African Journal of Biotechnology Vol. 10(54), pp. 11214-11216, 12 September, 2011 Available online at http://www.academicjournals.

org/AJB ISSN 16845315 2011 Academic Journals

Short Communication.

Prevalence of amoebiasis in Gadap Town, Karachi

S.M.Ali Shah1, Nadia Shamshad Malik2, Asim Awan3, Muneeb Ahmad Idrees4, M. Akram3, H.M. Asif1 and Shahzad Nawaz1
Faculty of Pharmacy and Alternative Medicine, The Islamia University of Bahawalpur. School of Pharmacy, The University of Lahore, Islamabad Campus, Islamabad, Pakistan. 3 Faculty of Eastern Medicine, Hamdard University, Karachi, Pakistan. 4 Department of Pharmaceutical Sciences, COMSATS Institute of Information Technology, Abbottabad, Pakistan.
2 1

Accepted 3 June, 2011

Amoebiasis is a common health problem and is prevalent in poor hygienic areas. Amoebiasis cases are most commonly found in rural areas due to poor water supply and lack of education. Amoebiasis is an infection caused by Entamoeba histolytica. In resource-rich nations, this parasitic protozoan is seen primarily in travelers and emigrants from endemic areas. Infections range from asymptomatic colonization to amoebic colitis and life-threatening abscesses. The aim of this study was to investigate the prevalence of amoebiasis in Gadap Town. Stool samples of 400 children were examined by direct microscopy, formalin ethyl acetate concentration, trichrome staining and culture. The patients living in the Gadap Town adjacent Madinat-al-Hikmah, Hamdard University, were enrolled in Shifa-ul-Mulk Memorial Hospital, Karachi. Overall, 16% of apparently asymptomatic patients were with amoebiasis and the prevalence was 12% in men and 4% in women. When analyzed according to age, the prevalence rate of amoebiasis increased with the increase of age. In conclusion, high prevalence of amoebiasis warrants further studies to identify the environmental risk factors. The results demonstrated the significance of amoebiasis as a public health problem among people with low socio-economic status in Gadap Town. Key words: Amoebiasis, Pakistan, Entamoeba histolytica. INTRODUCTION Amoebiasis is a type of gastroenteritis caused by a protozoan parasite, Entamoeba histolytica, which infects the bowel and resident in the large bowel; amoebae occasionally penetrate the intestinal mucosa and may disseminate to other organs. The factors that trigger invasion are unknown. Amoebiasis can affect anyone; however, the disease mostly occurs in young to middle age adults. Amoebiasis is generally associated with people living in areas of poor sanitation and is a common cause of diarrhea among travelers of developing countries (Guerrant et al., 1990). It has a very high incidence in tropical countries like Pakistan, India, Mexico, Central and South America. About 90% of infections are asymptomatic (do not produce any symptoms) and the remaining 10% produces a spectrum varying from dysentery to amoebic liver abscess (Trivediv et al., 1978). The most common symptoms of amoebiasis are diarrhea (which may contain blood), stomach cramps and fever. Rarely, amoebiasis can cause an abscess (infection) in the liver. After infection, it may take a few days, several months or even years before the person become ill but it is usually about two or four weeks. To trace the cause of the illness, it is necessary to know what have been eaten and drank and where has been traveled to in the weeks before the illness. E. histolytica parasites are only found in humans. Amoebiasis occurs when E. histolytica parasites are taken in through the mouth and the most common way this happens is by person-to-person spread (Shoba et al., 2001). There are a large number of species of amoebae which parasite the human intestinal tract, of these E. histolytica is the only species found to be associated with intestinal disease. Although many people harbor this organism worldwide, only about 10% develop clinically invasive disease, thus the parasite has been shown to

*Corresponding author. E-mail: makram_0451@hotmail.com. Tel: 92-021-6440083. Fax: 92-021-6440079.

Shah et al.

