenting with gastrointestinal complaints in Al-Bayda City, Libya, between January and December 2024. Stool samples were analyzed using standard parasitological methods for E. histolytica and ELISA/urea breath tests for H. pylori. FOB testing was performed using immunochemical kits. The mean age of participants was 36.7 ± 16.6 years, with 62.6% females. Prevalence rates were 20.2% for H. pylori and 23.1% for E. histolytica, while 29.8% of participants tested positive for FOB. Older age was significantly associated with H. pylori infection (45.2 ± 18.1 vs. 34.9 ± 15.7 years; p = 0.0002). No significant associations were observed between infections and sex, co-infection, or FOB positivity. Cross-tabulation indicated sporadic co-infection without statistical significance (χ² = 0.169, p > 0.05). These findings highlight moderate endemicity of gastrointestinal pathogens in the region, the importance of age-targeted screening for H. pylori, and the limited predictive value of FOB for detecting subclinical infections. The study underscores the need for comprehensive diagnostic strategies and public health interventions focused on hygiene, sanitation, and accurate parasitological and bacterial detection.