research article xenic cultivation and genotyping of
TRANSCRIPT
Research ArticleXenic Cultivation and Genotyping of Pathogenic Free-LivingAmoeba from Public Water Supply Sources in Uganda
Celsus Sente1 Joseph Erume2 Irene Naigaga1 Benigna Gabriela Namara3
Julius Mulindwa24 Sylvester Ochwo2 Phillip Kimuda Magambo2 Charles Drago Kato2
Andrew Tamale1 and Michael Ocaido1
1Department of Wildlife and Aquatic Animal Resources (WAAR) School of Veterinary Medicine and Animal Resources (SVAR)College of Veterinary Medicine Animal Resources and Biosecurity (COVAB) Makerere University PO Box 7062 Kampala Uganda2Department of Biomolecular Resources and Biolab Sciences School of Biosecurity Biotechnical and Laboratory Sciences (SBLS)College of Veterinary Medicine Animal Resources and Biosecurity (COVAB) Makerere University PO Box 7062 Kampala Uganda3Research Unit on AIDS Medical Research Council (MRC)Uganda Virus Research Institute (UVRI) PO Box 49 Entebbe Uganda4Department of Biochemistry and Sports Science (BSS) College of Natural Sciences (CONAS) Kampala Uganda
Correspondence should be addressed to Celsus Sente csente37gmailcom
Received 17 May 2016 Accepted 18 July 2016
Academic Editor Xinhua Shu
Copyright copy 2016 Celsus Sente et al This is an open access article distributed under the Creative Commons Attribution Licensewhich permits unrestricted use distribution and reproduction in any medium provided the original work is properly cited
Studies on waterborne parasites from natural environment and domestic water sources in Uganda are very scarce and unpublishedWater dwelling free-living amoebae (FLA) of the genus Acanthamoeba Hartmannella and Naegleria are often responsible forcausing morbidities and mortalities in individuals with recent contact with contaminated water but their presence in Ugandarsquospublic water supply sources is not known We cultivated and genotyped FLA from natural and domestic water from QueenElizabeth Protected Area (QEPA) and Kampala (KLA) The cultivated parasites were observed microscopically and recordedThe overall prevalence of FLA in QEPA (Acanthamoeba spp 35 Hartmannella spp 189 Naegleria spp 135) and KLA(Acanthamoeba spp 283Naegleria spp 166Hartmannella spp 231)were not significantly differentThe highest prevalenceacross water sources in QEPA and KLA was observed for Acanthamoeba spp followed by Hartmannella spp and Naegleria sppOverall FLA mean (plusmnSE) and mean (plusmnSE) across water sources were highest for Acanthamoeba spp compared to other FLA butwere not statistically significant (p gt 005) Analysis of the FLA sequences produced 1 Cercomonas 1 Nuclearia 1 Bodomorpha 2Hartmannella 5 Echinamoeba and 7 Acanthamoeba partial sequences indicating a muliplicity of water contaminants that need tobe controlled by proper water treatment
1 Introduction
Free-living amoeba (FLA) of the genera Naegleria Acan-thamoeba and Hartmannella have been associated withwater-related illnesses especially in developed countriesfound in America Europe and the Middle East [1ndash4] Inmany parts of Uganda there is dependence on environmentalwater for washing recreation drinking cooking and otherdomestic purposes [5] However in most cases this water isused without treatment an act which predisposes Ugandansto FLA infection [5] Since some of these amoebae are knownto be fatal it is imperative that their occurrence is monitored
in order to assess the human and probably animal risksinvolved
Studies worldwide have documented the common Nae-gleria Acanthamoeba and Hartmannella species associatedwith infectious diseases resulting from contaminated watersources utilised by communities Considering the large num-bers ofNaegleria species it is onlyN fowleriN australiensisand N italica that are considered to be pathogenic [6ndash8] while other species such as N gruberi N jadini Nlovaniensis N indonesiensis N robinsoni N fultoni and Npagei have not yet been reported as pathogenic [8] Infor-mation also denotes Acanthamoeba polyphaga A hatchetti
Hindawi Publishing CorporationNew Journal of ScienceVolume 2016 Article ID 6358315 9 pageshttpdxdoiorg10115520166358315
2 New Journal of Science
A castellanii A culbertsoni A rhysodes A lugdunensisA quina A griffini Balamuthia mandrillaris Hartmannellavermiformis and Vahlkampfia avara as pathogenic speciesmostly associated with keratitis in humans [9 10] Acan-thamoeba spp particularly renders amplification of Vibriocholerae Legionella pneumophila Bacillus anthracis andMycoplasma tuberculosis inside their cells [10ndash12] a propertyof paramount importance to both humans and wildlife inand around QEPA Hartmannella spp that have in manyinstances been isolated in mixed human amoebic keratitisinfections are recently considered to be very pathogenic FLA[13] This work therefore reports the different pathogenicFLA associated with tap and environmental surface water inQEPA and Kampala an indicator towards water toxicity forthe communities In the past 10 years outbreaks of choleratyphoid and other waterborne diseases have been docu-mented in the study areas [14ndash17] and these could be linkedto distribution by contaminated water sources as well
The FLA of the genera Naegleria Acanthamoeba andHartmannella predispose humans who collect water fromvarious sources to diseases [1 10 18] These pathogenic andopportunistic FLA are aerobic eukaryotic protists that occurworldwide and can potentially cause infections in humansand other animals [10 19 20] The bacterial parasites Vibriocholerae Legionella pneumophila Mycoplasma tuberculosisand Bacillus anthracis are easily amplified within certainAcanthamoeba spp Hartmannella spp Naegleria spp andother FLA consequently increasing their potential to causecholera legionellosis tuberculosis and anthrax respectively[10ndash12 19 20]
The risks associated with FLA infection inUganda are notknown the reason why this study is being carried out Theassociations are expected to be high because significant por-tions of these communities are using natural environmentalwater and domestic tap water sources without any definitemeasures for protecting water systems in QEPA and KLAfrom these organisms [5] FLA are not often mentioned aspossible infectious agents yet they have severe pathogeniceffects [25 26] Disease effects associated with pathogenicFLA in humans and animals often go undetected becausethere is scarce information about their distribution InUganda the gap being addressed is that of studyingpathogenic FLA in environmental water and domestic tapwater systems This information will help explain the risksassociatedwithwater-related illnesses among rural and urbandwelling Ugandans
2 Methods
21 Study Areas The study was conducted in a rural areaQueen Elizabeth Protected Area (QEPA) in western Ugandaand an urban area Kampala (KLA) City Uganda TheQEPA is located at 00 12S 30 00E (latitude 02000 lon-gitude 300000) and is 1978 sq km in size The pro-tected area is known for its wildlife including Cape buf-faloes (Syncerus caffer caffer) Hippopotami (Hippopotamusamphibius) Nile Crocodiles (Crocodylus niloticus) elephants
(Loxodonta africana) leopards (Panthera pardus) lions (Pan-thera leo) chimpanzees (Pan troglodytes) and Uganda kobs(Kobus kob thomasi) It is a home to 95 species of mammalsand more than 500 species of birds The protected area isalso famous for its volcanic features including volcanic conesand deep craters QEPA is a UNESCO ldquoMan and BiosphereReserverdquo with 11 village enclaves all with a fast growing pop-ulation of humanswhosemain economic activities are fishingand livestock production The diversity of animals in theprotected area coupled with adjacent human communitiesmakes it a vital hub for sharing of infections at water pointsources
Kampala is the capital city of Uganda lying at latitude0∘1810158405810158401015840N longitude 32∘3410158405510158401015840E with 7297mi2 (189 km2)and divided into five boroughs each consisting of a con-centration of slums with a rapidly growing populationCurrently estimated at 1659600 [27] Kampalarsquos population isincreasing steadily yet service provision is not improvingWater resources used in the city vary from piped waterprotected springs unprotected springs and natural surfacewater (lakes rivers streams swamps roadside gutters andpasture puddles) which are often relatively unsafe for humanconsumption
22 Ethical Consideration This study does not require anethical statement
23 Study Design The study involved one year of field workand one year of confirmatory laboratory phase Laboratoryphase involved analysing water samples for FLA The watersources considered were those from natural environmentaland domestic tap water sources The sampling sites werepurposively selected based on their benefit convenience andimportance to public health
In QEPA selection of the study area was based on certainlandmarks that included the following (1) along the Kyam-buraRiver (2)KazingaChannel banks (3)KazingaMidchan-nel (4) fish landing sites (FLS) and (5) community pipedtap water In Kampala the location of sampling sites wasbased on previous waterborne disease outbreak occurrencesWe selected areas in central Kampala (Banda KisenyiKatanga Kasubi Kazo Bwaise Lubigi and Makerere) thatwere reported to have undergone disease outbreak in the last 5years and collected samples from piped tap water and naturalenvironmental surface water (swamp and stream)
24 Laboratory Methods
241 Xenic Cultivation of FLA from Water Samples Weused nonnutritive medium (Page Amoeba Saline solution of25mM NaCl 1mM KH
2PO4 05mM Na
2HPO4 40mM
CaCl2 and 20mM MgSO
4) seeded with 01mL of a heat
inactivated 48-hour culture of Escherichia coli BL2 [5 28]Fresh water samples in the 50mL tubes were centrifuged at1000timesg for 15 minutes and supernatant was poured off toexpose the pellets Using sterile Pasteur pipettes the pelletswere removed from all the tubes and each was carefullyspreadplated on preseeded NNA-EI agar plates This was
New Journal of Science 3
followed by incubating the plates at 32∘C overnight afterwhich each plate was sealed with a plastic film and incubatedupside down at 32∘C up to 7 days Three days later theplates were monitored for detection of amoebae trophozoitesuntil day 7 using an inverted microscope (Motic AE2000Binocular TED PELLA Inc USA)
242 DNA Extraction All DNA was extracted from culturepositive plates by chemical lysis and purification [29] Fivehundred microliters of STE buffer (01M NaCl 1mM EDTA10mM trischloride PH 8 and 1 SDS) and 10 120583L proteinaseK (10mgmL) were added to each sample in an Eppendorftube All samples were put in a water bath and incubated at56∘C for one hour and then left to cool down before phenolextraction Phenol chloroform (521120583L) was added to eachsample vortexed and centrifuged at maximum speed(13200 rpm) for 5 minutesThe aqueous layer was transferredto a new Eppendorf tube and the step redone to make 2phenol-chloroform extractions The aqueous layer was sub-jected to another chloroform extraction centrifuged andtransferred to a new Eppendorf tube after which 1000120583L ofabsolute alcohol (96ndash100) was added to each sample Thesamples were put in a freezer at minus80∘C overnight for pre-cipitation The following day all samples were centrifuged at13200 rpm for 30 minutes and alcohol was poured offThe pellet was washed with 1000 120583L of 70 alcohol andcentrifuged at 13200 rpm for 15 minutes Alcohol was pouredoff to expose the pellet which was air-dried and dissolved in50120583L of TE buffer
243 DNA Amplification Amplification of 18S ribosomalDNA (18S rDNA) from Acanthamoeba and other FLA wasdone by primer pairs JDP1JDP2 and CRN51137 [12 30 31]Forward primer JDP1 (51015840GGCCCAGATCGTTTACCG-TGAA-31015840) and reverse primer JDP2 (51015840TCTCACAAG-CTGCTAGGGAGTCA-31015840) were genus-specific for Acan-thamoeba spp Forward primer CRN5 (51015840CTGGTTGAT-CCTGCCAGTAG-31015840) and reverse primer 1137 (51015840GTGCCC-TTCCGTCAAT-31015840) obtained amplimers from any eukaryoteaiding amplification of the 18S ribosomal DNA gene fromdifferent FLA
The reactions were carried out with a DreamTaq PCR kit(Thermo Scientific DreamTaq USA) A 25 120583L reaction vol-ume containing 125 120583L DreamTaq Green PCR Master Mix(2x) 05 120583M forward primer 05120583M reverse primer 9120583Lnuclease-free water and 25 120583LDNA template (50 pg concen-tration) was used The following conditions were consideredfor the PCR initial denaturation at 94∘C for 3 minutesfollowed by 35 cycles with denaturation at 94∘C for 30seconds followed by annealing at 55∘C for 30 seconds thenextension at 72∘C for 30 seconds and a final extension at72∘C for 5 minutes Five microliters of each PCR reactionwas tested for successful amplification using agarose gel(25WV) stained with ethidium bromide run against1 kbp DNA ladder Once enough electrophoretic separationwas reached the agarose gel was observed under a UV geldocumentation system thereafter capturing the gel images
Dry season Rainy season Dry season Rainy season
QEPA KLA
Acanthamoeba sppHartmannella spp
Naegleria sppOther FLA
(n = 204) (n = 174)(n = 116)(n = 204)
010203040506070
Ove
rall
prev
alen
ce
Figure 1 Overall seasonal prevalence of FLA
25 Nucleic Acid Sequencing and Analysis Positive gel sam-ples were extracted and the DNA purified with QIAquick GelExtraction Kit (Qiagen Inc Netherlands) Partial 18S rDNAsegment of the amoeba isolates was exposed to cycle sequenc-ing with JDP1JDP2 and CRN51137 as sequencing primers[31] Base trimming of the sequence files to obtain goodquality was done by ldquoSeqBuilderrdquo software (Dnastar USA)and a search for homologues in the NCBI database was doneusing ldquoblastnrdquo tool The resultant homologues with querycoverage gt 70 identity gt 70 and low E values (lt0)were considered Phylogenetic analysis was done and adendrogram was constructed [32]
26 Statistical Analysis Data was entered into Excel fromwhich it was extracted and analysed using SPSS (IBM USA)Variables were summarised by the use of mean and standarderror of themean (SEM) Application of univariate analysis tocompare prevalence across sampling sites was executed usingcross-tabulation with a 1205942 test All variables with a 119901 valueof le 005 were considered significant We employed Pearsoncorrelation coefficient (r) to carry out linear correlation anal-ysis between naturaltap water variables and water parasitepresence
3 Results
31 Prevalence of Parasites
311 Overall Seasonal Prevalence The water samples werecollected during cold rainy (November March and July) andcool dry (January May and September) seasons OverallFLA parasite prevalence in both study sites was higher duringthe rainy season except for Naegleria spp that was higher inthe dry season in QEPA (Figure 1)
312 Overall Prevalence andMean Theprevalence andmean(SEM) of the parasites from different sources are shownin Table 1 Both natural environmental and domestic tapwater sources were contaminated with FLA The overallprevalence of Acanthamoeba spp and other FLA in QEPAand Kampala was as follows Acanthamoeba spp (QEPA
4 New Journal of Science
Table 1 The overall prevalence of the FLA
Parasite QEPA KLAFreq (119899 = 408) Prev () Mean plusmn SE Freq (119899 = 290) Prev () Mean plusmn SE
Acanthamoeba spp 143 35 19 plusmn 02 82 283 28 plusmn 05Naegleria spp 55 135 04 plusmn 01 48 166 14 plusmn 03Hartmannella spp 77 189 12 plusmn 01 67 231 14 plusmn 03Freq frequency Prev prevalence
Table 2 Prevalence and mean across water sources
Parasite QEPA KLATap water (119899 = 84) Environmental water (119899 = 324) Tap water (119899 = 170) Environmental water (119899 = 65)
Acanthamoeba spp(+) () 36 (43) 107 (33) 48 (282) 15 (231)Mean plusmn SEM 226 plusmn 04 892 plusmn 16 52 plusmn 12 24 plusmn 13
Hartmannella spp(+) () 19 (226) 58 (179) 38 (224) 10 (154)Mean plusmn SEM 120 plusmn 015 493 plusmn 092 44 plusmn 10 09 plusmn 016
Naegleria spp(+) () 12 (143) 43 (133) 25 (147) 9 (138)Mean plusmn SEM 05 plusmn 015 158 plusmn 06 35 plusmn 11 05 plusmn 03
35 KLA 283) Hartmannella spp (QEPA 189 KLA231) and Naegleria spp (QEPA 135 KLA 166) Themean (plusmnSEM) was highest for Acanthamoeba spp followedby Hartmannella spp and lastly Naegleria spp
313 Prevalence of Parasites across Sampling Sites Prevalenceof parasites across water source (natural and tap water)considered is presented in Table 2 Acanthamoeba spp werethe most prevalent parasite across all sources Naturalenvironmental water had significantly higher mean valuescompared to tap water in both study sites
314 Molecular Identification and Phylogenetic Analysis Fol-lowing FLA sequencing the products were blasted andcompared with the GenBank results from NCBI (Figure 2Table 3) Comparisons between the FLA isolated in Ugandaand those from the NCBI database were made and dif-ferences in divergence noted (Figure 2 Table 4) wereassessedThe species identifiedwereAcanthamoeba spp (var-ious T-genotypes) Acanthamoeba polyphaga Hartmannellavermiformis Nuclearia pattersoni Echinamoeba exundansBodomorpha minima and Cercomonas agilis The Acan-thamoeba sequences got belonged to the group of sequencetypes T1 T2 T4 and T11 (Table 3)
The confirmed Acanthamoeba genotype T1 was isolatedfrom tap water in Bwaise whereas T2 and T11 were isolatedfrom the Kazinga Channel water in QEPA Genotype T4which is usually the commonest Acanthamoeba T-genotypewas isolated from tap water in Katunguru Trading CentreKasaka landing site Albertine Restaurant in QEPA and
Kisenyi slum in Kampala The Hartmannella vermiformisconfirmed was isolated from fish landing sites in QEPA Thenonpathogenic FLA (Table 3) were isolated from a variety oftap water samples in Albertine Restaurant Thembo Restau-rant andKatunguruTradingCenter aswell as natural surfacewater from fish landing sites and the Kyambura River inQEPA In Kampala natural water samples that were positivefor FLA were from Lubigi swamps
All the parasites identified in this study were matchedwith the reported diseases they cause in humans (Table 3)
4 Discussion
We investigated the presence of FLA in natural and domestic(tap) water in QEPA and KLA The prevalence and mean(plusmnSEM) of Acanthamoeba spp in all cases were higher thanNaegleria and Hartmannella spp All FLA were more preva-lent in the rainy season exceptNaegleria spp that were higherin the dry season Most waterborne parasites increase innumber during the rainy season due to contamination of thewater sources with sewage soil and other organic mattersfrom water run-off [5 33] Tap water had a higher prevalenceof FLA than the natural water source There is not muchdata in Uganda to compare with the present findings butstudies from other countries [34 35] also documented ahigher frequency of Acanthamoeba compared to other FLAin environmental and tap water samples in alkaline water atthe same temperaturesThe first ever study of FLA in Ugandadocumented higher prevalence and mean of Acanthamoebathan other FLA in both environmental and tap water [5]
New Journal of Science 5
1
02
072
008
009
004
006
012
014
089
0861
0
10
078
087
077
091
077
091
018
058
063
054
088
033
085
KU894812
AF2938951_Echinamoeba_exundansKU894811
KU894808
KU894813
KU894806
AJ4892611_Echinamoeba_thermarumKU894805
KU894814
JQ2716891_Hartmannella_vermiformisKT1856251_Vermamoeba_vermiformisKU894803
KU894799
KU894800
KU894801
KU894802
KU894804
KM1894191_Acanthamoeba_spKU894807
AY3646351_Nuclearia_pattersoniAF4846871_Nuclearia_simplexKU894810
AY7488061_Cercomonas_agilisEU7091401_Cercozoa_spEU6471741|_CercomonadidaKU894809
AF4112761_Bodomorpha_minimaKU884884
Figure 2 Phylogenetic tree based on neighbor-joining showing the divergence of FLA Comparison with closely related species from theGenBank database sequences with their accession numbers (GenBank NCBI)
Acanthamoeba spp are more commonly encountered prob-ably because they are more involved in a predator-preyrelationshipwithmicrobial coloniesThehigh numbers couldbe explained by the presence of organic matter from rottingleaves animal and human faeces which are from the run-off from the land that often concentrate at the banks of thewater bodies This is known to exacerbate microbial biofilmformation and as a result facilitate the proliferation of FLAIt is believed that there are more FLA when there is anaccumulation of more organic matter in soil and water [3637] Previous studies report thatmicroorganisms settle on theinner surfaces of water pipes later becoming a source ofsecondary microbial contamination [38]
The primer pair JDP1JDP2 that was used is more spe-cific in the amplification of Acanthamoeba DNA [30 39]whereas CRN51137 amplifies any eukaryoteDNA [30]Acan-thamoeba sequence types can be grouped T1 to T20 [40]Blasting of sequences and comparison with those fromNCBIdatabase produced 7 Acanthamoeba 5 Echinamoeba 2 Hart-mannella 1 Bodomorpha 1 Nuclearia and 1 Cercomonas par-tial sequences Acanthamoeba genotypes T1 T2 and T4 were
mainly isolated from tap water samples whereas 11 were iso-lated from environmental water samplesThis is in agreementwith previous studies that indicate that T2 Acanthamoebagenotype is mainly found in the environment and is phyloge-netically related to T6 and they have also been both isolatedfrom clinical AK cases in humans [40] Acanthamoebagenotype T11 is closely related to T4 and has been found toalso cause AK [33]Acanthamoeba of T4 genotype is reportedas the most commonly encountered T-genotype group inboth environmental water and clinical samples and also themost diverse [33] Genotype T1 is notorious for granulo-matous amoebic encephalitis [11] whereas others may causekeratitis cutaneous infections and sinusitis in humans [1841] Hartmannella vermiformis originally thought to be non-pathogenic [42] has over the past decade been repeatedlyreported in a number of mixed human AK infections [4 1324] Although other FLA isolated in this study are considerednonpathogenic it is possible that they too could becomevirulent anytime given a conducive environment
Infective trophozoites of FLA in the environment aremaintained and spread by water during rainy seasons when
6 New Journal of Science
Table 3 Isolated free-living amoeba accession numbers water source and associated diseases in humans
Accession Source FLA Diseases Characteristics
KU884884 Tap KLA Bwaise Acanthamoeba spp (T1) Encephalitis [11 21]Mental status changeshemiparesis meningismus andataxia [22]
KU894799 Tap QEPA Katunguru Acanthamoeba spp (T2) Keratitis [11 21] Blinding infection of the cornea[22 23]
KU894800 Tap QEPA Katunguru Acanthamoeba spp (T4) Keratitis [11 21] Blinding infection of the cornea[22 23]
KU894801 Tap QEPA Albertine Acanthamoeba polyphaga(T4) Keratitis [11 21] Blinding infection of the cornea
[22 23]
KU894802 Tap QEPA Kasaka Acanthamoeba spp (T4) Keratitis [11 21] Blinding infection of the cornea[22 23]
KU894803 Tap KLA Kisenyi Acanthamoeba spp (T4) Keratitis [11 21] Blinding infection of the cornea[22 23]
KU894804 KCB QEPA Acanthamoeba spp (T11) Keratitis andencephalitis [22]
Disseminated disease blindnessand CNS function impairment[22]
KU894805 FLS QEPA Hartmannella vermiformis Keratitis [4 13 24] Blinding infection of the cornea[22]
KU894806 TAP QEPA Albertine Echinamoeba exundans Unknown mdashKU894807 TAP QEPAThembo Nuclearia pattersoni Unknown mdashKU894808 TAP QEPA Katunguru Echinamoeba exundans Unknown mdashKU894809 FLS QEPA Bodomorpha minima Unknown mdashKU894810 Lubigi KLA Cercomonas agilis Unknown mdashKU894811 R Kyambura QEPA Echinamoeba exundans Unknown mdashKU894812 R Kyambura QEPA Echinamoeba exundans Unknown mdashKU894813 TAP QEPA Albertine Echinamoeba exundans Unknown mdash
KU894814 TAP QEPAThembo Hartmannella vermiformis Keratitis [4 13 24] Blinding infection of the cornea[22]
FLS fish landing sites KCB Kazinga Channel banks KLA Kampala QEPA Queen Elizabeth Protected Area R Kyambura the Kyambura River
there is a run-off of water containing human and animal fae-cal matter from land into the water bodies which eventuallyend up at the points where communities fetch and utilise thewater Most FLA prevalence and mean intensities are higherin the rainy season than dry season [43] However parasiteincidences can be high throughout the rainy and dry seasonsoften indicating poor disposal of human and animal excretaand continuous patterns of infection [43] In a natural waterenvironment pathogens have been isolated widely frommany water sources used by rural dwelling households [3344 45] Often inadequately treated domestic water (drinkingbathing cooking and recreational water) has an abundanceof such pathogens Water bodies are usually contaminatedby high concentrations organisms from agricultural run-offurban wastewater effluents [46] and for the case of QEPAandKLAhuman and animal faecal contaminationTheQEPAand KLA local communities have few poorly built latrinesmost of which are already filled up compelling many to digsmall holes in the ground and defecate outside on openland When there is a heavy downpour of rain humanand animal the faecal material is washed off into the publicwater supply system Upon using this water exposure to avariety of protozoan parasites is highly likely The risk of
human infection is much higher in children and immuno-compromised individuals such as those who haveHIVAIDSdiabetes and cancer and those who have recently undergoneorgan transport [3]
5 Conclusion
The findings from the present study indicate that there isreasonably high contamination of both natural and domesticwater systems with Acanthamoeba spp Hartmannella sppNaegleria spp and other FLAThis is evidence that the waterbeing used is of poor quality and predisposes communities toinfectious agents With the fact that there is proof thatsome are pathogenic and can be vectors of many emerg-ingreemerging infectious agents it is imperative to preventthem from contaminating domestic water sources
Abbreviations∘C CelsiusAK Amoebic keratitisCNS Central nervous systemEnviron Environment
New Journal of Science 7
Table4Estim
ationof
evolutionary
divergence
betweensequ
ences
Percentidentity
12
34
56
78
910
1112
1314
1516
1718
1920
2122
2324
2526
2728
Divergence
1532
536
534
528
538
