bluuebunny/crossref_metadata_2025 huggingface dataset:
Performance of the OptiMAL assay for detection and identification of malaria infections in asymptomatic residents of Irian Jaya, Indonesia.
Authors: Fryauff D J , Purnomo  , Sutamihardja M A , Elyazar I R , Susanti I , Krisin  , Subianto B , Marwoto H
Published: May 2017

The OptiMAL assay, a new immunochromatographic "dipstick" test for malaria based on detection of Plasmodium lactate dehydrogenase (pLDH), is purported to detect infections of approximately 200 parasites/microL of blood and to differentiate between Plasmodium falciparum and non-P. falciparum. We evaluated OptiMAL performance by comparing the test strip interpretations of two independent readers with consensus results obtained independently by expert malaria microscopists. Unbiased measures of sensitivity were derived by applying the OptiMAL test for detection and differentiation of light, asymptomatic infections by P. falciparum and Plasmodium vivax. OptiMAL readings were separated in time to determine whether the reaction signal was stable. Microscopy identified infections in 225 of 505 individuals screened; those with P. falciparum (n = 170) averaged 354 asexual forms/microL and P. vivax/Plasmodium malariae (n = 112) averaged 216 asexual forms/microL of blood. Concordance between OptiMAL and microscopy was 81% and 78% by the two independent readings. The assay's sensitivity for detection of any malaria species was 60.4% and 70.2% respectively and specificity was 97% and 89%. Most cases identified by microscopy as P. falciparum were graded as negative or non-falciparum by both OptiMAL readers. OptiMAL false negatives as well as misidentifications were related to low parasitemias (< 500/microL). The OptiMAL assay demonstrated 88-92% sensitivity for detecting infections of 500-1,000 parasites/microL, a range covering the mean parasitemia of primary symptomatic P. falciparum infections in malaria-naÃ¯ve Indonesian transmigrants. This device was markedly less sensitive than expert microscopy for discriminating between malaria species and is presently unsuited for use as an epidemiological screening tool. The OptiMAL assay is not approved for diagnostic use but is commercially available for research purposes only.
Diagnosis of malaria in non-endemic countries by the ParaSight-F test.
Authors: Brenier-Pinchart M P , Pinel C , Croisonnier A , Brion J P , Faure O , Ponard D , Ambroise-Thomas P
Published: May 2017

QBC, examination of thin blood smears, and Parasight-F were performed for every case of malaria suspected between May 1997 and December 1998. Data from 310 patients were reported. Fifty had malaria infection diagnosed by QBC and thin blood film, among whom 39 had Plasmodium falciparum infection. Three of these 39 were negative with the Parasight-F test. Eleven patients had a positive ParaSight-F test but microscopic diagnosis methods were negative. Interpretation of these 11 positive ParaSight-F results is proposed to depend on clinical criteria.
Use of the recombinant K39 dipstick test and the direct agglutination test in a setting endemic for visceral leishmaniasis in Nepal.
Authors: Bern C , Jha S N , Joshi A B , Thakur G D , Bista M B
Published: May 2017

We evaluated the field use of two serologic tests for visceral leishmaniasis (VL), the direct agglutination test (DAT) and rK39 dipstick test, in the context of a case-control study. Most VL cases in Nepal are currently diagnosed on clinical grounds and with relatively non-specific tests such as the formol-gel test. Among 14 newly diagnosed VL patients with bone-marrow slides confirmed positive in two independent laboratories, the sensitivity of both tests was 100%. Among 113 controls with no personal or household history of VL, the specificity of the rK39 was 100% while that of the DAT was 93%. The rK39 was less expensive than DAT, and has the advantages of ease of use and obtaining results within minutes. The wider use of the rK39 dipstick test could improve the specificity of VL diagnosis in Nepal.
Mechanical transport and transmission of Cryptosporidium parvum oocysts by wild filth flies.
Authors: Graczyk T K , Fayer R , Knight R , Mhangami-Ruwende B , Trout J M , Da Silva A J , Pieniazek N J
Published: May 2017

