Entamoeba Histolytica Research Articles

P-145. Parasitological characterization of stool samples from indigenous Wayuu children from La Guajira, Colombia

Abstract Background La Guajira, 396,511 children and most of them recognized as Wayuu indigenous population. They have many public health problems in primary services. This children are at high risk of suffering from intestinal parasitosis. The most common are Entamoeba histolytica (EH) and Giardia duodenalis (GD) in their infectious forms. The common source is contaminated food and water. Geohelminth (GH) infections can be complicated by pulmonary compromise and worsening health of children with nutritional problems. In Colombia, primary care for intestinal parasitosis is albendazole. As part of the social interest we want to know the main species that we can find in the feces of a group of these children to know if primary treatment with albendazole is sufficient. Coccidial structures by Ziehl-Neelsen (ZN) Methods Descriptive cross-sectional study. On December 2023 was assessing 44 coprological samples. Containers were labelled, consent and informed assent were signed. They were preserved in MIF reagent and stored at 4°C, processed by Formalin-Gasoline (F-G) with the addition of parasitological lugol for microscopic evaluation under 10x and 40x objectives. Coccidial structures were observed by Ziehl-Neelsen (ZN) staining with a 100x objective, both calibrated with a micrometer. The variables was analized by frequencies and measures of central tendency. Trophozoite of Entamoeba histolytica Results 44 samples were included. Abnormal results were found in 42/44 (95.5%) by ZN technique; 44 (95.5%) Microsporidium and 23 (52.3%) Cryptosporidium. In the F-G and addition of parasitological lugol, abnormal results were found in 38/44 (86.4%). Regarding Protozoa, 18 (40.9%) were found GD cysts, 36 (81.8%) B. hominis, 8 (18.2%) E. nana, 12 (27.3%) EH trophozoites and 2 (4.5%) C. Mesnili. Regarding GH, 2 (4.5%) were found with S. stercoralis and A. lumbricoides and 1 (2.3%) H. nana. Both ZN staining and parasitological lugol staining showed 19 (43.2%)C. cayetanensis and 14 (31.9%) C. belli. Cysts of Giardia Duodenalis Conclusion The frequency of PI was 95.5%, 42 (95.5%) protozoan and 5 (11.4%) GH. The most frequent isolates were Microsporidium, B. hominis and GD. Perhaps we could offer another deworming treatment in this population. This description could be the basis for other studies in this population to offer better alternatives and make the public health situation in this scenario more visible to the government. Egg of Hymenolepis nana Disclosures All Authors: No reported disclosures

Molecular identification of EhCRT gene Calreticulin isolated from children infected with Entamoeba histolytica.

To detect the gene of entamoeba histolytica by polymerase chain reaction and investigate the expression of immunogene entamoeba histolytica calreticulin in stool samples of infected patients. The case control study was conducted at Central Teaching Hospital of Paediatrics and Al Mahmoudia General Hospital, Iraq, from December 30, 2020, to September 1, 2021, and comprised diarrhoeal faecal samples collected from 86 children with age ranging from ˂1 year to 13 years who were suspected of having been infected with entamoeba histolytica. Microscopically positive samples were then subjected to conventional and real-time polymerase chain reaction for the detection of entamoeba histolytica HM1:IMSS strain using Phage shock protein (Psp) gene sequences and detection of entamoeba histolytica calreticulin expression. Of the 86 patients, 71(82.6%) were found to be infected with entamoeba histolytica; 39(54.93%) boys and 32(45.07%) girls. The remaining 15(17.4%) patients were taken as non-amoebic controls; 8(53.3%) boys and 7(46.7%) girls. There were 36(50.70%) cases and 8(53.33%) controls aged 1-4 years. Among the Entamoeba histolytica gene was detected in 44(62%) of the cases using conventional polymerase chain reaction, and immunogene entamoeba histolytica calreticulin was expressed in 36(50.7%) using real-time polymerase chain reaction. Data was analysed using SPSS 24. Polymerase chain reaction was found to be a useful tool for diagnosing entamoeba histolytica infection in children.

Effectiveness of a health education program on mothers' knowledge and practice regarding amebiasis.

