PREVALENCE OF ENTAMOEBA HISTOLYTICA

IN ENUGU METROPOLIS A CASE STUDY OF PARKLANE HOSIP

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ABSTRACT

Entamoeba Histolytica causes Ameobissis in man. It may lead to complications such as liver, lings and brain abscesses if not properly managed. The research work was to determine the prevalence of entamoeba histolytica causes amoebic dysentery in the population of people of all ages i.e. adult, children and middle-aged group in Enugu metropolis.
The methods of analysis used was the died microscope examination count which was carried out at park lane hospital Enugu.
One hundred and fifty two (152) stool samples from different individuals were colleted in the method faucal smear of the stool samples was made using eosin reagent and viewed and the x 10 and x 40 objective of the microscope. The positive samples revealed the cysts and motile Trophozoites of E. Histolytica.
The analytical result then showed that the rate at which E Histolytica occurs in Enugu metropolis in at the same rate in the population of all ages i.e. adult, children and middle aged group (youths). Therefore, the rate of prevalence of Entamoeba Histolylica in Enugu metropolis of dependent on age.

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TABLE OF CONTENTS

CHAPTER ONE
1.0 Introduction 1
1.1 Background information 1
1.2 Objective of the study 7
1.3 Statement of problem 8
1.4 Justification 9
1.5 Limitations of the study 9
1.6 Hypothesis 10
CHAPTER TWO
2.0 Literature Review 11
2.1 Historical Review 11
2.2 Morphology and mode of Reproduction 17
2.3 Mode of Nutrition 20
2.4 Incidence and Distribution of E. Histolytic 21
2.5 Reproduction, Transmission and Life Cycle 22
2.6 Mode of Infection and Epidemiology 24
2.7 Effects and Pathogenicity 27
2.8 Amoebic Dysentery 30
2.9 Abscess in the Liver, Lung, Brain, Skin, Gerifal Tract etc. 32
CHAPTER THREE
3.0 Materials and Methods 36
3.1 Materials Used 36
3.2 Sample Collection 36
3.3 Explanation, Preparation and Application of
some Material Used 38
3.4 Laboratory Diagnosis 40
3.5 Method Direct Microscopic Examration Technology 40
CHAPTER FOUR
4.0 Results and Discussion 42
4.1 Results of Stool Samples 42
4.2 Discussion 46
CHAPTER FIVE
5.0 Conclusion and Recommendation 49
5.1 Conclusion 49
5.2 Recommendation 50
5.3 Treatment and Control 51
Reference 54

CHAPTER ONE

1.0 INTRODUCTION
1.1 BACKGROUND OF INFORMATION
Entamoeba Histohytics belongs to the subphylum sarcodina which is characterized by organisms that move by pseudopodia or by locomotive profopksmic flow without discrete pseudopodia, flpella when present are usually restricted to developmental or other temporary stages (cook and zumla 2003). Members of the order (Amoebida) are characterized by having lob-like preudopodia and no testis or shells. The species of the amoeba trie as commemals or parasites in the intestines of various animals from termites to man (Schanidt and Roberts 1989).

There are about six species of amoeba common in man in most parts of the world but only one species Entamoeba Histolytica occurs throughout the world in man, apes, monkeys, dogs cat, rats. The frophozoitts or the feeding stage inhabits in the lower small intestal and colon where it multiplies by binary fissin and form four (4) characteristics four (4) nucleic cysts. These cysts are pared out and subsequently myested in contaminated water.

The times the amoeba invade the mucoss and submucosa and may be carried via the portal vcus to the liver and other parts of the body. Comderable damage may be caused in the with of the bowel or in the liver. In most people there is no tissue invasion and parasite cause no harm. Time manian are variable but usually includes diarrhea or dysentery with the loss of blood i.e. amoebic dysentery (Cox 1982).

Amoebic dysentery occurs when E histolytica trophozoites made the walls of the layer intestine and multiply in the submucosa, forming large flask-shaped ulcers. The amoebae ingest red cells from damaged capillaien. Compared with bacillary dysentery, the onset of amoebic dysentery is less acute, lasts layer and there is rurally no significant fever without treatment dysenteric attacks may recur for several years (Chees Brough 2002).

Entamoeba histoytica which parts in an amoeboid form in the human large intestines causes amoebians (prolozoan infection). The pathogenic amoeba enters a mucosal fold and feeds on red blood cells. Paretrating through the musculars mucoscie, an abscess forums which results in vascular necrosis. This leads to times dismtepartion and the development of an ulcer (flask-shaped ulcer) Active amoebae can be found in the base of an ulcer. In choric infection an amoebaean can be formed which may be confused with carcinoma.