538
514
521
565
345
360
315
522
256
533
254
537
252
251
248
243
250
252
305
299
305
309
1KU
884884
22391
973
956
960
944
944
533
554
549
329
346
307
554
264
525
239
915
238
235
256
242
246
246
293
289
299
310
2KU
894799
32203
19957
950
940
945
523
544
550
328
348
306
545
266
525
238
917
236
234
255
240
243
247
291
289
298
311
3KU
894800
42051
30
37
941
934
956
528
552
550
323
346
306
550
264
525
242
898
238
235
255
240
248
252
294
290
301
311
4KU
894801
52187
40
42
33
940
944
529
550
544
333
342
303
550
266
526
236
897
236
234
256
239
244
248
291
289
299
311
5KU
894802
62120
48
60
53
40
940
521
540
558
342
356
318
540
278
538
247
887
243
240
264
250
250
255
298
294
305
317
6KU
894803
72262
33
45
1743
57
509
530
554
332
353
315
530
275
536
251
890
246
243
263
248
254
258
299
298
307
326
7KU
894804
81310
1459
1409
1424
1447
1441
1388
795
632
357
370
329
807
277
546
283
562
277
277
256
256
256
264
302
299
305
310
8KU
894805
91271
1043
1030
1014
1032
1048
1006
484
659
455
420
362
960
430
666
322
583
323
322
416
381
315
322
356
353
364
352
9KU
894806
101335
1819
1777
1637
1793
1671
1584
500
389
474
537
491
670
415
666
389
581
381
383
395
395
479
486
471
477
482
485
10KU
894807
111410
1653
1636
1653
1490
1472
1564
640
264
483
652
596
478
677
651
553
313
545
545
654
585
549
556
588
591
592
589
11KU894808
121368
1691
1709
1633
1677
1562
1534
531
342
316
424
836
432
695
583
685
333
689
689
689
675
733
742
928
898
863
846
12KU
894809
131216
1391
1404
1392
1384
1332
1314
472
338
304
422
79374
701
534
697
291
683
683
681
664
744
752
847
860
864
958
13KU
894810
141279
1029
1026
1014
1017
1034
987
456
69
329
211
294
296
452
687
328
584
325
323
436
368
323
332
365
362
369
360
14KU
894811
151330
1238
1257
1247
1192
1156
1180
463
66
362
248
241
272
00
648
742
247
728
728
964
827
730
732
686
686
694
705
15KU
894812
161357
1507
1523
1474
1423
1350
1395
563
132
399
188
308
304
7646
493
506
472
472
617
542
486
494
515
517
529
529
16KU
894813
171211
1359
1390
1362
1366
1302
1275
363
311
390
432
247
263
290
292
319
220
952
952
715
701
699
703
682
681
691
711
17KU
894814
182065
45
47
46
68
68
51
1415
1039
1568
1499
1453
1227
1031
1140
1358
1247
232
230
250
235
242
246
290
287
297
294
18KM
1894191Ac
antham
oeba
sp
191208
1352
1400
1348
1345
1315
1279
352
300
386
428
235
264
278
284
318
101263
995
756
740
740
741
722
719
728
690
19JQ
2716891Hartm
annella
verm
iform
is
201222
1399
1449
1394
1390
1356
1318
352
305
381
428
235
264
283
284
318
101303
06
756
740
741
742
722
721
729
690
20KT
1856251Ve
rmam
oeba
verm
iform
is
211329
1267
1311
1272
1232
1197
1211
470
78367
253
234
275
07
04
53
295
1193
278
278
855
761
760
718
718
723
685
21AF2938951Echinamoeba
exun
dans
221318
1307
1352
1311
1307
1231
1242
462
145
364
358
252
290
161
149
171
315
1230
299
299
149
754
750
697
699
701
674
22AJ
4892611Echinamoeba
thermarum
231299
1447
1517
1401
1438
1399
1359
458
287
189
389
164
189
229
249
242
295
1311
278
276
241
250
970
764
780
773
750
23AY
3646351Nuclearia
patte
rson
i
241323
1460
1532
1413
1451
1388
1370
450
278
189
384
156
183
224
246
239
288
1321
271
269
238
252
25
769
785
780
758
24AF4
846871
Nuclearia
simplex
251368
1641
1706
1608
1625
1539
1545
536
349
319
427
00
103
293
284
314
284
1452
266
266
271
298
205
200
961
917
855
25AF4
112761Bo
domorph
aminim
a
261392
1768
1875
1724
1702
1632
1626
527
348
315
426
1699
291
283
308
281
1556
266
263
270
293
191
186
23
936
867
26EU
6471741|
Cercomon
adida
271342
1569
1629
1539
1522
1479
1455
506
311
326
423
60
103
271
268
288
261
1393
252
250
260
290
203
196
7258
872
27EU
7091401Cercozoasp
281245
1358
1360
1348
1364
1312
1282
507
348
320
447
80
02
314
279
322
268
1197
267
267
279
288
192
186
105
100
105
28AY
7488061Cercomon
asagilis
12
34
56
78
910
1112
1314
1516
1718
1920
2122
2324
2526
2728
8 New Journal of Science
FLA Free-living amoebaFLS Fish landing siteG Gravitational forceg GramsGAE Granulomatous amoebic encephalitisHIVAIDS Human immunodeficiency
virusacquired immune deficiencysyndrome
KCB Kazinga Channel bankKCM Kazinga Channel middleKLA KampalaL Litermg MilligramsmL MillilitersmM MillimolarNCBI National Center for Biotechnology
InformationNo NumberPA Protected areaPAM Primary amoebic
meningoencephalitispg Picogrampmol PicomolesPrev PrevalenceQEPA Queen Elizabeth Protected Arearpm Revolutions per minuteSG Specific gravityUNESCO United Nations Educational
Scientific and Cultural OrganizationUn-ID Amoeba Unidentified amoebaV Volts120583S Microseconds
Competing Interests
There are no competing interests
References
[1] A J Martinez and G S Visvesvara ldquoFree-living amphizoic andopportunistic amebasrdquo Brain Pathology vol 7 no 1 pp 583ndash598 1997
[2] WHO Combating Waterborne Disease at the HouseholdLevelInternational Network to Promote HouseholdWater Treat-ment and Safe Storage World Health Organization GenevaSwitzerland 2007
[3] CDC Domestic Water Sanitation and Hygiene Epidemiol-ogy Center for Disease Control Atlanta Ga USA 2015httpwwwcdcgovnceziddfwedwaterbornedomestichtml
[4] H Abedkhojasteh M Niyyati F Rahimi M Hei-Dari SFarnia andM Rezaeian ldquoFirst report of Hartmannella keratitisin a cosmetic soft contact lens wearer in Iranrdquo Iranian Journalof Parasitology vol 8 no 3 pp 481ndash485 2013
[5] C Sente J Erume I Naigaga et al ldquoOccurrence and geneticcharacterisation ofAcanthamoeba spp from environmental anddomestic water sources in Queen Elizabeth Protected AreaUgandardquo Parasites amp Vectors vol 9 article 127 2016
[6] J De Jonckheere ldquoNaegleria australiensis sp nov anotherpathogenic Naegleria from waterrdquo Protistologica vol 17 pp423ndash429 1981
[7] J FDe Jonckheere ldquoIsoenzymepatterns of pathogenic andnon-pathogenic Naegleria spp using agarose isoelectric focusingrdquoAnnales de Microbiologie vol 133 no 2 pp 319ndash342 1982
[8] J F De Jonckheere ldquoA century of research on the amoeboflag-ellate genus Naegleriardquo Acta Protozoologica vol 41 no 4 pp309ndash342 2002
[9] CDC ldquoAcanthamoeba keratitis associated with contact lensesmdashUnited Statesrdquo Morbidity and Mortality Weekly Report vol 35no 25 pp 405ndash408 1986
[10] V A Dunand S M Hammer R Rossi et al ldquoParasitic sinusitisand otitis in patients infected with human immunodeficiencyvirus report of five cases and reviewrdquo Clinical Infectious Dis-eases vol 25 no 2 pp 267ndash272 1997
[11] S Amir Acanthamoeba castellanii as a Host and Model toStudy Bacterial Virulence Karolinska UniversitetssjukhusetHuddinge Sweden 2009
[12] R Dey P S Hoffman and I J Glomski ldquoGermination andamplification of anthrax spores by soil-dwelling amoebasrdquoApplied and Environmental Microbiology vol 78 no 22 pp8075ndash8081 2012
[13] R Solgi M Niyyati A Haghighi and E N Mojarad ldquoOccur-rence of thermotolerant Hartmannella vermiformis and Naeg-leria spp in hot springs of Ardebil Province Northwest IranrdquoIranian Journal of Parasitology vol 7 no 2 pp 47ndash52 2012
[14] Uganda CholeraWHORegional Office for Africa 2012 httpwwwafrowhointenclusters-a-programmesdpcepidemic-a-pandemic-alert-and-response3601-uganda-cholera-situation-as-of-31-march-2012html
[15] G Ojore Uganda 2000 Children Die of Diarrhoea in AfricaDaily-WaterAid New Vision Publishing Kampala Uganda2012
[16] Uganda rural water services Inadequate quantity low qualitysatisfiedusers IRC 2014 httpwwwircwashorgnewsuganda-rural-water-services-inadequate-quantity-low-quality-satisfied-users
[17] WHO Regional Office for Africa Emergencies Preparednessand Response to Typhoid Fever Uganda 2015 httpwwwwhointcsrdon17-march-2015-ugandaen
[18] Naegleria Infection Medscape Drugs amp Diseases 2015 httpemedicinemedscapecomarticle223910-overviewa5
[19] G S Visvesvara H Moura and F L Schuster ldquoPathogenic andopportunistic free-living amoebae Acanthamoeba spp Bala-muthia mandrillaris Naegleria fowleri and Sappinia diploideardquoFEMS Immunology and Medical Microbiology vol 50 no 1 pp1ndash26 2007
[20] L J Stockman C J Wright G S Visvesvara B S Fields andM J Beach ldquoPrevalence of Acanthamoeba spp and other free-living amoebae in household water Ohio USAmdash1990ndash1992rdquoParasitology Research vol 108 no 3 pp 621ndash627 2011
[21] G S Visvesvara ldquoAmebic meningoencephalitides and keratitischallenges in diagnosis and treatmentrdquo Current Opinion inInfectious Diseases vol 23 no 6 pp 590ndash594 2010
[22] N Crum-Cianflone Acanthamoeba Naval Medical Center atSan Diego San Diego Calif USA 2015
[23] F Marciano-Cabral and G A Cabral ldquoAcanthamoeba spp asagents of disease in humansrdquoClinicalMicrobiology Reviews vol16 no 2 pp 273ndash307 2003
[24] J Lorenzo-Morales E Martınez-Carretero N Batista et alldquoEarly diagnosis of amoebic keratitis due to a mixed infectionwith Acanthamoeba and Hartmannellardquo Parasitology Researchvol 102 no 1 pp 167ndash169 2007
New Journal of Science 9
[25] Z Szenasi T Endo K Yagita and ENagy ldquoIsolation identifica-tion and increasing importance of lsquofree-livingrsquo amoebae causinghuman diseaserdquo Journal of Medical Microbiology vol 47 no 1pp 5ndash16 1998
[26] H Trabelsi F Dendana A Sellami et al ldquoPathogenic free-living amoebae epidemiology and clinical reviewrdquo PathologieBiologie vol 60 no 6 pp 399ndash405 2012
[27] Uganda Bureau of Statistics Estimated Population of Kampalain 2002 2010 amp 2011 Uganda Bureau of Statistics 2014
[28] F L Schuster and G S Visvesvara ldquoFree-living amoebae asopportunistic and non-opportunistic pathogens of humans andanimalsrdquo International Journal for Parasitology vol 34 no 9 pp1001ndash1027 2004
[29] M Pelandakis and P Pernin ldquoUse of multiplex PCR andPCR restriction enzyme analysis for detection and explorationof the variability in the free-living amoeba Naegleria in theenvironmentrdquoApplied and EnvironmentalMicrobiology vol 68no 4 pp 2061ndash2065 2002
[30] J M Schroeder G C Booton J Hay et al ldquoUse of subgenic 18Sribosomal DNA PCR and sequencing for genus and genotypeidentification of Acanthamoebae from humans with keratitisand from sewage sludgerdquo Journal of Clinical Microbiology vol39 no 5 pp 1903ndash1911 2001
[31] G C Booton D J Kelly Y-W Chu et al ldquo18S ribosomalDNA typing and tracking of Acanthamoeba species isolatesfrom corneal scrape specimens contact lenses lens cases andhomewater supplies ofAcanthamoeba keratitis patients inHongKongrdquo Journal of Clinical Microbiology vol 40 no 5 pp 1621ndash1625 2002
[32] K Tamura G Stecher D Peterson A Filipski and S KumarldquoMEGA6molecular evolutionary genetics analysis version 60rdquoMolecular Biology and Evolution vol 30 no 12 pp 2725ndash27292013
[33] P Bonilla-Lemus A S Caballero Villegas J Carmona Jimenezand A Lugo Vazquez ldquoOccurrence of free-living amoebae instreams of the Mexico Basinrdquo Experimental Parasitology vol145 supplement pp S28ndashS33 2014
[34] S Ghadar-Ghadr K Solhjoo M Norouz-Nejad R Rohi and SZia-Jahromi ldquoIsolation and identification of free living amoeba(Naegleria and Acanthamoeba) in Shiraz water resources bymorphological criteriardquo Pars of Jahrom University of MedicalSciences vol 10 no 3 pp 33ndash42 2012
[35] S Ghadar-Ghadr K Solhjoo M Norouz-Nejad R Rohi and SZia-Jahromi ldquoIsolation and identification of free living amoeba(Naegleria and Acanthamoeba) in Shiraz water resources bymorphological criteriardquo Journal of Jahrom University of MedicalSciences vol 10 no 3 pp 26ndash33 2012
[36] S Rodriguez-Zaragoza E Mayzlish and Y Steinberger ldquoVer-tical distribution of the free-living amoeba population in soilunder desert shrubs in the Negev Desert Israelrdquo Applied andEnvironmentalMicrobiology vol 71 no 4 pp 2053ndash2060 2005
[37] M Pruden J Falkinham K Williams H Wang K Martinsand W Rhoads ldquoRelationship between biodegradable organicmatter and pathogen concentrations in premise plumbingrdquoWater Research Foundation pp 58ndash90 2013
[38] A Rozej A Cydzik-Kwiatkowska B Kowalska and D Kowal-ski ldquoStructure and microbial diversity of biofilms on differentpipe materials of a model drinking water distribution systemsrdquoWorld Journal of Microbiology amp Biotechnology vol 31 no 1 pp37ndash47 2015
[39] M H Vodkin D K Howe G S Visvesvara and G LMcLaughlin ldquoIdentification ofAcanthamoeba at the generic and
specific levels using the polymerase chain reactionrdquoThe Journalof Protozoology vol 39 no 3 pp 378ndash385 1992
[40] M Crary Genetic Variability and Its Relationship to Acan-thamoeba Pathogenesis Molecular Genetics Ohio State Univer-sity Columbus Ohio USA 2012
[41] M S Torno Jr R Babapour A Gurevitch and M D WittldquoCutaneous acanthamoebiasis inAIDSrdquo Journal of theAmericanAcademy of Dermatology vol 42 no 2 part 2 pp 351ndash3542000
[42] J F De Jonckheere and S Brown ldquoThere is no evidence that thefree-living ameba Hartmannella is a human parasiterdquo ClinicalInfectious Diseases vol 26 no 3 p 773 1998
[43] P W Woodburn L Muhangi S Hillier et al ldquoRisk factors forhelminth malaria and HIV infection in pregnancy in EntebbeUgandardquo PLoS Neglected Tropical Diseases vol 3 no 6 articlee473 2009
[44] S Onichandran T Kumar C C Salibay et al ldquoWaterborneparasites a current status from the Philippinesrdquo Parasites ampVectors vol 7 no 1 article 244 2014
[45] T Kumar S Onichandran Y A L Lim et al ldquoComparativestudy on waterborne parasites between Malaysia andThailanda new insightrdquo The American Journal of Tropical Medicine andHygiene vol 90 no 4 pp 682ndash689 2014
[46] D CarmenaWaterborne Transmission of Cryptosporidium andGiardia Detection Surveillance and Implications for PublicHealth Faculty of Medicine IC London UK 2010
Submit your manuscripts athttpwwwhindawicom
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Anatomy Research International
PeptidesInternational Journal of
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Hindawi Publishing Corporation httpwwwhindawicom
International Journal of
Volume 2014
Zoology
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Molecular Biology International
GenomicsInternational Journal of
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
The Scientific World JournalHindawi Publishing Corporation httpwwwhindawicom Volume 2014
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
BioinformaticsAdvances in
Marine BiologyJournal of
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Signal TransductionJournal of
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
BioMed Research International
Evolutionary BiologyInternational Journal of
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Biochemistry Research International
ArchaeaHindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Genetics Research International
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Advances in
Virolog y
Hindawi Publishing Corporationhttpwwwhindawicom
Nucleic AcidsJournal of
Volume 2014
Stem CellsInternational
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
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Enzyme Research
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
International Journal of
Microbiology
2 New Journal of Science
A castellanii A culbertsoni A rhysodes A lugdunensisA quina A griffini Balamuthia mandrillaris Hartmannellavermiformis and Vahlkampfia avara as pathogenic speciesmostly associated with keratitis in humans [9 10] Acan-thamoeba spp particularly renders amplification of Vibriocholerae Legionella pneumophila Bacillus anthracis andMycoplasma tuberculosis inside their cells [10ndash12] a propertyof paramount importance to both humans and wildlife inand around QEPA Hartmannella spp that have in manyinstances been isolated in mixed human amoebic keratitisinfections are recently considered to be very pathogenic FLA[13] This work therefore reports the different pathogenicFLA associated with tap and environmental surface water inQEPA and Kampala an indicator towards water toxicity forthe communities In the past 10 years outbreaks of choleratyphoid and other waterborne diseases have been docu-mented in the study areas [14ndash17] and these could be linkedto distribution by contaminated water sources as well
The FLA of the genera Naegleria Acanthamoeba andHartmannella predispose humans who collect water fromvarious sources to diseases [1 10 18] These pathogenic andopportunistic FLA are aerobic eukaryotic protists that occurworldwide and can potentially cause infections in humansand other animals [10 19 20] The bacterial parasites Vibriocholerae Legionella pneumophila Mycoplasma tuberculosisand Bacillus anthracis are easily amplified within certainAcanthamoeba spp Hartmannella spp Naegleria spp andother FLA consequently increasing their potential to causecholera legionellosis tuberculosis and anthrax respectively[10ndash12 19 20]
The risks associated with FLA infection inUganda are notknown the reason why this study is being carried out Theassociations are expected to be high because significant por-tions of these communities are using natural environmentalwater and domestic tap water sources without any definitemeasures for protecting water systems in QEPA and KLAfrom these organisms [5] FLA are not often mentioned aspossible infectious agents yet they have severe pathogeniceffects [25 26] Disease effects associated with pathogenicFLA in humans and animals often go undetected becausethere is scarce information about their distribution InUganda the gap being addressed is that of studyingpathogenic FLA in environmental water and domestic tapwater systems This information will help explain the risksassociatedwithwater-related illnesses among rural and urbandwelling Ugandans
2 Methods
21 Study Areas The study was conducted in a rural areaQueen Elizabeth Protected Area (QEPA) in western Ugandaand an urban area Kampala (KLA) City Uganda TheQEPA is located at 00 12S 30 00E (latitude 02000 lon-gitude 300000) and is 1978 sq km in size The pro-tected area is known for its wildlife including Cape buf-faloes (Syncerus caffer caffer) Hippopotami (Hippopotamusamphibius) Nile Crocodiles (Crocodylus niloticus) elephants
(Loxodonta africana) leopards (Panthera pardus) lions (Pan-thera leo) chimpanzees (Pan troglodytes) and Uganda kobs(Kobus kob thomasi) It is a home to 95 species of mammalsand more than 500 species of birds The protected area isalso famous for its volcanic features including volcanic conesand deep craters QEPA is a UNESCO ldquoMan and BiosphereReserverdquo with 11 village enclaves all with a fast growing pop-ulation of humanswhosemain economic activities are fishingand livestock production The diversity of animals in theprotected area coupled with adjacent human communitiesmakes it a vital hub for sharing of infections at water pointsources
Kampala is the capital city of Uganda lying at latitude0∘1810158405810158401015840N longitude 32∘3410158405510158401015840E with 7297mi2 (189 km2)and divided into five boroughs each consisting of a con-centration of slums with a rapidly growing populationCurrently estimated at 1659600 [27] Kampalarsquos population isincreasing steadily yet service provision is not improvingWater resources used in the city vary from piped waterprotected springs unprotected springs and natural surfacewater (lakes rivers streams swamps roadside gutters andpasture puddles) which are often relatively unsafe for humanconsumption
22 Ethical Consideration This study does not require anethical statement
23 Study Design The study involved one year of field workand one year of confirmatory laboratory phase Laboratoryphase involved analysing water samples for FLA The watersources considered were those from natural environmentaland domestic tap water sources The sampling sites werepurposively selected based on their benefit convenience andimportance to public health
In QEPA selection of the study area was based on certainlandmarks that included the following (1) along the Kyam-buraRiver (2)KazingaChannel banks (3)KazingaMidchan-nel (4) fish landing sites (FLS) and (5) community pipedtap water In Kampala the location of sampling sites wasbased on previous waterborne disease outbreak occurrencesWe selected areas in central Kampala (Banda KisenyiKatanga Kasubi Kazo Bwaise Lubigi and Makerere) thatwere reported to have undergone disease outbreak in the last 5years and collected samples from piped tap water and naturalenvironmental surface water (swamp and stream)
24 Laboratory Methods
241 Xenic Cultivation of FLA from Water Samples Weused nonnutritive medium (Page Amoeba Saline solution of25mM NaCl 1mM KH
2PO4 05mM Na
2HPO4 40mM
CaCl2 and 20mM MgSO
4) seeded with 01mL of a heat
inactivated 48-hour culture of Escherichia coli BL2 [5 28]Fresh water samples in the 50mL tubes were centrifuged at1000timesg for 15 minutes and supernatant was poured off toexpose the pellets Using sterile Pasteur pipettes the pelletswere removed from all the tubes and each was carefullyspreadplated on preseeded NNA-EI agar plates This was
New Journal of Science 3
followed by incubating the plates at 32∘C overnight afterwhich each plate was sealed with a plastic film and incubatedupside down at 32∘C up to 7 days Three days later theplates were monitored for detection of amoebae trophozoitesuntil day 7 using an inverted microscope (Motic AE2000Binocular TED PELLA Inc USA)
242 DNA Extraction All DNA was extracted from culturepositive plates by chemical lysis and purification [29] Fivehundred microliters of STE buffer (01M NaCl 1mM EDTA10mM trischloride PH 8 and 1 SDS) and 10 120583L proteinaseK (10mgmL) were added to each sample in an Eppendorftube All samples were put in a water bath and incubated at56∘C for one hour and then left to cool down before phenolextraction Phenol chloroform (521120583L) was added to eachsample vortexed and centrifuged at maximum speed(13200 rpm) for 5 minutesThe aqueous layer was transferredto a new Eppendorf tube and the step redone to make 2phenol-chloroform extractions The aqueous layer was sub-jected to another chloroform extraction centrifuged andtransferred to a new Eppendorf tube after which 1000120583L ofabsolute alcohol (96ndash100) was added to each sample Thesamples were put in a freezer at minus80∘C overnight for pre-cipitation The following day all samples were centrifuged at13200 rpm for 30 minutes and alcohol was poured offThe pellet was washed with 1000 120583L of 70 alcohol andcentrifuged at 13200 rpm for 15 minutes Alcohol was pouredoff to expose the pellet which was air-dried and dissolved in50120583L of TE buffer
243 DNA Amplification Amplification of 18S ribosomalDNA (18S rDNA) from Acanthamoeba and other FLA wasdone by primer pairs JDP1JDP2 and CRN51137 [12 30 31]Forward primer JDP1 (51015840GGCCCAGATCGTTTACCG-TGAA-31015840) and reverse primer JDP2 (51015840TCTCACAAG-CTGCTAGGGAGTCA-31015840) were genus-specific for Acan-thamoeba spp Forward primer CRN5 (51015840CTGGTTGAT-CCTGCCAGTAG-31015840) and reverse primer 1137 (51015840GTGCCC-TTCCGTCAAT-31015840) obtained amplimers from any eukaryoteaiding amplification of the 18S ribosomal DNA gene fromdifferent FLA
The reactions were carried out with a DreamTaq PCR kit(Thermo Scientific DreamTaq USA) A 25 120583L reaction vol-ume containing 125 120583L DreamTaq Green PCR Master Mix(2x) 05 120583M forward primer 05120583M reverse primer 9120583Lnuclease-free water and 25 120583LDNA template (50 pg concen-tration) was used The following conditions were consideredfor the PCR initial denaturation at 94∘C for 3 minutesfollowed by 35 cycles with denaturation at 94∘C for 30seconds followed by annealing at 55∘C for 30 seconds thenextension at 72∘C for 30 seconds and a final extension at72∘C for 5 minutes Five microliters of each PCR reactionwas tested for successful amplification using agarose gel(25WV) stained with ethidium bromide run against1 kbp DNA ladder Once enough electrophoretic separationwas reached the agarose gel was observed under a UV geldocumentation system thereafter capturing the gel images
Dry season Rainy season Dry season Rainy season
QEPA KLA
Acanthamoeba sppHartmannella spp
Naegleria sppOther FLA
(n = 204) (n = 174)(n = 116)(n = 204)
010203040506070
Ove
rall
prev
alen
ce
Figure 1 Overall seasonal prevalence of FLA
25 Nucleic Acid Sequencing and Analysis Positive gel sam-ples were extracted and the DNA purified with QIAquick GelExtraction Kit (Qiagen Inc Netherlands) Partial 18S rDNAsegment of the amoeba isolates was exposed to cycle sequenc-ing with JDP1JDP2 and CRN51137 as sequencing primers[31] Base trimming of the sequence files to obtain goodquality was done by ldquoSeqBuilderrdquo software (Dnastar USA)and a search for homologues in the NCBI database was doneusing ldquoblastnrdquo tool The resultant homologues with querycoverage gt 70 identity gt 70 and low E values (lt0)were considered Phylogenetic analysis was done and adendrogram was constructed [32]
26 Statistical Analysis Data was entered into Excel fromwhich it was extracted and analysed using SPSS (IBM USA)Variables were summarised by the use of mean and standarderror of themean (SEM) Application of univariate analysis tocompare prevalence across sampling sites was executed usingcross-tabulation with a 1205942 test All variables with a 119901 valueof le 005 were considered significant We employed Pearsoncorrelation coefficient (r) to carry out linear correlation anal-ysis between naturaltap water variables and water parasitepresence
3 Results
31 Prevalence of Parasites
311 Overall Seasonal Prevalence The water samples werecollected during cold rainy (November March and July) andcool dry (January May and September) seasons OverallFLA parasite prevalence in both study sites was higher duringthe rainy season except for Naegleria spp that was higher inthe dry season in QEPA (Figure 1)
312 Overall Prevalence andMean Theprevalence andmean(SEM) of the parasites from different sources are shownin Table 1 Both natural environmental and domestic tapwater sources were contaminated with FLA The overallprevalence of Acanthamoeba spp and other FLA in QEPAand Kampala was as follows Acanthamoeba spp (QEPA
4 New Journal of Science
Table 1 The overall prevalence of the FLA
Parasite QEPA KLAFreq (119899 = 408) Prev () Mean plusmn SE Freq (119899 = 290) Prev () Mean plusmn SE
