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First molecular epidemiology of Entamoeba histolytica, E. dispar and E. moshkovskii infections in Yemen: different species-specific associated risk factors

Al-Areeqi MA, Sady H, Al-Mekhlafi HM, Anuar TS, Al-Adhroey AH, Atroosh WM, et al.

Trop Med Int Health, 2017 04;22(4):493-504.
PMID: 28151567 DOI: 10.1111/tmi.12848

OBJECTIVES: To investigate the molecular epidemiology of Entamoeba histolytica, E. dispar and E. moshkovskii infections among rural communities in Yemen.
METHODS: In a community-based study, faecal samples were collected from 605 participants and examined by wet mount, formalin-ether sedimentation, trichrome staining and nested multiplex PCR techniques. Demographic, socio-economic and environmental information was collected using a pre-tested questionnaire.
RESULTS: Overall, 324 (53.6%) of the samples were positive for Entamoeba cysts and/or trophozoites by microscopic examination. Molecular analysis revealed that 20.2%, 15.7% and 18.2% of the samples were positive for E. histolytica, E. dispar and E. moshkovskii, respectively. Multivariate analysis showed different sets of species-specific risk factors among these communities. Educational level was identified as the significant risk factor for E. histolytica; age and gender were the significant risk factors for E. moshkovskii; and sources of drinking water and consumption of unwashed vegetables were the significant risk factors for E. dispar. Moreover, living in coastal/foothill areas and presence of other infected family members were risk factors for both E. histolytica and E. moshkovskii infections.
CONCLUSION: The study reveals that Entamoeba spp. infection is highly prevalent among rural communities in Yemen, with E. histolytica, E. dispar and E. moshkovskii differentiated for the first time. Identifying and treating infected family members, providing health education pertinent to good personal and food hygiene practices and providing clean drinking water should be considered in developing a strategy to control intestinal parasitic infections in these communities, particularly in the coastal/foothill areas of the country.

Matched MeSH terms: Entamoeba/genetics; Entamoeba/growth & development*; Entamoeba histolytica/genetics
Summary of recent abstracts. II. Amoebiasis and intestinal protozoal infections

Apted FI

Trop Dis Bull, 1973 Feb;70(2):105-17.
PMID: 4349730
Matched MeSH terms: Entamoeba histolytica
Fulltext Molecular detection of Entamoeba histolytica and Entamoeba dispar infection among wild rats in Kuala Lumpur, Malaysia

Lau YL, Jamaiah I, Rohela M, Fong MY, Siti CO, Siti FA

Trop Biomed, 2014 Dec;31(4):721-7.
PMID: 25776597 MyJurnal

Entamoeba histolytica infection is the third-greatest parasitic disease responsible for death in the world. Wild rats harbouring E. histolytica can be the possible reservoir hosts for human amoebiasis. There were numerous studies on prevalence of intestinal parasites among wild rats in Malaysia but none has reported E. histolytica. Rats were captured from Sentul and Chow Kit areas, Kuala Lumpur, Malaysia. The preserved stool samples were used for microscopy examination and molecular analysis. Out of 137 samples collected, 12 were positive for E. histolytica / E. dispar / E. moshkovskii microscopically. Two E. histolytica (1.4%), 1 E. dispar (0.7%) and 6 mixed infections of E. histolytica and E. dispar (4.3%) were detected using PCR. This is the first report of molecular detection of E. histolytica/dispar infection among wild rats in Malaysia. This study provides useful information about the potential risks of zoonotic agents and the importance of developing control measures to prevent zoonotic transmission.

