Intestinal protozoa infections present a major public health challenge, particularly in areas with poor sanitation and limited access to clean water. Effective diagnostic methods are critical, yet traditional microscopy, though widely used for its simplicity, lacks the sensitivity and specificity of modern techniques like real-time Polymerase Chain Reaction (qPCR), making the latter a more effective tool for monitoring and assessing the burden of intestinal protozoa diseases. In this study, we implemented two duplex qPCR assays to detect Entamoeba dispar + Entamoeba histolytica and Cryptosporidium spp. + Chilomastix mesnili, along with singleplex assays for Giardia duodenalis and Blastocystis spp., using a 10 µL reaction volume. This marks the first molecular detection of Chilomastix mesnili by qPCR, enhancing diagnostic precision. Using these, we analyzed stool samples from 70 patients on Pemba Island, Tanzania, before and 54 samples after treatment with 20, 25, or 30 mg of emodepside or placebo, aiming to assess protozoa prevalence for this region and emodepside's potential antiprotozoal effects. Our qPCR reliably detected protozoa in 74.4% of samples, with Entamoeba histolytica and Entamoeba dispar in 31.4% of cases. Notably, one-third of these infections were caused by Entamoeba histolytica. No significant reduction in protozoa was observed after emodepside treatment compared to placebo. The study highlights the utility of qPCR in providing species-level differentiation and improving the speed and cost-effectiveness of testing. The high prevalence of protozoa in this region underscores the need for continued monitoring and control efforts, though emodepside was not effective against protozoa infections.

Amebic liver abscess (ALA), caused by an extraintestinal invasion of the virulent protozoan Entamoeba histolytica, is important among parasitic causes of morbidity and mortality, especially in the tropics. Clinical symptoms, medical-imaging abnormalities of the liver and serological tests are normally made for supportive diagnosis. Serum-based enzyme-linked immunosorbent assay (ELISA) has been conventionally used for diagnosing ALA but is time-consuming and sophisticated equipment is required. Therefore, we sought to develop a new and rapid innovative point-of-care immunochromatographic test (ICT) that can use whole blood as an alternative to serum-based ELISA. An ICT tool using simulated whole-blood samples was developed for immunoglobulin G antibody detection, and its diagnostic efficiency was evaluated in comparison with serum-based ELISA.

Both methods were tested to assess their diagnostic performance using a total of 253 serum samples. These came from ALA patients (n = 13), healthy individuals (n = 40), and patients with other diseases (n = 200).

Amebiasis-ICT exhibited 100% (95% confidential interval (CI) [75.3-100.0]) sensitivity and 97.1% (95% CI [94.1-98.8]) specificity, whereas ELISA gave the same sensitivity (100% 95% CI [75.3 -100.0]) and slightly lower specificity (95.8% 95% CI [92.5-98.0]). There were no significant differences in sensitivity and specificity between the two tests (Exact McNemar's test; p > 0.05), with Cohen's kappa agreement 96.44% (κ-value = 0.771, p < 0.001) indicating substantial agreement.

This ICT tool using simulated whole-blood samples has a high possibility of being used with real whole blood. Therefore, since there is no need to separate serum, this can be considered an innovative diagnostic tool to replace serum-based ELISA in clinics and field surveys in remote areas where medical facilities are limited.

A liver abscess can be due to several different microbiological aetiologies. While pyogenic liver abscess is most frequently encountered, amoebic liver abscess and hydatid cyst caused by the parasites, Entamoeba histolytica and Echinococcus granulosus, respectively, should be considered whenever there is epidemiological exposure. As parasitic infections are now rarely seen in clinical practice in developed countries with improvement in sanitation, lack of clinical experience in managing amoebic liver abscesses and overlapping clinical and imaging features between amoebic and pyogenic liver abscesses may lead to delay in diagnosis. In particular, although amoebic liver abscesses respond well to treatment if diagnosed early, they can progress and rupture with high mortality if treatment is delayed. Hence, early diagnosis and prompt initiation of antimicrobials are crucial to prevent complications and death. This case report highlights a case of a very large 21 cm ALA in a young lady to illustrate the challenges faced during diagnostic evaluation.

We aimed to understand the host and microbe interactions at the time of infection and inflammatory response in amoebic liver abscess (ALA) patients based on toll-like receptor (TLR) expression (mRNA), cytokine and IgG subtypes levels.

Liver aspirates from 100 ALA patients and 11 liver autopsy samples were used as negative controls. Blood samples from 100 ALA and 41 healthy individuals were collected. mRNA expression of TLR 1 to 9 genes was measured using reverse transcriptase polymerase chain reaction (RT-PCR). Serum cytokines level was quantified by flow cytometry. In-house ELISA for the analysis of IgG and its subtypes in the serum samples was performed. A total of 7 TLR genes (TLR1, TLR2, TLR4, TLR6, TLR7, TLR8 and TLR9) and 6 TLR genes (TLR1, TLR2, TLR3, TLR4, TLR5 and TLR8) were found to be elevated in liver aspirates and PBMCs respectively. Increased serum cytokine levels were observed in ALA patients vs. healthy controls. Interestingly, a significant increase in IgG and its subtypes (IgG1, IgG3 and IgG4) was found in the serum of ALA patients.

Increased levels of TLR, pro- and anti-inflammatory cytokines, IgG and its subtypes, are possibly linked with early-stage infection in ALA patients.

The role of TLRs in association with ALA might provide insights into new therapeutic strategies.

Amebic liver abscess (ALA) is rare in Chinese population due to dietary habit. Nine Chinese HIV-seropositive men who have sex with men (MSM) with occurrence of amebic liver abscess (ALA) was retrospectively studied. Six participants had concurrent HIV/Syphilis and two had HIV/HCV. Symptoms primarily included fever, abdominal discomfort, and diarrhea. All participants showed intrahepatic abscesses, mainly in liver segments 6, 7, and 8, while two had additional extrahepatic amebic abscesses. Those with CD4 count < 100 cells/μL exhibited multiple and larger liver abscesses. Metagenomic Next-Generation Sequencing (mNGS) conclusively revealed Entamoeba histolytica despite bacterial culture and smear tests' negative results. All affected individuals were treated with percutaneous catheter drainage and metronidazole for at least 10 days. In summary, HIV-positive MSM are prone to develop ALA, and CD4 count < 100 cells/μL is a risk for occurrence of multiple and larger ALA. The optimal ALA treatment course for ALA remains dabatable.