Acanthamoeba spp 143 35 19 plusmn 02 82 283 28 plusmn 05Naegleria spp 55 135 04 plusmn 01 48 166 14 plusmn 03Hartmannella spp 77 189 12 plusmn 01 67 231 14 plusmn 03Freq frequency Prev prevalence
Table 2 Prevalence and mean across water sources
Parasite QEPA KLATap water (119899 = 84) Environmental water (119899 = 324) Tap water (119899 = 170) Environmental water (119899 = 65)
Acanthamoeba spp(+) () 36 (43) 107 (33) 48 (282) 15 (231)Mean plusmn SEM 226 plusmn 04 892 plusmn 16 52 plusmn 12 24 plusmn 13
Hartmannella spp(+) () 19 (226) 58 (179) 38 (224) 10 (154)Mean plusmn SEM 120 plusmn 015 493 plusmn 092 44 plusmn 10 09 plusmn 016
Naegleria spp(+) () 12 (143) 43 (133) 25 (147) 9 (138)Mean plusmn SEM 05 plusmn 015 158 plusmn 06 35 plusmn 11 05 plusmn 03
35 KLA 283) Hartmannella spp (QEPA 189 KLA231) and Naegleria spp (QEPA 135 KLA 166) Themean (plusmnSEM) was highest for Acanthamoeba spp followedby Hartmannella spp and lastly Naegleria spp
313 Prevalence of Parasites across Sampling Sites Prevalenceof parasites across water source (natural and tap water)considered is presented in Table 2 Acanthamoeba spp werethe most prevalent parasite across all sources Naturalenvironmental water had significantly higher mean valuescompared to tap water in both study sites
314 Molecular Identification and Phylogenetic Analysis Fol-lowing FLA sequencing the products were blasted andcompared with the GenBank results from NCBI (Figure 2Table 3) Comparisons between the FLA isolated in Ugandaand those from the NCBI database were made and dif-ferences in divergence noted (Figure 2 Table 4) wereassessedThe species identifiedwereAcanthamoeba spp (var-ious T-genotypes) Acanthamoeba polyphaga Hartmannellavermiformis Nuclearia pattersoni Echinamoeba exundansBodomorpha minima and Cercomonas agilis The Acan-thamoeba sequences got belonged to the group of sequencetypes T1 T2 T4 and T11 (Table 3)
The confirmed Acanthamoeba genotype T1 was isolatedfrom tap water in Bwaise whereas T2 and T11 were isolatedfrom the Kazinga Channel water in QEPA Genotype T4which is usually the commonest Acanthamoeba T-genotypewas isolated from tap water in Katunguru Trading CentreKasaka landing site Albertine Restaurant in QEPA and
Kisenyi slum in Kampala The Hartmannella vermiformisconfirmed was isolated from fish landing sites in QEPA Thenonpathogenic FLA (Table 3) were isolated from a variety oftap water samples in Albertine Restaurant Thembo Restau-rant andKatunguruTradingCenter aswell as natural surfacewater from fish landing sites and the Kyambura River inQEPA In Kampala natural water samples that were positivefor FLA were from Lubigi swamps
All the parasites identified in this study were matchedwith the reported diseases they cause in humans (Table 3)
4 Discussion
We investigated the presence of FLA in natural and domestic(tap) water in QEPA and KLA The prevalence and mean(plusmnSEM) of Acanthamoeba spp in all cases were higher thanNaegleria and Hartmannella spp All FLA were more preva-lent in the rainy season exceptNaegleria spp that were higherin the dry season Most waterborne parasites increase innumber during the rainy season due to contamination of thewater sources with sewage soil and other organic mattersfrom water run-off [5 33] Tap water had a higher prevalenceof FLA than the natural water source There is not muchdata in Uganda to compare with the present findings butstudies from other countries [34 35] also documented ahigher frequency of Acanthamoeba compared to other FLAin environmental and tap water samples in alkaline water atthe same temperaturesThe first ever study of FLA in Ugandadocumented higher prevalence and mean of Acanthamoebathan other FLA in both environmental and tap water [5]
New Journal of Science 5
1
02
072
008
009
004
006
012
014
089
0861
0
10
078
087
077
091
077
091
018
058
063
054
088
033
085
KU894812
AF2938951_Echinamoeba_exundansKU894811
KU894808
KU894813
KU894806
AJ4892611_Echinamoeba_thermarumKU894805
KU894814
JQ2716891_Hartmannella_vermiformisKT1856251_Vermamoeba_vermiformisKU894803
KU894799
KU894800
KU894801
KU894802
KU894804
KM1894191_Acanthamoeba_spKU894807
AY3646351_Nuclearia_pattersoniAF4846871_Nuclearia_simplexKU894810
AY7488061_Cercomonas_agilisEU7091401_Cercozoa_spEU6471741|_CercomonadidaKU894809
AF4112761_Bodomorpha_minimaKU884884
Figure 2 Phylogenetic tree based on neighbor-joining showing the divergence of FLA Comparison with closely related species from theGenBank database sequences with their accession numbers (GenBank NCBI)
Acanthamoeba spp are more commonly encountered prob-ably because they are more involved in a predator-preyrelationshipwithmicrobial coloniesThehigh numbers couldbe explained by the presence of organic matter from rottingleaves animal and human faeces which are from the run-off from the land that often concentrate at the banks of thewater bodies This is known to exacerbate microbial biofilmformation and as a result facilitate the proliferation of FLAIt is believed that there are more FLA when there is anaccumulation of more organic matter in soil and water [3637] Previous studies report thatmicroorganisms settle on theinner surfaces of water pipes later becoming a source ofsecondary microbial contamination [38]
The primer pair JDP1JDP2 that was used is more spe-cific in the amplification of Acanthamoeba DNA [30 39]whereas CRN51137 amplifies any eukaryoteDNA [30]Acan-thamoeba sequence types can be grouped T1 to T20 [40]Blasting of sequences and comparison with those fromNCBIdatabase produced 7 Acanthamoeba 5 Echinamoeba 2 Hart-mannella 1 Bodomorpha 1 Nuclearia and 1 Cercomonas par-tial sequences Acanthamoeba genotypes T1 T2 and T4 were
mainly isolated from tap water samples whereas 11 were iso-lated from environmental water samplesThis is in agreementwith previous studies that indicate that T2 Acanthamoebagenotype is mainly found in the environment and is phyloge-netically related to T6 and they have also been both isolatedfrom clinical AK cases in humans [40] Acanthamoebagenotype T11 is closely related to T4 and has been found toalso cause AK [33]Acanthamoeba of T4 genotype is reportedas the most commonly encountered T-genotype group inboth environmental water and clinical samples and also themost diverse [33] Genotype T1 is notorious for granulo-matous amoebic encephalitis [11] whereas others may causekeratitis cutaneous infections and sinusitis in humans [1841] Hartmannella vermiformis originally thought to be non-pathogenic [42] has over the past decade been repeatedlyreported in a number of mixed human AK infections [4 1324] Although other FLA isolated in this study are considerednonpathogenic it is possible that they too could becomevirulent anytime given a conducive environment
Infective trophozoites of FLA in the environment aremaintained and spread by water during rainy seasons when
6 New Journal of Science
Table 3 Isolated free-living amoeba accession numbers water source and associated diseases in humans
Accession Source FLA Diseases Characteristics
KU884884 Tap KLA Bwaise Acanthamoeba spp (T1) Encephalitis [11 21]Mental status changeshemiparesis meningismus andataxia [22]
KU894799 Tap QEPA Katunguru Acanthamoeba spp (T2) Keratitis [11 21] Blinding infection of the cornea[22 23]
KU894800 Tap QEPA Katunguru Acanthamoeba spp (T4) Keratitis [11 21] Blinding infection of the cornea[22 23]
KU894801 Tap QEPA Albertine Acanthamoeba polyphaga(T4) Keratitis [11 21] Blinding infection of the cornea
[22 23]
KU894802 Tap QEPA Kasaka Acanthamoeba spp (T4) Keratitis [11 21] Blinding infection of the cornea[22 23]
KU894803 Tap KLA Kisenyi Acanthamoeba spp (T4) Keratitis [11 21] Blinding infection of the cornea[22 23]
KU894804 KCB QEPA Acanthamoeba spp (T11) Keratitis andencephalitis [22]
Disseminated disease blindnessand CNS function impairment[22]
KU894805 FLS QEPA Hartmannella vermiformis Keratitis [4 13 24] Blinding infection of the cornea[22]
KU894806 TAP QEPA Albertine Echinamoeba exundans Unknown mdashKU894807 TAP QEPAThembo Nuclearia pattersoni Unknown mdashKU894808 TAP QEPA Katunguru Echinamoeba exundans Unknown mdashKU894809 FLS QEPA Bodomorpha minima Unknown mdashKU894810 Lubigi KLA Cercomonas agilis Unknown mdashKU894811 R Kyambura QEPA Echinamoeba exundans Unknown mdashKU894812 R Kyambura QEPA Echinamoeba exundans Unknown mdashKU894813 TAP QEPA Albertine Echinamoeba exundans Unknown mdash
KU894814 TAP QEPAThembo Hartmannella vermiformis Keratitis [4 13 24] Blinding infection of the cornea[22]
FLS fish landing sites KCB Kazinga Channel banks KLA Kampala QEPA Queen Elizabeth Protected Area R Kyambura the Kyambura River
there is a run-off of water containing human and animal fae-cal matter from land into the water bodies which eventuallyend up at the points where communities fetch and utilise thewater Most FLA prevalence and mean intensities are higherin the rainy season than dry season [43] However parasiteincidences can be high throughout the rainy and dry seasonsoften indicating poor disposal of human and animal excretaand continuous patterns of infection [43] In a natural waterenvironment pathogens have been isolated widely frommany water sources used by rural dwelling households [3344 45] Often inadequately treated domestic water (drinkingbathing cooking and recreational water) has an abundanceof such pathogens Water bodies are usually contaminatedby high concentrations organisms from agricultural run-offurban wastewater effluents [46] and for the case of QEPAandKLAhuman and animal faecal contaminationTheQEPAand KLA local communities have few poorly built latrinesmost of which are already filled up compelling many to digsmall holes in the ground and defecate outside on openland When there is a heavy downpour of rain humanand animal the faecal material is washed off into the publicwater supply system Upon using this water exposure to avariety of protozoan parasites is highly likely The risk of
human infection is much higher in children and immuno-compromised individuals such as those who haveHIVAIDSdiabetes and cancer and those who have recently undergoneorgan transport [3]
5 Conclusion
The findings from the present study indicate that there isreasonably high contamination of both natural and domesticwater systems with Acanthamoeba spp Hartmannella sppNaegleria spp and other FLAThis is evidence that the waterbeing used is of poor quality and predisposes communities toinfectious agents With the fact that there is proof thatsome are pathogenic and can be vectors of many emerg-ingreemerging infectious agents it is imperative to preventthem from contaminating domestic water sources
Abbreviations∘C CelsiusAK Amoebic keratitisCNS Central nervous systemEnviron Environment
New Journal of Science 7
Table4Estim
ationof
evolutionary
divergence
betweensequ
ences
Percentidentity
12
34
56
78
910
1112
1314
1516
1718
1920
2122
2324
2526
2728
Divergence
1532
536
534
528
538
538
514
521
565
345
360
315
522
256
533
254
537
252
251
248
243
250
252
305
299
305
309
1KU
884884
22391
973
956
960
944
944
533
554
549
329
346
307
554
264
525
239
915
238
235
256
242
246
246
293
289
299
310
2KU
894799
32203
19957
950
940
945
523
544
550
328
348
306
545
266
525
238
917
236
234
255
240
243
247
291
289
298
311
3KU
894800
42051
30
37
941
934
956
528
552
550
323
346
306
550
264
525
242
898
238
235
255
240
248
252
294
290
301
311
4KU
894801
52187
40
42
33
940
944
529
550
544
333
342
303
550
266
526
236
897
236
234
256
239
244
248
291
289
299
311
5KU
894802
62120
48
60
53
40
940
521
540
558
342
356
318
540
278
538
247
887
243
240
264
250
250
255
298
294
305
317
6KU
894803
72262
33
45
1743
57
509
530
554
332
353
315
530
275
536
251
890
246
243
263
248
254
258
299
298
307
326
7KU
894804
81310
1459
1409
1424
1447
1441
1388
795
632
357
370
329
807
277
546
283
562
277
277
256
256
256
264
302
299
305
310
8KU
894805
91271
1043
1030
1014
1032
1048
1006
484
659
455
420
362
960
430
666
322
583
323
322
416
381
315
322
356
353
364
352
9KU
894806
101335
1819
1777
1637
1793
1671
1584
500
389
474
537
491
670
415
666
389
581
381
383
395
395
479
486
471
477
482
485
10KU
894807
111410
1653
1636
1653
1490
1472
1564
640
264
483
652
596
478
677
651
553
313
545
545
654
585
549
556
588
591
592
589
11KU894808
121368
1691
1709
1633
1677
1562
1534
531
342
316
424
836
432
695
583
685
333
689
689
689
675
733
742
928
898
863
846
12KU
894809
131216
1391
1404
1392
1384
1332
1314
472
338
304
422
79374
701
534
697
291
683
683
681
664
744
752
847
860
864
958
13KU
894810
141279
1029
1026
1014
1017
1034
987
456
69
329
211
294
296
452
687
328
584
325
323
436
368
323
332
365
362
369
360
14KU
894811
151330
1238
1257
1247
1192
1156
1180
463
66
362
248
241
272
00
648
742
247
728
728
964
827
730
732
686
686
694
705
15KU
894812
161357
1507
1523
1474
1423
1350
1395
563
132
399
188
308
304
7646
493
506
472
472
617
542
486
494
515
517
529
529
16KU
894813
171211
1359
1390
1362
1366
1302
1275
363
311
390
432
247
263
290
292
319
220
952
952
715
701
699
703
682
681
691
711
17KU
894814
182065
45
47
46
68
68
51
1415
1039
1568
1499
1453
1227
1031
1140
1358
1247
232
230
250
235
242
246
290
287
297
294
18KM
1894191Ac
antham
oeba
sp
191208
1352
1400
1348
1345
1315
1279
352
300
386
428
235
264
278
284
318
101263
995
756
740
740
741
722
719
728
690
19JQ
2716891Hartm
annella
verm
iform
is
201222
1399
1449
1394
1390
1356
1318
352
305
381
428
235
264
283
284
318
101303
06
756
740
741
742
722
721
729
690
20KT
1856251Ve
rmam
oeba
verm
iform
is
211329
1267
1311
1272
1232
1197
1211
470
78367
253
234
275
07
04
53
295
1193
278
278
855
761
760
718
718
723
685
21AF2938951Echinamoeba
exun
dans
221318
1307
1352
1311
1307
1231
1242
462
145
364
358
252
290
161
149
171
315
1230
299
299
149
754
750
697
699
701
674
22AJ
4892611Echinamoeba
thermarum
231299
1447
1517
1401
1438
1399
1359
458
287
189
389
164
189
229
249
242
295
1311
278
276
241
250
970
764
780
773
750
23AY
3646351Nuclearia
patte
rson
i
241323
1460
1532
1413
1451
1388
1370
450
278
189
384
156
183
224
246
239
288
1321
271
269
238
252
25
769
785
780
758
24AF4
846871
Nuclearia
simplex
251368
1641
1706
1608
1625
1539
1545
536
349
319
427
00
103
293
284
314
284
1452
266
266
271
298
205
200
961
917
855
25AF4
112761Bo
domorph
aminim
a
261392
1768
1875
1724
1702
1632
1626
527
348
315
426
1699
291
283
308
281
1556
266
263
270
293
191
186
23
936
867
26EU
6471741|
Cercomon
adida
271342
1569
1629
1539
1522
1479
1455
506
311
326
423
60
103
271
268
288
261
1393
252
250
260
290
203
196
7258
872
27EU
7091401Cercozoasp
281245
1358
1360
1348
1364
1312
1282
507
348
320
447
80
02
314
279
322
268
1197
267
267
279
288
192
186
105
100
105
28AY
7488061Cercomon
asagilis
12
34
56
78
910
1112
1314
1516
1718
1920
2122
2324
2526
2728
8 New Journal of Science
FLA Free-living amoebaFLS Fish landing siteG Gravitational forceg GramsGAE Granulomatous amoebic encephalitisHIVAIDS Human immunodeficiency
virusacquired immune deficiencysyndrome
KCB Kazinga Channel bankKCM Kazinga Channel middleKLA KampalaL Litermg MilligramsmL MillilitersmM MillimolarNCBI National Center for Biotechnology
InformationNo NumberPA Protected areaPAM Primary amoebic
meningoencephalitispg Picogrampmol PicomolesPrev PrevalenceQEPA Queen Elizabeth Protected Arearpm Revolutions per minuteSG Specific gravityUNESCO United Nations Educational
Scientific and Cultural OrganizationUn-ID Amoeba Unidentified amoebaV Volts120583S Microseconds
Competing Interests
There are no competing interests
References
[1] A J Martinez and G S Visvesvara ldquoFree-living amphizoic andopportunistic amebasrdquo Brain Pathology vol 7 no 1 pp 583ndash598 1997
[2] WHO Combating Waterborne Disease at the HouseholdLevelInternational Network to Promote HouseholdWater Treat-ment and Safe Storage World Health Organization GenevaSwitzerland 2007
[3] CDC Domestic Water Sanitation and Hygiene Epidemiol-ogy Center for Disease Control Atlanta Ga USA 2015httpwwwcdcgovnceziddfwedwaterbornedomestichtml
[4] H Abedkhojasteh M Niyyati F Rahimi M Hei-Dari SFarnia andM Rezaeian ldquoFirst report of Hartmannella keratitisin a cosmetic soft contact lens wearer in Iranrdquo Iranian Journalof Parasitology vol 8 no 3 pp 481ndash485 2013
[5] C Sente J Erume I Naigaga et al ldquoOccurrence and geneticcharacterisation ofAcanthamoeba spp from environmental anddomestic water sources in Queen Elizabeth Protected AreaUgandardquo Parasites amp Vectors vol 9 article 127 2016
[6] J De Jonckheere ldquoNaegleria australiensis sp nov anotherpathogenic Naegleria from waterrdquo Protistologica vol 17 pp423ndash429 1981
[7] J FDe Jonckheere ldquoIsoenzymepatterns of pathogenic andnon-pathogenic Naegleria spp using agarose isoelectric focusingrdquoAnnales de Microbiologie vol 133 no 2 pp 319ndash342 1982
[8] J F De Jonckheere ldquoA century of research on the amoeboflag-ellate genus Naegleriardquo Acta Protozoologica vol 41 no 4 pp309ndash342 2002
[9] CDC ldquoAcanthamoeba keratitis associated with contact lensesmdashUnited Statesrdquo Morbidity and Mortality Weekly Report vol 35no 25 pp 405ndash408 1986
[10] V A Dunand S M Hammer R Rossi et al ldquoParasitic sinusitisand otitis in patients infected with human immunodeficiencyvirus report of five cases and reviewrdquo Clinical Infectious Dis-eases vol 25 no 2 pp 267ndash272 1997
[11] S Amir Acanthamoeba castellanii as a Host and Model toStudy Bacterial Virulence Karolinska UniversitetssjukhusetHuddinge Sweden 2009
[12] R Dey P S Hoffman and I J Glomski ldquoGermination andamplification of anthrax spores by soil-dwelling amoebasrdquoApplied and Environmental Microbiology vol 78 no 22 pp8075ndash8081 2012
[13] R Solgi M Niyyati A Haghighi and E N Mojarad ldquoOccur-rence of thermotolerant Hartmannella vermiformis and Naeg-leria spp in hot springs of Ardebil Province Northwest IranrdquoIranian Journal of Parasitology vol 7 no 2 pp 47ndash52 2012
[14] Uganda CholeraWHORegional Office for Africa 2012 httpwwwafrowhointenclusters-a-programmesdpcepidemic-a-pandemic-alert-and-response3601-uganda-cholera-situation-as-of-31-march-2012html
[15] G Ojore Uganda 2000 Children Die of Diarrhoea in AfricaDaily-WaterAid New Vision Publishing Kampala Uganda2012
[16] Uganda rural water services Inadequate quantity low qualitysatisfiedusers IRC 2014 httpwwwircwashorgnewsuganda-rural-water-services-inadequate-quantity-low-quality-satisfied-users
[17] WHO Regional Office for Africa Emergencies Preparednessand Response to Typhoid Fever Uganda 2015 httpwwwwhointcsrdon17-march-2015-ugandaen
[18] Naegleria Infection Medscape Drugs amp Diseases 2015 httpemedicinemedscapecomarticle223910-overviewa5
[19] G S Visvesvara H Moura and F L Schuster ldquoPathogenic andopportunistic free-living amoebae Acanthamoeba spp Bala-muthia mandrillaris Naegleria fowleri and Sappinia diploideardquoFEMS Immunology and Medical Microbiology vol 50 no 1 pp1ndash26 2007
[20] L J Stockman C J Wright G S Visvesvara B S Fields andM J Beach ldquoPrevalence of Acanthamoeba spp and other free-living amoebae in household water Ohio USAmdash1990ndash1992rdquoParasitology Research vol 108 no 3 pp 621ndash627 2011
[21] G S Visvesvara ldquoAmebic meningoencephalitides and keratitischallenges in diagnosis and treatmentrdquo Current Opinion inInfectious Diseases vol 23 no 6 pp 590ndash594 2010
[22] N Crum-Cianflone Acanthamoeba Naval Medical Center atSan Diego San Diego Calif USA 2015
[23] F Marciano-Cabral and G A Cabral ldquoAcanthamoeba spp asagents of disease in humansrdquoClinicalMicrobiology Reviews vol16 no 2 pp 273ndash307 2003
[24] J Lorenzo-Morales E Martınez-Carretero N Batista et alldquoEarly diagnosis of amoebic keratitis due to a mixed infectionwith Acanthamoeba and Hartmannellardquo Parasitology Researchvol 102 no 1 pp 167ndash169 2007
New Journal of Science 9
[25] Z Szenasi T Endo K Yagita and ENagy ldquoIsolation identifica-tion and increasing importance of lsquofree-livingrsquo amoebae causinghuman diseaserdquo Journal of Medical Microbiology vol 47 no 1pp 5ndash16 1998
[26] H Trabelsi F Dendana A Sellami et al ldquoPathogenic free-living amoebae epidemiology and clinical reviewrdquo PathologieBiologie vol 60 no 6 pp 399ndash405 2012
[27] Uganda Bureau of Statistics Estimated Population of Kampalain 2002 2010 amp 2011 Uganda Bureau of Statistics 2014
[28] F L Schuster and G S Visvesvara ldquoFree-living amoebae asopportunistic and non-opportunistic pathogens of humans andanimalsrdquo International Journal for Parasitology vol 34 no 9 pp1001ndash1027 2004
[29] M Pelandakis and P Pernin ldquoUse of multiplex PCR andPCR restriction enzyme analysis for detection and explorationof the variability in the free-living amoeba Naegleria in theenvironmentrdquoApplied and EnvironmentalMicrobiology vol 68no 4 pp 2061ndash2065 2002
[30] J M Schroeder G C Booton J Hay et al ldquoUse of subgenic 18Sribosomal DNA PCR and sequencing for genus and genotypeidentification of Acanthamoebae from humans with keratitisand from sewage sludgerdquo Journal of Clinical Microbiology vol39 no 5 pp 1903ndash1911 2001
[31] G C Booton D J Kelly Y-W Chu et al ldquo18S ribosomalDNA typing and tracking of Acanthamoeba species isolatesfrom corneal scrape specimens contact lenses lens cases andhomewater supplies ofAcanthamoeba keratitis patients inHongKongrdquo Journal of Clinical Microbiology vol 40 no 5 pp 1621ndash1625 2002
[32] K Tamura G Stecher D Peterson A Filipski and S KumarldquoMEGA6molecular evolutionary genetics analysis version 60rdquoMolecular Biology and Evolution vol 30 no 12 pp 2725ndash27292013
[33] P Bonilla-Lemus A S Caballero Villegas J Carmona Jimenezand A Lugo Vazquez ldquoOccurrence of free-living amoebae instreams of the Mexico Basinrdquo Experimental Parasitology vol145 supplement pp S28ndashS33 2014
[34] S Ghadar-Ghadr K Solhjoo M Norouz-Nejad R Rohi and SZia-Jahromi ldquoIsolation and identification of free living amoeba(Naegleria and Acanthamoeba) in Shiraz water resources bymorphological criteriardquo Pars of Jahrom University of MedicalSciences vol 10 no 3 pp 33ndash42 2012
[35] S Ghadar-Ghadr K Solhjoo M Norouz-Nejad R Rohi and SZia-Jahromi ldquoIsolation and identification of free living amoeba(Naegleria and Acanthamoeba) in Shiraz water resources bymorphological criteriardquo Journal of Jahrom University of MedicalSciences vol 10 no 3 pp 26ndash33 2012
[36] S Rodriguez-Zaragoza E Mayzlish and Y Steinberger ldquoVer-tical distribution of the free-living amoeba population in soilunder desert shrubs in the Negev Desert Israelrdquo Applied andEnvironmentalMicrobiology vol 71 no 4 pp 2053ndash2060 2005
[37] M Pruden J Falkinham K Williams H Wang K Martinsand W Rhoads ldquoRelationship between biodegradable organicmatter and pathogen concentrations in premise plumbingrdquoWater Research Foundation pp 58ndash90 2013
[38] A Rozej A Cydzik-Kwiatkowska B Kowalska and D Kowal-ski ldquoStructure and microbial diversity of biofilms on differentpipe materials of a model drinking water distribution systemsrdquoWorld Journal of Microbiology amp Biotechnology vol 31 no 1 pp37ndash47 2015
[39] M H Vodkin D K Howe G S Visvesvara and G LMcLaughlin ldquoIdentification ofAcanthamoeba at the generic and
specific levels using the polymerase chain reactionrdquoThe Journalof Protozoology vol 39 no 3 pp 378ndash385 1992
[40] M Crary Genetic Variability and Its Relationship to Acan-thamoeba Pathogenesis Molecular Genetics Ohio State Univer-sity Columbus Ohio USA 2012
[41] M S Torno Jr R Babapour A Gurevitch and M D WittldquoCutaneous acanthamoebiasis inAIDSrdquo Journal of theAmericanAcademy of Dermatology vol 42 no 2 part 2 pp 351ndash3542000
[42] J F De Jonckheere and S Brown ldquoThere is no evidence that thefree-living ameba Hartmannella is a human parasiterdquo ClinicalInfectious Diseases vol 26 no 3 p 773 1998
[43] P W Woodburn L Muhangi S Hillier et al ldquoRisk factors forhelminth malaria and HIV infection in pregnancy in EntebbeUgandardquo PLoS Neglected Tropical Diseases vol 3 no 6 articlee473 2009
[44] S Onichandran T Kumar C C Salibay et al ldquoWaterborneparasites a current status from the Philippinesrdquo Parasites ampVectors vol 7 no 1 article 244 2014
[45] T Kumar S Onichandran Y A L Lim et al ldquoComparativestudy on waterborne parasites between Malaysia andThailanda new insightrdquo The American Journal of Tropical Medicine andHygiene vol 90 no 4 pp 682ndash689 2014
[46] D CarmenaWaterborne Transmission of Cryptosporidium andGiardia Detection Surveillance and Implications for PublicHealth Faculty of Medicine IC London UK 2010
Submit your manuscripts athttpwwwhindawicom
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
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New Journal of Science 3
followed by incubating the plates at 32∘C overnight afterwhich each plate was sealed with a plastic film and incubatedupside down at 32∘C up to 7 days Three days later theplates were monitored for detection of amoebae trophozoitesuntil day 7 using an inverted microscope (Motic AE2000Binocular TED PELLA Inc USA)
242 DNA Extraction All DNA was extracted from culturepositive plates by chemical lysis and purification [29] Fivehundred microliters of STE buffer (01M NaCl 1mM EDTA10mM trischloride PH 8 and 1 SDS) and 10 120583L proteinaseK (10mgmL) were added to each sample in an Eppendorftube All samples were put in a water bath and incubated at56∘C for one hour and then left to cool down before phenolextraction Phenol chloroform (521120583L) was added to eachsample vortexed and centrifuged at maximum speed(13200 rpm) for 5 minutesThe aqueous layer was transferredto a new Eppendorf tube and the step redone to make 2phenol-chloroform extractions The aqueous layer was sub-jected to another chloroform extraction centrifuged andtransferred to a new Eppendorf tube after which 1000120583L ofabsolute alcohol (96ndash100) was added to each sample Thesamples were put in a freezer at minus80∘C overnight for pre-cipitation The following day all samples were centrifuged at13200 rpm for 30 minutes and alcohol was poured offThe pellet was washed with 1000 120583L of 70 alcohol andcentrifuged at 13200 rpm for 15 minutes Alcohol was pouredoff to expose the pellet which was air-dried and dissolved in50120583L of TE buffer