Matched MeSH terms: Entamoeba/classification*; Entamoeba/genetics; Entamoeba/isolation & purification*
Fulltext Efficacies of two in-house indirect ELISAs for diagnosis of amoebic liver abscess

Tan ZN, Wong WK, Noordin R, Zeehaida M, Olivos GA, Lim BH

Trop Biomed, 2013 Jun;30(2):250-6.
PMID: 23959490 MyJurnal

Entamoeba histolytica causes amoebic diarrhoea, colitis and liver abscess (ALA). Diagnosis of ALA is difficult, as most patients do not have simultaneous intestinal amoebic infection. At Hospital Universiti Sains Malaysia (HUSM), diagnosis of ALA relies on a combination of clinical findings, ultrasound examination of the liver and serodiagnosis using a commercial kit. In this study, two in-house indirect ELISAs were developed and evaluated. One of the in-house assays utilises E. histolytica crude soluble antigen (CSA) to detect serum IgG specific to the parasite whereas the other uses E. histolytica ether extract antigen (EEA). Preparation of CSA requires a sonicator to lyse the amoeba whereas EEA was prepared by chemically solubilizing the trophozoites. Based on the cut-off value of mean optical density + 3SD, CSA-ELISA showed 100% (24/24) sensitivity and 93.33% (210/225) specificity; while EEA-ELISA showed 91.67% (22/24) sensitivity and 95.11% (214/225) specificity. In conclusion, both the in-house indirect ELISAs were found to be efficacious for diagnosis of ALA; and the EEA is easier to prepare than the commonly used CSA.

Matched MeSH terms: Entamoeba histolytica/immunology*
Fulltext Determining the prevalence of intestinal parasites in three Orang Asli (Aborigines) communities in Perak, Malaysia

Sinniah B, Sabaridah I, Soe MM, Sabitha P, Awang IP, Ong GP, et al.

Trop Biomed, 2012 Jun;29(2):200-6.
PMID: 22735840 MyJurnal

This study was conducted to determine the prevalence of intestinal parasites among children and adult Orang Aslis (Aborigines) from different locations in Perak. Faecal samples were collected and analyzed using the direct smear and formal ether sedimentation technique. Some of the faecal samples were stained using the Modified Acid fast stain for Cryptosporidium. Nail clippings of the respondents and the soil around their habitat were also analyzed. Of the 77 stool samples examined, 39 (50.6%) were positive for at least one intestinal parasite. The most common parasite detected was Trichuris trichiura (39.0%) followed by Ascaris lumbricoides (26.9%), Entamoeba coli (5.2%), Giardia lamblia (5.2%), Blastocystis hominis (3.9%), hookworm (3.9%), Entamoeba histolytica (1.3%), Iodamoeba butschlii (1.3%) and Cryptosporidium sp. (1.3%) respectively. Some respondents had single parasites (24.7%), some with two parasites (18.2%). Some with three parasites (6.5%) and one had four parasites species (1.3%). The parasites were slightly more common in females (54.7%) than males ((41.7%). The parasites were more common in the 13-20 year age group (90.9%) followed by 1-12 years (69.6%), 21-40 year age group (34.8%) and least in the 41-60 year age group (27.8%). Nail examinations of the respondents did not show any evidence of parasites. One had a mite, three had pollen grains and one had yeast cells isolated from the finger nails. Soil samples taken around their houses showed only one sample with a nematode ova and one with oocyst which was of a non human origin.

Matched MeSH terms: Entamoeba/isolation & purification; Entamoeba/pathogenicity
Fulltext Public health and clinical importance of amoebiasis in Malaysia: a review

Tengku SA, Norhayati M

Trop Biomed, 2011 Aug;28(2):194-222.
PMID: 22041740 MyJurnal

Entamoeba histolytica, the causative agent of human amoebiasis remains a significant cause of morbidity and mortality in developing countries and is responsible for up to 100,000 deaths worldwide each year. Entamoeba dispar, morphologically indistinguishable from E. histolytica is more common in humans in many parts of the world. Similarly Entamoeba moshkovskii, which was long considered to be a free-living amoeba is also morphologically identical to E. histolytica and E. dispar, and is highly prevalent in some E. histolytica endemic countries. Humans are the host of infection and there would not appear to be other meaningful animal reservoirs of E. histolytica. Entamoeba. histolytica can be present in sewage and contaminated water. The infection is mainly transmitted via ingestion of water or food contaminated by faeces containing E. histolytica cysts. Clinical features of amoebiasis range from asymptomatic colonization to amoebic dysentery and invasive extraintestinal amoebiasis, which is manifested most commonly in the form of abscesses in liver and lungs. The epidemiology of amoebiasis has dramatically changed since the separation of E. histolytica and E. dispar species and the worldwide prevalence of these species has not been estimated until recently. Morever, E. moshkovskii, another morphologically indistinguishable human parasitic Entamoeba was not mentioned or considered as a contributor to the prevalence figures in endemic areas. Amoebiasis is still a major health problem especially in aboriginal settlements and amongst people living in remote area in Malaysia. However, until now there is only one data currently available to indicate the true prevalence and incidence of E. histolytica and E. dispar. Further studies are needed to determine the burden of E. histolytica, E. dispar and E. moshkovskii infections in Malaysia. In the present review, we briefly summarize all methods use in diagnosing Entamoeba species, ranging from microscopic identification to molecular detection such as culture and isoenzyme analysis, antibody detection tests, antigen detection tests, immunochromatographic assays, conventional PCR, real-time PCR and loop-mediated isothermal amplification (LAMP).