This study was conducted to assess the effectiveness of a health education program on mothers' knowledge and practices related to amebiasis. Pre- and post-I and II-tests were used, along with a two-group quasi-experimental design. The study included a convenience sample of 120 mothers, including 60 from the study and 60 from the control group. Out of the entire number of PHCs in Wasit Governorate, seven were used for the study. A three-part structured questionnaire tests mothers' knowledge of the illness and attitudes about it. The results of this study indicated that there is statistically significant difference between the study and control groups during the post-test I and post-test II periods (t=14.968, P=.000 and t=13.731, P=.000, respectively). Data from the study group during the pre-test period of 31.17(9.14) revealed that (70%) of mothers had bad practices connected to Entameba Histolytica among children. According to the post-test I results, 47.4 (9.48) respondents, or 70%, identified good practices. The main finding showed that, after the educational program was implemented, mothers' knowledge and practice of amebiasis dramatically increased, with pre-post implementation differences that are statistically significant.

PREVALENCE OF INTESTINAL PROTOZOA, HELMINTHES, AND COCCIDIAN INFECTIONS AMONG PRIMARY SCHOOL CHILDREN IN THALA’A DISTRICT AT AMRAN GOVERNORATE, YEMEN

Background and objectives: The prevalence of intestinal parasite infection, which can range between 18% and 90%, is one of the most frequently reported diseases in Yemen and poses a serious health issue for schoolchildren. In Thala’a District, Amran Governorate, Yemen, the study's main goal was to ascertain the prevalence of intestinal parasite infection among primary school students. Subjects and methods: A cross-sectional survey was conducted from January to April 2022 among 400 schoolchildren, in the age groups 7-12 years. All the children were residents of the city of Thala’a. A pre-tested structured questionnaire was used to collect data. Stool samples were examined for intestinal parasites according to standard laboratory methods. Results: The children's ages ranged from 7 to 12 years, with a mean±SD of 9.52 ± 2.9 years. The results showed that 136/400 (34%) of the tested children were positive for intestinal parasite infection with a higher prevalence of specific intestinal worms (50.4%) than protozoa (33.3%) and coccidian infection (16.3%). The rate of infection alone was also higher than that of multiple parasitic infections (19.3% vs. 14.8%). The highest number of intestinal parasites was 50/400 (12.5%) for Ascaris lumbricoides, and 49/400 (12.25%) for Entameba histolytica followed by 9.8% for Giardia lamblia, 11.5% for Entrobius vermicularis, 6.5% for Cryptosporidium species, 6.5% for Hymenolepis nana, 2% for Schistosoma mansoni, and 0.8% for Trichuris trichiura. Considering the associated factors, boys had a higher infection rate than girls (50% vs. 24.2%) with an OR of 2.6, CI =1.7–3.9 (p < 0.001). A higher rate was also recorded in older children (41%) with an odds ratio of 1.6 (p=0.03). Conclusion: There is a high prevalence of intestinal parasites among school children in Thala’a city, and various control measures are required to control and prevent intestinal parasites among school children. Peer Review History: Received: 3 March 2023; Revised: 22 April; Accepted: 27 June 2023, Available online: 15 July 2023 Academic Editor: Dr. Asia Selman Abdullah, Pharmacy institute, University of Basrah, Iraq, asia_abdullah65@yahoo.com Received file: Reviewer's Comments: Average Peer review marks at initial stage: 5.5/10 Average Peer review marks at publication stage: 7.0/10 Reviewers: Rola Jadallah, Arab American University, Palestine, rola@aauj.edu Dr. Tamer Elhabibi, Suez Canal University, Egypt, tamer_hassan@pharm.suez.edu.eg Dr. Sheikh Abdul Khaliq, Department of Pharmacy Practice, Faculty of Pharmacy, Hamdard University, Karachi, Pakistan, drwadhsheikh1974@gmail.com

Microbial bowel infections-induced biochemical and biological abnormalities and their effects on young Egyptian swimmers