Amoebiasis and its extraintestinal manifestation amoebic liver abscess (ALA) is an endemic disease in tropical and subtropical countries. However, no meta-analysis on the prevalence, associated risk factors, and clinical markers has been performed. This study aims to bridge this research gap. Based on our inclusion criteria, 18 studies were selected for analysis. Using the "meta" package in RStudio, forest plots, regression analysis, and funnel plots were used to represent the proportional meta-analysis, significance of the correlation, and quality and publication bias of the included studies, respectively. A high prevalence of ALA (67%, p = 1.762 × 10-15) was noted in cases of liver abscess. ALA was significantly more prevalent in males (86%, p = 2.25 × 10-8), individuals with poor socioeconomic conditions (75%, p = 0.02496), history of alcohol consumption (63%, p = 1.421 × 10-8), and diabetic comorbidity (35%, p = 0.01169). There was a significant correlation with abdominal pain (91%, p = 1.286 × 10-12), infected right lobe (81%, p = 0.002), fever (73%, p = 2.567 × 10-12), hepatomegaly (69%, p = 1.223 × 10-5), anemia (69%, p = 1.223 × 10-5), and jaundice (11%, p = 0005258) in the affected individuals. We conclude that the above-stated risk factors and clinical markers are significantly associated with ALA and suggest that medical professionals in endemic regions must attribute liver abscess to be etiologically amoebic and correlate the disease manifestation with the risk factors and clinical markers. Further, research is needed to better understand disease manifestation.

Japanese encephalitis (JE) is a zoonotic parasitic disease caused by the Japanese encephalitis virus (JEV), and may cause fever, nausea, headache, or meningitis. It is currently unclear whether the epidemiological characteristics of the JEV have been affected by the extreme climatic conditions that have been observed in recent years.

This study aimed to examine the epidemiological characteristics, trends, and potential risk factors of JE in Taiwan from 2008 to 2020. Specifically, the study focused on gender, age, season, residential area, clinical manifestations, high-risk areas, and the impact of environmental and climate factors.

This study reviewed publicly available annual summary data on reported JE cases in the Taiwan Centers for Diseases Control between 2008 and 2020.

This study collected 309 confirmed domestic patients and 4 patients with imported JE. There was an increasing trend in the incidence of JE, 0.69-1.57 cases per 1,000,000 people, peaking in 2018. Case fatality rate was 7.7% (24/313). Comparing sex, age, season, and place of residence, the incidence rate was highest in males, 40- to 59-year-old patients, summer, and the Eastern region, with 1.89, 3.27, 1.25, and 12.2 cases per million people, respectively. The average coverage rate of the JE vaccine for children in Taiwan is 94.9%. Additionally, the major clinical manifestations of the cases included fever, unconsciousness, headache, stiff necks, psychological symptoms, vomiting, and meningitis. The major occurrence places of JE included paddy fields, pig farms, pigeon farms, poultry farms, and ponds. For air pollution factors, linear regression analysis showed that SO2 (ppb) concentration was positively associated with JE cases (β=2.184, P=.02), but O3 (ppb) concentration was negatively associated with them (β=-0.157, P=.01). For climate factors, relative humidity (%) was positively associated with JE cases (β=.380, P=.02).

This study is the first to report confirmed cases of JE from the surveillance data of the Taiwan Centers for Diseases Control between 2008 and 2020. It identified residence, season, and age as risk factors for JE in Taiwan. Air pollution and climatic factors also influenced the rise in JE cases. This study confirmed that JE remains a prevalent infectious disease in Taiwan, with its epidemic gradually increasing in severity. These findings empower clinicians and health care providers to make informed decisions, guiding their care and resource allocation for patients with JE, a disease that significantly impacts the health and well-being of the Taiwanese population.

Amoebas are characterized by their unique ability to exist both as free-living organisms and, occasionally, as parasites within host tissues, earning them the designation 'amphizoic amoebae'. While amoebic infections are less prevalent, their health impact can be tremendous, leading to several diseases. In low-income countries, poor sanitation and socioeconomic conditions significantly increase the risk of amoebic infections, particularly E. histolytica, which affects up to 50 million people and causes over 100,000 deaths each year. Diagnostic methods, including microscopy, serological tests, polymerase chain reaction, and the loop-mediated isothermal amplification assay, have improved the accuracy and timeliness of amoeba diagnosis. However, these methodologies are often cost-prohibitive for developing countries. Conversely, current treatments involve aggressive protocols using antibiotics, antifungals, and anticancer agents. However, the prognosis for severe infections such as Primary Amoebic Meningoencephalitis and Granulomatous Amebic Encephalitis remains poor. Despite advancements, effective treatments, and new low-cost therapeutic options are still being researched. Thus, the current review sought to provide a description of molecular aspects such as amoeba virulence factors and invasion processes, focusing on recent advances in the detection, identification, and treatment of associated diseases.

Entamoeba spp. are common zoonotic intestinal protozoa, which can lead to serious intestinal diseases in both humans and animals through fecal-oral transmission, leading to significant economic losses and public health challenges. To reveal the prevalence of Entamoeba in sheep and cattle in Shanxi Province, North China, fecal samples were collected from 311 sheep, 392 dairy cattle, and 393 beef cattle from three representative counties in the northern, central, and southern regions of Shanxi Province. DNA was extracted from the fecal samples and amplified by PCR with primers targeting the nuclear small subunit ribosomal RNA (SSU rRNA) gene of Entamoeba spp., followed by the sequencing of the positive products. The overall infection rates of Entamoeba were 51.5% (160/311), 82.9% (325/392), and 79.1% (311/393) in sheep, dairy cattle, and beef cattle, respectively. Statistical analysis showed a significant correlation between the infection rate of Entamoeba and the location factor in sheep, dairy cattle, and beef cattle (p < 0.001). According to the obtained SSU rRNA sequences, several Entamoeba species, namely Entamoeba bovis, Entamoeba Ribosomal Lineage (RL) 2, Entamoeba RL4, and Entamoeba RL8, were identified. This study represents the first molecular survey of Entamoeba prevalence in sheep, beef cattle, and dairy cattle in Shanxi Province. The findings extend the geographical distribution of Entamoeba spp. and provide valuable scientific data for the prevention and control of amoebiasis in Shanxi Province.

Parasitic infections remain a significant public health concern, particularly in underserved communities where access to healthcare and sanitation is limited. This study aims to investigate the incidence and pathological characteristics of parasitic infections in such communities, providing insights into the prevalence and impact of these infections on public health.

A cross-sectional study was conducted in underserved communities over a period of one year. A total of 500 participants were randomly selected and screened for parasitic infections through stool and blood samples. The samples were analyzed using microscopy and polymerase chain reaction (PCR) techniques to identify and quantify parasitic species. Pathological examinations were performed to assess the impact of infections on host tissues.

The incidence of parasitic infections was found to be 35% among the study population. The most common parasites identified were Ascaris lumbricoides (40%), Giardia lamblia (25%), and Entamoeba histolytica (20%). Pathological analysis revealed that Ascaris lumbricoides caused significant intestinal inflammation in 30% of infected individuals, while Giardia lamblia was associated with malabsorption syndrome in 15% of cases. Entamoeba histolytica was linked to liver abscesses in 10% of the infected participants.

Parasitic infections are highly prevalent in underserved communities, with significant pathological impacts on affected individuals.

