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Adao DEV, Li AOC, Dy AES, Rivera WL. Development of a salivary IgA detection method for accurate diagnosis of amebiasis. J Parasit Dis 2022; 46:714-721. [PMID: 36091277 PMCID: PMC9458784 DOI: 10.1007/s12639-022-01490-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Accepted: 04/09/2022] [Indexed: 10/18/2022] Open
Abstract
An amebiasis detection method was developed based on identifying anti-Entamoeba histolytica IgA in the saliva of infected individuals. The enzyme-linked immunosorbent assay (ELISA)-based detection method was tested along with microscopy and polymerase chain reaction (PCR) on saliva and stool samples from 110 asymptomatic individuals visiting the Manila Health Department - Public Health Laboratory of the City of Manila, Philippines. A receiver operating curve (ROC) was constructed to compare the ELISA results with PCR results. E. histolytica infection was detected in 18 of the 110 individuals. The developed method had an accuracy of 90%, sensitivity of 88.89%, specificity of 90.22%, positive predictive value of 64%, and negative predictive value of 97.65% if a 1:2 dilution of crude saliva sample in phosphate-buffered saline (PBS) was used for diagnosis when compared to PCR. The area under the curve (AUC) of the ROC was 0.9436 if a 1:2 dilution of a crude saliva sample was used. The developed assay presents an easy and accurate method of detecting amebiasis in infected individuals using saliva samples instead of stool or blood samples and has potential applications in both diagnosis and epidemiological studies.
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Affiliation(s)
- Davin Edric V. Adao
- Pathogen-Host-Environment Interactions Research Laboratory, Institute of Biology, College of Science, University of the Philippines Diliman, 1101 Quezon City, Philippines
| | - Angeline Odelia C. Li
- Pathogen-Host-Environment Interactions Research Laboratory, Institute of Biology, College of Science, University of the Philippines Diliman, 1101 Quezon City, Philippines
| | - Alexander Edward S. Dy
- Pathogen-Host-Environment Interactions Research Laboratory, Institute of Biology, College of Science, University of the Philippines Diliman, 1101 Quezon City, Philippines
| | - Windell L. Rivera
- Pathogen-Host-Environment Interactions Research Laboratory, Institute of Biology, College of Science, University of the Philippines Diliman, 1101 Quezon City, Philippines
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Huang SH, Tsai MS, Lee CY, Tsai CS, Liu CE, Lee YT, Chen HA, Chen LY, Lu YM, Tsai WC, Hsu WT, Liu WD, Yang CJ, Sun HY, Ko WC, Lu PL, Hung CC. Ongoing transmission of Entamoeba histolytica among newly diagnosed people living with HIV in Taiwan, 2009-2018. PLoS Negl Trop Dis 2020; 14:e0008400. [PMID: 32530918 PMCID: PMC7314233 DOI: 10.1371/journal.pntd.0008400] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2020] [Revised: 06/24/2020] [Accepted: 05/19/2020] [Indexed: 01/27/2023] Open
Abstract
Recent outbreaks of enterically transmitted infections, including acute hepatitis A and shigellosis, have raised the concerns of increasing Entamoeba histolytica infection (EHI) among people living with HIV (PLWH) in Taiwan. This study investigated the prevalence of EHI, its temporal trends, and associated factors among newly diagnosed PLWH in Taiwan. Medical records of newly diagnosed PLWH at six medical centers in Taiwan between 2009 and 2018 were reviewed. The annual prevalence of invasive amoebiasis and seroprevalence of E. histolytica were determined and examined by the Cochran-Armitage test. The clinical characteristics associated with invasive amoebiasis and seropositivity for E. histolytica were analyzed in multivariable regression models. Among 5362 patients seeking HIV care at six medical centers in Taiwan during the 10-year study period, 119 (2.2%) had invasive amoebiasis at the time or within six months of their HIV diagnosis. Among 3499 who had indirect hemagglutination antibody (IHA) determined, 284 (8.1%) had positive IHA (≥1:32) and 205 (5.9%) had high-titre IHA (≥1:128). The prevalence of invasive amoebiasis increased from 1.3% in 2012 to 3.3% in 2018 (p = 0.024). Invasive amoebiasis was independently associated with a greater age, men who have sex with men, rapid plasma reagin titre ≥1:4, and concurrent shigellosis and giardiasis. Increasing prevalence of invasive amoebiasis among newly diagnosed PLWH in Taiwan calls for strategies to prevent ongoing transmission in this population. Routine screening of EHI for early diagnosis and treatment is recommended, especially among men who have sex with men and those who present with other sexually or enterically transmitted infections. Outbreaks of enterically transmitted infection, including acute hepatitis A and shigellosis, among men who have sex with men and people living with HIV have been reported in Taiwan and in many developed countries in recent years. This study reveals that the prevalence of invasive amoebiasis among newly diagnosed people living with HIV increased in Taiwan since 2012, accompanied by increasing seroprevalence of syphilis and hepatitis A virus infection. This study also shows that concurrent infections with shigellosis and giardiasis and history of syphilis were independently associated with invasive amoebiasis, which indicates that transmission of Entamoeba histolytica might have occurred through sexual behaviours that increased faecal-oral contact in this population. In the era of improved access to HIV prevention and treatment, emerging and re-emerging enterically transmitted infections, including amoebiasis, pose an ongoing health threat to at-risk individuals and the public as a whole.