If amoebic ulcer perpetrates a blood renal, fresh blood is pared in the stool, which is a characteristic feature in the Dionysus. Amoeba are also carried in the breached circulatory system to various parts of the body, the liver being the Commonest, forming, liver absence. The right robe is the commonest site and liver damages a predisposing occurs. The expanding obscene can track outwards through the petroleum, abdomen wall and on to the skin or upwards to form a subphrenic abscess or enter the pleural charity.

The mansion site of amoebic obscene development is in the bran. All these features are illustrated in the diagram below (fig 1.1). Form the figure 1.1, infection by Endameba histolytic a occurs by ingestion of mature cysts (1) in fecal contaminated food, water, or hand. Excystation (2) occurs in the small intestine and hophozostes (3) are released, which myrate to the large intestine. The traphozortes multiply by binary fissin and produce cysts (4), which are passed in the faces. Because of the protection conferred by their walls, the cysts can sunrise days to weeks in the external environment and are responsible for trummissio. (Trophozoites can also be passed in diarrheal stools, but one rapidly destroyed once outside the body, and if ingested would not survive exposure to the gastric environment.

In many cases, the trophozortes remain confined to the intestinal human (A): non-invasive infection of individual who are symptomatic carnies, passing cysts in their stools. In some patients the troplozoites invade the intestinal muicosa (B): intestinal disease), or through the blood stream, extra intestinal sites such as the liver, brain and lung (C): extra-intestinal disease), with resultant pathologic manifestation. It has been established that the invasive and non inverse form represent two separate species respectively E histolytica and E dispar, however not person infected with E histolytica will have invasive disease. These two separate species that are morphologically indistinguishable. Transmission can also occur through focal exposure during sexual contact (in which case not only cysts, but also trophozoites could prove infective (WHO 2004).

However, infection also occur through drinking contaminated water or eating migrated salad vegetables, uncooked food or from carries. Files may carry the cysts for some 5 hours and spread the amoeba from the feces of infected persons to food. In circumstances of poor hygiene, direct fecal – oral transfer via food or by utensils can take place.

Amoebiasis is a disease of poor hyepiene more commonly found in cooler areas than hot. In the tropics it predominately occurs in hyhland areas or where there is large temperature flections cysts can survive in the cold for considerable periods but they are killed by temperature over 430C, which must be obtained in any composing system where human faces are used. Sunival of amoebic cysts in a useful indicator of ineffective decomposition.

The infection occurs in adult life and the longer the period of residence in an endemic area, the greater the chance of becoming infected. The incubation period in 2 – 4 weeks, illnen presenting as an acute dysentery diarrhea (Webber 1996).
In Europe and USA the prevalence of Entamoeba Histolytica is len than 5% and oval symptoms are rare. But in many parts of the tropics and subtropics such as Nigeria, prevalence is more than 50% and dysentery and liver involvement may be common. This is attributed to the fact that Nigerians are African at large do take less pains to observe baric hygiene an needed (Chandler and Read 1961).

Entamoeba histolytica is ranked as one of the most important parent because of the following reasons.
i. Capacity of causing diseases
ii. The discomforting frequency of the parasite
iii. It has world vride distribution oral is almost as frequently present though fortunately not so frequently pathogenic in the temperate zones as in the wanner areas of the world such as Nigeria in Africa. This is because Nigerians and Africans at large take ten pains in delousing its cysts with contaminated food or water (Cox 198z).

infants under a year old are rarely infected with this or amoebae except where the mother is very careless. The incidence generally increases during childhood and usually reaches its highest incidence in young adult. There seem to be no racial discrimination against the organism. In areas where moderate incidences of 5 to 20% occurs there are usually about twice as many E Cole infections. This to probably because the thicker and more resistant cysts will of E. Cole makes it transmission earlier (Schmidt and Robert 1989).

Microscopic examination of multiple faces samples of 2,825 person that was carried out in Enugu metropolis in Nigerian urban population curel the overall prevalence of Entamoeba Histolytics was 11.2%. Prevalence increased rapidly in younger age groups and these were no real differences between males and females. Prevalence was high among families who ate together from the same plate, among those who ate with their fingers and among those who ate away from home. Prevalence was not associated with type of water supply but was seemingly influenced by storage of household supplies.

A low infection rate was associated with the available of water closet and foiled habit. No association was found between prevalence and standard of education but the rate of infection was increased among workers with high occupational interaction. Significant differences were found among different ethnic groups the highest infection rate was recorded in the last month of…

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