bluuebunny/crossref_metadata_2025 huggingface dataset:
ISOLATION OF TWO VACCINIA VIRUS STRAINS FROM A SINGLE BOVINE VACCINIA OUTBREAK IN RURAL AREA FROM BRAZIL: IMPLICATIONS ON THE EMERGENCE OF ZOONOTIC ORTHOPOXVIRUSES
Authors: TRINDADE GILIANE S. , LOBATO ZÉLIA I. P. , DRUMOND BETÂNIA P. , LEITE JULIANA A. , TRIGUEIRO RICARDO C. , GUEDES MARIA I. M. C. , DA FONSECA FLÁVIO G. , DOS SANTOS JOÃO R. , BONJARDIM CLÁUDIO A. , FERREIRA PAULO C. P. , KROON ERNA G.
Published: September 2018

Outbreaks of bovine vaccinia disease caused by circulation of Vaccinia virus (VACV) strains have been a common occurrence in Brazil in the recent years, being an important emergent zoonosis. During a single outbreak that took place in 2001, two genetically different VACV strains were isolated and named Guarani P1 virus (GP1V) and Guarani P2 virus (GP2V). Molecular diagnosis was done through restriction fragment length polymorphism (RFLP) of ati gene (A26L) and by sequence analysis of a group of five VACV genes including the C11R, J2R, A56R, B18R, and E3L genes. These findings confirmed the co-circulation of two different Vaccinia virus strains during the same outbreak, raising important questions about the origin, emergence, and circulation of VACV strains in Brazil.
A NEW GENETIC VARIANT OF LA CROSSE VIRUS (BUNYAVIRIDAE) ISOLATED FROM NEW ENGLAND
Authors: ARMSTRONG PHILIP M. , ANDREADIS THEODORE G.
Published: September 2018

La Crosse virus (LACV) is found primarily in the Midwestern and Appalachian regions of the United States where it is a leading cause of mosquito-borne encephalitis in children. To determine whether the distribution of this virus extends further east into New England, we analyzed a bunyavirus that was isolated from a pool of eastern tree-hole mosquitoes, Ochlerotatus triseriatus (= Aedes triseriatus), collected from Fairfield, Connecticut (CT) in 2005. Nucleotide and encoded amino acid sequences from portions of the S, M, and L segments were more similar to the prototype strain of La Crosse virus than that of closely related snowshoe hare virus. Phylogenetic analysis of sequences from the M segment indicated that the CT isolate represents a distinct lineage of La Crosse virus, diverging earliest from other strains found in southeastern, central, and northeastern United States. Despite low sequence homology with other viral strains, the CT isolate was antigenically similar to the prototype strain of LACV by plaque-reduction neutralization tests with polyclonal and monoclonal antibodies. This represents the first isolation of LACV in New England to our knowledge and suggests long-term independent evolution of the CT isolate.
KNOWLEDGE, ATTITUDE, AND PRACTICES RELATED TO KALA-AZAR IN A RURAL AREA OF BIHAR STATE, INDIA
Authors: SINGH SHRI P. , REDDY DANDU C. S. , MISHRA RABINDRA N. , SUNDAR SHYAM
Published: September 2018

The Indian Government aspires to eliminate Kala-azar by 2010. Success of any disease control program depends on community participation, and there is no published data about the knowledge, attitude, and practices of the community about Kala-azar in endemic regions of India. For this knowledge, attitude, and practices (KAP) study, the heads of 3,968 households in a rural area, consisting of 26,444 populations, were interviewed using a pre-tested, semi-structured schedule. Most of the study subjects (97.4%) were aware of Kala-azar. Fever (71.3%) and weight loss (30.5%) were the most commonly known symptoms. The infectious nature of the disease was known to 39.9%. The majority believed that the disease spreads by mosquito bites (72.8%). For 63.6%, the breeding site of the vector was garbage collection. Only 23.6% preferred the public health sector for treatment, and 55.9% believed that facilities at primary health centers are not adequate. Poor knowledge of the study subjects about the disease and breeding sites of the vector underscores the need for health educational campaigns if the elimination program is to succeed.
PREVALENCE OF HIV AND SYPHILIS IN PREGNANT WOMEN IN LEÓN, NICARAGUA
Authors: HOEKSTRA CARLIJN E. L. , RIEDIJK MARTIENE , MATUTE ARMANDO J. , HAK EELKO , DELGADO EDGAR , ALONSO ROSA E. , BENAVIDES MARIA D. , VAN LOON ANTON M. , HOEPELMAN ILJA M.
Published: September 2018

The objective of this study was to determine the prevalence of HIV and syphilis and to identify risk factors among pregnant women visiting antenatal clinics in León, Nicaragua. During February to April 2004, blood samples from pregnant women were collected after written consent had been obtained. The samples were tested for antibodies against HIV and Treponema pallidum. A questionnaire was also completed. In total, 1,059 women were included. Antibodies against HIV were not detected in any of the women, whereas antibodies against T. pallidum were detected in 16 (1.5%). Risk factors for syphilis included illiteracy, lower education, and two or more pregnancies. HIV does not seem to be highly prevalent among pregnant women in León (prevalence, 0%; 95% CI, 0.0–0.3). The higher proportion of women infected with syphilis than found in earlier studies suggests that sexually transmitted diseases are circulating in the general population and highlights the increasing importance of HIV prevention.
CHANGING PATTERNS OF PLASMODIUM BLOOD-STAGE INFECTIONS IN THE WOSERA REGION OF PAPUA NEW GUINEA MONITORED BY LIGHT MICROSCOPY AND HIGH THROUGHPUT PCR DIAGNOSIS
Authors: KASEHAGEN LAURIN J. , MUELLER IVO , McNAMARA DAVID T. , BOCKARIE MOSES J. , KINIBORO BENSON , RARE LAWRENCE , LORRY KERRY , KASTENS WILL , REEDER JOHN C. , KAZURA JAMES W. , ZIMMERMAN PETER A.
Published: September 2018

