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Kawashima A, Yanagawa Y, Shimogawara R, Yagita K, Gatanaga H, Watanabe K. Amebiasis as a sexually transmitted infection: A re-emerging health problem in developed countries. Glob Health Med 2023; 5:319-327. [PMID: 38162428 PMCID: PMC10730925 DOI: 10.35772/ghm.2023.01064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 09/21/2023] [Accepted: 10/23/2023] [Indexed: 01/03/2024]
Abstract
Amebiasis, which is caused by Entamoeba histolytica (E. histolytica), is the second leading cause of parasite-related death worldwide. It manifests from asymptomatic carriers to severe clinical conditions, like colitis and liver abscesses. Amebiasis is commonly seen in developing countries, where water and food are easily contaminated by feces because of the poor sanitation. However, a recently challenge in many developed countries is the increase in domestic cases of invasive amebiasis as a sexually transmitted infection (STI amebiasis). In contrast to food-/ waterborne transmission of E. histolytica in developing countries, transmission of STI amebiasis occurs directly through human-to-human sexual contact (e.g., men who have sex with men and people who engage in oral-anal sex); in this setting, asymptomatic infected individuals are the main reservoir of E. histolytica. The Development of screening methods for the early diagnosis of asymptomatic E. histolytica infection is the key to epidemiologic control. Moreover, delay in diagnosis of severe cases (e.g., fulminant amebiasis) leads to death even in developed countries. It is also important to increase clinical awareness of domestically transmitted STI amebiasis in the clinical settings. This review considers the changing epidemiology and clinical manifestations of STI amebiasis, and finally discusses the future strategies for the better practice.
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Affiliation(s)
- Akira Kawashima
- AIDS Clinical Center, National Center for Global Health and Medicine, Tokyo, Japan
- Department of Parasitology, National Institute of Infectious Diseases, Tokyo, Japan
- The Joint Research Center for Human Retrovirus Infection Kumamoto University Campus, Kumamoto, Japan
| | - Yasuaki Yanagawa
- AIDS Clinical Center, National Center for Global Health and Medicine, Tokyo, Japan
- Department of Parasitology, National Institute of Infectious Diseases, Tokyo, Japan
- Department of Microbiology and Immunology, Stanford University School of Medicine, Stanford, CA, USA
| | - Rieko Shimogawara
- Department of Parasitology, National Institute of Infectious Diseases, Tokyo, Japan
| | - Kenji Yagita
- Department of Parasitology, National Institute of Infectious Diseases, Tokyo, Japan
| | - Hiroyuki Gatanaga
- AIDS Clinical Center, National Center for Global Health and Medicine, Tokyo, Japan
- The Joint Research Center for Human Retrovirus Infection Kumamoto University Campus, Kumamoto, Japan
| | - Koji Watanabe
- AIDS Clinical Center, National Center for Global Health and Medicine, Tokyo, Japan
- Department of Parasitology, National Institute of Infectious Diseases, Tokyo, Japan
- The Joint Research Center for Human Retrovirus Infection Kumamoto University Campus, Kumamoto, Japan
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Richardson D, Pakianathan M, Ewens M, Mitchell H, Mohammed H, Wiseman E, Tweed M, Nichols K, Rawdah W, Cooper R, Macrowan R, Irish M, Evans A, Godbole G. British Association of Sexual Health and HIV (BASHH) United Kingdom national guideline for the management of sexually transmitted enteric infections 2023. Int J STD AIDS 2023:9564624231168217. [PMID: 37247427 DOI: 10.1177/09564624231168217] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
This is the first British Association of Sexual Health and HIV (BASHH) national guideline for the management of sexually transmitted enteric infections (STEI). This guideline is primarily aimed for level 3 sexual health clinics; however, it may also be applicable to other settings such as primary care or other hospital departments where individuals with STEI may present. This guideline makes recommendations on testing, management, partner notification and public health control of STEI.
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Affiliation(s)
- Daniel Richardson
- University Hospitals Sussex NHS Foundation Trust, Brighton, UK
- Brighton & Sussex Medical School, Brighton, UK
| | | | | | | | | | | | | | | | - Waseem Rawdah
- University Hospitals Sussex NHS Foundation Trust, Brighton, UK
| | - Richard Cooper
- University Hospitals Sussex NHS Foundation Trust, Brighton, UK
| | | | | | - Amy Evans
- University Hospitals Sussex NHS Foundation Trust, Brighton, UK
- Leeds Teaching Hospitals NHS Trust, Leeds, UK
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3
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McNeil CJ, Kirkcaldy RD, Workowski K. Enteric Infections in Men Who Have Sex With Men. Clin Infect Dis 2022; 74:S169-S178. [PMID: 35416972 DOI: 10.1093/cid/ciac061] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Enteric pathogens are often associated with exposure to food, water, animals, and feces from infected individuals. However, in sexual networks of men who have sex with men (MSM), transmission of enteric pathogens may occur during direct or indirect oral-anal contact. METHODS We performed a scoping review of the literature for studies prior to July 2019 with key terms for gastrointestinal syndromes ("proctitis," "enteritis," "proctocolitis"), enteric pathogens or sexually transmitted infections (STIs), and outbreaks using multiple electronic databases. RESULTS We identified 5861 records through database searches, bibliography reviews, and keyword searches, of which 117 references were included in the pathogen-specific reviews. CONCLUSIONS The strength of observational data describing enteric pathogens in MSM and possible sexual transmission of enteric pathogens varies by pathogen; however, a robust body of literature describes the sexual transmission of Campylobacter, Giardia lamblia, and Shigella (particularly antimicrobial-resistant strains) in sexual networks of MSM. Providers are encouraged to consider enteritis or proctocolitis in MSM as possibly having been sexually transmitted and encourage targeted STI testing. Risk/harm reduction and prevention messages should also be incorporated, though there is an acknowledged paucity of evidence with regards to effective strategies. Further research is needed to understand the transmission and prevention of enteric pathogens in MSM.
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Affiliation(s)
- Candice J McNeil
- Department of Internal Medicine, Section on Infectious Diseases, Wake Forest School of Medicine, Winston Salem, North Carolina, USA
| | - Robert D Kirkcaldy
- Division of STD Prevention, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Kimberly Workowski
- Division of STD Prevention, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia.,Department of Medicine, Emory University, Atlanta, Georgia
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Farraj K, Diaz-Marty C, Lannom M, Delshad J, Koumas P, Smielewski M, Schneider Z, Verley J, Rankov L. A Case Of Entamoeba Histolytica Infection Among Men Who Have Sex With Men. J Investig Med High Impact Case Rep 2022; 10:23247096221078711. [PMID: 35225016 PMCID: PMC8891859 DOI: 10.1177/23247096221078711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Entamoeba histolytica is a parasite responsible for intestinal amebiasis and possible extraintestinal manifestations, such as liver abscesses. India, Africa, Mexico, and Central and South America have some of the highest rates of infection due to poor socioeconomic and environmental conditions. The infection has become more common in the United States due to an increase in emigration. There has been a rising incidence of sexual transmission of the infection, most commonly seen in men who have sex with men. Here, we present a case of a symptomatic extraintestinal E histolytica infection in a young Hispanic bisexual man.
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Affiliation(s)
| | | | | | - Jonah Delshad
- Nassau University Medical Center, East Meadow, NY, USA
| | | | | | | | - Janice Verley
- Nassau University Medical Center, East Meadow, NY, USA
| | - Leonid Rankov
- Nassau University Medical Center, East Meadow, NY, USA
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5
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Watanabe K, Yanagawa Y, Gatanaga H, Kikuchi Y, Oka S. Performance of an enzyme-linked immunosorbent-based serological assay for Entamoeba histolytica: Comparison with an indirect immunofluorescence assay using stored frozen samples. J Infect Chemother 2021; 27:736-739. [PMID: 33483275 DOI: 10.1016/j.jiac.2020.12.026] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2020] [Accepted: 12/30/2020] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Entamoeba histolytica infections are increasingly diagnosed as sexually transmitted infections in Japan. However, the stool ova-parasite examination (O&P) test has been the only approved diagnostic method used in Japan since production of the indirect immunofluorescence assay (IFA) serum antibody test was discontinued at the end of 2017. Herein, we assessed whether an enzyme-linked immunosorbent assay (ELISA)-based serological test could substitute for IFA. METHODS This cross-sectional study used stored frozen serum samples from the Biobank of the National Center for Global Health and Medicine. A serological ELISA-based test was performed on these samples and their titers were compared with those previously measured by IFA based on the medical record data. RESULTS Sixty seven stored frozen serum samples with differing recorded IFA antibody titers (16 samples with titers < ×100, 13 samples × 100, 16 samples × 200, 11 samples × 400, and 11 samples ≥ × 800) were analyzed. The sensitivity and specificity values for ELISA vs. IFA were 92.2% [95% confidential interval: 81.5-96.9] and 87.5% [64.0-97.8], respectively. A strong correlation between the antibody titers was confirmed by a one-way ANOVA (R square 0.83, p value < 0.0001) for the two diagnostic methods. CONCLUSION The ELISA and IFA antibody titers for E. histolytica were well correlated, and results from these methods were highly concordant. Introduction of an ELISA-based serological test for E. histolytica should be considered to improve E. histolytica infection diagnosis in Japan.
