bluuebunny/crossref_metadata_2025 huggingface dataset:
HOST POLYMORPHISMS AND THE INCIDENCE OF MALARIA IN UGANDAN CHILDREN
Authors: PARIKH SUNIL , DORSEY GRANT , ROSENTHAL PHILIP J.
Published: September 2018

Mutations in β-globin, glucose-6-phosphate dehydrogenase, and promoters for tumor necrosis factor-α and inducible nitric oxide synthase (iNOS) were examined for associations with the incidence of symptomatic malaria in a cohort of 307 Ugandan children. After adjustment of incidence rates for age, water source, use of preventative measures, and proximity to mosquito breeding sites, glucose-6-phosphate dehydrogenase A- heterozygous females had a significantly higher incidence of malaria (incidence rate ratio [IRR] = 1.63, P = 0.03) and a trend towards higher parasite densities (37,100 versus 26,200 parasites/μL; P = 0.18) compared with wild-type children. Male hemizygotes had trends in the same direction. Heterozygotes for sickle hemoglobin had trends toward a lower incidence of malaria and lower parasite density at presentation. Heterozygotes for the iNOS promoter G954C polymorphism, but not other promoter polymorphisms, had a significantly lower incidence of malaria compared with wild-type children (IRR = 0.69, P = 0.05). Host polymorphisms appear to impact upon the incidence of uncomplicated malaria in Ugandan children.
PREVALENCE OF TOXOCARIASIS IN NORTHEASTERN BRAZIL BASED ON SEROLOGY USING RECOMBINANT TOXOCARA CANIS ANTIGEN
Authors: DE ANDRADE LIMA COÊLHO RAQUEL , DE CARVALHO LUIZ BEZERRA , PEREZ EMÍLIA PESSOA , ARAKI KUNIOKI , TAKEUCHI TSUTOMU , ITO AKIRA , AOKI TAKASHI , YAMASAKI HIROSHI
Published: September 2018

To evaluate the prevalence of toxocariasis in children in Jaboatão dos Guararapes, Pernambuco in northeastern Brazil, 215 serum samples were examined by an enzyme-linked immunosorbent assay (ELISA) using a recombinant Toxocara canis antigen. In the ELISA, 26 (12.1%) of 215 subjects were positive. In a dot-blot assay using 53 of 215 serum samples, the diagnostic results correlated with those obtained by the ELISA. Moreover, it has been confirmed that the recombinant T. canis antigen was highly specific for toxocariasis by ELISA using serum samples positive for antibody to Ascaris lumbricoides. Considering the specificity of the recombinant antigen to toxocariasis, the ELISA or dot-blot assay using the recombinant T. canis antigen is recommended in tropical and sub-tropical regions where various parasitic infections are commonly endemic.
SHORT REPORT: NEONATAL SCREENING PILOT STUDY OF TOXOPLASMA GONDII CONGENITAL INFECTION IN MEXICO
Authors: VELA-AMIEVA MARCELA , CAÑEDO-SOLARES IRMA , GUTIÉRREZ-CASTRELLÓN PEDRO , PÉREZ-ANDRADE MARTHA , GONZÁLEZ-CONTRERAS CLAUDIA , ORTÍZ-CORTÉS JOEL , ORTEGA-VELÁZQUEZ VENANCIO , DE LA LUZ GALVÁN-RAMÍREZ MARIA , RUIZ-GARCÍA MATILDE , SALTIGERAL-SIMENTEL PATRICA , ORDAZ-FAVILA JUAN CARLOS , SÁNCHEZ CARMEN , CORREA DOLORES
Published: September 2018

Congenital toxoplasmosis is an obstetric problem in Mexico, but its actual frequency is unknown. Using a network for screening of non-infectious disorders, we performed a pilot study to determine the frequency of IgM antibodies to Toxoplasma gondii in 1,003 infants (53.1% male, mean ± SD age = 18.3 ± 13.0 days, birth weight = 3.116 ± 0.453 kg) in Mexico City from March to April 2003. Blood samples embedded in filter paper were assayed for IgM antibodies using a capture enzyme-linked immunosorbent assay and results were confirmed by Western blot. Two asymptomatic newborns, one of them premature, had IgM and IgG antibodies in a serum sample taken from both the infant and the mother and were clinically followed. Our data suggest a frequency of approximately two cases of congenital T. gondii infection per 1,000 newborns in Mexico City.
DO AFRICAN IMMIGRANTS LIVING IN FRANCE HAVE LONG-TERM MALARIAL IMMUNITY?
Authors: BOUCHAUD OLIVIER , COT MICHEL , KONY SABINE , DURAND RÉMY , SCHIEMANN RICARDA , RALAIMAZAVA PASCAL , COULAUD JEAN-PIERRE , LE BRAS JACQUES , DELORON PHILIPPE
Published: September 2018

Among populations living in areas endemic for malaria, repeated parasite exposure leads to a gradual increase in protective immunity to the disease. In contrast, this immunity is assumed to disappear after several years of non-exposure. This study was designed to investigate long-term immunity in subjects removed from the risk of exposure. Plasmodium falciparum malaria attacks occurring after short trips to sub-Saharan Africa were compared between 99 European patients and 252 African immigrants who had been resident in Europe for at least four years. Relative to the European patients, those originating from Africa had lower mean ± SD parasite densities (0.8 ± 1.5/100 red blood cells versus 1.4 ± 2.8/100 red blood cells; P = 0.007), less frequent severe disease (4.4% versus 15.2%; P = 0.0005), accelerated parasite clearance and defervescence, and higher levels of antibodies to P. falciparum. These results suggest the persistence of acquired immunity to P. falciparum malaria after several years of non-exposure in African immigrants.
MALARIA IN PREGNANT CAMEROONIAN WOMEN: THE EFFECT OF AGE AND GRAVIDITY ON SUBMICROSCOPIC AND MIXED-SPECIES INFECTIONS AND MULTIPLE PARASITE GENOTYPES
Authors: WALKER-ABBEY ANNIE , DJOKAM ROSINE R. T. , ENO ANNA , LEKE ROSE F. G. , TITANJI VINCENT P. K. , FOGAKO JOSEPHINE , SAMA GRACE , THUITA LUCY H. , BEARDSLEE ELIZA , SNOUNOU GEORGES , ZHOU AINONG , TAYLOR DIANE WALLACE
Published: September 2018