Over the course of six months wild filth flies were collected from traps left for 7-10 days in a barn with or without a calf shedding Cryptosporidium parvum Genotype 2 oocysts in diarrheic feces. The oocysts of C. parvum transported on the flies' exoskeletons and eluted from their droplets left on visited surfaces were infectious for mice. The mean number of oocysts carried by a fly varied from 4 to 131, and the total oocyst number per collection varied from 56 to approximately 4.56 x 10(3). Fly abundance and intensity of mechanical transmission of infectious C. parvum oocysts were positively correlated, and both increased significantly when an infected calf was in the barn. Molecular data showed that the oocysts shed by infected calves were carried by flies for at least 3 weeks. Filth flies can acquire infectious C. parvum oocysts from unsanitary sites, deposit them on visited surfaces, and therefore may be involved in human or animal cryptosporidiosis.
Factors associated with visceral leishmaniasis in Nepal: bed-net use is strongly protective.
Authors: Bern C , Joshi A B , Jha S N , Das M L , Hightower A , Thakur G D , Bista M B
Published: May 2017

Since 1980, visceral leishmaniasis (VL) has reemerged as a public health problem in lowland Nepal. We conducted a case-control study to identify risk factors. In univariate analyses among 84 cases and 105 controls, protective factors included sleeping on a bed or cot (Odds ratio [OR] 0.44, P < 0.01) and sleeping under a bed-net regularly (OR 0.23, P < 0.001) or in the warm months (OR 0.20, P < 0.001). The bed-nets in use in this region were commercially available and untreated with insecticide. Ownership of a cow or buffalo was protective (OR 0.34, P < 0.001), whereas dampness observed in the mud floor of the house was a strong risk factor (OR 4.0, P < 0.001). In multivariable models, bed-net usage, cow or buffalo ownership, and damp floors were significantly associated with altered risk. A program to increase bed-net usage could therefore decrease the incidence of VL in Nepal.
The epidemiology of Plasmodium falciparum malaria in two Cameroonian villages: Simbok and Etoa.
Authors: Quakyi I A , Leke R G , Befidi-Mengue R , Tsafack M , Bomba-Nkolo D , Manga L , Tchinda V , Njeungue E , Kouontchou S , Fogako J , Nyonglema P , Harun L T , Djokam R , Sama G , Eno A , Megnekou R , Metenou S , Ndountse L , Same-Ekobo A , Alake G , Meli J , Ngu J , Tietche F , Lohoue J , Mvondo J L , Wansi E , Leke R , Folefack A , Bigoga J , Bomba-Nkolo C , Titanji V , Walker-Abbey A , Hickey M A , Johnson A H , Taylor D W , Ndoutse L
Published: May 2017

In support of ongoing immunologic studies on immunity to Plasmodium falciparum, demographic, entomologic, parasitologic, and clinical studies were conducted in two Cameroonian villages located 3 km apart. Simbok (population = 907) has pools of water present year round that provide breeding sites for Anopheles gambiae, whereas Etoa (population = 485) has swampy areas that dry up annually in which A. funestus breed. Results showed that individuals in Simbok receive an estimated 1.9 and 1.2 infectious bites per night in the wet and dry season, respectively, whereas individuals in Etoa receive 2.4 and 0.4 infectious bites per night, respectively. Although transmission patterns differ, the rate of acquisition of immunity to malaria appears to be similar in both villages. A prevalence of 50-75% was found in children < 10 years old, variable levels in children 11-15 years old, and 31% in adults. Thus, as reported in other parts of Africa, individuals exposed to continuous transmission of P. falciparum slowly acquired significant, but not complete, immunity.
Asymptomatic infection and risk factors for leptospirosis in Nicaragua.
Authors: Ashford D A , Kaiser R M , Spiegel R A , Perkins B A , Weyant R S , Bragg S L , Plikaytis B , Jarquin C , De Lose Reyes J O , Amador J J
Published: May 2017

As part of an investigation of a 1995 outbreak of leptospirosis in Nicaragua, a cross-sectional serologic survey was conducted in the town of El Sauce. Of 566 persons, 85 (15%) were positive for IgM anti-Leptospira antibodies, indicating recent leptospirosis infection. Asymptomatic leptospirosis infection was common, with only 25 (29.4%) of the 85 seropositive inhabitants reporting a febrile illness in the 2 months before the survey. Multivariable analysis revealed that having an indoor water source remained independently protective against leptospirosis. Gathering wood was independently associated with infection. These findings suggest that asymptomatic infection with Leptospira is common in endemic areas of Leptospira transmission. Improvement in water sanitation and behavioral modifications to reduce environmental exposure may reduce the risk of leptospirosis in endemic regions.
The efficacy and tolerability of triclabendazole in Cuban patients with latent and chronic Fasciola hepatica infection.
Authors: MillÃ¡n J C , Mull R , Freise S , Richter J , _ _
Published: May 2017

