
==== Front
Acta Parasitol
Acta Parasitol
Acta Parasitologica
1230-2821
1896-1851
Springer International Publishing Cham

39162924
886
10.1007/s11686-024-00886-z
Original Paper
Entamoeba histolytica in Different Water Sources of Niğde Province of Turkey
http://orcid.org/0000-0001-9975-2744
Candan Cemal 1
http://orcid.org/0000-0002-2944-6837
Karatepe Mustafa mkaratepe@ohu.edu.tr

2
http://orcid.org/0000-0001-5612-2697
Karatepe Bilge 2
1 https://ror.org/03ejnre35 grid.412173.2 0000 0001 0700 8038 Graduate School of Natural and Applied Sciences, Department of Biotechnology , Niğde Ömer Halisdemir University, Niğde, Türkiye
2 https://ror.org/03ejnre35 grid.412173.2 0000 0001 0700 8038 Faculty of Science, Department of Biotechnology, Niğde Ömer Halisdemir University, Niğde, Türkiye
20 8 2024
20 8 2024
2024
69 3 15171521
15 3 2024
30 7 2024
© The Author(s) 2024
2024
https://creativecommons.org/licenses/by/4.0/ Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
Purpose

This study was carried out to determine the presence of Entamoeba histolytica in water sources of Niğde province in Turkey, between June and November 2021.

Methods

A total of 90 water samples were taken from 15 different water sources (drinking water, well water, spring water, wastewater and dam water) every month and the presence of E. histolytica antigens in the samples was examined by ELISA.

Results

The positivity for E. histolytica was determined in 7 (7.7%) of 90 samples. While no antigens were found in any of the samples in June and September, E. histolytica was positive for three samples (20%) in July, one sample (6.6%) in August and October and two samples in November (13.3%). One of 24 dam samples (4.1%), 1 of 12 wastewater samples (8.3%), 1 of 12 well samples (8.3%), and 4 of 24 fountain samples (16.6%) that examined by ELISA were found positive. On the other hand, none of the examined 18 spring samples were positive. In addition, 4 (8.8%) of 45 samples that examined in summer and 3 (6.6%) of 45 samples that examined in autumn were detected positive by using ELISA. Entamoeba histolytica positivity in samples was statistically insignificant in terms of months, water resources and seasons (P > 0.05).

Conclusion

As a result, the presence of E. histolytica, which is an important public health problem in water sources, was determined for the first time in Niğde province of Türkiye with this study.

Keywords

ELISA
Entamoeba histolytica
Niğde
Turkey
Water
Nigde Omer Halisdemir UniversityOpen access funding provided by the Scientific and Technological Research Council of Türkiye (TÜBİTAK).

issue-copyright-statement© Springer Nature Switzerland AG 2024
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pmcIntroduction

Amebiasis is one of the protozoan diseases in the intestines caused by E. histolytica. Entamoeba histolytica is more prevalent in developing countries and is generally transmitted to humans through cysts found in feces or contaminated food and water [1]. It is estimated that approximately 10% of the world’s population is infected with this parasite, with distribution in Turkey ranging from 0 to 17% [2, 3]. While E. histolytica primarily infects humans, it can also parasitize various monkey species, dogs, cats, pigs, cattle, and rats. However, it is noted that the parasite does not form cysts in hosts other than humans. The parasite usually settles in the intestines of hosts but can also migrate to other organs such as the liver, lungs, brain, and spleen, causing abscesses [3–5].

Entamoeba histolytica generally causes asymptomatic infections, but in some cases, it can lead to symptoms ranging from a few watery stools to profuse bloody diarrhea. Symptoms may include foul-smelling stools, weakness, and fatigue [3, 6, 7].

The diagnosis of amebiasis is made through various laboratory analyses. The diagnosis of protozoan infections can be established through symptoms, direct microscopic examination, and methods such as ELISA and PCR. Serological tests are crucial for diagnosing amoebiasis, as the diagnostic level of the parasite remains very low, even when at least three different stool samples are microscopically examined [6, 7].

In this study, the aim was to determine the presence of E. histolytica, which is important for human health, in water samples taken from different water sources in the Niğde province of Turkey by ELISA.

