دراسة وبائية عن الأميبا الحالة للنسج بحث كامل جاهز مع الواجهه واقرار المشرف والاهداء والمحتويات
Abstract
Amoeba histolytica is one of the most
dangerous infectious diseases, as it comes in second place after malaria as a
cause of death. The World Health
Organization has estimated that there are about 50 million individuals in the
world suffering from infection with Amoeba histolytica, which causes 50,000
deaths annually.
The
life cycle of histolytic amoeba includes two stages: the cyst stage and the
vegetative trophozoite stage. Infection with histolytica amoeba occurs by
ingestion of infectious cysts with contaminated water and food.
The current study was conducted during the
period from December 2017 to March 2018. Two methods were used in diagnosis,
the direct examination method and the agricultural media method, where 253
samples of stool that were taken from people in the city of Al-Qasim were
examined, as the prevalence of the infection was. 12.25 Entamoeba histolytica was a parasite,
And the highest rate of infection was in
the age group under ten years, at a rate of 4.3%, while the lowest rate of
infection was in the age group of 20-30% years, at a rate of 1.9%. The rate of
infection between males and females was close, as the rate of infection in
males was 7.11% compared to 5.13 in females. It was also noted that a high
incidence of infection was observed in the countryside, reaching 61%, while the
percentage was lower in the city. It reached 39%.
Amoeba histolytica was isolated from the
disease infected with the parasite after they were examined and confirmed to be
infected with this parasite.
Chapter One
{Introduction}
Introduction
Parasites
spread throughout the world, especially in tropical and subtropical regions.
This is due to the availability of climatic conditions, such as differences in
temperature, high population, low level of health awareness, and increased
poverty rates, which help the presence of parasites in these areas (1).
Parasites depend for their lives on living
organisms of another species in order to obtain shelter and secure their
nutritional needs, or both. A parasite is an organism that lives permanently or
temporarily on the surface of another organism or inside it, called the host.
The parasite benefits and the host is harmed. The discovery of microscopes
played a major role in identifying the precise internal structures of these
parasites. Entamoeba histolytica is one of the common parasites in Iraq and the
world, causing what is called amoebic dysentery. The number of infections with
it has been estimated at (480) million. In the case of infection with systemic
entamoeba histolytica, the liver is mainly affected, while the infection rate
of other organs is small (2).
The
parasite-carrying amoebic dysentery was diagnosed in Russia in the year 1875 by
researcher Robert Koch. Then he added in 1887 that amoebic colitis is generated
in dogs, which in turn produce feces carrying the parasite. The parasite may
penetrate the wall of the mucous membrane of the large intestine, where It
settles in the liver and causes liver abscesses, and severe infections cause
appendicitis Wormworms, diarrhea, malnutrition, severe defecation, peritonitis,
lung abscesses, and also cause megacolon and general weight loss (3).
Parasite
infection occurs as a result of eating food and water contaminated with
parasite cysts by the host, after which the vegetative stage emerges from the
cysts in the small intestine. It then moves to the large intestine. There are
factors that help increase the penetration of the parasite, which are
temperature fluctuations, hot, irritating foods, and some inflammatory
conditions. It has also been found that high-grade organisms, such as dogs and
cats, are infected with the parasite (4).
Entamoeba histolytica is a unicellular protozoan parasite belonging to
the genus Entamoeba. It inhabits the human large intestine and can cause both
intestinal and extraintestinal diseases. This parasite is the causative agent
of amoebic dysentery, characterized by painful diarrhea with blood, and in
severe cases, it can lead to liver abscesses (5).
The transmission of E. histolytica primarily occurs through the
ingestion of food or water contaminated with feces containing the parasite.
This infection is prevalent in regions with poor sanitation, where its
prevalence can reach up to 50% in some areas (6).
The parasite exists in two forms during its life cycle: the trophozoite
(active form) and the cyst (infectious form). The mature cyst is the infectious
stage, capable of surviving in the environment for extended periods before
being ingested by a new host (7).
Upon ingestion, the mature cyst transforms into the trophozoite in the
large intestine, where it can either remain as a commensal organism without
causing symptoms or invade the intestinal mucosa, leading to ulceration and
disease. In some cases, the parasite may spread to other organs, such as the
liver, lungs, and even the brain, causing severe complications (8).