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Affiliation(s)
- Koji Watanabe
- AIDS Clinical Center, National Center of Global Health and Medicine, Tokyo, Japan.
| | - Yasuaki Yanagawa
- AIDS Clinical Center, National Center of Global Health and Medicine, Tokyo, Japan
| | - Hiroyuki Gatanaga
- AIDS Clinical Center, National Center of Global Health and Medicine, Tokyo, Japan; Joint Research Center for Human Retrovirus Infection, Kumamoto University, Kumamoto, Japan
| | - Yoshimi Kikuchi
- AIDS Clinical Center, National Center of Global Health and Medicine, Tokyo, Japan
| | - Shinichi Oka
- AIDS Clinical Center, National Center of Global Health and Medicine, Tokyo, Japan; Joint Research Center for Human Retrovirus Infection, Kumamoto University, Kumamoto, Japan
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Utility of the Rapid Antigen Detection Test E. histolytica Quik Chek for the Diagnosis of Entamoeba histolytica Infection in Nonendemic Situations. J Clin Microbiol 2020; 58:JCM.01991-20. [PMID: 32878955 PMCID: PMC7587111 DOI: 10.1128/jcm.01991-20] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Accepted: 08/30/2020] [Indexed: 12/19/2022] Open
Abstract
Entamoeba histolytica infection is an increasingly common sexually transmitted infection in Japan. Currently, stool ova and parasite examination (O&P) is the only approved diagnostic method. Here, we assessed the utility of the commercially available rapid antigen detection test (Quik Chek) for E. histolytica A multicenter cross-sectional study was conducted. Stool samples that had been submitted for O&P were included. The samples were subjected to both Quik Chek and PCR, and the Quik Chek results were assessed in comparison with PCR as the reference standard. E. histolytica infection was confirmed in 5.8% (38/657) of the samples and comprised 20 diarrheal and 18 nondiarrheal cases. The overall sensitivity and specificity of Quik Chek were 44.7% (95% confidence interval, 30.1 to 60.3) and 99.8% (99.1 to 100), respectively. The sensitivity of Quik Chek was higher for diarrheal cases (60.0%) than for nondiarrheal cases (27.8%). Furthermore, the combined use of Quik Chek with O&P increased the sensitivity (78.9%), especially for diarrheal cases (up to 90%). The E. histolytica burden assessed by quantitative PCR was similar between Quik Chek-positive and -negative samples. The Quik Chek assay sensitivity was lower for cyst-containing stools than for trophozoite-containing stools, although it was shown that cultured E. histolytica clinical strains from Quik Chek-negative cyst-containing stools exhibited antigenicity in vitro The present study confirmed the high specificity of Quik Chek for E. histolytica infection. Combined use with O&P increased the sensitivity of detection, facilitating the use of Quik Chek in point-of-care settings in nonendemic situations.
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Yanagawa Y, Nagata N, Yagita K, Watanabe K, Okubo H, Kikuchi Y, Gatanaga H, Oka S, Watanabe K. Clinical features and gut microbiome of asymptomatic Entamoeba histolytica infection. Clin Infect Dis 2020; 73:e3163-e3171. [PMID: 32564059 PMCID: PMC8563208 DOI: 10.1093/cid/ciaa820] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Accepted: 06/15/2020] [Indexed: 01/21/2023] Open
Abstract
Background Entamoeba histolytica infection is a sexually transmitted disease in some developed countries. Asymptomatic infection often occurs and can be a source of transmission; however, limited data are available regarding the pathogenesis of E. histolytica. Methods This was a single-center, cross-sectional study. Specimens were prospectively collected from patients with clinically suspected cases. Entamoeba histolytica infection was defined as a case in which the identification of E. histolytica was confirmed by polymerase chain reaction (PCR) of a clinical specimen. Data from asymptomatic cases were compared with those from symptomatic invasive cases. Results Sixty-four E. histolytica–infected cases, including 13 asymptomatic cases, were identified during the study period. Microbiological diagnosis was made by endoscopic sampling in 26.6% of these cases (17/64). Endoscopy identified macroscopically visible lesions in all cases; however, the sensitivity of histopathology on biopsy samples was low (45.5%) compared with PCR (94.7%). In asymptomatic cases, infection sites were limited around the proximal colon; moreover, trophozoites were frequently identified at infection sites whereas cystic forms were commonly detected in stools. Gut microbiome analyses showed more uniform composition in asymptomatic cases than in symptomatic invasive cases, which were represented by a relatively high abundance of Ruminococcaceae, Coriobacteriaceae, and Clostridiaceae, and a low abundance of Streptococcaceae. Conclusions These results indicate that the encystation and attenuation of E. histolytica are highly affected by the intestinal contents, including the gut microbiome.
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Affiliation(s)
- Yasuaki Yanagawa
- AIDS Clinical Center, National Center of Global Health and Medicine, Tokyo, Japan
| | - Naoyoshi Nagata
- Department of Gastroenterology and Hepatology, National Center of Global Health and Medicine, Tokyo, Japan.,Department of Gastroenterological Endoscopy, Tokyo Medical University, Tokyo, Japan
| | - Kenji Yagita
- Department of Parasitology, National Institutes of Infectious Diseases, Tokyo, Japan
| | - Kazuhiro Watanabe
- Department of Gastroenterology and Hepatology, National Center of Global Health and Medicine, Tokyo, Japan
| | - Hidetaka Okubo
- Department of Gastroenterology and Hepatology, National Center of Global Health and Medicine, Tokyo, Japan
| | - Yoshimi Kikuchi
- AIDS Clinical Center, National Center of Global Health and Medicine, Tokyo, Japan
| | - Hiroyuki Gatanaga
- AIDS Clinical Center, National Center of Global Health and Medicine, Tokyo, Japan.,Joint Research Center for Human Retrovirus Infection, Kumamoto University, Kumamoto, Japan
| | - Shinichi Oka
- AIDS Clinical Center, National Center of Global Health and Medicine, Tokyo, Japan.,Joint Research Center for Human Retrovirus Infection, Kumamoto University, Kumamoto, Japan
| | - Koji Watanabe
- AIDS Clinical Center, National Center of Global Health and Medicine, Tokyo, Japan
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Abstract
BACKGROUND Infection with the protozoan Entamoeba histolytica is common in low- and middle-income countries, and up to 100,000 people with severe disease die every year. Adequate therapy for amoebic colitis is necessary to reduce illness, prevent development of complicated disease and extraintestinal spread, and decrease transmission. OBJECTIVES To evaluate antiamoebic drugs for treating amoebic colitis. SEARCH METHODS We searched the available literature up to 22 March 2018. We searched the Cochrane Infectious Diseases Group Specialised Register, CENTRAL, MEDLINE, Embase, LILACS, mRCT, and conference proceedings. We contacted individual researchers, organizations, and pharmaceutical companies, and we checked reference lists. SELECTION CRITERIA Randomized controlled trials of antiamoebic drugs given alone or in combination, compared with placebo or another antiamoebic drug, for treating adults and children with a diagnosis of amoebic colitis. DATA COLLECTION AND ANALYSIS Two review authors independently assessed the eligibility and methodological quality of trials and extracted and analysed the data. We calculated clinical and parasitological failure rates and rates of relapse and adverse events as risk ratios (RRs) with 95% confidence intervals (CIs), using a random-effects model. We determined statistical heterogeneity and explored possible sources of heterogeneity using subgroup analyses. We carried out sensitivity analysis by using trial quality to assess the robustness of reported results. MAIN RESULTS In total, 41 trials (4999 participants) met the inclusion criteria of this review. In this update, we added four trials to the 37 trials included in the first published review version. Thirty trials were published over 20 years ago. Only one trial used adequate methods of randomization and allocation concealment, was blinded, and analysed all randomized participants. Only one trial used an E histolytica stool antigen test, and two trials used amoebic culture.Tinidazole may be more effective than metronidazole for reducing clinical failure (RR 0.28, 95% CI 0.15 to 0.51; 477 participants, eight trials; low-certainty evidence) and is probably associated with fewer adverse events (RR 0.65, 95% CI 0.46 to 0.92; 477 participants, 8 trials; moderate-certainty evidence). Compared with metronidazole, combination therapy may result in fewer parasitological failures (RR 0.36, 95% CI 0.15 to 0.86; 720 participants, 3 trials; low-certainty evidence), but we are uncertain which combination is more effective than another. Evidence is insufficient to allow conclusions regarding the efficacy of other antiamoebic drugs. AUTHORS' CONCLUSIONS Compared with metronidazole, tinidazole may be more effective in reducing clinical failure and may be associated with fewer adverse events. Combination drug therapy may be more effective for reducing parasitological failure compared with metronidazole alone. However, these results are based mostly on small trials conducted over 20 years ago with a variety of poorly defined outcomes. Tests that detect E histolytica more accurately are needed, particularly in countries where concomitant infection with other bacteria and parasites is common.