Materials and Methods

Study Area

Niğde is located at an altitude of 1,299 m in the Central Anatolia Region of Türkiye. According to the 2020 statistics, the population of Niğde city center is 230.776 people. Niğde experiences the typical continental climate of Central Anatolia, with hot and dry summers and cold and snowy winters. Rainfall is generally in the form of snow in winter and rain in the spring. The average temperatures indicate that July is the hottest month, while January is the coldest. Showers are observed in the form of heavy rain in April, May, and the early days of June. The average precipitation in the city is 0.9 mm. April has the highest rainfall with 78.5 mm, while July has the lowest with 0.2 mm.

Field Study

Water samples were collected from 15 different water sources every month, between June 2021 and November 2021 in the Niğde province. The samples were collected in 5 L clean plastic containers. The collected water samples included 4 from dam waters used for agricultural irrigation, 2 each from wastewater and well water, 3 from spring water, and 4 from fountains used for drinking water purposes.

Laboratory Study

The sample number was chosen considering these many samples were proven to represent the population adequately in previous studies [8, 9]. A total of 90 water samples were stored at 4 °C until they were processed in the laboratory. A vacuum pump filtration device with a 0.45 μm cellulose acetate membrane filter (Ø, 45 mm) was used for filtering the water samples. Subsequently, the filter was transferred to a clean tube, and 20 ml of the same water sample was added. After vortexing to remove particulate matter, the sample was centrifuged at 2500 rpm for 10 min to discard the upper portion, and the 1.5 ml sediment at the bottom was transferred to an eppendorf tube and stored in a deep freezer at -20℃ until further analysis with the ELISA.

ELISA (Enzyme Linked Immunosorbent Assay)

A commercial ELISA kit (E. histolytica II™, TECHLAB 2001 Kraft Drive Blacksburg, VA 24060 − 6358 USA) was used to investigate the specific adhesin antigen of E. histolytica in samples collected from different water sources. The ELISA was performed following the procedure provided by the manufacturer.

ELISA results were read at 450 nm wavelength using an ELISA microplate reader, MR-96 A, and the obtained values were calculated using the kit procedure.

Statistical Analysis

In the conducted study, the chi-square test was used for the statistical evaluation of positivity values concerning the months of water sample collection, water sources, and seasons. Therefore, the SPSS (Statistical Programme for Social Science) for Windows 24.0 Statistical Package Program was utilized.

Results

Out of the total 90 water samples collected from 15 different water sources in the Niğde province, the presence of E. histolytica was detected in seven samples (7.7%) through the ELISA.

Table 1 Entamoeba histolytica presence in water sources with regard to months

Months	Number of
Examined Sources	Number of
Positive Samples	Positives
(%)	
June	15	-	-	
July	15	3	20	
August	15	1	6.6	
September	15	-	-	
October	15	1	6.6	
November	15	2	13.3	
Total 90	7	7.7	

In Table 1, the presence of E. histolytica is given according to the months. Accordingly, for water samples taken from 15 different sources, in June and September, none of them showed E. histolytica presence. In July, three samples (Uluagac, Yesilburc, Okcu) showed positivity at a rate of 20%. In August (Kemerhisar) and October (Alaaddin), one sample each showed positivity at a rate of 6.6%. In November, two samples (Alaaddin, Kizilca Creek) showed positivity at a rate of 13.3%. Entamoeba histolytica positivity of water samples by months was found to be statistically insignificant (p > 0.05).

Table 2 Entamoeba histolytica presence according to the sampled water sources

Sampled Water Sources	Study Center	Number of Examined Samples	Number of Positive Samples	Positives (%)	
Dam	Gumusler, Akkaya, Uluagac*, Gebere	24	1	4.1	
Wastewater	Kizilca Creek*,

Yesil Creek

	12	1	8.3	
Well Water	Kemerhisar*,

Tepe Garden

	12	1	8.3	
Spring Water	Kumluca, Hancerli,

Roma Pool

	18	0	-	
Fountain	Yesilburc*, Alaaddin**, Sadirvan,

Okcu*

	24	4	16.6	
Total	90	7	7.7	
*: Positive samples

In Table 2, E. histolytica presence is presented according to the water sources from which the samples were collected. Accordingly, out of the 24 dam water samples examined with the ELISA test, 1 (4.1%) was found to be positive. Among the 12 wastewater samples, 1 (8.3%) was positive, as well as 1 (8.3%) out of the 12 well water samples. Additionally, 4 (16.6%) out of the 24 fountain water samples were found to be positive. In contrast, none of the 18 spring water samples examined showed the presence of E. histolytica. When the collected water samples were examined in terms of E. histolytica positivity rates based on water sources, it was determined to be statistically insignificant (p > 0.05).