Swimmers’ personal hygiene affects the spread of microbes in pools. The present study aimed to determine the incidence of microbial infections among young Egyptian swimmers and its impact on swimmers’ scores. From January 2020 to June 2021, 528 public club swimmers were examined cross-sectionally. Swimmers were divided into two groups according to their star tests and their scores in the competition (group 1 with a high score and group 2 with a low score). Stool samples, biochemical and biological parameters were assessed. Microbial infections were 54% for intestinal parasitosis and 2.8% for Helicobacter pylori. The rate of intestinal parasitosis was higher among Gp2 as compared to Gp1. The results also revealed higher prevalence of Cryptosporidium spp., Giardia lamblia, Entameba histolytica, and Cyclospora among Gp2 than Gp1. Swimming frequency, and duration influenced the infectious status that induced anemia, abnormal blood pressure, and heart rate. Infected swimmers with cryptosporidiosis had higher alanine transaminase levels, white blood cells, and differential cells but lower aspartate transaminase levels. Giardiasis showed higher reduction in the biochemical markers including ferritin, lactoferrin, iron, and transferrin among Gp 2, compared to Gp 1 and thus affected the swimmers’ scores. Thus, raising swimmers’ hygiene awareness and targeting health education is obliged.

Prevalence of intestinal parasitic infection in patients at Wasit Province, Iraq

Intestinal parasites are the causative agents of number of important human infections in developing countries. The present study was aimed to determine the prevalence of protozoan and helminthes infections in diarrheal patients at Wasit province during the period from July, 2022 to September, 2022. A total of 120 stool samples from both gender and different age suffering from diarrheal, abdominal pain and fever. All stool samples were examined microscopically by the direct method for identification the trophozoite and cyst of protozoa and ova of helminthes. Only 55 samples were positive for intestinal parasite. The result showed that the percent of parasite infection among patients and control were 55 (45.83) % and 0(0%) respectively. The higher infection was recorded with Entameba histolytica was 30 (54.5%). The males infection were predominance 17(30.9%) than the females 13(23.63%). According the residence urban areas were reported12 (21.81%) and rural areas were 18(32.72%) infected with Entameba histolytica. The number and percent of co-infection with Entamoeba histolytica and Blastocystis hominis was 7(12.72%) and the male was 3(5.45%) while the female was 4(7. 27%). The infection of Giardia lamblia was 6(10.9%) and the males was 4(7.27%) while the females was 2(3.63%).

Review: Modern Management of Liver Abscess

AbstractAn encapsulated collection of suppurated material within the liver is termed a liver abscess, which may be caused due to bacterial, parasitic, or fungal infection. Liver abscesses can be divided into infectious, iatrogenic, and malignant. Infection spreading through the biliary tract is the most common cause now. Escherichia coli, the most common organism causing liver abscess two decades ago, is replaced by Klebsiella pneumonia, accounting for 50 to 70% of cases in the Asian subcontinent; however, liver abscesses due to Entameba histolytica are also found quiet often in day to day clinical practice. Risk factors associated with the development of liver abscess are increasing age, male sex, presence of underlying diabetes mellitus, liver cirrhosis, continuous use of proton pump inhibitors, and immunocompromised state. Fever and abdominal pain are the typical clinical symptoms of a liver abscess. Other common symptoms include nausea, vomiting, malaise, and chills. Tachycardia, right upper quadrant tenderness, and hepatomegaly are common examination findings. USG of the abdomen is performed in all suspected cases of liver abscess and has a sensitivity of 85%. Small abscesses, less than 3 to 4 cm, can be managed with antibiotics. Percutaneous drainage can be done either by single-time needle aspiration or catheter drainage.

Molecular investication of entamoeba histolytica by nested multiplex PCR in diarrheoginic patients

The current study was for determine Entamoeba histolytica in diarrheal patients by molecular investigation (nested multiplex PCR) in order obtained for an accurate diagnosis of Entamoeba histolytica that causes amoebiasis. Total stool samples (133) that collected from symptomatic patients with diarrhea according to age, gender. Then all samples undergo for a direct microscopic examination, The result revealed that 100(73.18%) were positive samples with Entamoeba spp. The results of microscopic examination revealed a higher infection rate of Entamoeba spp were in the female 83.87% compared the male 67.6% with significant difference at P<0.05 ,and recorded high infection rate in age group in (4-10)years and age group (more than 50)years 83.33%,86.66% respectively, and lower infection rate in age group (>1)year 55.55% .Showed the method nested multiplex polymerase chain reaction by using 18s rRNA small subunit gene, nested multiplex PCR for these positive samples by using specific primer for E. histolytica revealed a higher infection rate was E. histolytica 73(91.25%) (monoinfection). Entamoeba histolytica high infection rate recorded in the female 97.43% compared the male 82.35%. In addition, E. histolytica recorded the more percentage infection was in age group (less than one year) and (31-50)years was scored 3(100%), 11(100%), respectively.