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Affiliation(s)
- Maria Liza M Gonzales
- University of the Philippines Manila College of Medicine‐Philippine General HospitalDepartment of PediatricsTaft AvenueManilaNational Capital RegionPhilippines1000
| | - Leonila F Dans
- University of the Philippines Manila College of Medicine‐Philippine General HospitalDepartment of PediatricsTaft AvenueManilaNational Capital RegionPhilippines1000
| | - Juliet Sio‐Aguilar
- University of the Philippines Manila College of Medicine‐Philippine General HospitalDepartment of PediatricsTaft AvenueManilaNational Capital RegionPhilippines1000
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Mori M, Tsuge S, Fukasawa W, Jeelani G, Nakada-Tsukui K, Nonaka K, Matsumoto A, Ōmura S, Nozaki T, Shiomi K. Discovery of Antiamebic Compounds That Inhibit Cysteine Synthase From the Enteric Parasitic Protist Entamoeba histolytica by Screening of Microbial Secondary Metabolites. Front Cell Infect Microbiol 2018; 8:409. [PMID: 30568921 PMCID: PMC6290340 DOI: 10.3389/fcimb.2018.00409] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Accepted: 11/01/2018] [Indexed: 01/21/2023] Open
Abstract
Amebiasis is caused by infection with the protozoan parasite Entamoeba histolytica. Although metronidazole has been a drug of choice against amebiasis for decades, it shows side effects and low efficacy against asymptomatic cyst carriers. In addition, metronidazole resistance has been documented for bacteria and protozoa that share its targets, anaerobic energy metabolism. Therefore, drugs with new mode of action or targets are urgently needed. L-cysteine is the major thiol and an essential amino acid for proliferation and anti-oxidative defense of E. histolytica trophozoites. E. histolytica possesses the de novo L-cysteine biosynthetic pathway, consisting of two reactions catalyzed by serine acetyltransferase and cysteine synthase (CS, O-acetylserine sulfhydrylase). As the pathway is missing in humans, it is considered to be a rational drug target against amebiasis. In this study, we established a protocol to screen both a library of structurally known compounds and microbial culture extracts to discover compounds that target de novo cysteine biosynthesis of E. histolytica. The new screening system allowed us to identify the compounds that differentially affect the growth of the trophozoites in the cysteine-deprived medium compared to the cysteine-containing medium. A total of 431 structurally defined compounds of the Kitasato Natural Products Library and 6,900 microbial culture broth extracts were screened on the system described above. Five compounds, aspochalasin B, chaetoglobosin A, prochaetoglobosin III, cerulenin, and deoxyfrenolicin, from the Kitasato Natural Products Library, showed differential antiamebic activities in the cysteine-deprived medium when compared to the growth in the cysteine-containing medium. The selectivity of three cytochalasans apparently depends on their structural instability. Eleven microbial extracts showed selective antiamebic activities, and one fungal secondary metabolite, pencolide, was isolated. Pencolide showed cysteine deprivation-dependent antiamebic activity (7.6 times lower IC50 in the absence of cysteine than that in the presence of cysteine), although the IC50 value in the cysteine-deprived medium was rather high (283 μM). Pencolide also showed inhibitory activity against both CS1 and CS3 isoenzymes with comparable IC50 values (233 and 217 μM, respectively). These results indicated that antiamebic activity of pencolide is attributable to inhibition of CS. Cytotoxicity of pencolide was 6.7 times weaker against mammalian MRC-5 cell line than E. histotytica. Pencolide has the maleimide structure, which is easily attacked by Michael donors including the thiol moiety of cysteine. The cysteine-adducts of pencolide were detected by mass spectrometric analysis as predicted. As CS inhibition by the pencolide adducts was weak and their IC50 values to CS was comparable to that to the parasite in the cysteine-containing medium, the cysteine-adducts of pencolide likely contribute to toxicity of pencolide to the parasite in the cysteine-rich conditions. However, we cannot exclude a possibility that pencolide inactivates a variety of targets other than CSs in the absence of cysteine. Taken together, pencolide is the first compound that inhibits CS and amebic cell growth in a cysteine-dependent manner with relatively low mammalian cytotoxicity.
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Affiliation(s)
- Mihoko Mori
- Graduate School of Infection Control Sciences, Kitasato University, Tokyo, Japan
- Kitasato Institute for Life Sciences, Kitasato University, Tokyo, Japan
| | - Satoshi Tsuge
- Graduate School of Infection Control Sciences, Kitasato University, Tokyo, Japan
| | - Wataru Fukasawa
- Graduate School of Infection Control Sciences, Kitasato University, Tokyo, Japan
| | - Ghulam Jeelani
- Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Kumiko Nakada-Tsukui
- Department of Parasitology, National Institute of Infectious Diseases, Tokyo, Japan
| | - Kenichi Nonaka
- Graduate School of Infection Control Sciences, Kitasato University, Tokyo, Japan
- Kitasato Institute for Life Sciences, Kitasato University, Tokyo, Japan
| | - Atsuko Matsumoto
- Graduate School of Infection Control Sciences, Kitasato University, Tokyo, Japan
- Kitasato Institute for Life Sciences, Kitasato University, Tokyo, Japan
| | - Satoshi Ōmura
- Kitasato Institute for Life Sciences, Kitasato University, Tokyo, Japan
| | - Tomoyoshi Nozaki
- Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Kazuro Shiomi
- Graduate School of Infection Control Sciences, Kitasato University, Tokyo, Japan
- Kitasato Institute for Life Sciences, Kitasato University, Tokyo, Japan
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Shirley DAT, Farr L, Watanabe K, Moonah S. A Review of the Global Burden, New Diagnostics, and Current Therapeutics for Amebiasis. Open Forum Infect Dis 2018; 5:ofy161. [PMID: 30046644 PMCID: PMC6055529 DOI: 10.1093/ofid/ofy161] [Citation(s) in RCA: 170] [Impact Index Per Article: 28.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Accepted: 07/03/2018] [Indexed: 12/21/2022] Open
Abstract
Amebiasis, due to the pathogenic parasite Entamoeba histolytica, is a leading cause of diarrhea globally. Largely an infection of impoverished communities in developing countries, amebiasis has emerged as an important infection among returning travelers, immigrants, and men who have sex with men residing in developed countries. Severe cases can be associated with high case fatality. Polymerase chain reaction–based diagnosis is increasingly available but remains underutilized. Nitroimidazoles are currently recommended for treatment, but new drug development to treat parasitic agents is a high priority. Amebiasis should be considered before corticosteroid therapy to decrease complications. There is no effective vaccine, so prevention focuses on sanitation and access to clean water. Further understanding of parasite biology and pathogenesis will advance future targeted therapeutic and preventative strategies.