In Papua New Guinea (PNG), complex patterns of malaria commonly include single and mixed infections of Plasmodium falciparum, P. vivax, P. malariae, and P. ovale. Here, we assess recent epidemiologic characteristics of Plasmodium blood-stage infections in the Wosera region through four cross-sectional surveys (August 2001 to June 2003). Whereas previous studies performed here have relied on blood smear/light microscopy (LM) for diagnosing Plasmodium species infections, we introduce a newly developed, post-polymerase chain reaction (PCR), semi-quantitative, ligase detection reaction-fluorescent microsphere assay (LDR-FMA). A direct comparison of the two methods for > 1,100 samples showed that diagnosis was concordant for > 80% of the analyses performed for P. falciparum (PF), P. vivax (PV), and P. malariae (PM). Greater sensitivity of the LDR-FMA accounted for 75% of the discordance between diagnoses. Based on LM, the prevalence of blood-stage PF, PV, and PM infections was found to be markedly reduced compared with an early 1990s survey. In addition, there were significant shifts in age distribution of infections, with PV becoming the most common parasite in children < 4 years of age. Consistent with previous studies, prevalence of all Plasmodium species infections increased significantly in samples analyzed by the PCR-based LDR-FMA. This increase was most pronounced for PM, PO, and mixed infections and in adolescent (10–19 years) and adult age groups, suggesting that LM may lead to under-reported prevalence of less common Plasmodium species, infection complexity, and a skewed distribution of infections towards younger age groups. This study shows that the application of LDR-FMA diagnosis in large epidemiologic studies or malaria control interventions is feasible and may contribute novel insights regarding the epidemiology of malaria.
EXPERIMENTAL INFECTION OF THE NEOTROPICAL MALARIA VECTOR ANOPHELES DARLINGI BY HUMAN PATIENT-DERIVED PLASMODIUM VIVAX IN THE PERUVIAN AMAZON
Authors: BHARTI AJAY R. , CHUQUIYAURI RAUL , BROUWER KIMBERLY C. , STANCIL JEFFREY , LIN JESSICA , LLANOS-CUENTAS ALEJANDRO , VINETZ JOSEPH M.
Published: September 2018

Malaria transmission from humans to mosquitoes is modulated by human host immune factors. Understanding mechanisms by which the human host response may impair parasite infectivity for mosquitoes has direct implications for the development of transmission-blocking vaccines. We hypothesized that despite a low transmission intensity of malaria in the Peruvian Amazon region of Iquitos, transmission-blocking immunity against Plasmodium vivax might be common, given an unexpectedly high proportion of asymptomatic parasitemic individuals in this region. To test this hypothesis, the ability of symptomatic P. vivax malaria patients to experimentally infect wild-caught outbred Anopheles darlingi mosquitoes was tested using the indirect membrane feeding technique. Only half (52/102) of P. vivax parasitemic patients successfully infected mosquitoes. Transmitters were more likely to have gametocytes (OR 6.35, P = 0.003), high parasitemia (OR 3.79, P = 0.024), and, in terms of basic clinical parameters, a slower pulse rate (mean ± SD: 82.3 ± 12.3 versus 88.7 ± 13.5, P = 0.016) than non-transmitters. Log10 gametocytemia and log10 real-time reverse transcriptase Pvs25 PCR quantifying gametocytes were significantly and positively correlated with oocyst counts (correlation coefficient 0.505, R2 = 0.26, P = 0.001). These experiments are the first to establish a system of determining transmission patterns in experimental infection of outbred natural neotropical malaria vectors in the Amazon region. Patients with P. vivax inefficiently infect outbred An. darlingi mosquitoes, raising the possibility that some degree of naturally occurring transmission-blocking immunity is present on a population basis in the Peruvian Amazon, an area of low intensity of malaria transmission.
DIVERSITY AND ECOLOGY OF SAND FLIES (DIPTERA: PSYCHODIDAE: PHLEBOTOMINAE) IN COASTAL FRENCH GUIANA
Authors: ROTUREAU BRICE , GABORIT PASCAL , ISSALY JEAN , CARINCI ROMUALD , FOUQUE FLORENCE , CARME BERNARD
Published: September 2018

In French Guiana, at least five Leishmania species are known to be sympatically transmitted in sylvatic ecotopes. However, the previous surveys on the phlebotomine sand fly fauna were published 20 years ago. During that period, many ecological changes have occurred. Sand fly collections were conducted with CDC light traps in five stations representing the main ecotopes of French Guiana. A total of 817 sand flies belonging to 2 genera, 18 sub-genera, and 46 different species were identified. The species Lutzomyia umbratilis (16.6% of the collected specimens), Lu. infraspinosa (12.7%), Lu. ininii (8.0%), and Lu. flaviscutellata (6.1%) were the most common species. The stratification by height, activity period, and resting site preferences of the most abundant sand flies were analyzed. Population abundance and diversity were compared for each ecotope. The potential of certain sand fly species in leishmaniasis transmission is discussed.
BURDEN OF MALARIA AT COMMUNITY LEVEL IN CHILDREN LESS THAN 5 YEARS OF AGE IN TOGO
Authors: ELIADES M. JAMES , WOLKON ADAM , MORGAH KODJO , CRAWFORD SARA B. , DORKENOO AMEYO , SODAHLON YAO , HAWLEY WILLIAM A. , HIGHTOWER ALLEN W. , KUILE FEIKO O. TER , TERLOUW DIANNE J.
Published: September 2018

A community-based baseline cross-sectional survey was conducted in three districts in Togo in September 2004 as part of a multidisciplinary evaluation of the impact of the Togo National Integrated Child Health Campaign. During this campaign, long-lasting-insecticide-treated bed nets (LLITNs) were distributed to households with children between 9 months and 5 years of age throughout the country in December 2004. The pre-intervention survey provided baseline malaria and anemia prevalence in children < 5 years of age during peak malaria transmission. Of 2,532 enrolled children from 1,740 households, 62.2% (1,352/2,172) were parasitemic and 84.4% (2,129/2,524) were anemic (hemoglobin < 11 g/dL). Moderate-to-severe anemia (< 8.0 g/dL) was found in 21.7% (543/2,524), with a peak prevalence in children 6–17 months of age and was strongly correlated with parasitemia (OR = 2.3, 95% CI: 1.8–2.5). Net ownership (mainly untreated) was 225/2,532 (8.9%). Subsequent nation-wide introduction of LLITNs and the introduction of artemisinin-based combination therapy have the potential to markedly reduce this burden of malaria.
A RANDOMIZED TRIAL OF ARTESUNATE–SULFAMETHOXYPYRAZINE–PYRIMETHAMINE VERSUS ARTEMETHER–LUMEFANTRINE FOR THE TREATMENT OF UNCOMPLICATED PLASMODIUM FALCIPARUM MALARIA IN MALI
Authors: SAGARA ISSAKA , DICKO ALASSANE , DJIMDE ABDOULAYE , GUINDO OUSMANE , KONE MAMADY , TOLO YOUSSOUF , THERA MAHAMADOU A. , SOGOBA MOUSSA , FOFANA MOUSSA , OUATTARA AMED , SISSOKO MADY , JANSEN HERWIG F. , DOUMBO OGOBARA K.
Published: September 2018

