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      PREVALENCE OF Entamoeba histolytica/Entamoeba dispar IN THE CITY OF CAMPINA GRANDE, IN NORTHEASTERN BRAZIL Translated title: Prevalência de Entamoeba histolytica/Entamoeba dispar na cidade de Campina Grande, Nordeste do Brasil

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          There is a clear need to perform epidemiological studies to find the true prevalence of Entamoeba histolytica around the world. The evaluation of this prevalence has been hindered by the existence of two different species which are morphologically identical, but genetically different, namely E. histolytica, which causes amebiasis, and E. dispar, which is non-pathogenic. In Brazil, the E. dispar has been detected in communities in the Southeastern (SE) and Northeastern (NE) regions with poor sanitation. However, individuals infected with E. histolytica have been identified in other regions. There is an absence of reports on the prevalence of these parasites in the state of Paraíba, which also has areas with poor sanitary conditions where a high prevalence of the E. histolytica/E. dispar complex has been detected in children from urban slums. The present study evaluated the prevalence of E. histolytica and E. dispar in 1,195 asymptomatic children between two and 10 years of age, living in a sprawling urban slum in Campina Grande, in the state of Paraíba, in Northeastern Brazil. These children were examined and their feces samples were analyzed microscopically. A total of 553 children tested positive for the E. histolytica/E. dispar complex, and 456 of the positive samples were tested with the E. histolytica II® ELISA kit. All 456 samples were negative for the presence of the adhesin E. histolytica specific antigen. The evidence suggests that in this community E. histolytica is absent and E. dispar is the dominant species.

          Translated abstract

          A prevalência mundial de Entamoeba histolytica não está bem estabelecida. Este fato deve-se à complicação derivada da existência de duas espécies morfologicamente idênticas, mas geneticamente diferentes: a E. histolytica que causa amebíases e a E. dispar descrita como não patogênica. No Brasil, em comunidades com precárias condições sanitárias e endêmicas para várias parasitoses, localizadas nas regiões Sudeste (SE) e Nordeste (NE), somente E. dispar tem sido encontrada, porém outras regiões, apresentam indivíduos infectados por E. histolytica. Na região agreste do Estado da Paraíba (NE) que apresenta as mesmas precárias condições sanitárias, não tem sido reportada prevalência específica destes parasitos, embora fosse encontrada alta prevalência do complexo E. dispar/E. histolytica em crianças em favela urbana. O presente estudo foi realizado em favela da cidade de Campina Grande, Estado da Paraíba, onde 1.195 crianças de dois a 10 anos sem sintomatologia foram examinadas. Amostras de fezes destas crianças foram analisadas microscopicamente, encontrando-se 553 positivas para o complexo E. dispar/E. histolytica. Do total de amostras positivas, 456 foram submetidas à pesquisa do antígeno especifico para E. histolytica pelo teste ELISA E. histolytica II®,obtendose resultado negativo para a presença do antígeno adesina específico de E. histolytica , em todas as amostras testadas. Os resultados sugerem que nesta comunidade não há infecção por E. histolytica , e que E. dispar é a espécie dominante na região.

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          Most cited references 60

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          Laboratory diagnostic techniques for Entamoeba species.

          The genus Entamoeba contains many species, six of which (Entamoeba histolytica, Entamoeba dispar, Entamoeba moshkovskii, Entamoeba polecki, Entamoeba coli, and Entamoeba hartmanni) reside in the human intestinal lumen. Entamoeba histolytica is the causative agent of amebiasis and is considered a leading parasitic cause of death worldwide in humans. Although recent studies highlight the recovery of E. dispar and E. moshkovskii from patients with gastrointestinal symptoms, there is still no convincing evidence of a causal link between the presence of these two species and the symptoms of the host. New approaches to the identification of E. histolytica are based on detection of E. histolytica-specific antigen and DNA in stool and other clinical samples. Several molecular diagnostic tests, including conventional and real-time PCR, have been developed for the detection and differentiation of E. histolytica, E. dispar, and E. moshkovskii in clinical samples. The purpose of this review is to discuss different methods that exist for the identification of E. histolytica, E. dispar, and E. moshkovskii which are available to the clinical diagnostic laboratory. To address the need for a specific diagnostic test for amebiasis, a substantial amount of work has been carried out over the last decade in different parts of the world. The molecular diagnostic tests are increasingly being used for both clinical and research purposes. In order to minimize undue treatment of individuals infected with other species of Entamoeba such as E. dispar and E. moshkovskii, efforts have been made for specific diagnosis of E. histolytica infection and not to treat based simply on the microscopic examination of Entamoeba species in the stool. The incorporation of many new technologies into the diagnostic laboratory will lead to a better understanding of the public health problem and measures to control the disease.
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            Reassessment of the epidemiology of amebiasis: state of the art.

            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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              A redescription of Entamoeba histolytica Schaudinn, 1903 (Emended Walker, 1911) separating it from Entamoeba dispar Brumpt, 1925.

               L Diamond,  C G Clark (2015)
              Explaining the low incidence of invasive disease (10%) in humans infected with Entamoeba histolytica has occupied the attention of generations of both clinical and nonclinical investigators. One possible explanation would be the existence of two morphologically identical species-one an invasive pathogen, the other noninvasive. This was first proposed by Brumpt in 1925, but his explanation was virtually ignored until 1978 when the first of several publications appeared suggesting that E. histolytica did indeed consist of two species. We have reexamined Brumpt's claim in light of recent biochemical, immunological and genetic studies and conclude that the data derived from these investigations provide unequivocal evidence supporting his hypothesis. With this in mind, we redescribe the invasive parasite retaining the name Entamoeba histolytica Schaudinn, 1903 (Emended Walker, 1911), and set it apart from the noninvasive parasite described by Brumpt, Entamoeba dispar Brumpt, 1925.

                Author and article information

                Rev Inst Med Trop Sao Paulo
                Rev. Inst. Med. Trop. Sao Paulo
                Revista do Instituto de Medicina Tropical de São Paulo
                Instituto de Medicina Tropical
                Sep-Oct 2014
                Sep-Oct 2014
                : 56
                : 5
                : 451-454
                [(1) ] Centro de Ciências Biológicas e da Saúde, Universidade Federal de Campina Grande, Paraíba, Brazil, Centro de Ciências Biológicas e da Saúde, Universidade Federal de Campina Grande, Paraíba, Brazil
                [(2) ] Laboratório de Imunopatologia Keizo Asami (LIKA), Universidade Federal de Pernambuco, Recife, Brazil, Laboratório de Imunopatologia Keizo Asami (LIKA), Universidade Federal de Pernambuco, Recife, Brazil
                Author notes
                Correspondence to: Elizabeth Malagueño, LIKA-Universidade Federal de Pernambuco, Recife, PE, Brasil. Comendador Bento Aguiar 84, Ilha do Retiro, 50720-705 Recife, PE, Brasil. E-mail: elimalagueno@ 123456hotmail.com

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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                Figures: 0, Tables: 0, References: 27, Pages: 4
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