Bacterial biofilms have attracted significant attention due to their involvement in persistent infections, food and water contamination, and infrastructure corrosion. This review delves into the intricate interactions between bacterial biofilms and unicellular parasites, shedding light on their impact on biofilm formation, structure, and function. Unicellular parasites, including protozoa, influence bacterial biofilms through grazing activities, leading to adaptive changes in bacterial communities. Moreover, parasites like Leishmania and Giardia can shape biofilm composition in a grazing independent manner, potentially influencing disease outcomes. Biofilms, acting as reservoirs, enable the survival of protozoan parasites against environmental stressors and antimicrobial agents. Furthermore, these biofilms may influence parasite virulence and stress responses, posing challenges in disease treatment. Interactions between unicellular parasites and fungal-containing biofilms is also discussed, hinting at complex microbial relationships in various ecosystems. Understanding these interactions offers insights into disease mechanisms and antibiotic resistance dissemination, paving the way for innovative therapeutic strategies and ecosystem-level implications.

Infectious outbreaks are the foremost global public health concern, challenging the current healthcare system, which claims millions of lives annually. The most crucial way to control an infectious outbreak is by early detection through point-of-care (POC) diagnostics. POC diagnostics are highly advantageous owing to the prompt diagnosis, which is economical, simple and highly efficient with remote access capabilities. In particular, utilization of nanomaterials to architect POC devices has enabled highly integrated and portable (compact) devices with enhanced efficiency. As such, this review will detail the factors influencing the emergence of infectious diseases and methods for fast and accurate detection, thus elucidating the underlying factors of these infections. Furthermore, it comprehensively highlights the importance of different nanomaterials in POCs to detect nucleic acid, whole pathogens, proteins and antibody detection systems. Finally, we summarize findings reported on nanomaterials based on advanced POCs such as lab-on-chip, lab-on-disc-devices, point-of-action and hospital-on-chip. To this end, we discuss the challenges, potential solutions, prospects of integrating internet-of-things, artificial intelligence, 5G communications and data clouding to achieve intelligent POCs.

Entamoeba histolytica is an enteric protozoan parasite that causes human amebic colitis and extraintestinal abscesses. As a prerequisite for parasite colonization and invasion, adherence of E. histolytica is predominantly mediated by galactose (Gal)- and N-acetyl-d-galactosamine (GalNAc)-inhibitable lectins. The intermediate subunit (Igl) of Gal-/GalNAc-inhibitable lectin is a cysteine-rich protein containing multiple CXXC motifs and is considered a key factor affecting trophozoite's pathogenicity. However, details of the function of Igl during parasite adherence remain unclear. Here, using segmentally expressed Igl proteins and a CHO cell model transfected with Igl fragments, we identified a carbohydrate-recognition domain (CRD)-like region between amino acids 989 and 1,088. Through single- and double-point mutations in the Igl segments, two core CXXC motifs responsible for carbohydrate recognition in the CRD-like region, which are highly conserved among several lectins, were confirmed. In addition to adhesion, the roles of CRD-like region and its core CXXC motifs in various pathogenic effects were further explored. To our knowledge, this is the first report showing an adhesion-related region in E. histolytica Igl. The identification and characterization of this CRD-like region provides further insights into molecular mechanisms underlying E. histolytica pathogenicity and also aids in the determination of a potential drug target in this parasite.

Entamoeba histolytica adhesion mainly depends on galactose (Gal)-/N-acetyl-d-galactosamine (GalNAc)-inhibitable lectins, subsequently triggering a series of amebic reactions. Among the three subunits of Gal-/GalNAc-inhibitable lectin, heavy subunit and intermediate subunit (Igl) have exhibited lectin activity, but that of Igl remains poorly understood. In this study, we confirmed a carbohydrate-recognition domain (CRD)-like limiting region in E. histolytica Igl and further identified its two core CXXC motifs responsible for carbohydrate recognition. Moreover, the role of Igl's CRD-like region and its CXXC motifs in hemolysis and pathogenic effects was explored. This is the first study to determine an adhesion-related region in E. histolytica Igl protein, providing a new reference direction for subsequent research studies. Since the potential homogeneity of galectin-2 in several mammals and Igl CRD-like region, it could be meaningful to relate the corresponding pathogeneses and phenotypes of these two proteins. Except for adhesion, studies on the involvement of Igl CRD-like region in different parasite-host interactions are also promising.

Tetraspanins (TSPANs) are a family of highly conserved proteins present in a wide variety of eukaryotes. Although protein-protein interactions of TSPANs have been well established in eukaryotes including parasitic protists, the role they play in parasitism and pathogenesis remains largely unknown. In this study, we characterized three representative members of TSPANs, TSPAN4, TSPAN12, and TSPAN13 from the human intestinal protozoan Entamoeba histolytica. Co-immunoprecipitation assays demonstrated that TSPAN4, TSPAN12 and TSPAN13 are reciprocally pulled down together with several other TSPAN-interacting proteins including TSPAN binding protein of 55kDa (TBP55) and interaptin. Blue native-PAGE analysis showed that these TSPANs form several complexes of 120-250 kDa. Repression of tspan12 and tspan13 gene expression led to decreased secretion of cysteine proteases, while repression of tspan4 led to a four-fold increase in the activity of cysteine proteases in crude extracellular vesicles (EVs) fraction. Meanwhile, strains overexpressing HA-tagged TSPAN12 and TSPAN13 demonstrated reduced adhesion to collagen. Altogether, this study reveals that the TSPANs, especially TSPAN12 and TSPAN13, are engaged with complex protein-protein interactions and are involved in the pathogenicity-related biological functions such as protease secretion and adhesion, offering insights into the potential regulatory mechanisms of tetraspanins in protozoan parasites.

Entamoeba histolytica is a protozoan parasite that belongs to the Amoebozoa supergroup whose study related to the nucleocytoplasmic transport of proteins through the nucleus is poorly studied. In this work, we have performed in silico predictions of the potential nuclear localization signals (NLS) corresponding to the proteome of 8201 proteins from Entamoeba histolytica annotated in the AmoebaDB database. We have found the presence of monopartite nuclear localization signals (MNLSs), bipartite nuclear localization signals (BNLSs), and non-canonical monopartite NLSs with lengths exceeding 20 amino acid residues. Additionally, we detected a new type of NLS consisting of multiple juxtaposed bipartite NLSs (JNLSs) that have not been described in any eukaryotic organism. Also, we have generated consensus sequences for the nuclear import of proteins with the NLSs obtained. Docking experiments between EhImportin α and an MNLS, BNLS, and JNLS outlined the interacting residues between the Importin and cargo proteins, emphasizing their putative roles in nuclear import. By transfecting HA-tagged protein constructs, we assessed the nuclear localization of MNLS (U1A and U2AF1), JMNLS (U2AF2), and non-canonical NLS (N-terminus of Pol ll) in vivo. Our data provide the basis for understanding the nuclear transport process in E. histolytica.