The choice of artemisinin-based combination that is being adopted for malaria treatment in sub-Saharan Africa may depend on several factors, including cost, efficacy, side effects, and simplicity of administration. We tested the hypothesis that artesunate–sulfamethoxypyrazine–pyrimethamine is as efficacious as the four-dose regimen of artemether–lumefantrine for treatment of Plasmodium falciparum malaria. The study was carried out during two transmission seasons (2003 and 2004) in Sotuba, Mali. Participants at least 6 months of age with uncomplicated P. falciparum malaria were randomly assigned to receive artesunate–sulfamethoxypyrazine–pyrimethamine or artemether–lumefantrine. Treatment efficacy was assessed using the World Health Organization 28-day protocol. A total of 606 (303 in each arm) patients were enrolled. The cure rate was higher for artesunate–sulfamethoxypyrazine–pyrimethamine than for artemether–lumefantrine (98.7% versus 89.6%; P < 0.0001). After correction for cases of re-infection, the cure rates were 100% and 99.0%, respectively (P = 0.08). No serious adverse events occurred. Artesunate–sulfamethoxypyrazine–pyrimethamine is well-tolerated and effective against P. falciparum malaria. It showed an additional benefit of preventing new infections.
IN VITRO ACTIVITY OF ARTEMISONE COMPARED WITH ARTESUNATE AGAINST PLASMODIUM FALCIPARUM
Authors: RAMHARTER MICHAEL , BURKHARDT DOMINIK , NEMETH JOHANNES , ADEGNIKA AYOLA A. , KREMSNER PETER G.
Published: September 2018

Artemisinins show the potential for neurotoxicity in preclinical studies. Artemisone is a leading candidate of second-generation semi-synthetic artemisinin derivatives for antimalarial therapy devoid of neurotoxicity. Artemisone showed 3–5-fold higher in vitro activity (50% effective concentration (EC50) = 0.14 nmol/L, EC90 = 2.55 nmol/L) than artesunate against fresh Plasmodium falciparum isolates from Gabon and a high-activity correlation indicates a shared drug target.
THERAPEUTIC EFFICACY OF QUININE PLUS SULFADOXINE-PYREMETHAMINE FOR THE TREATMENT OF UNCOMPLICATED FALCIPARUM MALARIA IN BANGLADESH
Authors: THRIEMER KAMALA , HAQUE RASHIDUL , WAGATSUMA YUKIKO , SALAM MOHAMMED ABDUS , AKTHER SELIM , ATTLMAYR BERNHARD , FUKUDA MARK , SCHAECHER KURT , MILLER R. SCOTT , NOEDL HARALD
Published: September 2018

In terms of drug resistance Bangladesh acts as an important gateway to the Indian Subcontinent. However, little is known about the current status of drug resistance in this country. The aim of this study was therefore to determine the therapeutic efficacy as well as in vitro drug sensitivity of quinine for 3 days plus a single dose of sulfadoxine/pyrimethamine (Q3F), an affordable alternative to the previously used chloroquine, for the treatment of uncomplicated falciparum malaria. Sixty-three patients were enrolled in the study; the overall cure rate in a 42-day follow-up after PCR adjustment was 87.3% (95% CI: 77.6–94.1). One patient was classified as early treatment failure (1.7%, 95% CI: 0.0–8.9%); 6 patients (10%; 95% CI: 3.8–20.5%) had late treatment failures within a median time of 27 days. HRP2 in vitro drug sensitivity tests were performed on all samples. Significantly higher (P = 0.008) in vitro IC50s for pyrimethamine in treatment failures reflect the somewhat compromised drug sensitivity to this drug. These data suggest that the combination of 3 days of quinine with a single dose of sulfadoxine/pyrimethamine is an interesting and affordable alternative as long as or whenever ACT is not available.
MULTILOCUS ENZYME ELECTROPHORESIS SUPPORTS SPECIATION WITHIN THE ANOPHELES NILI GROUP OF MALARIA VECTORS IN CAMEROON
Authors: AWONO-AMBENE HERMAN P. , SIMARD FRÉDÉRIC , ANTONIO-NKONDJIO CHRISTOPHE , COHUET ANNA , KENGNE PIERRE , FONTENILLE DIDIER
Published: September 2018

Multilocus enzyme analysis of the genetic variability and population structure was conducted among three malaria vector species of the Anopheles nili group in Cameroon: An. nili, An. carnevalei, and the recently described An. ovengensis. We detected species-specific alleles and large differences in shared allele frequencies at six of nine loci (e.g., PGM, GOT1, IDH1, IDH2, PGI, and α-GPD). This non-random distribution of alleles leads to high and significant values of differentiation indexes (0.569 < Fst < 0.874, P < 10−4). These results fully agree with standard morphologic descriptions, and therefore provide further support for recent taxonomic classification within the An. nili group.
SCABIES MITE INACTIVATED SERINE PROTEASE PARALOGUES ARE PRESENT BOTH INTERNALLY IN THE MITE GUT AND EXTERNALLY IN FECES
Authors: WILLIS CHARLENE , FISCHER KATJA , WALTON SHELLEY F. , CURRIE BART J. , KEMP DAVID J.
Published: September 2018