Matched MeSH terms: Entamoeba/classification; Entamoeba/isolation & purification*
Fulltext Identification of Entamoeba histolytica trophozoites in fresh stool sample: comparison of three staining techniques and study on the viability period of the trophozoites

Tan ZN, Wong WK, Nik Zairi Z, Abdullah B, Rahmah N, Zeehaida M, et al.

Trop Biomed, 2010 Apr;27(1):79-88.
PMID: 20562817 MyJurnal

Entamoeba histolytica causes about 50 million infections worldwide with a death rate of over 100,000 annually. In endemic developing countries where resources are limited, microscopic examinations based on Wheatley trichrome staining is commonly used for diagnosis of intestinal amoebiasis. Other than being a time-consuming method, it must be performed promptly after stool collection as trophozoites disintegrate rapidly in faeces. The aim of this study was to compare the efficacies of Eosin-Y, Wheatley trichrome and Iodine stains in delineating the diagnostic features of the parasite, and subsequently to determine the suitable microscopy observation period for detection of erythrophagocytic and non-erythrophagocytic trophozoites spiked in semi-solid stool sample. Wheatley trichrome staining technique was performed using the standard method while the other two techniques were performed on the slides by mixing the respective staining solution with the spiked stool sample. One million of axenically cultured non-erythrophagocytic E. histolytica and erythrophagocytic E. histolytica were separately spiked into 2 g of fresh semisolid faeces. Percentage viability of the trophozoites in the spiked stool sample was determined at 30 minute intervals for eight hours using the 0.4% Trypan blue exclusion method. The results showed that Eosin-Y and Wheatley trichrome stained the karyosome and chromatin granules better as compared to Iodine stain. The percentage viability of non-erythrophagocytic trophozoites decreased faster than the erythrophagocytic form in the first 5 hours and both dropped to ~10% in the 6th hour spiked sample. In conclusion, Eosin-Y staining technique was found to be the easiest to perform, most rapid and as accurate as the commonly used Wheatley trichrome technique; Eosin-Y stained slide sealed with DPX could also be kept as a permanent record. A period not exceeding 6 hours after stool collection was found to be the most suitable in order to obtain good microscopy results of viable trophozoites.

Matched MeSH terms: Entamoeba histolytica/cytology; Entamoeba histolytica/isolation & purification*
Fulltext A study on the usefulness of Techlab Entamoeba histolytica II antigen detection ELISA in the diagnosis of amoebic liver abscess (ALA) at Hospital Universiti Sains Malaysia (HUSM), Kelantan, Malaysia