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Affiliation(s)
- Sung-Hsi Huang
- Department of Internal Medicine, National Taiwan University Hospital Hsin-Chu Branch, Hsin-Chu, Taiwan
- Department of Tropical Medicine and Parasitology, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Mao-Song Tsai
- Department of Internal Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan
- School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan
| | - Chun-Yuan Lee
- Department of Internal Medicine, Kaohsiung Medical University Hospital and College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chin-Shiang Tsai
- Department of Internal Medicine, National Cheng Kung University Hospital, and College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Chun-Eng Liu
- Department of Internal Medicine, Changhua Christian Hospital, Changhua, Taiwan
| | - Yuan-Ti Lee
- School of Medicine, Chung Shan Medical University, Taichung, Taiwan
- Department of Internal Medicine, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Hong-An Chen
- Department of Internal Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan
| | - Ling-Ya Chen
- Center of Infection Control, National Taiwan University Hospital, Taipei, Taiwan
| | - Yu-Man Lu
- Department of Internal Medicine, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Wan-Chen Tsai
- Department of Internal Medicine, National Taiwan University Hospital Biomedical Park Hospital, Hsin-Chu, Taiwan
| | - Wei-Ting Hsu
- Department of Internal Medicine, National Taiwan University Hospital Yun-Lin Branch, Yun-Lin County, Taiwan
| | - Wang-Da Liu
- Department of Internal Medicine, National Taiwan University Cancer Center, Taipei, Taiwan
| | - Chia-Jui Yang
- Department of Internal Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan
| | - Hsin-Yun Sun
- Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Wen-Chien Ko
- Department of Internal Medicine, National Cheng Kung University Hospital, and College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Po-Liang Lu
- Department of Internal Medicine, Kaohsiung Medical University Hospital and College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- * E-mail: (PLL); (CCH)
| | - Chien-Ching Hung
- Department of Tropical Medicine and Parasitology, National Taiwan University College of Medicine, Taipei, Taiwan
- Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
- Department of Medical Research, China Medical University Hospital
- China Medical University, Taichung, Taiwan
- * E-mail: (PLL); (CCH)
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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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Wuerz T, Kane JB, Boggild AK, Krajden S, Keystone JS, Fuksa M, Kain KC, Warren R, Kempston J, Anderson J. A review of amoebic liver abscess for clinicians in a nonendemic setting. CANADIAN JOURNAL OF GASTROENTEROLOGY = JOURNAL CANADIEN DE GASTROENTEROLOGIE 2012; 26:729-33. [PMID: 23061067 PMCID: PMC3472914 DOI: 10.1155/2012/852835] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/14/2011] [Accepted: 04/18/2012] [Indexed: 01/11/2023]
Abstract
Amoebic liver abscess (ALA) is an uncommon but potentially life-threatening complication of infection with the protozoan parasite Entamoeba histolytica. E histolytica is widely distributed throughout the tropics and subtropics, causing up to 40 million infections annually. The parasite is transmitted via the fecal-oral route, and once it establishes itself in the colon, it has the propensity to invade the mucosa, leading to ulceration and colitis, and to disseminate to distant extraintestinal sites, the most common of which is the liver. The authors provide a topical review of ALA and summarize clinical data from a series of 29 patients with ALA presenting to seven hospitals in Toronto, Ontario, a nonendemic setting, over 30 years.
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Affiliation(s)
- Terry Wuerz
- Department of Medicine, University of Manitoba, Winnipeg, Manitoba
| | | | - Andrea K Boggild
- Tropical Disease Unit, Division of Infectious Diseases, Toronto General Hospital-University Health Network
| | | | - Jay S Keystone
- Tropical Disease Unit, Division of Infectious Diseases, Toronto General Hospital-University Health Network
| | | | - Kevin C Kain
- Tropical Disease Unit, Division of Infectious Diseases, Toronto General Hospital-University Health Network
- Sandra A Rotman Laboratories, McLaughlin-Rotman Centre for Global Health, Toronto General Hospital-University Health Network
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Hung CC, Wu PY, Chang SY, Ji DD, Sun HY, Liu WC, Wu CH, Chang SC. Amebiasis among persons who sought voluntary counseling and testing for human immunodeficiency virus infection: a case-control study. Am J Trop Med Hyg 2011; 84:65-9. [PMID: 21212204 DOI: 10.4269/ajtmh.2011.10-0238] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
This case-control study aimed to characterize the factors associated with amebiasis, defined as presence of anti-Entamoeba histolytica antibody titers of ≧ 128 by indirect hemagglutination assay, among persons seeking voluntary counseling and testing (VCT) for human immunodeficiency virus (HIV) infection. Between April 2006 and September 2009, 57 of 4,802 persons (1.2%) seeking VCT services were seropositive for E. histolytica infection. Compared with 228 seronegative controls, case subjects were older (odds ratio [OR] for per 1-year increase, 1.098; 95% confidence interval [CI], 1.036, 1.165), less likely to hold bachelor degree or higher (OR, 0.359; 95% CI, 0.152, 0.846), and were more likely to be men who have sex with men (MSM) (OR, 8.382; 95% CI, 2.050, 34.266) and have oral-anal sex (OR, 4.016; 95% CI, 1.711, 9.427) in multiple logistic regression analysis. The MSM, fecal-oral contamination, lower educational achievement, and older age were associated with increased risk for amebiasis among persons seeking VCT for HIV infection.
