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Systematic review
Factors associated with Entamoeba histolytica proctocolitis in men who have sex with men: a systematic review
  1. Robbie Hughes1,
  2. Daniel Richardson1,2,
  3. Colin Fitzpatrick2
  1. 1 Global health and Infection, Brighton and Sussex Medical School, Brighton, UK
  2. 2 University Hospitals Sussex NHS Foundation Trust, Brighton, UK
  1. Correspondence to Professor Daniel Richardson, Global health and Infection, Brighton and Sussex Medical School, Brighton, UK; daniel.richardson7{at}nhs.net

Abstract

Objective Entamoeba histolytica is parasitic infection that can cause a proctocolitis (amoebiasis) and extraintestinal sequelae (eg, liver abscess) and can be sexually transmitted in men who have sex with men (MSM). We aimed to identify factors associated with E. histolytica in MSM to provide insight for future control strategies.

Design/methods We searched MEDLINE, Embase, CINAHL and Web of Science Core Collections for manuscripts published up to November 2022. One author screened abstracts; two authors independently conducted a full-text review. We included manuscripts that contained primary data on factors associated with transmission in MSM. Quality and risk of bias were assessed independently by two authors using the Joanna Briggs Institute critical appraisal tools. We used the nine-point synthesis method to synthesise narrative data.

Results Nine manuscripts consisting of 832 individuals with E. histolytica were included; six cross-sectional studies, two case-control studies and one cohort study. E. histolytica in MSM was associated with: increasing age, transmission in warm seasons, lower educational achievement, concurrent sexually transmitted infection (STI) (Treponema pallidum, Neisseria gonorrhoeae, Chlamydia trachomatis), hepatitis B core antibody positivity, hepatitis C antibody positivity, concurrent sexually transmitted enteric infection (Shigella spp, Giardia duodenalis), having a previous STI (T. pallidum, N. gonorrhoeae), oral-anal sex, exclusively/majority receptive anal sex and having an increased number of sexual partners.

Conclusion This review has highlighted some important demographic, biological and behavioural factors associated with E. histolytica in MSM which can inform future clinical guidelines and public health control strategies.

PROSPERO registration number CRD42022366168.

  • INFECTIVE COLITIS
  • INFECTIOUS DIARRHOEA

Data availability statement

Data sharing not applicable to this article as no data sets were generated or analysed during the current study.

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Data availability statement

Data sharing not applicable to this article as no data sets were generated or analysed during the current study.

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Footnotes

  • Contributors DR came up with the study concept and is the content guarantor. RH, CF and DR designed the study protocol. RH conducted the data search. RH, DR and CF independently reviewed the manuscript eligibility. RH and DR independently conducted the risk of bias assessment. RH conducted the synthesis and RH, DR and CF all contributed to the final manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.