Zeehaida M, Wan Nor Amilah WA, Amry AR, Hassan S, Sarimah A, Rahmah N

Trop Biomed, 2008 Dec;25(3):209-16.
PMID: 19287359

Amoebic serodiagnosis at Hospital Universiti Sains Malaysia (HUSM), Kelantan employs an indirect haemagglutination assay (IHA) which detects anti-Entamoeba histolytica antibodies in patients' serum samples. In an amoebiasis endemic area such as Kelantan, interpretation of a positive IHA result can be problematic due to the high background antibody levels. The TechLab E. histolytica II ELISA is a commercial kit for detection of specific Gal/GalNAc lectin antigen in stool samples, and has been reported to be able to detect the antigen in serum samples from patients with amoebic liver abscess (ALA). Thus in this study we investigated the usefulness of TechLab E. histolytica II ELISA for diagnosis of ALA by comparing it with IHA. This is a cross sectional study involving 58 suspected ALA patients who were admitted to the surgical ward, HUSM, Kelantan. The diagnosis of ALA was established based on clinical symptoms and signs, ultrasound and/or CT scan results. The serum specimens obtained from the patients were tested with IHA (Dade Behring Diagnostics, Marburg, Germany) and TechLab E. histolytica II ELISA (Techlab, Blacksburg, Virginia, USA) according to the manufacturers' instructions. Of the 58 patients, 72.4% (42) were positive by IHA and only 8.6% (5) were positive by the TechLab E. histolytica II ELISA. Agreement between the IHA and ELISA was poor (kappa value 0.019, p=0.691). There was also no correlation between ELISA results and IHA antibody titers. The TechLab E. histolytica II ELISA was not sensitive in detecting amoebic antigen in samples from ALA patients. In addition the results of the test did not correlate with the IHA anti-E. histolytica antibody titres. Therefore, the TechLab E. histolytica II ELISA was found not to be useful for serological diagnosis of ALA at HUSM.

Matched MeSH terms: Entamoeba histolytica/immunology*
Fulltext Use of molecular tools to distinguish Entamoeba histolytica and Entamoeba dispar infection among the aborigines in Cameron Highlands

Noor Azian MY, Lokman Hakim S, Maslawaty MN

Trop Biomed, 2006 Jun;23(1):31-6.
PMID: 17041549 MyJurnal

Amoebiasis is an infectious diseased caused by parasitic one-celled protozoan called Entamoeba histolytica. Numerous protozoa also can inhabit the gastro-intestinal tract of human. Majority of these protozoa are non-pathogenic commensals or only causes disease under certain circumstances. Morphologically, E. histolytica, the invasive form, share the same characteristic with the nonpathogenic form, E. dispar. Both strains can be distinguished by using DNA identification. Many previous researches in Malaysia only reported infection with E. histolytica infection. Therefore in this study we tried to classify infection among the aborigines in Cameron Highland as true E. histolytica or E. dispar by Nested Polymerase Chain Reaction (Nested PCR) and Restriction enzyme (RE) digestion. Results showed that 31 samples were positive by microscopic examination, however of these 28 (13.2%) samples were positive for E. histolytica and 12 (5.6%) samples were positive for E. dispar by molecular tools.

Matched MeSH terms: Entamoeba/genetics*; Entamoeba histolytica/genetics*
Fulltext Proteinases in Naegleria Fowleri (strain NF3), a pathogenic amoeba: a preliminary study

Mat Amin N

Trop Biomed, 2004 Dec;21(2):57-60.
PMID: 16493399

Naegleria fowleri is a free-living amoeba, known as a causative agent for a fatal disease of the central nervous system (CNS) in man such as Primary amoebic meningoencephalitis (PAM). Factors contributing to its pathogenicity and its distribution in the environment have been investigated by previous researchers. In case of its pathogenicity, several enzymes such as phospolipase A and sphingomyelinase, have been proposed to probably act as aggressors in promoting PAM but no study so far have been conducted to investigate the presence of proteinase enzyme in this amoeba although a 56kDa cystein proteinase enzyme has been identified in Entamoeba histolytica as an important contributing factor in the amoeba's virulence. In this preliminary study, a pathogenic amoeba, Naegleria fowleri (strain NF3) was examined for the presence of proteinases. Samples of enzymes in this amoeba were analysed by electrophoresis using SDS-PAGE-gelatin gels. The results showed that this amoeba possesses at least two high molecular weight proteinases on gelatin gels; their apparent molecular weights are approximately 128 kDa and approximately 170 kDa. Band of approximately 128 kDa enzyme is membrane-associated and its activity is higher at alkaline pH compared with lower pH; at lower pH, its activity is greatly stimulated by DTT. The approximately 170 kDa band enzyme appears to be inactivated at pH 8.0, at lower ph its activity is higher and DTT-dependance. The activity of this enzyme is partially inhibited by inhibitor E-64 but markedly inhibited to antipain suggesting it belongs to the cysteine proteinase group.

