AMOEBIASIS : SYMPTOMS, TREATMENT, PREVENTION AND CONTROL

The term amoebiasis is a condition of harbourng Entamobeba histolytica with or without clinical manifestation. Amoebiasis may be intedtinal or extra-intestinal.The intestinal amoebiasis manifests symptoms of amoebic dysentary, non-dysenteric colitis, amoeboma and amoebic appendictis bringing about many complication like intestinal perforation, peritionitis and haemorrhage. The Extra-intestinal amoebiasis occurs in the liver,lungs brain,spleen,and skin etc. The more common among these is hepatic amoebasis. Amoebiasis is estimated to affect 10% of the world's population and 15% of Indian population.The causative agent,E.histolytica is a lumen-dwelling protozoon parasite and exists in two forms : 1) rtophozoite or manga or feeding stage. 2) Cystic or minuta or infective stage. The cysts, which are the infective forms, are resistant to marked changes in the external environment. E.histlytic is a monogenitic parasite and its only host is human. Its feeding stage: the trophozoite is monopodial, i.e with one pseudopodium abd no contractile vacuole. It has two forms : the pathogenic magna form and nonpathogenic minuta form.Magna form affects the mucosa and submucosa causing ulcers. The minuta form is founded in the lumen of the intestne and forms the tetra-nucleate ancysted mature cyst. The mature cyst bears two chromatoid bodies and four nuclei. This is the infective state of Entamoeba and is realesed from the body of the host through feacal matter which contains the cysts of E.histolytica. The primary cause of prevalence of amoebiasis in india are defecation in the open air leading to contamination of the soil, lack of pure drinking water supply and low standard of living.

Transmission :

Transmission of Amoebasis is mainly by the oral route It is due to intake of cyst contaminated water and food. The infection may also be caused by files, cockroaches and rodents which carry the cyst and contaminate food and drink. The incubation period is 3 to 4 weeks but shorter in massive infection.

Symptoms :

Amoebasis causes 6-10 loose motion per day with blood stained mucous. loose motion may be altered by constipation and massive infection leads to ulceration of the gut, liver, lungs and brain.

Treatment :

There is no single drug which can be eliminate all stages of E.histolytic infections usually can be treated effectively by oral dose of matronidazole at the rate of 400-800 mg t.d.s. for ten days The other drugs are mexaform, Enteroquinol, Diogoguin, Tinidazole, Enterovioform and Tinidafylplus.

 Prevention and Control :

Primarily, prevention is aimed at discouraging defecation in open air ,which leads to contamination of water, food, vegetables and fruits. Water filtration and boiling are effective measures against amoebiasis. Vegetables should be properly washed before use. Safe disposal  of human excreta is crucial to controlling amoibiasis. Educating ignorant people with personal hygine and proper toilet habits also proves fruitful.

Secondary prevention aims at early diagnosis of the disease. Intestinal amoebasis is diagnosed by examining the faces of the patient to identify the trophozoites and cysts. Extra intestinal amoebiasis is diagnosed by the serological tests, immuno-electrophoresis (CIE) and ELISA.