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Affiliation(s)
- Debbie-Ann T Shirley
- Department of Pediatrics, University of Virginia School of Medicine, Charlottesville, Virginia
| | - Laura Farr
- Department of Medicine, University of Virginia School of Medicine, Charlottesville, Virginia
| | - Koji Watanabe
- AIDS Clinical Center, National Center for Global Health and Medicine, Shinjuku, Tokyo, Japan
| | - Shannon Moonah
- Department of Medicine, University of Virginia School of Medicine, Charlottesville, Virginia
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Escolà-Vergé L, Arando M, Vall M, Rovira R, Espasa M, Sulleiro E, Armengol P, Zarzuela F, Barberá MJ. Outbreak of intestinal amoebiasis among men who have sex with men, Barcelona (Spain), October 2016 and January 2017. ACTA ACUST UNITED AC 2018; 22:30581. [PMID: 28797327 PMCID: PMC5553055 DOI: 10.2807/1560-7917.es.2017.22.30.30581] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2017] [Accepted: 07/26/2017] [Indexed: 11/23/2022]
Abstract
Entamoeba histolytica has been recently recognised as an emerging sexually transmissible pathogen in men who have sex with men (MSM), causing sporadic outbreaks in countries where it is not endemic. Here we report two closed clusters of invasive amoebiasis occurring in Barcelona, Spain, in October 2016 (four cases) and in January 2017 (four cases).
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Affiliation(s)
- Laura Escolà-Vergé
- Department of Infectious Diseases, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Maider Arando
- Sexually Transmitted Infections Unit (Drassanes). Department of Infectious Diseases, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Martí Vall
- Sexually Transmitted Infections Unit (Drassanes). Department of Infectious Diseases, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Roger Rovira
- Sexually Transmitted Infections Unit (Drassanes). Department of Infectious Diseases, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Mateu Espasa
- Microbiology Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Elena Sulleiro
- Microbiology Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Pere Armengol
- Sexually Transmitted Infections Unit (Drassanes). Department of Infectious Diseases, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Francesc Zarzuela
- Microbiology Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - María-Jesús Barberá
- Sexually Transmitted Infections Unit (Drassanes). Department of Infectious Diseases, Hospital Universitari Vall d'Hebron, Barcelona, Spain
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Alvarado-Esquivel C, Sanchez-Anguiano LF, Hernandez-Tinoco J, Estrada-Martinez S, Perez-Alamos AR, Ramos-Nevarez A, Cerrillo-Soto SM, Guido-Arreola CA. Entamoeba histolytica Infection in Female Sex Workers: A Matched Case-Control Study in Durango, Mexico. J Clin Med Res 2017; 9:624-629. [PMID: 28611864 PMCID: PMC5458661 DOI: 10.14740/jocmr3065w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/05/2017] [Indexed: 11/17/2022] Open
Abstract
Background Infection with Entamoeba histolytica (E. histolytica) can be potentially transmitted by sexual contact. The seroepidemiology of E. histolytica in female sex workers has not been studied. The aim of the study was to determine whether E. histolytica is associated with the occupation of female sex work. In addition, the correlates of E. histolytica seroprevalence in female sex workers were also investigated. Methods We performed an age- and gender-matched case-control study of 187 female sex workers and 374 women without sex work. Cases and controls were tested for the presence of E. histolytica IgG antibodies using a commercially available enzyme-linked immunoassay. Seroprevalence association with the characteristics of female sex workers was determined by bivariate analysis. Results Anti-E. histolytica IgG antibodies were found in five (2.7%) of 187 female sex workers and in 16 (4.3%) of 374 controls (odds ratios (OR) = 0.61; 95% confidence intervals (CI): 0.22 - 1.70; P = 0.34). Mean optical density of the immunoassay in seropositive cases and controls was 1.35 ± 0.93 and 0.73 ± 0.45, respectively (P = 0.05). Seroprevalence of E. histolytica infection did not vary significantly with age, education, socioeconomic level, or health status of sex workers. Seropositivity to E. histolytica did not correlate with work characteristics such as duration in the occupation, condom use, type of sex, or a history of sexually transmitted diseases, or with behavioral variables such as washing hands before eating, or consumption of untreated water. Conclusions Results indicate that female sex workers do not have an increased risk for E. histolytica infection in Durango City, Mexico. Further studies to determine the risk of infection with E. histolytica by sexual contact should be conducted.
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Affiliation(s)
- Cosme Alvarado-Esquivel
- Biomedical Research Laboratory, Faculty of Medicine and Nutrition, Juarez University of Durango State, Avenida Universidad S/N, 34000 Durango, Mexico
| | - Luis Francisco Sanchez-Anguiano
- Institute for Scientific Research "Dr. Roberto Rivera-Damm", Juarez University of Durango State, Avenida Universidad S/N, 34000 Durango, Mexico
| | - Jesus Hernandez-Tinoco
- Institute for Scientific Research "Dr. Roberto Rivera-Damm", Juarez University of Durango State, Avenida Universidad S/N, 34000 Durango, Mexico
| | - Sergio Estrada-Martinez
- Institute for Scientific Research "Dr. Roberto Rivera-Damm", Juarez University of Durango State, Avenida Universidad S/N, 34000 Durango, Mexico
| | - Alma Rosa Perez-Alamos
- Institute for Scientific Research "Dr. Roberto Rivera-Damm", Juarez University of Durango State, Avenida Universidad S/N, 34000 Durango, Mexico
| | - Agar Ramos-Nevarez
- Clinica de Medicina Familiar, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, Predio Canoas S/N, 34079 Durango, Mexico
| | - Sandra Margarita Cerrillo-Soto
- Clinica de Medicina Familiar, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, Predio Canoas S/N, 34079 Durango, Mexico
| | - Carlos Alberto Guido-Arreola
- Clinica de Medicina Familiar, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, Predio Canoas S/N, 34079 Durango, Mexico
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Underestimated Amoebic Appendicitis among HIV-1-Infected Individuals in Japan. J Clin Microbiol 2016; 55:313-320. [PMID: 27847377 PMCID: PMC5228245 DOI: 10.1128/jcm.01757-16] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2016] [Accepted: 11/03/2016] [Indexed: 01/07/2023] Open
Abstract
Entamoeba histolytica is not a common causative agent of acute appendicitis. However, amoebic appendicitis can sometimes be severe and life threatening, mainly due to a lack of awareness. Also, its frequency, clinical features, and pathogenesis remain unclear. The study subjects were HIV-1-infected individuals who presented with acute appendicitis and later underwent appendectomy at our hospital between 1996 and 2014. Formalin-fixed paraffin-embedded preserved appendix specimens were reexamined by periodic acid-Schiff (PAS) staining and PCR to identify undiagnosed amoebic appendicitis. Appendectomies were performed in 57 patients with acute appendicitis. The seroprevalence of E. histolytica was 33% (14/43) from the available stored sera. Based on the medical records, only 3 cases were clinically diagnosed as amoebic appendicitis, including 2 diagnosed at the time of appendectomy and 1 case diagnosed by rereview of the appendix after the development of postoperative complications. Retrospective analyses using PAS staining and PCR identified 3 and 3 more cases, respectively. Thus, E. histolytica infection was confirmed in 9 cases (15.8%) in the present study. Apart from a significantly higher leukocyte count in E. histolytica-positive patients than in negative patients (median, 13,760 versus 10,385 cells/μl, respectively, P = 0.02), there were no other differences in the clinical features of the PCR-positive and -negative groups. In conclusion, E. histolytica infection was confirmed in 9 (15.8%) of the appendicitis cases. However, only 3, including one diagnosed after intestinal perforation, were diagnosed before the present analyses. These results strongly suggest there is frequently a failure to detect trophozoites in routine examination, resulting in an underestimation of the incidence of amoebic appendicitis.
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14
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Hayat F, Azam A, Shin D. Recent progress on the discovery of antiamoebic agents. Bioorg Med Chem Lett 2016; 26:5149-5159. [PMID: 27707603 DOI: 10.1016/j.bmcl.2016.09.040] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2016] [Revised: 09/13/2016] [Accepted: 09/14/2016] [Indexed: 12/12/2022]
Abstract
A large number of protozoans infect humans but Entamoeba histolytica is the only organism responsible for causing amoebiasis, a deadly disease after malaria. Numerous heterocycle-based antiamoebic agents have been previously synthesized as E. histolytica inhibitors and while some of these agents have shown moderate activity, the search for a novel and ideal antiamoebic compound is still ongoing. In this digest Letter, we present the latest data on antiamoebic agents from 2011 to 2016 based on the different classes of heterocyclic agents.