Current chemotherapy for the treatment of infections caused by the liver fluke Fasciola hepatica is not satisfactory. Therefore, the efficacy and tolerability of triclabendazole (TCZ) was assessed for this indication. Eighty-two patients (51 female, 31 male, age 15-81 yr, mean 42 yr) with chronic or latent F. hepatica infection refractory to previous anti-helminthic chemotherapy were enrolled in a 60-day open, non-comparative trial. Patients received 20 mg/kg TCZ as two doses of 10 mg/kg administered after food 12 hr apart. Efficacy of treatment was assessed by stool microscopy, determination of Fasciola excretory-secretory antigen (FES) in feces, and by ultrasonography (US) which were systematically performed pre-therapy and on Days 1-7, 15, 30, and 60 post-therapy. For continuous safety assessment, patients were hospitalized during the first week after therapy and then monitored at home for the appearance of any adverse events. Clinical chemistry and hematology tests were carried out on Days 1, 3, 7, 15, and 60, and whenever an adverse effect occurred possibly related to therapy. Seventy-one (92.2%) of the 77 patients who completed the 60-day follow-up period became egg-negative. Efficacy of therapy was supported by the disappearance or decrease of FES antigen and of ultrasonography abnormalities. In the 6 remaining patients, parasitological cure was achieved by another single TCZ dose of 10 mg/kg on Day 60. A total of 74 adverse events possibly related to therapy was reported by 54 patients. The most important adverse event was colic-like abdominal pain (40 patients [49%]) consistent with the expulsion of the parasite through the bile ducts as confirmed by US on Days 2-7. Most adverse events (53) were graded as mild, 20 as moderate, and only 1 as severe (a biliary colic responding to spasmolytic therapy within two hours). Triclabendazole 20 mg/kg is an effective therapy for the treatment of F. hepatica infection in patients who have failed to respond to other antihelminthic agents. Biliary colics reflecting the expulsion of dead or damaged parasites usually occur during Day 3-7 and respond well to spasmolytic therapy.
16alpha-bromoepiandrosterone, a dehydroepiandrosterone (DHEA) analogue, inhibits Plasmodium falciparum and Plasmodium berghei growth.
Authors: Freilich D , Ferris S , Wallace M , Leach L , Kallen A , Frincke J , Ahlem C , Hacker M , Nelson D , Hebert J
Published: May 2017

Dehydroepiandrosterone (DHEA) and its analogue, 16alpha-bromoepiandrosterone (alpha-epi-Br), may have activity against viral and parasitic infections, including human immunodeficiency virus (HIV) and Cryptosporidium parvum. Therefore, we evaluated its antimalarial effects on Plasmodium falciparum and Plasmodium berghei. In vitro, chloroquine (CQ)-sensitive and resistant strains of P. falciparum parasitized red blood cells were incubated with escalating doses of alpha-epi-Br or CQ. In vivo, 62 rats were infected with P. berghei and treated with CQ or alpha-epi-Br. At the highest doses tested against a CQ-sensitive strain, parasitemias decreased from 25.4% in the saline control group to 4.3% and 4.8% in the alpha-epi-Br and CQ groups, respectively (P < 0.05). Against two CQ-resistant strains, parasitemias decreased from 22.3-28.8% and 24.8-30% in the CQ and saline groups, respectively, to 2.5-2.7% in the alpha-epi-Br groups (P = 0.003). In vivo, on Day 4, parasitemias decreased from 23% in the saline group to 9-12% and 12% in the in alpha-epi-Br and CQ groups, respectively (P < 0.05). These data demonstrate that alpha-epi-Br shows activity against CQ-sensitive and resistant strains of P. falciparum in vitro. At the doses tested against P. berghei in vivo in rats, alpha-epi-Br is comparable to CQ.
Safety and immunogenicity of a new equine tetanus immunoglobulin associated with tetanus-diphtheria vaccine.
Authors: Lang J , Kamga-Fotso L , Peyrieux J C , Blondeau C , Lutsch C , Forrat R
Published: May 2017