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Affiliation(s)
- Chien-Ching Hung
- Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.
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Hosoe N, Kobayashi T, Kanai T, Bessho R, Takayama T, Inoue N, Imaeda H, Iwao Y, Kobayashi S, Mukai M, Ogata H, Hibi T. In vivo visualization of trophozoites in patients with amoebic colitis by using a newly developed endocytoscope. Gastrointest Endosc 2010; 72:643-6. [PMID: 20579647 DOI: 10.1016/j.gie.2010.04.031] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2010] [Accepted: 04/19/2010] [Indexed: 12/15/2022]
Abstract
BACKGROUND The endocytoscopy system (ECS) is a new method to provide real-time super-magnifying microscopic imaging in vivo. Routine diagnosis of amebic colitis requires multiple tests that are both time consuming and costly. OBJECTIVE To determine the feasibility of ECS to directly detect the amebic parasites in vivo. DESIGN Prospective, single-center, pilot study. SETTING Tertiary-care university hospital. PATIENTS This study involved 5 patients who were suspected to have amebic colitis by conventional colonoscopy in our institute. INTERVENTIONS A super-magnifying ECS with 450 x magnification. MAIN OUTCOME MEASUREMENTS We compared ECS findings with those of conventional methods-serum antibody tests and histology of colon biopsy specimens. RESULTS We successfully visualized the amebic trophozoites in all 5 cases. In contrast, 3 specimens had positive results on serology, and 3 had positive histology results on hematoxylin and eosin staining. LIMITATIONS Pilot study with a limited number of patients. Findings were compared only with serology and histology findings. CONCLUSIONS ECS would be a useful tool for the prompt diagnosis of amebic colitis via the real-time in vivo visualization of amebic trophozoites.
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Affiliation(s)
- Naoki Hosoe
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, School of Medicine, Keio University, Shinjuku, Tokyo, Japan
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Ximénez C, Morán P, Rojas L, Valadez A, Gómez A. Reassessment of the epidemiology of amebiasis: state of the art. INFECTION GENETICS AND EVOLUTION 2009; 9:1023-32. [PMID: 19540361 DOI: 10.1016/j.meegid.2009.06.008] [Citation(s) in RCA: 133] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/03/2009] [Revised: 05/25/2009] [Accepted: 06/08/2009] [Indexed: 10/20/2022]
Abstract
The epidemiology of amebiasis has dramatically changed since the separation of Entamoeba histolytica and Entamoeba dispar species, and the worldwide prevalence of these species has not been estimated until recently. The most cited data regarding prevalence, morbidity, or mortality due to amebiasis is the 1986 Walsh report, in which 100,000 deaths are reported to occur worldwide each year due to medical complications of invasive amebiasis. However, the prevalence values of Entamoeba histolytica infection could be completely erroneous since the estimations were performed prior to the molecular characterization of E. histolytica and E. dispar species. Moreover, Entamoeba moshkovskii, another morphologically indistinguishable human parasitic Entamoeba, was not mentioned or considered as a contributor to the prevalence figures in endemic areas. However, recent available prevalence and morbidity data obtained through molecular techniques allow the construction of a more reliable map of endemic regions of amebiasis all over the world [the Asian subcontinent (India, Bangladesh), Africa, Asian Pacific Countries (Thailand, Japan), South and Central America (Mexico, Colombia)]. The epidemiology of infectious diseases focuses on identification of factors that determine disease distribution in time and space, transmission factors responsible for the disease, clinical manifestations, and progression in the host, with the goal being the design of realistic intervention and prevention strategies in a reasonable period of time. In the present review, we will describe how molecular tools have made actual knowledge regarding the epidemiology of amebiasis possible. We will also analyze the most relevant available data on prevalence, morbidity, geographic distribution, patterns of transmission, exposure, and risk factors for infection in the human host. Our intention is to emphasize the recent molecular typing methods applied in genotyping Entamoeba species and strains, and to assess their value and limitations. Finally, we will discuss those areas of the host-parasite relationship that are still not fully understood, and the scientific challenges to approach this important public health problem in the future.
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Affiliation(s)
- Cecilia Ximénez
- Departamento de Medicina Experimental, Facultad de Medicina, Universidad Nacional Autónoma de México, México DF, Mexico.
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