IMPACT OF COVID-19 PANDEMIC ON INTESTINAL PARASITIC INFECTIONS: EXPERIENCE OF PARASITOLOGY AND MYCOLOGY LABORATORY OF AVICENNA MILITARY HOSPITAL IN MARRAKECH

Intestinal parasitic infections (IPIs) are a worldwide public health threat that remains frequent, especially in countries where hygienic conditions are precarious. The Covid-19 pandemic that the world is experiencing since March 2020 was associated with the establishment of a set of hygienic measures. The aim of this study is to highlight a possible impact of those measures on the prevalence of IPIs by evaluating the results of stool specimens examinations for patients of the Avicenna military hospital in Marrakech for a period extended from 2017 to 2022. The overall prevalence of IPIs was found to be 32%. The prevalence of protozoa infections was much higher than the prevalence of helminthic infections (95% vs. 5%). Amongst the protozoa, blastocystis hominis (BH) was the most common parasite. Our study showed a fall in the overall prevalence of IPIs starting from 2020 and a consequent drop in the prevalence of the most incriminated protozoa in parasitic diarrheas: entamoeba histolytica histolytica and giardia intestinalis. Those findings show the effectiveness of the hygiene measures, implemented during covid-19 pandemic, on the carriage of these parasites. The replacement of Entamoeba histolytica histolytica by blastocystis hominis in terms of pathogenicity could be explained by the reactivation of the carriage of BH due to the imbalance of the intestinal flora caused by the use of alcohol and bleach for sanitization. Therefore the present study highlights the positive impact of hygienic measures, carried out during covid-19 pandemic, on the prevalence of IPIs and leads us to emphasize the need to pursue those measures even outside the pandemic.

Amoebiasis in Pregnancy: A Review and Update of the Literature

Amoebiasis in Pregnancy: A Review and Update of the Literature

The positive effect of malaria IPTp-SP on birthweight is mediated by gestational weight gain but modifiable by maternal carriage of enteric pathogens.

SummaryBackgroundPoor pregnancy and birth outcomes are common in sub-Saharan Africa and have complex aetiologies. Sulfadoxine-pyrimethamine (SP), given for intermittent preventive therapy of malaria in pregnancy (IPTp), is one of few existing interventions that improves outcomes of both mother and baby despite widespread SP-resistant malaria. Compelling evidence exists that malaria-independent pathways contribute to this protective effect, but the exact sources of non anti-malarial protection remained unknown. We hypothesized that the beneficial effect of SP on birthweight is mediated by SP activity on maternal factors, including increased gestational weight gain and antibiotic activity on pathogens in the maternal gut.MethodsExpectant mothers from a larger randomized control trial comparing the efficacy of IPTp-SP to IPTp with dihydroartemisinin-piperaquine (DP) were also enrolled in this sub-study study at their first antenatal care visit before commencement of IPTp (n = 105). Participants were followed monthly until delivery. Weights and mid-to-upper-arm circumferences (MUAC) were recorded. Monthly stool samples were collected and screened for five Escherichia coli pathotypes, Shigella spp., Vibrio cholerae, Salmonella, Campylobacter coli/jejuni, and three protozoa (Giardia spp., Entameba histolytica, and Cryptosporidium spp.) using previously validated molecular assays.FindingsIPTp-SP vs. IPTP-DP was associated with higher maternal gestational weight gain (GWG) and nutritional indicators (MUAC and body-mass index, BMI). GWG was found to be a mediator of the birthweight and IPTp-SP relationship, as the birthweight of SP infants, but not DP infants, varied according to maternal GWG. The burden of maternal enteric infections was high. The three most commonly observed pathogens were enteroaggregative E. coli (EAEC), atypical enteropathogenic E.coli/enterohaemorrhagic E. coli (aEPEC/EHEC), and typical enteropathogenic E.coli (tEPEC). We found that SP reduced the prevalence of EAEC in a dose-dependent manner. After 3 or more doses, SP-recipients were 90% less likely to be infected with EAEC compared to DP-recipients (ORadj = 0.07, CI95 = 0.12, 0.39, p = 0.002). Compared to DP, this coincided with higher maternal gestational weight gain (GWG) and nutritional indicators (MUAC and body-mass index, BMI). The beneficial effect of SP on maternal GWG, MUAC and BMI, was lower if SP mothers had detectable EAEC, aEPEC/EHEC, tEPEC, and LT-ETEC at baseline. Maternal EAEC and tEPEC at baseline associated with lower birthweight for babies of both SP mothers and DP mothers. When comparing IPTp regimens, the positive effect of SP on birthweight compared to DP was only observed for infants of women who did not test positive for EAEC at baseline (adjusted mean birthweight difference SP vs. DP = 156.0 g, CI95 = -18.0 g, 336.9 g, p = 0.087), though confidence intervals crossed the null.InterpretationOur findings indicate that in pregnant Malawian women, IPTp-SP vs. IPTp-DP is consistently associated with higher MUAC, BMI, and GWG following the WHO-recommended regimen of at least 3 doses, but carriage of maternal gut pathogens before initiation of IPTp lessens this effect. Because GWG was a mediator of the association between birthweight and SP, we show that SP's previously proven positive effect on birthweight is by promoting maternal weight gain. Overall, our results present one plausible pathway SP exerts malaria-independent protection against poor birth outcomes in the context of its waning antimalarial activity and warrants further investigation.FundingA full list of funding bodies that contributed to this study can be found in the Acknowledgements section.