The scabies mite, Sarcoptes scabiei, is the causative agent of scabies, a disease that is common among disadvantaged populations and facilitates streptococcal infections with serious sequelae. Previously, we encountered large families of genes encoding paralogues of house dust mite protease allergens with their catalytic sites inactivated by mutation (scabies mite inactivated protease paralogues [SMIPPs]). We postulated that SMIPPs have evolved as an adaptation to the parasitic lifestyle of the scabies mite, functioning as competitive inhibitors of proteases involved in the host–parasite interaction. To propose testable hypotheses for their functions, it is essential to know their locations in the mite. Here we show by immunohistochemistry that SMIPPs exist in two compartments: 1) internal to the mite in the gut and 2) external to the mite after excretion from the gut in scybala (fecal pellets). SMIPPs may well function in both of these compartments to evade host proteases.
WEST NILE VIRUS QUANTIFICATION IN FECES OF EXPERIMENTALLY INFECTED AMERICAN AND FISH CROWS
Authors: KIPP AARON M. , LEHMAN JENNIFER A. , BOWEN RICHARD A. , FOX PATRICIA E. , STEPHENS MICHAEL R. , KLENK KACI , KOMAR NICHOLAS , BUNNING MICHEL L.
Published: September 2018

To better understand the potential environmental health risk presented by West Nile virus (WNV)-contaminated feces, we quantified the amount of WNV present in the feces of experimentally infected American crows (Corvus brachyrhynchos) and fish crows (Corvus ossifragus). Peak fecal titers ranged from 103.5 to 108.8 plaque-forming units (PFU)/g for 10 American crows and from 102.3 to 106.4 PFU/g for 10 fish crows. The presence of infectious WNV in bird feces indicates a potential for direct transmission of WNV. Thus, handlers of sick or dead birds should take appropriate precautions to avoid exposure to fecal material.
EXPERIMENTAL INFECTION OF FOX SQUIRRELS (SCIURUS NIGER) WITH WEST NILE VIRUS
Authors: ROOT J. JEFFREY , OESTERLE PAUL T. , NEMETH NICOLE M. , KLENK KACI , GOULD DANIEL H. , MCLEAN ROBERT G. , CLARK LARRY , HALL JEFFREY S.
Published: September 2018

Tree squirrels (Sciurus spp.) have exhibited high seroprevalence rates, suggesting that they are commonly exposed to West Nile virus (WNV). Many characteristics of WNV infections in tree squirrels, such as the durations and levels of viremia, remain unknown. To better understand WNV infections in fox squirrels (S. niger), we subcutaneously inoculated fourteen fox squirrels with WNV. Peak viremias ranged from 104.00 plaque-forming units (PFU)/mL of serum on day 2 post-infection (DPI) to 104.98 PFU/mL on 3 DPI, although viremias varied between individuals. Oral secretions of some fox squirrels were positive for WNV viral RNA, occasionally to moderate levels (103.2 PFU equivalent/swab). WNV PFU equivalents in organs were low or undetectable on 12 DPI; gross and histologic lesions were rare. The viremia profiles of fox squirrels indicate that they could serve as amplifying hosts in nature. In addition, viral RNA in the oral cavity and feces indicate that this species could contribute to alternative WNV transmission in suburban communities.
MOLECULAR DETECTION OF RICKETTSIA FELIS, RICKETTSIA TYPHI AND TWO GENOTYPES CLOSELY RELATED TO BARTONELLA ELIZABETHAE
Authors: DE SOUSA RITA , EDOUARD-FOURNIER PIERRE , SANTOS-SILVA MARGARIDA , AMARO FATIMA , BACELLAR FATIMA , RAOULT DIDIER
Published: September 2018

A total of 56 fleas were collected from mice, rats, and one hedgehog in national parks of mainland Portugal and the Madeira Island. All fleas were tested for the presence of bacteria of the genera Rickettsia and Bartonella using PCR assays. In fleas from mainland Portugal, we detected Rickettsia felis in one Archaeopsylla erinacei maura flea and in one Ctenophtalmus sp. In five Leptopsylla segnis fleas taken from rats in the Madeira Island, we identified Rickettsia typhi. In addition, in four fleas from the genera Ornithophaga and Stenoponia collect from mice and a rat in mainland Portugal, we detected the presence of two new Bartonella genotypes closely related to Bartonella elizabethae. Our findings emphasize the potential risk of flea-transmitted infections in mainland Portugal and the Madeira archipelago, and extend our knowledge of the potential flea vectors of human pathogens.
IMMUNOLOGIC TESTS IN PATIENTS AFTER CLINICAL CURE OF VISCERAL LEISHMANIASIS
Authors: DE ALMEIDA SILVA LUCIANA , ROMERO HÉCTOR DARDO , PRATA ALUÍZIO , COSTA ROBERTO TEODORO , NASCIMENTO EVALDO , CARVALHO SÍLVIO FERNANDES GUIMARÃES , RODRIGUES VIRMONDES
Published: September 2018

The results of five serologic tests (ELISA using promastigote antigen [ELISAp] and recombinant K39 [ELISArK39] and K26 [ELISArK26] antigens, indirect immunofluorescence test using promastigote antigen [IIFT], and immunochromatographic tests using the rK39 antigen [TRALd]) and of the Montenegro skin test (MST) were analyzed in 41 individuals treated for kala-azar and living in Porteirinha, Minas Gerais, Brazil. The tests were carried out 1 week to 12 years after specific treatment. All MSTs during the 8 months after treatment were negative, whereas after 1 year, 28 (84.8%) were positive. Negativity in all serologic tests was observed for 11 (26.8%) of the 41 individuals, whereas positivity in at least one test was observed for 70.3% of subjects evaluated ≥ 2 years after treatment. With respect to each exam, positivity was 38.0% for TRALd, 61.9% for ELISA rK39, 47.6% for ELISA rK26, 38.0% for ELISAp, and 40.5% for IIFT. None of the individuals presented recurrence of the disease during the 4 years of follow-up. The tests were repeated in 24 of the 41 individuals, after some time, and the results were the same in 33.3% of the cases. We conclude that serological tests for kala-azar might continue to be positive after treatment of the disease, although this does not indicate a poor prognosis or a poor therapeutic response.
LOSS OF LEISHMANIN SKIN TEST ANTIGEN SENSITIVITY AND POTENCY IN A LONGITUDINAL STUDY OF VISCERAL LEISHMANIASIS IN BANGLADESH
Authors: BERN CARYN , AMANN JOSEF , HAQUE RASHIDUL , CHOWDHURY RAJIB , ALI MUSTAKIM , KURKJIAN KATIE M. , VAZ LOUISE , WAGATSUMA YUKIKO , BREIMAN ROBERT F. , SECOR W. EVAN , MAGUIRE JAMES H.
Published: September 2018