Table 3 Entamoeba histolytica presence according to seasons

Seasons	Study Center	Number of Examined Samples	Number of Positive Samples	Positives (%)	
Summer	Uluagac*, Yesilburc*, Okcu*, Kemerhisar*	45	4	8.8	
Autumn	Alaaddin**,

Kizilca Creek*

	45	3	6.6	
Total	90	7	7.7	
*: Positive samples

In Table 3, E. histolytica presence determined according to seasons for the collected water samples is provided. Accordingly, out of the 45 water samples examined with the ELISA test during the summer months, 4 (8.8%) were positive, and out of the 45 samples examined in the fall months, 3 (6.6%) were positive. The presence of E. histolytica was detected in water samples during the summer and fall months, and the positivity determined in terms of seasons was found to be statistically insignificant (p > 0.05).

Discussion and Conclusion

Amebiasis caused by E. histolytica is widespread in Turkey and worlwide. Amoebic dysentery is frequently occured in developing and underdeveloped countries. Entamoeba histolytica exists in our environment as a cyst form and is transmitted to humans orally by inadequately sterilized vegetables, fruits, and drinking water [3, 10].

In many countries around the world, various studies have been conducted on waterborne protozoa in different water sources, and mostly E. histolytica, G. intestinalis (G. lamblia), and C. parvum species have been identified [11–23]. In this study, E. histolytica was found positive in neighbourhood fountains, well water, wastewater, and dam waters examined by ELISA. In contrast, no parasites were found in any of the 18 spring water samples examined similar to elsewhere [11–23]. In this context, the detected E. histolytica positivity in different water sources suggests fecal contamination, which should be used after effective treatment and disinfection.

In Turkey, the presence of protozoan parasites in different water sources revealed protozoa such as G. intestinalis, C. parvum and T. gondii that have been investigated more than E. histolytica [24–31]. In a study conducted in Ankara, samples taken from various water sources were examined for standard microscopic, IFA, ELISA, and PCR techniques. Two of the examined well water samples were found to have G. intestinalis, two of the river water samples had E. histolytica, and one had C. parvum, no parasites were detected in municipal waters and dam water [8]. In this study, however, it was found that 7 out of a total of 90 water samples taken from 15 different water sources in Niğde province were positive for E. histolytica by ELISA test, and the prevalence of E. histolytica was determined to be 7.7%. Of the positive samples, 4 were neighbourhood fountains (Yesilburc, Okcu, and Alaaddin), 1 was a dam (Uluagac), 1 was well water (Kemerhisar), and 1 was wastewater (Kizilca Creek). It was observed that the results obtained from various water sources for E. histolytica in this study conducted in the Niğde province differed from the results in Ankara. The difference may be due to the contamination levels of the water samples, the disinfection methods applied, and the detection methods used.

Amebiasis caused by E. histolytica is widespread worldwide, it is more common in tropical and subtropical regions. In Niğde region, the presence of E. histolytica in humans was found microscopically in fecal samples of university students at a rate of 2.12% [32], and in primary school students at a rate of 13.34% [33]. This situation suggests that people in the Niğde province are infected with this parasite (2.12–13.34%), and when there is a problem in the sewage systems, water sources may become contaminated fecally. Thus, waters containing E. histolytica may pose a risk to public health.