Matched MeSH terms: Entamoeba histolytica
Fulltext Important zoonotic intestinal protozoan parasites in Asia

Mak JW

Trop Biomed, 2004 Dec;21(2):39-50.
PMID: 16493397

Intestinal protozoa are increasingly being studied because of their association with acute and chronic diarrhoea in immunocompromised as well as immunocompetent patients. Various community outbreaks due to contamination of water or food with these protozoa have further highlighted their importance in public health. Among these important pathogens are Giardia duodenalis, Entamoeba histolytica, Cryptosporidium parvum, Cyclospora cayetanensis, Isospora belli, and microsporidia. Except for the cyst-forming G. duodenalis and E. histolytica, the others are intracellular and form spores which are passed out with the faeces. These organisms are also found in various animals and birds and zoonotic transmission is thought to occur. These infections are distributed worldwide, with a higher prevalence in developing compared to developed countries. However, the relative importance of zoonotic infections especially in developing countries has not been studied in detail. The prevalence rates are generally higher in immunodeficient compared to immunocompetent patients. Higher prevalence rates are also seen in rural compared to urban communities. Most studies on prevalence have been carried out in developed countries where the laboratory and other health infrastructure are more accessible than those in developing countries. This relative inadequacy of laboratory diagnosis can affect accurate estimates of the prevalence of these infections in developing countries. However, reports of these infections in travellers and workers returning from developing countries can provide some indication of the extent of these problems. Most studies on prevalence of amoebiasis in developing countries were based on morphological identification of the parasite in faecal smears. As the pathogenic E. histolytica is morphologically indistinguishable from that of non-pathogenic E. dispar, estimates of amoebiasis may not be accurate. The epidemiology of human microsporidia infections is not completely understood. Two species, Enterocytozoon bieneusi and Encephalitozoon intestinalis, are associated with gastrointestinal disease in humans and it is believed that human to human as well as animal to human infections occur. However, the importance of zoonotic infections has not been fully characterised. G. duodenalis cysts, microsporidia and Cryptosporidium oocysts have been detected in various ground water resources, but their role in community outbreaks and maintenance of the infection has not been fully characterised. The taxonomic classification and pathogenic potential of B. hominis are still controversial. While considered by many as yeast, fungi or protozoon, recent sequence analysis of the complete SSUrRNA gene has placed it within an informal group, the stramenopiles. This review covers recent published data on these zoonotic infections and examines their public health importance in Asian countries.

Matched MeSH terms: Entamoeba histolytica
Intestinal parasitic infections frequency in referred patients to a large teaching hospital, Khuzestan, Southwest, Iran, 2017

Feiz Haddad MH, Maraghi S, Ali SA, Feiz Haddad R, Nasser Zadeh R

Trop Biomed, 2018 Dec 01;35(4):915-925.
PMID: 33601841

Intestinal parasitic infections (IPIs) are among the most important infectious diseases in Iran. A cross sectional study was designed to determine frequency of intestinal parasites among referrals to a large teaching hospital in Khuzestan, Southwest of Iran, 2017. A total number of 5613 stool samples were examined through direct smear and formalin-ether concentration methods to detect possible parasitic infections. Samples consisted of 2643 (47.09%) male and 2970 (52.91%) female. A total of 1468 (26.15%) samples were positive (13.11% male and 13.4% female) and 4145 (73.85%) were negative. The results also showed that 255 of samples had more than one type of parasite (mix infections). Counting single and mix parasite infections, the total number of positive cases reached to 1723. Helminthes parasites were present in 12 (0.7%) cases, while intestinal protozoan parasites were in 1711 (99.3%) cases. Almost equally, pathogenic and nonpathogenic parasites infected 860 (49.91%) and 863 (50.09%) of patients, respectively. The frequency for helminthes was determined at 0.52% with Hymenolepis nana and Enterobius vermicularis however, Giardia lamblia in 38.54% and Entamoeba histolytica/dispar at 10.68% were concluded as protozoa elements. The IPIs frequency was recorded in female and male patients at 49.16% and 50.14%, respectively. According to the current results the infection rate of intestinal parasites has been significantly reduced especially for helminths infections in this region possibly due to public attention to health issues such as; increased awareness of people, improvement of sanitation, seasonal variations, health education and personal hygiene.

