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To B, Chai N, Fitzpatrick C, Richardson D. Factors associated with Cryptosporidium in men who have sex with men: A systematic review. Int J STD AIDS 2024; 35:668-674. [PMID: 38671340 DOI: 10.1177/09564624241249203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/28/2024]
Abstract
BACKGROUND Cryptosporidium parasites are an important cause of diarrhoea globally and sexual transmission may occur in men who have sex with men (MSM). We aimed to systematically review the literature to explore any factors associated with transmission of Cryptosporidium in MSM to provide insight for future guidelines and public health strategies. METHODS We searched MEDLINE, Embase, CINAHL and Web of Science for manuscripts published up to July 2023. A primary author conducted an initial screen of abstracts and full text eligibility, and risk of bias was assessed independently by two authors using the Joanna Briggs Institute critical appraisal tools. We used the nine-point synthesis without meta-analysis method to synthesise narrative data. The review was registered on PROSPERO (CRD42023374279). RESULTS Six manuscripts were included in the final review from the USA (n = 3), Europe (n = 1) and Australia (n = 2) and were case series (n = 2), cross sectional (n = 2) and case control studies (n = 2) published between 1984 and 2021 and overall there were 1582 cases of Cryptosporidium in MSM. We identified demographic factors (living with HIV, younger age [<30 years old], geographical areas [Southern Europe v Northern Europe], previous Treponema pallidum, previous Entamoeba histolytica) and behavioural factors (recreational drug use, higher number of sexual partners and MSM attending sex on premises venues with spa/sauna) associated with Cryptosporidium in MSM. CONCLUSIONS Despite a small number of manuscripts in this review, we identified demographic and behavioural factors associated with Cryptosporidium in MSM. These data will provide insight for public health interventions for future outbreaks of Cryptosporidium in MSM.
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Affiliation(s)
- Benjaman To
- University Hospitals Sussex NHS Foundation Trust, Brighton, United Kingdom of Great Britain and Northern Ireland
| | - Ningyu Chai
- University Hospitals Sussex NHS Foundation Trust, Brighton, United Kingdom of Great Britain and Northern Ireland
| | - Colin Fitzpatrick
- University Hospitals Sussex NHS Foundation Trust, Brighton, United Kingdom of Great Britain and Northern Ireland
| | - Daniel Richardson
- University Hospitals Sussex NHS Foundation Trust, Brighton, United Kingdom of Great Britain and Northern Ireland
- Brighton and Sussex Medical School
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2
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Guillén N. Pathogenicity and virulence of Entamoeba histolytica, the agent of amoebiasis. Virulence 2023; 14:2158656. [PMID: 36519347 DOI: 10.1080/21505594.2022.2158656] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 12/11/2022] [Indexed: 12/23/2022] Open
Abstract
The amoeba parasite Entamoeba histolytica is the causative agent of human amebiasis, an enteropathic disease affecting millions of people worldwide. This ancient protozoan is an elementary example of how parasites evolve with humans, e.g. taking advantage of multiple mechanisms to evade immune responses, interacting with microbiota for nutritional and protective needs, utilizing host resources for growth, division, and encystation. These skills of E. histolytica perpetuate the species and incidence of infection. However, in 10% of infected cases, the parasite turns into a pathogen; the host-parasite equilibrium is then disorganized, and the simple lifecycle based on two cell forms, trophozoites and cysts, becomes unbalanced. Trophozoites acquire a virulent phenotype which, when non-controlled, leads to intestinal invasion with the onset of amoebiasis symptoms. Virulent E. histolytica must cross mucus, epithelium, connective tissue and possibly blood. This highly mobile parasite faces various stresses and a powerful host immune response, with oxidative stress being a challenge for its survival. New emerging research avenues and omics technologies target gene regulation to determine human or parasitic factors activated upon infection, their role in virulence activation, and in pathogenesis; this research bears in mind that E. histolytica is a resident of the complex intestinal ecosystem. The goal is to eradicate amoebiasis from the planet, but the parasitic life of E. histolytica is ancient and complex and will likely continue to evolve with humans. Advances in these topics are summarized here.
