1.Public health and clinical importance of amoebiasis in Malaysia: A review
Tropical Biomedicine 2011;28(2):194-222
Entamoeba histolytica, the causative agent of human amoebiasis remains a
significant cause of morbidity and mortality in developing countries and is responsible for up
to 100,000 deaths worldwide each year. Entamoeba dispar, morphologically indistinguishable
from E. histolytica is more common in humans in many parts of the world. Similarly Entamoeba
moshkovskii, which was long considered to be a free-living amoeba is also morphologically
identical to E. histolytica and E. dispar, and is highly prevalent in some E. histolytica endemic
countries. Humans are the host of infection and there would not appear to be other meaningful
animal reservoirs of E. histolytica. Entamoeba. histolytica can be present in sewage and
contaminated water. The infection is mainly transmitted via ingestion of water or food
contaminated by faeces containing E. histolytica cysts. Clinical features of amoebiasis range
from asymptomatic colonization to amoebic dysentery and invasive extraintestinal amoebiasis,
which is manifested most commonly in the form of abscesses in liver and lungs. The
epidemiology of amoebiasis has dramatically changed since the separation of E. histolytica
and E. dispar species and the worldwide prevalence of these species has not been estimated
until recently. Morever, E. moshkovskii, another morphologically indistinguishable human
parasitic Entamoeba was not mentioned or considered as a contributor to the prevalence
figures in endemic areas. Amoebiasis is still a major health problem especially in aboriginal
settlements and amongst people living in remote area in Malaysia. However, until now there
is only one data currently available to indicate the true prevalence and incidence of E.
histolytica and E. dispar. Further studies are needed to determine the burden of E. histolytica,
E. dispar and E. moshkovskii infections in Malaysia. In the present review, we briefly summarize
all methods use in diagnosing Entamoeba species, ranging from microscopic identification to
molecular detection such as culture and isoenzyme analysis, antibody detection tests, antigen
detection tests, immunochromatographic assays, conventional PCR, real-time PCR and loopmediated
isothermal amplification (LAMP).