Current Global Status and the Epidemiology of Entamoeba gingivalis in Humans: A Systematic Review and Meta-analysis

Abstract

Purpose Entamoeba gingivalis (E. gingivalis) is one of the members of the wide range of oral resident pathogens in humans, particularly found in dental plaques, surfaces of gingiva or teeth, interdental spaces and carious lesions. The purpose of the current review and meta-analysis was to determine the global prevalence of E. gingivalis infection and its association with oral diseases based on published literatures.Methods Multiple English databases (PubMed, Scopus, Science Direct, Web of Science and Google Scholar) were explored for papers published until August 2020. A total of 52 studies (including 7596 participants) met the inclusion criteria.Results The overall prevalence of E. gingivalis was estimated to be 37% (95% CI: 29% -46%). With regard to different countries, the highest and lowest pooled prevalence of E. gingivalis infection were related to Jordan with 87% (95% CI: 81% -92%) and Portugal with 3% (95% CI: 0% -10%), respectively. Based on WHO regions, the highest prevalence was related to the region of the Americas with 56% (95% CI: 31%-79%). The infection was most prevalent in 46-55 mean age groups [61% (95% CI: 21% -94%)].Among different diagnostic methods, the highest rate of the pooled prevalence was related to the molecular [53% (95% CI: 24% -81%)] and the direct methods [36% (95% CI: 25% -47%)], respectively. Our analyses revealed that E. gingivalis infection was associated with 4.34-fold increased risk of oral diseases (P < 0.05). ConclusionOur ndings revealed a high prevalence rate of the infection among periodontal disease patients with 37% (95% CI: 20% -57%). To conclude, it must be considered that E. gingivalis can be a risk factor associated with oral diseases and a wide range of research is needed to specify its role in the pathogenesis of these disorders.

Oral Colonization by Entamoeba gingivalis and Trichomonas tenax: A PCR-Based Study in Health, Gingivitis, and Periodontitis

“…In periodontitis, the role of the bacterial fraction of the oral microbiome has been studied extensively with accumulating evidence pointing to its contribution to the etiology of the disease ( Teles et al., 2013 ). However, the fraction of protozoa was not studied to a similar level compared to its bacterial counterpart ( Deng et al., 2017 ; Bonner et al., 2018 ; Bisson et al., 2019 ; Santi-Rocca, 2020 ; Badri et al., 2021 ; Eslahi et al., 2021 ). Nevertheless, this protozoan fraction does not seem to be negligible in some clinical setups, with E. gingivalis RNA accounting for up to 9% of the total RNA in periodontal pockets ( Deng et al., 2017 ).…”

“…For T. tenax , the estimates were much lower and significant differences were found moving from 3.2% in the healthy group to 18.2% among individuals with periodontal disease. To assess the reproducibility of these results, a limited number of studies were found ( Kikuta et al., 1996 ; Trim et al., 2011 ; Bonner et al., 2014 ; Garcia et al., 2018a ; Santi-Rocca, 2020 ; Badri et al., 2021 ; Eslahi et al., 2021 ). The comparisons were further complicated by the reliance of a majority of the previous studies on microscopic detection methods (examination of wet mounts or permanent stained smears) ( Athari et al., 2007 ; Ghabanchi et al., 2010 ; Al-hamiary et al., 2011 ; Ibrahim and Abbas, 2012 ; Yazar et al., 2016 ; Hassan et al., 2019 ).…”

“…Despite the variability in results of the previously published reports, two recurring patterns were observed and were in line with our results. First, the observation of an increase in the prevalence of both oral parasites moving from health to gingivitis and reaching the highest levels in periodontitis ( Santi-Rocca, 2020 ; Badri et al., 2021 ). Second, the generally higher prevalence of E. gingivalis in comparison to T. tenax in both health and disease.…”

Study of immunological parameter (ECP) of entamoeba gingivalis in immunocompromised patients with periodontitis in Al-Najaf Al-Ashraf City

“…The study presented by Badri revealed a high prevalence rate of the infection among periodontal disease patients with 37% (95% CI 20-57%). To conclude, it must be considered that E. gingivalis can be a risk factor associated with oral diseases and a wide range of research is needed to specify its role in the pathogenesis of these disorders (Badri et al, 2021).…”

Prevalence and risk factors of oral cavity parasites in pregnant women in Western Iran

“…The human oral cavity contains numerous microorganisms so that a set of different bacterial and viral agents, like the oral microbiome, live inside the gum plaques ( Deo and Deshmukh, 2019 ). Entamoeba gingivalis and Trichomonas tenax are considered as anaerobic protozoan parasites observed in human oral cavity ( Marty et al, 2017 ; Badri et al, 2021 ). These parasites have no cyst forms; thus, they can transmit between individuals, generally through saliva, kissing or contaminated dishes, food, and drinking water, toothpicks, gum or other utensils ( Marty et al, 2017 ; Badri et al, 2021 ).…”