PREVALENCE OF ACANTHAMOEBA IN MALAYSIAN WATER SOURCES AND ITS PUBLIC HEALTH IMPLICATIONS: A SCOPING REVIEW

Abstract

Acanthamoeba, a free-living amoeba, poses significant public health risks, causing infections like Acanthamoeba keratitis (AK) in contact lens users and granulomatous amoebic encephalitis (GAE) in immunocompromised individuals. This scoping review examines Acanthamoeba prevalence in Malaysian water sources using a PRISMA-ScR-guided methodology. Literature searches from 2010 to 2024 identified studies focused on natural and artificial water sources, employing microscopy, culture, and molecular techniques for detection and genotyping. The findings revealed high contamination rates: 54.4 % in swimming pools, 90.2 % in drinking water, 100.0 % in recreational rivers, 86.7 % in lakes, 76.0 % in hot springs, and 72.0 % in marine waters, with the pathogenic T4 genotype predominating. Acanthamoeba’s role as a "Trojan horse," harbouring amoeba-resistant bacteria (ARBs), amplifies public health concerns. Prevalence in Malaysia exceeds neighbouring countries, influenced by factors such as climate and water management practices. Key research gaps include the lack of longitudinal studies and insufficient exploration of environmental influences on Acanthamoeba virulence. The review highlights the need for improved water treatment protocols, advanced diagnostics, and targeted public health measures. Effective strategies should prioritize thorough monitoring, public education, and enhanced water safety practices to mitigate risks and protect high-risk populations.