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Diagnosis and Epidemiology of Amoebiasis in India


Affiliations
1 Department of Zoology, Pandit Deendayal Upadhyaya Adarsha Mahavidyalaya, Karimganj 788 723, India
2 Department of Zoology, Gurucharan College, Silchar 788 004, India
3 School of Life Sciences, Jawaharlal Nehru University, New Delhi 110 067, India
4 Department of Biotechnology, Assam University, Silchar 788 011, India
 

It is now well established that Entamoeba histolytica was indeed a species complex comprising of pathogenic E. histolytica and morphologically indistinguishable non-pathogenic E. dispar and E. moshkovskii. A greater hindrance is the different and inconsistent use of diagnostic methods in different areas of the world. Though microscopy has poor sensitivity, it seems that till today, many epidemiological studies are either based on microscopy alone or PCR assay carried out on microscopy screened samples or PCR assay performed on a very small sample size and thus fails to figure out the true magnitude of amoebiasis. The present review recommends DNA-based systematic approach like rDNA-based DNA dot blot screening followed by PCR assay to determine the true prevalence rate, suggesting its implication in the large-scale epidemiological study. DNA-based studies from across the world showed that the prevalence rate varies from 0.55% to 69.6% among human populations. The studies indicate that various unhygienic practices like unhygienic toilet facilities, poor living conditions, hand washing habits, etc. HIV infection and mutation in LEPR are among common factors that increase the likelihood of amoebiasis. On the other hand, till today it remains unclear if the E. histolytica causing intestinal and extra-intestinal amoebiasis is a similar or different strain.