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Affiliation(s)
- Faisal Hayat
- College of Pharmacy, Gachon University, 191 Hambakmoe-ro, Yeonsu-gu, Incheon 21936, South Korea
| | - Amir Azam
- Department of Chemistry, Jamia Millia Islamia (Central University), Jamia Nagar, New Delhi 110025, India
| | - Dongyun Shin
- College of Pharmacy, Gachon University, 191 Hambakmoe-ro, Yeonsu-gu, Incheon 21936, South Korea.
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15
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Yanagawa Y, Nagata N, Watanabe K, Tsukada K, Teruya K, Kikuchi Y, Gatanaga H, Akiyama J, Uemura N, Oka S. Increases in Entamoeba histolytica Antibody-Positive Rates in Human Immunodeficiency Virus-Infected and Noninfected Patients in Japan: A 10-Year Hospital-Based Study of 3,514 Patients. Am J Trop Med Hyg 2016; 95:604-609. [PMID: 27296390 PMCID: PMC5014266 DOI: 10.4269/ajtmh.16-0134] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2016] [Accepted: 05/05/2016] [Indexed: 11/30/2022] Open
Abstract
Serological evidence of the epidemiological trends in Entamoeba histolytica infection is scarce, especially in nonendemic countries. We aimed to determine the antibody-positive rates over a 10-year period, and compare the trends between human immunodeficiency virus (HIV)–infected and –noninfected patients. We reviewed 3,514 patients who underwent antibody testing during the study periods, which were divided into five annual categories: 2004–2005, 2006–2007, 2008–2009, 2010–2011, and 2012–2013. Anti-E. histolytica antibody was assessed by indirect immunofluorescence assay. The antibody-positive rate increased yearly from 2004–2005 to 2012–2013 (P < 0.001), although there was no increase in the annual number of antibody tests. This trend was seen among males (18.6–28.3%; P < 0.01), females (5.4–28.2%; P < 0.01), HIV-infected patients (18.4–26.9%; P < 0.001), and non-HIV-infected patients (14.6–36.8%; P < 0.001), and HIV-infected men who have sex with men (19.4–29.1%; P < 0.001). Among antibody-positive patients, there was a significant increase in the proportion of patients with high (≥ 1,600) titers (0.7–12.9%; P < 0.001), whereas this trend was not seen in patients with low (100) or intermediate (200–800) titers (P = 0.282 and 0.409, respectively). This large hospital-based study demonstrated that positive anti-E. histolytica antibody rates increased over 10 years, even though the annual number of antibody tests remained constant. Moreover, this trend was identified in non-high-risk patients (females and non-HIV-infected patients) as well as in high-risk patients. The proportion of patients with high antibody titers significantly increased among the antibody-positive patients.
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Affiliation(s)
- Yasuaki Yanagawa
- Center for AIDS Research, Kumamoto University, Kumamoto, Japan.,Department of AIDS Clinical Center, National Center for Global health and Medicine, Tokyo, Japan
| | - Naoyoshi Nagata
- Department of Gastroenterology and Hepatology, National Center for Global Health and Medicine, Tokyo, Japan
| | - Koji Watanabe
- Department of AIDS Clinical Center, National Center for Global health and Medicine, Tokyo, Japan
| | - Kunihisa Tsukada
- Department of AIDS Clinical Center, National Center for Global health and Medicine, Tokyo, Japan
| | - Katsuji Teruya
- Department of AIDS Clinical Center, National Center for Global health and Medicine, Tokyo, Japan
| | - Yoshimi Kikuchi
- Department of AIDS Clinical Center, National Center for Global health and Medicine, Tokyo, Japan
| | - Hiroyuki Gatanaga
- Center for AIDS Research, Kumamoto University, Kumamoto, Japan.,Department of AIDS Clinical Center, National Center for Global health and Medicine, Tokyo, Japan
| | - Junichi Akiyama
- Department of Gastroenterology and Hepatology, National Center for Global Health and Medicine, Tokyo, Japan
| | - Naomi Uemura
- Department of Gastroenterology and Hepatology, National Center for Global Health and Medicine, Kohnodai Hospital, Chiba, Japan
| | - Shinichi Oka
- Center for AIDS Research, Kumamoto University, Kumamoto, Japan.,Department of AIDS Clinical Center, National Center for Global health and Medicine, Tokyo, Japan
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16
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Caron M, Allard R, Bédard L, Latreille J, Buckeridge DL. Enteric disease episodes and the risk of acquiring a future sexually transmitted infection: a prediction model in Montreal residents. J Am Med Inform Assoc 2016; 23:1159-1165. [PMID: 27026613 DOI: 10.1093/jamia/ocw026] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2015] [Revised: 11/11/2015] [Accepted: 12/12/2015] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE The sexual transmission of enteric diseases poses an important public health challenge. We aimed to build a prediction model capable of identifying individuals with a reported enteric disease who could be at risk of acquiring future sexually transmitted infections (STIs). MATERIALS AND METHODS Passive surveillance data on Montreal residents with at least 1 enteric disease report was used to construct the prediction model. Cases were defined as all subjects with at least 1 STI report following their initial enteric disease episode. A final logistic regression prediction model was chosen using forward stepwise selection. RESULTS The prediction model with the greatest validity included age, sex, residential location, number of STI episodes experienced prior to the first enteric disease episode, type of enteric disease acquired, and an interaction term between age and male sex. This model had an area under the curve of 0.77 and had acceptable calibration. DISCUSSION A coordinated public health response to the sexual transmission of enteric diseases requires that a distinction be made between cases of enteric diseases transmitted through sexual activity from those transmitted through contaminated food or water. A prediction model can aid public health officials in identifying individuals who may have a higher risk of sexually acquiring a reportable disease. Once identified, these individuals could receive specialized intervention to prevent future infection. CONCLUSION The information produced from a prediction model capable of identifying higher risk individuals can be used to guide efforts in investigating and controlling reported cases of enteric diseases and STIs.
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Affiliation(s)
- Melissa Caron
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, 1020 Pine Ave West, Montreal, Quebec, Canada, H3A 1A2
| | - Robert Allard
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, 1020 Pine Ave West, Montreal, Quebec, Canada, H3A 1A2.,Direction de santé publique, CIUSSS du Centre-Est-de-l'Île-de-Montréal, 1301 Sherbrooke St East, Montreal, Quebec, Canada, H2L 1M3
| | - Lucie Bédard
- Direction de santé publique, CIUSSS du Centre-Est-de-l'Île-de-Montréal, 1301 Sherbrooke St East, Montreal, Quebec, Canada, H2L 1M3.,École de santé publique, Université de Montréal, 7101 avenue du Parc, Montreal, Quebec, Canada, H3N 1X9
| | - Jérôme Latreille
- Direction de santé publique, CIUSSS du Centre-Est-de-l'Île-de-Montréal, 1301 Sherbrooke St East, Montreal, Quebec, Canada, H2L 1M3
| | - David L Buckeridge
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, 1020 Pine Ave West, Montreal, Quebec, Canada, H3A 1A2 .,Direction de santé publique, CIUSSS du Centre-Est-de-l'Île-de-Montréal, 1301 Sherbrooke St East, Montreal, Quebec, Canada, H2L 1M3
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17
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Ishikane M, Arima Y, Kanayama A, Takahashi T, Yamagishi T, Yahata Y, Matsui T, Sunagawa T, Nozaki T, Oishi K. Epidemiology of Domestically Acquired Amebiasis in Japan, 2000-2013. Am J Trop Med Hyg 2016; 94:1008-14. [PMID: 26976888 DOI: 10.4269/ajtmh.15-0560] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2015] [Accepted: 01/28/2016] [Indexed: 01/19/2023] Open
Abstract
Notifications of amebiasis have been increasing in Japan. Using national surveillance data during 2000-2013, reported cases of amebiasis were analyzed. A case of amebiasis was defined as laboratory-confirmed Entamoeba histolytica infection, regardless of presence of symptoms. We described temporal trends and analyzed correlates of asymptomatic versus symptomatic cases based on odds ratios (ORs) and 95% confidence intervals (CIs) using logistic regression. Of 9,946 cases reported during 2000-2013, 7,403 were domestic cases. During this period, the proportion of domestic cases increased from 63% to 85%. Among male cases, majority were middle aged, and from 2008, the number of cases attributed to heterosexual contact surpassed that of homosexual contact. During 2010-2013, increase in notifications was associated with asymptomatic cases, colonoscopy diagnosis, and males with unknown or heterosexual route of infection. Among males, colonoscopy (OR = 31.5; 95% CI = 14.0-71.0) and cases with unknown route of infection, relative to homosexual contact (OR = 2.2; 95% CI = 1.3-3.9), were associated with asymptomatic infections in multivariate analysis. Although the recent rise may have been due to enhanced detection by colonoscopy or reporting, the large number of asymptomatic cases, with reportedly unknown or heterosexual route of infection, has led to a better understanding of amebiasis in Japan and highlights the potential public health concern.
