The persistence of amoebosis caused by Entamoeba histolytica in Nigeria and the role of malnutrition

Abstract

Amoebosis, caused by the protozoan parasite Entamoeba histolytica is a gastrointestinal infection and the second leading cause of death from parasitic disease worldwide. The disease is endemic in many developing countries and kills over one hundred thousand persons annually. Adequate nutrition composed of macro- and micronutrients in their balanced proportions is central to effective gut immune response and the homeostasis of commensal organisms in the gastrointestinal tract. Entamoeba histolytica is a gut pathobiont that can exploit a shift in nutritional status to cause amoebosis, with extra-intestinal complications. Although undernutrition is rarely a public health concern in high income settings, bioavailability of functional nutrients remains suboptimal. On the other hand, nutrient deficiencies constitute a chronic challenge in very low-income regions. This study sought to review the pivotal influence of malnutrition on intact microbiota and functional immunity, as determinants of susceptibility to amoebosis in the Nigerian example of tropical regions. The dynamics of the infection such as possible coinfection with opportunistic pathogens were also, evaluated. Based on the available reports, we posit that amoebosis is a common tropical infection perpetuated by malnutrition following poor living standard including unhygienic environmental exposure.