Annual leishmanin skin test (LST) surveys were conducted in a visceral leishmaniasis-endemic Bangladeshi community from 2002 through 2004, using Leishmania infantum antigen from the same manufacturer and batch. In 2002, 530 (35%) of 1,532 had positive LST results; the prevalence increased with increasing age. The LST result was positive in 24 (51%) of 47, 18 (72%) of 25, and 11 (85%) of 13 kala-azar patients treated in the previous 1–11, 12–23, and 24–35 months. A positive LST result in 2002 was associated with protection against subsequent kala-azar (P < 0.0001). In 2003–2004, decreased antigen sensitivity was observed. Among 686 participants, 34% were LST-positive in 2002, 29% in 2003, and 19% in 2004. Of 63 cured kala-azar patients, 70% were positive in 2002, 53% in 2003, and only 30% in 2004. Among 171 participants tested with both antigens, L. infantum study antigen sensitivity was 70% compared with L. amazonensis antigen. Our data underscore the need for better production, standardization, and documentation of sensitivity, potency, and stability of leishmanin antigens.
INCIDENCE, ETIOLOGY, AND IMPACT OF DIARRHEA AMONG DEPLOYED US MILITARY PERSONNEL IN SUPPORT OF OPERATION IRAQI FREEDOM AND OPERATION ENDURING FREEDOM
Authors: MONTEVILLE MARSHALL R. , RIDDLE MARK S. , BAHT USHA , PUTNAM SHANNON D. , FRENCK ROBERT W. , BROOKS KENNETH , MOUSTAFA MANAL , BLAND JAIME , SANDERS JOHN W.
Published: September 2018

A health assessment survey was collected from US military personnel deployed to the Middle East taking part in the “Rest and Recuperation” program or on temporary assignment to Camp As Sayliyah Doha, Qatar, from January to December 2004. In addition, a concurrent clinic-based observational study was conducted to determine pathogen etiology and potential risk factors. From 28,322 health assessment surveys, overall self-reported incidence of diarrhea was 4.9 cases per 100 person-months. Disease incidence increased with rank and was higher in Iraq compared with Afghanistan. During this period, 109 US military personnel with acute diarrhea and 85 asymptomatic personnel were enrolled in the observational study. Enterotoxigenic E. coli (ETEC) was the predominant pathogen (32%), followed by enteroaggregative E. coli (12%) and Salmonella spp. (6%). These data are consistent with previous reports implicating ETEC as the primary cause of acute diarrhea for military personnel deployed to this region.
BCG VACCINE EFFECTIVENESS AGAINST BURULI ULCER: A CASE-CONTROL STUDY IN BENIN
Authors: NACKERS FABIENNE , DRAMAIX MICHÈLE , JOHNSON ROCH CHRISTIAN , ZINSOU CLAUDE , ROBERT ANNIE , DE BIURRUN BAKEDANO ELISA , GLYNN JUDITH R. , PORTAELS FRANÇOISE , TONGLET RENÉ
Published: September 2018

BCG remains the only possible prophylactic intervention against Buruli ulcer (BU). Estimating its public health impact on BU control is an important issue. We conducted a case-control study to investigate the vaccine effectiveness of routine BCG vaccine against BU in southern Benin. From August 2002 to August 2003, BCG vaccination status was obtained for 279 clinically diagnosed BU cases and 988 age- and sex-matched neighborhood controls. BCG coverage, which was estimated by the presence of a scar or a vaccination record, was 64.5% in cases and 67.2% in controls. There was no evidence of a protective effect of routine BCG vaccination against BU in southern Benin (vaccine effectiveness adjusted for socioeconomic status = 12%, 95% confidence interval = −24% to 37%).
SURVEY OF COMMUNITY KNOWLEDGE, ATTITUDES, AND PRACTICES DURING A MALARIA EPIDEMIC IN CENTRAL JAVA, INDONESIA
Authors: SANJANA PARSA , BARCUS MAZIE J. , BANGS MICHAEL J. , OMPUSUNGGU SAHAT , ELYAZAR IQBAL , MARWOTO HARIJANI , TUTI SEKAR , SURURI MOHAMMED , TJOKROSONTO SOESANTO , BAIRD J. KEVIN
Published: September 2018

We surveyed adults in a randomly selected sample of 1,000 households in 50 villages in nine malarial sub-districts in Purworejo, central Java, Indonesia from May to July 2001. The survey assessed malaria knowledge, attitudes, and practices in communities experiencing epidemic malaria to begin exploring broad strategies for controlling the disease in the region. A pre-tested survey instrument consisting of 93 questions addressed demographic characteristics, socioeconomic factors, knowledge and perceptions of malaria, burden and severity of disease, treatment-seeking behavior, malaria prevention practices, and perceptions of government malaria control efforts. The survey was taken by in-person interview of all subjects. Most (97%) subjects were aware of malaria and more than two-thirds correctly identified mosquitoes as the vector. Forty-one percent of households in both forest/hilly and agricultural/urban areas reported malaria illness in the past year. Thirty-six percent (357 households) owned at least one bed net, 92% of these had been purchased by the owners. However, only 36% of households with bed nets affirmed their use as a means of preventing malaria. Nearly all respondents reported a willingness to accept spraying of residual insecticides for malaria prevention, yet less than 5% were willing to pay a nominal fee (US $3) for this service. Fifty-two percent of respondents reported self-treatment of malaria illness without visiting a health facility. This assessment of knowledge, attitudes, and practices showed a broad awareness of malaria and its consequences among residents of malarial areas in the Menoreh Hills of Central Java.
CHARACTERIZATION OF COUNTERFEIT ARTESUNATE ANTIMALARIAL TABLETS FROM SOUTHEAST ASIA
Authors: HALL KRYSTYN ALTER , NEWTON PAUL N. , GREEN MICHAEL D. , DE VEIJ MARLEEN , VANDENABEELE PETER , PIZZANELLI DAVID , MAYXAY MAYFONG , DONDORP ARJEN , FERNANDEZ FACUNDO M.
Published: September 2018