Matched MeSH terms: Entamoeba histolytica
Parasitological survey of schoolchildren from a highaltitude community from Tucumán Province, Argentina: Remarkable low detection of soil-transmitted helminths in comparison with coastal communities

Dib JR, Fernández-Zenoff MV, Oquilla J, Rudelli M, Lazarte S, González SN

Trop Biomed, 2015 Dec 01;32(4):800-804.
PMID: 33557474

The prevalence of intestinal parasitic infections among schoolchildren in Colalao del Valle, a high-altitude community in Tucumán province, Argentina, was investigated. The data revealed a high prevalence of parasitism (79.7%) with no significant differences in distribution by sex or age. Protozoa infections were the most common with Blastocystis hominis being the most prevalent (62.5%), followed by Giardia lamblia (29.7%), Endolimax nana (15.6%), Entamoeba coli (12.5%) and Iodamoeba bütschlii (3.1%). Interestingly, there was an absence of soil-transmitted helminths among the studied population which could be related to climate (variable temperatures, moderate rainfall) and soil type (clay).

Matched MeSH terms: Entamoeba
Entamoeba infections and associated risk factors among migrant workers in Peninsular Malaysia

Sahimin N, Yunus MH, Douadi B, Yvonne Lim AL, Noordin R, Behnke JM, et al.

Trop Biomed, 2019 Dec 01;36(4):1014-1026.
PMID: 33597471

The influx of low skilled migrant workers to Malaysia from low socio-economic countries where gastrointestinal parasitic infections are prevalent has raised concerns about transmission to the local population. Three methods for detection (serology, microscopy and molecular techniques) were utilized to identify Entamoeba infections amongst the targeted cohort and determine risk factors associated with infection. Serological screening of 484 migrant workers from five working sectors in Peninsular Malaysia using IgG4 ELISA based on the rPPDK antigen showed an overall seroprevalence of 7.4% (n = 36; CL95 = 5.3-10.1%) with only one factor statistically associated with seropositivity of anti-amoebic antibodies, i.e. years of residence in Malaysia (χ2 1 = 4.007, p = 0.045). Microscopic examination of 388 faecal samples for protozoan cysts and trophozoites showed a slightly higher prevalence (11.6%; n=45; CL95: 8.4-14.8%). Meanwhile, amplification of the 16S rDNA gene detected two species i.e. Entamoeba dispar (23/388; 5.9%; CL95: 3.6-8.3%) and E. histolytica (11/388; 2.8%; CL95: 1.2-4.5%) and mixed infections with both parasites in only three samples (3/388; 0.8%; CL95: 0.2-2.2%). Entamoeba dispar infection was significantly associated with those employed in food and domestic services (χ2 4 = 12.879, p = 0.012). However, none of the factors affected the prevalence of E. histolytica infection. Despite the low prevalence of E. histolytica in faecal samples of the study cohort, the presence of this pathogenic parasite still poses potential public health risks and calls for tighter control strategies based on better availability of chemotherapeutic treatment and accessibility to appropriate health education.

Matched MeSH terms: Entamoeba/classification; Entamoeba/isolation & purification
Prevalence and risk factors for infection with Entamoeba histolytica/dispar/ moshkovskii complex in people living in the slightest and outermost islands of Indonesia