In a single-center double-blind, randomized trial in West Africa, we evaluated the safety and immunogenicity of a new pasteurized, pepsin-digested equine tetanus immunoglobulin (heat-treated equine tetanus immunoglobulin [HT-ETIG]) in the post-exposure prophylaxis of tetanus compared with the reference product, equine tetanus immunoglobulin (ETIG). A total of 134 adults presenting to Garoua Hospital, Cameroon with a tetanus-prone wound were randomized to receive a 3,000 international units (IU) intramuscular injection (deltoid) of either HT-ETIG or ETIG, simultaneously with a tetanus-diphtheria vaccine. No serious adverse reactions were reported. The incidences of local and systemic reactions were similar in the two groups. Repeated measures of equine tetanus-antibody levels measured from Day 0 to Day 28 showed that titers were significantly higher in the HT-ETIG group (P = 0.017). At Day 7, a higher percentage of subjects in the HT-ETIG group had equine antibody levels > or = 0.1 IU/ml (80.4% versus 37.9%; P < 0.0001). No cases of tetanus occurred during the follow-up, attesting to the efficacy of the combined prophylactic treatment.
Inhibition of local hemorrhage and dermonecrosis induced by Bothrops asper snake venom: effectiveness of early in situ administration of the peptidomimetic metalloproteinase inhibitor batimastat and the chelating agent CaNa2EDTA.
Authors: Rucavado A , Escalante T , Franceschi A , Chaves F , LeÃ³n G , Cury Y , Ovadia M , GutiÃ©rrez J M
Published: May 2017

The effectiveness of the chelating agent CaNa2EDTA and the peptidomimetic matrix metalloproteinase inhibitor batimastat (BB-94) to inhibit local tissue damage induced by Bothrops asper snake venom was studied in mice. Both compounds totally inhibited proteolytic, hemorrhagic, and dermonecrotic effects, and partially reduced edema-forming activity, when incubated with venom prior to injection. Much lower concentrations of batimastat than of CaNa2EDTA were required to inhibit these effects. In addition, batimastat, but not CaNa2EDTA, partially reduced myotoxic activity of the venom. When the inhibitors were administered at various time intervals after envenomation at the same site of venom injection, both compounds were effective in neutralizing local hemorrhage and dermonecrosis if administered rapidly after venom. Inhibition was not as effective as the time lapse between venom and inhibitor injections increased. Owing to the relevance of metalloproteinases in the pathogenesis of local tissue damage induced by B. asper and other pit viper venoms, it is suggested that administration of peptidomimetic metalloproteinase inhibitors or CaNa2EDTA at the site of venom injection may represent a useful alternative to complement antivenoms in the neutralization of venom-induced local tissue damage.
Enzootic transmission of deer tick virus in New England and Wisconsin sites.
Authors: Ebel G D , Campbell E N , Goethert H K , Spielman A , Telford S R
Published: May 2017

To determine whether rodents that are intensely exposed to the deer tick-transmitted agents of Lyme disease, human granulocytic ehrlichiosis, and human babesiosis are also exposed to deer tick virus (DTV), we assayed serum samples from white-footed mice (Peromyscus leucopus) and meadow voles (Microtus pennsylvanicus) in sites densely infested by deer ticks. To conduct serosurveys, we developed an enzyme-linked immunosorbent assay (ELISA) and Western blot assay by cloning, expressing, and purifying a portion of the DTV envelope glycoprotein (DTV rE) for use as test antigen. Sera from mice and voles trapped in Massachusetts, Rhode Island, and Wisconsin were screened by ELISA for IgG reactive to DTV rE. Samples that were positive or borderline by ELISA were subsequently analyzed by immunoblotting. Samples reactive in both assays were considered to be positive. Three percent of 264 mouse samples collected from sites in Rhode Island, 3.8% of 52 samples from mice trapped in Wisconsin, and 3.9% of 282 samples collected from mice trapped on Nantucket Island, MA were positive. No samples from either Great Island, MA, or voles from any study site were reactive. A reverse transcriptase-polymerase chain reaction yielded molecular evidence of DTV infecting questing adult deer ticks in sites where seroreactive mice were trapped, but not from ticks collected where serologic evidence of virus perpetuation was absent. White-footed mice appear to be exposed to DTV in certain sites where other deer tick-borne agents perpetuate. This virus may be maintained in the same enzootic cycle.
A case of chromomycosis treated by a combination of cryotherapy, shaving, oral 5-fluorocytosine, and oral amphotericin B.
Authors: Poirriez J , Breuillard F , Francois N , Fruit J , Sendid B , Gross S , Dei-Cas E
Published: May 2017