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Affiliation(s)
- Masahiro Ishikane
- Field Epidemiology Training Program, National Institute of Infectious Diseases, Tokyo, Japan; Division of Global Infectious Diseases, Department of Infection and Epidemiology, Graduate School of Medicine, Tohoku University, Miyagi, Japan; Infectious Disease Surveillance Center, National Institute of Infectious Diseases, Tokyo, Japan; Department of Global Infectious Diseases and Tropical Medicine, National Defense Medical College, Saitama, Japan; Department of Parasitology, National Institute of Infectious Diseases, Tokyo, Japan
| | - Yuzo Arima
- Field Epidemiology Training Program, National Institute of Infectious Diseases, Tokyo, Japan; Division of Global Infectious Diseases, Department of Infection and Epidemiology, Graduate School of Medicine, Tohoku University, Miyagi, Japan; Infectious Disease Surveillance Center, National Institute of Infectious Diseases, Tokyo, Japan; Department of Global Infectious Diseases and Tropical Medicine, National Defense Medical College, Saitama, Japan; Department of Parasitology, National Institute of Infectious Diseases, Tokyo, Japan
| | - Atsuhiro Kanayama
- Field Epidemiology Training Program, National Institute of Infectious Diseases, Tokyo, Japan; Division of Global Infectious Diseases, Department of Infection and Epidemiology, Graduate School of Medicine, Tohoku University, Miyagi, Japan; Infectious Disease Surveillance Center, National Institute of Infectious Diseases, Tokyo, Japan; Department of Global Infectious Diseases and Tropical Medicine, National Defense Medical College, Saitama, Japan; Department of Parasitology, National Institute of Infectious Diseases, Tokyo, Japan
| | - Takuri Takahashi
- Field Epidemiology Training Program, National Institute of Infectious Diseases, Tokyo, Japan; Division of Global Infectious Diseases, Department of Infection and Epidemiology, Graduate School of Medicine, Tohoku University, Miyagi, Japan; Infectious Disease Surveillance Center, National Institute of Infectious Diseases, Tokyo, Japan; Department of Global Infectious Diseases and Tropical Medicine, National Defense Medical College, Saitama, Japan; Department of Parasitology, National Institute of Infectious Diseases, Tokyo, Japan
| | - Takuya Yamagishi
- Field Epidemiology Training Program, National Institute of Infectious Diseases, Tokyo, Japan; Division of Global Infectious Diseases, Department of Infection and Epidemiology, Graduate School of Medicine, Tohoku University, Miyagi, Japan; Infectious Disease Surveillance Center, National Institute of Infectious Diseases, Tokyo, Japan; Department of Global Infectious Diseases and Tropical Medicine, National Defense Medical College, Saitama, Japan; Department of Parasitology, National Institute of Infectious Diseases, Tokyo, Japan
| | - Yuichiro Yahata
- Field Epidemiology Training Program, National Institute of Infectious Diseases, Tokyo, Japan; Division of Global Infectious Diseases, Department of Infection and Epidemiology, Graduate School of Medicine, Tohoku University, Miyagi, Japan; Infectious Disease Surveillance Center, National Institute of Infectious Diseases, Tokyo, Japan; Department of Global Infectious Diseases and Tropical Medicine, National Defense Medical College, Saitama, Japan; Department of Parasitology, National Institute of Infectious Diseases, Tokyo, Japan
| | - Tamano Matsui
- Field Epidemiology Training Program, National Institute of Infectious Diseases, Tokyo, Japan; Division of Global Infectious Diseases, Department of Infection and Epidemiology, Graduate School of Medicine, Tohoku University, Miyagi, Japan; Infectious Disease Surveillance Center, National Institute of Infectious Diseases, Tokyo, Japan; Department of Global Infectious Diseases and Tropical Medicine, National Defense Medical College, Saitama, Japan; Department of Parasitology, National Institute of Infectious Diseases, Tokyo, Japan
| | - Tomimasa Sunagawa
- Field Epidemiology Training Program, National Institute of Infectious Diseases, Tokyo, Japan; Division of Global Infectious Diseases, Department of Infection and Epidemiology, Graduate School of Medicine, Tohoku University, Miyagi, Japan; Infectious Disease Surveillance Center, National Institute of Infectious Diseases, Tokyo, Japan; Department of Global Infectious Diseases and Tropical Medicine, National Defense Medical College, Saitama, Japan; Department of Parasitology, National Institute of Infectious Diseases, Tokyo, Japan
| | - Tomoyoshi Nozaki
- Field Epidemiology Training Program, National Institute of Infectious Diseases, Tokyo, Japan; Division of Global Infectious Diseases, Department of Infection and Epidemiology, Graduate School of Medicine, Tohoku University, Miyagi, Japan; Infectious Disease Surveillance Center, National Institute of Infectious Diseases, Tokyo, Japan; Department of Global Infectious Diseases and Tropical Medicine, National Defense Medical College, Saitama, Japan; Department of Parasitology, National Institute of Infectious Diseases, Tokyo, Japan
| | - Kazunori Oishi
- Field Epidemiology Training Program, National Institute of Infectious Diseases, Tokyo, Japan; Division of Global Infectious Diseases, Department of Infection and Epidemiology, Graduate School of Medicine, Tohoku University, Miyagi, Japan; Infectious Disease Surveillance Center, National Institute of Infectious Diseases, Tokyo, Japan; Department of Global Infectious Diseases and Tropical Medicine, National Defense Medical College, Saitama, Japan; Department of Parasitology, National Institute of Infectious Diseases, Tokyo, Japan
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18
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Caron M, Bédard L, Latreille J, Buckeridge DL. An exploratory analysis of individuals with multiple episodes of different reportable diseases, Montreal, 1990-2012. Public Health 2015; 131:49-55. [PMID: 26715312 DOI: 10.1016/j.puhe.2015.10.032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2015] [Revised: 08/28/2015] [Accepted: 10/29/2015] [Indexed: 11/17/2022]
Abstract
OBJECTIVES Studies of public health reporting have only examined multiple episodes of the same communicable disease within an individual. We aimed to characterize Montreal residents with multiple reportable disease episodes from 1990 to 2012, while accounting for all types of reportable diseases. STUDY DESIGN Retrospective cohort study. METHODS We performed an exploratory analysis using descriptive statistics, contingency tables, and logistic regression. RESULTS There were 157,839 individuals with at least one disease report and a total of 179,455 disease reports. The 9.8% of subjects with more than one episode accounted for 20.7% of all reported episodes. Among subjects with four or fewer episodes, 54.0% were women, while 74.3% of subjects with five or more episodes were men. Subjects with multiple episodes were more likely to be reported for sexually transmitted infections than were persons with a single episode [difference of proportions: 10.4% (95% CI: 10.0%-10.9%)] and to reside in the neighbourhood encompassing Montreal's gay village. CONCLUSIONS Individuals with multiple communicable disease reports place a large burden on public health officials. These results may help guide investigation and prevention efforts to reduce the number of excess episodes.
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Affiliation(s)
- M Caron
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada
| | - L Bédard
- Direction de santé publique, CIUSSS du Centre-Est-de-l'Île-de-Montréal, Montreal, QC, Canada; École de santé publique, Université de Montréal, Montreal, QC, Canada
| | - J Latreille
- Direction de santé publique, CIUSSS du Centre-Est-de-l'Île-de-Montréal, Montreal, QC, Canada
| | - D L Buckeridge
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada; Direction de santé publique, CIUSSS du Centre-Est-de-l'Île-de-Montréal, Montreal, QC, Canada.