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Affiliation(s)
- Nancy Guillén
- Cell Biology and Infection Department, Institut Pasteur and Centre National de la Recherche Scientifique CNRS-ERM9195, Paris, France
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3
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Griemert T, Siegel E, Brandstetter M, Straub BK, Kreft A, Galle PR, Sprinzl MF. Entamoeba histolytica-associated proctitis and ileitis mimicking Crohn's disease-A case report. Clin Case Rep 2023; 11:e6833. [PMID: 37220511 PMCID: PMC10199808 DOI: 10.1002/ccr3.6833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 09/28/2022] [Accepted: 12/05/2022] [Indexed: 05/25/2023] Open
Abstract
We report about a proctitis and ileitis terminalis, leading to the misdiagnosis of Chron's disease, in a male patient who has sex with men. Molecular multiplex analysis identified Entamoeba histolytica as the underlying cause. We provide diagnostic images, clues and pitfalls for diagnosis of E. histolytica associated proctitis.
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Affiliation(s)
- Thomas Griemert
- Department of Internal Medicine IUniversity Medical Center of the Johannes Gutenberg UniversityMainzGermany
| | - Ekkehard Siegel
- Institute of MicrobiologyUniversity Medical Center of the Johannes Gutenberg UniversityMainzGermany
| | - Moritz Brandstetter
- Institute of MicrobiologyUniversity Medical Center of the Johannes Gutenberg UniversityMainzGermany
| | - Beate K. Straub
- Institute of PathologyUniversity Medical Center of the Johannes Gutenberg UniversityMainzGermany
| | - Andreas Kreft
- Institute of PathologyUniversity Medical Center of the Johannes Gutenberg UniversityMainzGermany
| | - Peter R. Galle
- Department of Internal Medicine IUniversity Medical Center of the Johannes Gutenberg UniversityMainzGermany
| | - Martin F. Sprinzl
- Department of Internal Medicine IUniversity Medical Center of the Johannes Gutenberg UniversityMainzGermany
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Interleukin 10 (IL-10) Production and Seroprevalence of Entamoeba histolytica Infection among HIV-Infected Patients in South Africa. Pathogens 2022; 12:pathogens12010019. [PMID: 36678367 PMCID: PMC9866282 DOI: 10.3390/pathogens12010019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 12/16/2022] [Accepted: 12/17/2022] [Indexed: 12/24/2022] Open
Abstract
Infections by the parasite E. histolytica are increasing in HIV-infected individuals. Interleukin (IL-10) plays an important role in maintaining the mucosal barrier. Therefore, the seroprevalence of E. histolytica was investigated in relation to the IL-10 serum concentration among HIV- infected patients. A total of 647 blood samples were collected from asymptomatic HIV-infected patients. The Entamoeba histolytica antigen (GALNAC lectin) and serum antibodies were assessed using specific ELISAs (TECHLAB, Virginia, USA). IL10 blood levels were measured using a commercial ELISA test, and the results were analyzed using parametric and non-parametric statistical tests. The Gal/GALNAC lectin was detected in only 0.5% (3/647) of individuals, and the antibodies against E. histolytica were detected in 65.2% (422/647) of the samples. A significant increase in IL-10 levels was found in 68.1% of patients who were sero-negative for E. histolytica antibodies compared to patients who were sero-positive. There is a high level of exposure to E. histolytica among HIV patients in South Africa, although the prevalence of amoebic liver abscesses might be low. This study revealed that elevated levels of IL-10 might be associated with a reduced risk of amebiasis.