Early diagnosis and appropriate treatment are crucial to preventing
complications of E. histolytica infection. Diagnostic methods include
microscopic examination of stool samples, immunological tests, and polymerase
chain reaction (PCR) techniques for detecting parasite DNA (9).
Preventive measures include improving sanitation conditions, ensuring
the cleanliness of food and water sources, and raising awareness about the
importance of regular handwashing (10).
The aim of the research:
is to shed
light on amoebic dysentery and its parasites, as well as to know the origin and
spread of the parasite and to collect many statistics that indicate that many
people are infected with amoebic dysentery.
Chapter Two
Literatures Review
Morphological and biological features of the parasite
1.Trophozoite Stage:
The
trophozoite is the active, motile, and feeding stage of Entamoeba histolytica.
It is the form responsible for causing infection and can invade host tissues,
leading to amoebiasis. The trophozoite plays a crucial role in the life cycle
of the parasite.
Morphological
Characteristics of the Trophozoite:
1. Size: The trophozoite typically ranges from 15 to 60 micrometers in diameter. The size can vary depending on the environment and conditions of the host (11).
2. Shape: The trophozoite is irregular in shape and often appears amoeboid. It can change shape as it moves, aided by pseudopodia, which are temporary extensions of the cytoplasm that allow for motility (12).
3. Cytoplasm: The cytoplasm is divided into two main components:
Endoplasm: The inner, dense region containing the nucleus, mitochondria, and other organelles (13).
Ectoplasm: The outer, clear region involved in the formation of pseudopodia for movement (14).
4. Nucleus: The trophozoite typically has one or more nuclei, which can be seen clearly under a microscope. The nucleus contains chromatin and a nucleolus, which aid in identifying the parasite (15).
5.
Movement: E. histolytica moves by extending pseudopodia, which are lobe-like
protrusions of the cytoplasm. This movement allows it to traverse intestinal
tissue or other affected tissues (16).
Life Cycle of Entamoeba histolytica
(including Trophozoite stage):
The life cycle of Entamoeba histolytica
involves two main forms:
Cyst: The cyst is the infective form that is resistant to
environmental stress, including stomach acid and desiccation. It is ingested
through contaminated food or water (17).
Trophozoite: After ingestion, the cyst transforms into
the trophozoite in the intestines, where it can invade the mucosal lining,
causing damage and symptoms of amoebiasis. The trophozoite may spread to other
organs such as the liver, lungs, and brain, leading to extra-intestinal disease
(18).
Entamoeba histolytica trophozoite
2.Cystic Stage:
The cyst is the infective form of Entamoeba
histolytica, capable of surviving in the external environment and being
transmitted from person to person. It is highly resistant to environmental
stresses such as stomach acid and desiccation, making it an essential stage in
the parasite's transmission.
Morphological Characteristics of the Cyst:
1. Size: The cyst is typically 10 to 20 micrometers
in diameter, smaller than the trophozoite form. Its size can vary slightly
depending on environmental conditions (11).
2. Shape: The cyst is spherical or oval in shape,
making it highly compact and resistant to environmental stress (12).
3. Cytoplasm: The cyst has a clear, homogenous
cytoplasm that contains the nucleus and is protected by a thick wall, which
provides resistance to harsh environmental conditions (13).
4. Nucleus: The cyst contains 1 to 4 nuclei, depending
on its maturity. The number of nuclei increases as the cyst matures, which is
an important characteristic for identifying the cyst under a microscope (15).
5. Chromatoidal
Bodies: Some cysts
contain chromatoidal bodies, which are condensed ribosomal material that can be
seen under a microscope. These bodies are characteristic of the cyst form (14).
Transmission and Infection Process:
The cyst is the infective form of E.
histolytica and is transmitted via the fecal-oral route. When an individual
ingests contaminated food or water containing the cysts, the cysts pass through
the stomach, where they are resistant to stomach acid. Once in the small
intestine, the cysts excyst and transform into trophozoites, which then
colonize the colon and can cause amoebic dysentery or extra-intestinal disease
(17).