Junaidi -, Asmaruddin MS, Kurrohman T, Nurdin -, Khazanah W

Trop Biomed, 2023 Jun 01;40(2):160-164.
PMID: 37650401 DOI: 10.47665/tb.40.2.005

Entamoeba histolytica (E. histolytica), the causative agent of amoebiasis, is still a global public health problem that cannot be controlled, especially in tropical and subtropical countries. This study was conducted to obtain information about the incidence of Entamoeba histolytica/dispar/ moshkovskii complex infection and the factors that influence it. The prevalence of infection with the Entamoeba histolytica/dispar/moshkovskii complex and the factors that influence it in people living on the smallest and outermost island of Indonesia, Sabang Island, Aceh Province. This study involved 335 respondents aged >= 10 years. Respondents were selected by non-probability sampling technique. Interviews and observations were conducted to identify risk factors. The Entamoeba histolytica/dispar/ moshkovskii complex was identified by direct examination, concentration, and Whitley's trichrome staining techniques. A Chi-Square test was performed to analyze the correlation of risk factors with the incidence of infection. The prevalence of infection with the Entamoeba histolytica/dispar/ moshkovskii complex in the people of Sabang Island was 26.6% (89/335). Source and adequacy of clean water correlated with the incidence of Entamoeba histolytica/dispar/moshkovskii complex infection. Demographic variables are not correlated with the incidence of infection. However, the group of women aged > 61 years, unemployed, unmarried, and earning less than the regional minimum wage tend to be more likely to be found with Entamoeba histolytica/dispar/moshkovskii complex infections. Thus it can be concluded that the prevalence of infection with the Entamoeba histolytica/dispar/moshkovskii complex on Sabang Island is in the high category. The prevalence of E. histolytica as the causative agent of amoebiasis cannot be explained with certainty because the two identical non-pathogenic Entamoeba species cannot be distinguished by microscopic identification. Sources and adequacy of clean water correlate with the incidence of Entamoeba histolytica/dispar/moshkovskii complex infection in the people of Sabang Island.

Matched MeSH terms: Entamoeba histolytica*
Oral parasitic protozoan Entamoeba gingivalis in periodontal disease patients, northeastern Thailand

Boonsuya A, Chitpitaklert P, Pechdee P, Srithongklang W, Thanchonnang C, La N, et al.

Trop Biomed, 2023 Dec 01;40(4):471-477.
PMID: 38308835 DOI: 10.47665/tb.40.4.013

Entamoeba gingivalis is present in the oral cavity of humans and is associated with periodontal disease. Consequently, this study aimed to comprehensively investigate the E. gingivalis infection and the associated risk factors among individuals suffering from periodontal conditions. A cross-sectional descriptive study was carried out within a cohort of periodontal patients. Dental plaque specimens were meticulously collected and subsequently subjected to thorough examination using the polymerase chain reaction (PCR)-based technique targeting the small subunit ribosomal RNA (SrRNA) gene of the organism. The occurrence of risk factors for E. gingivalis infection was analyzed by the chi-square test and binary logistic regression. Out of the 230 participants, 60 were clinically diagnosed with periodontitis, while 170 were afflicted with gingivitis. Out of the 230 patients, 25 (10.9%) tested positive for E. gingivalis infections. An in-depth analysis unveiled that a significant majority of infections were recorded within subgroups characterized by a marital status (15.45%), manifestation of periodontitis (25.00%), and concomitant presence of underlying disease (20.83%). Furthermore, the high risk factor associated with E. gingivalis infection was the female (ORadj = 13.65, 95% CI = 1.08-173.21), followed by periodontitis (ORadj = 3.30, 95% CI = 1.21-9.00), respectively. The study employs a molecular diagnostic approach to screen for E. gingivalis enrichment within a subset of periodontal patients with advancing disease. The findings emphasize the necessity for further research to elucidate the pathogenesis of E. gingivalis and advocate for vigilant surveillance within a substantial population of periodontal patients.

Matched MeSH terms: Entamoeba*
Fulltext Amebic Liver abscess Complicated by Inferior Vena Cava Thrombosis: A Case Report

Ray S, Khanra D, Saha M, Talukdar A

Med J Malaysia, 2012 Oct;67(5):524-5.
PMID: 23770872

Amebic liver abscess is the most common extraintestinal manifestation of infection with Entamoeba histolytica. It is a common disease, especially in endemic areas, but it is a rare cause of inferior vena cava (IVC) obstruction, with only a few cases appearing in the literature. The authors describe a case of amebic liver abscess in a patient who developed a rare vascular complication of inferior vena cava thrombosis. The case responded to conservative treatment and radiological intervention.