A case of chromomycosis from Comoro Islands was first treated without success with high doses of oral amphotericin B (3 g per day). Treatment with itraconazole (400 mg per day) was also unsuccessful. Then, in vitro tests were done to study the susceptibility of this Fonsecaea pedrosoi strain to antifungal drugs. It was resistant to itraconazole, sensitive to 5-fluorocytosine, and the combination of 5-fluorocytosine with amphotericin B was synergistic. The patient was then treated with this last combination of drugs, which seemed to be effective. The patient stopped this treatment after six months, and relapse occurred two years later. The best therapeutic strategy in cases of chromomycosis seems to be a combination of two drugs chosen according to the results of prior antifungal susceptibility testing.
Interstitial dendritic cells of the heart harbor Trypanosoma cruzi antigens in experimentally infected dogs: importance for the pathogenesis of chagasic myocarditis.
Authors: Andrade S G , Pimentel A R , de Souza M M , Andrade Z A
Published: May 2017

Heart sections from 16 mongrel dogs, two normal controls and 14 infected with Trypanosoma cruzi, were submitted to immunohistochemical staining with either rabbit anti-cow S100 Protein monoclonal antibody or rabbit anti-T. cruzi purified specific antibody, using the peroxidase technique to investigate the participation of the interstitial dendritic cells of the heart (IDCs) in myocarditis of Chagas disease. Trypanosoma cruzi antigens were revealed as granular and dense deposits in IDC membrane in the heart of infected dogs both during acute and chronic myocarditis, but not in normal controls. Anti-S100 Protein labeled the IDCs, both in normal and infected dogs and a significant increase in the numbers of IDCs occurred in the myocardium, proportionally to the intensity of the inflammatory infiltration. These findings suggest that IDCs, probably by presenting T. cruzi antigens to immune-competent cells, play an important role in the pathogenesis of Chagas disease.
Enhanced development in nature of larval Anopheles arabiensis mosquitoes feeding on maize pollen.
Authors: Ye-Ebiyo Y , Pollack R J , Spielman A
Published: May 2017

To determine whether pollen produced by maize (Zea m. mays) may contribute to the development of larval Anopheles gambiae complex mosquitoes, the main African vectors of malaria, we correlated duration of larval development, pupation success, and size of the resulting adults with degree of access to this potential nutriment. Maize pollen is abundant during the wet season on the surface of water near maize plantings in a malaria-endemic region of Ethiopia, and larval Anopheles arabiensis readily ingest these particles in nature. Larvae develop to the pupal stage more rapidly, more frequently, and produce larger adults where maize pollen is abundant than do those that have little access to this food. The force of transmission of malaria in sub-Saharan Africa might be reduced if maize plantings were excluded from the immediate vicinity of homes or, perhaps, if pollen of such maize were to express entomotoxins.
Plasmodium coatneyi: observations on periodicity, mosquito infection, and transmission to Macaca mulatta monkeys.
Authors: Collins W E , Warren M , Sullivan J S , Galland G G
Published: May 2017