243 DNA Amplification Amplification of 18S ribosomalDNA (18S rDNA) from Acanthamoeba and other FLA wasdone by primer pairs JDP1JDP2 and CRN51137 [12 30 31]Forward primer JDP1 (51015840GGCCCAGATCGTTTACCG-TGAA-31015840) and reverse primer JDP2 (51015840TCTCACAAG-CTGCTAGGGAGTCA-31015840) were genus-specific for Acan-thamoeba spp Forward primer CRN5 (51015840CTGGTTGAT-CCTGCCAGTAG-31015840) and reverse primer 1137 (51015840GTGCCC-TTCCGTCAAT-31015840) obtained amplimers from any eukaryoteaiding amplification of the 18S ribosomal DNA gene fromdifferent FLA
The reactions were carried out with a DreamTaq PCR kit(Thermo Scientific DreamTaq USA) A 25 120583L reaction vol-ume containing 125 120583L DreamTaq Green PCR Master Mix(2x) 05 120583M forward primer 05120583M reverse primer 9120583Lnuclease-free water and 25 120583LDNA template (50 pg concen-tration) was used The following conditions were consideredfor the PCR initial denaturation at 94∘C for 3 minutesfollowed by 35 cycles with denaturation at 94∘C for 30seconds followed by annealing at 55∘C for 30 seconds thenextension at 72∘C for 30 seconds and a final extension at72∘C for 5 minutes Five microliters of each PCR reactionwas tested for successful amplification using agarose gel(25WV) stained with ethidium bromide run against1 kbp DNA ladder Once enough electrophoretic separationwas reached the agarose gel was observed under a UV geldocumentation system thereafter capturing the gel images
Dry season Rainy season Dry season Rainy season
QEPA KLA
Acanthamoeba sppHartmannella spp
Naegleria sppOther FLA
(n = 204) (n = 174)(n = 116)(n = 204)
010203040506070
Ove
rall
prev
alen
ce
Figure 1 Overall seasonal prevalence of FLA
25 Nucleic Acid Sequencing and Analysis Positive gel sam-ples were extracted and the DNA purified with QIAquick GelExtraction Kit (Qiagen Inc Netherlands) Partial 18S rDNAsegment of the amoeba isolates was exposed to cycle sequenc-ing with JDP1JDP2 and CRN51137 as sequencing primers[31] Base trimming of the sequence files to obtain goodquality was done by ldquoSeqBuilderrdquo software (Dnastar USA)and a search for homologues in the NCBI database was doneusing ldquoblastnrdquo tool The resultant homologues with querycoverage gt 70 identity gt 70 and low E values (lt0)were considered Phylogenetic analysis was done and adendrogram was constructed [32]
26 Statistical Analysis Data was entered into Excel fromwhich it was extracted and analysed using SPSS (IBM USA)Variables were summarised by the use of mean and standarderror of themean (SEM) Application of univariate analysis tocompare prevalence across sampling sites was executed usingcross-tabulation with a 1205942 test All variables with a 119901 valueof le 005 were considered significant We employed Pearsoncorrelation coefficient (r) to carry out linear correlation anal-ysis between naturaltap water variables and water parasitepresence
3 Results
31 Prevalence of Parasites
311 Overall Seasonal Prevalence The water samples werecollected during cold rainy (November March and July) andcool dry (January May and September) seasons OverallFLA parasite prevalence in both study sites was higher duringthe rainy season except for Naegleria spp that was higher inthe dry season in QEPA (Figure 1)
312 Overall Prevalence andMean Theprevalence andmean(SEM) of the parasites from different sources are shownin Table 1 Both natural environmental and domestic tapwater sources were contaminated with FLA The overallprevalence of Acanthamoeba spp and other FLA in QEPAand Kampala was as follows Acanthamoeba spp (QEPA
4 New Journal of Science
Table 1 The overall prevalence of the FLA
Parasite QEPA KLAFreq (119899 = 408) Prev () Mean plusmn SE Freq (119899 = 290) Prev () Mean plusmn SE
Acanthamoeba spp 143 35 19 plusmn 02 82 283 28 plusmn 05Naegleria spp 55 135 04 plusmn 01 48 166 14 plusmn 03Hartmannella spp 77 189 12 plusmn 01 67 231 14 plusmn 03Freq frequency Prev prevalence
Table 2 Prevalence and mean across water sources
Parasite QEPA KLATap water (119899 = 84) Environmental water (119899 = 324) Tap water (119899 = 170) Environmental water (119899 = 65)
Acanthamoeba spp(+) () 36 (43) 107 (33) 48 (282) 15 (231)Mean plusmn SEM 226 plusmn 04 892 plusmn 16 52 plusmn 12 24 plusmn 13
Hartmannella spp(+) () 19 (226) 58 (179) 38 (224) 10 (154)Mean plusmn SEM 120 plusmn 015 493 plusmn 092 44 plusmn 10 09 plusmn 016
Naegleria spp(+) () 12 (143) 43 (133) 25 (147) 9 (138)Mean plusmn SEM 05 plusmn 015 158 plusmn 06 35 plusmn 11 05 plusmn 03
35 KLA 283) Hartmannella spp (QEPA 189 KLA231) and Naegleria spp (QEPA 135 KLA 166) Themean (plusmnSEM) was highest for Acanthamoeba spp followedby Hartmannella spp and lastly Naegleria spp
313 Prevalence of Parasites across Sampling Sites Prevalenceof parasites across water source (natural and tap water)considered is presented in Table 2 Acanthamoeba spp werethe most prevalent parasite across all sources Naturalenvironmental water had significantly higher mean valuescompared to tap water in both study sites
314 Molecular Identification and Phylogenetic Analysis Fol-lowing FLA sequencing the products were blasted andcompared with the GenBank results from NCBI (Figure 2Table 3) Comparisons between the FLA isolated in Ugandaand those from the NCBI database were made and dif-ferences in divergence noted (Figure 2 Table 4) wereassessedThe species identifiedwereAcanthamoeba spp (var-ious T-genotypes) Acanthamoeba polyphaga Hartmannellavermiformis Nuclearia pattersoni Echinamoeba exundansBodomorpha minima and Cercomonas agilis The Acan-thamoeba sequences got belonged to the group of sequencetypes T1 T2 T4 and T11 (Table 3)
The confirmed Acanthamoeba genotype T1 was isolatedfrom tap water in Bwaise whereas T2 and T11 were isolatedfrom the Kazinga Channel water in QEPA Genotype T4which is usually the commonest Acanthamoeba T-genotypewas isolated from tap water in Katunguru Trading CentreKasaka landing site Albertine Restaurant in QEPA and
Kisenyi slum in Kampala The Hartmannella vermiformisconfirmed was isolated from fish landing sites in QEPA Thenonpathogenic FLA (Table 3) were isolated from a variety oftap water samples in Albertine Restaurant Thembo Restau-rant andKatunguruTradingCenter aswell as natural surfacewater from fish landing sites and the Kyambura River inQEPA In Kampala natural water samples that were positivefor FLA were from Lubigi swamps
All the parasites identified in this study were matchedwith the reported diseases they cause in humans (Table 3)
4 Discussion
We investigated the presence of FLA in natural and domestic(tap) water in QEPA and KLA The prevalence and mean(plusmnSEM) of Acanthamoeba spp in all cases were higher thanNaegleria and Hartmannella spp All FLA were more preva-lent in the rainy season exceptNaegleria spp that were higherin the dry season Most waterborne parasites increase innumber during the rainy season due to contamination of thewater sources with sewage soil and other organic mattersfrom water run-off [5 33] Tap water had a higher prevalenceof FLA than the natural water source There is not muchdata in Uganda to compare with the present findings butstudies from other countries [34 35] also documented ahigher frequency of Acanthamoeba compared to other FLAin environmental and tap water samples in alkaline water atthe same temperaturesThe first ever study of FLA in Ugandadocumented higher prevalence and mean of Acanthamoebathan other FLA in both environmental and tap water [5]
New Journal of Science 5
1
02
072
008
009
004
006
012
014
089
0861
0
10
078
087
077
091
077
091
018
058
063
054
088
033
085
KU894812
AF2938951_Echinamoeba_exundansKU894811
KU894808
KU894813
KU894806
AJ4892611_Echinamoeba_thermarumKU894805
KU894814
JQ2716891_Hartmannella_vermiformisKT1856251_Vermamoeba_vermiformisKU894803
KU894799
KU894800
KU894801
KU894802
KU894804
KM1894191_Acanthamoeba_spKU894807
AY3646351_Nuclearia_pattersoniAF4846871_Nuclearia_simplexKU894810
AY7488061_Cercomonas_agilisEU7091401_Cercozoa_spEU6471741|_CercomonadidaKU894809
AF4112761_Bodomorpha_minimaKU884884
Figure 2 Phylogenetic tree based on neighbor-joining showing the divergence of FLA Comparison with closely related species from theGenBank database sequences with their accession numbers (GenBank NCBI)
Acanthamoeba spp are more commonly encountered prob-ably because they are more involved in a predator-preyrelationshipwithmicrobial coloniesThehigh numbers couldbe explained by the presence of organic matter from rottingleaves animal and human faeces which are from the run-off from the land that often concentrate at the banks of thewater bodies This is known to exacerbate microbial biofilmformation and as a result facilitate the proliferation of FLAIt is believed that there are more FLA when there is anaccumulation of more organic matter in soil and water [3637] Previous studies report thatmicroorganisms settle on theinner surfaces of water pipes later becoming a source ofsecondary microbial contamination [38]
The primer pair JDP1JDP2 that was used is more spe-cific in the amplification of Acanthamoeba DNA [30 39]whereas CRN51137 amplifies any eukaryoteDNA [30]Acan-thamoeba sequence types can be grouped T1 to T20 [40]Blasting of sequences and comparison with those fromNCBIdatabase produced 7 Acanthamoeba 5 Echinamoeba 2 Hart-mannella 1 Bodomorpha 1 Nuclearia and 1 Cercomonas par-tial sequences Acanthamoeba genotypes T1 T2 and T4 were
mainly isolated from tap water samples whereas 11 were iso-lated from environmental water samplesThis is in agreementwith previous studies that indicate that T2 Acanthamoebagenotype is mainly found in the environment and is phyloge-netically related to T6 and they have also been both isolatedfrom clinical AK cases in humans [40] Acanthamoebagenotype T11 is closely related to T4 and has been found toalso cause AK [33]Acanthamoeba of T4 genotype is reportedas the most commonly encountered T-genotype group inboth environmental water and clinical samples and also themost diverse [33] Genotype T1 is notorious for granulo-matous amoebic encephalitis [11] whereas others may causekeratitis cutaneous infections and sinusitis in humans [1841] Hartmannella vermiformis originally thought to be non-pathogenic [42] has over the past decade been repeatedlyreported in a number of mixed human AK infections [4 1324] Although other FLA isolated in this study are considerednonpathogenic it is possible that they too could becomevirulent anytime given a conducive environment
Infective trophozoites of FLA in the environment aremaintained and spread by water during rainy seasons when
6 New Journal of Science
Table 3 Isolated free-living amoeba accession numbers water source and associated diseases in humans
Accession Source FLA Diseases Characteristics
KU884884 Tap KLA Bwaise Acanthamoeba spp (T1) Encephalitis [11 21]Mental status changeshemiparesis meningismus andataxia [22]
KU894799 Tap QEPA Katunguru Acanthamoeba spp (T2) Keratitis [11 21] Blinding infection of the cornea[22 23]
KU894800 Tap QEPA Katunguru Acanthamoeba spp (T4) Keratitis [11 21] Blinding infection of the cornea[22 23]
KU894801 Tap QEPA Albertine Acanthamoeba polyphaga(T4) Keratitis [11 21] Blinding infection of the cornea
[22 23]
KU894802 Tap QEPA Kasaka Acanthamoeba spp (T4) Keratitis [11 21] Blinding infection of the cornea[22 23]
KU894803 Tap KLA Kisenyi Acanthamoeba spp (T4) Keratitis [11 21] Blinding infection of the cornea[22 23]
KU894804 KCB QEPA Acanthamoeba spp (T11) Keratitis andencephalitis [22]
Disseminated disease blindnessand CNS function impairment[22]
KU894805 FLS QEPA Hartmannella vermiformis Keratitis [4 13 24] Blinding infection of the cornea[22]
KU894806 TAP QEPA Albertine Echinamoeba exundans Unknown mdashKU894807 TAP QEPAThembo Nuclearia pattersoni Unknown mdashKU894808 TAP QEPA Katunguru Echinamoeba exundans Unknown mdashKU894809 FLS QEPA Bodomorpha minima Unknown mdashKU894810 Lubigi KLA Cercomonas agilis Unknown mdashKU894811 R Kyambura QEPA Echinamoeba exundans Unknown mdashKU894812 R Kyambura QEPA Echinamoeba exundans Unknown mdashKU894813 TAP QEPA Albertine Echinamoeba exundans Unknown mdash
KU894814 TAP QEPAThembo Hartmannella vermiformis Keratitis [4 13 24] Blinding infection of the cornea[22]
FLS fish landing sites KCB Kazinga Channel banks KLA Kampala QEPA Queen Elizabeth Protected Area R Kyambura the Kyambura River
there is a run-off of water containing human and animal fae-cal matter from land into the water bodies which eventuallyend up at the points where communities fetch and utilise thewater Most FLA prevalence and mean intensities are higherin the rainy season than dry season [43] However parasiteincidences can be high throughout the rainy and dry seasonsoften indicating poor disposal of human and animal excretaand continuous patterns of infection [43] In a natural waterenvironment pathogens have been isolated widely frommany water sources used by rural dwelling households [3344 45] Often inadequately treated domestic water (drinkingbathing cooking and recreational water) has an abundanceof such pathogens Water bodies are usually contaminatedby high concentrations organisms from agricultural run-offurban wastewater effluents [46] and for the case of QEPAandKLAhuman and animal faecal contaminationTheQEPAand KLA local communities have few poorly built latrinesmost of which are already filled up compelling many to digsmall holes in the ground and defecate outside on openland When there is a heavy downpour of rain humanand animal the faecal material is washed off into the publicwater supply system Upon using this water exposure to avariety of protozoan parasites is highly likely The risk of
human infection is much higher in children and immuno-compromised individuals such as those who haveHIVAIDSdiabetes and cancer and those who have recently undergoneorgan transport [3]
5 Conclusion
The findings from the present study indicate that there isreasonably high contamination of both natural and domesticwater systems with Acanthamoeba spp Hartmannella sppNaegleria spp and other FLAThis is evidence that the waterbeing used is of poor quality and predisposes communities toinfectious agents With the fact that there is proof thatsome are pathogenic and can be vectors of many emerg-ingreemerging infectious agents it is imperative to preventthem from contaminating domestic water sources
Abbreviations∘C CelsiusAK Amoebic keratitisCNS Central nervous systemEnviron Environment
New Journal of Science 7
Table4Estim
ationof
evolutionary
divergence
betweensequ
ences
Percentidentity
12
34
56
78
910
1112
1314
1516
1718
1920
2122
2324
2526
2728
Divergence
1532
536
534
528
538
538
514
521
565
345
360
315
522
256
533
254
537
252
251
248
243
250
252
305
299
305
309
1KU
884884
22391
973
956
960
944
944
533
554
549
329
346
307
554
264
525
239
915
238
235
256
242
246
246
293
289
299
310
2KU
894799
32203
19957
950
940
945
523
544
550
328
348
306
545
266
525
238
917
236
234
255
240
243
247
291
289
298
311
3KU
894800
42051
30
37
941
934
956
528
552
550
323
346
306
550
264
525
242
898
238
235
255
240
248
252
294
290
301
311
4KU
894801
52187
40
42
33
940
944
529
550
544
333
342
303
550
266
526
236
897
236
234
256
239
244
248
291
289
299
311
5KU
894802
62120
48
60
53
40
940
521
540
558
342
356
318
540
278
538
247
887
243
240
264
250
250
255
298
294
305
317
6KU
894803
72262
33
45
1743
57
509
530
554
332
353
315
530
275
536
251
890
246
243
263
248
254
258
299
298
307
326
7KU
894804
81310
1459
1409
1424
1447
1441
1388
795
632
357
370
329
807
277
546
283
562
277
277
256
256
256
264
302
299
305
310
8KU
894805
91271
1043
1030
1014
1032
1048
1006
484
659
455
420
362
960
430
666
322
583
323
322
416
381
315
322
356
353
364
352
9KU
894806
101335
1819
1777
1637
1793
1671
1584
500
389
474
537
491
670
415
666
389
581
381
383
395
395
479
486
471
477
482
485
10KU
894807
111410
1653
1636
1653
1490
1472
1564
640
264
483
652
596
478
677
651
553
313
545
545
654
585
549
556
588
591
592
589
11KU894808
121368
1691
1709
1633
1677
1562
1534
531
342
316
424
836
432
695
583
685
333
689
689
689
675
733
742
928
898
863
846
12KU
894809
131216
1391
1404
1392
1384
1332
1314
472
338
304
422
79374
701
534
697
291
683
683
681
664
744
752
847
860
864
958
13KU
894810
141279
1029
1026
1014
1017
1034
987
456
69
329
211
294
296
452
687
328
584
325
323
436
368
323
332
365
362
369
360
14KU
894811
151330
1238
1257
1247
1192
1156
1180
463
66
362
248
241
272
00
648
742
247
728
728
964
827
730
732
686
686
694
705
15KU
894812
161357
1507
1523
1474
1423
1350
1395
563
132
399
188
308
304
7646
493
506
472
472
617
542
486
494
515
517
529
529
16KU
894813
171211
1359
1390
1362
1366
1302
1275
363
311
390
432
247
263
290
292
319
220
952
952
715
701
699
703
682
681
691
711
17KU
894814
182065
45
47
46
68
68
51
1415
1039
1568
1499
1453
1227
1031
1140
1358
1247
232
230
250
235
242
246
290
287
297
294
18KM
1894191Ac
antham
oeba
sp
191208
1352
1400
1348
1345
1315
1279
352
300
386
428
235
264
278
284
318
101263
995
756
740
740
741
722
719
728
690
19JQ
2716891Hartm
annella
verm
iform
is
201222
1399
1449
1394
1390
1356
1318
352
305
381
428
235
264
283
284
318
101303
06
756
740
741
742
722
721
729
690
20KT
1856251Ve
rmam
oeba
verm
iform
is
211329
1267
1311
1272
1232
1197
1211
470
78367
253
234
275
07
04
53
295
1193
278
278
855
761
760
718
718
723
685
21AF2938951Echinamoeba
exun
dans
221318
1307
1352
1311
1307
1231
1242
462
145
364
358
252
290
161
149
171
315
1230
299
299
149
754
750
697
699
701
674
22AJ
4892611Echinamoeba
thermarum
231299
1447
1517
1401
1438
1399
1359
458
287
189
389
164
189
229
249
242
295
1311
278
276
241
250
970
764
780
773
750
23AY
3646351Nuclearia
patte
rson
i
241323
1460
1532
1413
1451
1388
1370
450
278
189
384
156
183
224
246
239
288
1321
271
269
238
252
25
769
785
780
758
24AF4
846871
Nuclearia
simplex
251368
1641
1706
1608
1625
1539
1545
536
349
319
427
00
103
293
284
314
284
1452
266
266
271
298
205
200
961
917
855
25AF4
112761Bo
domorph
aminim
a
261392
1768
1875
1724
1702
1632
1626
527
348
315
426
1699
291
283
308
281
1556
266
263
270
293
191
186
23
936
867
26EU
6471741|
Cercomon
adida
271342
1569
1629
1539
1522
1479
1455
506
311
326
423
60
103
271
268
288
261
1393
252
250
260
290
203
196
7258
872
27EU
7091401Cercozoasp
281245
1358
1360
1348
1364
1312
1282
507
348
320
447
80
02
314
279
322
268
1197
267
267
279
288
192
186
105
100
105
28AY
7488061Cercomon
asagilis
12
34
56
78
910
1112
1314
1516
1718
1920
2122
2324
2526
2728
8 New Journal of Science
FLA Free-living amoebaFLS Fish landing siteG Gravitational forceg GramsGAE Granulomatous amoebic encephalitisHIVAIDS Human immunodeficiency
virusacquired immune deficiencysyndrome
KCB Kazinga Channel bankKCM Kazinga Channel middleKLA KampalaL Litermg MilligramsmL MillilitersmM MillimolarNCBI National Center for Biotechnology
InformationNo NumberPA Protected areaPAM Primary amoebic
meningoencephalitispg Picogrampmol PicomolesPrev PrevalenceQEPA Queen Elizabeth Protected Arearpm Revolutions per minuteSG Specific gravityUNESCO United Nations Educational
Scientific and Cultural OrganizationUn-ID Amoeba Unidentified amoebaV Volts120583S Microseconds
Competing Interests
There are no competing interests
References
[1] A J Martinez and G S Visvesvara ldquoFree-living amphizoic andopportunistic amebasrdquo Brain Pathology vol 7 no 1 pp 583ndash598 1997
[2] WHO Combating Waterborne Disease at the HouseholdLevelInternational Network to Promote HouseholdWater Treat-ment and Safe Storage World Health Organization GenevaSwitzerland 2007
[3] CDC Domestic Water Sanitation and Hygiene Epidemiol-ogy Center for Disease Control Atlanta Ga USA 2015httpwwwcdcgovnceziddfwedwaterbornedomestichtml
[4] H Abedkhojasteh M Niyyati F Rahimi M Hei-Dari SFarnia andM Rezaeian ldquoFirst report of Hartmannella keratitisin a cosmetic soft contact lens wearer in Iranrdquo Iranian Journalof Parasitology vol 8 no 3 pp 481ndash485 2013
[5] C Sente J Erume I Naigaga et al ldquoOccurrence and geneticcharacterisation ofAcanthamoeba spp from environmental anddomestic water sources in Queen Elizabeth Protected AreaUgandardquo Parasites amp Vectors vol 9 article 127 2016
[6] J De Jonckheere ldquoNaegleria australiensis sp nov anotherpathogenic Naegleria from waterrdquo Protistologica vol 17 pp423ndash429 1981
[7] J FDe Jonckheere ldquoIsoenzymepatterns of pathogenic andnon-pathogenic Naegleria spp using agarose isoelectric focusingrdquoAnnales de Microbiologie vol 133 no 2 pp 319ndash342 1982
[8] J F De Jonckheere ldquoA century of research on the amoeboflag-ellate genus Naegleriardquo Acta Protozoologica vol 41 no 4 pp309ndash342 2002
[9] CDC ldquoAcanthamoeba keratitis associated with contact lensesmdashUnited Statesrdquo Morbidity and Mortality Weekly Report vol 35no 25 pp 405ndash408 1986
[10] V A Dunand S M Hammer R Rossi et al ldquoParasitic sinusitisand otitis in patients infected with human immunodeficiencyvirus report of five cases and reviewrdquo Clinical Infectious Dis-eases vol 25 no 2 pp 267ndash272 1997
[11] S Amir Acanthamoeba castellanii as a Host and Model toStudy Bacterial Virulence Karolinska UniversitetssjukhusetHuddinge Sweden 2009
[12] R Dey P S Hoffman and I J Glomski ldquoGermination andamplification of anthrax spores by soil-dwelling amoebasrdquoApplied and Environmental Microbiology vol 78 no 22 pp8075ndash8081 2012
[13] R Solgi M Niyyati A Haghighi and E N Mojarad ldquoOccur-rence of thermotolerant Hartmannella vermiformis and Naeg-leria spp in hot springs of Ardebil Province Northwest IranrdquoIranian Journal of Parasitology vol 7 no 2 pp 47ndash52 2012
[14] Uganda CholeraWHORegional Office for Africa 2012 httpwwwafrowhointenclusters-a-programmesdpcepidemic-a-pandemic-alert-and-response3601-uganda-cholera-situation-as-of-31-march-2012html
[15] G Ojore Uganda 2000 Children Die of Diarrhoea in AfricaDaily-WaterAid New Vision Publishing Kampala Uganda2012
[16] Uganda rural water services Inadequate quantity low qualitysatisfiedusers IRC 2014 httpwwwircwashorgnewsuganda-rural-water-services-inadequate-quantity-low-quality-satisfied-users
[17] WHO Regional Office for Africa Emergencies Preparednessand Response to Typhoid Fever Uganda 2015 httpwwwwhointcsrdon17-march-2015-ugandaen
[18] Naegleria Infection Medscape Drugs amp Diseases 2015 httpemedicinemedscapecomarticle223910-overviewa5
[19] G S Visvesvara H Moura and F L Schuster ldquoPathogenic andopportunistic free-living amoebae Acanthamoeba spp Bala-muthia mandrillaris Naegleria fowleri and Sappinia diploideardquoFEMS Immunology and Medical Microbiology vol 50 no 1 pp1ndash26 2007
[20] L J Stockman C J Wright G S Visvesvara B S Fields andM J Beach ldquoPrevalence of Acanthamoeba spp and other free-living amoebae in household water Ohio USAmdash1990ndash1992rdquoParasitology Research vol 108 no 3 pp 621ndash627 2011
[21] G S Visvesvara ldquoAmebic meningoencephalitides and keratitischallenges in diagnosis and treatmentrdquo Current Opinion inInfectious Diseases vol 23 no 6 pp 590ndash594 2010
[22] N Crum-Cianflone Acanthamoeba Naval Medical Center atSan Diego San Diego Calif USA 2015
[23] F Marciano-Cabral and G A Cabral ldquoAcanthamoeba spp asagents of disease in humansrdquoClinicalMicrobiology Reviews vol16 no 2 pp 273ndash307 2003
[24] J Lorenzo-Morales E Martınez-Carretero N Batista et alldquoEarly diagnosis of amoebic keratitis due to a mixed infectionwith Acanthamoeba and Hartmannellardquo Parasitology Researchvol 102 no 1 pp 167ndash169 2007
New Journal of Science 9
[25] Z Szenasi T Endo K Yagita and ENagy ldquoIsolation identifica-tion and increasing importance of lsquofree-livingrsquo amoebae causinghuman diseaserdquo Journal of Medical Microbiology vol 47 no 1pp 5ndash16 1998
[26] H Trabelsi F Dendana A Sellami et al ldquoPathogenic free-living amoebae epidemiology and clinical reviewrdquo PathologieBiologie vol 60 no 6 pp 399ndash405 2012
[27] Uganda Bureau of Statistics Estimated Population of Kampalain 2002 2010 amp 2011 Uganda Bureau of Statistics 2014
[28] F L Schuster and G S Visvesvara ldquoFree-living amoebae asopportunistic and non-opportunistic pathogens of humans andanimalsrdquo International Journal for Parasitology vol 34 no 9 pp1001ndash1027 2004
[29] M Pelandakis and P Pernin ldquoUse of multiplex PCR andPCR restriction enzyme analysis for detection and explorationof the variability in the free-living amoeba Naegleria in theenvironmentrdquoApplied and EnvironmentalMicrobiology vol 68no 4 pp 2061ndash2065 2002
[30] J M Schroeder G C Booton J Hay et al ldquoUse of subgenic 18Sribosomal DNA PCR and sequencing for genus and genotypeidentification of Acanthamoebae from humans with keratitisand from sewage sludgerdquo Journal of Clinical Microbiology vol39 no 5 pp 1903ndash1911 2001
[31] G C Booton D J Kelly Y-W Chu et al ldquo18S ribosomalDNA typing and tracking of Acanthamoeba species isolatesfrom corneal scrape specimens contact lenses lens cases andhomewater supplies ofAcanthamoeba keratitis patients inHongKongrdquo Journal of Clinical Microbiology vol 40 no 5 pp 1621ndash1625 2002
[32] K Tamura G Stecher D Peterson A Filipski and S KumarldquoMEGA6molecular evolutionary genetics analysis version 60rdquoMolecular Biology and Evolution vol 30 no 12 pp 2725ndash27292013
[33] P Bonilla-Lemus A S Caballero Villegas J Carmona Jimenezand A Lugo Vazquez ldquoOccurrence of free-living amoebae instreams of the Mexico Basinrdquo Experimental Parasitology vol145 supplement pp S28ndashS33 2014
[34] S Ghadar-Ghadr K Solhjoo M Norouz-Nejad R Rohi and SZia-Jahromi ldquoIsolation and identification of free living amoeba(Naegleria and Acanthamoeba) in Shiraz water resources bymorphological criteriardquo Pars of Jahrom University of MedicalSciences vol 10 no 3 pp 33ndash42 2012
[35] S Ghadar-Ghadr K Solhjoo M Norouz-Nejad R Rohi and SZia-Jahromi ldquoIsolation and identification of free living amoeba(Naegleria and Acanthamoeba) in Shiraz water resources bymorphological criteriardquo Journal of Jahrom University of MedicalSciences vol 10 no 3 pp 26ndash33 2012
[36] S Rodriguez-Zaragoza E Mayzlish and Y Steinberger ldquoVer-tical distribution of the free-living amoeba population in soilunder desert shrubs in the Negev Desert Israelrdquo Applied andEnvironmentalMicrobiology vol 71 no 4 pp 2053ndash2060 2005