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19
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Watanabe K, Petri WA. Molecular biology research to benefit patients with Entamoeba histolytica infection. Mol Microbiol 2015; 98:208-17. [PMID: 26173474 DOI: 10.1111/mmi.13131] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/13/2015] [Indexed: 12/28/2022]
Abstract
The development of molecular microbiology has made it possible for us to deepen our understanding of the pathogenesis of amebiasis. Research using the trophozoite form of Entamoeba histolytica has clearly shown us the importance of the interface between the parasite and host cells in vitro. Immuno-pathogenesis after excystation was similarly well advanced by the use of a novel murine model of amebic colitis. However, it is still challenging to apply these findings to clinical and epidemiological settings. This is mainly because of the lack of a complete infection animal model of amebiasis by oral-fecal infection. Moreover, in vitro experiments have predominantly been performed using the same axenic cultured strain HM-1: IMSS isolated about 50 years ago, whereas highly diverse strains are prevalent all over the world. Translational research informed by clinical observations has the greatest potential for the development of effective interventions. Here, we highlight discoveries of the experiments designed from cohort observation and discuss remaining problems to be solved.
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Affiliation(s)
- Koji Watanabe
- Division of Infectious Diseases and International Health, University of Virginia, Charlottesville, VA, USA.,AIDS Clinical Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - William A Petri
- Division of Infectious Diseases and International Health, University of Virginia, Charlottesville, VA, USA
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20
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Prevalent and incident HIV diagnoses among Entamoeba histolytica-infected adult males: a changing epidemiology associated with sexual transmission--Taiwan, 2006-2013. PLoS Negl Trop Dis 2014; 8:e3222. [PMID: 25299178 PMCID: PMC4191956 DOI: 10.1371/journal.pntd.0003222] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2014] [Accepted: 08/26/2014] [Indexed: 11/27/2022] Open
Abstract
Background Sexually transmitted Entamoeba histolytica infection (EHI) has been increasingly recognized among men who have sex with men (MSM). We used the National Disease Surveillance Systems (NDSS) to identify prevalent and incident HIV diagnoses among adults with EHI and to determine the associated factors. Methodology The NDSS collect demographic, clinical, and behavioral characteristics of case patients through physician reports and public health interviews. EHI was confirmed by polymerase-chain-reaction assays, histopathology, or serology with documented liver abscess. We linked NDSS databases to identify prevalent and incident HIV diagnoses among noninstitutionalized Taiwanese adults with confirmed EHI during 2006–2013. Cox proportional-hazards analysis was used to determine associated factors. Principal findings Of noninstitutionalized adults with EHI, we identified prevalent HIV diagnosis in 210 (40%) of 524 males and one (1.7%) of 59 females, and incident HIV diagnosis in 71 (23%) of 314 males. MSM accounted for 183 (87%) and 64 (90%) of prevalent and incident HIV diagnoses in males, respectively. From 2006–2009 to 2010–2013, the prevalence of HIV diagnosis increased from 32% to 45% (P = 0.001) while the incidence of HIV diagnosis increased from 5.4 to 11.3 per 100 person-years (P = 0.001) among males with EHI. Incident HIV diagnosis was independently associated with a younger age, residing in metropolitan areas, hospitalization, previous syphilis, and engagement in oral, anal, or oral–anal sex before illness onset. Conclusions/significance Prevalent and incident HIV diagnoses were increasingly identified among adult males in Taiwan, preferentially affecting younger urban MSM. Surveillance and risk-reduction interventions are recommended against the interplay of HIV epidemic and sexually transmitted EHI. Although sexually transmitted Entamoeba histolytica infection has been increasingly recognized among men who have sex with men (MSM) in Australia, Japan, Korea, and Taiwan, particularly those with HIV infection, no studies have examined E. histolytica infection in relation to HIV and attribution of sexual transmission at a national level. We analyzed the national surveillance data in Taiwan and demonstrated that the prevalent and incident HIV diagnoses increased among E. histolytica-infected adult males from 2006–2009 to 2010–2013, which were associated with previous syphilis and engagement of oral, anal, oral–anal sex. The findings indicate sexual transmission might have replaced traditional risk factors as the major route of E. histolytica transmission among adult males in Taiwan. E. histolytica infection associated with prevalent and incident HIV diagnoses preferentially affects younger urban MSM, suggesting new targets of surveillance and public health interventions for this sexually transmissible protozoan infection.
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21
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Watanabe K, Aoki T, Nagata N, Tanuma J, Kikuchi Y, Oka S, Gatanaga H. Clinical Significance of High Anti-Entamoeba histolytica Antibody Titer in Asymptomatic HIV-1-infected Individuals. J Infect Dis 2013; 209:1801-7. [DOI: 10.1093/infdis/jit815] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
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22
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Seroprevalence of Entamoeba histolytica infection among Chinese men who have sex with men. PLoS Negl Trop Dis 2013; 7:e2232. [PMID: 23717699 PMCID: PMC3662687 DOI: 10.1371/journal.pntd.0002232] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2012] [Accepted: 04/11/2013] [Indexed: 11/19/2022] Open
Abstract
Background Men who have sex with men (MSM) were found to be one of the high-risk populations for Entamoeba histolytica (E. histolytica) infection. Accompanied by the prevalence of human immunodeficiency virus (HIV) among MSM, invasive amebiasis caused by E. histolytica has been paid attention to as an opportunistic parasitic infection. However, the status of E. histolytica infection among MSM has been barely studied in mainland China. Methods Seroprevalance of E. histolytica was determined using an enzyme-linked immunosorbent assay based on a cross-sectional study conducted in Beijing and Tianjin, China. Factors potentially associated with E. histolytica infection were identified by logistic regression analysis. Results A total of 602 MSM were included in the study and the laboratory data on serostatus of E. histolytica were available for 599 of them (99.5%). 246 (41.1%) and 51 (8.5%) of the study participants were E. histolytica seropositive and HIV seropositive, respectively. Univariate analyses suggested preferred anal sex behaviors were associated with E. histolytica seropositivity. In multivariate logistic regression analysis, “only has receptive anal sex” (OR: 2.03; 95% CI: 1.22 3.37), “majority receptive anal sex” (OR: 1.83; 95% CI: 1.13, 2.95), and “sadomasochistic behavior (SM)” (OR: 2.30; 95% CI: 1.04, 5.13) were found to be significantly associated with E. histolytica infection. Conclusions High seroprevalence of E. histolytica infection was observed among MSM from Beijing and Tianjin, China. Receptive anal sex behavior and SM were identified as potential predictors. Therefore, E. histolytica and HIV co-infection needs to be concerned among MSM due to their sharing the common risk behaviors. Entamoeba histolytica (E. histolytica) is a very common human gastrointestinal parasitic disease which affects 50 million people worldwide. Men who have sex with men (MSM) have already been found to be one of the high-risk populations with E. histolytica infection. Previous studies have reported an increased risk for E. histolytica infection and invasive amebiasis in HIV seropositive MSM. This pilot study aimed to investigate the serology of E. histolytica among MSM from mainland China. High prevalence of E. histolytica infection (41.1%, 246/599) was observed among the study population, receptive anal sex behavior and sadomasochistic behavior were found to be associated with the E. histolytica serostatus. Although HIV infection was not found to be associated with E. histolytica infection in this pilot study, studies from other countries had reported increased risks for E. histolytica infection and invasive amebiasis among HIV-positive MSM. Our findings suggest E. histolytica infection control needs to be concerned with respect to the increasing HIV prevalence among Chinese MSM population.