Plasmodium coatneyi has adapted well to experimental studies with Macaca mulatta monkeys and Anopheles dirus mosquitoes. Studies were made to determine 1) the course of asexual parasitemia, 2) periods when infective gametocytes were produced, 3) the laboratory-reared mosquitoes susceptible to infection, 4) the mosquito most capable of transmitting the infection to monkeys via bite, 5) the pattern of recrudescence, and 6) the prepatent periods following the bites of infected An. dirus mosquitoes. The period when infective gametocytes are produced is concentrated primarily in the first week when parasitemia exceeds 1,000/microl. Mosquitoes were more heavily infected on days when the asexual parasite counts were highest. Gametocyte counts were generally low. Mature forms of the parasite markedly sequestered giving a pattern of high-low periodicity. Anopheles dirus and An. freeborni mosquitoes were nearly equal in terms of their ability to support oocyst development. Other species (An. stephensi, An. maculatus, and An. gambiae.) were less supportive. High sporozoite densities in the salivary glands were frequently produced in An. dirus and sporozoite transmission was obtained via the bites of these mosquitoes after 12-18 days of extrinsic incubation. Prepatent periods ranged from 10 to 15 days. The presence of frequent parasitic recrudescences suggests mechanisms similar to that seen in human infections with P. falciparum. It is proposed that P. coatneyi in M. mulatta monkeys can be a suitable model for studies on cerebral pathology, vaccine efficacy, and the testing of antimalarial drugs.
Canine visceral leishmaniasis in Colombia: relationship between clinical and parasitologic status and infectivity for sand flies.
Authors: Travi B L , Tabares C J , Cadena H , Ferro C , Osorio Y
Published: May 2017

We studied the reservoir competency of canines with distinct clinical presentations of Leishmania chagasi infection. The parasitologic status of asymptomatic and symptomatic dogs was determined by standard culture methods Infectivity was assessed by multiple xenodiagnoses with Lutzomyia longipalpis, over a period of 2-11 months. Asymptomatic dogs were non-infective (0 of 5) while 2 of 7 oligosymptomatic dogs infected L longipalpis, transmitting the parasites at low rates (range 0.9-5.2% of engorged flies). Polysymptomatic dogs transmitted L. chagasi more frequently (4 of 8 dogs) and reached higher infection rates (range 5.0-22.5% of engorged flies). The skin of the ear tended to be more infective to sand flies than that of the abdomen. Polymerase chain reaction hybridization (PCR-H) was a sensitive method for detection of L. chagasi, yielding the highest positive rate in serum (16 of 17 dogs) with no distinction between clinical groups. No association between skin positivity by PCR-H and infectivity to sand flies was found. The infectivity of dogs from clinically comparable groups from Colombian and Mediterranean foci differed. This may be a reflection of varied nutritional conditions or vector competency of distinct sand fly species.
Effect of climatic factors and population density on varicella zoster virus epidemiology within a tropical country.
Authors: Lolekha S , Tanthiphabha W , Sornchai P , Kosuwan P , Sutra S , Warachit B , Chup-Upprakarn S , Hutagalung Y , Weil J , Bock H L
Published: May 2017

Blood samples were collected from healthy subjects, aged 9 months-29 years in urban and rural communities from 4 distinct regions in Thailand, to determine the seroprevalence rate of varicella-zoster virus (VZV) antibody and its relationship with demographic, climatic, and socioeconomic factors. The overall seroprevalence rate was 52.8% and increased from 15.5% in the 9-month to 4-year-old group to 75.9% in the 20-29 year-olds. The age-adjusted seroprevalence was significantly higher in the cooler than in the warmer regions. In the warmer regions only, the age-specific seroprevalence was significantly higher in the urban population than in the rural population. In Thailand, climate is the main determinant of VZV seroprevalence. The delayed onset of natural immunity is more marked in warmer climate areas. Population density is a secondary determinant; in the warmer areas, the pattern of adolescent and adult susceptibility was greater in rural than in urban areas.
Hepatitis c and cirrhotic liver disease in the Nile delta of Egypt: a community-based study.
Authors: Darwish M A , Faris R , Darwish N , Shouman A , Gadallah M , El-Sharkawy M S , Edelman R , Grumbach K , Rao M R , Clemens J D
Published: May 2017