[37] M Pruden J Falkinham K Williams H Wang K Martinsand W Rhoads ldquoRelationship between biodegradable organicmatter and pathogen concentrations in premise plumbingrdquoWater Research Foundation pp 58ndash90 2013
[38] A Rozej A Cydzik-Kwiatkowska B Kowalska and D Kowal-ski ldquoStructure and microbial diversity of biofilms on differentpipe materials of a model drinking water distribution systemsrdquoWorld Journal of Microbiology amp Biotechnology vol 31 no 1 pp37ndash47 2015
[39] M H Vodkin D K Howe G S Visvesvara and G LMcLaughlin ldquoIdentification ofAcanthamoeba at the generic and
specific levels using the polymerase chain reactionrdquoThe Journalof Protozoology vol 39 no 3 pp 378ndash385 1992
[40] M Crary Genetic Variability and Its Relationship to Acan-thamoeba Pathogenesis Molecular Genetics Ohio State Univer-sity Columbus Ohio USA 2012
[41] M S Torno Jr R Babapour A Gurevitch and M D WittldquoCutaneous acanthamoebiasis inAIDSrdquo Journal of theAmericanAcademy of Dermatology vol 42 no 2 part 2 pp 351ndash3542000
[42] J F De Jonckheere and S Brown ldquoThere is no evidence that thefree-living ameba Hartmannella is a human parasiterdquo ClinicalInfectious Diseases vol 26 no 3 p 773 1998
[43] P W Woodburn L Muhangi S Hillier et al ldquoRisk factors forhelminth malaria and HIV infection in pregnancy in EntebbeUgandardquo PLoS Neglected Tropical Diseases vol 3 no 6 articlee473 2009
[44] S Onichandran T Kumar C C Salibay et al ldquoWaterborneparasites a current status from the Philippinesrdquo Parasites ampVectors vol 7 no 1 article 244 2014
[45] T Kumar S Onichandran Y A L Lim et al ldquoComparativestudy on waterborne parasites between Malaysia andThailanda new insightrdquo The American Journal of Tropical Medicine andHygiene vol 90 no 4 pp 682ndash689 2014
[46] D CarmenaWaterborne Transmission of Cryptosporidium andGiardia Detection Surveillance and Implications for PublicHealth Faculty of Medicine IC London UK 2010
Submit your manuscripts athttpwwwhindawicom
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Anatomy Research International
PeptidesInternational Journal of
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Hindawi Publishing Corporation httpwwwhindawicom
International Journal of
Volume 2014
Zoology
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Molecular Biology International
GenomicsInternational Journal of
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
The Scientific World JournalHindawi Publishing Corporation httpwwwhindawicom Volume 2014
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
BioinformaticsAdvances in
Marine BiologyJournal of
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Signal TransductionJournal of
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
BioMed Research International
Evolutionary BiologyInternational Journal of
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Biochemistry Research International
ArchaeaHindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Genetics Research International
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Advances in
Virolog y
Hindawi Publishing Corporationhttpwwwhindawicom
Nucleic AcidsJournal of
Volume 2014
Stem CellsInternational
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
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Enzyme Research
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
International Journal of
Microbiology
4 New Journal of Science
Table 1 The overall prevalence of the FLA
Parasite QEPA KLAFreq (119899 = 408) Prev () Mean plusmn SE Freq (119899 = 290) Prev () Mean plusmn SE
Acanthamoeba spp 143 35 19 plusmn 02 82 283 28 plusmn 05Naegleria spp 55 135 04 plusmn 01 48 166 14 plusmn 03Hartmannella spp 77 189 12 plusmn 01 67 231 14 plusmn 03Freq frequency Prev prevalence
Table 2 Prevalence and mean across water sources
Parasite QEPA KLATap water (119899 = 84) Environmental water (119899 = 324) Tap water (119899 = 170) Environmental water (119899 = 65)
Acanthamoeba spp(+) () 36 (43) 107 (33) 48 (282) 15 (231)Mean plusmn SEM 226 plusmn 04 892 plusmn 16 52 plusmn 12 24 plusmn 13
Hartmannella spp(+) () 19 (226) 58 (179) 38 (224) 10 (154)Mean plusmn SEM 120 plusmn 015 493 plusmn 092 44 plusmn 10 09 plusmn 016
Naegleria spp(+) () 12 (143) 43 (133) 25 (147) 9 (138)Mean plusmn SEM 05 plusmn 015 158 plusmn 06 35 plusmn 11 05 plusmn 03
35 KLA 283) Hartmannella spp (QEPA 189 KLA231) and Naegleria spp (QEPA 135 KLA 166) Themean (plusmnSEM) was highest for Acanthamoeba spp followedby Hartmannella spp and lastly Naegleria spp
313 Prevalence of Parasites across Sampling Sites Prevalenceof parasites across water source (natural and tap water)considered is presented in Table 2 Acanthamoeba spp werethe most prevalent parasite across all sources Naturalenvironmental water had significantly higher mean valuescompared to tap water in both study sites
314 Molecular Identification and Phylogenetic Analysis Fol-lowing FLA sequencing the products were blasted andcompared with the GenBank results from NCBI (Figure 2Table 3) Comparisons between the FLA isolated in Ugandaand those from the NCBI database were made and dif-ferences in divergence noted (Figure 2 Table 4) wereassessedThe species identifiedwereAcanthamoeba spp (var-ious T-genotypes) Acanthamoeba polyphaga Hartmannellavermiformis Nuclearia pattersoni Echinamoeba exundansBodomorpha minima and Cercomonas agilis The Acan-thamoeba sequences got belonged to the group of sequencetypes T1 T2 T4 and T11 (Table 3)
The confirmed Acanthamoeba genotype T1 was isolatedfrom tap water in Bwaise whereas T2 and T11 were isolatedfrom the Kazinga Channel water in QEPA Genotype T4which is usually the commonest Acanthamoeba T-genotypewas isolated from tap water in Katunguru Trading CentreKasaka landing site Albertine Restaurant in QEPA and
Kisenyi slum in Kampala The Hartmannella vermiformisconfirmed was isolated from fish landing sites in QEPA Thenonpathogenic FLA (Table 3) were isolated from a variety oftap water samples in Albertine Restaurant Thembo Restau-rant andKatunguruTradingCenter aswell as natural surfacewater from fish landing sites and the Kyambura River inQEPA In Kampala natural water samples that were positivefor FLA were from Lubigi swamps
All the parasites identified in this study were matchedwith the reported diseases they cause in humans (Table 3)
4 Discussion
We investigated the presence of FLA in natural and domestic(tap) water in QEPA and KLA The prevalence and mean(plusmnSEM) of Acanthamoeba spp in all cases were higher thanNaegleria and Hartmannella spp All FLA were more preva-lent in the rainy season exceptNaegleria spp that were higherin the dry season Most waterborne parasites increase innumber during the rainy season due to contamination of thewater sources with sewage soil and other organic mattersfrom water run-off [5 33] Tap water had a higher prevalenceof FLA than the natural water source There is not muchdata in Uganda to compare with the present findings butstudies from other countries [34 35] also documented ahigher frequency of Acanthamoeba compared to other FLAin environmental and tap water samples in alkaline water atthe same temperaturesThe first ever study of FLA in Ugandadocumented higher prevalence and mean of Acanthamoebathan other FLA in both environmental and tap water [5]
New Journal of Science 5
1
02
072
008
009
004
006
012
014
089
0861
0
10
078
087
077
091
077
091
018
058
063
054
088
033
085
KU894812
AF2938951_Echinamoeba_exundansKU894811
KU894808
KU894813
KU894806
AJ4892611_Echinamoeba_thermarumKU894805
KU894814
JQ2716891_Hartmannella_vermiformisKT1856251_Vermamoeba_vermiformisKU894803
KU894799
KU894800
KU894801
KU894802
KU894804
KM1894191_Acanthamoeba_spKU894807
AY3646351_Nuclearia_pattersoniAF4846871_Nuclearia_simplexKU894810
AY7488061_Cercomonas_agilisEU7091401_Cercozoa_spEU6471741|_CercomonadidaKU894809
AF4112761_Bodomorpha_minimaKU884884
Figure 2 Phylogenetic tree based on neighbor-joining showing the divergence of FLA Comparison with closely related species from theGenBank database sequences with their accession numbers (GenBank NCBI)
Acanthamoeba spp are more commonly encountered prob-ably because they are more involved in a predator-preyrelationshipwithmicrobial coloniesThehigh numbers couldbe explained by the presence of organic matter from rottingleaves animal and human faeces which are from the run-off from the land that often concentrate at the banks of thewater bodies This is known to exacerbate microbial biofilmformation and as a result facilitate the proliferation of FLAIt is believed that there are more FLA when there is anaccumulation of more organic matter in soil and water [3637] Previous studies report thatmicroorganisms settle on theinner surfaces of water pipes later becoming a source ofsecondary microbial contamination [38]
The primer pair JDP1JDP2 that was used is more spe-cific in the amplification of Acanthamoeba DNA [30 39]whereas CRN51137 amplifies any eukaryoteDNA [30]Acan-thamoeba sequence types can be grouped T1 to T20 [40]Blasting of sequences and comparison with those fromNCBIdatabase produced 7 Acanthamoeba 5 Echinamoeba 2 Hart-mannella 1 Bodomorpha 1 Nuclearia and 1 Cercomonas par-tial sequences Acanthamoeba genotypes T1 T2 and T4 were
mainly isolated from tap water samples whereas 11 were iso-lated from environmental water samplesThis is in agreementwith previous studies that indicate that T2 Acanthamoebagenotype is mainly found in the environment and is phyloge-netically related to T6 and they have also been both isolatedfrom clinical AK cases in humans [40] Acanthamoebagenotype T11 is closely related to T4 and has been found toalso cause AK [33]Acanthamoeba of T4 genotype is reportedas the most commonly encountered T-genotype group inboth environmental water and clinical samples and also themost diverse [33] Genotype T1 is notorious for granulo-matous amoebic encephalitis [11] whereas others may causekeratitis cutaneous infections and sinusitis in humans [1841] Hartmannella vermiformis originally thought to be non-pathogenic [42] has over the past decade been repeatedlyreported in a number of mixed human AK infections [4 1324] Although other FLA isolated in this study are considerednonpathogenic it is possible that they too could becomevirulent anytime given a conducive environment
Infective trophozoites of FLA in the environment aremaintained and spread by water during rainy seasons when
6 New Journal of Science
Table 3 Isolated free-living amoeba accession numbers water source and associated diseases in humans
Accession Source FLA Diseases Characteristics
KU884884 Tap KLA Bwaise Acanthamoeba spp (T1) Encephalitis [11 21]Mental status changeshemiparesis meningismus andataxia [22]
KU894799 Tap QEPA Katunguru Acanthamoeba spp (T2) Keratitis [11 21] Blinding infection of the cornea[22 23]
KU894800 Tap QEPA Katunguru Acanthamoeba spp (T4) Keratitis [11 21] Blinding infection of the cornea[22 23]
KU894801 Tap QEPA Albertine Acanthamoeba polyphaga(T4) Keratitis [11 21] Blinding infection of the cornea
[22 23]
KU894802 Tap QEPA Kasaka Acanthamoeba spp (T4) Keratitis [11 21] Blinding infection of the cornea[22 23]
KU894803 Tap KLA Kisenyi Acanthamoeba spp (T4) Keratitis [11 21] Blinding infection of the cornea[22 23]
KU894804 KCB QEPA Acanthamoeba spp (T11) Keratitis andencephalitis [22]
Disseminated disease blindnessand CNS function impairment[22]
KU894805 FLS QEPA Hartmannella vermiformis Keratitis [4 13 24] Blinding infection of the cornea[22]
KU894806 TAP QEPA Albertine Echinamoeba exundans Unknown mdashKU894807 TAP QEPAThembo Nuclearia pattersoni Unknown mdashKU894808 TAP QEPA Katunguru Echinamoeba exundans Unknown mdashKU894809 FLS QEPA Bodomorpha minima Unknown mdashKU894810 Lubigi KLA Cercomonas agilis Unknown mdashKU894811 R Kyambura QEPA Echinamoeba exundans Unknown mdashKU894812 R Kyambura QEPA Echinamoeba exundans Unknown mdashKU894813 TAP QEPA Albertine Echinamoeba exundans Unknown mdash
KU894814 TAP QEPAThembo Hartmannella vermiformis Keratitis [4 13 24] Blinding infection of the cornea[22]
FLS fish landing sites KCB Kazinga Channel banks KLA Kampala QEPA Queen Elizabeth Protected Area R Kyambura the Kyambura River
there is a run-off of water containing human and animal fae-cal matter from land into the water bodies which eventuallyend up at the points where communities fetch and utilise thewater Most FLA prevalence and mean intensities are higherin the rainy season than dry season [43] However parasiteincidences can be high throughout the rainy and dry seasonsoften indicating poor disposal of human and animal excretaand continuous patterns of infection [43] In a natural waterenvironment pathogens have been isolated widely frommany water sources used by rural dwelling households [3344 45] Often inadequately treated domestic water (drinkingbathing cooking and recreational water) has an abundanceof such pathogens Water bodies are usually contaminatedby high concentrations organisms from agricultural run-offurban wastewater effluents [46] and for the case of QEPAandKLAhuman and animal faecal contaminationTheQEPAand KLA local communities have few poorly built latrinesmost of which are already filled up compelling many to digsmall holes in the ground and defecate outside on openland When there is a heavy downpour of rain humanand animal the faecal material is washed off into the publicwater supply system Upon using this water exposure to avariety of protozoan parasites is highly likely The risk of
human infection is much higher in children and immuno-compromised individuals such as those who haveHIVAIDSdiabetes and cancer and those who have recently undergoneorgan transport [3]
5 Conclusion
The findings from the present study indicate that there isreasonably high contamination of both natural and domesticwater systems with Acanthamoeba spp Hartmannella sppNaegleria spp and other FLAThis is evidence that the waterbeing used is of poor quality and predisposes communities toinfectious agents With the fact that there is proof thatsome are pathogenic and can be vectors of many emerg-ingreemerging infectious agents it is imperative to preventthem from contaminating domestic water sources
Abbreviations∘C CelsiusAK Amoebic keratitisCNS Central nervous systemEnviron Environment
New Journal of Science 7
Table4Estim
ationof
evolutionary
divergence
betweensequ
ences
Percentidentity
12
34
56
78
910
1112
1314
1516
1718
1920
2122
2324
2526
2728
Divergence
1532
536
534
528
538
538
514
521
565
345
360
315
522
256
533
254
537
252
251
248
243
250
252
305
299
305
309
1KU
884884
22391
973
956
960
944
944
533
554
549
329
346
307
554
264
525
239
915
238
235
256
242
246
246
293
289
299
310
2KU
894799
32203
19957
950
940
945
523
544
550
328
348
306
545
266
525
238
917
236
234
255
240
243
247
291
289
298
311
3KU
894800
42051
30
37
941
934
956
528
552
550
323
346
306
550
264
525
242
898
238
235
255
240
248
252
294
290
301
311
4KU
894801
52187
40
42
33
940
944
529
550
544
333
342
303
550
266
526
236
897
236
234
256
239
244
248
291
289
299
311
5KU
894802
62120
48
60
53
40
940
521
540
558
342
356
318
540
278
538
247
887
243
240
264
250
250
255
298
294
305
317
6KU
894803
72262
33
45
1743
57
509
530
554
332
353
315
530
275
536
251
890
246
243
263
248
254
258
299
298
307
326
7KU
894804
81310
1459
1409
1424
1447
1441
1388
795
632
357
370
329
807
277
546
283
562
277
277
256
256
256
264
302
299
305
310
8KU
894805
91271
1043
1030
1014
1032
1048
1006
484
659
455
420
362
960
430
666
322
583
323
322
416
381
315
322
356
353
364
352
9KU
894806
101335
1819
1777
1637
1793
1671
1584
500
389
474
537
491
670
415
666
389
581
381
383
395
395
479
486
471
477
482
485
10KU
894807
111410
1653
1636
1653
1490
1472
1564
640
264
483
652
596
478
677
651
553
313
545
545
654
585
549
556
588
591
592
589
11KU894808
121368
1691
1709
1633
1677
1562
1534
531
342
316
424
836
432
695
583
685
333
689
689
689
675
733
742
928
898
863
846
12KU
894809
131216
1391
1404
1392
1384
1332
1314
472
338
304
422
79374
701
534
697
291
683
683
681
664
744
752
847
860
864
958
13KU
894810
141279
1029
1026
1014
1017
1034
987
456
69
329
211
294
296
452
687
328
584
325
323
436
368
323
332
365
362
369
360
14KU
894811
151330
1238
1257
1247
1192
1156
1180
463
66
362
248
241
272
00
648
742
247
728
728
964
827
730
732
686
686
694
705
15KU
894812
161357
1507
1523
1474
1423
1350
1395
563
132
399
188
308
304
7646
493
506
472
472
617
542
486
494
515
517
529
529
16KU
894813
171211
1359
1390
1362
1366
1302
1275
363
311
390
432
247
263
290
292
319
220
952
952
715
701
699
703
682
681
691
711
17KU
894814
182065
45
47
46
68
68
51
1415
1039
1568
1499
1453
1227
1031
1140
1358
1247
232
230
250
235
242
246
290
287
297
294
18KM
1894191Ac
antham
oeba
sp
191208
1352
1400
1348
1345
1315
1279
352
300
386
428
235
264
278
284
318
101263
995
756
740
740
741
722
719
728
690
19JQ
2716891Hartm
annella
verm
iform
is
201222
1399
1449
1394
1390
1356
1318
352
305
381
428
235
264
283
284
318
101303
06
756
740
741
742
722
721
729
690
20KT
1856251Ve
rmam
oeba
verm
iform
is
211329
1267
1311
1272
1232
1197
1211
470
78367
253
234
275
07
04
53
295
1193
278
278
855
761
760
718
718
723
685
21AF2938951Echinamoeba
exun
dans
221318
1307
1352
1311
1307
1231
1242
462
145
364
358
252
290
161
149
171
315
1230
299
299
149
754
750
697
699
701
674
22AJ
4892611Echinamoeba
thermarum
231299
1447
1517
1401
1438
1399
1359
458
287
189
389
164
189
229
249
242
295
1311
278
276
241
250
970
764
780
773
750
23AY
3646351Nuclearia
patte
rson
i
241323
1460
1532
1413
1451
1388
1370
450
278
189
384
156
183
224
246
239
288
1321
271
269
238
252
25
769
785
780
758
24AF4
846871
Nuclearia
simplex
251368
1641
1706
1608
1625
1539
1545
536
349
319
427
00
103
293
284
314
284
1452
266
266
271
298
205
200
961
917
855
25AF4
112761Bo
domorph
aminim
a
261392
1768
1875
1724
1702
1632
1626
527
348
315
426
1699
291
283
308
281
1556
266
263
270
293
191
186
23
936
867
26EU
6471741|
Cercomon
adida
271342
1569
1629
1539
1522
1479
1455
506
311
326
423
60
103
271
268
288
261
1393
252
250
260
290
203
196
7258
872
27EU
7091401Cercozoasp
281245
1358
1360
1348
1364
1312
1282
507
348
320
447
80
02
314
279
322
268
1197
267
267
279
288
192
186
105
100
105
28AY
7488061Cercomon
asagilis
12
34
56
78
910
1112
1314
1516
1718
1920
2122
2324
2526
2728
8 New Journal of Science
FLA Free-living amoebaFLS Fish landing siteG Gravitational forceg GramsGAE Granulomatous amoebic encephalitisHIVAIDS Human immunodeficiency
virusacquired immune deficiencysyndrome
KCB Kazinga Channel bankKCM Kazinga Channel middleKLA KampalaL Litermg MilligramsmL MillilitersmM MillimolarNCBI National Center for Biotechnology
InformationNo NumberPA Protected areaPAM Primary amoebic
meningoencephalitispg Picogrampmol PicomolesPrev PrevalenceQEPA Queen Elizabeth Protected Arearpm Revolutions per minuteSG Specific gravityUNESCO United Nations Educational
Scientific and Cultural OrganizationUn-ID Amoeba Unidentified amoebaV Volts120583S Microseconds
Competing Interests
There are no competing interests
References
[1] A J Martinez and G S Visvesvara ldquoFree-living amphizoic andopportunistic amebasrdquo Brain Pathology vol 7 no 1 pp 583ndash598 1997
[2] WHO Combating Waterborne Disease at the HouseholdLevelInternational Network to Promote HouseholdWater Treat-ment and Safe Storage World Health Organization GenevaSwitzerland 2007
[3] CDC Domestic Water Sanitation and Hygiene Epidemiol-ogy Center for Disease Control Atlanta Ga USA 2015httpwwwcdcgovnceziddfwedwaterbornedomestichtml
[4] H Abedkhojasteh M Niyyati F Rahimi M Hei-Dari SFarnia andM Rezaeian ldquoFirst report of Hartmannella keratitisin a cosmetic soft contact lens wearer in Iranrdquo Iranian Journalof Parasitology vol 8 no 3 pp 481ndash485 2013
[5] C Sente J Erume I Naigaga et al ldquoOccurrence and geneticcharacterisation ofAcanthamoeba spp from environmental anddomestic water sources in Queen Elizabeth Protected AreaUgandardquo Parasites amp Vectors vol 9 article 127 2016
[6] J De Jonckheere ldquoNaegleria australiensis sp nov anotherpathogenic Naegleria from waterrdquo Protistologica vol 17 pp423ndash429 1981
[7] J FDe Jonckheere ldquoIsoenzymepatterns of pathogenic andnon-pathogenic Naegleria spp using agarose isoelectric focusingrdquoAnnales de Microbiologie vol 133 no 2 pp 319ndash342 1982
[8] J F De Jonckheere ldquoA century of research on the amoeboflag-ellate genus Naegleriardquo Acta Protozoologica vol 41 no 4 pp309ndash342 2002
[9] CDC ldquoAcanthamoeba keratitis associated with contact lensesmdashUnited Statesrdquo Morbidity and Mortality Weekly Report vol 35no 25 pp 405ndash408 1986
[10] V A Dunand S M Hammer R Rossi et al ldquoParasitic sinusitisand otitis in patients infected with human immunodeficiencyvirus report of five cases and reviewrdquo Clinical Infectious Dis-eases vol 25 no 2 pp 267ndash272 1997
[11] S Amir Acanthamoeba castellanii as a Host and Model toStudy Bacterial Virulence Karolinska UniversitetssjukhusetHuddinge Sweden 2009
[12] R Dey P S Hoffman and I J Glomski ldquoGermination andamplification of anthrax spores by soil-dwelling amoebasrdquoApplied and Environmental Microbiology vol 78 no 22 pp8075ndash8081 2012
[13] R Solgi M Niyyati A Haghighi and E N Mojarad ldquoOccur-rence of thermotolerant Hartmannella vermiformis and Naeg-leria spp in hot springs of Ardebil Province Northwest IranrdquoIranian Journal of Parasitology vol 7 no 2 pp 47ndash52 2012
[14] Uganda CholeraWHORegional Office for Africa 2012 httpwwwafrowhointenclusters-a-programmesdpcepidemic-a-pandemic-alert-and-response3601-uganda-cholera-situation-as-of-31-march-2012html
[15] G Ojore Uganda 2000 Children Die of Diarrhoea in AfricaDaily-WaterAid New Vision Publishing Kampala Uganda2012
[16] Uganda rural water services Inadequate quantity low qualitysatisfiedusers IRC 2014 httpwwwircwashorgnewsuganda-rural-water-services-inadequate-quantity-low-quality-satisfied-users
[17] WHO Regional Office for Africa Emergencies Preparednessand Response to Typhoid Fever Uganda 2015 httpwwwwhointcsrdon17-march-2015-ugandaen
[18] Naegleria Infection Medscape Drugs amp Diseases 2015 httpemedicinemedscapecomarticle223910-overviewa5
[19] G S Visvesvara H Moura and F L Schuster ldquoPathogenic andopportunistic free-living amoebae Acanthamoeba spp Bala-muthia mandrillaris Naegleria fowleri and Sappinia diploideardquoFEMS Immunology and Medical Microbiology vol 50 no 1 pp1ndash26 2007
[20] L J Stockman C J Wright G S Visvesvara B S Fields andM J Beach ldquoPrevalence of Acanthamoeba spp and other free-living amoebae in household water Ohio USAmdash1990ndash1992rdquoParasitology Research vol 108 no 3 pp 621ndash627 2011
[21] G S Visvesvara ldquoAmebic meningoencephalitides and keratitischallenges in diagnosis and treatmentrdquo Current Opinion inInfectious Diseases vol 23 no 6 pp 590ndash594 2010
[22] N Crum-Cianflone Acanthamoeba Naval Medical Center atSan Diego San Diego Calif USA 2015
[23] F Marciano-Cabral and G A Cabral ldquoAcanthamoeba spp asagents of disease in humansrdquoClinicalMicrobiology Reviews vol16 no 2 pp 273ndash307 2003
[24] J Lorenzo-Morales E Martınez-Carretero N Batista et alldquoEarly diagnosis of amoebic keratitis due to a mixed infectionwith Acanthamoeba and Hartmannellardquo Parasitology Researchvol 102 no 1 pp 167ndash169 2007
New Journal of Science 9
[25] Z Szenasi T Endo K Yagita and ENagy ldquoIsolation identifica-tion and increasing importance of lsquofree-livingrsquo amoebae causinghuman diseaserdquo Journal of Medical Microbiology vol 47 no 1pp 5ndash16 1998
[26] H Trabelsi F Dendana A Sellami et al ldquoPathogenic free-living amoebae epidemiology and clinical reviewrdquo PathologieBiologie vol 60 no 6 pp 399ndash405 2012
[27] Uganda Bureau of Statistics Estimated Population of Kampalain 2002 2010 amp 2011 Uganda Bureau of Statistics 2014
[28] F L Schuster and G S Visvesvara ldquoFree-living amoebae asopportunistic and non-opportunistic pathogens of humans andanimalsrdquo International Journal for Parasitology vol 34 no 9 pp1001ndash1027 2004
[29] M Pelandakis and P Pernin ldquoUse of multiplex PCR andPCR restriction enzyme analysis for detection and explorationof the variability in the free-living amoeba Naegleria in theenvironmentrdquoApplied and EnvironmentalMicrobiology vol 68no 4 pp 2061ndash2065 2002
[30] J M Schroeder G C Booton J Hay et al ldquoUse of subgenic 18Sribosomal DNA PCR and sequencing for genus and genotypeidentification of Acanthamoebae from humans with keratitisand from sewage sludgerdquo Journal of Clinical Microbiology vol39 no 5 pp 1903ndash1911 2001
[31] G C Booton D J Kelly Y-W Chu et al ldquo18S ribosomalDNA typing and tracking of Acanthamoeba species isolatesfrom corneal scrape specimens contact lenses lens cases andhomewater supplies ofAcanthamoeba keratitis patients inHongKongrdquo Journal of Clinical Microbiology vol 40 no 5 pp 1621ndash1625 2002
[32] K Tamura G Stecher D Peterson A Filipski and S KumarldquoMEGA6molecular evolutionary genetics analysis version 60rdquoMolecular Biology and Evolution vol 30 no 12 pp 2725ndash27292013
[33] P Bonilla-Lemus A S Caballero Villegas J Carmona Jimenezand A Lugo Vazquez ldquoOccurrence of free-living amoebae instreams of the Mexico Basinrdquo Experimental Parasitology vol145 supplement pp S28ndashS33 2014
[34] S Ghadar-Ghadr K Solhjoo M Norouz-Nejad R Rohi and SZia-Jahromi ldquoIsolation and identification of free living amoeba(Naegleria and Acanthamoeba) in Shiraz water resources bymorphological criteriardquo Pars of Jahrom University of MedicalSciences vol 10 no 3 pp 33ndash42 2012
[35] S Ghadar-Ghadr K Solhjoo M Norouz-Nejad R Rohi and SZia-Jahromi ldquoIsolation and identification of free living amoeba(Naegleria and Acanthamoeba) in Shiraz water resources bymorphological criteriardquo Journal of Jahrom University of MedicalSciences vol 10 no 3 pp 26ndash33 2012
[36] S Rodriguez-Zaragoza E Mayzlish and Y Steinberger ldquoVer-tical distribution of the free-living amoeba population in soilunder desert shrubs in the Negev Desert Israelrdquo Applied andEnvironmentalMicrobiology vol 71 no 4 pp 2053ndash2060 2005
