Trend of Entamoeba histolytica infestation in Kolkata
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Entamoeba histolytica infection is found almost all over the world and is highly endemic and a major cause of parasitic diarrhoea particularly in the developing countries.
A systemic surveillance was set up at the Infectious Disease hospital, Kolkata, India between November 2007 and October 2009 for understanding the trend of E. histolytica infection in Kolkata. Fecal samples were collected from diarrhoeal patients attending the hospital, under the surveillance system and processed for detection of E. histolytica.
During the last two years about 2500 diarrhoeal samples were collected and screened for E. histolytica. About 3.6% were positive for E. histolytica. As compared to the earlier years, E. histolytica infection was observed to be less amongst patients screened during the last two years. No seasonality was observed in Kolkata although in the neighboring tropical country Bangladesh, a typical seasonality of E. histolytica infection was noticed.
The study indicates that the detection rate of E. histolytica infection amongst diarrhoeal patients in Kolkata is decreasing during the last two years than that of Bangladesh.
KeywordsFecal Sample Tropical Country Tinidazole Entamoeba Histolytica Vibrio Cholerae
Amoebiasis caused by infection with E. histolytica occurs almost all over the world and is highly endemic especially in the developing countries. It is one of the major causes of dysentery/diarrhoea in Kolkata, India. According to our previous study (unpublished), detection of Entamoeba histolytica showed a marked seasonality, i.e. high peak during post-monsoon and post-winter seasons. According to the reports from other tropical countries, especially in Bangladesh, which is geographically closest to Kolkata, there is a typical pattern of detection of E. histolytic w here E. histolytica usually shows its highest peaks in the wet season and gradually decreases with the arrival of dry season [1, 2]. In a study in Bangladesh, it was shown that wet environment is not the only factor that affects the detection curve of E. histolytica, but anti-Carbohydrate Recognition Domain IgA level in the gut is another determining factor for its occurrence in a closed population . However, even in that case E. histolytica detection followed a particular seasonality and trend. However in Kolkata the present scenario is different from other tropical regions.
Study design and results
The present study demonstrates that there is no particular seasonality of occurrence of E. histolytica infection which is not typical of a tropical area like Kolkata. A different pattern which is almost unique in comparison to other tropical countries has been observed. Contribution of environmental and host factors as well as parasite genotypes are very important for the outcome of infection [2, 5]. Although no physical or environmental factor behind this changing pattern of E. histolytica infestation in Kolkata has yet been reported, but it is certain that E. histolytica is showing a slow but obvious change in its seasonality and this might be a signal for a transition period of changing nature of infestation by this parasite in this part of the world. It is worth mentioning that impact of climate change might lead to such changes, although no such studies are available.
This study was supported by grants from
1. Japan Health Science Foundation and
2. Okayama University Program of Founding Research Centre for Emerging and Reemerging Infectious Disease, Ministry of Education, Culture, Sports, Science and Technology of Japan.
Authors also acknowledge the help and support given by Prof. Y. Takeda, Dr. G. B. Nair, Dr. Samiran Panda and Dr. K. Rajendran of NICED during preparation of this letter and Debarati Ganguly of Calcutta University for her careful proof reading and correction of English in the letter.
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