Keywords

Entamoeba Complex, Microscopy, DNA-Based Diagnosis and Molecular Epidemiology, Risk Factor, Strain Typing.
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  • Kean, B. H., A history of amebiasis. In Amoebiasis: Human Infection by Entamoeba histolytica (ed. Ravdin, J. I.), John Wiley, New York, 1988, pp. 1–10.
  • Lesh, F. A., Massive development of amoebas in the large intestine. Am. J. Trop. Med. Hyg., 1975, 24, 383–392.
  • Schaudinn, F., The development of some rhizopoda (preliminary report). Arbeiten aus dem Kaisherlichen Gesundheitsamte, 1903, 19, 547.
  • Brumpt, E., Etude sommaire de l’ ‘Entamoeba dispar’ n. sp. Amibe a kystes quadrinucléés, parasite de l’homme. Bull. Acad. Med., 1925, 94, 943–952.
  • Martinez-Palomo, A., Gonzalez-Robles, A. and de la Torre, M., Selective agglutination of pathogenic strains of Entamoeba histolytica induced con A. Nat. New Biol., 1973, 245, 186–187.
  • Diamond, L. S., Axenic cultivation of Entamoeba histolytica. Science, 1961, 134, 336–337.
  • Sargeaunt, P. G., Williams, J. E. and Grene, J. D., The differentiation of invasive and non-invasive Entamoeba histolytica by isoenzyme electrophoresis. Trans. R. Soc. Trop. Med. Hyg., 1978, 72, 519–521.
  • World Health Organization, Amoebiasis. Weekly Epidemiological Record, 1997, 72, 97–99.
  • Ximenez, C. et al., Novelties on amoebiasis: a neglected tropical disease. J. Glob. Infect. Dis., 2011, 3, 166–174.
  • Parija, S. C. and Khairnar, K., Entamoeba moshkovskii and Entamoeba dispar associated infections in Pondicherry, India. J. Health Popul. Nutr., 2005, 23, 292–295.
  • Fotedar, R., Stark, D., Marriott, D., Ellis, J. and Harkness, J., Entamoeba moshkovskii infections in Sydney, Australia. Eur. J. Clin. Microbiol. Infect. Dis., 2008, 27, 133–137.
  • Krogstad, D. J., Spencer Jr, H. C., Healy, G. R., Gleason, N. N., Sexton, D. J. and Herron, C. A., Amebiasis: epidemiologic studies in the United States, 1971–1974. Ann. Intern. Med., 1978, 88, 89–97.
  • Talamas-Lara, D. et al., Erythrophagocytosis in Entamoeba histolytica and Entamoeba dispar: a comparative study. Biomed Res. Int., 2014, 2014, 626259.
  • Fotedar, R., Stark, D., Beebe, N., Marriott, D., Ellis, J. and Harkness, J., Laboratory diagnostic techniques for Entamoeba species. Clin. Microbiol. Rev., 2007, 20, 511–532.
  • Anuar, T. S. et al., Evaluation of formalin-ether sedimentation and trichrome staining techniques: its effectiveness in detecting Entamoeba histolytica/dispar/moshkovskii in stool samples. J. Microbiol. Methods, 2013, 92, 344–348.
  • Hemadi, A. et al., Bioconjugated fluorescent silica nanoparticles for the rapid detection of Entamoeba histolytica. Acta Trop., 2015, 145, 26–30.
  • Robinson, G. L., The laboratory diagnosis of human parasitic amoebae. Trans. R. Soc. Trop. Med. Hyg., 1968, 62, 285–294.
  • Diamond, L. S., A new liquid medium for xenic cultivation of Entamoeba histolytica and other lumen dwelling protozoa. J. Parasitol., 1982, 68, 958–959.
  • van Hal, S. J., Stark, D. J., Fotedar, R., Marriott, D., Ellis, J. T. and Harkness, J. L., Amoebiasis: current status in Australia. Med. J. Aust., 2007, 186, 412–416.
  • Stark, D. et al., Comparison of stool antigen detection kits to PCR for diagnosis of amebiasis. J. Clin. Microbiol., 2008, 46, 1678–1681.
  • Elbakri, A., Samie, A., Ezzedine, S. and Odeh, R. A., Differential detection of Entamoeba histolytica, Entamoeba dispar and Entamoeba moshkovskii in fecal samples by nested PCR in the United Arab Emirates (UAE). Acta Parasitol., 2013, 58, 185–190.
  • Dhanalakshmi, S. and Parija, S. C., Seroprevalence of Entamoeba histolytica from a tertiary care hospital, South India. Trop. Parasitol., 2016, 6, 78–81.
  • Kebede, A. et al., The use of real-time PCR to identify Entamoeba histolytica and E. dispar infections in prisoners and primary-school children in Ethiopia. Ann. Trop. Med. Parasitol., 2004, 98, 43–48.
  • Leiva, B., Lebbad, M., Winiecka-Krusnell, J., Altamirano, I., Tellez, A. and Linder, E., Overdiagnosis of Entamoeba histolytica and Entamoeba dispar in Nicaragua: a microscopic, triage parasite panel and PCR study. Arch. Med. Res., 2006, 37, 529–534.
  • Srivastava, S., Bhattacharya, S. and Paul, J., Species- and strain-specific probes derived from repetitive DNA for distinguishing Entamoeba histolytica and Entamoeba dispar. Exp. Parasitol., 2005, 110, 303–308.
  • Nath, J., Ghosh, S. K. and Singha, B., Problem in amoebiasis diagnosis in clinical setting: a review from conventional microscopy to advance molecular based diagnosis. J. Acad. Indus. Res., 2013, 2, 257–261.
  • Nath, J., Banyal, N., Gautam, D. S., Ghosh, S. K., Singha, B. and Paul, J., Systematic detection and association of Entamoeba species in stool samples from selected sites in India. Epidemiol. Infect., 2015, 143, 108–119.
  • Frickmann, H. et al., Influence of parasite density and sample storage time on the reliability of Entamoeba histolytica-specific PCR from formalin-fixed and paraffin-embedded tissues. Diagn. Mol. Pathol., 2013, 22, 236–244.
  • Parija, S. C., Mandal, J. and Ponnambath, D. K., Laboratory methods of identification of Entamoeba histolytica and its differentiation from look-alike Entamoeba spp. Trop. Parasitol., 2014, 4, 90–95.