Polymerase chain reaction (PCR)–based methods were used to investigate malaria in pregnant women residing in Yaoundé, Cameroon. Microscopy and species-specific PCR-based diagnosis show that at delivery 82.4% of the women were infected with Plasmodium falciparum (27.5% blood-smear positive and 54.9% submicroscopic infections). The prevalence of P. malariae and P. ovale was 7.6% and 2.5%, respectively, with 9.4% infected with more than one species. Based on genotyping of the merozoite surface protein 1 (msp-1) and msp-2 alleles, the mean number of genetically different P. falciparum parasites in peripheral blood was 3.4 (range = 1–9) and 3.5 (range 1–8) in the placenta. Plasmodium falciparum detected by microscopy and PCR as well as mixed-species infections were significantly higher in women ≤ 20 years old and paucigravidae, but maternal anemia was associated only with microscopic detection of parasites. Neither submicroscopic infections nor number of parasite genotypes decreased significantly with age or gravidity. Thus, pregnancy-associated immunity helps reduce malaria to submicroscopic levels, but does not reduce the number of circulating parasite genotypes.
DIFFERENCE IN SUSCEPTIBILITY TO MALARIA BETWEEN TWO SYMPATRIC ETHNIC GROUPS IN MALI
Authors: DOLO AMAGANA , MODIANO DAVID , MAIGA BOUBACAR , DAOU MODIBO , DOLO GUIMOGO , GUINDO HAMADOUN , BA MAMADOU , MAIGA HAMA , COULIBALY DRISSA , PERLMAN HEDVIG , BLOMBERG MARITA TROYE , TOURÉ YEYA TIEMOKO , COLUZZI MARIO , DOUMBO OGOBARA
Published: September 2018

We compared malaria indicators among sympatric groups to study human heterogeneities in the response to Plasmodium falciparum malaria infection. Four cross-sectional surveys and two longitudinal surveys in two sympatric ethnic groups (Dogon and Fulani) in Mali were carried out from 1998 to 2000. Spleen and parasite rates were evaluated during the cross-sectional surveys and disease incidence was assessed during longitudinal surveys. In spite of similar sociocultural factors and entomologic inoculation rates between ethnic groups, the Fulani had a significantly higher spleen enlargement rate, lower parasite rate, and were less affected by the disease than the Dogon group, whose frequency of hemoglobin C was higher than that recorded among the Fulani group. The Fulani group had significantly higher levels of IgG and IgE against crude malaria antigen than the Dogon group, suggesting a role of anti-malaria antibodies in the immune protection seen in this group.
COMPARISON OF SULFADOXINE-PYRIMETHAMINE WITH AND WITHOUT CHLOROQUINE FOR UNCOMPLICATED MALARIA IN NIGERIA
Authors: PITMANG SIMON L. , THACHER TOM D. , MADAKI J. K. A. , EGAH DANIEL Z. , FISCHER PHILIP R.
Published: September 2018

While resistance to older antimalarials is increasingly common, newer antimalarials are still not widely available or affordable in much of Africa. Older antimalarials used in combination might be adequately effective in treating uncomplicated malaria. The objective of this study was to determine whether the combination of sulfadoxine-pyrimethamine (SP) and chloroquine (CQ) is superior to SP alone in the treatment of uncomplicated Plasmodium falciparum malaria in Nigerian patients. We recruited subjects with malaria, defined as the presence of fever and parasitemia > 2,000/μL, from the outpatient department of a Nigerian teaching hospital. We alternately assigned 280 subjects to receive SP with or without CQ. We assessed clinical and parasitologic responses on days 1, 2, 3, 7, and 14. A total of 114 in the SP + CQ group and 116 in the SP group completed the study. By day 3, 97 (75%) in the SP + CQ group and 52 (42%) in the SP group had cleared their parasitemia (P < 0.001); by day 14, 112 (98%) and 67 (58%), respectively, had cleared their parasitemia (P < 0.001). By day 3, 82 (63%) in the SP + CQ group and 20 (16%) in the SP group were symptom free (P < 0.001). When a modified World Health Organization clinical classification system was used, adequate clinical response occurred in 99 (87%) and 61 (53%) of those in the SP + CQ and SP groups, respectively. RI, RII, and RIII resistance to SP + CQ was 7.9%, 3.5%, and 1.8%, respectively, whereas resistance to SP was 23%, 17%, and 5%, respectively. Combined SP + CQ is superior to SP alone for treatment of uncomplicated malaria in Nigerian patients and may prolong the usefulness of these readily available and affordable drugs.
DIURNAL PATTERN OF HUMAN-BITING ACTIVITY AND TRANSMISSION OF SUBPERIODIC WUCHERERIA BANCROFTI (FILARIIDEA: DIPETALONEMATIDAE) BY OCHLEROTATUS NIVEUS (DIPTERA: CULICIDAE) ON THE ANDAMAN AND NICOBAR ISLANDS OF INDIA
Authors: SHRIRAM ANANGANALLUR N. , RAMAIAH KAPA D. , KRISHNAMOORTHY KALIANNAGOUNDER , SEHGAL SUBASH C.
Published: September 2018

We monitored diel-landing periodicity (biting activity/cycle) of Ochlerotatus niveus and the infection/infectivity pattern through human-landing collections on Teressa Island, which is remotely located in the Nicobar district of the Andaman and Nicobar group of Islands of India, for a period of one year. The biting activity was seen throughout the day, exhibiting a bimodal peak, the first at dawn (4:00–6:00 am) and the other towards dusk (5:00–6:00 pm). This pattern was similar during all the seasons of the year. Peak biting hours of Oc. niveus coincides with the peak appearance of microfilariae. Overall infection and infectivity rates were 2.65% and 0.5%, respectively. Perennial transmission is evident from the records of vectors with parasites (infection), including infective larvae in all months of the year, although no infective mosquitoes were recorded at a few points. The risk of transmission of filariasis based on parity status of Oc. niveus was maximal at dusk (5:00–6:00 pm) in this region. The issue of control with respect to reducing human-vector contact is discussed.
APPLICATION OF SYNTHETIC 8-KD AND RECOMBINANT GP50 ANTIGENS IN THE DIAGNOSIS OF NEUROCYSTICERCOSIS BY ENZYME-LINKED IMMUNOSORBENT ASSAY
Authors: BUENO EDNEIA C. , SCHEEL CHRISTINA M. , VAZ ADELAIDE J. , MACHADO LUIS R. , LIVRAMENTO JOSÉ A. , TAKAYANAGUI OSVALDO M. , TSANG VICTOR C. W. , HANCOCK KATHY
Published: September 2018