In conclusion, the presence of E. histolytica in different water sources (drinking water, well water, spring water, wastewater, and dam water) in the Niğde province is reported for the first time in this study. The presence of E. histolytica in 7.7% of water sources was determined by ELISA. ELISA is among the most popular methods used in diagnostic laboratories throughout the world. When the test protocol is applied correctly, ELISA kits have very high sensitivity and specificity (> 95%). The E. histolytica-specific ELISA offers the significant advantage of the rapid differentiation of E. histolytica from E. dispar [34, 35]. In addition, further investigations, including molecular techniques are required in order to determine the importance of this parasite as a cause of clinical disease in human in Niğde province. However, it is less expensive and relatively easier to detect the protozoan species with ELISA compared to PCR analysis. This study emphasize the importance of an adequately and appropriately disinfection treatment of drinking water, well water, wastewater, and dam waters in terms of public health in the Niğde province. It is crucial to increase public awareness of the impact of E. histolytica on public health in the Niğde province to contribute to the prevention of waterborne parasitic epidemic diseases and ensure people’s access to safe and healthy water.

Acknowledgements

This study was supported by the Scientific Research Projects Coordination Unit of Niğde Ömer Halisdemir University (Project Number: SAT 2021/9-LÜTEP) and was summarised from Cemal CANDAN ‘s master thesis.

Funding

Open access funding provided by the Scientific and Technological Research Council of Türkiye (TÜBİTAK).

Declarations

Conflict of Interest

The authors declared that there are no conflicts of interest.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
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References