Globally, intestinal protozoa E. histolytica/dispar and Giardia lamblia are the cause of amoebiasis and giardiasis, respectively. Despite their important medical importance and common occurrence in Ethiopia, they are minimally addressed in terms of their prevalence, sensitive diagnostic methods, and associated risk factors. Infections with E. histolytica/dispar and G. lamblia are often misdiagnosed and underreported in impoverished countries. Thus, the purpose of this study was to ascertain the prevalence of Giardia lamblia and E. histolytica/dispar infections as well as related variables among schoolchildren in the Amhara region. A cross-sectional study was conducted among 844 schoolchildren in the Amhara region from April to December 2019. A stool sample was collected from each study participant and processed via the formol ether concentration technique (FECT) and spontaneous tube sedimentation techniques (STST). Data were entered in EpiData and analysed by SPSS statistical software. The prevalence of E. histolytica and G. lamblia infections using each diagnostic method and composite reference was determined by descriptive statistics. The association of risk factors with E. histolytica/dispar and G. lamblia infections was analysed by logistic regression and variables with p < 0.05 were considered to have statistical significance. From the total, 243 (28.8%) schoolchildren were found to be infected by at least one of E. histolytica/dispar or G. lamblia. The prevalence of E. histolytica/dispar and G. lamblia infections was 201 (23.8%) and 62 (7.3%), respectively. The co-infection prevalence with both E. histolytica/dispar and G. lamblia was 22 (2.6%). The sensitivity (78.6%) and negative predictive value of STST (19.6%) were higher than FECT sensitivity (65.4%) and negative predictive value (13.1%). Children in 10-14 years of age (AOR = 1.66;95%CI: 1.16-2.38), lived in the rural (AOR = 1.97;95%CI: 1.12-3.49), used latrine improperly (AOR = 1.49;95%CI: 1.04-2.13), did not wash hands before meal (AOR = 2.10; 95%CI:1.08-4.10), and after latrine (AOR = 1.51;95%CI: 1.05-2.19), ate unwashed raw vegetables (AOR = 1.85;95%CI:1.26-2.70), and played with soil (AOR = 1.48;95%CI:1.06-2.06) were associated with E. histolytica/dispar and G. lamblia infection. These findings revealed high prevalence of E. histolytica/dispar and G. lamblia infections was high in the Amhara region. Therefore, proper implementation of water, sanitation and hygiene should be advocated at the community and school levels to mitigate the disease burden.

Amoebiasis is a prevalent infection in the tropics and can sometimes present as liver abscess. Cardiac tamponade is an uncommon complication of ruptured amoebic liver abscess requiring urgent pericardiocentesis, which has a high success rate, but procedural complications can include injury to cardiac chambers, abdominal viscera, and even death. This case underscores the approach to diagnose and manage an unintended visceral puncture during pericardiocentesis, which is a rare but life-threatening complication.

A 41-year-old male presented with intermittent fever over 2 months and chest pain for 15 days. Echocardiography revealed a significant pericardial effusion causing cardiac tamponade. In an emergency setting, percutaneous pericardiocentesis was attempted to drain the effusion. However, the pigtail inadvertently punctured a sizable liver abscess. Consequently, another pigtail was inserted into the pericardial cavity to successfully drain the effusion. Patient was discharged on Day 12 and is doing well at 6 months follow-up.

A previously undiagnosed case of a ruptured amoebic liver abscess presented with the uncommon complication of cardiac tamponade, necessitating emergency pericardiocentesis, which inadvertently led to the cannulation of the liver abscess. This case underscores the significance of image-guided pericardiocentesis in minimizing procedural complications. This case also highlights the intricacies of addressing accidental visceral puncture during pericardiocentesis, specially involving the liver. It also underscores the need to consider the possibility of a ruptured amoebic liver abscess when anchovy sauce-like pus is drained from pericardial cavity, especially in high epidemiologically prevalent country like India.

We construct, analyze and interpret a mathematical model for an environmental transmitted disease characterized for the existence of three disease stages: acute, severe and asymptomatic. Besides, we consider that severe and asymptomatic cases may present relapse between them. Transmission dynamics driven by the contact rates only occurs when a parameter R∗>1, as normally occur in directly-transmitted or vector-transmitted diseases, but it will not adequately correspond to a basic reproductive number as it depends on environmental parameters. In this case, the forward transcritical bifurcation that exists for R∗<1, becomes a backward bifurcation, producing multiple steady-states, a hysteresis effect and dependence on initial conditions. A threshold parameter for an epidemic outbreak, independent of R∗ is only the ratio of the external contamination inflow shedding rate to the environmental clearance rate. R∗ describes the strength of the transmission to infectious classes other than the I-(acute) type infections. The epidemic outbreak conditions and the structure of R∗ appearing in this model are both responsible for the existence of endemic states.

miRNAs are known as non-coding RNAs that can regulate gene expression. They are reported in many microorganisms and their host cells. Parasite infection can change or shift host miRNAs expression, which can aim at both parasite eradication and infection.

This study dealt with examination of miRNA expressed in intestinal protozoan, coccidia , as well as profile changes in host cell miRNA after parasitic infection and their role in protozoan clearance/ survival.

The authors searched ISI Web of Sciences, Pubmed, Scholar, Scopus, another databases and articles published up to 2024 were included. The keywords of miRNA, intestinal protozoa, toxoplasma and some words associated with topics were used in this search.

Transfection of miRNA mimics or inhibitors can control parasitic diseases, and be introduced as a new therapeutic option in parasitology.

This review can be used to provide up-to date knowledge for future research on these issues.

The protozoan parasite Entamoeba histolytica is the causative agent of amebiasis, with clinical outcomes ranging from asymptomatic infections to severe invasive diseases. The innate immune system, particularly macrophages, is of paramount importance in resisting the invasion of host tissues and organs by the trophozoites of E. histolytica. Parasite-derived pathogenic factors, such as lectins, play a pivotal role in the promotion of macrophage polarization phenotypes that have undergone alteration. Nevertheless, the precise mechanisms by which E. histolytica modulates immune polarization remain largely unknown. The current study focused on the immunomodulatory effects of the Igl-C fragment of E. histolytica Gal/GalNAc lectin on macrophage polarization. These results demonstrated that Igl-C could induce the secretion of IL-1β, IL-6, and other cytokines, activating a mixed M1/M2 polarization state. M1 polarization of macrophages occurs in the early stages and gradually transitions to M2 polarization in the later stages, which may contribute to the persistence of the infection. Igl-C induces the macrophage M1 phenotype and causes the release of immune effector molecules, including iNOS and cytokines, by activating the NF-κB p65 and JAK-STAT1 transcription factor signaling pathways. Furthermore, Igl-C supports the macrophage M2 phenotype via JAK-STAT3 and IL-4-STAT6 pathways, which activate arginase expression in later stages, contributing to the tissue regeneration and persistence of the parasite. The involvement of distinct signaling pathways in mediating this response highlights the complex interplay between the parasite and the host immune system. These findings enhance our understanding of the Igl-C-mediated pathogenic mechanisms during E. histolytica infection.