  • Kumari, V. et al., Genomic distribution of SINEs in Entamoeba histolytica strains: implication for genotyping. BMC Genomics, 2013, 14, 432.
  • Zaki, M., Reddy, S. G., Jackson, T. F., Ravdin, J. I. and Clark, C. G., Genotyping of Entamoeba species in South Africa: diversity, stability, and transmission patterns within families. J. Infect. Dis., 2003, 187, 1860–1869.
  • Escuetade Cadiz, A., Kobayashi, S., Takeuchi, T., Tachibana, H. and Nozaki, T., Identification of an avirulent Entamoeba histolytica strain with unique tRNA linked short tandem repeat markers. Parasitol. Int., 2010, 59, 75–81.
  • Ayeh-Kumi, P., Ali, I. M., Lockhart, L. A., Gilchrist, C. A. and Petri Jr, W. A., Entamoeba histolytica: genetic diversity of clinical isolates from Bangladesh as demonstrated by polymorphisms in the serine-rich gene. Exp. Parasitol., 2001, 99, 80–88.
  • Samie, A. et al., Entamoeba histolytica: genetic diversity of African strains based on the polymorphism of the serine-rich protein gene. Exp. Parasitol., 2008, 118, 354–361.
  • ElBakri, A., Samie, A., Ezzedine, S. and Odeh, R., Genetic variability of the serine-rich Entamoeba histolytica protein gene in clinical isolates from the United Arab Emirates. Trop. Biomed., 2014, 31, 370–377.
  • Simonishvili, S. et al., Entamoeba histolytica: the serine-rich gene polymorphism-based genetic variability of clinical isolates from Georgia. Exp. Parasitol., 2005, 110, 313–317.
  • Freitas, M. A. R. et al., Differentially expressed genes of virulent and nonvirulent Entamoeba histolytica strains identified by suppression subtractive hybridization. Biomed. Res. Int., 2014, 2014, 285607.
  • Zhang, H., Ehrenkaufer, G. M., Hall, N. and Singh, U., Small RNA pyrosequencing in the protozoan parasite Entamoeba histolytica reveals strain-specific small RNAs that target virulence genes. BMC Genomics, 2013, 14, 53.
  • Calegar, D. A. et al., Frequency and molecular characterisation of Entamoeba histolytica, Entamoeba dispar, Entamoeba moshkovskii, and Entamoeba hartmanni in the context of water scarcity in northeastern Brazil. Mem. Inst. Oswaldo Cruz., 2016, 111, 114–119.
  • Shubha, D. and Fatima, F., A coprological survey for assessing intensity of parasitic infection in school children: cross-sectional study. Trop. Parasitol., 2011, 1, 88–93.
  • Barda, B. et al., Freezing parasites in pre-Himalayan region, Himachal Pradesh: Experience with mini-FLOTAC. Acta Trop., 2013, 130, 11–16.
  • Dhanabal, J., Selvadoss, P. P. and Muthuswamy, K., Comparative study of the prevalence of intestinal parasites in low socioeconomic areas from South Chennai, India. J. Parasitol. Res., 2014, 2014, 630968.
  • Mukherjee, A. K., Das, K., Bhattacharya, M. K., Nozaki, T. and Ganguly, S., Trend of Entamoeba histolytica infestation in Kolkata. Gut Pathog., 2010, 2, 12.
  • Prakash, A., Chakraborti, A., Mahajan, R. C. and Ganguly, N. K., Entamoeba histolytica: rapid detection of Indian isolates by cysteine proteinase gene-specific polymerase chain reaction. Exp. Parasitol., 2000, 95, 285–287.
  • Mukhopadhyay, A., Chakraborti, A., Mahajan, R. C. and Ganguly, N. K., Entamoeba histolytica: rapid identification and differentiation of Indian isolates by riboprinting. Exp. Parasitol., 2002, 102, 109–112.
  • Parija, S. C., Garg, A., Pushpa, K., Khairnar, K. and Priya, T., Polymerase chain reaction confirmation of diagnosis of intestinal amebiasis in Puducherry. Indian J. Gastroenterol., 2010, 29, 140–142.
  • Nath, J., Ghosh, S. K., Singha, B. and Paul, J., Molecular epidemiology of amoebiasis: a cross-sectional study among North East Indian population. PLoS Negl. Trop. Dis., 2015, 9, e0004225.
  • Haque, R., Ali, I. K. M. and Petri Jr, W. A., Prevalence and immune response of Entamoeba histolytica infection in preschool children in Bangladesh. Am. J. Trop. Med. Hyg., 1999, 60, 1031–1034.
  • Ramos, F. et al., High prevalence rate of Entamoeba histolytica asymptomatic infection in a rural Mexican community. Am. J. Trop. Med. Hyg., 2005, 73, 87–91.
  • Al-Hindi, A. et al., Entamoeba histolytica or Entamoeba dispar among children in Gaza, Gaza Strip? J. Egypt. Soc. Parasitol., 2005, 35, 59–68.
  • Pestehchian, N., Nazary, M., Haghighi, A., Salehi, M. and Yosefi, H., Frequency of Entamoeba histolytica and Entamoeba dispar prevalence among patients with gastrointestinal complaints in Chelgerd city, southwest of Iran. J. Res. Med. Sci., 2011, 16, 1436–1440.
  • Hussein, A. S., Prevalence of intestinal parasites among school children in northern districts of West Bank-Palestine. Trop. Med. Int. Health, 2011, 16, 240–244.
  • Ngui, R. et al., Differentiating Entamoeba histolytica, Entamoeba dispar and Entamoeba moshkovskii using nested polymerase chain reaction (PCR) in rural communities in Malaysia. Parasit. Vectors, 2012, 5, 187.
  • Yakoob, J., Abbas, Z., Beg, M. A., Naz, S., Khan, R. and Jafri, W., Entamoeba species associated with chronic diarrhoea in Pakistan. Epidemiol. Infect., 2012, 140, 323–328.
  • Emile, N., Bosco, N. J. and Karine, B., Prevalence of intestinal parasitic infections and associated risk factors among Kigali institute of education students in Kigali, Rwanda. Trop. Biomed., 2013, 30, 718–726.