[37] M Pruden J Falkinham K Williams H Wang K Martinsand W Rhoads ldquoRelationship between biodegradable organicmatter and pathogen concentrations in premise plumbingrdquoWater Research Foundation pp 58ndash90 2013
[38] A Rozej A Cydzik-Kwiatkowska B Kowalska and D Kowal-ski ldquoStructure and microbial diversity of biofilms on differentpipe materials of a model drinking water distribution systemsrdquoWorld Journal of Microbiology amp Biotechnology vol 31 no 1 pp37ndash47 2015
[39] M H Vodkin D K Howe G S Visvesvara and G LMcLaughlin ldquoIdentification ofAcanthamoeba at the generic and
specific levels using the polymerase chain reactionrdquoThe Journalof Protozoology vol 39 no 3 pp 378ndash385 1992
[40] M Crary Genetic Variability and Its Relationship to Acan-thamoeba Pathogenesis Molecular Genetics Ohio State Univer-sity Columbus Ohio USA 2012
[41] M S Torno Jr R Babapour A Gurevitch and M D WittldquoCutaneous acanthamoebiasis inAIDSrdquo Journal of theAmericanAcademy of Dermatology vol 42 no 2 part 2 pp 351ndash3542000
[42] J F De Jonckheere and S Brown ldquoThere is no evidence that thefree-living ameba Hartmannella is a human parasiterdquo ClinicalInfectious Diseases vol 26 no 3 p 773 1998
[43] P W Woodburn L Muhangi S Hillier et al ldquoRisk factors forhelminth malaria and HIV infection in pregnancy in EntebbeUgandardquo PLoS Neglected Tropical Diseases vol 3 no 6 articlee473 2009
[44] S Onichandran T Kumar C C Salibay et al ldquoWaterborneparasites a current status from the Philippinesrdquo Parasites ampVectors vol 7 no 1 article 244 2014
[45] T Kumar S Onichandran Y A L Lim et al ldquoComparativestudy on waterborne parasites between Malaysia andThailanda new insightrdquo The American Journal of Tropical Medicine andHygiene vol 90 no 4 pp 682ndash689 2014
[46] D CarmenaWaterborne Transmission of Cryptosporidium andGiardia Detection Surveillance and Implications for PublicHealth Faculty of Medicine IC London UK 2010
Submit your manuscripts athttpwwwhindawicom
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Anatomy Research International
PeptidesInternational Journal of
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Hindawi Publishing Corporation httpwwwhindawicom
International Journal of
Volume 2014
Zoology
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Molecular Biology International
GenomicsInternational Journal of
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
The Scientific World JournalHindawi Publishing Corporation httpwwwhindawicom Volume 2014
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
BioinformaticsAdvances in
Marine BiologyJournal of
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Signal TransductionJournal of
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
BioMed Research International
Evolutionary BiologyInternational Journal of
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Biochemistry Research International
ArchaeaHindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Genetics Research International
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Advances in
Virolog y
Hindawi Publishing Corporationhttpwwwhindawicom
Nucleic AcidsJournal of
Volume 2014
Stem CellsInternational
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Enzyme Research
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
International Journal of
Microbiology
New Journal of Science 5
1
02
072
008
009
004
006
012
014
089
0861
0
10
078
087
077
091
077
091
018
058
063
054
088
033
085
KU894812
AF2938951_Echinamoeba_exundansKU894811
KU894808
KU894813
KU894806
AJ4892611_Echinamoeba_thermarumKU894805
KU894814
JQ2716891_Hartmannella_vermiformisKT1856251_Vermamoeba_vermiformisKU894803
KU894799
KU894800
KU894801
KU894802
KU894804
KM1894191_Acanthamoeba_spKU894807
AY3646351_Nuclearia_pattersoniAF4846871_Nuclearia_simplexKU894810
AY7488061_Cercomonas_agilisEU7091401_Cercozoa_spEU6471741|_CercomonadidaKU894809
AF4112761_Bodomorpha_minimaKU884884
Figure 2 Phylogenetic tree based on neighbor-joining showing the divergence of FLA Comparison with closely related species from theGenBank database sequences with their accession numbers (GenBank NCBI)
Acanthamoeba spp are more commonly encountered prob-ably because they are more involved in a predator-preyrelationshipwithmicrobial coloniesThehigh numbers couldbe explained by the presence of organic matter from rottingleaves animal and human faeces which are from the run-off from the land that often concentrate at the banks of thewater bodies This is known to exacerbate microbial biofilmformation and as a result facilitate the proliferation of FLAIt is believed that there are more FLA when there is anaccumulation of more organic matter in soil and water [3637] Previous studies report thatmicroorganisms settle on theinner surfaces of water pipes later becoming a source ofsecondary microbial contamination [38]
The primer pair JDP1JDP2 that was used is more spe-cific in the amplification of Acanthamoeba DNA [30 39]whereas CRN51137 amplifies any eukaryoteDNA [30]Acan-thamoeba sequence types can be grouped T1 to T20 [40]Blasting of sequences and comparison with those fromNCBIdatabase produced 7 Acanthamoeba 5 Echinamoeba 2 Hart-mannella 1 Bodomorpha 1 Nuclearia and 1 Cercomonas par-tial sequences Acanthamoeba genotypes T1 T2 and T4 were
mainly isolated from tap water samples whereas 11 were iso-lated from environmental water samplesThis is in agreementwith previous studies that indicate that T2 Acanthamoebagenotype is mainly found in the environment and is phyloge-netically related to T6 and they have also been both isolatedfrom clinical AK cases in humans [40] Acanthamoebagenotype T11 is closely related to T4 and has been found toalso cause AK [33]Acanthamoeba of T4 genotype is reportedas the most commonly encountered T-genotype group inboth environmental water and clinical samples and also themost diverse [33] Genotype T1 is notorious for granulo-matous amoebic encephalitis [11] whereas others may causekeratitis cutaneous infections and sinusitis in humans [1841] Hartmannella vermiformis originally thought to be non-pathogenic [42] has over the past decade been repeatedlyreported in a number of mixed human AK infections [4 1324] Although other FLA isolated in this study are considerednonpathogenic it is possible that they too could becomevirulent anytime given a conducive environment
Infective trophozoites of FLA in the environment aremaintained and spread by water during rainy seasons when
6 New Journal of Science
Table 3 Isolated free-living amoeba accession numbers water source and associated diseases in humans
Accession Source FLA Diseases Characteristics
KU884884 Tap KLA Bwaise Acanthamoeba spp (T1) Encephalitis [11 21]Mental status changeshemiparesis meningismus andataxia [22]
KU894799 Tap QEPA Katunguru Acanthamoeba spp (T2) Keratitis [11 21] Blinding infection of the cornea[22 23]
KU894800 Tap QEPA Katunguru Acanthamoeba spp (T4) Keratitis [11 21] Blinding infection of the cornea[22 23]
KU894801 Tap QEPA Albertine Acanthamoeba polyphaga(T4) Keratitis [11 21] Blinding infection of the cornea
[22 23]
KU894802 Tap QEPA Kasaka Acanthamoeba spp (T4) Keratitis [11 21] Blinding infection of the cornea[22 23]
KU894803 Tap KLA Kisenyi Acanthamoeba spp (T4) Keratitis [11 21] Blinding infection of the cornea[22 23]
KU894804 KCB QEPA Acanthamoeba spp (T11) Keratitis andencephalitis [22]
Disseminated disease blindnessand CNS function impairment[22]
KU894805 FLS QEPA Hartmannella vermiformis Keratitis [4 13 24] Blinding infection of the cornea[22]
KU894806 TAP QEPA Albertine Echinamoeba exundans Unknown mdashKU894807 TAP QEPAThembo Nuclearia pattersoni Unknown mdashKU894808 TAP QEPA Katunguru Echinamoeba exundans Unknown mdashKU894809 FLS QEPA Bodomorpha minima Unknown mdashKU894810 Lubigi KLA Cercomonas agilis Unknown mdashKU894811 R Kyambura QEPA Echinamoeba exundans Unknown mdashKU894812 R Kyambura QEPA Echinamoeba exundans Unknown mdashKU894813 TAP QEPA Albertine Echinamoeba exundans Unknown mdash
KU894814 TAP QEPAThembo Hartmannella vermiformis Keratitis [4 13 24] Blinding infection of the cornea[22]
FLS fish landing sites KCB Kazinga Channel banks KLA Kampala QEPA Queen Elizabeth Protected Area R Kyambura the Kyambura River
there is a run-off of water containing human and animal fae-cal matter from land into the water bodies which eventuallyend up at the points where communities fetch and utilise thewater Most FLA prevalence and mean intensities are higherin the rainy season than dry season [43] However parasiteincidences can be high throughout the rainy and dry seasonsoften indicating poor disposal of human and animal excretaand continuous patterns of infection [43] In a natural waterenvironment pathogens have been isolated widely frommany water sources used by rural dwelling households [3344 45] Often inadequately treated domestic water (drinkingbathing cooking and recreational water) has an abundanceof such pathogens Water bodies are usually contaminatedby high concentrations organisms from agricultural run-offurban wastewater effluents [46] and for the case of QEPAandKLAhuman and animal faecal contaminationTheQEPAand KLA local communities have few poorly built latrinesmost of which are already filled up compelling many to digsmall holes in the ground and defecate outside on openland When there is a heavy downpour of rain humanand animal the faecal material is washed off into the publicwater supply system Upon using this water exposure to avariety of protozoan parasites is highly likely The risk of
human infection is much higher in children and immuno-compromised individuals such as those who haveHIVAIDSdiabetes and cancer and those who have recently undergoneorgan transport [3]
5 Conclusion
The findings from the present study indicate that there isreasonably high contamination of both natural and domesticwater systems with Acanthamoeba spp Hartmannella sppNaegleria spp and other FLAThis is evidence that the waterbeing used is of poor quality and predisposes communities toinfectious agents With the fact that there is proof thatsome are pathogenic and can be vectors of many emerg-ingreemerging infectious agents it is imperative to preventthem from contaminating domestic water sources
Abbreviations∘C CelsiusAK Amoebic keratitisCNS Central nervous systemEnviron Environment
New Journal of Science 7
Table4Estim
ationof
evolutionary
divergence
betweensequ
ences
Percentidentity
12
34
56
78
910
1112
1314
1516
1718
1920
2122
2324
2526
2728
Divergence
1532
536
534
528
538
538
514
521
565
345
360
315
522
256
533
254
537
252
251
248
243
250
252
305
299
305
309
1KU
884884
22391
973
956
960
944
944
533
554
549
329
346
307
554
264
525
239
915
238
235
256
242
246
246
293
289
299
310
2KU
894799
32203
19957
950
940
945
523
544
550
328
348
306
545
266
525
238
917
236
234
255
240
243
247
291
289
298
311
3KU
894800
42051
30
37
941
934
956
528
552
550
323
346
306
550
264
525
242
898
238
235
255
240
248
252
294
290
301
311
4KU
894801
52187
40
42
33
940
944
529
550
544
333
342
303
550
266
526
236
897
236
234
256
239
244
248
291
289
299
311
5KU
894802
62120
48
60
53
40
940
521
540
558
342
356
318
540
278
538
247
887
243
240
264
250
250
255
298
294
305
317
6KU
894803
72262
33
45
1743
57
509
530
554
332
353
315
530
275
536
251
890
246
243
263
248
254
258
299
298
307
326
7KU
894804
81310
1459
1409
1424
1447
1441
1388
795
632
357
370
329
807
277
546
283
562
277
277
256
256
256
264
302
299
305
310
8KU
894805
91271
1043
1030
1014
1032
1048
1006
484
659
455
420
362
960
430
666
322
583
323
322
416
381
315
322
356
353
364
352
9KU
894806
101335
1819
1777
1637
1793
1671
1584
500
389
474
537
491
670
415
666
389
581
381
383
395
395
479
486
471
477
482
485
10KU
894807
111410
1653
1636
1653
1490
1472
1564
640
264
483
652
596
478
677
651
553
313
545
545
654
585
549
556
588
591
592
589
11KU894808
121368
1691
1709
1633
1677
1562
1534
531
342
316
424
836
432
695
583
685
333
689
689
689
675
733
742
928
898
863
846
12KU
894809
131216
1391
1404
1392
1384
1332
1314
472
338
304
422
79374
701
534
697
291
683
683
681
664
744
752
847
860
864
958
13KU
894810
141279
1029
1026
1014
1017
1034
987
456
69
329
211
294
296
452
687
328
584
325
323
436
368
323
332
365
362
369
360
14KU
894811
151330
1238
1257
1247
1192
1156
1180
463
66
362
248
241
272
00
648
742
247
728
728
964
827
730
732
686
686
694
705
15KU
894812
161357
1507
1523
1474
1423
1350
1395
563
132
399
188
308
304
7646
493
506
472
472
617
542
486
494
515
517
529
529
16KU
894813
171211
1359
1390
1362
1366
1302
1275
363
311
390
432
247
263
290
292
319
220
952
952
715
701
699
703
682
681
691
711
17KU
894814
182065
45
47
46
68
68
51
1415
1039
1568
1499
1453
1227
1031
1140
1358
1247
232
230
250
235
242
246
290
287
297
294
18KM
1894191Ac
antham
oeba
sp
191208
1352
1400
1348
1345
1315
1279
352
300
386
428
235
264
278
284
318
101263
995
756
740
740
741
722
719
728
690
19JQ
2716891Hartm
annella
verm
iform
is
201222
1399
1449
1394
1390
1356
1318
352
305
381
428
235
264
283
284
318
101303
06
756
740
741
742
722
721
729
690
20KT
1856251Ve
rmam
oeba
verm
iform
is
211329
1267
1311
1272
1232
1197
1211
470
78367
253
234
275
07
04
53
295
1193
278
278
855
761
760
718
718
723
685
21AF2938951Echinamoeba
exun
dans
221318
1307
1352
1311
1307
1231
1242
462
145
364
358
252
290
161
149
171
315
1230
299
299
149
754
750
697
699
701
674
22AJ
4892611Echinamoeba
thermarum
231299
1447
1517
1401
1438
1399
1359
458
287
189
389
164
189
229
249
242
295
1311
278
276
241
250
970
764
780
773
750
23AY
3646351Nuclearia
patte
rson
i
241323
1460
1532
1413
1451
1388
1370
450
278
189
384
156
183
224
246
239
288
1321
271
269
238
252
25
769
785
780
758
24AF4
846871
Nuclearia
simplex
251368
1641
1706
1608
1625
1539
1545
536
349
319
427
00
103
293
284
314
284
1452
266
266
271
298
205
200
961
917
855
25AF4
112761Bo
domorph
aminim
a
261392
1768
1875
1724
1702
1632
1626
527
348
315
426
1699
291
283
308
281
1556
266
263
270
293
191
186
23
936
867
26EU
6471741|
Cercomon
adida
271342
1569
1629
1539
1522
1479
1455
506
311
326
423
60
103
271
268
288
261
1393
252
250
260
290
203
196
7258
872
27EU
7091401Cercozoasp
281245
1358
1360
1348
1364
1312
1282
507
348
320
447
80
02
314
279
322
268
1197
267
267
279
288
192
186
105
100
105
28AY
7488061Cercomon
asagilis
12
34
56
78
910
1112
1314
1516
1718
1920
2122
2324
2526
2728
8 New Journal of Science
FLA Free-living amoebaFLS Fish landing siteG Gravitational forceg GramsGAE Granulomatous amoebic encephalitisHIVAIDS Human immunodeficiency
virusacquired immune deficiencysyndrome
KCB Kazinga Channel bankKCM Kazinga Channel middleKLA KampalaL Litermg MilligramsmL MillilitersmM MillimolarNCBI National Center for Biotechnology
InformationNo NumberPA Protected areaPAM Primary amoebic
meningoencephalitispg Picogrampmol PicomolesPrev PrevalenceQEPA Queen Elizabeth Protected Arearpm Revolutions per minuteSG Specific gravityUNESCO United Nations Educational
Scientific and Cultural OrganizationUn-ID Amoeba Unidentified amoebaV Volts120583S Microseconds
Competing Interests
There are no competing interests
References
[1] A J Martinez and G S Visvesvara ldquoFree-living amphizoic andopportunistic amebasrdquo Brain Pathology vol 7 no 1 pp 583ndash598 1997
[2] WHO Combating Waterborne Disease at the HouseholdLevelInternational Network to Promote HouseholdWater Treat-ment and Safe Storage World Health Organization GenevaSwitzerland 2007
[3] CDC Domestic Water Sanitation and Hygiene Epidemiol-ogy Center for Disease Control Atlanta Ga USA 2015httpwwwcdcgovnceziddfwedwaterbornedomestichtml
[4] H Abedkhojasteh M Niyyati F Rahimi M Hei-Dari SFarnia andM Rezaeian ldquoFirst report of Hartmannella keratitisin a cosmetic soft contact lens wearer in Iranrdquo Iranian Journalof Parasitology vol 8 no 3 pp 481ndash485 2013
[5] C Sente J Erume I Naigaga et al ldquoOccurrence and geneticcharacterisation ofAcanthamoeba spp from environmental anddomestic water sources in Queen Elizabeth Protected AreaUgandardquo Parasites amp Vectors vol 9 article 127 2016
[6] J De Jonckheere ldquoNaegleria australiensis sp nov anotherpathogenic Naegleria from waterrdquo Protistologica vol 17 pp423ndash429 1981
[7] J FDe Jonckheere ldquoIsoenzymepatterns of pathogenic andnon-pathogenic Naegleria spp using agarose isoelectric focusingrdquoAnnales de Microbiologie vol 133 no 2 pp 319ndash342 1982
[8] J F De Jonckheere ldquoA century of research on the amoeboflag-ellate genus Naegleriardquo Acta Protozoologica vol 41 no 4 pp309ndash342 2002
[9] CDC ldquoAcanthamoeba keratitis associated with contact lensesmdashUnited Statesrdquo Morbidity and Mortality Weekly Report vol 35no 25 pp 405ndash408 1986
[10] V A Dunand S M Hammer R Rossi et al ldquoParasitic sinusitisand otitis in patients infected with human immunodeficiencyvirus report of five cases and reviewrdquo Clinical Infectious Dis-eases vol 25 no 2 pp 267ndash272 1997
[11] S Amir Acanthamoeba castellanii as a Host and Model toStudy Bacterial Virulence Karolinska UniversitetssjukhusetHuddinge Sweden 2009
[12] R Dey P S Hoffman and I J Glomski ldquoGermination andamplification of anthrax spores by soil-dwelling amoebasrdquoApplied and Environmental Microbiology vol 78 no 22 pp8075ndash8081 2012
[13] R Solgi M Niyyati A Haghighi and E N Mojarad ldquoOccur-rence of thermotolerant Hartmannella vermiformis and Naeg-leria spp in hot springs of Ardebil Province Northwest IranrdquoIranian Journal of Parasitology vol 7 no 2 pp 47ndash52 2012
[14] Uganda CholeraWHORegional Office for Africa 2012 httpwwwafrowhointenclusters-a-programmesdpcepidemic-a-pandemic-alert-and-response3601-uganda-cholera-situation-as-of-31-march-2012html
[15] G Ojore Uganda 2000 Children Die of Diarrhoea in AfricaDaily-WaterAid New Vision Publishing Kampala Uganda2012
[16] Uganda rural water services Inadequate quantity low qualitysatisfiedusers IRC 2014 httpwwwircwashorgnewsuganda-rural-water-services-inadequate-quantity-low-quality-satisfied-users
[17] WHO Regional Office for Africa Emergencies Preparednessand Response to Typhoid Fever Uganda 2015 httpwwwwhointcsrdon17-march-2015-ugandaen
[18] Naegleria Infection Medscape Drugs amp Diseases 2015 httpemedicinemedscapecomarticle223910-overviewa5
[19] G S Visvesvara H Moura and F L Schuster ldquoPathogenic andopportunistic free-living amoebae Acanthamoeba spp Bala-muthia mandrillaris Naegleria fowleri and Sappinia diploideardquoFEMS Immunology and Medical Microbiology vol 50 no 1 pp1ndash26 2007
[20] L J Stockman C J Wright G S Visvesvara B S Fields andM J Beach ldquoPrevalence of Acanthamoeba spp and other free-living amoebae in household water Ohio USAmdash1990ndash1992rdquoParasitology Research vol 108 no 3 pp 621ndash627 2011
[21] G S Visvesvara ldquoAmebic meningoencephalitides and keratitischallenges in diagnosis and treatmentrdquo Current Opinion inInfectious Diseases vol 23 no 6 pp 590ndash594 2010
[22] N Crum-Cianflone Acanthamoeba Naval Medical Center atSan Diego San Diego Calif USA 2015
[23] F Marciano-Cabral and G A Cabral ldquoAcanthamoeba spp asagents of disease in humansrdquoClinicalMicrobiology Reviews vol16 no 2 pp 273ndash307 2003
[24] J Lorenzo-Morales E Martınez-Carretero N Batista et alldquoEarly diagnosis of amoebic keratitis due to a mixed infectionwith Acanthamoeba and Hartmannellardquo Parasitology Researchvol 102 no 1 pp 167ndash169 2007
New Journal of Science 9
[25] Z Szenasi T Endo K Yagita and ENagy ldquoIsolation identifica-tion and increasing importance of lsquofree-livingrsquo amoebae causinghuman diseaserdquo Journal of Medical Microbiology vol 47 no 1pp 5ndash16 1998
[26] H Trabelsi F Dendana A Sellami et al ldquoPathogenic free-living amoebae epidemiology and clinical reviewrdquo PathologieBiologie vol 60 no 6 pp 399ndash405 2012
[27] Uganda Bureau of Statistics Estimated Population of Kampalain 2002 2010 amp 2011 Uganda Bureau of Statistics 2014
[28] F L Schuster and G S Visvesvara ldquoFree-living amoebae asopportunistic and non-opportunistic pathogens of humans andanimalsrdquo International Journal for Parasitology vol 34 no 9 pp1001ndash1027 2004
[29] M Pelandakis and P Pernin ldquoUse of multiplex PCR andPCR restriction enzyme analysis for detection and explorationof the variability in the free-living amoeba Naegleria in theenvironmentrdquoApplied and EnvironmentalMicrobiology vol 68no 4 pp 2061ndash2065 2002
[30] J M Schroeder G C Booton J Hay et al ldquoUse of subgenic 18Sribosomal DNA PCR and sequencing for genus and genotypeidentification of Acanthamoebae from humans with keratitisand from sewage sludgerdquo Journal of Clinical Microbiology vol39 no 5 pp 1903ndash1911 2001
[31] G C Booton D J Kelly Y-W Chu et al ldquo18S ribosomalDNA typing and tracking of Acanthamoeba species isolatesfrom corneal scrape specimens contact lenses lens cases andhomewater supplies ofAcanthamoeba keratitis patients inHongKongrdquo Journal of Clinical Microbiology vol 40 no 5 pp 1621ndash1625 2002
[32] K Tamura G Stecher D Peterson A Filipski and S KumarldquoMEGA6molecular evolutionary genetics analysis version 60rdquoMolecular Biology and Evolution vol 30 no 12 pp 2725ndash27292013
[33] P Bonilla-Lemus A S Caballero Villegas J Carmona Jimenezand A Lugo Vazquez ldquoOccurrence of free-living amoebae instreams of the Mexico Basinrdquo Experimental Parasitology vol145 supplement pp S28ndashS33 2014
[34] S Ghadar-Ghadr K Solhjoo M Norouz-Nejad R Rohi and SZia-Jahromi ldquoIsolation and identification of free living amoeba(Naegleria and Acanthamoeba) in Shiraz water resources bymorphological criteriardquo Pars of Jahrom University of MedicalSciences vol 10 no 3 pp 33ndash42 2012
[35] S Ghadar-Ghadr K Solhjoo M Norouz-Nejad R Rohi and SZia-Jahromi ldquoIsolation and identification of free living amoeba(Naegleria and Acanthamoeba) in Shiraz water resources bymorphological criteriardquo Journal of Jahrom University of MedicalSciences vol 10 no 3 pp 26ndash33 2012
[36] S Rodriguez-Zaragoza E Mayzlish and Y Steinberger ldquoVer-tical distribution of the free-living amoeba population in soilunder desert shrubs in the Negev Desert Israelrdquo Applied andEnvironmentalMicrobiology vol 71 no 4 pp 2053ndash2060 2005
[37] M Pruden J Falkinham K Williams H Wang K Martinsand W Rhoads ldquoRelationship between biodegradable organicmatter and pathogen concentrations in premise plumbingrdquoWater Research Foundation pp 58ndash90 2013
[38] A Rozej A Cydzik-Kwiatkowska B Kowalska and D Kowal-ski ldquoStructure and microbial diversity of biofilms on differentpipe materials of a model drinking water distribution systemsrdquoWorld Journal of Microbiology amp Biotechnology vol 31 no 1 pp37ndash47 2015
[39] M H Vodkin D K Howe G S Visvesvara and G LMcLaughlin ldquoIdentification ofAcanthamoeba at the generic and
specific levels using the polymerase chain reactionrdquoThe Journalof Protozoology vol 39 no 3 pp 378ndash385 1992
[40] M Crary Genetic Variability and Its Relationship to Acan-thamoeba Pathogenesis Molecular Genetics Ohio State Univer-sity Columbus Ohio USA 2012
[41] M S Torno Jr R Babapour A Gurevitch and M D WittldquoCutaneous acanthamoebiasis inAIDSrdquo Journal of theAmericanAcademy of Dermatology vol 42 no 2 part 2 pp 351ndash3542000
[42] J F De Jonckheere and S Brown ldquoThere is no evidence that thefree-living ameba Hartmannella is a human parasiterdquo ClinicalInfectious Diseases vol 26 no 3 p 773 1998
[43] P W Woodburn L Muhangi S Hillier et al ldquoRisk factors forhelminth malaria and HIV infection in pregnancy in EntebbeUgandardquo PLoS Neglected Tropical Diseases vol 3 no 6 articlee473 2009
[44] S Onichandran T Kumar C C Salibay et al ldquoWaterborneparasites a current status from the Philippinesrdquo Parasites ampVectors vol 7 no 1 article 244 2014
[45] T Kumar S Onichandran Y A L Lim et al ldquoComparativestudy on waterborne parasites between Malaysia andThailanda new insightrdquo The American Journal of Tropical Medicine andHygiene vol 90 no 4 pp 682ndash689 2014
[46] D CarmenaWaterborne Transmission of Cryptosporidium andGiardia Detection Surveillance and Implications for PublicHealth Faculty of Medicine IC London UK 2010
Submit your manuscripts athttpwwwhindawicom
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Anatomy Research International
PeptidesInternational Journal of
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Hindawi Publishing Corporation httpwwwhindawicom
International Journal of
Volume 2014
Zoology
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Molecular Biology International
GenomicsInternational Journal of
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
The Scientific World JournalHindawi Publishing Corporation httpwwwhindawicom Volume 2014
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
BioinformaticsAdvances in
Marine BiologyJournal of
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Signal TransductionJournal of
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
BioMed Research International
Evolutionary BiologyInternational Journal of
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Biochemistry Research International
ArchaeaHindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Genetics Research International
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Advances in
Virolog y
Hindawi Publishing Corporationhttpwwwhindawicom
Nucleic AcidsJournal of
Volume 2014
Stem CellsInternational
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Enzyme Research
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
International Journal of
Microbiology
6 New Journal of Science
Table 3 Isolated free-living amoeba accession numbers water source and associated diseases in humans
Accession Source FLA Diseases Characteristics
KU884884 Tap KLA Bwaise Acanthamoeba spp (T1) Encephalitis [11 21]Mental status changeshemiparesis meningismus andataxia [22]
KU894799 Tap QEPA Katunguru Acanthamoeba spp (T2) Keratitis [11 21] Blinding infection of the cornea[22 23]
KU894800 Tap QEPA Katunguru Acanthamoeba spp (T4) Keratitis [11 21] Blinding infection of the cornea[22 23]
KU894801 Tap QEPA Albertine Acanthamoeba polyphaga(T4) Keratitis [11 21] Blinding infection of the cornea
[22 23]
