Amoebiasis: Prevention, medicine, Symptoms & diagnosis:

This article will help you have a look at what amoebiasis its prevention,diagnosis,causes,complications & also answers some faq’s.  

Overview

Amoebiasis is a common infection of the human gastro-intestinal tract. Amoebiasis is more closely related to poor sanitation and socioeconomic status than to climate. It has worldwide distribution. It is a major health problem in China, South East and West Asia and Latin America, especially Mexico. Amoebiasis is a disease caused by the parasite Entamoeba histolytica. Only about 10% to 20% of people who are infected with E. histolytica become sick from the infection.

Amebiasis is also referred to as amoebic dysentery (a more severe instance of the infection), and refers to parasitic infection of the intestines. Additionally, despite its relatively less severity, it claims over 40,000 to 100,000 lives a year.

Some General Information about Amoebiasis:

Amoebiasis Pathogen : Entamoeba histolytica
Mode of transmission of Amoebiasis : Contaminated food and water
Symptoms of Amoebiasis :
(i) Formation of ulcers in intestine.
(ii) Feeling of abdominal pain and nausea.
(iii) Acute diarrhoea and mucus in stool.

Prevention and cure for Amoebiasis :
(i) Proper sanitation should be maintained.
(ii) Vegetables and fruits must be properly washed before eating.
(iii) Antibiotics may be given to the patients.

Causes of amoebiasis: 

Amoebiasis is caused by parasite Entamoeba histolytica. Several protozoan species in the genus Entamoeba colonize humans, but not all of them are associated with disease. It exists in two forms- Vegetative (trophozoite) and cystic forms (cyst). Trophozoites multiply and encyst in the colon. The cysts are excreted in stool and are infective to humans. Cysts remain viable and infective for several days in faeces, water, sewage and soil in the presence of moisture and low temperature.

● Infection in men

Generally, the risk of infection for men and women is one and the same as far as amebiasis is concerned. However, the impact it has can vary. More specifically, the infection rate of men with invasive amoebiasis is much more common in adult men than in women. Additionally, liver abscesses caused by the infection are seen in men 7-12 times more than in women. Finally, men are generally more susceptible to contracting invasive amoebiasis given their higher propensity to develop asymptomatic infections, which can result in a lack of timely medical intervention.

● Infection in Women

According to a study conducted that analysed females with genital amoebiasis, about 37% of patients were diagnosed with pain in the abdomen, about 8.1% displayed signs of ulcerative lesions and just about 2.8% were observed to go through weight loss.

 ● Infection in Babies

While the concern surrounding amoebiasis in adults is limited unless and until the patient develops severe symptoms, the infection in a baby can be more worrisome. However, it is worth noting that due to the sanitary conditions children spend their lives in, it is uncommon for children under the age of five to contract amoebiasis and even more so as far as amoebic dysentery is concerned. If children are displaying symptoms, however, they are often treated at home or with standard medication. However, if a child is displaying signs of more severe symptoms such as extensive vomiting, then a doctor should be consulted.

Transmission occurs via:

  1. · Faecal–oral route, either directly by person-to-person contact or indirectly by eating or drinking faecally contaminated food or water.
  2. · Sexual transmission by oral-rectal contact is also recognized especially among male homosexuals.
  3. · Vectors such as flies, cockroaches and rodents can also transmit the infection.

The incubation period for E histolytica infection is commonly 2-4 weeks but may range from a few days to years.The use of night soil for agricultural purposes favours the spread of the disease. Epidemic/ outbreaks (occurrence of more cases of a disease than would be expected in a community or region during a given time period) are usually associated with sewage seepage into the water supply.

 
Diagnosis of amoebiasis:

Entamoeba histolytica must be differentiated from other intestinal protozoa. Microscopic identification of cysts and trophozoites in the stool is the common method for diagnosing E. histolytica. Differentiation is based on morphologic characteristics of the cysts and trophozoites In addition, E. histolytica trophozoites can also be identified in aspirates or biopsy samples obtained during colonoscopy or surgery.

Immunodiagnosis (Antibody Detection)

a) Enzyme immunoassay (EIA) is most useful in patients with extra-intestinal disease (i.e., amoebic liver abscess) when organisms are not generally found on stool examination.
b) Indirect hemagglutination (IHA).

One instance that might cause your doctor to suspect the presence of amebiasis or amoebic dysentery is your recent travel history. Individuals are likely to contract amoebiasis if they travel to locations with low levels of hygiene. Your doctor might then test for E. histolytica, and in some instances run lab tests to determine if there is damage to the liver. Furthermore, doctors might also choose to test for lesions on the liver or cysts via a CT scan or ultrasound.

 

Complications of amoebiasis:

Complications of amoebic colitis include the following:

  1. · Fulminant or necrotizing colitis
  2. · Toxic megacolon
  3. · Amoeboma
  4. · Recto vaginal fistula
Complications of amoebic liver abscess include the following:

  1. · Intraperitoneal, intrathoracic, or intrapericardial rupture, with or without secondary bacterial infection
  2. · Direct extension to pleura or pericardium
  3. · Dissemination and formation of brain abscess
Other complications due to amoebiasis include the following:

  1. · Bowel perforation
  2. · Gastrointestinal bleeding
  3. · Stricture formation
  4. · Intussusception
  5. · Peritonitis
  6. · Empyema

Treatment :

In most cases, you are likely to visit your local doctor, or general physician if you suspect that you have contracted amoebic dysentery; and in most mild cases, this visit would suffice to diagnose and treat your condition. In some cases, however, more specialised medical personnel might be required. A gastroenterologist, or more colloquially known as a “G.I doctor” specializes in problems through the digestive system. Additionally, in some cases, an infectious disease specialist might be required. Given that most cases of amoebiasis present little to no symptoms, upon diagnosis, the treatment generally consists of a 10-day course of Flagyl in capsule form. In severe cases, if the peritoneal tissue or colon has developed perforations, surgery might have to be considered as an option. If this is a case, a general surgeon might also need to be consulted.

Conclusion:

Amoebiasis and amoebic dysentery are common occurrences in areas of low hygiene. However, skipping vital hygiene routines could significantly increase the chances of contracting amoebiasis, even in otherwise sanitary conditions. While a majority of individuals diagnosed with amoebiasis are asymptomatic or have mild symptoms, it is essential to visit a doctor if you begin noticing even mild symptoms. While there are steps that you can take to reduce the chances of contracting the disease, one cannot guarantee prevention. In the event that you do contract amoebiasis (or any other disease/illness for that matter), one must have the resources to be able to get the treatment they require. Hence, it is advisable to purchase health insurance to avoid financial strain in case of medical emergencies.

Author: Hi there, my name is Subin Joshua, and I am a Medical student. I grew up in a family of teachers and know that being a social worker is my calling. My passion for helping others has been evident in my involvement in helping the poor and needy for the last three years. Through those experiences, I have learned to interact with a diverse group of people, which has increased my ability to relate to others.

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