  • Lau, Y. L., Anthony, C., Fakhrurrazi, S. A., Ibrahim, J., Ithoi, I. and Mahmud, R., Real-time PCR assay in differentiating Entamoeba histolytica, Entamoeba dispar, and Entamoeba moshkovskii infections in Orang Asli settlements in Malaysia. Parasit. Vectors, 2013, 6, 250.
  • Santos, R. V., Nunes Jda, S., Camargo, J. A., Rocha, E. M., Fontes, G. and Camargo, L. M., High occurrence of Entamoeba histolytica in the municipalities of Ariquemes and Monte Negro, State of Rondônia, Western Amazonia, Brazil. Rev. Inst. Med. Trop. Sao. Paulo., 2013, 55, 193–196.
  • Bracho Mora, A., Rivero de Rodriguez, Z., Arraiz, N., Villalobos, R. and Urdaneta, H., Detection of Entamoeba histolytica and Entamoeba dispar by PCR in children, less than five years of age with diarrhea, in Maracaibo, Venezuela. A preliminary study. Invest. Clin., 2013, 54, 373–381.
  • Al-Malki, J. S., Factors associated with high prevalence of Entamaeba histolytica/dispar infection among children in Jeddah, KSA. American-Eurasian J. Agric. Environ. Sci., 2014, 14, 50–56.
  • Koffi, M., N’Djeti, M., Konan, T. and Dje, Y., Molecular characterization of intestinal protozoan parasites from children facing diarrheal disease and associated risk factors in Yamoussoukro, Côte d’Ivoire. Afr. J. Environ. Sci. Technol., 2014, 8, 178–184.
  • Lopez, M. C. et al., Molecular epidemiology of Entamoeba: First description of Entamoeba moshkovskii in a rural area from Central Colombia. PLoS ONE, 2015, 10, e0140302.
  • Sabah, A. A. and Temsah, A. G., Prevalence of some gastrointestinal parasites in diabetic patients in tanta city, Gharbia Governorate, Egypt. J. Egypt. Soc. Parasitol., 2015, 45, 681–684.
  • Alvarado-Esquivel, C., Hernandez-Tinoco, J., Francisco Sanchez-Anguiano, L., RamosNevarez, A., Margarita Cerrillo-Soto, S. and Alberto Guido-Arreola, C., Serosurvey of Entamoeba histolytica exposure among Tepehuanos population in Durango, Mexico. Int. J. Biomed. Sci., 2015, 11, 61–66.
  • Yimer, M., Zenebe, Y., Mulu, W., Abera, B. and Saugar, J. M., Molecular prevalence of Entamoeba histolytica/dispar infection among patients attending four health centres in northwest Ethiopia. Trop Doct., 2017, 47, 11–15.
  • Hassen Amer, O., Ashankyty, I. M. and Haouas, N. A., Prevalence of intestinal parasite infections among patients in local public hospitals of Hail, Northwestern Saudi Arabia. Asian Pac. J. Trop. Med., 2016, 9, 44–48.
  • Fuhrimann, S. et al., Risk of intestinal parasitic infections in people with different exposures to wastewater and fecal sludge in Kampala, Uganda: a crosssectional study. PLoS Negl. Trop. Dis., 2016, 10, e0004469.
  • Heudorf, U., Karathana, M., Krackhardt, B., Huber, M., Raupp, P. and Zinn, C., Surveillance for parasites in unaccompanied minor refugees migrating to Germany in 2015. GMS Hyg. Infect. Control, 2016, 11; doi:10.3205/dgkh000265.
  • Heckendorn, F. et al., Species-specific field testing of Entamoeba spp. in an area of high endemicity. Trans. R. Soc. Trop. Med. Hyg., 2002, 96, 521–528.
  • Beck, D. L., Dogan, N., Maro, V., Sam, N. E., Shao, J. and Houpt, E. R., High prevalence of Entamoeba moshkovskii in a Tanzanian HIV population. Acta Trop., 2008, 107, 48–49.
  • Nath, J., Ghosh, S. K., Bhattacharjee, P., Paul, J. and Singha, B., High prevalence of Entamoeba moshkovskii infection in HIV seropositive patients of Barak Valley, Assam, India. BMC Infect. Dis., 2014, 14, P1.
  • Anuar. T. S., et al., First molecular identification of Entamoeba moshkovskii in Malaysia. Parasitol., 2013, 139, 1521–1525.
  • Pham Duc, P., Nguyen-Viet, H., Hattendorf, J., Zinsstag, J., Dac Cam, P. and Odermatt, P., Risk factors for Entamoeba histolytica infection in an agricultural community in Hanam province, Vietnam. Parasit. Vectors, 2011, 4, 102.
  • Karambaigi, F., Abdi, J. and Sayehmiri, K., Prevalence of Entamoeba histolytica in Iran during 1988 to 2009: Systematic review and meta-analyses. Afr. J. Microbiol. Res., 2012, 6, 3944–3947.
  • Duggal, P., et al., A mutation in the leptin receptor is associated with Entamoeba histolytica infection in children. J. Clin. Invest., 2011, 121, 1191–1198.
  • Verma, A. K., Ahuja, V. and Paul, J., The trend in distribution of Q223R mutation of leptin receptor gene in amoebic liver abscess patients from North India: a prospective study. Biomed Res. Int., 2014, 2014, 847132.
  • Chen, H. L., Bair, M. J., Lin, I. T., Wu, C. H. and Lee, Y. K., Clinical manifestations and risk factors of amebic liver abscess in Southeast Taiwan compared with other regions of Taiwan. Am. J. Trop. Med. Hyg., 2013, 89, 1214–1218.
  • Zhou, F. et al., Seroprevalence of Entamoeba histolytica infection among Chinese men who have sex with men. PLoS Negl. Trop. Dis., 2013, 7, e2232.
  • Mahmud, M. A., Bezabih, A. M. and Gebru, R. B., Risk factors for intestinal parasitosis among antiretroviral treated HIV/AIDS patients in Ethiopia. Int. J. STD AIDS, 2014, 25, 778–784.
  • Adamu, H., Wegayehu, T. and Petros, B., High prevalence of diarrhoegenic intestinal parasite infections among non-ART HIV patients in Fitche Hospital, Ethiopia. PLoS ONE, 2013, 8, e72634.

