Amoebiasis: definition, symptoms and treatments

Amoebiasis is the third most deadly parasitic disease in the world. Approximately 10% of the world’s population is infected by parasitic amoebae. Often asymptomatic, the infection can however lead to numerous complications. How can it be detected and treated?

What is amoebiasis?

Amebiasis is a condition related to an infection caused by a microscopic parasite that settles in the intestine. This disease remains a global public health problem, as it affects more than 50 million people worldwide due to lack of sanitation and water hygiene.

Amoebae are present all over the world, but are more prevalent in tropical countries and in hot and humid regions with low levels of hygiene.

The infection is usually asymptomatic and clinical signs range from mild diarrhea to hospitalization.

Diagnosis is based on the identification of E. histolytica in the stool and by serological tests.

What causes amebiasis?

Amebiasis is caused by the amoeba “Entamoeba histolytica”, a parasite characteristic of humans. This parasite is present throughout the year but only lives in water or in the presence of high humidity. In other areas, it can occur in small epidemics or isolated cases.

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Amoebae belong to the protozoan family. Entemoeba histolytica is the only amoeba capable of penetrating the mucosa of the intestine and its wall. This parasite can take two forms, an active form (trophozoite) and a dormant form (cyst).

The infection starts when the cysts have been absorbed. Indeed, when they are born, they deliver trophozoites which multiply and cause signs of inflammation, the consequences of which are an intestinal infection.

Sometimes they spread to the liver or other parts of the body.

The methods of contamination are direct (from human to human) or indirect (through food and water). In areas where hygiene is poor, amoebiasis is transmitted through the consumption of food or water contaminated with feces.

What are the symptoms of amebiasis?

Most people with amebiasis are asymptomatic, but symptoms may appear a few days or weeks after infection.

Primary amebiasis is the initial infection of the intestine by the amoebae, while late amebiasis occurs when the primary amebiasis has not been treated and usually affects the liver.

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Intestinal or colonic amoebiasis

  • Mild diarrhea at the beginning without fever;
  • Abdominal pain, cramps;
  • Diarrhoea that prolongs and becomes more severe: Dysentery, with blood and mucus in the mucusy stool, (amoebic dysentery);
  • Fatigue, emaciation and, sometimes, fever.

Hepatic amoebiasis

  • Pain in the area where the liver is located;
  • Fever;
  • Increase in the volume of the liver.

How is amebiasis treated?

When a person has symptoms, treatment is based on two drugs: one that kills the amoebae and another that kills the cysts in the large intestine.

  • For mild forms of intestinal amoebiasis: broad-spectrum antiparasitic drugs and contact amoebicides (metronidazole or tinidazole followed by paromomycin or another active drug to eradicate the cyst, accompanied by hygienic and dietary measures);
  • For severe intestinal forms and hepatic forms, they require hospitalization and urgent treatment.

It is important to treat intestinal amebiasis in order to avoid the appearance of extradigestive forms. Without forgetting, people who have no symptoms (asymptomatic) must also be treated to fight against the transmission of the disease.

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To overcome the risk of catching amoebae, it is necessary first to destroy the fecal contamination of water, food and hands and to implement diagnostic methods that can show the presence of cysts even in carriers who do not have symptoms.

In the meantime:

  • Avoid putting hands to mouth after shaking hands;
  • Do not use dirty dish towels to dry your hands in the bathroom;
  • Consume encapsulated bottled mineral water;
  • Eat fruits and vegetables that have been cleaned with boiled or chlorinated water;
  • Monitor swimming pools by removing organic matter;
  • Renew the water in swimming pools.