Molecular Prevalence of Ent amoeba histolytica and Ent amoeba dispar Infection among Aboriginal Communities in the Southern Region of Perak, Malaysia

INTRODUCTION: In Malaysia, there are little up-to-date data on the prevalence of Ent amoeba spp. and most of the previous studies were carried out using the conventional insensitive method of stool microscopic examinations. MATERIALS AND METHODS: A cross-sectional study was conducted from September 2018 to Mac 2019 in the three villages of Orang Asli communities at Slim River, Perak using the molecular assay. Risk factors associated with Ent amoeba spp. infection was assessed by analysing questionnaire responses obtained from the study participants. RESULTS: From the 55 stool samples collected, molecular prevalence revealed 7.3% and 9.1% E. histolytica and E. dispar infection respectively. Infection was due to indiscriminate defecation and not washing hands after playing with soil or gardening, as well as associated with gastrointestinal symptoms. CONCLUSION: This study showed that there is still an ongoing transmission of Ent amoeba spp. among the studied population, thus warrants the implementation of specific prevention and control strategies of this infection in Malaysia.

Therapeutic effect of camel milk on albino mice (Mus musculus) colon experimentally infected with Entameba histolytica

The present study aimed to determine the therapeutic effect of camel milk on colonic tissues of albino mice experimentally infected with E. histolytica. Albino mice (Mus musculus) was infected experimentally with E. histolytica cyst stage at a dose 1x106 cell/ml, which was isolated from faecal samples of infected children with E. histolytica who attended to Children's Hospital in the city of Kirkuk at period from May to July 2019. The infected group showed, sever lymphocytes infiltration, and trophozoit stage in the mucous layer with the presence of necrotic materials. In the group of mice which administered with 3 ml of camel milk, colon tissue was normal and there were no histopathological changes compared with mice infected with E. histolytica. While, in the infected group and later treated with camel milk, the histological sections confirm the improvement of colon tissue layers after treatment compared with infected group. Also, in this group, the stages of the parasite were absent. Therefore, from the current study it can be concluded that camel milk has a therapeutic role against the tissue lesions caused by E. histolytica.