The gold standard serodiagnostic assay for cysticercosis and neurocysticercosis, diseases caused by the metacestode of Taenia solium, uses lentil lectin-purified glycoprotein (LLGP) in a Western blot assay. We tested two antigens derived from LLGP, synthetic TS18var1 (sTS18var1) and recombinant GP50 antigen (rGP50), in an enzyme-linked immunosorbent assay (ELISA) using serum and cerebrospinal fluid (CSF) samples. The sensitivity for serum and CSF was 94.7% and 100% for rGP50 and 90.4% and 90.2% for sTS18var1, respectively. The specificity for serum and CSF samples was 93.8% and 100% for rGP50 and 90.3% and 98.0% for sTS18var1, respectively. The use of these antigens individually or combined as a diagnostic antigen cocktail eliminates the need for purification of antigens from parasite material and offers the advantage of using a simple and quantitative ELISA format.
DEATH RELATED TO ALBENDAZOLE-INDUCED PANCYTOPENIA: CASE REPORT AND REVIEW
Authors: OPATRNY LUCIE , PRICHARD ROGER , SNELL LINDA , MACLEAN J. DICK
Published: September 2018

Albendazole is a benzimidazole with wide spectrum coverage as an antiparasitic drug. Reported side effects have been minimal. We report the case of a patient who died with severe prolonged pancytopenia beginning during the third week of therapy for a pulmonary echinococcal cyst. This case was a 68-year-old man who presented with a large cystic lung mass. His medical history was significant for Child-Pugh class B cirrhosis. A prolonged course of albendazole was initiated. Two weeks later, the patient presented in septic shock with severe pancytopenia. The patient was initially resuscitated, but died after 10 days with no marrow recovery. Autopsy was consistent with albendazole-induced pancytopenia. This is the third human case of pancytopenia and the first death reported in relation to albendazole-induced pancytopenia. Neutropenia seems to be related more to higher dosage and longer duration of use. Albendazole sulfoxide peak dose and half life are significantly prolonged by liver disease and concomitant administration of certain drugs. The severity and duration of albendazole-induced pancytopenia in this case was likely related to the underlying liver disease. Frequent serial monitoring of blood counts and cessation of medication with any evidence of marrow toxicity in such patients is warranted.
PHYLOGEOGRAPHY AND POPULATION STRUCURE OF AEDES AEGYPTI IN ARIZONA
Authors: MERRILL SAMUEL A. , RAMBERG FRANK B. , HAGEDORN HENRY H.
Published: September 2018

Aedes aegypti, the mosquito responsible for transmitting dengue, has colonized many cities and towns throughout Arizona. Determining both the migration between, and the origin of, local Ae. aegypti populations is important for vector control and disease prevention purposes. Amplified fragment length polymorphism was used to infer geographic structure and local substructure, and effective migration rates (M, migrants per generation) between populations, and to determine genetic differentiation between populations (ΦPT). Three geographically and genetically differentiated groups of populations were identified. Population substructure was only detected in the border town of Nogales. Reliable estimates of M between regions ranged from 1.02 to 3.41 and between cities within regions from 1.66 to 4.44. In general, pairwise ΦPT were lowest between cities within regions. The observed patterns of genetic differentiation suggest infrequent migration between populations and are compatible with the idea of human transport facilitating dispersal between regions.
ORAL TRANSMISSION OF WEST NILE VIRUS IN A HAMSTER MODEL
Authors: SBRANA ELENA , TONRY JESSICA H. , XIAO SHU-YUAN , DA ROSA AMELIA P. A. TRAVASSOS , HIGGS STEPHEN , TESH ROBERT B.
Published: September 2018

The results of experiments comparing the pathogenesis of West Nile virus (WNV) following infection by mosquito bite, needle inoculation, and ingestion are reported. Adult hamsters were readily infected by all three routes. The level and duration of viremia, clinical manifestations, pathology, and antibody response in the hamsters following mosquito infection and needle inoculation were similar; after oral infection, the onset of viremia was delayed and the mortality was lower, but the level and duration of viremia, histopathology, and antibody response were similar to the other routes. The results from this and previously published studies indicate that a wide variety of animal species are susceptible to oral infection with WNV and that orally infected animals develop a viremia and illness similar to that following the bite of infected mosquitoes. Oral infection appears to be an alternative transmission mechanism used by a number of different flaviviruses; its potential role in the natural history of WNV is discussed.
INFECTION WITH HUMAN IMMUNODEFICIENCY VIRUS, HERPES SIMPLEX VIRUS TYPE 2, AND HUMAN HERPES VIRUS 8 IN REMOTE VILLAGES OF SOUTHWESTERN PAPUA NEW GUINEA
Authors: SULIGOI B. , DANAYA R. T. , SARMATI L. , OWEN I. L. , BOROS S. , POZIO E. , ANDREONI M. , REZZA G.
Published: September 2018

To investigate the spread of human immunodeficiency virus (HIV) and other sexually transmitted viruses, two serosurveys (the first in 1999 among 56 adults and the second in 2001 among 351 adults) were conducted in remote villages of the southwestern part of Papua New Guinea. Only one individual was positive for antibodies to HIV. In 2001, the seroprevalence of human herpes virus 8 (HHV-8) was 32.2%, and the seroprevalence of herpes simplex virus type 2 (HSV-2) was 27.4%. Both prevalence rates increased with age, and were lower in the villages near the Bensbach River. The seropositivity of HSV-2 was independently correlated with HHV-8 infection. Our data show that the inhabitants of the southwestern region of Papua New Guinea currently experience an extremely low circulation of HIV. However, the high prevalence of infectious agents that can be sexually transmitted, such as HSV-2 and to a lesser extent HHV-8, indicates the presence of behavioral patterns that may facilitate the spread of HIV in this area of currently low endemicity.
IMMUNOGENICITY AND SAFETY OF BERNA-YF COMPARED WITH TWO OTHER 17D YELLOW FEVER VACCINES IN A PHASE 3 CLINICAL TRIAL
Authors: PFISTER MARKUS , KÜRSTEINER OLIVER , HILFIKER HELENE , FAVRE DIDIER , DURRER PETER , ENNAJI ABDALLAH , L’AGE-STEHR JOHANNA , KAUFHOLD ACHIM , HERZOG CHRISTIAN
Published: September 2018