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Zhao W, Yao L, Zhuang M, Lin YL, Chen XH, Wang L, Song B, Zhao YS, Xiao Y, Zhang FM, Wang FX, Ling H. A baseline epidemiological study of the co-infection of enteric protozoans with human immunodeficiency virus among men who have sex with men from Northeast China. PLoS Negl Trop Dis 2022; 16:e0010712. [PMID: 36067140 PMCID: PMC9447920 DOI: 10.1371/journal.pntd.0010712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 08/01/2022] [Indexed: 12/04/2022] Open
Abstract
Background Human immunodeficiency virus (HIV) and enteric parasite co-infection not only aggravates the clinical symptoms of parasites but also accelerates acquired immunodeficiency syndrome (AIDS) progression. However, co-infection research on men who have sex with men (MSM), the predominant high-risk population of HIV/AIDS in China, is still limited. In this study, we investigated the epidemiology of enteric parasites, risk factors, and associations with clinical significance in an MSM HIV/AIDS population in Heilongjiang Province, northeast China. Methods We recruited 308 MSMs HIV/AIDS patients and 199 HIV-negative individuals in two designated AIDS hospitals in Heilongjiang between April 2016 and July 2017. Fresh stool samples were collected. DNA extraction, molecular identification, and genotyping of Cryptosporidium species, Entamoeba histolytica, Cyclospora cayetanensis, Enterocytozoon bieneusi, and Blastocystis hominis were performed. Fourteen diarrhea-related pathogens were examined to exclude the influence of other bacterial pathogens on diarrhea incidence. Results 31.5% of MSM HIV/AIDS participants were infected with at least one parasite species, a significantly higher proportion than that found in the HIV-negative individuals (2.5%). E. bieneusi presented the highest prevalence, followed by B. hominis, E. histolytica, Cryptosporidium spp., and C. cayetanensis. Warm seasons were the risk factor for parasitic infections in this population [odds ratio (OR) = 2.6, 95% CI: 1.47–4.57]. In addition, these individuals showed a higher proportion (35.8%) of present diarrhea (PD) compared with men who have sex with women (MSW) with HIV/AIDS (16.7%). The infection proportions of both Cryptosporidium spp. and E. histolytica were significantly higher in the PD. E. bieneusi infection was more prevalent in the historic diarrhea (HD) group. CD4+ T cell counts in the MSM patients with the above three parasites were significantly lower. New species and genotypes were found, and MSM patients had a wider range of species or genotypes. Conclusions Enteric parasitic infection was prevalent in the MSM HIV/AIDS population, especially in patients with present diarrhea during warm seasons. E. histolytica and B. hominis should also be considered high-risk parasites for opportunistic infections in AIDS patients in addition to Cryptosporidium spp. Human immunodeficiency virus (HIV) and enteric parasite co-infection not only aggravates the clinical symptoms of parasites but also accelerates acquired immunodeficiency syndrome (AIDS) progression. In China, despite a large number of HIV-infected people, the data regarding co-infection with enteric intracellular parasites in this population is still sparse. In the present study, we investigated the epidemiology of Cryptosporidium spp., Enterocytozoon bieneusi, Blastocystis hominis, Entamoeba histolytica and Cyclospora cayetanensis in 384 HIV/AIDS including 308 MSM HIV/AIDS populations in two designated AIDS hospitals in Heilongjiang Province, North-East China between April 2016 and July 2017 by polymerase chain reaction. We also try to track the possible sources, risk factors, and any associations, with clinical significance, of human parasitic infections. Such knowledge will provide insights into prognosis, treatment, and preventive strategies against infections with such pathogens. The findings in this study have important implications for public health, the control of AIDS progression and control of parasitic infections.
