Abstract
In Australia, amoebiasis is thought to occur in travellers, immigrants from endemic areas, and among men who have sex with men. Prevalence of amoebiasis in communities with immigrants from Entamoeba histolytica-endemic countries is unknown. The present study is a retrospective case series analysis of patients with laboratory-confirmed amoebiasis from Western Sydney Local Health District, Australia, between years 2005 and 2016. Forty-nine patients with amoebiasis were identified, resulting in an estimated annual incidence of up to 1.1 cases per 100,000 adults. Many were born in Australia (15/47) and India (12/47). Three patients (3/37) had no history of overseas travel, two others had not travelled to an endemic country, and an additional two had a very remote history of overseas travel; one died of fulminant amoebic colitis. Three patients (3/16) were employed in the food industry and one had a history of colonic irrigation in an Australian ‘wellness clinic’. Patients had invasive amoebiasis with either liver abscess (41/48) or colitis (7/48), diagnosed most commonly by serology. Invasive procedures were common, including aspiration of liver abscess (28/41), colonoscopy (11/49), and partial hepatectomy (1/49). Although rare, local acquisition of amoebiasis occurs in Western Sydney and contributes to significant morbidity and hospital admissions.
Highlights
Amoebiasis, caused by the parasite Entamoeba histolytica, has a worldwide distribution, with an estimated 50 million people being infected [1]
We aim to determine the epidemiology of amoebiasis in Western Sydney, an area with a high proportion of immigrants from endemic countries [10], in order to raise awareness and improve the morbidity and mortality associated with invasive disease
4 of 13 serology-positive cases that had faecal concentrate examination performed were positive for E. histolytica/dispar
Summary
Amoebiasis, caused by the parasite Entamoeba histolytica, has a worldwide distribution, with an estimated 50 million people being infected [1]. With 40,000–100,000 deaths reported yearly, it is the second leading cause of death from parasitic diseases worldwide [2]. High-risk areas include South Asia, Southeast Asia, the Middle East, and South America [3]. In Australia, amoebiasis is thought to be imported by travellers and recent immigrants from high risk areas [7], with an estimated prevalence of 2% in travellers and 1% in immigrants [8]. Locally-acquired disease affects the MSM population [5], and the Indigenous community in northern Australia [9]. As amoebiasis is not a nationally notifiable disease in Australia, the prevalence of amoebiasis, including the prevalence of locally-acquired cases, is unknown. We aim to determine the epidemiology of amoebiasis in Western Sydney, an area with a high proportion of immigrants from endemic countries [10], in order to raise awareness and improve the morbidity and mortality associated with invasive disease
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