Parasites Entamoeba spp., Enterocytozoon bieneusi and Blastocystis are prevalent pathogens causing gastrointestinal illnesses in animals and humans. Consequently, researches on their occurrence, distribution and hosts are crucial for the well-being of both animals and humans. Due to the confined spaces and frequent interaction between animals and humans, animal sanctuaries have emerged as potential reservoirs for these parasites. In this study, the wildlife sanctuary near the Huang Gorge of the Qinling Mountains in northwest China is chosen as an ideal site for parasite distribution research, considering its expansive stocking area and high biodiversity.

We collected 191 fecal specimens from 37 distinct wildlife species and extracted genomic DNA. We identified these three parasites by amplifying specific gene regions and analyzed their characteristics and evolutionary relationships. All the parasites exhibited a high overall infection rate, reaching 90.05%. Among them, seven Entamoeba species were identified, accounting for a prevalence of 54.97%, with the highest infection observed in Entamoeba bovis. In total, 11 Enterocytozoon bieneusi genotypes were discovered, representing a prevalence of 35.08%, including three genotypes of human-pathogenic Group 1 and two novel genotypes (SXWZ and SXLG). Additionally, 13 Blastocystis subtypes were detected, showing a prevalence of 74.87% and encompassing eight zoonotic subtypes. All of the above suggests significant possibilities of parasite transmission between animals and humans.

This study investigated the occurrence and prevalence of three intestinal parasites, enhancing our understanding of their genetic diversity and host ranges in northwest China. Furthermore, the distribution of these parasites implies significant potential of zoonotic transmission, underscoring the imperative for ongoing surveillance and implementation of control measures. These efforts are essential to mitigate the risk of zoonotic disease outbreaks originating from wildlife sanctuary.

This case report provides data on unique challenges related to amoebiasis diagnostics and treatment in non-endemic regions. The presented case report is focused a 28-year-old male patient of Indian origin, temporarily living in Poland, who was diagnosed with an amoebic liver abscess. The patient presented with a range of non-specific symptoms including shortness of breath, chest pain, and fever. The differential diagnosis included cardio-pulmonary diseases, a range of tropical diseases such as malaria or typhoid fever, bacterial abscesses, and malignancies, necessitating a comprehensive, multi-modal diagnostic approach. This approach included an extensive review of patient history, physical examination, and various laboratory and imaging investigations. A further challenge in this case was the unavailability of standard cysticidal treatments in Poland, which required individualized therapeutic strategy. Despite these obstacles, the patient was successfully treated using an alternative regimen of intravenous metronidazole, ceftriaxone, doxycycline, chloroquine, and finally, trimethoprim/sulfamethoxazole (treatment with metronidazole was used as a base drug, due to the lack of typical cysticidal treatment, an alternative treatment was added: chloroquine is a recommended drug used in the treatment of pregnant patients, in addition, doxycycline showed in vitro activity against Entamoeba histolytica). This therapeutic journey underscored the value of adaptability in treatment protocols, particularly in regions where certain resources may not be readily available. This case report underlines the importance of broadening the differential diagnosis in non-endemic regions to include tropical diseases, particularly in the context of increasing global travel and migration. It also highlights the significance of employing comprehensive diagnostic strategies and adaptable treatment protocols in such scenarios. In addition, the report reiterates the need for global collaboration and education among healthcare providers to effectively manage tropical diseases, especially in non-endemic regions. Through its exploration of the complexities associated with diagnosing and managing amebiasis in a non-endemic region, this report offers valuable insights to clinicians worldwide.

Background Bacteria and parasites cause liver abscesses (LAs), with the unusual but fatal consequence of ruptured LA. Along with the clinical signs of icterus, right upper quadrant pain, and a history of loose stools, patients present with non-specific symptoms such as fever, nausea, and generalized weakness. Consistent findings include male sex prevalence and frequent alcohol consumption. Leukocytosis, abnormal liver function, and an increased international normalized ratio have been identified by biochemical analysis; however, these findings are not specific to a ruptured LA diagnosis, and imaging is necessary to reach a definitive diagnosis. Ultrasonography usually confirms the diagnosis, and computed tomography is required in certain situations. In confined ruptures, percutaneous drainage combined with antibiotic therapy is typically the initial treatment course. Generally reserved for non-responders or moribund patients with delayed presentation, an open surgical approach may involve simple draining of a ruptured abscess or ileocecal resection, or right hemicolectomy in cases of large bowel perforations, both of which increase patient morbidity. A definite guide to management is still missing in the literature. In this article, we have discussed and correlated with data the predictors of surgery and preoperative predictors of perforation. Materials and methods This retrospective study was performed at Safdarjung Hospital, New Delhi, between January 2022 and December 2023. The study included 115 patients diagnosed with ruptured LA by ultrasound. Medical records were analyzed, and various parameters of the illness, clinical features, hematological and biochemical profiles, ultrasound features, and therapeutic measures were noted and assessed. Results Of the 115 patients, 88% (n = 101) were male. The most common symptoms were abdominal pain (114 patients) and right upper abdominal tenderness (107 patients). Fifty-two patients were treated with percutaneous drainage, and 42 underwent laparotomy. Intercostal drainage (ICD) tubes were placed in 19 patients. Sixteen patients had large bowel perforations. Twenty-three patients died (20%), including 17 patients who underwent laparotomy and nine patients who had large bowel perforation (39.1% associated with overall mortality, 52.9% associated with mortality in laparotomy). One patient with percutaneous drainage and a right ICD tube died in the intensive care unit. Four patients died before intervention. Significant associations were noted between perforation and mortality in patients who underwent surgical drainage. Loose motions, alcohol and smoking consumption, and deranged creatinine and albumin levels were found to have a significant association with surgical drainage. Conclusion The study found that a ruptured liver abscess (LA) may require surgery to drain the collection or repair the pathological bowel, which increases the morbidity, but it is a lifesaving procedure over percutaneous catheter drainage. The study also identified factors associated with a higher risk of death, such as a history of loose stools and low blood albumin levels.

Wild rhesus macaques are a potential source of zoonotic parasites for humans, and Entamoeba spp. are common intestinal parasites. To investigate the prevalence of Entamoeba in wild rhesus macaques in China and explore the genetic differentiation of the potentially pathogenic species Entamoeba nuttalli, a total of 276 fecal samples from five populations at high altitudes (HAG, 2,800-4,100 m above sea level) and four populations at low altitudes (LAG, 5-1,000 m above sea level) were collected. PCR methods based on the ssrRNA gene were used to detect Entamoeba infection. Genotyping of E. nuttalli was performed based on six tRNA-linked short tandem repeat (STR) loci for further genetic analyses. The results revealed that Entamoeba infection (69.2%) was common in wild rhesus macaques in China, especially in LAG which had a significantly higher prevalence rate than that in HAG (P < 0.001). Three zoonotic species were identified: Entamoeba chattoni (60.9%) was the most prevalent species and distributed in all the populations, followed by Entamoeba coli (33.3%) and Entamoeba nuttalli (17.4%). In addition, a novel Entamoeba ribosomal lineage named RL13 (22.8%) was identified, and phylogenetic analysis revealed a close genetic relationship between RL13 and Entamoeba. hartmanni. Genotyping of E. nuttalli obtained 24 genotypes from five populations and further analysis showed E. nuttalli had a high degree of genetic differentiation (FST > 0.25, Nm < 1) between the host populations. The result of analysis of molecular variance (AMOVA) revealed that observed genetic differences mainly originate from differences among populations (FST = 0.91). Meanwhile, the phylogenetic tree showed that these genotypes of E. nuttalli were clustered according to geographical populations, indicating a significant phylogeographic distribution pattern. Considering the potential pathogenicity of E. nuttalli, attention should be paid to its risk of zoonotic transmission.