BERNA-YF (Flavimun®) is a live, attenuated yellow fever (YF) vaccine of the 17D strain produced by Berna Biotech Ltd. following a transfer of technology from the Robert Koch Institute (RKI) in Berlin, Germany. In this phase 3 bridging study, the immunogenicity and safety of BERNA-YF were compared with the original RKI YF vaccine (RKI-YF) and to a current, commercially available YF vaccine, Stamaril® (AP-YF; Aventis Pasteur, Lyon, France), in 304 healthy, adult volunteers. All three vaccines elicited an effective immune response with seroprotection achieved in 100% of individuals in each vaccine group at a neutralizing antibody titer ≥ 1:10. BERNA-YF was shown to be comparable to the other two vaccine products, and subgroup analysis showed no differences in immune response between three consecutive production batches. The immune response to BERNA-YF and RKI-YF was very similar, with no significant difference in antibody titer between the two groups (P = 0.4634). However, AP-YF vaccination resulted in a significantly lower antibody titer (P < 0.0001 versus BERNA-YF). Males exhibited a higher antibody response than females to both BERNA-YF and RKI-YF, but not to AP-YF. All three vaccines were well tolerated and no serious adverse events were reported.
SEROPREVALENCE OF INFECTION WITH TOXOPLASMA GONDII IN INDIGENOUS BRAZILIAN POPULATIONS
Authors: SOBRAL CLEIDE A. , AMENDOEIRA MARIA REGINA R. , TEVA ANTONIO , PATEL BALMUKUND N. , KLEIN CARLOS H.
Published: September 2018

The prevalence of Toxoplasma gondii in indigenous Brazilian tribes with different degrees of acculturation was studied in the Enawenê-Nawê, an isolated tribe, in the state of Mato Grosso, the Waiãpi, with intermittent non-Indian contacts, in the state of Amapá, and the Tiriyó, with constant non-Indian contacts, in the state of Pará. An IgG–enzyme-linked immunosorbent assay (IgG-ELISA) or an IgG/IgM–indirect immunofluorescence antibody (IFA) assay were performed for the detection of antibodies to T. gondii in 2000–2001. Both assays showed that the Tiriyó had the lowest crude seroprevalence (55.6%), the Enawenê-Nawê the highest crude seroprevalence (80.4%), and the Waiãpi an intermediate crude seroprevalence (59.6%). The age-adjusted prevalence (95% confidence intervals) values for the Tiriyó, Enawenê-Nawê, and Waiãpi were 57.3% (53.4, 61.1%), 78.8% (72.2, 85.7%), and 57.7% (52.5, 62.9%), respectively. Contact with non-Indians probably did not influence the prevalence of the infection. However, differential contact with soil-harboring oocysts from wild felines may be responsible for the various seroprevalences in the different tribes.
HANTAVIRUS PULMONARY SYNDROME IN CENTRAL BOLIVIA: RELATIONSHIPS BETWEEN RESERVOIR HOSTS, HABITATS, AND VIRAL GENOTYPES
Authors: CARROLL DARIN S. , MILLS JAMES N. , MONTGOMERY JOEL M. , BAUSCH DANIEL G. , BLAIR PATRICK J. , BURANS JAMES P. , FELICES VIDAL , GIANELLA ALBERTO , IIHOSHI NAOMI , NICHOL STUART T. , OLSON JAMES G. , ROGERS DUKE S. , SALAZAR MILAGROS , KSIAZEK THOMAS G.
Published: September 2018

In August 2002, two cases of hantavirus pulmonary syndrome (HPS) were confirmed in Mineros and Concepción, within the Santa Cruz Department of Bolivia. Extensive alteration of the native ecosystem, from dense forest to pasture or sugarcane, had occurred in both regions. An ecologic assessment of reservoir species associated with the human disease identified a single hantavirus antibody-positive Oligoryzomys microtis from Mineros and three hantavirus antibody-positive Calomys callosus from Concepción. In Mineros, the virus from the O. microtis was 90% similar to sequences published for Río Mamoré virus. Viral nucleotide sequences from two C. callosus were 87–88% similar to the sequence of Laguna Negra virus. The viral sequence from the C. callosus was 99% identical to viral sequences obtained from the HPS patient in this area, implicating C. callosus as the host and Laguna Negra virus as the agent responsible for the HPS case near Concepción.
SHORT REPORT: EFFICACY OF PENTAVALENT ANTIMONY FOR TREATMENT OF COLOMBIAN CUTANEOUS LEISHMANIASIS
Authors: SOTO J. , TOLEDO J. , VEGA J. , BERMAN J.
Published: September 2018

Two hundred twenty-six consecutive adult patients with cutaneous leishmaniasis in Colombia were treated with Glucantime and 81% were cured. The 19% who failed treatment had received a statistically significant lower total amount of antimony (354 mg/kg) than those who were cured (405 mg/kg) (P = 0.002). Thirty-nine of the failures were re-treated with Glucantime and 59% were cured. This large experience on initial and re-treatment cure rates probably represents the values found in clinical practice. In this series, parasite resistance may have been induced by the relatively low initial dose of antimony administered to some patients.
A RANDOMIZED, DOUBLE-BLIND, DOUBLE-DUMMY, CONTROLLED DOSE COMPARISON OF THALIDOMIDE FOR TREATMENT OF ERYTHEMA NODOSUM LEPROSUM
Authors: VILLAHERMOSA LAARNI G. , FAJARDO TRANQUILINO T. , ABALOS RODOLFO M. , BALAGON MARIA V. , TAN ESTERLINA V. , CELLONA ROLAND V. , PALMER JEFFREY P. , WITTES JANET , THOMAS STEVEN D. , KOOK KARIN A. , WALSH GERALD P. , WALSH DOUGLAS S.
Published: September 2018