Status and perception of intestinal parasitosis among students of a health professional institution in NDjamena, Chad

Intestinal parasitic diseases remain an epidemiology a real problem in Chad, but little research has been done in this area. The purpose of the study is to determine the status of intestinal parasites infection among students in a health professional training institution and to assess their level of perception of this health problem. This prospective and descriptive study took place between June and July 2018. A total of 107 stool samples were collected from students in a health professional training institution in the city of N’Djamena. Direct examination and formalin-ether concentration methods were used to search for parasites. The results showed that the overall prevalence of intestinal parasites among the students was 64.5%. The parasite species identified were Entamoeba histolytica, Giardia lamblia, Ascaris lumbricoides, Taenia solium and Strongyloides stercoralis with respective percentages: 46.73, 13.08, 13.08, 1.87, and 0.93%. The rates of infestation according to the ethological factors were: - cooking water: 46.51 and 75.80% respectively for the national water company (SNE) and drilled water; feeding mode: 60 and 64.70% for respectively individual and collective; washing hands with soap before meals: 78.57 and 62.37% for respectively no and yes. To fight the diseases caused by parasitosis should involve a strategy on sanitation and health education.The species of parasites identified indicate that the fight against diseases caused by the above parasitosis should involve a strategy on sanitation and health education. Key words: Parasite, students, N’Djamena, health professional institution, Chad.

Fatores socioambientais e prevalência de enteroparasitas em pacientes em hemodiálise no pantanal mato-grossense, Brasil

Pacientes em tratamento de hemodiálise devido ao seu sistema imunológico diminuído são facilmente acometidos por enteroparasitas, que levam a uma piora do quadro de saúde destes indivíduos. O objetivo desta pesquisa foi identificar a prevalência de enteroparasitas nos pacientes renais crônicos em tratamento de hemodiálise e possíveis associações com os fatores socioambientais. Trata-se de um estudo transversal com 53 pacientes. Para análise de associação foi utilizado os testes qui-quadrado (x²) de Pearson e Razão de Odds (OR). Os exames coprológicos foram analisados utilizando as técnicas de Hoffman e Sheather. A positividade de enteroparasitas atingiu 92.5%, sendo Blastocystis sp. o mais predominante (95.9%). Em relação aos helmintos, apenas Ascaris lumbricoides foi encontrado (4.1%). Infecções mistas apareceram em 53% dos casos. A associação dupla mais comum foi entre Blastocystis sp. e Endolimax nana, observada em 22.4% dos casos. Nossos resultados mostraram alta prevalência de protozoários de repercussão preocupante para saúde desses pacientes como Cryptosporidium sp., Giardia lamblia e Entamoeba histolytica, evidenciando a necessidade de estratégias de prevenção das infecções parasitárias e intervenções adequadas nos pacientes sob tratamento de hemodiálise.

Acute fulminant necrotizing amebic colitis in a pediatric patient: a rare complication of amebiasis with high mortality\u2014a case report

BackgroundThe majority of amebic infections among humans remain asymptomatic. Rarely, the disease takes a fulminant acute course due to the development of necrotizing amebic colitis. This complication is usually found in adult patients. However, on the contrary, this case was diagnosed in a 9-year-old patient. He was transferred to the Sirimavo Bandaranayake Specialized Children’s Hospital (SBSCH), Peradeniya from the District General Hospital, Kilinochchi. To our knowledge, this is the first report of this rare complication in a child in Sri Lanka.Case presentationWe present a case of acute fulminant necrotizing amebic colitis in a 9-year-old boy. Surgical exploration revealed extensive ulceration and multiple perforations in the entire colon. PAS-Martius Yellow 40 stain highlighted amebae with erythrophagocytosis within the necrotic debris of the ulcers. The polymerase chain reaction (PCR) that was conducted to confirm the diagnosis was positive for Entameba histolytica. The post-operative course was marked with antimicrobial treatment for septicemia and the need for ventilator assistance. Antimicrobial treatment included intravenous metronidazole. The patient progressively recovered and was discharged on a normal diet.ConclusionThis case reports an acute fulminant necrotizing amebic colitis in a 9-year-old patient. After the treatments, the patient progressively recovered and was discharged on a normal diet. E. histolytica infections in northern Sri Lanka should be given attention as a public health concern. Furthermore, this case highlights that acute fulminant amebic colitis requires early surgical intervention, aggressive supportive and anti-amebic treatments. Clinicians should be cognizant of this potentially fatal complication of amebic colitis.