Amoebiasis, caused by the enteric parasite, Entamoeba histolytica, is one of the major food- and water-borne parasitic diseases in developing countries with improper sanitation and poor hygiene. Infection with E. histolytica has diverse disease outcomes, which are determined by the genetic diversity of the infecting strains. Comparative genetic analysis of infecting E. histolytica strains associated with differential disease outcomes from different geographical regions of the world is important to identify the specific genetic patterns of the pathogen that trigger certain disease outcomes of Amoebiasis. The strategy is able to elucidate the genealogical relation and population structure of infecting E. histolytica strains from different geographical regions. In the present study, we have performed a comparative genetic analysis of circulating E. histolytica strains identified from different parts of the world, including our study region, based on five tRNA-linked short tandem repeat (STR) loci (i.e., D-A, NK2, R-R, STGA-D and A-L) and evaluated their potential associations with differential disease outcomes of Amoebiasis. A number of regional-specific, emerging haplotypes of E. histolytica, significantly associated with specific disease outcomes have been identified. Haplotypes, which have a significant positive association with asymptomatic and amoebic liver abscess outcomes, showed a significant negative association with diarrheal outcome, or vice versa. Comparative multi-locus analysis revealed that E. histolytica isolates from our study region are phylogenetically segregated from the isolates of other geographical regions. This study provides a crucial overview of the population structure and emerging pattern of the enteric parasite, E. histolytica.

Amoebiasis is a disease caused by Entamoeba histolytica, affecting the large intestine of humans and occasionally leading to extra-intestinal lesions. Entamoeba dispar is another amoeba species considered commensal, although it has been identified in patients presenting with dysenteric and nondysenteric colitis, as well as amoebic liver abscess. Amoebic virulence factors are essential for the invasion and development of lesions. There is evidence showing that the association of enterobacteria with trophozoites contributes to increased gene expression of amoebic virulence factors. Enteropathogenic Escherichia coli is an important bacterium causing diarrhea, with high incidence rates in the world population, allowing it to interact with Entamoeba sp. in the same host. In this context, this study aims to evaluate the influence of enteropathogenic Escherichia coli on ACFN and ADO Entamoeba dispar strains by quantifying the gene expression of virulence factors, including galactose/N-acetyl-D-galactosamine-binding lectin, cysteine proteinase 2, and amoebapores A and C. Additionally, the study assesses the progression and morphological aspect of amoebic liver abscess and the profile of inflammatory cells. Our results demonstrated that the interaction between EPEC and ACFN Entamoeba dispar strains was able to increase the gene expression of virulence factors, as well as the lesion area and the activity of the inflammatory infiltrate. However, the association with the ADO strain did not influence the gene expression of virulence factors. Together, our findings indicate that the interaction between EPEC, ACFN, and ADO Entamoeba dispar strains resulted in differences in vitro and in vivo gene expression of Gal/GalNAc-binding lectin and CP2, in enzymatic activities of MPO, NAG, and EPO, and consequently, in the ability to cause lesions.

Parasitic diseases are a serious global health concern, causing many common and severe infections, including Chagas disease, leishmaniasis, and schistosomiasis. The NLRP3 inflammasome belongs to the NLR (nucleotide-binding domain leucine-rich-repeat-containing proteins) family, which are cytosolic proteins playing key roles in the detection of pathogens. NLRP3 inflammasomes are activated in immune responses to Plasmodium, Leishmania, Toxoplasma gondii, Entamoeba histolytica, Trypanosoma cruzi, and other parasites. The role of NLRP3 is not fully understood, but it is a crucial component of the innate immune response to parasitic infections and its functions as a sensor triggering the inflammatory response to the invasive parasites. However, while this response can limit the parasites' growth, it can also result in potentially catastrophic host pathology. This makes it essential to understand how NLRP3 interacts with parasites to initiate the inflammatory response. Plasmodium hemozoin, Leishmania glycoconjugate lipophosphoglycan (LPG) and E. histolytica Gal/GalNAc lectin can stimulate NLRP3 activation, while the dense granule protein 9 (GRA9) of T. gondii has been shown to suppress it. Several other parasitic products also have diverse effects on NLRP3 activation. Understanding the mechanism of NLRP3 interaction with these products will help to develop advanced therapeutic approaches to treat parasitic diseases. This review summarizes current knowledge of the NLRP3 inflammasome's action on the immune response to parasitic infections and aims to determine the mechanisms through which parasitic molecules either activate or inhibit its action.

Acanthamoeba castellanii is an opportunistic pathogen with public health implications, largely due to its invasive nature and non-specific symptoms. Our study focuses on the potential of azole compounds, particularly those with triazole scaffolds, as anti-amoebic agents. Out of 10 compounds, compounds T1 and T8 exhibited effective anti-Acanthamoeba activity with MIC50 values of 125.37 and 143.92 μg mL-1, respectively. Interestingly, compounds T1, T4, T5 and T8 revealed profound anti-excystation activity with MIC50 at 32.01, 85.53, 19.54 and 80.57 μg mL-1, respectively, alongside limited cytotoxicity to human cells. The study underscores the potential of T1, T4, T5, and T8, thiazole-based compounds, as anti-Acanthamoeba agents by both eliminating amoeba viability and preventing excystation, via preserving the amoeba in its latent cyst form, exposing them to elimination by the immune system. Notably, compounds T1, T4, T5, and T8 showed optimal molecular properties, moderate oral bioavailability, and stable complex formation with Acanthamoeba CYP51. They also display superior binding interactions. Further research is needed to understand their mechanisms and optimize their efficacy against Acanthamoeba infections.

Human amoebiasis still represents a major health problem worldwide. Metronidazole has been used as the most common drug to treat the disease; however, it is also known that the drug causes undesirable side effects. This has led to the search for new pharmacological alternatives which include phytochemical compounds with antiamoebic effects. We analyzed the amoebicidal activity of stevioside (STV), a diterpene glycoside present in Stevia rebaudiana, on trophozoites of E. histolytica. Different concentrations of STV were tested, and an inhibitory concentration of 50% of cell viability (IC50) was determined with an exposition of 9.53 mM for 24 h. Trophozoites exposed to STV showed morphological changes evidenced by the decrease in the basic structures related to the movement and adherence to the substrate, as well as ultrastructural features characterized by a loss of regularity on the cell membrane, an increase in cytoplasmic granularity, and an increase in apparent autophagic vacuoles. Also, the decrease in cysteine protease expression and the proteolytic activity of trophozoites to degrade the cell monolayer were analyzed. A histological analysis of hamster livers inoculated with trophozoites and treated with STV showed changes related to the granulomatous reaction of the liver parenchymal tissue. Our results constitute the first report related to the possible use of STV as a therapeutic alternative in amoebiasis.