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Kline K, McCarthy JS, Pearson M, Loukas A, Hotez PJ. Neglected tropical diseases of Oceania: review of their prevalence, distribution, and opportunities for control. PLoS Negl Trop Dis 2013; 7:e1755. [PMID: 23383349 PMCID: PMC3561157 DOI: 10.1371/journal.pntd.0001755] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Among Oceania's population of 35 million people, the greatest number living in poverty currently live in Papua New Guinea (PNG), Fiji, Vanuatu, and the Solomon Islands. These impoverished populations are at high risk for selected NTDs, including Necator americanus hookworm infection, strongyloidiasis, lymphatic filariasis (LF), balantidiasis, yaws, trachoma, leprosy, and scabies, in addition to outbreaks of dengue and other arboviral infections including Japanese encephalitis virus infection. PNG stands out for having the largest number of cases and highest prevalence for most of these NTDs. However, Australia's Aboriginal population also suffers from a range of significant NTDs. Through the Pacific Programme to Eliminate Lymphatic Filariasis, enormous strides have been made in eliminating LF in Oceania through programs of mass drug administration (MDA), although LF remains widespread in PNG. There are opportunities to scale up MDA for PNG's major NTDs, which could be accomplished through an integrated package that combines albendazole, ivermectin, diethylcarbamazine, and azithromycin, in a program of national control. Australia's Aboriginal population may benefit from appropriately integrated MDA into primary health care systems. Several emerging viral NTDs remain important threats to the region.
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Affiliation(s)
- Kevin Kline
- Departments of Pediatrics and Molecular Virology & Microbiology, and National School of Tropical Medicine, Baylor College of Medicine, Houston, Texas, United States of America
- Sabin Vaccine Institute and Texas Children's Hospital-Baylor College of Medicine Center for Vaccine Development, Houston, Texas, United States of America
| | - James S. McCarthy
- Clinical Tropical Medicine Laboratory, Queensland Institute of Medical Research, University of Queensland, Brisbane, Australia
| | - Mark Pearson
- Centre for Biodiscovery and Molecular Development of Therapeutics, James Cook University, Cairns, Queensland, Australia
| | - Alex Loukas
- Centre for Biodiscovery and Molecular Development of Therapeutics, James Cook University, Cairns, Queensland, Australia
| | - Peter J. Hotez
- Departments of Pediatrics and Molecular Virology & Microbiology, and National School of Tropical Medicine, Baylor College of Medicine, Houston, Texas, United States of America
- Sabin Vaccine Institute and Texas Children's Hospital-Baylor College of Medicine Center for Vaccine Development, Houston, Texas, United States of America
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Hung CC, Chang SY, Ji DD. Entamoeba histolytica infection in men who have sex with men. THE LANCET. INFECTIOUS DISEASES 2012; 12:729-36. [PMID: 22917103 DOI: 10.1016/s1473-3099(12)70147-0] [Citation(s) in RCA: 79] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Entamoeba histolytica infection (amoebiasis) is the second leading cause of death from parasitic diseases. Epidemiological studies from developed countries have reported an increasing prevalence of amoebiasis and of invasive infections, such as amoebic colitis, among men who have sex with men (MSM) who engage in oral-anal sex. Although most infections with E histolytica are asymptomatic, clinical manifestations of invasive amoebiasis mainly include amoebic colitis and amoebic liver abscess, which are associated with substantial morbidity and medical cost. Laboratory diagnosis of amoebiasis should be based on detection of E histolytica by use of tests with high sensitivity and specificity, such as specific amoebic-antigen or PCR-based assays. Microscopy used in routine clinical laboratories is not sensitive or specific enough for detection of E histolytica. Metronidazole or tinidazole remains the mainstay of treatment for invasive amoebiasis, followed by treatment with luminal agents to prevent relapse and transmission of E histolytica to sexual partners or close contacts.
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Affiliation(s)
- Chien-Ching Hung
- Department of Internal Medicine, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan.
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Abstract
The review provides current views on human protozoan parasites of the gut. The recognition of the importance of cryptosporidium, cyclospora and microsporidia over the last three decades emphasises the possibility that more pathogenic intestinal protozoa are presently unrecognized. Each of these is a zoonotic infection and the potential for a zoonotic element to the transmission of giardiasis has been recognized. A common theme in increased understanding of the biology and pathological mechanisms involved in causing disease is the application of molecular techniques to the various stages of the parasite life cycle. Molecular methods are increasingly contributing to laboratory diagnosis of these conditions with increased yields of positive results though in the tropics it is likely that fecal microscopy will remain the standard for some time to come. The nitroimidazole compounds are the mainstay of treatment for giardia and amebiasis with no major advance in therapeutics since their role was appreciated. Nitazoxanide was shown to be effective for cryptosporidiosis in the 1990s.
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Fletcher SM, Stark D, Harkness J, Ellis J. Enteric protozoa in the developed world: a public health perspective. Clin Microbiol Rev 2012; 25:420-49. [PMID: 22763633 PMCID: PMC3416492 DOI: 10.1128/cmr.05038-11] [Citation(s) in RCA: 240] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Several enteric protozoa cause severe morbidity and mortality in both humans and animals worldwide. In developed settings, enteric protozoa are often ignored as a cause of diarrheal illness due to better hygiene conditions, and as such, very little effort is used toward laboratory diagnosis. Although these protozoa contribute to the high burden of infectious diseases, estimates of their true prevalence are sometimes affected by the lack of sensitive diagnostic techniques to detect them in clinical and environmental specimens. Despite recent advances in the epidemiology, molecular biology, and treatment of protozoan illnesses, gaps in knowledge still exist, requiring further research. There is evidence that climate-related changes will contribute to their burden due to displacement of ecosystems and human and animal populations, increases in atmospheric temperature, flooding and other environmental conditions suitable for transmission, and the need for the reuse of alternative water sources to meet growing population needs. This review discusses the common enteric protozoa from a public health perspective, highlighting their epidemiology, modes of transmission, prevention, and control. It also discusses the potential impact of climate changes on their epidemiology and the issues surrounding waterborne transmission and suggests a multidisciplinary approach to their prevention and control.
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Affiliation(s)
| | - Damien Stark
- School of Medical and Molecular Biosciences, University of Technology Sydney, Sydney, NSW, Australia
- St. Vincent's Hospital, Sydney, Division of Microbiology, SydPath, Darlinghurst, NSW, Australia
| | - John Harkness
- School of Medical and Molecular Biosciences, University of Technology Sydney, Sydney, NSW, Australia
- St. Vincent's Hospital, Sydney, Division of Microbiology, SydPath, Darlinghurst, NSW, Australia
| | - John Ellis
- The ithree Institute, University of Technology Sydney, Sydney, NSW, Australia
- School of Medical and Molecular Biosciences, University of Technology Sydney, Sydney, NSW, Australia
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Slavik T. Human immunodeficiency virus-related gastrointestinal pathology: a southern Africa perspective with review of the literature (part 1: infections). Arch Pathol Lab Med 2012; 136:305-15. [PMID: 22372907 DOI: 10.5858/arpa.2011-0332-ra] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
CONTEXT Human immunodeficiency virus infection is rife in sub-Saharan Africa and in southern Africa in particular. Despite the increasing availability of antiretroviral therapy in this region, opportunistic infections remain common and frequently involve the gastrointestinal tract. OBJECTIVE To review the histopathologic findings and distinguishing features of human immunodeficiency virus-associated gastrointestinal infections in southern Africa and relate those findings to the documented international literature. DATA SOURCES The available literature on this topic was reviewed and supplemented with personal experience in a private histopathology practice in South Africa. CONCLUSIONS In southern Africa, the range of gastrointestinal, opportunistic infectious pathology in human immunodeficiency virus afflicted patients is diverse and includes viral, bacterial, fungal, and parasitic infections. This infectious pathology is sometimes a manifestation of systemic disease. In profoundly immunocompromised patients, unusual histologic features, involvement of uncommon gastrointestinal tract sites, and more than one pathogen may be seen.
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Affiliation(s)
- Tomas Slavik
- Ampath Pathology Laboratories, University of Pretoria, South Africa.
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Hung CC, Chang SY, Ji DD. Amebiasis deaths in the United States. Am J Trop Med Hyg 2012; 86. [PMID: 22556095 PMCID: PMC3335701 DOI: 10.4269/ajtmh.2012.12-0121a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Takashima M, Kakimoto T, Saito H, Misaki S, Onishi Y, Kasugai T, Akuta K, Kasahara H, Yamamoto K, Doi Y, Ujiie H, Sugahara H, Hoshida Y, Sakoda H. Synchronous tumor with diffuse large B-cell lymphoma and ameboma. J Clin Oncol 2011; 29:e769-71. [PMID: 21947830 DOI: 10.1200/jco.2011.36.1238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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