Life Cycle of Entamoeba histolytica
(including Cyst Stage):
The cyst is the primary infectious form
that survives in the environment. After ingestion, it excysts and releases
trophozoites, the active form that causes disease. The trophozoites may invade
the intestinal mucosa, and in some cases, they may spread to extra-intestinal
tissues like the liver, lungs, or brain (18).
Entamoeba histolytica cyst
The tetranucleate cysts pass out
with the feces of the patient and form the infective stage. They appear as
minute, shining, greenish, refractile spheres. At low temperature, they can
survive for 5-6 weeks and at room temperature for about 1 week. The cysts die
if dried or desiccated.
Life cycle of Entamoeba
histolytica
The life cycle of Entamoeba histolytica
consists of two main stages: the cyst stage (infective form) and the
trophozoite stage (invasive form). Transmission occurs primarily through the
fecal-oral route, via ingestion of contaminated food or water containing mature
cysts (19).
1. Cyst Stage
(Infective Stage)
The mature
quadrinucleate cyst is the resistant form that survives outside the host in
contaminated food, water, or soil (20).
The cysts
are highly resistant to gastric acidity and environmental stresses, enabling
them to persist for weeks in moist environments (21).
Humans
acquire the infection through the ingestion of cysts, which pass through the
stomach and reach the small intestine, where they undergo excystation,
releasing trophozoites (22).
2. Trophozoite
Stage (Pathogenic Stage)
The
trophozoite is the motile and feeding stage, responsible for colonizing the
large intestine (23).
It moves by
extending pseudopodia, feeding on intestinal bacteria and host cells (24).
In most
cases, trophozoites remain in the intestinal lumen without causing symptoms
(asymptomatic infection) (25). However, in pathogenic cases, trophozoites
invade the intestinal mucosa, leading to amoebic dysentery (bloody diarrhea)
and tissue destruction (26).
In severe
cases, trophozoites enter the bloodstream and spread to other organs such as
the liver, lungs, and brain, causing extraintestinal amoebiasis, primarily
forming liver abscesses (27).
3. Encystation
(Formation of Cysts and Transmission)
Some
trophozoites undergo encystation in the lower colon, forming immature cysts,
which develop into infectious quadrinucleate cysts (28).
These cysts
are excreted in feces, completing the life cycle (29).
In areas
with poor sanitation, cysts contaminate food and water sources, leading to new
infections (30).
Summary of
the Life Cycle:
Ingestion of
infectious cysts through contaminated food or water (31).
Excystation
occurs in the small intestine, releasing trophozoites (32).
Trophozoites
colonize the large intestine, causing either asymptomatic or symptomatic
infection (33).
Some
trophozoites undergo encystation, forming cysts in the colon (34).
Cysts are
excreted in feces and survive in the environment until ingested by a new host (35).
لتحميل الجانب العملي يرجى تحميل الملف بصيغة الوورد
Conclusions
In light of the current study, the following
conclusions were reached:
1- The main feature of this disease is the
presence of blood in the stool, accompanied by severe colic, severe diarrhea,
and fever.
2- The incidence of the parasite was higher
among males than females.
3- The
age groups (66-75) years recorded the lowest incidence rates among different
age groups.
4- The age groups (1 month-15) years recorded
the highest incidence rates among different age groups.
Recommendations
1-
Pay attention to personal hygiene, such as washing
hands before eating and drinking and after using private toilets.
2- Wash hands well after using toilets in
public places such as cafes, restaurants, and hotel.
3- Pay attention to drinking water sources by
conducting periodic tests to ensure that they are free of microbial
contamination, sterilizing them, and ensuring their continuous maintenance.
4- Pay
attention to maintaining private and public sewage networks to prevent water
leakage from them into drinking water sources and not allowing the competent
authorities to drill wells except with prior permission that meets safety
conditions and the legal distance from sewage sources.
5- Conducting laboratory tests for school
children and their families to periodically confirm infection and treat those
infected to reduce the spread of the disease among the population. The
responsible health authorities must provide tests in public health centers
6- a
permanent basis.
7- Health education through visual and audio
media and giving awareness lectures to school students and families about the
seriousness of infection and how to prevent it.
8-
Activating the food control apparatus in restaurants
and shops, and providing technicians working in laboratories with training
courses on new modern diagnostic methods.
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