11215

60.00% 50.00% 40.00% 30.00% 20.00% 10.00% 0.00%

Prevalence (%)

Multan

Gadap Town

Fertilizer Company Hospital Pakistan

Figure 1. Prevalence rate of amoebiasis in previous studies and the present study

present two very different clinical presentations. Laboratory diagnosis is made on finding the characteristic cysts in a wet preparation or a permanent stained preparation (Kloos et al., 1977. Chaturvedi et al, 1983). Microscopic examination for identifying demonstrable E. histolytica cysts or trophozoites in stool samples is the most confirmative method of diagnosis. Trophozoites survive only for a few hours, so the diagnosis mostly goes with the presence of cysts. But fresh warm faeces always show trophozoites. The cysts are identified by their spherical nature with chromatin bars and nucleus. They are noticed as brownish eggs when stained with iodine.
MATERIALS AND METHODS Stool specimens from 400 individuals between the age of 5 and 16 years attending O.P.D for different disease treatments were examined for the presence of intestinal parasites. Age eligible for study was 5 to 16 years and gender eligible for study was both male and female, with inclusion and exclusion criteria. Informed consent from the patients was taken. The patients living in the Gadap Town adjacent Madinat-al-Hikmah, Hamdard University, in Shifa-ul-Mulk Memorial Hospital, Karachi were approached in the Shifa ul Mulk Memorial Hospital and were briefed about the study design and research methodology.

were female (48%). All subjects were divided into different age groups and mean ages were calculated accordingly. Mean age of subjects between 5 and 8 years was 6 years. Mean age of subjects between 9 and 12 was 10 years. Mean age of subjects between 13 and 16 years was 14 years. Stool D/R is an accurate test. It is considered the best method for epidemiological studies and it has been observed that the test is highly sensitive and specific for diagnosis of the amoebiasis of all ages. Out of 400 patients, 64 were positive for amoebiasis (16%). Several epidemiological reports have shown that the rate of amoebiasis increases significantly with age. In our study, the prevalence was more in older children than in younger age. This study showed low prevalence rate as compared to the previous study which was first done in Nishtar Hospital, Multan and secondly in Engro fertilizer company Hospital, Pakistan as shown in Figure 1 (Zahida et al., 2010; Munazza et al., 2011). Conclusion The prevalence of amoebiasis was relatively high in Gadap Town, especially in populations living under poor hygienic conditions. Water source, defecation site, personal hygiene and the extent of maternal education are the main factors that determine the prevalence of amoebiasis. The study showed a relatively high prevalence of amoebiasis and suggests an imperative for the implementation of control measures
REFERENCES Chaturvedi GN, Sing KP (1983). Side Effects of a Traditional Indigenous Drug-Kutaja, Holarrhena Antidysenterica. Indian J. physiol. pharmacol. 27 (3): 255-256. Guerrant RL, Huges JM, Lima NL, Crane J (1990). Diarrhea in developed and developing countries: magnitude, special settings and

RESULTS AND DISCUSSION Amoebiasis is defined by the World Health Organization (WHO) and Pan American Health Organization (PAHO) as the infection by E. histolytica, regardless of symptomatology (WHO, 1997). This protozoan parasite has a global distribution and especially high prevalence in countries where poor socioeconomic and sanitary conditions predominate (Stanley et al., 2003). Out of a total number of 400 subjects, 208 were male (52%) and 192

11216

Afr. J. Biotechnol.

etiologies. Rev. infect. dis. 12: 541-50. Kloos H (1977). Preliminary Studies of Medicinal Plants and Plant Products in Markets of Central Ethiopia. Ethnomedicine. 4 (1): 63104. Munazza E, Ghulam M, Mahmood A, Shujaat A, Qazi N, Hassham H, Amir W, Kalsoom F, Izhar H (2011). Determination of the prevalence of Entamoeba histolytica in human ata private fertilizer company hospital in Pakistan using microscopic technique, Afr. J. Microbiol. Res. 5(2): 149-152. Shoba FG, Thomas M (2001). Study of Antidiarrhoeal Activity of Four Medicinal Plants In Castor-Oil Induced Diarrhoea. J ethnopharmacol. 76 (1): 73-76. Trivediv VP, Nesamany S, Shara Vk (1978). A Clinical Study of Effects of Bilwa Majja Churna On Intestinal Parasites. J. Res. indian Med. yoga homeopathy, 13: 28-35.

WHO/PAHO/UNESCO report: (1997). a consultation with experts on amoebiasis: Mexico City, Mexico 28-29 January,. Epidemiol. Bull. 18(1): 13-14. Stanley SL (2003). Jr. Amoebiasis. Lancet. 361(9362):1025-1034. Zahida T, Shabana K, Lashari L (2010). Prevalence of entamoeba histolytica in humans, Pak. J. Pharm. Sci. 23(3): 344-348