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Prevalence of free-living amoebae in swimming pools and recreational waters, a systematic review and meta-analysis
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  • Beni Jequicene Mussengue Chaúque,
  • Denise Leal dos Santos,
  • Davood Anvari,
  • Marilise Brittes Rott
Beni Jequicene Mussengue Chaúque
Universidade Federal do Rio Grande do Sul Instituto de Ciencias Basicas da Saude

Corresponding Author:[email protected]

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Denise Leal dos Santos
Universidade Federal do Rio Grande do Sul Instituto de Ciencias Basicas da Saude
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Davood Anvari
Iranshahr University of Medical Sciences
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Marilise Brittes Rott
Universidade Federal do Rio Grande do Sul Instituto de Ciencias Basicas da Saude
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Abstract

Free-living amoebae (FLA) are cosmopolitan microorganisms known to be pathogenic to humans who often have a history of contact with contaminated water. Swimming pools and recreational waters are among the environments where the greatest human exposure to FLA occurs. This study aimed to determine the prevalence of FLA in swimming pools and recreational waters, through a systematic review and meta-analysis that included studies published between 1977 and 2021. 71 studies were included and an overall prevalence of FLA in swimming pools and recreational waters of 40.89% (95% CI = 33.97–48.00) was found. Considering the studies published up to 2010 (1977 - 2010) and after 2010 (>2010 - 2021) the prevalence were 51.54% (95% CI = 36.65-66.29) and 37.95% (95% CI = 30.34 – 45.86), respectively. The highest prevalence were found in the American continent (59.52%), in Malaysia (89.33%) and in indoor hot pools 52.27%. In studies that used morphological methods, PCR and both methods simultaneously to identify FLA, the prevalence was 56.41, 22.32 and 39.94%, respectively. Considering only PCR-based studies, the prevalence of Naegleria spp., Acanthamoeba spp., Hartmanella spp. and Vermamoeba spp. was 10.01, 15.38, 16.40 and 16.06%, respectively. There is considerable risk of AFL infection in swimming pools and recreational waters. Recreational water safety needs to be routinely monitored and, in case of risk, locations need to be identified with warning signs and users need to be educated. Swimming pools and artificial recreational water should be properly disinfected. Photolysis of NaOCl or NaCl in water by UV-C radiation is a promising alternative to disinfect swimming pools and artificial recreational waters.
Nov 2022Published in Parasitology Research volume 121 issue 11 on pages 3033-3050. 10.1007/s00436-022-07631-3