Risk factors for Entamoeba histolytica infection in an agricultural community in Hanam province, Vietnam

Abstract

BackgroundEntamoeba histolytica is an important protozoan intestinal infection in resource-poor settings, including Vietnam. The study objective was to assess risk factors of E. histolytica infection in a community in Vietnam, where wastewater and human excreta are used in agriculture. A case-control study was conducted among residents of Hanam province, Northern Vietnam. Cases (n = 46) infected with E. histolytica and non-infected controls (n = 138) were identified in a cross-sectional survey among 794 randomly selected individuals and matched for age, sex and place of residence. Potential risk factors including exposure to human and animal excreta and household wastewater were assessed with a questionnaire.ResultsPeople from households with an average socio-economic status had a much higher risk of E. histolytica infection (odds ratio [OR]=4.3, 95% confidence interval [CI]: 1.3-14.0) compared with those from households with a good socioeconomic status. Those individuals who never or rarely used soap for hand washing had a 3.4 times higher risk for infection (OR=3.4, 95% CI: 1.1-10.0), compared to those who used always soap. In contrast, none of the factors related to use of human or animal excreta was statistically significant associated with E. histolytica infection. People having close contact with domestic animals presented a greater risk of E. histolytica infection (OR = 5.9, 95% CI: 1.8-19.0) than those without animal contact. E. histolytica infection was not associated with direct contact with Nhue river water, pond water and household's sanitary conditions, type of latrine or water source used.ConclusionsOur study suggests that in settings where human and animal excreta and Nhue River water are intensively used in agriculture, socio-economic and personal hygiene factors determine infection with E. histolytica, rather than exposure to human and animal excreta in agricultural activities.

Prevalence and Risk Factors Associated with Entamoeba histolytica/dispar/moshkovskii Infection among Three Orang Asli Ethnic Groups in Malaysia

“…moshkovskii and this finding is consistent with a previous study from Brazil [37] and Iran [38]. By contrast, recent reports from Kenya, Yemen, Vietnam, and Tajikistan found no association between E. histolytica infection and the consumption of raw vegetables [27], [29], [39], [40]. We observed that tapioca shoots, wild fern shoots and locally planted leaves are the main raw vegetables as salad by the Senois; they usually do not wash these vegetables before eating.…”

Prevalence of Dientamoeba fragilis, Giardia duodenalis, Entamoeba histolytica/dispar, and Cryptosporidium spp in Da Nang, Vietnam, detected by a multiplex real‐time PCR

“…In this study, we showed that the prevalence of E. dispar, E. histolytica and C. spp is low for patients with GI symptoms and in a healthy group without GI symptoms. The prevalence of E. dispar in the adult population is similar to that described in other studies from Vietnam concerning E. histolytica (18,19). However, the prevalence of E. histolytica may be overestimated because typing was not made by PCR.…”

Soil‐transmitted helminth infections associated with wastewater and sludge reuse: a review of current evidence

“…The interlinkages between different contamination sources and transmission routes are essential in these types of studies. Pham-Duc et al [75] found that hygiene was the main pre-disposing factor to an increased risk of parasitic infections (mainly protozoan) rather than exposure to wastewater or sludge. The epidemiological studies highlight a high incidence of STH infections among farmers and consumers of vegetables irrigated with wastewater or on sludge amended soil.…”