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Balantidiasis in humans: A systematic review and meta-analysis
Rayana Katylin Mendes da Silva1, Laís Verdan Dib2, Maria Regina Amendoeira3
1Microbiology and Parasitology Department, Federal Fluminense University, Biomedical Institute, Professor Hernani de Mello Street, 101, São Domingos, Niterói, Rio de Janeiro 24210-130, Brazil.
Acta Tropica
|August 2, 2021
Summary
Human balantidiasis, caused by Balantioides coli, is a zoonotic infection with intestinal and extraintestinal manifestations. Proximity to pigs is a risk factor, and diagnosis often involves direct examination of trophozoites.
Area of Science:
- Parasitology
- Infectious Diseases
- Public Health
Background:
- Balantioides coli (B. coli) is a protozoan parasite with zoonotic potential, causing human infections primarily in the large intestine.
- Human balantidiasis is infrequently documented, necessitating a comprehensive review of its characteristics.
- Infections can be severe and potentially fatal, highlighting the importance of understanding transmission and clinical presentation.
Purpose of the Study:
- To systematically review and meta-analyze the epidemiological, clinical, and laboratory features of human balantidiasis.
- To consolidate existing knowledge on B. coli infections in humans due to scarce information.
- To identify factors associated with human balantidiasis.
Main Methods:
- Systematic review and meta-analysis of scientific articles retrieved from multiple databases.
- Descriptive analyses and chi-squared tests were employed.
- Forest plots and heterogeneity index (I² ) were used for data summarization.
Main Results:
- 103 articles (75 case reports, 28 epidemiological studies) were included, reporting 997 cases (3.98% prevalence).
- Most publications (68.9%) were from 1998-2020, with high concentrations in South America and Asia (Brazil, India), and Ethiopia reporting the highest African cases (47.5%).
- Proximity to pigs was significantly associated with infection (p < 0.05); dysentery was the predominant symptom; trophozoites were the most diagnosed form; tetracycline and nitroimidazole combinations were common treatments.
Conclusions:
- Human balantidiasis presents with varied clinical and epidemiological profiles, often linked to pig proximity.
- Diagnostic methods like direct examination are crucial, with trophozoites being the most common finding.
- High heterogeneity in meta-analysis data and incomplete information in some articles pose challenges for comprehensive analysis.
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