Residents of Egypt's Nile river delta have among the world's highest seroprevalence of hepatitis C virus (HCV) infection. To assess the impact of HCV on chronic liver disease, we studied the association between HCV, other hepatitis viruses, and cirrhotic liver disease in a cross-sectional, community-based survey of 801 persons aged > or = 10 years living in a semi-urban, Nile delta village. Residents were systematically sampled using questionnaires, physical examination, abdominal ultrasonography and serologically for antibodies to HCV (confirmed by a third-generation immunoblot assay) and to hepatitis A virus (HAV), hepatitis B virus (HBV), and hepatitis E virus (HEV). The seroprevalence of HCV increased with age from 19% in persons 10-19 years old to about 60% in persons 30 years and older. Although no practices that might facilitate HCV transmission were discovered, the seroprevalence of HCV was significantly associated with remote (> 1 year) histories of schistosomiasis. Sonographic evidence of cirrhosis was present in 3% (95% CI: 1%, 4%) of the population (0.7% of persons under 30 years of age and in 5% of older persons), and was significantly associated with HCV seroreactivity. Our findings are consistent with the hypothesis that past mass parenteral chemotherapy campaigns for schistosomiasis facilitated HCV transmission, and that HCV may be a major cause of the high prevalence of liver cirrhosis in this Nile village.
Four cases of acute chagasic myocarditis in French Guiana.
Authors: Carme B , Aune I , Nguyen G , Aznar C , Beaudet B
Published: May 2017

The authors report four cases of acute chagasic myocarditis which had been diagnosed and treated in Cayenne, French Guiana, in the past 6 years. This French territory, which has the highest standard of living in South America, should be considered an area of risk for sporadic Chagas disease with epidemiologic features similar to those of the disease found in dense Amazon forest areas. Appropriate measures must be taken to screen and promptly manage Chagas disease in the French Guiana population.
Community-acquired pneumonia in Ugandan adults: short-term parenteral ampicillin therapy for bacterial pneumonia.
Authors: Yoshimine H , Oishi K , Mubiru F , Nalwoga H , Takahashi H , Amano H , Ombasi P , Watanabe K , Joloba M , Aisu T , Ahmed K , Shimada M , Mugerwa R , Nagatake T
Published: May 2017

A hospital-based prospective study of 99 patients with community-acquired pneumonia (CAP) was carried out in Kampala, Uganda. We evaluated microbiological etiologies, clinical features and effectiveness of short-term parenteral ampicillin followed by oral amoxicillin for these patients in relation to HIV-status. We demonstrated a very high prevalence (75%) of HIV-1 infection. No significant difference was observed with respect to age, gender, prior antibiotic usage, symptoms, laboratory data or bacterial etiology between HIV-1-infected and HIV-uninfected CAP patients. Most strains of Streptococcus pneumoniae (n = 19) and Haemophilus influenzae (n = 8) isolated from HIV-1-infected patients were penicillin-resistant (95%) and beta-lactamase producing (75%) strains, respectively. A high percentage of good clinical response was found in both HIV-1-infected (81%) and HIV-uninfected (86%) among 39 patients with CAP due to a defined bacterial pathogen. These data support the use of short-term parenteral ampicillin for patients with bacterial CAP irrespective of HIV-status.
Short report: IgG1/IgG3 antibody responses to various analogs of recombinant ypfmsp119--a study in immune adults living in areas of Plasmodium falciparum transmission.
Authors: Diallo T O , Spiegel A , Diouf A , Perraut R , Kaslow D C , Garraud O
Published: May 2017

To further characterize protective-type (IgG1/IgG3) antibody responses to Plasmodium falciparum blood stage in putatively immune individuals' plasma, we have tested for various analogs of the 19 kDa C-terminus of the MSP1 antigen obtained as secreted recombinant proteins from Saccharomyces cerevisiae. One of four proteins was then identified on the basis of consistent IgG3, along with less variable IgG1 recognition. This protein has thus been selected for further functional assays of IgG1/IgG3 antibodies.
Chloroquine/doxycycline combination versus chloroquine alone, and doxycycline alone for the treatment of Plasmodium falciparum and Plasmodium vivax malaria in northeastern Irian Jaya, Indonesia.
Authors: Taylor W R , Widjaja H , Richie T L , Basri H , Ohrt C , Tjitra  , Taufik E , Jones T R , Kain K C , Hoffman S L
Published: May 2017