In a randomized, double-blind, double-dummy controlled study, 22 men with erythema nodosum leprosum (ENL) received six capsules containing either 100 mg (group A, n = 12) or 300 mg (group B, n = 10) of thalidomide daily for one week. A six-week, four capsules per day taper followed, in which group A received 50 mg/day of thalidomide in weeks 2 and 3, then dummy capsules in weeks 4 through 7, while group B had gradual decrements every two weeks. Both regimens caused comparable improvement in 19 patients at day 7 (group A [12 of 12] versus group B [7 of 10]; P = 0.08), but slower tapering in group B showed less re-emergence of ENL through week 7 (P = 0.02, versus group A). Most patients developed new lesions soon after stopping treatment. Slower tapering from a higher initial thalidomide dose may improve clinical ENL responses, but high recurrence rates after discontinuation indicates further assessment is needed to identify better tapering regimens.
ULTRASONOGRAPHIC EXAMINATION OF HAITIAN CHILDREN WITH LYMPHATIC FILARIASIS: A LONGITUDINAL ASSESSMENT IN THE CONTEXT OF ANTIFILARIAL DRUG TREATMENT
Authors: FOX LEANNE M. , FURNESS BRUCE W. , HASER JENNIFER K. , BRISSAU JEAN-MARC , LOUIS-CHARLES JACKY , WILSON SUSAN F. , ADDISS DAVID G. , LAMMIE PATRICK J. , BEACH MICHAEL J.
Published: September 2018

To assess the clinical findings associated with detection of adult Wuchereria bancrofti worms on ultrasound, 186 schoolchildren in a filariasis-endemic area of Haiti underwent physical and ultrasonographic examinations. The filaria dance sign (FDS) of adult W. bancrofti was detected in the inguinal and crural lymphatics of 28 (15%) children. FDS detection was more common in older children (P = 0.003) and in those with a history of inguinal lymph node inflammation (P = 0.002) or crural lymphadenopathy on physical exam (P = 0.01). Twenty-five FDS-positive children were reexamined after three annual cycles of mass treatment for lymphatic filariasis (LF). The total number of adult worm nests detected by ultrasound decreased from 29 to 4 (P ≤0.0001). FDS and lymphangiectasia were detected in the intrascrotal (N = 3) and inguinal (N = 1) lymphatic vessels of three postpubescent boys. This study demonstrates clinical and subclinical findings of LF in FDS-positive children.
ATTENUATION OF CYTOADHERENCE OF PLASMODIUM FALCIPARUM TO MICROVASCULAR ENDOTHELIUM UNDER FLOW BY HEMODILUTION
Authors: FLATT CHRISTINE , MITCHELL SHEONA , YIPP BRYAN , LOOAREESUWAN SORNCHAI , HO MAY
Published: September 2018

The cytoadherence of Plasmodium falciparum–infected erythrocytes (IRBCs) to endothelium is mediated by adhesion molecules within the physical constraints of a viscous fluid containing mostly erythrocytes. The volume fraction of erythrocytes (hematocrit) and their physical properties, such as deformability, are important properties of blood that affect cell recruitment to the vascular wall. In the present study, we examined the effect of hematocrit on IRBC rolling and adhesion on human microvascular endothelial cells in a flow chamber system in vitro. We found hematocrit to be a major determinant of IRBC/endothelial cell interactions. There was a 5-fold and 12-fold increase in IRBC rolling and adhesion, respectively, when hematocrit increased from 10% to 30%, as a result of changes in shear rate. Similar effects were seen in the presence of less deformable erythrocytes, serum proteins, and on endothelium stimulated with tumor necrosis factor-α. The results indicate that hemorheologic variations are an important determinant of the degree of cytoadherence.
RISK FACTORS ASSOCIATED WITH HEPATITIS C AMONG PATIENTS CO-INFECTED WITH HUMAN IMMUNODEFICIENCY VIRUS: A CASE-CONTROL STUDY
Authors: MENDES-CORREA MARIA CÁSSIA JACINTHO , BARONE ANTONIO ALCI , GIANINI REINALDO JOSÉ
Published: September 2018

A case-control study was carried out to assess the risk factors associated with hepatitis C in patients infected with human immunodeficiency virus. One hundred eighteen patients tested positive for hepatitis C virus (HCV) and were included as cases, and 117 tested negative for HCV and were included as controls. Information was collected through a questionnaire. The risk factors that showed a significant association with co-infection by multivariate analysis were an age of 30–39 years (odds ratio [OR] = 4.65, 95% confidence interval [CI] = 1.31–16.43), an age of 40–49 years (OR = 6.48, 95% CI = 1.70–24.78), an age > 50 years (OR = 7.50, 95% CI = 1.54–36.68), use of intravenous drugs (OR = 25.46, 95% CI = 4.91–131.88), use of inhaled illicit drugs (OR = 3.56, 95% CI = 1.22–10.44), anal intercourse (OR = 3.93, 95% CI = 1.27–12.13), a sexual partner with a history of liver disease (OR = 5.45, 95% CI = 1.33–22.32), a sexual partner with a history of blood transfusions (OR = 4.79, 95% CI = 0.95–24.19), and sexual partner with a history of intravenous drug use (OR = 3.46, 95% CI = 1.24–9.65).
ENVIRONMENTAL PREDICTORS OF ROSS RIVER VIRUS DISEASE OUTBREAKS IN QUEENSLAND, AUSTRALIA
Authors: GATTON MICHELLE L. , KAY BRIAN H. , RYAN PETER A.
Published: September 2018

Ross River virus (RRV) disease is the most common mosquito-borne disease in Australia, with the majority of cases reported from Queensland. In this study we investigate the relationship between local RRV disease outbreaks and standardized rainfall and temperature data in Queensland. No one set of variables could be found to accurately predict RRV disease outbreaks across all of Queensland, although good predictive models could be developed for smaller regions. The variables identified as important in predicting RRV disease outbreaks differed between regions, and also between summer and autumn. This work highlights the sensitive relationship between virus prevalence, mosquito bionomics, and climate, illustrating that critical climatic factors differ depending on underlying environmental conditions. Identification of factors leading to RRV disease outbreaks will help local authorities identify periods of high risk, optimizing the provision of additional mosquito control measures.
IMPORTED GIARDIASIS: IMPACT OF INTERNATIONAL TRAVEL, IMMIGRATION, AND ADOPTION
Authors: EKDAHL KARL , ANDERSSON YVONNE
Published: September 2018