1. Current W Garcia L Cryptosporidiosis Clin Microbiol Reviews 1991 4 325 358 10.1128/cmr.4.3.325
Current W, Garcia L (1991) Cryptosporidiosis. Clin Microbiol Reviews 4:325–358. 10.1128/cmr.4.3.32510.1128/cmr.4.3.325
2. Özçelik S Malatyalı E Amebiasis and the role of Virulance factors in Entamoeba histolytica Pathogenesis Türk Hijyen Ve Deneysel Biyoloji Dergisi 2008 65 139 148
Özçelik S, Malatyalı E (2008) Amebiasis and the role of Virulance factors in Entamoeba histolytica Pathogenesis. Türk Hijyen Ve Deneysel Biyoloji Dergisi 65:139–148
3. Yukarı BA Özcel MA Yukarı BA Entamoebiasis Veteriner Hekimliğinde Parazit Hastalıkları 2013 İzmir Meta Basım
Yukarı BA (2013) Entamoebiasis. In: Özcel MA, Yukarı BA (eds) Veteriner Hekimliğinde Parazit Hastalıkları. Meta Basım, İzmir
4. Soulsby EJL Helminths, Arthropods and Protozoa of Domesticated animals 1986 London Bailliere and Tindall
Soulsby EJL (1986) Helminths, Arthropods and Protozoa of Domesticated animals. Bailliere and Tindall, London
5. Taylor MA Coop RL Wall RL Veterinary parasitology 2016 Oxford, UK Blackwell Publishing
Taylor MA, Coop RL, Wall RL (2016) Veterinary parasitology. Blackwell Publishing, Oxford, UK
6. Doganci L Tanyuksel M Doganci T Accurate diagnosis is essential for amebiasis World J Gastroenterol 2004 10 1231 10.3748/wjg.v10.i8.1231 15069733
Doganci L, Tanyuksel M, Doganci T (2004) Accurate diagnosis is essential for amebiasis. World J Gastroenterol 10:1231. 10.3748/wjg.v10.i8.123115069733 10.3748/wjg.v10.i8.1231
7. Haque R Huston CD Hughes M Houpt E Petri WA Entamoeba histolytica N Engl J Med 2003 348 1565 1573 10.1056/NEJMra022710 12700377
Haque R, Huston CD, Hughes M, Houpt E, Petri WA (2003) Entamoeba histolytica. N Engl J Med 348:1565–1573. 10.1056/NEJMra02271012700377 10.1056/NEJMra022710
8. Bakir B Tanyuksel M Saylam F Tanriverdi S Araz RE Hacim AK Hasde M Investigation of waterborne parasites in drinking water sources of Ankara, Turkey J Microbiol 2003 41 148 151
Bakir B, Tanyuksel M, Saylam F, Tanriverdi S, Araz RE, Hacim AK, Hasde M (2003) Investigation of waterborne parasites in drinking water sources of Ankara, Turkey. J Microbiol 41:148–151
9. Koloren Z Sotiriadou I Karanis P Investigations and comparative detection of Cryptosporidium species by microscopy, nested PCR and LAMP in water supplies of Ordu, Middle Black Sea, Turkey Annals Trop Med Parasitol 2011 105 607 615 10.1179/2047773211Y.0000000011
Koloren Z, Sotiriadou I, Karanis P (2011) Investigations and comparative detection of Cryptosporidium species by microscopy, nested PCR and LAMP in water supplies of Ordu, Middle Black Sea, Turkey. Annals Trop Med Parasitol 105:607–615. 10.1179/2047773211Y.000000001110.1179/2047773211Y.0000000011
10. Yukarı BA (2015) Entamoebidae, Hartmannellidae, Vahlkampfidae. In: Dumanlı N, Karaer KZ (eds) Veteriner Protozooloji. Medisan Yayınevi, Ankara
11. Ferrer A Nguyen-Viet H Zinsstag J Quantification of diarrhea risk related to wastewater contact in Thailand EcoHealth 2012 9 49 59 10.1007/s10393-012-0746-x 22311100
Ferrer A, Nguyen-Viet H, Zinsstag J (2012) Quantification of diarrhea risk related to wastewater contact in Thailand. EcoHealth 9:49–59. 10.1007/s10393-012-0746-x22311100 10.1007/s10393-012-0746-x
12. Akbar N Ayaz S Rahman S Khan S Khan SN Noor AA Shagufta BI Raza F Waqar M Molecular detection of Entamoeba histolytica in different water sources of District Peshawar, Pakistan Annual Res Rev Biology 2014 1 1461 1470 10.9734/ARRB/2014/7935
Akbar N, Ayaz S, Rahman S, Khan S, Khan SN, Noor AA, Shagufta BI, Raza F, Waqar M (2014) Molecular detection of Entamoeba histolytica in different water sources of District Peshawar, Pakistan. Annual Res Rev Biology 1:1461–1470. 10.9734/ARRB/2014/793510.9734/ARRB/2014/7935
13. Ghasemi E Rahdar M Rostami M Prevalence of Entamoeba histolytica/dispar in drinking water in the city of Shush, Khuzestan Province in 2011 Int J Curr Microbiol Appl Sci 2015 4 582 588
Ghasemi E, Rahdar M, Rostami M (2015) Prevalence of Entamoeba histolytica/dispar in drinking water in the city of Shush, Khuzestan Province in 2011. Int J Curr Microbiol Appl Sci 4:582–588