Molecular Identification and Prevalence of Entamoeba histolytica, Entamoeba dispar and Entamoeba moshkovskii in Erbil City, Northern Iraq.

The present study was conducted to evaluate the infection rates of Entamoeba histolytica, Entamoeba dispar, and Entamoeba moshkovskii among asymptomatic individuals in Erbil City, northern Iraq. The research intent was to discover whether pathogenic or nonpathogenic species cause a high rate of symptomless Entamoeba infections. Stool samples were microscopically examined, and the 18S-rRNA gene was targeted utilizing the nested PCR technique in the positive specimens. Initial results based on morphological features showed that the Entamoeba prevalence rate was 7.4%. Significantly higher rates of infections were seen in females than in males and in low-income people than in moderate-income people. The incidence rates among the asymptomatic individuals, as determined by molecular analysis, were as follows: E. histolytica - 6%, E. dispar - 4.3%, and E. moshkovskii - 0.3%. Of all the Entamoeba positive samples, a single infection with E. histolytica was identified in 41.4% samples; the single infection with E. dispar in 18.6% samples, 35.7% samples had mixed infections with two Entamoeba species, and 4.3% had mixed infections with three species. The current study concluded that 7.4% of healthy people, who live in the endemic area under investigation, carry Entamoeba species asymptomatically. Additionally, the majority of asymptomatic Entamoeba infections were caused by the pathogenic E. histolytica (81.4%) compared to E. dispar (58.6%), and E. moshkovskii with the lowest rate of infection. Single and co-infections with E. histolytica and E. dispar were noted. E. moshkovskii, which was identified for the first time in the region, was only seen in mixed infections. The present study was conducted to evaluate the infection rates of Entamoeba histolytica, Entamoeba dispar, and Entamoeba moshkovskii among asymptomatic individuals in Erbil City, northern Iraq. The research intent was to discover whether pathogenic or nonpathogenic species cause a high rate of symptomless Entamoeba infections. Stool samples were microscopically examined, and the 18S-rRNA gene was targeted utilizing the nested PCR technique in the positive specimens. Initial results based on morphological features showed that the Entamoeba prevalence rate was 7.4%. Significantly higher rates of infections were seen in females than in males and in low-income people than in moderate-income people. The incidence rates among the asymptomatic individuals, as determined by molecular analysis, were as follows: E. histolytica – 6%, E. dispar – 4.3%, and E. moshkovskii – 0.3%. Of all the Entamoeba positive samples, a single infection with E. histolytica was identified in 41.4% samples; the single infection with E. dispar in 18.6% samples, 35.7% samples had mixed infections with two Entamoeba species, and 4.3% had mixed infections with three species. The current study concluded that 7.4% of healthy people, who live in the endemic area under investigation, carry Entamoeba species asymptomatically. Additionally, the majority of asymptomatic Entamoeba infections were caused by the pathogenic E. histolytica (81.4%) compared to E. dispar (58.6%), and E. moshkovskii with the lowest rate of infection. Single and co-infections with E. histolytica and E. dispar were noted. E. moshkovskii, which was identified for the first time in the region, was only seen in mixed infections.