From the Swedish national database, regarding notified Giardia cases, we could for the period 1997–2003 identify 3,697 cases of travel-associated giardiasis, 4,151 cases in newly arrived immigrants and refugees, and 455 cases in internationally adopted children. These were compared with data sets on the number of international travelers, immigrants/refugees, and adopted children. The overall risk of being notified with giardiasis in returning travelers was 5.3 of 100,000, with the highest incidences in travelers from the Indian Subcontinent (628 of 100,000), East Africa (358 of 100,000), and West Africa (169 of 100,000). A large proportion of the travel-related cases were seen in persons with family roots in the country of infection—a risk group deserving special attention. The overall risk in immigrants and refugees was 1,180/100,000 with the highest risk in persons from Afghanistan (3,800 of 100,000) and Iraq (2,990 of 100,000). The incidence was highest among internationally adopted children (8,110 of 100,000), with geographical risks not entirely correlating to those in travelers and immigrants.
PROTEASE SECRETED BY THE INFECTIVE LARVAE OF ANGIOSTRONGYLUS CANTONENSIS AND ITS ROLE IN THE PENETRATION OF MOUSE INTESTINE
Authors: LEE JUNE-DER , YEN CHUAN-MIN
Published: September 2018

The infective third-stage larvae of Angiostrongylus cantonensis secrete a proteolytic enzyme that is thought to be essential for both larval penetration into the intestinal wall of the host and full development. Protease activity in these larvae during culture in vitro was determined by zymography, pH optimum, and substrate and inhibitor specificity. Excretory-secretory (ES) products of the third-stage larvae showed protease activity as three bands with molecular masses of 66, 30, and 23 kD by gelatin zymography. The optimal pH value for this protease activity was 10.0. The protease was found to have collagenolytic as well as elastinolytic activity, but these activities were inhibited by serine protease or metalloprotease inhibitors. The importance of this protease in larval penetration of the intestinal wall and entering the blood stream was observed in vitro by cocultured third-stage larvae of A. cantonensis with specific protease inhibitors in the intestines of BALB/c mice. The penetration rates of larvae significantly decreased when serine protease or metalloprotease inhibitors were added to the intestines. These results showed that serine protease and metalloprotease in ES products of A. cantonensis third-stage larvae are associated with larval penetration of the intestinal walls of mice.
SURVEILLANCE FOR ANTIMICROBIAL RESISTANCE PROFILES AMONG SHIGELLA SPECIES ISOLATED FROM A SEMIRURAL COMMUNITY IN THE NORTHERN ADMINISTRATIVE AREA OF SANTIAGO, CHILE
Authors: FULLÁ NOELIA , PRADO VALERIA , DURÁN CLAUDIA , LAGOS ROSANNA , LEVINE MYRON M.
Published: September 2018

Variations in antibiotic resistance patterns were studied among 178 Shigella strains isolated from 1997 to 2001 in children less than five years of age with acute diarrhea from Colina, a semi-rural community in Santiago, Chile. The minimal inhibitory concentration of several commonly used antibiotics was determined by the agar dilution method. Shigella strains showed high rates of resistance to ampicillin (82%), cotrimoxazole (65%), tetracycline (53%), and chloramphenicol (49%). Furthermore, 51% of the strains showed resistance patterns to multiple antibiotics. Only 9% of the strains were resistant to amoxicillin-clavulanic acid and no resistance was observed to ciprofloxacin, nalidixic acid, or cefotaxime. Continuous monitoring of resistance patterns in Shigella is essential for establishing and updating guidelines for antibiotic treatment in shigellosis.
SUSCEPTIBILITY OF OCHLEROTATUS TAENIORHYNCHUS AND CULEX NIGRIPALPUS FOR EVERGLADES VIRUS
Authors: COFFEY LARK L. , WEAVER SCOTT C.
Published: September 2018

Everglades virus (EVEV), an alphavirus in the Venezuelan equine encephalitis (VEE) complex, is a mosquito-borne human pathogen endemic to South Florida. Field isolations of EVEV from Culex (Melanoconion) cedecei and laboratory susceptibility experiments established this species as its primary vector. However, isolates of EVEV from Ochlerotatus taeniorhynchus and Culex nigripalpus, more abundant and widespread species in South Florida, suggested that they also transmit EVEV and could infect many people. We performed susceptibility experiments with F1 generation Oc. taeniorhynchus and Cx. nigripalpus to evaluate their permissiveness to EVEV infection. In contrast to the high degree of susceptibility of Cx. (Mel.) cedecei, Oc. taeniorhynchus and Cx. nigripalpus were relatively refractory to oral EVEV infection, indicating that they are probably not important vectors. Identification of vectors involved in enzootic EVEV transmission will assist in understanding potential changes in vector use that could accompany the emergence of epizootic or epidemic EVEV.
TRANSMISSION OF ENTEROCYTOZOON BIENEUSI GENOTYPE A IN A THAI ORPHANAGE
Authors: LEELAYOOVA SAOVANEE , SUBRUNGRUANG ITTISAK , RANGSIN RAM , CHAVALITSHEWINKOON-PETMITR PORNTIP , WORAPONG JEERAPAN , NAAGLOR TAWEE , MUNGTHIN MATHIRUT
Published: September 2018

A cross-sectional study of Enterocytozoon bieneusi infection in children who lived in an orphanage in Bangkok, Thailand was conducted in April 2003. Two hundred ninety stool specimens were collected and examined under light microscopy after staining with gram-chromotrope. Confirmation of E. bieneusi was done using transmission electron microscopy. Of 290 samples, 12 (4.1%) were positive for E. bieneusi. Genotypic characterization of 10 E. bieneusi showed that all were genotype A, which might indicate the same source of infection. Multivariate analysis showed that orphans who were 12–23 months old, girls, and living in one particular house were independently associated with E. bieneusi infection. Our study suggests that E. bieneusi infection in this orphanage might be transmitted person to person.
LABORATORY-CONFIRMED MEDITERRANEAN SPOTTED FEVER IN A JAPANESE TRAVELER TO KENYA
Authors: YOSHIKAWA HIROKO , KIMURA MIKIO , OGAWA MOTOHIKO , ROLAIN JEAN-MARC , RAOULT DIDIER
Published: September 2018