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  • Diagnosis and Epidemiology of Amoebiasis in India

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Authors

Joyobrato Nath
Department of Zoology, Pandit Deendayal Upadhyaya Adarsha Mahavidyalaya, Karimganj 788 723, India
Baby Singha
Department of Zoology, Gurucharan College, Silchar 788 004, India
Jaishree Paul
School of Life Sciences, Jawaharlal Nehru University, New Delhi 110 067, India
Sankar Kumar Ghosh
Department of Biotechnology, Assam University, Silchar 788 011, India

Abstract


It is now well established that Entamoeba histolytica was indeed a species complex comprising of pathogenic E. histolytica and morphologically indistinguishable non-pathogenic E. dispar and E. moshkovskii. A greater hindrance is the different and inconsistent use of diagnostic methods in different areas of the world. Though microscopy has poor sensitivity, it seems that till today, many epidemiological studies are either based on microscopy alone or PCR assay carried out on microscopy screened samples or PCR assay performed on a very small sample size and thus fails to figure out the true magnitude of amoebiasis. The present review recommends DNA-based systematic approach like rDNA-based DNA dot blot screening followed by PCR assay to determine the true prevalence rate, suggesting its implication in the large-scale epidemiological study. DNA-based studies from across the world showed that the prevalence rate varies from 0.55% to 69.6% among human populations. The studies indicate that various unhygienic practices like unhygienic toilet facilities, poor living conditions, hand washing habits, etc. HIV infection and mutation in LEPR are among common factors that increase the likelihood of amoebiasis. On the other hand, till today it remains unclear if the E. histolytica causing intestinal and extra-intestinal amoebiasis is a similar or different strain.

Keywords


Entamoeba Complex, Microscopy, DNA-Based Diagnosis and Molecular Epidemiology, Risk Factor, Strain Typing.

References





DOI: https://doi.org/10.18520/cs%2Fv114%2Fi10%2F2045-2052