In southeast Asia, the widespread high prevalence of counterfeits tablets of the vital antimalarial artesunate is of great public health concern. To assess the seriousness of this problem, we quantified the amount of active ingredient present in artesunate tablets by liquid chromatography coupled to mass spectrometry. This method, in conjunction with analysis of the packaging, classified tablets as genuine, substandard, or fake and validated results of the colorimetric Fast Red TR test. Eight (35%) of 23 fake artesunate samples contained the wrong active ingredients, which were identified as different erythromycins and paracetamol. Raman spectroscopy identified calcium carbonate as an excipient in 9 (39%) of 23 fake samples. Multivariate unsupervised pattern recognition results indicated two major clusters of artesunate counterfeits, those with counterfeit foil stickers and containing calcium carbonate, erythromycin, and paracetamol, and those with counterfeit holograms and containing starch but without evidence of erythromycin or paracetamol.
SEVERE PLASMODIUM FALCIPARUM MALARIA IN CAMEROON: ASSOCIATED WITH THE GLUTATHIONE S-TRANSFERASE M1 NULL GENOTYPE
Authors: KAVISHE REGINALD A. , KOENDERINK JAN B. , MCCALL MATTHEW B.B. , PETERS WILBERT H.M. , MULDER BERT , HERMSEN CORNELUS C. , SAUERWEIN ROBERT W. , RUSSEL FRANS G.M. , VAN DER VEN ANDRE J.A.M.
Published: September 2018

Glutathione S-transferases (GST) are a family of enzymes involved in phase-II detoxification of endogenous and xenobiotic compounds. Polymorphisms in GST genes have been associated with susceptibility to different diseases. In this study we determined the frequencies of polymorphisms in GSTM1, GSTT1, and GSTP1 in DNA of 138 children from Cameroon, presenting with uncomplicated malaria (N = 19), malaria with minor complications (N = 81), or severe malaria (N = 38). Analyses of GSTM1 and GSTT1 were performed using PCR-multiplex procedure, while GSTP1 was done by PCR-RFLP. Subjects presenting with malaria with complications were found more often of the GSTM1-null genotype (58–64%) as compared with those with uncomplicated malaria (32%), a difference that was statistically significant. We conclude that the GSTM1-null genotype is associated with malaria with complications.
FACTORS AFFECTING INFECTION OR REINFECTION WITH SCHISTOSOMA HAEMATOBIUM IN COASTAL KENYA: SURVIVAL ANALYSIS DURING A NINE-YEAR, SCHOOL-BASED TREATMENT PROGRAM
Authors: SATAYATHUM SUDTIDA A. , MUCHIRI ERIC M. , OUMA JOHN H. , WHALEN CHRISTOPHER C. , KING CHARLES H.
Published: September 2018

Urinary schistosomiasis remains a significant burden for Africa and the Middle East. Success of regional control strategies will depend, in part, on what influence local environmental and behavioral factors have on individual risk for primary infection and/or reinfection. Based on experience in a multi-year (1984–1992), school-based Schistosoma haematobium control program in Coast Province, Kenya, we examined risk for infection outcomes as a function of age, sex, pretreatment morbidity, treatment regimen, water contact, and residence location, with the use of life tables and Cox proportional-hazards analysis. After adjustment, location of residence, age less than 12 years, pretreatment hematuria, and incomplete treatment were the significant independent predictors of infection, whereas sex and frequency of water contact were not. We conclude that local physical features and age-related factors play a predominant role in S. haematobium transmission in this setting. In large population-based control programs, treatment allocation strategies may need to be tailored to local conditions on a village-by-village basis.
IDENTIFICATION OF A NOVEL GENE ENCODING A SECRETED ANTIGEN 1 OF BABESIA GIBSONI AND EVALUATION OF ITS USE IN SERODIAGNOSIS
Authors: JIA HONGLIN , ZHOU JINLIN , IKADAI HIROMI , MATSUU AYA , SUZUKI HIROSHI , IGARASHI IKUO , FUJISAKI KOZO , XUAN XUENAN
Published: September 2018

Serum from a dog immunized with blood plasma from a B. gibsoni-infected dog, putatively containing secreted antigens, was used to screen a cDNA expression library. A novel gene encoding BgSA1 was identified from the isolated clones. The serum raised in mice immunized with the recombinant BgSA1 expressed in Escherichia coli could recognize a native parasite protein with a molecular mass of 59 kDa. Comparing with the previously established ELISA with recombinant P50 as antigen, the ELISA with recombinant BgSA1 as the antigen was more sensitive when they were used to detect field samples. Moreover, a sandwich ELISA with anti-BgSA1 antibodies could detect the circulating BgSA1 in a serial blood plasma from a dog experimentally infected with B. gibsoni. These results indicated that BgSA1 could be a useful target for the development of a diagnostic test for the detection of specific antibodies and circulating antigens.
CRYPTOSPORIDIUM HOMINIS: EXPERIMENTAL CHALLENGE OF HEALTHY ADULTS
Authors: CHAPPELL CYNTHIA L. , OKHUYSEN PABLO C. , LANGER-CURRY REBECCA , WIDMER GIOVANNI , AKIYOSHI DONNA E. , TANRIVERDI SULTAN , TZIPORI SAUL
Published: September 2018

Cryptosporidium hominis causes diarrhea in humans and has been associated with community outbreaks. This study describes the infectivity, illness, and serologic response after experimental challenge of 21 healthy adult volunteers with 10–500 C. hominis (TU502) oocysts. Sixteen subjects (76.2%) had evidence of infection; the 50% infectious dose (ID50) was estimated to be 10–83 oocysts using clinical and microbiologic definitions of infection, respectively. Diarrhea occurred in 40% of subjects receiving 10 oocysts with a stepwise increase to 75% in those receiving 500 oocysts. A serum IgG response was seen in those receiving more than 30 oocysts. Greatest responses were seen in volunteers with diarrhea and oocyst shedding. Volunteers with no evidence of infection had indeterminant or negative IgG responses. Cryptosporidium hominis10 oocysts) and is clinically is infectious for healthy adults (ID50 = similar to C. parvum-induced illness. In contrast to C. parvum, C. hominis elicted a serum IgG response in most infected persons.
CHANGES IN BACTERIAL PROFILE DURING AMEBIASIS: DEMONSTRATION OF ANAEROBIC BACTERIA IN ALA PUS SAMPLES
Authors: RANI REKHA , MURTHY R.S. , BHATTACHARYA SUDHA , AHUJA VINEET , RIZVI M.A. , PAUL JAISHREE
Published: September 2018