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Affiliation(s)
- Wei Zhao
- Department of Microbiology, School of Basic Medicine, Wu Lien-Teh Institute, Harbin Medical University, Heilongjiang Provincial Key Laboratory of Infection and Immunity, Key Laboratory of Pathogen Biology, Harbin, China
- Department of Parasitology, School of Basic Medicine, Wenzhou Medical University, Wenzhou, China
| | - Lan Yao
- Department of Parasitology, School of Basic Medicine, Harbin Medical University, Harbin, China
| | - Min Zhuang
- Department of Microbiology, School of Basic Medicine, Wu Lien-Teh Institute, Harbin Medical University, Heilongjiang Provincial Key Laboratory of Infection and Immunity, Key Laboratory of Pathogen Biology, Harbin, China
| | - Yuan-Long Lin
- Shenzhen Key Laboratory of Pathogen and Immunity, National Clinical Research Center for Infectious Disease, State Key Discipline of Infectious Disease, Shenzhen Third People’s Hospital, Second Hospital Affiliated to Southern University of Science and Technology, Shenzhen, China
| | - Xiao-Hong Chen
- Department of Infectious Diseases, Fourth Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Li Wang
- The Heilongjiang province hospital, Harbin, China
| | - Bo Song
- Department of Infectious Diseases, Fourth Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Ya-Shuang Zhao
- Department of Epidemiology, Public Health College, Harbin Medical University, Harbin, China
| | - Yun Xiao
- College of Bioinformatics Science and Technology, Harbin Medical University, Harbin, China
| | - Feng-Min Zhang
- Department of Microbiology, School of Basic Medicine, Wu Lien-Teh Institute, Harbin Medical University, Heilongjiang Provincial Key Laboratory of Infection and Immunity, Key Laboratory of Pathogen Biology, Harbin, China
| | - Fu-Xiang Wang
- Shenzhen Key Laboratory of Pathogen and Immunity, National Clinical Research Center for Infectious Disease, State Key Discipline of Infectious Disease, Shenzhen Third People’s Hospital, Second Hospital Affiliated to Southern University of Science and Technology, Shenzhen, China
- * E-mail: (FXW); (HL)
| | - Hong Ling
- Department of Microbiology, School of Basic Medicine, Wu Lien-Teh Institute, Harbin Medical University, Heilongjiang Provincial Key Laboratory of Infection and Immunity, Key Laboratory of Pathogen Biology, Harbin, China
- Department of Parasitology, School of Basic Medicine, Harbin Medical University, Harbin, China
- * E-mail: (FXW); (HL)
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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: 12] [Impact Index Per Article: 6.0] [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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7
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Abstract
Although rare in the developed world, amebiasis continues to be a leading cause of diarrhea and illness in developing nations with crowding, poor sanitation, and lack of clean water supply. Recent immigrants or travelers returning from endemic regions after a prolonged stay are at high risk of developing amebiasis. A high index of suspicion for amebiasis should be maintained for other high-risk groups like men having sex with men, people with AIDS/HIV, immunocompromised hosts, residents of mental health facility or group homes. Clinical presentation of intestinal amebiasis varies from diarrhea to colitis and dysentery. Amebic liver abscess (ALA) is the most common form of extraintestinal amebiasis. Various diagnostic tools are available and when amebiasis is suspected, a combination of stool tests and serology should be sent to maximize the yield of testing. Treatment with an amebicidal drug such as metronidazole/tinidazole and a luminal cysticidal agent such as paromomycin for clinical disease is indicated. However, for asymptomatic disease treatment with a luminal cysticidal agent to decrease chances of invasive disease and transmission is recommended.
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Affiliation(s)
- Shipra Gupta
- West Virginia University School of Medicine, One Medical Center Drive, HSC 9214, Morgantown, WV 26506, USA.
| | - Layne Smith
- West Virginia University School of Pharmacy, One Medical Center Drive, Morgantown, WV-26506, USA
| | - Adriana Diakiw
- West Virginia University School of Medicine, One Medical Center Drive, HSC 9214, Morgantown, WV 26506, USA
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8
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Uribe-Querol E, Rosales C. Immune Response to the Enteric Parasite Entamoeba histolytica. Physiology (Bethesda) 2021; 35:244-260. [PMID: 32490746 DOI: 10.1152/physiol.00038.2019] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Entamoeba histolytica is a protozoan parasite responsible for amoebiasis, a disease with a high prevalence in developing countries. Establishing an amoebic infection involves interplay between pathogenic factors for invasion and tissue damage, and immune responses for protecting the host. Here, we review the pathogenicity of E. histolytica and summarize the latest knowledge on immune response and immune evasion mechanisms during amoebiasis.