Melatonin is a pleiotropic neurohormone found in different animal, plant, and microorganism species. It is a product resulting from tryptophan metabolism in the pineal gland and is widely known for its ability to synchronize the circadian rhythm to antitumor functions in different types of cancers. The molecular mechanisms responsible for its immunomodulatory, antioxidant and cytoprotective effects involve binding to high-affinity G protein-coupled receptors and interactions with intracellular targets that modulate signal transduction pathways. In vitro and in vivo studies have reported the therapeutic potential of melatonin in different infectious and parasitic diseases. In this review, the protective and pathophysiological roles of melatonin in fighting protozoan and helminth infections and the possible mechanisms involved against these stressors will be discussed.

Amoebiasis, caused by the enteric parasite Entamoeba histolytica has differential disease outcomes. The association of parasite genotypes with outcomes of amoebic infection is still a paradox and requires to be explored. The genetic information of infecting strains from endemic settings of different geographical regions is essential to evaluate the relation. Comparative genetics of E. histolytica clinical isolates from different disease outcomes have been explored based on two tRNA-linked STR loci (STGA-D and A-L). All of the repeat patterns in the A-L locus were newly identified and unique to Indian isolates. The majority of newly identified repeat patterns in STGA-D locus have outcome-specific distributions, predicting the emergence of disease-specific mutations in this target locus. Statistical analysis further reinforces this observation, as identified repeat patterns only from STGA-D but not A-L locus were significantly associated with disease outcomes. Phylogenetic analysis indicates independent segregation and divergence of tRNA-linked STR arrays for each STR locus.

Amoebic liver abscess is a severe and potentially life-threatening infection requiring prompt diagnosis and early targeted treatment. Diagnosis is challenging because conventional diagnostic methods such as light microscopy and serology are often unreliable. Molecular techniques have emerged as an additional diagnostic tool, suddenly becoming the new diagnostic reference standard. More recently, commercial multiplex PCR panels, including FilmArray, have been introduced, which permit the simultaneous detection of several enteric pathogens including Entamoeba histolytica in stool samples. We report a case of an amoebic liver abscess promptly diagnosed by FilmArray gastrointestinal panel performed on liver drainage fluid.

Blastocystis hominis (B. hominis) is a protozoan parasite that has a worldwide distribution. Some studies have suggested a link between B. hominis and the development of irritable bowel syndrome (IBS). The objective of this study was to determine the prevalence of B. hominis in patients with IBS compared to healthy individuals.

A total of 65 stool samples from patients with IBS and 65 samples from healthy individuals in northern Iran were examined. The samples were tested using various methods including direct smear, formalin ether sedimentation and culture to detect the presence of B. hominis. Additionally, polymerase chain reaction (PCR) was performed on all culture-positive isolates to confirm the results and identify the genotype.

B. hominis was detected in 15.38% of IBS patients and 9.2% of the healthy group. The culture in RPMI1640 was found to be better than the formalin ether and direct smear methods. Positive samples were confirmed using the molecular method. No significant difference was observed in the order of B. hominis infection between the two groups.

The results of our study indicate that no significant difference was observed in the order of B. hominis infection between IBS patients and healthy groups. Therefore, further study is necessary to determine the potential pathogenic effects of this parasite and its role in causing IBS.

Protozoal infections cause significant morbidity and mortality in humans and animals. The use of several antiprotozoal drugs is associated with serious adverse effects and resistance development, and drugs that are more effective are urgently needed. Microorganisms, mammalian cells and fluids, insects, and reptiles are sources of antimicrobial peptides (AMPs) that act against pathogenic microorganisms; these AMPs have been widely studied as a promising alternative therapeutic option to conventional antibiotics, aiming to treat infections caused by multidrug-resistant pathogens. One advantage of AMP molecules is their adaptability, as they can be easily fine-tuned for broad-spectrum or targeted activity by changing the amino acid residues in their sequence. Consequently, these variations in structural and physicochemical properties can alter the antimicrobial activities of AMPs and decrease resistance development. This article presents an overview of peptide activities against amebiasis, giardiasis, trichomoniasis, Chagas disease, leishmaniasis, malaria, and toxoplasmosis. AMPs and their analogs demonstrate great potential as therapeutics, with potent and selective activity, when compared with commercially available drugs, and hold the potential to act as new scaffolds for the development of novel anti-protozoal drugs.

Amebic liver abscesses (ALAs), one of the most common extraintestinal manifestations of invasive amebiasis, pose diagnostic challenges due to their various clinical presentations and difficulty in distinguishing them from pyogenic abscesses. This case presentation highlights the intricacy of determining the source of an unusually large liver abscess that had an even rare occurrence of a coinciding pulmonary embolus without any evidence of a deep vein thrombosis. This unusual combination underscores the challenges in identifying and managing atypical cases of ALA and emphasizes the need for more comprehensive data to enhance our understanding of such occurrences.

The aim of the article is to improve the differential diagnosis of specific and nonspecific inflammatory bowel diseases. In Russia, this scientific direction is associated with the name of G.F. Lang, who performed in 1901-1902 the study "On ulcerative inflammation of the large intestine caused by balantidiasis". The etiology of specific colitis is associated with infection with parasites, bacteria and viruses that cause inflammation of the intestinal wall, diarrhea, often with an admixture of mucus, pus and blood. Specific colitis (SC) may be accompanied by fever, abdominal pain, and tenesmus. Bacterial colitis is commonly caused by Salmonella, Shigella, Escherichia coli, Clostridium difficile, Campylobacter jejuni, Yersinia enterocolitica, and Mycobacterium tuberculosis. Viral colitis is caused by rotavirus, adenovirus, cytomegalovirus, and norovirus. Parasitic colitis can be caused by Entamoeba histolytica and balantidia. In gay people, SC can cause sexually transmitted infections: Neisseria gonorrhoeae, Chlamydia trachomatis, and treponema pallidum, affecting the rectum. Stool microscopy, culture, and endoscopy are used to establish the diagnosis. Stool culture helps in the diagnosis of bacterial colitis in 50% of patients, and endoscopic studies reveal only nonspecific pathological changes. Differential diagnosis of SC should be carried out with immune-inflammatory bowel diseases (ulcerative colitis, Crohn's disease, undifferentiated colitis), radiation colitis and other iatrogenic bowel lesions. The principles of diagnosis and therapy of inflammatory bowel diseases associated with various etiological.