KU894802 Tap QEPA Kasaka Acanthamoeba spp (T4) Keratitis [11 21] Blinding infection of the cornea[22 23]
KU894803 Tap KLA Kisenyi Acanthamoeba spp (T4) Keratitis [11 21] Blinding infection of the cornea[22 23]
KU894804 KCB QEPA Acanthamoeba spp (T11) Keratitis andencephalitis [22]
Disseminated disease blindnessand CNS function impairment[22]
KU894805 FLS QEPA Hartmannella vermiformis Keratitis [4 13 24] Blinding infection of the cornea[22]
KU894806 TAP QEPA Albertine Echinamoeba exundans Unknown mdashKU894807 TAP QEPAThembo Nuclearia pattersoni Unknown mdashKU894808 TAP QEPA Katunguru Echinamoeba exundans Unknown mdashKU894809 FLS QEPA Bodomorpha minima Unknown mdashKU894810 Lubigi KLA Cercomonas agilis Unknown mdashKU894811 R Kyambura QEPA Echinamoeba exundans Unknown mdashKU894812 R Kyambura QEPA Echinamoeba exundans Unknown mdashKU894813 TAP QEPA Albertine Echinamoeba exundans Unknown mdash
KU894814 TAP QEPAThembo Hartmannella vermiformis Keratitis [4 13 24] Blinding infection of the cornea[22]
FLS fish landing sites KCB Kazinga Channel banks KLA Kampala QEPA Queen Elizabeth Protected Area R Kyambura the Kyambura River
there is a run-off of water containing human and animal fae-cal matter from land into the water bodies which eventuallyend up at the points where communities fetch and utilise thewater Most FLA prevalence and mean intensities are higherin the rainy season than dry season [43] However parasiteincidences can be high throughout the rainy and dry seasonsoften indicating poor disposal of human and animal excretaand continuous patterns of infection [43] In a natural waterenvironment pathogens have been isolated widely frommany water sources used by rural dwelling households [3344 45] Often inadequately treated domestic water (drinkingbathing cooking and recreational water) has an abundanceof such pathogens Water bodies are usually contaminatedby high concentrations organisms from agricultural run-offurban wastewater effluents [46] and for the case of QEPAandKLAhuman and animal faecal contaminationTheQEPAand KLA local communities have few poorly built latrinesmost of which are already filled up compelling many to digsmall holes in the ground and defecate outside on openland When there is a heavy downpour of rain humanand animal the faecal material is washed off into the publicwater supply system Upon using this water exposure to avariety of protozoan parasites is highly likely The risk of
human infection is much higher in children and immuno-compromised individuals such as those who haveHIVAIDSdiabetes and cancer and those who have recently undergoneorgan transport [3]
5 Conclusion
The findings from the present study indicate that there isreasonably high contamination of both natural and domesticwater systems with Acanthamoeba spp Hartmannella sppNaegleria spp and other FLAThis is evidence that the waterbeing used is of poor quality and predisposes communities toinfectious agents With the fact that there is proof thatsome are pathogenic and can be vectors of many emerg-ingreemerging infectious agents it is imperative to preventthem from contaminating domestic water sources
Abbreviations∘C CelsiusAK Amoebic keratitisCNS Central nervous systemEnviron Environment
New Journal of Science 7
Table4Estim
ationof
evolutionary
divergence
betweensequ
ences
Percentidentity
12
34
56
78
910
1112
1314
1516
1718
1920
2122
2324
2526
2728
Divergence
1532
536
534
528
538
538
514
521
565
345
360
315
522
256
533
254
537
252
251
248
243
250
252
305
299
305
309
1KU
884884
22391
973
956
960
944
944
533
554
549
329
346
307
554
264
525
239
915
238
235
256
242
246
246
293
289
299
310
2KU
894799
32203
19957
950
940
945
523
544
550
328
348
306
545
266
525
238
917
236
234
255
240
243
247
291
289
298
311
3KU
894800
42051
30
37
941
934
956
528
552
550
323
346
306
550
264
525
242
898
238
235
255
240
248
252
294
290
301
311
4KU
894801
52187
40
42
33
940
944
529
550
544
333
342
303
550
266
526
236
897
236
234
256
239
244
248
291
289
299
311
5KU
894802
62120
48
60
53
40
940
521
540
558
342
356
318
540
278
538
247
887
243
240
264
250
250
255
298
294
305
317
6KU
894803
72262
33
45
1743
57
509
530
554
332
353
315
530
275
536
251
890
246
243
263
248
254
258
299
298
307
326
7KU
894804
81310
1459
1409
1424
1447
1441
1388
795
632
357
370
329
807
277
546
283
562
277
277
256
256
256
264
302
299
305
310
8KU
894805
91271
1043
1030
1014
1032
1048
1006
484
659
455
420
362
960
430
666
322
583
323
322
416
381
315
322
356
353
364
352
9KU
894806
101335
1819
1777
1637
1793
1671
1584
500
389
474
537
491
670
415
666
389
581
381
383
395
395
479
486
471
477
482
485
10KU
894807
111410
1653
1636
1653
1490
1472
1564
640
264
483
652
596
478
677
651
553
313
545
545
654
585
549
556
588
591
592
589
11KU894808
121368
1691
1709
1633
1677
1562
1534
531
342
316
424
836
432
695
583
685
333
689
689
689
675
733
742
928
898
863
846
12KU
894809
131216
1391
1404
1392
1384
1332
1314
472
338
304
422
79374
701
534
697
291
683
683
681
664
744
752
847
860
864
958
13KU
894810
141279
1029
1026
1014
1017
1034
987
456
69
329
211
294
296
452
687
328
584
325
323
436
368
323
332
365
362
369
360
14KU
894811
151330
1238
1257
1247
1192
1156
1180
463
66
362
248
241
272
00
648
742
247
728
728
964
827
730
732
686
686
694
705
15KU
894812
161357
1507
1523
1474
1423
1350
1395
563
132
399
188
308
304
7646
493
506
472
472
617
542
486
494
515
517
529
529
16KU
894813
171211
1359
1390
1362
1366
1302
1275
363
311
390
432
247
263
290
292
319
220
952
952
715
701
699
703
682
681
691
711
17KU
894814
182065
45
47
46
68
68
51
1415
1039
1568
1499
1453
1227
1031
1140
1358
1247
232
230
250
235
242
246
290
287
297
294
18KM
1894191Ac
antham
oeba
sp
191208
1352
1400
1348
1345
1315
1279
352
300
386
428
235
264
278
284
318
101263
995
756
740
740
741
722
719
728
690
19JQ
2716891Hartm
annella
verm
iform
is
201222
1399
1449
1394
1390
1356
1318
352
305
381
428
235
264
283
284
318
101303
06
756
740
741
742
722
721
729
690
20KT
1856251Ve
rmam
oeba
verm
iform
is
211329
1267
1311
1272
1232
1197
1211
470
78367
253
234
275
07
04
53
295
1193
278
278
855
761
760
718
718
723
685
21AF2938951Echinamoeba
exun
dans
221318
1307
1352
1311
1307
1231
1242
462
145
364
358
252
290
161
149
171
315
1230
299
299
149
754
750
697
699
701
674
22AJ
4892611Echinamoeba
thermarum
231299
1447
1517
1401
1438
1399
1359
458
287
189
389
164
189
229
249
242
295
1311
278
276
241
250
970
764
780
773
750
23AY
3646351Nuclearia
patte
rson
i
241323
1460
1532
1413
1451
1388
1370
450
278
189
384
156
183
224
246
239
288
1321
271
269
238
252
25
769
785
780
758
24AF4
846871
Nuclearia
simplex
251368
1641
1706
1608
1625
1539
1545
536
349
319
427
00
103
293
284
314
284
1452
266
266
271
298
205
200
961
917
855
25AF4
112761Bo
domorph
aminim
a
261392
1768
1875
1724
1702
1632
1626
527
348
315
426
1699
291
283
308
281
1556
266
263
270
293
191
186
23
936
867
26EU
6471741|
Cercomon
adida
271342
1569
1629
1539
1522
1479
1455
506
311
326
423
60
103
271
268
288
261
1393
252
250
260
290
203
196
7258
872
27EU
7091401Cercozoasp
281245
1358
1360
1348
1364
1312
1282
507
348
320
447
80
02
314
279
322
268
1197
267
267
279
288
192
186
105
100
105
28AY
7488061Cercomon
asagilis
12
34
56
78
910
1112
1314
1516
1718
1920
2122
2324
2526
2728
8 New Journal of Science
FLA Free-living amoebaFLS Fish landing siteG Gravitational forceg GramsGAE Granulomatous amoebic encephalitisHIVAIDS Human immunodeficiency
virusacquired immune deficiencysyndrome
KCB Kazinga Channel bankKCM Kazinga Channel middleKLA KampalaL Litermg MilligramsmL MillilitersmM MillimolarNCBI National Center for Biotechnology
InformationNo NumberPA Protected areaPAM Primary amoebic
meningoencephalitispg Picogrampmol PicomolesPrev PrevalenceQEPA Queen Elizabeth Protected Arearpm Revolutions per minuteSG Specific gravityUNESCO United Nations Educational
Scientific and Cultural OrganizationUn-ID Amoeba Unidentified amoebaV Volts120583S Microseconds
Competing Interests
There are no competing interests
References
[1] A J Martinez and G S Visvesvara ldquoFree-living amphizoic andopportunistic amebasrdquo Brain Pathology vol 7 no 1 pp 583ndash598 1997
[2] WHO Combating Waterborne Disease at the HouseholdLevelInternational Network to Promote HouseholdWater Treat-ment and Safe Storage World Health Organization GenevaSwitzerland 2007
[3] CDC Domestic Water Sanitation and Hygiene Epidemiol-ogy Center for Disease Control Atlanta Ga USA 2015httpwwwcdcgovnceziddfwedwaterbornedomestichtml
[4] H Abedkhojasteh M Niyyati F Rahimi M Hei-Dari SFarnia andM Rezaeian ldquoFirst report of Hartmannella keratitisin a cosmetic soft contact lens wearer in Iranrdquo Iranian Journalof Parasitology vol 8 no 3 pp 481ndash485 2013
[5] C Sente J Erume I Naigaga et al ldquoOccurrence and geneticcharacterisation ofAcanthamoeba spp from environmental anddomestic water sources in Queen Elizabeth Protected AreaUgandardquo Parasites amp Vectors vol 9 article 127 2016
[6] J De Jonckheere ldquoNaegleria australiensis sp nov anotherpathogenic Naegleria from waterrdquo Protistologica vol 17 pp423ndash429 1981
[7] J FDe Jonckheere ldquoIsoenzymepatterns of pathogenic andnon-pathogenic Naegleria spp using agarose isoelectric focusingrdquoAnnales de Microbiologie vol 133 no 2 pp 319ndash342 1982
[8] J F De Jonckheere ldquoA century of research on the amoeboflag-ellate genus Naegleriardquo Acta Protozoologica vol 41 no 4 pp309ndash342 2002
[9] CDC ldquoAcanthamoeba keratitis associated with contact lensesmdashUnited Statesrdquo Morbidity and Mortality Weekly Report vol 35no 25 pp 405ndash408 1986
[10] V A Dunand S M Hammer R Rossi et al ldquoParasitic sinusitisand otitis in patients infected with human immunodeficiencyvirus report of five cases and reviewrdquo Clinical Infectious Dis-eases vol 25 no 2 pp 267ndash272 1997
[11] S Amir Acanthamoeba castellanii as a Host and Model toStudy Bacterial Virulence Karolinska UniversitetssjukhusetHuddinge Sweden 2009
[12] R Dey P S Hoffman and I J Glomski ldquoGermination andamplification of anthrax spores by soil-dwelling amoebasrdquoApplied and Environmental Microbiology vol 78 no 22 pp8075ndash8081 2012
[13] R Solgi M Niyyati A Haghighi and E N Mojarad ldquoOccur-rence of thermotolerant Hartmannella vermiformis and Naeg-leria spp in hot springs of Ardebil Province Northwest IranrdquoIranian Journal of Parasitology vol 7 no 2 pp 47ndash52 2012
[14] Uganda CholeraWHORegional Office for Africa 2012 httpwwwafrowhointenclusters-a-programmesdpcepidemic-a-pandemic-alert-and-response3601-uganda-cholera-situation-as-of-31-march-2012html
[15] G Ojore Uganda 2000 Children Die of Diarrhoea in AfricaDaily-WaterAid New Vision Publishing Kampala Uganda2012
[16] Uganda rural water services Inadequate quantity low qualitysatisfiedusers IRC 2014 httpwwwircwashorgnewsuganda-rural-water-services-inadequate-quantity-low-quality-satisfied-users
[17] WHO Regional Office for Africa Emergencies Preparednessand Response to Typhoid Fever Uganda 2015 httpwwwwhointcsrdon17-march-2015-ugandaen
[18] Naegleria Infection Medscape Drugs amp Diseases 2015 httpemedicinemedscapecomarticle223910-overviewa5
[19] G S Visvesvara H Moura and F L Schuster ldquoPathogenic andopportunistic free-living amoebae Acanthamoeba spp Bala-muthia mandrillaris Naegleria fowleri and Sappinia diploideardquoFEMS Immunology and Medical Microbiology vol 50 no 1 pp1ndash26 2007
[20] L J Stockman C J Wright G S Visvesvara B S Fields andM J Beach ldquoPrevalence of Acanthamoeba spp and other free-living amoebae in household water Ohio USAmdash1990ndash1992rdquoParasitology Research vol 108 no 3 pp 621ndash627 2011
[21] G S Visvesvara ldquoAmebic meningoencephalitides and keratitischallenges in diagnosis and treatmentrdquo Current Opinion inInfectious Diseases vol 23 no 6 pp 590ndash594 2010
[22] N Crum-Cianflone Acanthamoeba Naval Medical Center atSan Diego San Diego Calif USA 2015
[23] F Marciano-Cabral and G A Cabral ldquoAcanthamoeba spp asagents of disease in humansrdquoClinicalMicrobiology Reviews vol16 no 2 pp 273ndash307 2003
[24] J Lorenzo-Morales E Martınez-Carretero N Batista et alldquoEarly diagnosis of amoebic keratitis due to a mixed infectionwith Acanthamoeba and Hartmannellardquo Parasitology Researchvol 102 no 1 pp 167ndash169 2007
New Journal of Science 9
[25] Z Szenasi T Endo K Yagita and ENagy ldquoIsolation identifica-tion and increasing importance of lsquofree-livingrsquo amoebae causinghuman diseaserdquo Journal of Medical Microbiology vol 47 no 1pp 5ndash16 1998
[26] H Trabelsi F Dendana A Sellami et al ldquoPathogenic free-living amoebae epidemiology and clinical reviewrdquo PathologieBiologie vol 60 no 6 pp 399ndash405 2012
[27] Uganda Bureau of Statistics Estimated Population of Kampalain 2002 2010 amp 2011 Uganda Bureau of Statistics 2014
[28] F L Schuster and G S Visvesvara ldquoFree-living amoebae asopportunistic and non-opportunistic pathogens of humans andanimalsrdquo International Journal for Parasitology vol 34 no 9 pp1001ndash1027 2004
[29] M Pelandakis and P Pernin ldquoUse of multiplex PCR andPCR restriction enzyme analysis for detection and explorationof the variability in the free-living amoeba Naegleria in theenvironmentrdquoApplied and EnvironmentalMicrobiology vol 68no 4 pp 2061ndash2065 2002
[30] J M Schroeder G C Booton J Hay et al ldquoUse of subgenic 18Sribosomal DNA PCR and sequencing for genus and genotypeidentification of Acanthamoebae from humans with keratitisand from sewage sludgerdquo Journal of Clinical Microbiology vol39 no 5 pp 1903ndash1911 2001
[31] G C Booton D J Kelly Y-W Chu et al ldquo18S ribosomalDNA typing and tracking of Acanthamoeba species isolatesfrom corneal scrape specimens contact lenses lens cases andhomewater supplies ofAcanthamoeba keratitis patients inHongKongrdquo Journal of Clinical Microbiology vol 40 no 5 pp 1621ndash1625 2002
[32] K Tamura G Stecher D Peterson A Filipski and S KumarldquoMEGA6molecular evolutionary genetics analysis version 60rdquoMolecular Biology and Evolution vol 30 no 12 pp 2725ndash27292013
[33] P Bonilla-Lemus A S Caballero Villegas J Carmona Jimenezand A Lugo Vazquez ldquoOccurrence of free-living amoebae instreams of the Mexico Basinrdquo Experimental Parasitology vol145 supplement pp S28ndashS33 2014
[34] S Ghadar-Ghadr K Solhjoo M Norouz-Nejad R Rohi and SZia-Jahromi ldquoIsolation and identification of free living amoeba(Naegleria and Acanthamoeba) in Shiraz water resources bymorphological criteriardquo Pars of Jahrom University of MedicalSciences vol 10 no 3 pp 33ndash42 2012
[35] S Ghadar-Ghadr K Solhjoo M Norouz-Nejad R Rohi and SZia-Jahromi ldquoIsolation and identification of free living amoeba(Naegleria and Acanthamoeba) in Shiraz water resources bymorphological criteriardquo Journal of Jahrom University of MedicalSciences vol 10 no 3 pp 26ndash33 2012
[36] S Rodriguez-Zaragoza E Mayzlish and Y Steinberger ldquoVer-tical distribution of the free-living amoeba population in soilunder desert shrubs in the Negev Desert Israelrdquo Applied andEnvironmentalMicrobiology vol 71 no 4 pp 2053ndash2060 2005
[37] M Pruden J Falkinham K Williams H Wang K Martinsand W Rhoads ldquoRelationship between biodegradable organicmatter and pathogen concentrations in premise plumbingrdquoWater Research Foundation pp 58ndash90 2013
[38] A Rozej A Cydzik-Kwiatkowska B Kowalska and D Kowal-ski ldquoStructure and microbial diversity of biofilms on differentpipe materials of a model drinking water distribution systemsrdquoWorld Journal of Microbiology amp Biotechnology vol 31 no 1 pp37ndash47 2015
[39] M H Vodkin D K Howe G S Visvesvara and G LMcLaughlin ldquoIdentification ofAcanthamoeba at the generic and
specific levels using the polymerase chain reactionrdquoThe Journalof Protozoology vol 39 no 3 pp 378ndash385 1992
[40] M Crary Genetic Variability and Its Relationship to Acan-thamoeba Pathogenesis Molecular Genetics Ohio State Univer-sity Columbus Ohio USA 2012
[41] M S Torno Jr R Babapour A Gurevitch and M D WittldquoCutaneous acanthamoebiasis inAIDSrdquo Journal of theAmericanAcademy of Dermatology vol 42 no 2 part 2 pp 351ndash3542000
[42] J F De Jonckheere and S Brown ldquoThere is no evidence that thefree-living ameba Hartmannella is a human parasiterdquo ClinicalInfectious Diseases vol 26 no 3 p 773 1998
[43] P W Woodburn L Muhangi S Hillier et al ldquoRisk factors forhelminth malaria and HIV infection in pregnancy in EntebbeUgandardquo PLoS Neglected Tropical Diseases vol 3 no 6 articlee473 2009
[44] S Onichandran T Kumar C C Salibay et al ldquoWaterborneparasites a current status from the Philippinesrdquo Parasites ampVectors vol 7 no 1 article 244 2014
[45] T Kumar S Onichandran Y A L Lim et al ldquoComparativestudy on waterborne parasites between Malaysia andThailanda new insightrdquo The American Journal of Tropical Medicine andHygiene vol 90 no 4 pp 682ndash689 2014
[46] D CarmenaWaterborne Transmission of Cryptosporidium andGiardia Detection Surveillance and Implications for PublicHealth Faculty of Medicine IC London UK 2010
Submit your manuscripts athttpwwwhindawicom
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Anatomy Research International
PeptidesInternational Journal of
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Hindawi Publishing Corporation httpwwwhindawicom
International Journal of
Volume 2014
Zoology
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Molecular Biology International
GenomicsInternational Journal of
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
The Scientific World JournalHindawi Publishing Corporation httpwwwhindawicom Volume 2014
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
BioinformaticsAdvances in
Marine BiologyJournal of
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Signal TransductionJournal of
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
BioMed Research International
Evolutionary BiologyInternational Journal of
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Biochemistry Research International
ArchaeaHindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Genetics Research International
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Advances in
Virolog y
Hindawi Publishing Corporationhttpwwwhindawicom
Nucleic AcidsJournal of
Volume 2014
Stem CellsInternational
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Enzyme Research
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
International Journal of
Microbiology
New Journal of Science 7
Table4Estim
ationof
evolutionary
divergence
betweensequ
ences
Percentidentity
12
34
56
78
910
1112
1314
1516
1718
1920
2122
2324
2526
2728
Divergence
1532
536
534
528
538
538
514
521
565
345
360
315
522
256
533
254
537
252
251
248
243
250
252
305
299
305
309
1KU
884884
22391
973
956
960
944
944
533
554
549
329
346
307
554
264
525
239
915
238
235
256
242
246
246
293
289
299
310
2KU
894799
32203
19957
950
940
945
523
544
550
328
348
306
545
266
525
238
917
236
234
255
240
243
247
291
289
298
311
3KU
894800
42051
30
37
941
934
956
528
552
550
323
346
306
550
264
525
242
898
238
235
255
240
248
252
294
290
301
311
4KU
894801
52187
40
42
33
940
944
529
550
544
333
342
303
550
266
526
236
897
236
234
256
239
244
248
291
289
299
311
5KU
894802
62120
48
60
53
40
940
521
540
558
342
356
318
540
278
538
247
887
243
240
264
250
250
255
298
294
305
317
6KU
894803
72262
33
45
1743
57
509
530
554
332
353
315
530
275
536
251
890
246
243
263
248
254
258
299
298
307
326
7KU
894804
81310
1459
1409
1424
1447
1441
1388
795
632
357
370
329
807
277
546
283
562
277
277
256
256
256
264
302
299
305
310
8KU
894805
91271
1043
1030
1014
1032
1048
1006
484
659
455
420
362
960
430
666
322
583
323
322
416
381
315
322
356
353
364
352
9KU
894806
101335
1819
1777
1637
1793
1671
1584
500
389
474
537
491
670
415
666
389
581
381
383
395
395
479
486
471
477
482
485
10KU
894807
111410
1653
1636
1653
1490
1472
1564
640
264
483
652
596
478
677
651
553
313
545
545
654
585
549
556
588
591
592
589
11KU894808
121368
1691
1709
1633
1677
1562
1534
531
342
316
424
836
432
695
583
685
333
689
689
689
675
733
742
928
898
863
846
12KU
894809
131216
1391
1404
1392
1384
1332
1314
472
338
304
422
79374
701
534
697
291
683
683
681
664
744
752
847
860
864
958
13KU
894810
141279
1029
1026
1014
1017
1034
987
456
69
329
211
294
296
452
687
328
584
325
323
436
368
323
332
365
362
369
360
14KU
894811
151330
1238
1257
1247
1192
1156
1180
463
66
362
248
241
272
00
648
742
247
728
728
964
827
730
732
686
686
694
705
15KU
894812
161357
1507
1523
1474
1423
1350
1395
563
132
399
188
308
304
7646
493
506
472
472
617
542
486
494
515
517
529
529
16KU
894813
171211
1359
1390
1362
1366
1302
1275
363
311
390
432
247
263
290
292
319
220
952
952
715
701
699
703
682
681
691
711
17KU
894814
182065
45
47
46
68
68
51
1415
1039
1568
1499
1453
1227
1031
1140
1358
1247
232
230
250
235
242
246
290
287
297
294
18KM
1894191Ac
antham
oeba
sp
191208
1352
1400
1348
1345
1315
1279
352
300
386
428
235
264
278
284
318
101263
995
756
740
740
741
722
719
728
690
19JQ
2716891Hartm
annella
verm
iform
is
201222
1399
1449
1394
1390
1356
1318
352
305
381
428
235
264
283
284
318
101303
06
756
740
741
742
722
721
729
690
20KT
1856251Ve
rmam
oeba
verm
iform
is
211329
1267
1311
1272
1232
1197
1211
470
78367
253
234
275
07
04
53
295
1193
278
278
855
761
760
718
718
723
685
21AF2938951Echinamoeba
exun
dans
221318
1307
1352
1311
1307
1231
1242
462
145
364
358
252
290
161
149
171
315
1230
299
299
149
754
750
697
699
701
674
22AJ
4892611Echinamoeba
thermarum
231299
1447
1517
1401
1438
1399
1359
458
287
189
389
164
189
229
249
242
295
1311
278
276
241
250
970
764
780
773
750
23AY
3646351Nuclearia
patte
rson
i
241323
1460
1532
1413
1451
1388
1370
450
278
189
384
156
183
224
246
239
288
1321
271
269
238
252
25
769
785
780
758
24AF4
846871
Nuclearia
simplex
251368
1641
1706
1608
1625
1539
1545
536
349
319
427
00
103
293
284
314
284
1452
266
266
271
298
205
200
961
917
855
25AF4
112761Bo
domorph
aminim
a
261392
1768
1875
1724
1702
1632
1626
527
348
315
426
1699
291
283
308
281
1556
266
263
270
293
191
186
23
936
867
26EU
6471741|
Cercomon
adida
271342
1569
1629
1539
1522
1479
1455
506
311
326
423
60
103
271
268
288
261
1393
252
250
260
290
203
196
7258
872
27EU
7091401Cercozoasp
281245
1358
1360
1348
1364
1312
1282
507
348
320
447
80
02
314
279
322
268
1197
267
267
279
288
192
186
105
100
105
28AY
7488061Cercomon
asagilis
12
34
56
78
910
1112
1314
1516
1718
1920
2122
2324
2526
2728
8 New Journal of Science
FLA Free-living amoebaFLS Fish landing siteG Gravitational forceg GramsGAE Granulomatous amoebic encephalitisHIVAIDS Human immunodeficiency
virusacquired immune deficiencysyndrome
KCB Kazinga Channel bankKCM Kazinga Channel middleKLA KampalaL Litermg MilligramsmL MillilitersmM MillimolarNCBI National Center for Biotechnology
InformationNo NumberPA Protected areaPAM Primary amoebic
meningoencephalitispg Picogrampmol PicomolesPrev PrevalenceQEPA Queen Elizabeth Protected Arearpm Revolutions per minuteSG Specific gravityUNESCO United Nations Educational
Scientific and Cultural OrganizationUn-ID Amoeba Unidentified amoebaV Volts120583S Microseconds
Competing Interests
There are no competing interests
References
[1] A J Martinez and G S Visvesvara ldquoFree-living amphizoic andopportunistic amebasrdquo Brain Pathology vol 7 no 1 pp 583ndash598 1997
[2] WHO Combating Waterborne Disease at the HouseholdLevelInternational Network to Promote HouseholdWater Treat-ment and Safe Storage World Health Organization GenevaSwitzerland 2007
[3] CDC Domestic Water Sanitation and Hygiene Epidemiol-ogy Center for Disease Control Atlanta Ga USA 2015httpwwwcdcgovnceziddfwedwaterbornedomestichtml
[4] H Abedkhojasteh M Niyyati F Rahimi M Hei-Dari SFarnia andM Rezaeian ldquoFirst report of Hartmannella keratitisin a cosmetic soft contact lens wearer in Iranrdquo Iranian Journalof Parasitology vol 8 no 3 pp 481ndash485 2013
[5] C Sente J Erume I Naigaga et al ldquoOccurrence and geneticcharacterisation ofAcanthamoeba spp from environmental anddomestic water sources in Queen Elizabeth Protected AreaUgandardquo Parasites amp Vectors vol 9 article 127 2016
[6] J De Jonckheere ldquoNaegleria australiensis sp nov anotherpathogenic Naegleria from waterrdquo Protistologica vol 17 pp423ndash429 1981
[7] J FDe Jonckheere ldquoIsoenzymepatterns of pathogenic andnon-pathogenic Naegleria spp using agarose isoelectric focusingrdquoAnnales de Microbiologie vol 133 no 2 pp 319ndash342 1982
[8] J F De Jonckheere ldquoA century of research on the amoeboflag-ellate genus Naegleriardquo Acta Protozoologica vol 41 no 4 pp309ndash342 2002
[9] CDC ldquoAcanthamoeba keratitis associated with contact lensesmdashUnited Statesrdquo Morbidity and Mortality Weekly Report vol 35no 25 pp 405ndash408 1986
[10] V A Dunand S M Hammer R Rossi et al ldquoParasitic sinusitisand otitis in patients infected with human immunodeficiencyvirus report of five cases and reviewrdquo Clinical Infectious Dis-eases vol 25 no 2 pp 267ndash272 1997
[11] S Amir Acanthamoeba castellanii as a Host and Model toStudy Bacterial Virulence Karolinska UniversitetssjukhusetHuddinge Sweden 2009
[12] R Dey P S Hoffman and I J Glomski ldquoGermination andamplification of anthrax spores by soil-dwelling amoebasrdquoApplied and Environmental Microbiology vol 78 no 22 pp8075ndash8081 2012
[13] R Solgi M Niyyati A Haghighi and E N Mojarad ldquoOccur-rence of thermotolerant Hartmannella vermiformis and Naeg-leria spp in hot springs of Ardebil Province Northwest IranrdquoIranian Journal of Parasitology vol 7 no 2 pp 47ndash52 2012
[14] Uganda CholeraWHORegional Office for Africa 2012 httpwwwafrowhointenclusters-a-programmesdpcepidemic-a-pandemic-alert-and-response3601-uganda-cholera-situation-as-of-31-march-2012html
[15] G Ojore Uganda 2000 Children Die of Diarrhoea in AfricaDaily-WaterAid New Vision Publishing Kampala Uganda2012
[16] Uganda rural water services Inadequate quantity low qualitysatisfiedusers IRC 2014 httpwwwircwashorgnewsuganda-rural-water-services-inadequate-quantity-low-quality-satisfied-users
[17] WHO Regional Office for Africa Emergencies Preparednessand Response to Typhoid Fever Uganda 2015 httpwwwwhointcsrdon17-march-2015-ugandaen
[18] Naegleria Infection Medscape Drugs amp Diseases 2015 httpemedicinemedscapecomarticle223910-overviewa5
