Microbiology and Parasitology Department, Federal Fluminense University, Biomedical Institute, Professor Hernani de Mello Street, 101, São Domingos, Niterói, Rio de Janeiro 24210-130, Brazil.
Microbiology and Parasitology Department, Federal Fluminense University, Biomedical Institute, Professor Hernani de Mello Street, 101, São Domingos, Niterói, Rio de Janeiro 24210-130, Brazil; Toxoplasmosis and other Protozoosis Laboratory, Oswaldo Cruz Institut, Oswaldo Cruz Foudation, Brazil Avenue, 4365, Manguinhos, Rio de Janeiro 21045-900, Brazil.
Acta Trop. 2021 Nov;223:106069. doi: 10.1016/j.actatropica.2021.106069. Epub 2021 Jul 31.
Balantioides coli is a protozoan that infects different hosts species, including humans, with zoonotic transmission. The parasite, which lives in the large intestine and in other organs, can lead to serious infections that may culminate in death. Information about human balantidiasis is generally still very scanty. In view of the above, the purpose of this study was to analyze the epidemiological, clinical and laboratory characteristics of human balantidiasis based on a systematic review and meta-analysis. The scientific articles were retrieved from various databases and were subjected to descriptive analyses, chi-squared tests, and summarized on a forest plot and the heterogeneity index (I). A total of 103 articles were eligible and included in this review. Out of these 103 articles, 75 were clinical case reports and 28 were epidemiological studies, indicating a frequency of 997 (3.98%) people potentially infected with B. coli. The publication dates of the analyzed articles ranged from 1910 to 2020, but the majority (68.9%) were published between 1998 and 2020. A considerable number of these articles were published in South America and Asia, mostly in Brazil and India, respectively. However, in Africa, Ethiopia, was observed the higher number of infected people (47.5%). A significant association (p < 0.05) was identified between proximity to pigs and positivity for B. coli, since more than 16% infected people were in proximity with pigs and/or their excreta. Infection by the protozoan was classified mainly as intestinal, and the predominant symptom was dysentery. Extraintestinal infections were found in 27 individuals, with colonization of the genitourinary tract frequently highlighted. Direct examination (17.2%), followed by an association of direct examination and sedimentation (45.7%), were the most commonly performed parasitological techniques, and the most frequently diagnosed form was trophozoites, corresponding to 22.5% of cases. The most common treatment for parasitized individuals (11.8%) was an association of tetracycline drugs with nitroimidazole derivatives. The articles retrieved, mainly epidemiological ones, used in meta-analysis showed high heterogeneity (I> 50%, p < 0.05), impairing the retrieval and comparison of results. Some articles were found to provide incomplete information, making it difficult to retrieve and analyze variables. However, this review enabled us to compile and restate factors that appear to be associated with cases of human balantidiasis.
结肠内巴通体是一种寄生于多种宿主的原生动物，可通过动物-人途径传播。该寄生虫主要寄生于大肠和其他器官，可引起严重感染，甚至导致死亡。关于人类巴通体病的信息通常仍然非常有限。有鉴于此，本研究旨在通过系统回顾和荟萃分析，分析人类巴通体病的流行病学、临床和实验室特征。从多个数据库中检索科学文章，并进行描述性分析、卡方检验，并在森林图和异质性指数（I）上进行总结。共有 103 篇文章符合纳入标准并被纳入本综述。在这 103 篇文章中，75 篇为临床病例报告，28 篇为流行病学研究，表明有 997（3.98%）人可能感染了结肠内巴通体。分析文章的出版日期范围为 1910 年至 2020 年，但大多数（68.9%）发表于 1998 年至 2020 年。这些文章中有相当数量发表在南美洲和亚洲，分别主要发表在巴西和印度。然而，在非洲，埃塞俄比亚观察到感染人数最多（47.5%）。在与猪的接近程度与结肠内巴通体阳性之间存在显著关联（p<0.05），因为超过 16%的感染人群与猪及其粪便接近。寄生虫感染主要被分类为肠道感染，主要症状为痢疾。在 27 名个体中发现了肠道外感染，常伴有泌尿生殖道定植。直接检查（17.2%），其次是直接检查和沉淀的联合检查（45.7%），是最常用的寄生虫学技术，最常诊断的形式是滋养体，占 22.5%。寄生虫感染个体最常见的治疗方法（11.8%）是四环素类药物与硝基咪唑衍生物联合治疗。在荟萃分析中使用的主要为流行病学文章，显示出高度的异质性（I>50%，p<0.05），妨碍了结果的检索和比较。一些文章提供的信息不完整，使得检索和分析变量变得困难。然而，本综述使我们能够编纂和重新陈述与人类巴通体病病例相关的因素。