Little is known about the changes in gut resident flora during amebic colitis and amebic liver abscess (ALA) caused by Entamoeba histolytica infection. Fecal samples from ALA patients, from healthy E. histolytica negative and positive (asymptomatic) individuals, and from pre- and post-metronidazole–treated healthy volunteers and pus samples from ALA patients were tested for the presence of various bacterial genera using 16S rRNA–based primers. Statistically significant reduction in Lactobacillus due to E. histolytica infection was observed in asymptomatic individuals and ALA patients. On the other hand, reduction in Bacteroides, Bifidobacterium, and Clostridium in the same samples was due to metronidazole treatment. Two anaerobic genera, viz. Bacteroides and Peptostreptococcus, were detected in ALA pus samples, and this observation is unprecedented. In addition, PCR revealed metronidazole resistance genes in fecal and pus samples of metronidazole-treated individuals. Re-examination of the ameba-bacterium relationship in amebiasis is suggested.
TRIATOMA INFESTANS CHOOSES TO FEED UPON IMMUNE PREY
Authors: HECHT MARIANA M. , BUSSACOS ANA CAROLINA , LOZZI SILENE P. , SANTANA JAIME M. , TEIXEIRA ANTONIO R.L.
Published: September 2018

Blood-feeding Triatoma infestans obtained its fills from immune chickens in 15 min, but it needed 40 min for feeding upon non-immune chickens. High-titer specific IgGs and skin reactivity against T. infestans saliva antigens were elicited in immune chickens. Fluorescence-labeled leukocytes from non-immune or immune chickens were used to determine sources of blood drawn by equal numbers of triatomines distributed in separate compartments of a hut-like box. It was shown that 64.4 ± 4.7% of the reduviids were captured in the immune chicken room; 35.6 ± 4.5% were present in the non-immune chicken dwelling, and these differences were statistically significant (P < 0.001). Furthermore, T. infestans feeding upon immune birds reached the adult stage 40 days before those feeding upon non-immune birds, and differences were statistically significant. These results appear to have a broad epidemiologic significance as for spreading enzootics; hence, the immunologic status of vertebrate host populations appears to favor T. infestans as the main transmitter of Trypanosoma cruzi.
CD4+ T-CELL COUNTS, CD4+/CD8+ T-CELL COUNT RATIOS, AND ANTIBODY LEVELS IN MIGRANT FISHERMEN INFECTED WITH SCHISTOSOMA JAPONICUM IN THE DONGTING LAKE, CHINA
Authors: LI YUESHENG , ZENG QINREN , ELLIS MAGDA K. , XIONG TIE , BALEN JULIE , MCMANUS DONALD P.
Published: September 2018

In this study, CD4+ and CD8+ T cells and antibody levels were measured in 94 migrant fishermen infected with Schistosoma japonicum from Dongting Lake, China. Prevalence among these fishermen was high (63.8%), with a mean infection intensity of 61.4 ± 3.8 epg, and included a high proportion of individuals (39.4%) with substantial parenchymal fibrosis (stages ≥ 2/3). The CD4+/CD8+ ratio in men (1.34 ± 0.11) was significantly lower than that of women (1.58 ± 0.15). CD4+ T cells and the ratio of CD4+/CD8+ were significantly decreased both in subjects infected with S. japonicum and those with parenchymal fibrosis. However, levels of total IgA, IgM, and anti-schistosome egg antigen IgG correlated positively with infection intensity and pathologic lesion number. These results suggest an imbalance between cell-mediated and humoral immunity in these fishermen, the precise cause of which remains undetermined.
DOSE-RANGING STUDY FOR TRIALS OF THERAPEUTIC INFECTION WITH NECATOR AMERICANUS IN HUMANS
Authors: MORTIMER KEVIN , BROWN ALAN , FEARY JOHANNA , JAGGER CHRIS , LEWIS SARAH , ANTONIAK MARILYN , PRITCHARD DAVID , BRITTON JOHN
Published: September 2018

Epidemiological studies suggest that a hookworm infection producing 50 eggs/gram of feces may protect against asthma. We conducted a dose-ranging study to identify the dose of hookworm larvae necessary to achieve 50 eggs/gram of feces for therapeutic trials of asthma. Ten healthy subjects without asthma or airway hyperresponsiveness to inhaled methacholine received 10, 25, 50, or 100 Necator americanus larvae administered double blind to an area of skin on the arm. Subjects were seen weekly for 12 weeks and were then treated with mebendazole. Skin itching at the entry site and gastrointestinal symptoms were common at higher doses. Lung function did not change. Levels of blood eosinophils and IgE increased transiently, and levels of IgG increased progressively. All doses resulted in at least 50 eggs/gram of feces in the eight subjects who completed the study. Infection with 10 N. americanus larvae is well tolerated, elicits a modest host eosinophil response, and is potentially suitable for use in preliminary clinical therapeutic trials.
ASSOCIATION OF MACROPHAGE INFLAMMATORY RESPONSE AND CELL DEATH AFTER IN VITRO BORRELIA BURGDORFERI INFECTION WITH ARTHRITIS RESISTANCE
Authors: GLICKSTEIN LISA J. , COBURN JENIFER L.
Published: September 2018

Susceptibility to Borrelia burgdorferi infection and subsequent arthritis is genetically determined in mice and determined by innate immunity. Accordingly, macrophage responses to B. burgdorferi challenge may differ between mouse strains. Bone marrow–derived macrophages were infected ex vivo with clonal B. burgdorferi strain N40. Interleukin-12 and tumor necrosis factor-α (TNF-α) production were higher in macrophages from resistant C57Bl/6 mice than in macrophages from susceptible C3H/HeJ mice. However, TNF-α production was observed in lower concentrations in C3H/HeJ (toll-like receptor-4−/−) macrophages than in C3H/FeJ (TLR4+/+) macrophages, suggesting that TLR4 might contribute to the response to B. burgdorferi. A higher cytokine response to B. burgdorferi was associated with cell death in macrophages from resistant C57Bl/6 mice. Understanding variability in the response of macrophages to B. burgdorferi may contribute to understanding Lyme arthritis.
RISK FACTORS ASSOCIATED WITH DIARRHEA AMONG INTERNATIONAL VISITORS TO CUZCO, PERU
Authors: CABADA MIGUEL M. , MALDONADO FERNANDO , QUISPE WANDA , MOZO KAREN , SERRANO EDSON , GONZÁLEZ ELSA , SEAS CARLOS , VERDONCK KRISTIEN , ECHEVARRIA JUAN I. , DUPONT HERBERT L. , GOTUZZO EDUARDO
Published: September 2018

