Abstract
Dientamoeba fragilis is a cosmopolitan and neglected protozoan. Although little is known concerning its pathogenicity and its true prevalence worldwide, its role as enteric pathogen is emerging, as the occurrence of dientamoebiasis has increased also in industrialised countries. This study investigated the occurrence and prevalence of intestinal parasites, focusing on D. fragilis in a 10-year period (2011–2020) in a single tertiary-care hospital located in Northern Italy. A statistical evaluation of the correlation between dientamoebiasis and specific signs other than gastrointestinal-related ones was performed. The laboratory diagnosis was performed on 16,275 cases of suspected intestinal parasitoses. Intestinal parasites were detected in 3254 cases, 606 of which were associated to D. fragilis, which represented 18.6% (606/3254) of all the intestinal parasitoses with a 3.7% (606/16,275) prevalence and an increasing trend during the last five years (2011–2015: 2.8% vs. 2016–2020: 4.8%). D. fragilis was commonly detected in foreigners, especially those from developing countries, as well as in children; prevalence was equal in males and females. With regard to the clinical aspect, the only putative sign statistically related to dientamoebiasis was anal pruritus. Despite the controversial epidemiological knowledges on dientamoebiasis, the prevalence of D. fragilis found in this study highlights the need to consider this parasite in any differential diagnosis of gastrointestinal disease.
Highlights
IntroductionDientamoeba fragilis is a protozoan parasite of the human bowel with a worldwide distribution [1,2]
Published: 12 February 2022Dientamoeba fragilis is a protozoan parasite of the human bowel with a worldwide distribution [1,2]
D. fragilis as a human intestinal pathogen has been questioned for long time, since its mode of nutrition resembles that of the non-pathogenetic amoebas Entamoeba coli and Endolimax nana [5], and conflicting data has emerged from the earliest few epidemiologic studies in the field
Summary
Dientamoeba fragilis is a protozoan parasite of the human bowel with a worldwide distribution [1,2]. It was originally considered as a binucleate amoeba, D. fragilis has been reclassified in the family Dientamoebidae of the newly revised class Tritrichomonadidae, given its antigenic and genetic trichomonad affinities, as well as its flagellate-like features despite the actual lack of flagella [3,4]. D. fragilis as a human intestinal pathogen has been questioned for long time, since its mode of nutrition resembles that of the non-pathogenetic amoebas Entamoeba coli and Endolimax nana [5], and conflicting data has emerged from the earliest few epidemiologic studies in the field. The pathogenic role of D. fragilis in gastrointestinal illness is strongly supported by several studies accounting the clinical improvement of patients after therapeutic intervention and eradication of the infection [3,4,6,7].
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