Epidemiology of Entamoeba Species Across the Districts of Duhok Governorate, Kurdistan Region-Iraq.

Abstract

Amebiasis remains an important public health problem worldwide and is primarily transmitted through the fecal-oral route, posing a significant health risk in developing countries where the disease is endemic. This study aimed to determine the prevalence of Entamoeba spp. infection and assess its association with selected demographic, environmental, and clinical factors in Duhok Governorate, Kurdistan Region, Iraq. A cross-sectional study was conducted between January and August 2025. A total of 500 stool samples were collected from symptomatic and asymptomatic individuals aged 3 years and older attending six healthcare facilities across five districts. Samples were examined microscopically using the direct wet mount method, and demographic and clinical data were collected through a standardized questionnaire. The overall prevalence of Entamoeba spp. infection was 19.8% (99/500). The highest proportion of infection was observed among individuals aged 10-19 years (29.5%). A significant association was found between infection and geographical region (P ≤ 0.001), with Zakho reporting the highest infection prevalence (32.0%). Infection distribution also differed significantly among healthcare facilities (P ≤ 0.001). No significant associations were observed between infection and sex, educational level, drinking water type, or chronic disease (P > 0.05). Family size showed a significant but weak negative correlation with infection status (r = −0.115, P = 0.010). In conclusion, Entamoeba spp. infection remains relatively common in Duhok Governorate, particularly among children. Geographic variation in infection distribution suggests that age related behaviors and local environmental conditions may contribute to transmission, highlighting the need for targeted public health interventions.