14. Mahmoudi MR Nazemalhosseini-Mojarad E Karanis P Genotyping of Giardia lamblia and Entamoeba spp from river waters in Iran Parasitol Res 2015 114 4565 4570 10.1007/s00436-015-4702-x 26350378
Mahmoudi MR, Nazemalhosseini-Mojarad E, Karanis P (2015) Genotyping of Giardia lamblia and Entamoeba spp from river waters in Iran. Parasitol Res 114:4565–4570. 10.1007/s00436-015-4702-x26350378 10.1007/s00436-015-4702-x
15. Hemmati A Hooshmand E Hosseini MJ Identification of Entamoeba histolytica by molecular method in surface water of Rasht city, Iran Iran J Public Health 2015 44 238 243 25905058
Hemmati A, Hooshmand E, Hosseini MJ (2015) Identification of Entamoeba histolytica by molecular method in surface water of Rasht city, Iran. Iran J Public Health 44:238–24325905058
16. Berglund B Dienus O Sokolova E Berglind E Matussek A Pettersson T Lindgren PE Occurrence and removal efficiency of parasitic protozoa in Swedish wastewater treatment plants Sci Total Environ 2017 598 821 827 10.1016/j.scitotenv.2017.04.015 28458199
Berglund B, Dienus O, Sokolova E, Berglind E, Matussek A, Pettersson T, Lindgren PE (2017) Occurrence and removal efficiency of parasitic protozoa in Swedish wastewater treatment plants. Sci Total Environ 598:821–827. 10.1016/j.scitotenv.2017.04.01528458199 10.1016/j.scitotenv.2017.04.015
17. Ajonina C Buzie C Möller J Otterpohl R The detection of Entamoeba histolytica and Toxoplasma Gondii in wastewater J Toxicol Environ Health 2018 81 1 5 10.1080/15287394.2017.1392399
Ajonina C, Buzie C, Möller J, Otterpohl R (2018) The detection of Entamoeba histolytica and Toxoplasma Gondii in wastewater. J Toxicol Environ Health 81:1–5. 10.1080/15287394.2017.139239910.1080/15287394.2017.1392399
18. Elfadaly HA Hassanain NA Hassanain MA Barakat AM Shaapan RM Evaluation of primitive ground water supplies as a risk factor for the development of major waterborne zoonosis in Egyptian children living in rural areas J Infect Public Health 2018 11 203 208 10.1016/j.jiph.2017.07.025 28843417
Elfadaly HA, Hassanain NA, Hassanain MA, Barakat AM, Shaapan RM (2018) Evaluation of primitive ground water supplies as a risk factor for the development of major waterborne zoonosis in Egyptian children living in rural areas. J Infect Public Health 11:203–208. 10.1016/j.jiph.2017.07.02528843417 10.1016/j.jiph.2017.07.025
19. Sabbahi S Trad M Ben Ayed L Marzougui N Occurrence of intestinal parasites in sewage samples and efficiency of wastewater treatment systems in Tunisia Water Qual Res J 2018 53 86 101 10.2166/wqrj.2018.033
Sabbahi S, Trad M, Ben Ayed L, Marzougui N (2018) Occurrence of intestinal parasites in sewage samples and efficiency of wastewater treatment systems in Tunisia. Water Qual Res J 53:86–101. 10.2166/wqrj.2018.03310.2166/wqrj.2018.033
20. Al-Khalidy KAH Abbas AJ Detection of some intestinal parasites in the wastewater of some health centers (popular clinics) in some areas of Al-Diwaniyah city, Iraq Eurasian J Biosci 2020 14 2115 2121
Al-Khalidy KAH, Abbas AJ (2020) Detection of some intestinal parasites in the wastewater of some health centers (popular clinics) in some areas of Al-Diwaniyah city, Iraq. Eurasian J Biosci 14:2115–2121
21. Al-Nihmi FM Salih AA Qazzan J Radman B Al-Woree W Belal S Al-Motee J Ahlam AA Al-Harthee A Al-Samawee H Al-Samawee B Atiah H Detection of pathogenic waterborne parasites in treated wastewater of Rada’a City-Yemen J Sci Res Med Biol Sci 2020 1 30 39 10.47631/jsrmbs.v1i1.23
Al-Nihmi FM, Salih AA, Qazzan J, Radman B, Al-Woree W, Belal S, Al-Motee J, Ahlam AA, Al-Harthee A, Al-Samawee H, Al-Samawee B, Atiah H (2020) Detection of pathogenic waterborne parasites in treated wastewater of Rada’a City-Yemen. J Sci Res Med Biol Sci 1:30–39. 10.47631/jsrmbs.v1i1.2310.47631/jsrmbs.v1i1.23
22. Shankar P Mishra J Bharti V Parashar D Singh S Multiplex PCR assay for simultaneous detection and differentiation of Entamoeba histolytica, Giardia lamblia, and Salmonella spp. in the municipality-supplied drinking water J Lab Physicians 2019 11 275 280 10.4103/JLP.JLP_66_18 31579243
Shankar P, Mishra J, Bharti V, Parashar D, Singh S (2019) Multiplex PCR assay for simultaneous detection and differentiation of Entamoeba histolytica, Giardia lamblia, and Salmonella spp. in the municipality-supplied drinking water. J Lab Physicians 11:275–280. 10.4103/JLP.JLP_66_1831579243 10.4103/JLP.JLP_66_18
