Introduction: Dientamoeba fragilis is a cosmopolitan but overlooked amoeba-like flagellate. It may cause gastrointestinal symptoms similar to those of irritable bowel syndrome. So far, no epidemiological analysis has been conducted in Greece.
Aim: This study aimed to describe the prevalence of D. fragilis infection and its associated factors in the country over the recent decade.
Material and methods: Faecal samples from 1361 Greek patients with possible intestinal parasitosis were tested for parasites including D. fragilis. Laboratory and demographic characteristics of patients with D. fragilis infection were compared to those of patients with Giardia lamblia- and Blastocystis sp.-infection and analysed.
Results: D. fragilis was found in 4.6% of patients with possible enteric parasitosis. It ranked third after Blastocystis sp. (8.4%). It ranked second after G. lamblia (4.9%) among pathogenic intestinal protozoa. D. fragilis-infected women had a high peak at their forties (women's parenting age), while a lesser peak was found in D. fragilis-infected men in their late forties (men's parenting age). D. fragilis was more likely than G. lamblia [PR = 4.70(1.68-13.14)] and Blastocystis sp. [PR = 2.2(1.07-4.90)] to be acquired in rural areas, in which young males (<40 years) were more likely than females to become infected with D. fragilis [MH- PR = 5.76(1.70-19.54)].
Conclusions: D. fragilis was identified at a low rate among Greek patients with possible intestinal parasitosis. Primary care physicians in Greece should be aware of the possibility of D. fragilis infection in people in their parenting age and in young men living in rural areas, when presented with non-specific gastrointestinal symptoms that cannot be explained by other enteropathogens and request further laboratory testing.
Keywords: Blastocystis; Dientamoeba fragilis; Giardia; Mode of transmission; Parenting age; Rural areas.
© 2026. The Author(s), under exclusive license to Springer Nature Switzerland AG.