A Japanese traveler returning from Kenya became ill, presenting with fever and a prominent, generalized rash without an eschar. Results of the immunofluorescence antibody assay of the patient’s sera performed in Japan were compatible with illness due to a spotted fever group (SFG) rickettsia, and a presumptive diagnosis of African SFG rickettsiosis, probably either Mediterranean spotted fever (MSF) or African tick-bite fever (ATBF), was rendered. To further define the disease diagnosis, sera were examined in France by Western immunoblotting combined with cross-adsorption, which confirmed the diagnosis of MSF but not of ATBF. Because of the need to further characterize the epidemiologic and clinical features of the two African SFG rickettsioses, clinicians are encouraged to contact a specialized laboratory when encountering such cases.
MOLECULAR SURVEILLANCE OF MUTATIONS IN DIHYDROFOLATE REDUCTASE AND DIHYROPTEROATE SYNTHASE GENES OF PLASMODIUM FALCIPARUM IN ETHIOPIA
Authors: GEBRU-WOLDEAREGAI TAMIRAT , HAILU ASRAT , GROBUSCH MARTIN P. , KUN JÜRGEN F. J.
Published: September 2018

Point mutations in the genes for dihydrofolate reductase (DHFR) and dihydropteroate synthase (DHPS) of Plasmodium falciparum isolates are associated with sulfadoxine/pyrimethamine (SP) treatment failure, respectively. This study was conducted to assess the prevalence of SP resistance in P. falciparum isolates collected at the Jimma Health Center in southwestern Ethiopia. In this study, the genetic profile of P. falciparum isolates with respect to DHFR and DHPS genes was assessed in 124 individuals. The prevalence of single, double, and multiple mutations in these genes was calculated. The sequence profile showed that all samples carried a double mutation at the positions 51 and 108 (I51N108) in the DHFR gene. Sixty-seven (54.03%) of the isolates had an additional third mutation at position 59, resulting in the triple mutant I51R59N108. All isolates carried mutations G437 and E540 in the DHPS gene. Two isolates (1.61%) had additional mutations at codon 581 (A581).
USEFULNESS OF THE PLASMODIUM FALCIPARUM CHLOROQUINE RESISTANCE TRANSPORTER T76 GENOTYPE FAILURE INDEX FOR THE ESTIMATION OF IN VIVO CHLOROQUINE RESISTANCE IN BURKINA FASO
Authors: TINTO HALIDOU , SANOU BOROMA , DUJARDIN JEAN-CLAUDE , OUÉDRAOGO JEAN BOSCO , VAN OVERMEIR CHANTAL , ERHART ANNETTE , VAN MARCK ERIC , GUIGUEMDÉ TINGA ROBERT , D’ALESSANDRO UMBERTO
Published: September 2018

The prevalence of chloroquine (CQ) treatment failure and the genotype failure index was determined in four sentinel sites in Burkina Faso. In three sites, the genotype failure index varied between 1.7 and 3, a result confirming the relationship between the Plasmodium falciparum CQ resistance transporter (Pfcrt) T76 mutation and CQ resistance. In the remaining site, the genotype failure index was unusually low, 1.1, which was significantly different than that in the other sites (P < 0.00001). These findings are discussed. Often but not always, the prevalence of CQ resistance can be correctly estimated by the Pfcrt T76 genotype failure index.
COMPARISON OF IgG REACTIVITIES TO PLASMODIUM VIVAX MEROZOITE INVASION ANTIGENS IN A BRAZILIAN AMAZON POPULATION
Authors: TRAN TUAN M. , OLIVEIRA-FERREIRA JOSELI , MORENO ALBERTO , SANTOS FATIMA , YAZDANI SYED S. , CHITNIS CHETAN E. , ALTMAN JOHN D. , MEYER ESMERALDA V-S. , BARNWELL JOHN W. , GALINSKI MARY R.
Published: September 2018

Naturally acquired antibody reactivity to two major Plasmodium vivax vaccine candidates was investigated in 294 donors from three malaria-endemic communities of Rondônia state, Brazil. Antibody recognition of recombinantly expressed antigens covering five different regions of P. vivax reticulocyte binding protein 1 (PvRBP1) and region II of P. vivax Duffy binding protein (PvDBP-RII) were compared. Positive IgG responses to these antigens were significantly related to the level of malaria exposure in terms of past infections and years of residence in the endemic area when corrected for age. The highest prevalence of anti-PvRBP1 total IgG antibodies corresponded to the amino acid regions denoted PvRBP1431-748 (41%) and PvRBP1733-1407 (47%). Approximately one-fifth of positively responding sera had titers of at least 1:1,600. Total IgG responses to PvDBP-RII were more prevalent (67%), of greater magnitude, and acquired more rapidly than those to individual PvRBP1 antigens. Responses to both PvRBP1 and PvDBP-RII were biased toward the cytophilic subclasses IgG1 and IgG3. These data provide the first insights on acquired antibody responses to PvRBP1 and a comparative view with PvDBP-RII that may prove valuable for understanding protective immune responses to these two vaccine candidates as they are evaluated as components of multitarget blood-stage vaccines.
DETECTION OF LEISHMANIAL ANTIGEN IN THE URINE OF PATIENTS WITH VISCERAL LEISHMANIASIS BY A LATEX AGGLUTINATION TEST
Authors: SUNDAR SHYAM , AGRAWAL SHRINKHLA , PAI KALPANA , CHANCE MICHAEL , HOMMEL MARCEL
Published: September 2018

Diagnosis of visceral leishmaniasis (VL) is usually done by demonstration of parasites in tissue smears. However, obtaining these smears may be risky, painful, and difficult. Antibody-based diagnostics are limited by their inability to predict active disease. In this study, a new latex agglutination test (KAtex), which detects parasite antigen in freshly voided and boiled urine, was evaluated in patients with VL before the start (n = 382) and at the end of treatment (n = 273); 185 healthy controls from leishmaniasis-endemic region were also studied. The KAtex result was positive in 87% (95% confidence interval [CI] = 83.3–90.3). However, at the end of treatment only 3% (95% CI = 1.6–6.2) patients were positive. The specificity of the test was 99% and 2 of 185 healthy controls tested positive. Positive and negative predictive values were 0.994 and 0.788, respectively. KAtex is a promising test, and in a simplified and improved format it could be applied meaningfully in the diagnosis of VL.
THE SENSITIVITY OF CLINICAL ISOLATES OF LEISHMANIA FROM PERU AND NEPAL TO MILTEFOSINE
Authors: YARDLEY VANESSA , CROFT SIMON L. , DE DONCKER SIMONNE , DUJARDIN JEAN-CLAUDE , KOIRALA SIDDHARTHA , RIJAL SUMAN , MIRANDA CESAR , LLANOS-CUENTAS ALEJANDRO , CHAPPUIS FRANCOIS
Published: September 2018