The objective of this study was to determine the risk factors for travelers’ diarrhea (TD) reported by visitors to Cuzco, Peru. In this cross-sectional study, self-administered questionnaires looking at perceived occurrence of health problems and pre-travel health advice were obtained from departing travelers at Cuzco’s International Airport between August and November 2002. A total of 5,988 travelers participated in the study. The mean age was 35 years, and 51% were women. The prevalence of TD was 24%. Factors associated with TD in the multivariable analysis were use of antibiotic prophylaxis (OR: 3.20), vaccination against cholera (OR: 1.44), history of advice for safe food and water consumption (OR: 1.46), being younger than 35 years of age (OR: 1.37), being a resident of the United States (OR: 1.28), not staying in hotels in Cuzco (OR: 1.13), and number of unsafe food or beverages consumed (OR: 1.04). Remaining in Cuzco < 1 week was a protective factor (OR: 0.58). TD is common among travelers to Cuzco. This study suggests that conventional recommendations are not invariably effective at decreasing TD.
A COMPARISON OF SULFADOXINE-PYRIMETHAMINE WITH CHLOROQUINE AND PYRIMETHAMINE FOR PREVENTION OF MALARIA IN PREGNANT NIGERIAN WOMEN
Authors: TUKUR IBRAHIM U. , THACHER TOM D. , SAGAY ATIENE S. , MADAKI JEREMIAH K. A.
Published: September 2018

Few studies have documented the effectiveness in west Africa of intermittent preventive treatment of malaria with sulfadoxine-pyrimethamine (SP) in pregnancy. Pregnant Nigerian women were assigned to receive either SP given twice or presumptive chloroquine (CQ) treatment followed by weekly pyrimethamine (CQ + P); 250 were enrolled in each group. Of those completing follow-up, 4 (1.8%) in the SP group and 22 (9.8%) in the CQ + P groups had a febrile illness (P = 0.005). None in the SP group but 11 (4.9%) in the CQ + P group had peripheral parasitemia prior to or during delivery (P = 0.002). Two (1.2%) in the SP group and 9 (5.0%) in the CQ + P group were anemic at delivery (P = 0.04). There were six low birth weight infants in the SP group and eight in the CQ + P group (P = 0.21). Intermittent preventive treatment with SP is superior to CQ + P for prevention of malaria and anemia in pregnant women in Nigeria.
MOSQUITOES DO SENESCE: DEPARTURE FROM THE PARADIGM OF CONSTANT MORTALITY
Authors: STYER LINDA M. , CAREY JAMES R. , WANG JANE-LING , SCOTT THOMAS W.
Published: September 2018

Although variation in mortality is considered by virtually all vector-borne disease specialists to be one of the most important determinants of an arthropod’s capacity to transmit pathogens, the operational assumption often is that insect vector mortality is independent of age. Acceptance of the non-senescence assumption leads to the erroneous conclusion that mosquito age is unimportant, results in misleading predictions regarding disease reductions after vector control, and represses study of other aspects of mosquito biology that change with age. We brought large-scale laboratory life table techniques (N > 100,000) to bear on the question of age-dependent mortality in the mosquito vector of dengue virus, Aedes aegypti. Mortality was highly age dependent in both sexes. Mortality was low at young ages (< 10 days old), steadily increased at middle ages, and decelerated at older ages. A newly derived age-dependent model of pathogen transmission shows the importance of young mosquitoes and population age structure to transmission dynamics. Departure from the age-independent mortality paradigm encourages research on overlooked complexities in mosquito biology, the need for innovative methods to study mosquito population dynamics, and the need to study age-dependent changes for an accurate understanding of mosquito biology and pathogen transmission.
A NEWLY RECOGNIZED SPECIES IN THE ANOPHELES (NYSSORHYNCHUS) ALBITARSIS COMPLEX (DIPTERA: CULICIDAE) FROM PUERTO CARREÑO, COLOMBIA
Authors: BROCHERO HELENA H. L. , LI CONG , WILKERSON RICHARD C.
Published: September 2018

We report a previously unrecognized mosquito species from eastern Colombia belonging to the Anopheles (Nyssorhynchus) albitarsis complex. We provisionally name this taxon An. albitarsis species “F.” Until now, the only members of the Albitarsis Complex recorded from north of the Amazon River have been An. marajoara and a putative phylogenetic species, An. albitarsis “E.” As with the other largely monomorphic species in the complex, we were able to detect its presence using ribosomal DNA internal transcribed spacer 2 (rDNA ITS2) and partial white gene sequences. Unlike An. marajoara, but in common with other species in the complex, An. albitarsis F lacks the white gene fourth intron. This species is sympatric with An. marajoara in a malaria-endemic area in Puerto Carreño, Vichada Department, Colombia. It could be an important current and/or historical vector of human malaria parasites at this locality and, depending on its actual distribution, elsewhere in Colombia and Venezuela.
THE ANOPHELES GAMBIAE VITELLOGENIN GENE (VGT2) PROMOTER DIRECTS PERSISTENT ACCUMULATION OF A REPORTER GENE PRODUCT IN TRANSGENIC ANOPHELES STEPHENSI FOLLOWING MULTIPLE BLOODMEALS
Authors: CHEN XIAO-GUANG , MARINOTTI OSVALDO , WHITMAN LUCIA , JASINSKIENE NIJOLE , JAMES ANTHONY A.
Published: September 2018

Mosquitoes made resistant to pathogens through genetic engineering are proposed as a basis for developing a strategy to control disease transmission. Transgenic approaches that introduce exogenous antipathogen effector genes into mosquito genomes require cis-acting regulatory DNA to control tissue-, stage-, and sex-specific transgene expression. We show that control sequences derived from a vitellogenin-encoding gene of Anopheles gambiae, a major vector in sub-Saharan Africa, can direct expression of an exogenous gene in a tissue-, stage-, and sex-specific manner in Anopheles stephensi, a vector of urban malaria in southern Asia. Specific reporter gene expression was observed in fat-body tissues of transgenic blood-fed females, but not in transgenic males or non-blood-fed transgenic females. Multiple bloodmeals resulted in the continuous presence of reporter gene transcripts for at least 12 days. The persistent expression makes the heterologous promoter a good candidate for controlling transcription of engineered antipathogen effector genes in this important malaria vector.