Features of the course of contemporary intestinal amebiasis

Acute intestinal infections, including intestinal amebiasis, remain a pressing public health problem. Amebiasis still represents an important and partially solved problem to health care. In the Astrakhan region, intestinal amebiasis is being continuously recorded. We analyzed the clinical picture of acute intestinal amebiasis in 150 adult patients dominated by female patients comprising 60.7%, aged 18 to 79 years old, and treated within 2010–2016 at the Regional Infectious Clinical Hospital. All patients were mostly of young and middle age (up to 50 years) — 108 patients. More than 50% of patients were admitted to the hospital within the first three days of the disease. However, in 35 cases (23.3%), late hospitalization was carried out (5 days after the onset). Proper diagnosis was made to 44 patients (29.3%), most commonly diagnosing preliminarily with acute gastroenteritis and acute dysentery. All cases of intestinal amebiasis were confirmed by detecting in the feces of patients with a vegetative form of entamoeba histolytica. The disease was featured with sporadic course, being mostly recorded during the summer-autumn period (78.0%). In 142 patients (94.7%), the moderate severity was observed. Cardiovascular disorders were mainly found in severe amebiasis as well as patients comorbid with cardiovascular diseases. A coprological method was used to confirm the diagnosis. Microscopic examination of feces was carried out immediately after defecation (warm type). A combination therapy was applied to patients with intestinal amebiasis. A great attention was paid to patient nutrition: high-protein sparing diet, grated food. Patients with ulcerative colitis received individualized diet (restricted carbohydrates, exclusion of milk and fiber). Etiotropic therapy was carried out with using 5-nitroimidazole preparations: metronidazole (Trichopol, Flagin, Tiberal), MacGioror, Tinidazole (Phasycin) combined with tetracycline. The treatment included group B vitamin cocktail, methyluracil (suppository), enzymes (creon, mezim, pancreatin), enterosorbents (smecta, polyphepan, enterosgel), antispasmodics (no-spa, drotaverin). Patients were administered with therapeutic microenemas containing furacilin solution, rosehip oil, and sea buckthorn oil. Infusion therapy consisting of polyionic solutions was applied by assessing blood electrolyte level. Fresh frozen plasma and albumin were transfused upon decline of serum protein and albumin level. Packed erythrocytes Erythrocyte mass and hemostatic drugs were injected in case of severe intestinal amebiasis if indicated: dicynone, cryoprecipitate, and calcium preparations. Finally, anemia cases were treated as well. In all cases, the disease outcome was favorable, without any mortality. Complications were noted in the form of intestinal bleeding observed in 6 patients (4.0%), wherein amebiasis proceeded together with ulcerative colitis. Acute intestinal amebiasis is currently featured with typical clinical picture that proceeds with less severe symptoms. Intestinal bleeding was observed in patients with intestinal amoebiasis in combination with ulcerative colitis. Chronization of intestinal amebiasis occurs in single cases (3.9%).

FREQUENCY OF INTESTINAL PARASITIC INFECTIONS AMONG SCHOOLCHILDREN IN IBB CITY-YEMEN

Objectives: Intestinal parasitic infections are widely distributed and remain one of the most health problems in Yemen. This is a cross-sectional study aimed to determine the prevalence of intestinal parasitic infection and associated factors among schoolchildren in Ibb City, Yemen.
 Methods: A total of 300 stool samples were collected from schoolchildren between January to April 2018 and examined by direct smear and formalin ether concentration techniques.
 Results: The result showed that 62.7% were positive for intestinal parasites, with a higher frequency of single than multiple infections (85.1 vs. 14.36%, respectively). Also, 85.64% were infected by protozoa whereas 14.36% infected by helminths. The prevalence of infection was 61.70% for Entameba histolytica, 23.94% for Giardia lamblia, 7.45% for Ascaris lumbricoides, 4.3% for Hymenolepis nana, and 2.61% for Enterobius vermicularis. Moreover, the highest prevalence of E. histolytica, G. lamblia, and A. lumbricoides was within group aged 9-12 years. H. nana was between age groups of 9-12 and 13-16 years while E. vermicularis was found among 5-8 and 9-12 years. In addition, females were 69% infected significantly higher than males 54.55%. Besides, the various signs and symptoms associated with intestinal infections have been documented.
 Conclusion: High prevalence of intestinal infection was documented among schoolchildren drinking from cistern water, poor hygiene practices, poor food sanitation, non-swimming, and non-previously treated for Schistosoma parasite. High frequency of intestinal parasitic infection between schoolchildren in the study area requires more effort to implement the appropriate programmers that warrant to control and prevention the prevalence of intestinal parasitosis.
 Peer Review History: 
 Received 1 March 2019; Revised 7 April; Accepted 3 May, Available online 15 May 2020
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 Received file 
 
 Average Peer review marks at initial stage: 6.0/10
 Average Peer review marks at publication stage: 8.0/10
 Reviewer(s) detail:
 Name: Dr. Hassan A.H. Al-Shamahy
 Affiliation: Sana'a University, Yemen
 E-mail: shmahe@yemen.net.ye
 
 Name: Hebatallaha A Moustafa
 Affiliation: Ain Shams University, Egypt
 E-mail: anasweety2003@yahoo.com
 Comments of reviewer(s): 
 
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