[19] G S Visvesvara H Moura and F L Schuster ldquoPathogenic andopportunistic free-living amoebae Acanthamoeba spp Bala-muthia mandrillaris Naegleria fowleri and Sappinia diploideardquoFEMS Immunology and Medical Microbiology vol 50 no 1 pp1ndash26 2007
[20] L J Stockman C J Wright G S Visvesvara B S Fields andM J Beach ldquoPrevalence of Acanthamoeba spp and other free-living amoebae in household water Ohio USAmdash1990ndash1992rdquoParasitology Research vol 108 no 3 pp 621ndash627 2011
[21] G S Visvesvara ldquoAmebic meningoencephalitides and keratitischallenges in diagnosis and treatmentrdquo Current Opinion inInfectious Diseases vol 23 no 6 pp 590ndash594 2010
[22] N Crum-Cianflone Acanthamoeba Naval Medical Center atSan Diego San Diego Calif USA 2015
[23] F Marciano-Cabral and G A Cabral ldquoAcanthamoeba spp asagents of disease in humansrdquoClinicalMicrobiology Reviews vol16 no 2 pp 273ndash307 2003
[24] J Lorenzo-Morales E Martınez-Carretero N Batista et alldquoEarly diagnosis of amoebic keratitis due to a mixed infectionwith Acanthamoeba and Hartmannellardquo Parasitology Researchvol 102 no 1 pp 167ndash169 2007
New Journal of Science 9
[25] Z Szenasi T Endo K Yagita and ENagy ldquoIsolation identifica-tion and increasing importance of lsquofree-livingrsquo amoebae causinghuman diseaserdquo Journal of Medical Microbiology vol 47 no 1pp 5ndash16 1998
[26] H Trabelsi F Dendana A Sellami et al ldquoPathogenic free-living amoebae epidemiology and clinical reviewrdquo PathologieBiologie vol 60 no 6 pp 399ndash405 2012
[27] Uganda Bureau of Statistics Estimated Population of Kampalain 2002 2010 amp 2011 Uganda Bureau of Statistics 2014
[28] F L Schuster and G S Visvesvara ldquoFree-living amoebae asopportunistic and non-opportunistic pathogens of humans andanimalsrdquo International Journal for Parasitology vol 34 no 9 pp1001ndash1027 2004
[29] M Pelandakis and P Pernin ldquoUse of multiplex PCR andPCR restriction enzyme analysis for detection and explorationof the variability in the free-living amoeba Naegleria in theenvironmentrdquoApplied and EnvironmentalMicrobiology vol 68no 4 pp 2061ndash2065 2002
[30] J M Schroeder G C Booton J Hay et al ldquoUse of subgenic 18Sribosomal DNA PCR and sequencing for genus and genotypeidentification of Acanthamoebae from humans with keratitisand from sewage sludgerdquo Journal of Clinical Microbiology vol39 no 5 pp 1903ndash1911 2001
[31] G C Booton D J Kelly Y-W Chu et al ldquo18S ribosomalDNA typing and tracking of Acanthamoeba species isolatesfrom corneal scrape specimens contact lenses lens cases andhomewater supplies ofAcanthamoeba keratitis patients inHongKongrdquo Journal of Clinical Microbiology vol 40 no 5 pp 1621ndash1625 2002
[32] K Tamura G Stecher D Peterson A Filipski and S KumarldquoMEGA6molecular evolutionary genetics analysis version 60rdquoMolecular Biology and Evolution vol 30 no 12 pp 2725ndash27292013
[33] P Bonilla-Lemus A S Caballero Villegas J Carmona Jimenezand A Lugo Vazquez ldquoOccurrence of free-living amoebae instreams of the Mexico Basinrdquo Experimental Parasitology vol145 supplement pp S28ndashS33 2014
[34] S Ghadar-Ghadr K Solhjoo M Norouz-Nejad R Rohi and SZia-Jahromi ldquoIsolation and identification of free living amoeba(Naegleria and Acanthamoeba) in Shiraz water resources bymorphological criteriardquo Pars of Jahrom University of MedicalSciences vol 10 no 3 pp 33ndash42 2012
[35] S Ghadar-Ghadr K Solhjoo M Norouz-Nejad R Rohi and SZia-Jahromi ldquoIsolation and identification of free living amoeba(Naegleria and Acanthamoeba) in Shiraz water resources bymorphological criteriardquo Journal of Jahrom University of MedicalSciences vol 10 no 3 pp 26ndash33 2012
[36] S Rodriguez-Zaragoza E Mayzlish and Y Steinberger ldquoVer-tical distribution of the free-living amoeba population in soilunder desert shrubs in the Negev Desert Israelrdquo Applied andEnvironmentalMicrobiology vol 71 no 4 pp 2053ndash2060 2005
[37] M Pruden J Falkinham K Williams H Wang K Martinsand W Rhoads ldquoRelationship between biodegradable organicmatter and pathogen concentrations in premise plumbingrdquoWater Research Foundation pp 58ndash90 2013
[38] A Rozej A Cydzik-Kwiatkowska B Kowalska and D Kowal-ski ldquoStructure and microbial diversity of biofilms on differentpipe materials of a model drinking water distribution systemsrdquoWorld Journal of Microbiology amp Biotechnology vol 31 no 1 pp37ndash47 2015
[39] M H Vodkin D K Howe G S Visvesvara and G LMcLaughlin ldquoIdentification ofAcanthamoeba at the generic and
specific levels using the polymerase chain reactionrdquoThe Journalof Protozoology vol 39 no 3 pp 378ndash385 1992
[40] M Crary Genetic Variability and Its Relationship to Acan-thamoeba Pathogenesis Molecular Genetics Ohio State Univer-sity Columbus Ohio USA 2012
[41] M S Torno Jr R Babapour A Gurevitch and M D WittldquoCutaneous acanthamoebiasis inAIDSrdquo Journal of theAmericanAcademy of Dermatology vol 42 no 2 part 2 pp 351ndash3542000
[42] J F De Jonckheere and S Brown ldquoThere is no evidence that thefree-living ameba Hartmannella is a human parasiterdquo ClinicalInfectious Diseases vol 26 no 3 p 773 1998
[43] P W Woodburn L Muhangi S Hillier et al ldquoRisk factors forhelminth malaria and HIV infection in pregnancy in EntebbeUgandardquo PLoS Neglected Tropical Diseases vol 3 no 6 articlee473 2009
[44] S Onichandran T Kumar C C Salibay et al ldquoWaterborneparasites a current status from the Philippinesrdquo Parasites ampVectors vol 7 no 1 article 244 2014
[45] T Kumar S Onichandran Y A L Lim et al ldquoComparativestudy on waterborne parasites between Malaysia andThailanda new insightrdquo The American Journal of Tropical Medicine andHygiene vol 90 no 4 pp 682ndash689 2014
[46] D CarmenaWaterborne Transmission of Cryptosporidium andGiardia Detection Surveillance and Implications for PublicHealth Faculty of Medicine IC London UK 2010
Submit your manuscripts athttpwwwhindawicom
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Anatomy Research International
PeptidesInternational Journal of
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Hindawi Publishing Corporation httpwwwhindawicom
International Journal of
Volume 2014
Zoology
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Molecular Biology International
GenomicsInternational Journal of
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
The Scientific World JournalHindawi Publishing Corporation httpwwwhindawicom Volume 2014
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
BioinformaticsAdvances in
Marine BiologyJournal of
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Signal TransductionJournal of
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
BioMed Research International
Evolutionary BiologyInternational Journal of
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Biochemistry Research International
ArchaeaHindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Genetics Research International
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Advances in
Virolog y
Hindawi Publishing Corporationhttpwwwhindawicom
Nucleic AcidsJournal of
Volume 2014
Stem CellsInternational
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Enzyme Research
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
International Journal of
Microbiology
8 New Journal of Science
FLA Free-living amoebaFLS Fish landing siteG Gravitational forceg GramsGAE Granulomatous amoebic encephalitisHIVAIDS Human immunodeficiency
virusacquired immune deficiencysyndrome
KCB Kazinga Channel bankKCM Kazinga Channel middleKLA KampalaL Litermg MilligramsmL MillilitersmM MillimolarNCBI National Center for Biotechnology
InformationNo NumberPA Protected areaPAM Primary amoebic
meningoencephalitispg Picogrampmol PicomolesPrev PrevalenceQEPA Queen Elizabeth Protected Arearpm Revolutions per minuteSG Specific gravityUNESCO United Nations Educational
Scientific and Cultural OrganizationUn-ID Amoeba Unidentified amoebaV Volts120583S Microseconds
Competing Interests
There are no competing interests
References
[1] A J Martinez and G S Visvesvara ldquoFree-living amphizoic andopportunistic amebasrdquo Brain Pathology vol 7 no 1 pp 583ndash598 1997
[2] WHO Combating Waterborne Disease at the HouseholdLevelInternational Network to Promote HouseholdWater Treat-ment and Safe Storage World Health Organization GenevaSwitzerland 2007
[3] CDC Domestic Water Sanitation and Hygiene Epidemiol-ogy Center for Disease Control Atlanta Ga USA 2015httpwwwcdcgovnceziddfwedwaterbornedomestichtml
[4] H Abedkhojasteh M Niyyati F Rahimi M Hei-Dari SFarnia andM Rezaeian ldquoFirst report of Hartmannella keratitisin a cosmetic soft contact lens wearer in Iranrdquo Iranian Journalof Parasitology vol 8 no 3 pp 481ndash485 2013
[5] C Sente J Erume I Naigaga et al ldquoOccurrence and geneticcharacterisation ofAcanthamoeba spp from environmental anddomestic water sources in Queen Elizabeth Protected AreaUgandardquo Parasites amp Vectors vol 9 article 127 2016
[6] J De Jonckheere ldquoNaegleria australiensis sp nov anotherpathogenic Naegleria from waterrdquo Protistologica vol 17 pp423ndash429 1981
[7] J FDe Jonckheere ldquoIsoenzymepatterns of pathogenic andnon-pathogenic Naegleria spp using agarose isoelectric focusingrdquoAnnales de Microbiologie vol 133 no 2 pp 319ndash342 1982
[8] J F De Jonckheere ldquoA century of research on the amoeboflag-ellate genus Naegleriardquo Acta Protozoologica vol 41 no 4 pp309ndash342 2002
[9] CDC ldquoAcanthamoeba keratitis associated with contact lensesmdashUnited Statesrdquo Morbidity and Mortality Weekly Report vol 35no 25 pp 405ndash408 1986
[10] V A Dunand S M Hammer R Rossi et al ldquoParasitic sinusitisand otitis in patients infected with human immunodeficiencyvirus report of five cases and reviewrdquo Clinical Infectious Dis-eases vol 25 no 2 pp 267ndash272 1997
[11] S Amir Acanthamoeba castellanii as a Host and Model toStudy Bacterial Virulence Karolinska UniversitetssjukhusetHuddinge Sweden 2009
[12] R Dey P S Hoffman and I J Glomski ldquoGermination andamplification of anthrax spores by soil-dwelling amoebasrdquoApplied and Environmental Microbiology vol 78 no 22 pp8075ndash8081 2012
[13] R Solgi M Niyyati A Haghighi and E N Mojarad ldquoOccur-rence of thermotolerant Hartmannella vermiformis and Naeg-leria spp in hot springs of Ardebil Province Northwest IranrdquoIranian Journal of Parasitology vol 7 no 2 pp 47ndash52 2012
[14] Uganda CholeraWHORegional Office for Africa 2012 httpwwwafrowhointenclusters-a-programmesdpcepidemic-a-pandemic-alert-and-response3601-uganda-cholera-situation-as-of-31-march-2012html
[15] G Ojore Uganda 2000 Children Die of Diarrhoea in AfricaDaily-WaterAid New Vision Publishing Kampala Uganda2012
[16] Uganda rural water services Inadequate quantity low qualitysatisfiedusers IRC 2014 httpwwwircwashorgnewsuganda-rural-water-services-inadequate-quantity-low-quality-satisfied-users
[17] WHO Regional Office for Africa Emergencies Preparednessand Response to Typhoid Fever Uganda 2015 httpwwwwhointcsrdon17-march-2015-ugandaen
[18] Naegleria Infection Medscape Drugs amp Diseases 2015 httpemedicinemedscapecomarticle223910-overviewa5
[19] G S Visvesvara H Moura and F L Schuster ldquoPathogenic andopportunistic free-living amoebae Acanthamoeba spp Bala-muthia mandrillaris Naegleria fowleri and Sappinia diploideardquoFEMS Immunology and Medical Microbiology vol 50 no 1 pp1ndash26 2007
[20] L J Stockman C J Wright G S Visvesvara B S Fields andM J Beach ldquoPrevalence of Acanthamoeba spp and other free-living amoebae in household water Ohio USAmdash1990ndash1992rdquoParasitology Research vol 108 no 3 pp 621ndash627 2011
[21] G S Visvesvara ldquoAmebic meningoencephalitides and keratitischallenges in diagnosis and treatmentrdquo Current Opinion inInfectious Diseases vol 23 no 6 pp 590ndash594 2010
[22] N Crum-Cianflone Acanthamoeba Naval Medical Center atSan Diego San Diego Calif USA 2015
[23] F Marciano-Cabral and G A Cabral ldquoAcanthamoeba spp asagents of disease in humansrdquoClinicalMicrobiology Reviews vol16 no 2 pp 273ndash307 2003
[24] J Lorenzo-Morales E Martınez-Carretero N Batista et alldquoEarly diagnosis of amoebic keratitis due to a mixed infectionwith Acanthamoeba and Hartmannellardquo Parasitology Researchvol 102 no 1 pp 167ndash169 2007
New Journal of Science 9
[25] Z Szenasi T Endo K Yagita and ENagy ldquoIsolation identifica-tion and increasing importance of lsquofree-livingrsquo amoebae causinghuman diseaserdquo Journal of Medical Microbiology vol 47 no 1pp 5ndash16 1998
[26] H Trabelsi F Dendana A Sellami et al ldquoPathogenic free-living amoebae epidemiology and clinical reviewrdquo PathologieBiologie vol 60 no 6 pp 399ndash405 2012
[27] Uganda Bureau of Statistics Estimated Population of Kampalain 2002 2010 amp 2011 Uganda Bureau of Statistics 2014
[28] F L Schuster and G S Visvesvara ldquoFree-living amoebae asopportunistic and non-opportunistic pathogens of humans andanimalsrdquo International Journal for Parasitology vol 34 no 9 pp1001ndash1027 2004
[29] M Pelandakis and P Pernin ldquoUse of multiplex PCR andPCR restriction enzyme analysis for detection and explorationof the variability in the free-living amoeba Naegleria in theenvironmentrdquoApplied and EnvironmentalMicrobiology vol 68no 4 pp 2061ndash2065 2002
[30] J M Schroeder G C Booton J Hay et al ldquoUse of subgenic 18Sribosomal DNA PCR and sequencing for genus and genotypeidentification of Acanthamoebae from humans with keratitisand from sewage sludgerdquo Journal of Clinical Microbiology vol39 no 5 pp 1903ndash1911 2001
[31] G C Booton D J Kelly Y-W Chu et al ldquo18S ribosomalDNA typing and tracking of Acanthamoeba species isolatesfrom corneal scrape specimens contact lenses lens cases andhomewater supplies ofAcanthamoeba keratitis patients inHongKongrdquo Journal of Clinical Microbiology vol 40 no 5 pp 1621ndash1625 2002
[32] K Tamura G Stecher D Peterson A Filipski and S KumarldquoMEGA6molecular evolutionary genetics analysis version 60rdquoMolecular Biology and Evolution vol 30 no 12 pp 2725ndash27292013
[33] P Bonilla-Lemus A S Caballero Villegas J Carmona Jimenezand A Lugo Vazquez ldquoOccurrence of free-living amoebae instreams of the Mexico Basinrdquo Experimental Parasitology vol145 supplement pp S28ndashS33 2014
[34] S Ghadar-Ghadr K Solhjoo M Norouz-Nejad R Rohi and SZia-Jahromi ldquoIsolation and identification of free living amoeba(Naegleria and Acanthamoeba) in Shiraz water resources bymorphological criteriardquo Pars of Jahrom University of MedicalSciences vol 10 no 3 pp 33ndash42 2012
[35] S Ghadar-Ghadr K Solhjoo M Norouz-Nejad R Rohi and SZia-Jahromi ldquoIsolation and identification of free living amoeba(Naegleria and Acanthamoeba) in Shiraz water resources bymorphological criteriardquo Journal of Jahrom University of MedicalSciences vol 10 no 3 pp 26ndash33 2012
[36] S Rodriguez-Zaragoza E Mayzlish and Y Steinberger ldquoVer-tical distribution of the free-living amoeba population in soilunder desert shrubs in the Negev Desert Israelrdquo Applied andEnvironmentalMicrobiology vol 71 no 4 pp 2053ndash2060 2005
[37] M Pruden J Falkinham K Williams H Wang K Martinsand W Rhoads ldquoRelationship between biodegradable organicmatter and pathogen concentrations in premise plumbingrdquoWater Research Foundation pp 58ndash90 2013
[38] A Rozej A Cydzik-Kwiatkowska B Kowalska and D Kowal-ski ldquoStructure and microbial diversity of biofilms on differentpipe materials of a model drinking water distribution systemsrdquoWorld Journal of Microbiology amp Biotechnology vol 31 no 1 pp37ndash47 2015
[39] M H Vodkin D K Howe G S Visvesvara and G LMcLaughlin ldquoIdentification ofAcanthamoeba at the generic and
specific levels using the polymerase chain reactionrdquoThe Journalof Protozoology vol 39 no 3 pp 378ndash385 1992
[40] M Crary Genetic Variability and Its Relationship to Acan-thamoeba Pathogenesis Molecular Genetics Ohio State Univer-sity Columbus Ohio USA 2012
[41] M S Torno Jr R Babapour A Gurevitch and M D WittldquoCutaneous acanthamoebiasis inAIDSrdquo Journal of theAmericanAcademy of Dermatology vol 42 no 2 part 2 pp 351ndash3542000
[42] J F De Jonckheere and S Brown ldquoThere is no evidence that thefree-living ameba Hartmannella is a human parasiterdquo ClinicalInfectious Diseases vol 26 no 3 p 773 1998
[43] P W Woodburn L Muhangi S Hillier et al ldquoRisk factors forhelminth malaria and HIV infection in pregnancy in EntebbeUgandardquo PLoS Neglected Tropical Diseases vol 3 no 6 articlee473 2009
[44] S Onichandran T Kumar C C Salibay et al ldquoWaterborneparasites a current status from the Philippinesrdquo Parasites ampVectors vol 7 no 1 article 244 2014
[45] T Kumar S Onichandran Y A L Lim et al ldquoComparativestudy on waterborne parasites between Malaysia andThailanda new insightrdquo The American Journal of Tropical Medicine andHygiene vol 90 no 4 pp 682ndash689 2014
[46] D CarmenaWaterborne Transmission of Cryptosporidium andGiardia Detection Surveillance and Implications for PublicHealth Faculty of Medicine IC London UK 2010
Submit your manuscripts athttpwwwhindawicom
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Anatomy Research International
PeptidesInternational Journal of
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Hindawi Publishing Corporation httpwwwhindawicom
International Journal of
Volume 2014
Zoology
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Molecular Biology International
GenomicsInternational Journal of
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
The Scientific World JournalHindawi Publishing Corporation httpwwwhindawicom Volume 2014
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
BioinformaticsAdvances in
Marine BiologyJournal of
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Signal TransductionJournal of
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
BioMed Research International
Evolutionary BiologyInternational Journal of
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Biochemistry Research International
ArchaeaHindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Genetics Research International
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Advances in
Virolog y
Hindawi Publishing Corporationhttpwwwhindawicom
Nucleic AcidsJournal of
Volume 2014
Stem CellsInternational
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Enzyme Research
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
International Journal of
Microbiology
New Journal of Science 9
[25] Z Szenasi T Endo K Yagita and ENagy ldquoIsolation identifica-tion and increasing importance of lsquofree-livingrsquo amoebae causinghuman diseaserdquo Journal of Medical Microbiology vol 47 no 1pp 5ndash16 1998
[26] H Trabelsi F Dendana A Sellami et al ldquoPathogenic free-living amoebae epidemiology and clinical reviewrdquo PathologieBiologie vol 60 no 6 pp 399ndash405 2012
[27] Uganda Bureau of Statistics Estimated Population of Kampalain 2002 2010 amp 2011 Uganda Bureau of Statistics 2014
[28] F L Schuster and G S Visvesvara ldquoFree-living amoebae asopportunistic and non-opportunistic pathogens of humans andanimalsrdquo International Journal for Parasitology vol 34 no 9 pp1001ndash1027 2004
[29] M Pelandakis and P Pernin ldquoUse of multiplex PCR andPCR restriction enzyme analysis for detection and explorationof the variability in the free-living amoeba Naegleria in theenvironmentrdquoApplied and EnvironmentalMicrobiology vol 68no 4 pp 2061ndash2065 2002
[30] J M Schroeder G C Booton J Hay et al ldquoUse of subgenic 18Sribosomal DNA PCR and sequencing for genus and genotypeidentification of Acanthamoebae from humans with keratitisand from sewage sludgerdquo Journal of Clinical Microbiology vol39 no 5 pp 1903ndash1911 2001
[31] G C Booton D J Kelly Y-W Chu et al ldquo18S ribosomalDNA typing and tracking of Acanthamoeba species isolatesfrom corneal scrape specimens contact lenses lens cases andhomewater supplies ofAcanthamoeba keratitis patients inHongKongrdquo Journal of Clinical Microbiology vol 40 no 5 pp 1621ndash1625 2002
[32] K Tamura G Stecher D Peterson A Filipski and S KumarldquoMEGA6molecular evolutionary genetics analysis version 60rdquoMolecular Biology and Evolution vol 30 no 12 pp 2725ndash27292013
[33] P Bonilla-Lemus A S Caballero Villegas J Carmona Jimenezand A Lugo Vazquez ldquoOccurrence of free-living amoebae instreams of the Mexico Basinrdquo Experimental Parasitology vol145 supplement pp S28ndashS33 2014
[34] S Ghadar-Ghadr K Solhjoo M Norouz-Nejad R Rohi and SZia-Jahromi ldquoIsolation and identification of free living amoeba(Naegleria and Acanthamoeba) in Shiraz water resources bymorphological criteriardquo Pars of Jahrom University of MedicalSciences vol 10 no 3 pp 33ndash42 2012
[35] S Ghadar-Ghadr K Solhjoo M Norouz-Nejad R Rohi and SZia-Jahromi ldquoIsolation and identification of free living amoeba(Naegleria and Acanthamoeba) in Shiraz water resources bymorphological criteriardquo Journal of Jahrom University of MedicalSciences vol 10 no 3 pp 26ndash33 2012
[36] S Rodriguez-Zaragoza E Mayzlish and Y Steinberger ldquoVer-tical distribution of the free-living amoeba population in soilunder desert shrubs in the Negev Desert Israelrdquo Applied andEnvironmentalMicrobiology vol 71 no 4 pp 2053ndash2060 2005
[37] M Pruden J Falkinham K Williams H Wang K Martinsand W Rhoads ldquoRelationship between biodegradable organicmatter and pathogen concentrations in premise plumbingrdquoWater Research Foundation pp 58ndash90 2013
[38] A Rozej A Cydzik-Kwiatkowska B Kowalska and D Kowal-ski ldquoStructure and microbial diversity of biofilms on differentpipe materials of a model drinking water distribution systemsrdquoWorld Journal of Microbiology amp Biotechnology vol 31 no 1 pp37ndash47 2015
[39] M H Vodkin D K Howe G S Visvesvara and G LMcLaughlin ldquoIdentification ofAcanthamoeba at the generic and
specific levels using the polymerase chain reactionrdquoThe Journalof Protozoology vol 39 no 3 pp 378ndash385 1992
[40] M Crary Genetic Variability and Its Relationship to Acan-thamoeba Pathogenesis Molecular Genetics Ohio State Univer-sity Columbus Ohio USA 2012
[41] M S Torno Jr R Babapour A Gurevitch and M D WittldquoCutaneous acanthamoebiasis inAIDSrdquo Journal of theAmericanAcademy of Dermatology vol 42 no 2 part 2 pp 351ndash3542000
[42] J F De Jonckheere and S Brown ldquoThere is no evidence that thefree-living ameba Hartmannella is a human parasiterdquo ClinicalInfectious Diseases vol 26 no 3 p 773 1998
[43] P W Woodburn L Muhangi S Hillier et al ldquoRisk factors forhelminth malaria and HIV infection in pregnancy in EntebbeUgandardquo PLoS Neglected Tropical Diseases vol 3 no 6 articlee473 2009
[44] S Onichandran T Kumar C C Salibay et al ldquoWaterborneparasites a current status from the Philippinesrdquo Parasites ampVectors vol 7 no 1 article 244 2014
[45] T Kumar S Onichandran Y A L Lim et al ldquoComparativestudy on waterborne parasites between Malaysia andThailanda new insightrdquo The American Journal of Tropical Medicine andHygiene vol 90 no 4 pp 682ndash689 2014
[46] D CarmenaWaterborne Transmission of Cryptosporidium andGiardia Detection Surveillance and Implications for PublicHealth Faculty of Medicine IC London UK 2010
Submit your manuscripts athttpwwwhindawicom
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Anatomy Research International
PeptidesInternational Journal of
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Hindawi Publishing Corporation httpwwwhindawicom
International Journal of
Volume 2014
Zoology
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Molecular Biology International
GenomicsInternational Journal of
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
The Scientific World JournalHindawi Publishing Corporation httpwwwhindawicom Volume 2014
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
BioinformaticsAdvances in
Marine BiologyJournal of
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Signal TransductionJournal of
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
BioMed Research International
Evolutionary BiologyInternational Journal of
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Biochemistry Research International
ArchaeaHindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Genetics Research International
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Advances in
Virolog y
Hindawi Publishing Corporationhttpwwwhindawicom
Nucleic AcidsJournal of
Volume 2014
Stem CellsInternational
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Enzyme Research
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
International Journal of
Microbiology
Submit your manuscripts athttpwwwhindawicom
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Anatomy Research International
PeptidesInternational Journal of
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Hindawi Publishing Corporation httpwwwhindawicom
International Journal of
Volume 2014
Zoology
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Molecular Biology International
GenomicsInternational Journal of
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
The Scientific World JournalHindawi Publishing Corporation httpwwwhindawicom Volume 2014
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
BioinformaticsAdvances in
Marine BiologyJournal of
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Signal TransductionJournal of
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
BioMed Research International
Evolutionary BiologyInternational Journal of
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Biochemistry Research International
ArchaeaHindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Genetics Research International
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Advances in
Virolog y
Hindawi Publishing Corporationhttpwwwhindawicom
Nucleic AcidsJournal of
Volume 2014
Stem CellsInternational
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
Enzyme Research
Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014
International Journal of
Microbiology