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 Table of Contents  
LETTERS TO EDITOR
Year : 2016  |  Volume : 5  |  Issue : 1  |  Page : 64-66

Seroprevalance of extra-intestinal amoebiasis in a Tertiary Health Care Center located in Central India


1 Department of Microbiology, Sri Aurobindo Institute of Medical Sciences Medical College and PG Institute, Indore, Madhya Pradesh, India
2 Department of Medicine, White Crescent Diagnostic Center, Indore, Madhya Pradesh, India

Date of Web Publication13-Jan-2016

Correspondence Address:
Trupti Bajpai
Asst. Prof. Department of Microbiology, Sri Aurobindo Institute of Medical Sciences and Post Graduate Institute, Sri Aurobindo Medical College and Post Graduate Institute, Indore - Ujjain Highway, MR 10 Crossing, Indore, Madhya Pradesh
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2278-344X.173885

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How to cite this article:
Gorie N, Bhatambare GS, Bajpai T, Khan Z. Seroprevalance of extra-intestinal amoebiasis in a Tertiary Health Care Center located in Central India. Int J Health Allied Sci 2016;5:64-6

How to cite this URL:
Gorie N, Bhatambare GS, Bajpai T, Khan Z. Seroprevalance of extra-intestinal amoebiasis in a Tertiary Health Care Center located in Central India. Int J Health Allied Sci [serial online] 2016 [cited 2019 Sep 21];5:64-6. Available from: http://www.ijhas.in/text.asp?2016/5/1/64/173885

Sir,

Amoebiasis is a disease caused by the protozoan Entamoeba histolytica. Most infections are asymptomatic; clinical manifestations include amoebic dysentery and extraintestinal disease. Worldwide, approximately 40–50 million people develop colitis or extraintestinal disease annually with 40,000 deaths. Amoebic liver abscess is the most common extraintestinal manifestation of amoebiasis.[1] Serological tests are useful in detecting infection by E. histolytica, if the organism goes extraintestinal. These tests demonstrate the presence of anti-amoebic antibodies in serum and are found to be positive for most patients with amoebic liver abscess. The present prospective study was designed to see the prevalence of amoebic liver abscess with respect to age and sex distribution, clinical signs and symptoms, and anti-amoebic antibody titer level by ELISA test. It was conducted in the Department of Microbiology of a Teaching Tertiary Care Centre. During the study, 97 cases of liver abscess were processed for antibody detection by ELISA. It was performed by using the commercially available kit DRG E. histolytica IgG (Amoebiasis) International Inc., USA. The test was performed in accordance with the manufacturer's instructions.[2] Patients included in this study were clinically diagnosed as amoebic liver abscess and findings were already confirmed by ultrasonography.

Of 97 cases, 75 (77.31%) were positive and 22 (22.9%) were negative for anti-amoebic antibody. Our results were much similar to study conducted in Northern India (that reported prevalence from 57.14% to 87.93% over a period of 12 years), but it was much higher than those reported in Eastern India (27%).[3],[4],[5] Clinical features such as pain in right hypochondrium, fever, chills, malaise, dyspnea, diarrhea, cough, tenderness, and hepatomegaly that are usually followed by anorexia and weight loss were the most common features suggestive of amoebic liver abscess, observed in this study [Table 1]. In this study, patient's history and physical examination revealed that fever, right upper abdominal pain, and hepatomegaly were present in 72 (96%) cases. Findings of ultrasonography suggestive of liver abscess were also correlated with our results. The most prominent feature was the involvement of right lobe of the liver that was found in 62 (80%) of cases [Figure 1] and [Table 2]. More or less these findings corelate with other studies from various countries. Our study revealed that male patients were found to be more susceptible than females that were similar to the studies from East Asian countries.[6],[7] Amoebic liver abscess had occurred in all age groups, but the prevalence was higher in the age group between 20 and 45 years, which is similar to study conducted in Asian countries [Table 3].[6],[7],[8],[9]
Table 1: The percentage of clinical sign and symptoms

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Figure 1: The percentage of involvement of lobe

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Table 2: Percentage of patients with different liver lobes affected

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Table 3: The distribution of samples according to the age and sex

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According to the observation and results of this study, we conclude that ELISA is reliable, economic and easily performed diagnostic tool that can be recommended for serodiagnosis of amoebic liver abscess. However, a drawback of serologic tests that detect antibodies against total amoebic antigens is that individuals in areas of endemicity can remain positive for years after infection. Focus on improved sanitation, personal hygiene, safe disposal of human excreta, protection of water supplies from fecal pollution, detection and proper treatment of carriers can help in prevention and reduction of amoebiasis in the community.

Acknowledgment

The authors wish to thank the Chairperson and Dean of the institute for providing laboratory facilities and healthy working atmosphere during the study period. The authors are also thankful to the technical staff of the institute for providing necessary helping hand during the endeavor.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

 
  References Top

1.
Ali IK, Clark CG, Petri WA Jr. Molecular epidemiology of amebiasis. Infect Genet Evol 2008;8:698-707.  Back to cited text no. 1
    
2.
Healy GR. Immunologic tools in the diagnosis of amebiasis: Epidemiology in the United States. Rev Infect Dis 1986;8:239-46.  Back to cited text no. 2
    
3.
Choudhuri G, Prakash V, Kumar A, Shahi SK, Sharma M. Protective immunity to Entamoeba histolytica infection in subjects with antiamoebic antibodies residing in a hyperendemic zone. Scand J Infect Dis 1991;23:771-6.  Back to cited text no. 3
    
4.
Haque R, Mollah NU, Ali IK, Alam K, Eubanks A, Lyerly D, et al. Diagnosis of amebic liver abscess and intestinal infection with the TechLab Entamoeba histolytica II antigen detection and antibody tests. J Clin Microbiol 2000;38:3235-9.  Back to cited text no. 4
    
5.
Lal M, Berry V, Swahney R, Kaur R, Singh G. Prevalence of IgG antibodies to amoebiasis in patients attending a tertiary care hospital in Punjab. J Adv Res Biol Sci 2011;3:77-9.  Back to cited text no. 5
    
6.
Chuah SK, Chang-Chien CS, Sheen IS, Lin HH, Chiou SS, Chiu CT, et al. The prognostic factors of severe amebic liver abscess: A retrospective study of 125 cases. Am J Trop Med Hyg 1992;46:398-402.  Back to cited text no. 6
    
7.
Ohnishi K, Murata M. Present characteristics of symptomatic amebiasis due to Entamoeba histolytica in the east-southeast area of Tokyo. Epidemiol Infect 1997;119:363-7.  Back to cited text no. 7
    
8.
Mahdi NK, al-Obaidi F, Benyan AZ. Hepatic abscess among Iraqi patients. J Pak Med Assoc 1989;39:259-62.  Back to cited text no. 8
    
9.
Shaikh Z, Khan MH, Qamar R. Clinical profile of 100 cases of liver abscess. J Pak Med Assoc 1989;39:256-9.  Back to cited text no. 9
    


    Figures

  [Figure 1]
 
 
    Tables

  [Table 1], [Table 2], [Table 3]



 

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