23. Danjuma FY Onaji AI Ocheme JO Danladi YP Analysis of physicohemical parameters and prevalence of Entamoeba histolytica in water drawn from cast and non-cast wells in Zaria, Nigeria Int J Adv Res 2020 8 1298 1305 10.21474/IJAR01/11046
Danjuma FY, Onaji AI, Ocheme JO, Danladi YP (2020) Analysis of physicohemical parameters and prevalence of Entamoeba histolytica in water drawn from cast and non-cast wells in Zaria, Nigeria. Int J Adv Res 8:1298–1305. 10.21474/IJAR01/1104610.21474/IJAR01/11046
24. Demirel E (2014) Detection of Toxoplasma gondii in the Water Samples of Ordu and Giresun Provinces by Molecular Techniques. Dissertation, University of Ordu
25. Ayaz E (2015) Investigation on Cryptosporidium parvum by using Molecular Technics in Water Samples Collected From Provinces of Giresun and Samsun. Dissertation, University of Ordu
26. Kaya Y Karaman Ü Yolalan G Evaluation of Spring Waters in Ordu Province in terms of Parasite Presence ODÜ Tıp Dergisi 2021 8 14 18
Kaya Y, Karaman Ü, Yolalan G (2021) Evaluation of Spring Waters in Ordu Province in terms of Parasite Presence. ODÜ Tıp Dergisi 8:14–18
27. Koloren Z Demirel E Detection of Toxoplasma Gondii in Turkish river and drinking water samples by different PCR and LAMP methods CLEAN–Soil Air Water 2013 41 963 968 10.1002/clen.201200468
Koloren Z, Demirel E (2013) Detection of Toxoplasma Gondii in Turkish river and drinking water samples by different PCR and LAMP methods. CLEAN–Soil Air Water 41:963–968. 10.1002/clen.20120046810.1002/clen.201200468
28. Kolören Z Karaman Ü Determination of waterborne parasites in environmental water samples collected from Terme and Kocaman Rivers in Samsun province of the Black Sea Region Akademik Ziraat Dergisi 2017 6 177 182 10.29278/azd.371077
Kolören Z, Karaman Ü (2017) Determination of waterborne parasites in environmental water samples collected from Terme and Kocaman Rivers in Samsun province of the Black Sea Region. Akademik Ziraat Dergisi 6:177–182. 10.29278/azd.37107710.29278/azd.371077
29. Sağlam T (2018) A Research on Some Single Cells (Protozoa) Parasites in Agricultural Irrigation and Drinking Water Resources in Denizli City Center. Dissertation, University of Pamukkale
30. Sağlam T Düşen S Yağcı MA Yağcı A Investigation of Cryptosporidium spp. and Giardia spp. in Lake Eğirdir (Isparta) Türk Mikrobiyoloji Cemiyeti Dergisi 2021 51 363 367 10.5222/TMCD.2021.87004
Sağlam T, Düşen S, Yağcı MA, Yağcı A (2021) Investigation of Cryptosporidium spp. and Giardia spp. in Lake Eğirdir (Isparta). Türk Mikrobiyoloji Cemiyeti Dergisi 51:363–367. 10.5222/TMCD.2021.8700410.5222/TMCD.2021.87004
31. Seferoğlu O (2014) Detection of Giardia intestinalis in the Water Samples of Samsun and Giresun Provinces by Molecular Techniques, Dissertation, University of Ordu
32. Sarıaslan Y Doğanay M Türkmen H The prevalence of intestinal parasites in female students between 17 and 25 years of age in the Sabancı dormitory in Niğde, Turkey Türkiye Parazitoloji Dergisi 2001 25 66 68
Sarıaslan Y, Doğanay M, Türkmen H (2001) The prevalence of intestinal parasites in female students between 17 and 25 years of age in the Sabancı dormitory in Niğde, Turkey. Türkiye Parazitoloji Dergisi 25:66–68
33. Koz TB (2003) The prevalence of the intestinal and ectoparasites among the primary school students in the center of Niğde and its villages. Dissertation, University of Niğde
34. Tanyuksel M Petri WA Laboratory diagnosis of Amebiasis Clin Microbiol Rev 2003 16 713 729 10.1128/cmr.16.4.713-729.2003 14557296
Tanyuksel M, Petri WA (2003) Laboratory diagnosis of Amebiasis. Clin Microbiol Rev 16:713–729. 10.1128/cmr.16.4.713-729.200314557296 10.1128/cmr.16.4.713-729.2003
35. Fotedar R Stark D Beebe N Marriott D Ellis J Harkness J Laboratory Diagnostic techniques for Entamoeba Species Clin Microbiol Rev 2007 20 511 532 10.1128/cmr.00004-07 17630338
Fotedar R, Stark D, Beebe N, Marriott D, Ellis J, Harkness J (2007) Laboratory Diagnostic techniques for Entamoeba Species. Clin Microbiol Rev 20:511–532. 10.1128/cmr.00004-0717630338 10.1128/cmr.00004-07