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Affiliation(s)
- Eileen Uribe-Querol
- División de Estudios de Posgrado e Investigación, Facultad de Odontología, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - Carlos Rosales
- Departamento de Inmunología, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Mexico City, Mexico
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9
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Madden GR, Shirley DA, Townsend G, Moonah S. Case Report: Lower Gastrointestinal Bleeding due to Entamoeba histolytica Detected Early by Multiplex PCR: Case Report and Review of the Laboratory Diagnosis of Amebiasis. Am J Trop Med Hyg 2020; 101:1380-1383. [PMID: 31674299 DOI: 10.4269/ajtmh.19-0237] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
We report a case of Entamoeba histolytica infection in a young man who presented with cerebral infarction and shortly after admission developed bloody diarrhea with fever. A rapid diagnosis of severe E. histolytica colitis was established through the use of a multiplex polymerase chain reaction enteropathogen stool panel. This result was unexpected in a patient native to the United States without known risk factors for amebiasis and negative stool microscopy examination for ova and parasites. Rapid diagnosis allowed prompt initiation of appropriate anti-amebic therapy and ultimately a good outcome in a condition that otherwise carries high morbidity and fatality.
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Affiliation(s)
- Gregory R Madden
- Division of Infectious Diseases and International Health, Department of Medicine, University of Virginia Health System, Charlottesville, Virginia
| | - Debbie-Ann Shirley
- Division of Pediatric Infectious Diseases, Department of Pediatrics, University of Virginia, Charlottesville, Virginia
| | - Gregory Townsend
- Division of Infectious Diseases and International Health, Department of Medicine, University of Virginia Health System, Charlottesville, Virginia
| | - Shannon Moonah
- Division of Infectious Diseases and International Health, Department of Medicine, University of Virginia Health System, Charlottesville, Virginia
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Shirley DAT, Watanabe K, Moonah S. Significance of amebiasis: 10 reasons why neglecting amebiasis might come back to bite us in the gut. PLoS Negl Trop Dis 2019; 13:e0007744. [PMID: 31725715 PMCID: PMC6855409 DOI: 10.1371/journal.pntd.0007744] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Affiliation(s)
- Debbie-Ann T. Shirley
- Department of Pediatrics, University of Virginia School of Medicine, Charlottesville, Virginia, United States of America
| | - 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, United States of America
- * E-mail:
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11
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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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12
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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: 182] [Impact Index Per Article: 30.3] [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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13
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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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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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15
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Narayan S, Galanis E. Are enteric infections sexually transmitted in British Columbia? CANADA COMMUNICABLE DISEASE REPORT = RELEVE DES MALADIES TRANSMISSIBLES AU CANADA 2016; 42:24-29. [PMID: 29770000 PMCID: PMC5864255 DOI: 10.14745/ccdr.v42i02a01] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
BACKGROUND Enteric infections may on occasion be sexually transmitted, particularly among people who engage in oral-anal sexual contact. Although outbreaks of enteric infections have been reported among men who have sex with men (MSM) in British Columbia (BC), the epidemiology of sexually transmitted enteric infections has never been assessed. OBJECTIVE To describe the epidemiology of enteric infections in BC to determine if sexual transmission may be occurring. METHODS A descriptive analysis was conducted of all reported cases of shigellosis, amebiasis and giardiasis in BC for the period 2003-2012. RESULTS For shigellosis and amebiasis, there was a high male-to-female ratio and a higher rate of infection in males aged 20-59 years as compared to all other age-sex groups. Additionally, for shigellosis, adult males were significantly more likely than females to acquire disease locally (RR 1.9; CI 1.7--.4). CONCLUSION Analysis suggests that sexual transmission of enteric infections, particularly shigellosis and amebiasis, may be occurring in MSM in BC. Further studies are indicated.
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Affiliation(s)
- S Narayan
- Simon Fraser University, Burnaby, BC
| | - E Galanis
- BC Centre for Disease Control, Vancouver, BC
| | - BC STEI Group
- BC STEI group membership: Forsting S, Hoang L, Jeyes J, Nowakowski C6, Ritson M4, Stone J, Tone G
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16
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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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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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