Matched MeSH terms: Entamoeba histolytica
A colonic amoebic abscess mimicking colonic carcinoma

Tan LP, Foong KK, Yvonne Ai LL

Med J Malaysia, 2018 10;73(5):334-335.
PMID: 30350818 MyJurnal

Amebiasis is one of the major causes of diarrhea in the developing countries and it can present with a wide range of gastrointestinal symptoms depending on the phase of infection. We described a case of 50 year-old male patient who presented with abdominal pain, diarrhea and vomiting. After right hemicolectomy for appendicular abscess with tumour over the ileum, histopathological examinations revealed numerous trophozoites of Entamoeba histolytica in a background of inflammations (Figure 1). Following resection of the ameboma, he received intravenous metronidazole treatment for total of two weeks duration.

Matched MeSH terms: Entamoeba histolytica
Fulltext Comparison of the Anaerocult A and the oil blocking methods for the in vitro cultivation of Entamoeba histolytica

Mohd Shah NA, Wan Abdul Wahab WN, Mohd Nawi SF, Mohd-Zain Z, Latif B, Suhaimi R

Malays J Pathol, 2015 Dec;37(3):271-4.
PMID: 26712674 MyJurnal

Entamoeba histolytica, the causative agent for human amoebiasis, is among the most deadly parasites, accounting for the second highest mortality rate among parasitic diseases. Because this parasite dwells in low oxygen tension, for its cultivation, microaerophilic conditions are required to mimick the human gut environment. Several methods developed for optimal growth environment are commercially available and some are conventionally modified in-house which include the Anaerocult A and oil blocking preparation methods. This study was undertaken to compare the reliability of the Anaerocult A and the oil blocking methods in generating anaerobic environment for cultivation of E. histolytica. The trophozoites of E. histolytica HM1: IMSS strains were axenically cultivated in TYI-S-33 medium in culture incubated anaerobically by using Anaerocult A (Merck) and mineral oil blocking method. The outcomes of both methods were determined by the minimum inhibitory concentration (MIC) of metronidazole against E. histolytica by giving a score to the growth pattern of the trophozoites. The reliability of both methods was assessed based on susceptibility testing of E. histolytica to metronidazole. The MIC obtained by both anaerobic condition methods was 6.25 ug/ ml, thus showing that oil-blocking method is comparable to the Anaerocult A method and therefore, considered as a reliable method for generating an anaerobic environment for the cultivation of E. histolytica.

Matched MeSH terms: Entamoeba histolytica*
Fulltext Different clinical outcomes of Entamoeba histolytica in Malaysia: does genetic diversity exist?

Anuar TS, Al-Mekhlafi HM, Abdul Ghani MK, Azreen SN, Salleh FM, Ghazali N, et al.

Korean J Parasitol, 2013 Apr;51(2):231-6.
PMID: 23710093 DOI: 10.3347/kjp.2013.51.2.231

The present study was conducted to investigate the clinical outcomes of Entamoeba histolytica infection in symptomatic and asymptomatic Orang Asli (aborigine) communities in Malaysia. Examination was performed on 500 stool samples obtained from Orang Asli communities in 3 different states using formalin-ether concentration, trichrome staining, and single-round PCR techniques. Out of 500 stool samples, single infection of E. histolytica, Entamoeba dispar, and Entamoeba moshkovskii was identified in 3.2%, 13.4%, and 1%, respectively. In addition, 10 samples had mixed infections with E. histolytica and E. dispar. Six samples containing E. dispar were also positive for E. moshkovskii, and only 2 samples had E. histolytica in association with E. dispar and E. moshkovskii. Seventeen E. histolytica-positive samples were from symptomatic subjects, whereas the remaining 11 samples came from asymptomatic subjects. These findings suggest a predominant distribution of pathogenic potential of E. histolytica strains in this community. Therefore, further studies on genotyping of E. histolytica is required, to find out association between E. histolytica genotype and the outcome of the infection.

Matched MeSH terms: Entamoeba/classification*; Entamoeba/isolation & purification; Entamoeba/pathogenicity*

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