Necrotizing amebic colitis is an uncommon amebiasis complication associated with high mortality. We present a case of necrotizing amebic colitis in an old patient whose diagnosis was revealed at postmortem examination. An 81-year-old man died at home without medical attention. The postmortem examination revealed ulcers involving the entire colon and intestinal perforation. The ulcers were large, geographic, and necrotizing, extending from the cecum to the rectum. The histological examination disclosed the infectious etiology by showing amebic trophozoites at the base of the ulcers. No extra-intestinal lesions were found. No information about previous episodes of dysentery or travel could be obtained. The potential role of aging or drug-causing immunosuppression and the evolution of chronic and latent intestinal infection to a severe and invasive form of amebiasis is discussed. This case reinforces the value of postmortem examination for diagnosing diseases not clinically identified.

Amebiasis is an important cause of morbidity and mortality worldwide, and caused by infection with the protozoan parasite Entamoeba histolytica. Metronidazole is currently the first-line drug despite adverse effects and concerns on the emergence of drug resistance. Fumagillin, a fungal metabolite from Aspergillus fumigatus, and its structurally related natural and synthetic compounds have been previously explored as potential anti-angiogenesis inhibitors for cancers, anti-microbial, and anti-obese compounds. Although fumagillin was used for human amebiasis in clinical trials in 1950s, the mode of action of fumagillin remains elusive until now. In this report, we showed that fumagillin covalently binds to methionine aminopeptidase 2 (MetAP2) and non-covalently but abundantly binds to patatin family phospholipase A (PLA). Susceptibility against fumagillin of the amebic strains in which expression of E. histolytica MetAP2 (EhMetAP2) gene was silenced increased compared to control strain. Conversely, overexpression of EhMetAP2 mutants that harbors amino acid substitutions responsible for resistance to ovalicin, a fumagillin analog, in human MetAP2, also resulted in decrease in fumagillin susceptibility. In contrast, neither gene silencing nor overexpression of E. histolytica PLA (EhPLA) affected fumagillin susceptibility. These data suggest that EhPLA is not essential and not the target of fumagillin for its amebicidal activity. Taken together, our data have demonstrated that EhMetAP2 is the primary target for amebicidal activity of fumagillin, and EhMetAP2 represents a rational explorable target for the development of alternative therapeutic agents against amebiasis.

Amoebic liver abscess (ALA) and pyogenic liver abscesses (PLA) are the most common causes of liver abscess in developing and developed countries, respectively. Although incidence of liver abscess is low, but mortality is high amongst the patients due to delayed diagnosis. The study was done to find out the prevalence of amoebic and PLA among patients of liver abscess. The clinical, personal, and demographical details were also evaluated to find out the risk factor(s) associated with ALA and PLA, respectively.

A retrospective study was conducted to find the prevalence of amoebic and PLA. Clinical, demographic, personal details were evaluated from hospital records. Laboratory parameters such as total leucocyte count, platelets, bilirubin, ESR (Erythrocyte Sedimentation Rate), hemoglobin, glycosylated hemoglobin (HbA1c), alkaline phosphate (ALP), Aspartate aminotransferase (SGOT/AST), Alanine aminotransferase (SGPT/ALT), serum albumin, bilirubin levels, and procalcitonin were recorded. The Ultrasonography (USG) findings regarding the size, location, volume, and number of abscesses were also analyzed.

Total of 107 patients of liver abscess were evaluated, and 61.6% of patients were of amoebic etiology, and 25.3% were of pyogenic etiology. Males of 20-60 years of age were predominantly affected with right upper quadrant pain and fever as the most common presentations. ALA patients were found to have solitary abscess in the right lobe involving 6th and 7th segments, with decreased hemoglobin, hyperbilirubinemia, elevated ALP and SGOT, with normal SGPT, and addiction to alcohol. PLA patients had increased HbA1c, increased PCT values, low serum albumin levels, and low platelet-to-white blood cell values. The most common bacteria causing PLA was Escherichia coli (n = 8) followed by Enterobacter cloacae (n = 5). Mortality was seen in 6 patients.

Liver abscess is found to have relatively high mortality and morbidity. Therefore, early diagnosis is the only method to prevent mortality and morbidity in these patients. Since the presentation is very nonspecific, evaluation of certain risk factors and laboratory parameters can aid in the diagnosis.

Amebic liver abscesses should be considered in adult males with a liver abscess and a history of travel to endemic areas. Effective treatment includes metronidazole, followed by paromomycin.

Amoebic liver abscess is one frequently encountered intra-abdominal infection, caused by Entamoeba histolytica and has various abdominal and thoracic life-threatening complications. Herein, describe a case of a 30-year-old female, who suffered from multiple amoebic liver abscesses and presented with massive right-sided pleural effusion. She was managed with recommended antibiotics and pigtail catheter for liver abscess and an intercostal drainage tube for massive pleural effusion. However, postintercostal drainage, her chest X-ray demonstrated a right mediastinal shadow, which was confirmed as an intrathoracic extension of the hepatic liver abscess on computed tomography. An ultrasound-guided pigtail catheter was manipulated and placed at the site of thoracic communication. This led to clinical and radiological improvement, but unfortunately, she developed ventilator-acquired pneumonia and died due to her illness. The case represents an uncommon complication of amoebic liver abscess, which is rarely described and adds more knowledge on the thoracic complexities of this infectious disease.

Parasitic infections are highly prevalent in low-income environments worldwide. While orphans and street children represent a particularly vulnerable population group, they are often exempt from preventive interventions such as Mass Drug Administration. In part, this could be due to a lack of data showing the burden of disease in this group. This study aims to address this gap.

For this cross-sectional study, 144 orphans and 112 street children were screened for Schistosoma mansoni (S. mansoni), Schistosoma haematobium (S. haematobium), soil-transmitted helminths and intestinal protozoa using POC-CCA testing, urine filtration, and Kato-Katz technique. Nutritional status, water- and washing patterns were determined using a standardised questionnaire. Ultrasonography was performed to screen for organ abnormalities.

The prevalence of S. mansoni determined by POC-CCA-test was 65.9% for orphans and 94.5% for street children. 19.2% of the orphans tested positive for S. mansoni in Kato Katz. Of the street children, 77.1% showed positive test results in Kato-Katz. Only 1.3% of the orphans stated in the questionnaire that they use the lake to wash, whereas 91.1% of the street children named the lake as at least one of their options for washing. Microscopy showed positive results for Giardia intestinalis (G. intestinalis) in 8.2% and for Entamoeba histolytica/dispar (E. histolytica/dispar) in 23% of orphans and 8.1% for G. intestinalis, and 23.8% for E. histolytica/dispar in street children. In the ultrasonography, we did not observe patterns that indicate severe periportal fibrosis.

The results indicate a significantly higher rate of infections with S. mansoni in street children compared with orphans. This might be explained by the lack of access to adequate sanitation for street children as well as regular contact with the water of Lake Victoria. However, we did not find similar results concerning infection rates with protozoa. The study results show overall inadequate living conditions in this study population, which could be addressed by public health interventions.