Clinical isolates of Leishmania, from visceral leishmaniasis (VL) cases in Nepal and from cutaneous leishmaniasis (CL) cases in Peru, were cultured using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) to type species and strain. Promastigotes from 38 isolates, within eight passages from isolation, were used to infect mouse peritoneal macrophage cultures in vitro, and the amastigote sensitivity to miltefosine was determined. The concentration required to kill 50% of intracellular amastigotes from Nepalese VL isolates, all typed as Leishmania (L.) donovani (N = 24) from both Sbv responders and nonresponders, ranged from 8.7 to 0.04 μg/mL. In contrast, the concentration required to kill 50% intracellular amastigotes from isolates from Peru, typed as L.(V.) braziliensis (N = 8), was > 30 to 8.4 μg/mL, L.(V.) guyanensis (N = 2) > 30 to 1.9 μg/mL, L.(L.) mexicana (N = 1) > 30 μg/mL, and L. (V.) lainsoni (N = 4) was 3.4 to 1.9 μg/mL. This demonstrates a notable difference in the intrinsic sensitivity of Leishmania species to miltefosine in vitro. If this model can be correlated to therapeutic outcome, it may have implications for the interpretation of clinical trials.
ATYPICAL CLINICAL VARIANTS IN NEW WORLD CUTANEOUS LEISHMANIASIS: DISSEMINATED, ERYSIPELOID, AND RECIDIVA CUTIS DUE TO LEISHMANIA (V.) PANAMENSIS
Authors: CALVOPINA MANUEL , GOMEZ EDUARDO A. , UEZATO HIROSHI , KATO HIROTOMO , NONAKA SHIGEO , HASHIGUCHI YOSHIHISA
Published: September 2018

In recent times, there has been an increase in the number of reports for new and rare variants of cutaneous leishmaniasis (CL). Here, we describe three unusual clinical forms of CL identified in Ecuadorian children. A total of 131 patients with CL were diagnosed over a 2-year period of active search. In 3 (2.29%), the lesions were very unusual; these included erysipeloid, recidiva cutis (LRC), and disseminated leishmaniasis (DL). The erysipeloid case is characterized by erythematous and indurated plaque seen on the face of a 5-year-old boy; the LRC one is differentiated by slowly progressing red-brown papules around large scars of healed sores in a 6-year-old girl, and the DL case is characterized by dozens of cutaneous ulcers distributed in the whole body of a 1-year-old girl. Leishmania parasites were isolated by lesion aspirate and analyzed by the technique multilocus enzyme electrophoresis (MLEE). All three isolates were identified as Leishmania (Viannia) panamensis. These distinct clinical variants rarely have been reported previously in the American cutaneous leishmaniasis, and for the first time L. (V.) panamensis was identified as the etiologic agent. Our cases extend the spectrum of clinical presentations in New World leishmaniasis.
INFECTION BY HUMAN IMMUNODEFICIENCY VIRUS-1 IS NOT A RISK FACTOR FOR AMEBIASIS
Authors: MORÁN PATRICIA , RAMOS FERNANDO , RAMIRO MANUEL , CURIEL OCTAVIO , GONZÁLEZ ENRIQUE , VALADEZ ALICIA , GÓMEZ ALEJANDRO , GARCÍA GABRIELA , MELENDRO EMMA I. , XIMÉNEZ CECILIA
Published: September 2018

The purpose of this study was to determine whether HIV-1 infected patients in our community were more susceptible to Entamoeba histolytica and Entamoeba dispar infection than non-HIV-infected individuals. The prevalence and frequency of invasive amebiasis was determined in 203 HIV+/AIDS subjects and 140 close relatives or sexual partners, all of whom were HIV−. Anti–E. histolytica antibodies (IgG, IgA) were assessed as indicators of E. histolytica invasive infection. Polymerase chain reaction (PCR) was used for the characterization of the Entamoeba species. The prevalence estimated with PCR data showed that E. histolytica infection was more common in the HIV+/AIDS group (25.32%), than in HIV− contacts (18.46%). E. histolytica + E. dispar infection was more frequent in HIV+/AIDS patients (13.3%), than in HIV− contacts (0.7%). E. histolytica and/or E. dispar infection was highly prevalent in HIV+/AIDS patients (34.1%) without evidence of recent or current invasive disease. Contacts of HIV+/AIDS patients who were infected with E. histolytica were asymptomatic cyst passers. Our results suggest that E. histolytica strains prevalent in the studied community appear to be of low pathogenic potential.
DIFFERENTIAL INTROGRESSION OF CHROMSOMAL REGIONS BETWEEN ANOPHELES GAMBIAE AND AN. ARABIENSIS
Authors: SLOTMAN MICHEL A. , TORRE ALESSANDRA DELLA , CALZETTA MARIA , POWELL JEFFREY R.
Published: September 2018

Evidence for introgression between Anopheles gambiae and An. arabiensis has accumulated for some time. We examined the fate of introgressed DNA directly, using microsatellite markers located throughout the genome. Introgressed X chromosomes were removed within two generations. Furthermore, substantial differences in introgressive capacity between the two autosomes were found. After introgression from An. arabiensis into An. gambiae, most introgressed alleles at third chromosome markers, particularly those on 3R, decreased steadily, indicating selection against them. No such pattern was observed for 2L markers and several 2R markers. The frequency of introgressed alleles on 2L were close to the original frequency even after 19 generations, whereas only two 2R markers showed a modest decrease. Even though limited information was available on the reciprocal cross, the pattern appears to be identical. Although the decrease in frequency of the introgressed X chromosome can be attributed to the presence of sterility and inviability effects, the variation in introgressive capacity of the autosomes does not appear to be explained by the presence of inversion polymorphisms, or regions causing hybrid sterility and inviability. These results can have some important implications for the spread of insecticide resistance and the control of these vector populations via the release of transgenic mosquitoes.