JCM Accepts, published online ahead of print on 2 July 2008

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J. Clin. Microbiol. doi:10.1128/JCM.01151-08
Copyright (c) 2008, American Society for Microbiology and/or the Listed Authors/Institutions. All Rights Reserved.

Cost-Effectiveness of Detection of Intestinal Amebiasis Using Serologies and Specific Amebic Antigen Assays among Persons with or without Human Immunodeficiency Virus Infection

Sui-Yuan Chang, Hsin-Yun Sun, Dar-Der Ji, Yi-Chun Lo, Cheng-Hsin Wu, Pei-Ying Wu, Wen-Chun Liu, Chien-Ching Hung^*, and Shan-Chwen Chang

Department of Laboratory Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan; Department of Clinical Laboratory Sciences and Medical Biotechnology, National Taiwan University College of Medicine, Taipei, Taiwan; Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan; Research and Diagnostic Center, Centers for Disease Control, Department of Health, Taipei, Taiwan

^* To whom correspondence should be addressed. Email: hcc0401{at}ntu.edu.tw.

Among 345 persons who underwent indirect hemagglutination (IHA) serological assays and specific stool amebic antigen assays, 24 of 36 (66.7%) who were seropositive for Entamoeba histolytica had intestinal amebiasis by antigen assays, compared with 2 of 309 (0.2%) who were seronegative (odds ratio, 307; 95% confidence interval, 64.9, 1451). The estimated cost to detect a case of intestinal amebiasis by serologies followed by antigen assays (52 USD) could be reduced by 74.3% and 69.9% compared with concurrent use of both assays (202 USD) and antigen assays alone (173 USD), respectively. Our finding suggests that IHA assays followed by specific amebic antigen assays can be cost-effective in the diagnosis of intestinal amebiasis among persons with or without HIV infection who are at risk for E. histolytica infection.