Combination therapy is one method of overcoming the global challenge of drug-resistant Plasmodium falciparum malaria. We conducted a hospital-based 28-day in vivo test comparing chloroquine/doxycycline to chloroquine or doxycycline alone for treating P. falciparum and Plasmodium vivax malaria in Irian Jaya, Indonesia. Eighty-nine patients with uncomplicated falciparum malaria were randomized to standard dose chloroquine (n = 30), doxycycline (100 mg every 12 hours [7 days], n = 20), or chloroquine with doxycycline (n = 39); corresponding numbers for vivax malaria (n = 63) were 23, 16, 24. Endpoints were parasite sensitivity (S) or resistance (RI/RII/RIII). Of the 105 evaluable patients, chloroquine/doxycycline cured (S) 20/22 (90.9% [95% CI 78.9-100%]) patients with P. falciparum malaria; 2/22 (9.1% [0-21%]) were RIII resistant. Doxycycline cured 11/17 (64.7% [42.0-87.4%]) patients, and chloroquine 4/20 (20% [2.5-37.5%]). Against P. vivax, chloroquine/doxycycline cured (S) 12/17 (70.6% [48.9-92.2%]) patients, doxycycline 4/12 (33.3% [6.6-59.9%]), and chloroquine 5/17 (29.4% [7.7-51.1%]). Chloroquine/doxycycline was effective against P. falciparum but only modestly effective against P. vivax. These findings support the use of chloroquine/doxycycline as an inexpensive alternative to mefloquine for treating chloroquine-resistant P. falciparum but not chloroquine-resistant P. vivax in this setting.
Clinical trial of beta-arteether versus quinine for the treatment of cerebral malaria in children in Yaounde, Cameroon.
Authors: Moyou-Somo R , Tietche F , Ondoa M , Kouemeni L E , Ekoe T , Mbonda E , Nsangou C , Jemea B , Guemkam G
Published: May 2017

One hundred and two children aged 0-10 years with cerebral malaria (Blantyre coma score of 2 or less) were randomly treated either with intramuscular arteether (3.2 mg/kg on Day 0, followed by 1.6 mg/kg on Days 1 to 4) or intravenous (i.v.) quinine dihydrochloride (20 mg of the salt/kg, followed by 10 mg of the salt/kg every 8 hr up to Day 6). Treatment with oral quinine sulfate (10 mg/kg every 8 hr) was substituted for i.v. quinine when the patient was able to take oral medicine. All patients were followed up in the hospital for 7 days; thereafter, they were treated as outpatients on Days 14, 21, and 28. Mortality rate, the main efficacy parameter, was 11.8% lower in the arteether treatment group than in the quinine group (15.7% versus 27.4%); however, the difference was not significant (P = 0.25). Means for fever clearance time, coma resolution time, and parasite clearance time were similar in the 2 treatment groups (42.2 +/- 34.9 hr; 34.8 +/- 18.8 hr, and 46.3 +/- 28.5 hr, respectively for arteether, versus 45.0 +/- 26.7 hr; 30.3 +/- 18.9 hr, and 40.7 +/- 18.9 hr, respectively, for quinine). At 28 days, the cure rates were 73.2% and 64.9% for the arteether and quinine treatment groups, respectively. Arteether is safe and therapeutically at least as effective as quinine for the treatment of cerebral malaria in children in Cameroon. Because of its ease of administration, arteether appears to be suited for use in the rural zones where monitoring facilities do not exist.
A colorimetric in vitro drug sensitivity assay for Plasmodium falciparum based on a highly sensitive double-site lactate dehydrogenase antigen-capture enzyme-linked immunosorbent assay.
Authors: Druilhe P , Moreno A , Blanc C , Brasseur P H , Jacquier P
Published: May 2017

We report a double-site enzyme-linked lactate dehydrogenase immunodetection assay (DELI), a highly sensitive antigen-capture enzyme-linked immunosorbent assay, which proved to be more sensitive for the detection of Plasmodium falciparum than thick blood smears, as sensitive as the polymerase chain reaction, and probably more reliable. This technique can help to detect infra-microscopic parasitemias (one parasite in 10(6)-10(8) red blood cells) from biological samples, and being quantitative, provide a fast substitute to thick smears for epidemiologic purposes. The technique can also be used to measure the in vitro drug sensitivity of P. falciparum with greater ease, much greater speed, and simpler equipment than that required for the isotopic microtest. Results obtained with four antimalarial drugs upon 16 strains closely paralleled those obtained by the isotopic assay (R = 0.95). In contrast with the latter, much lower parasite densities could be tested in the DELI assay (as low as 0.005%), thereby extending the number of isolates that can be investigated. The ease of implementation and low cost of the DELI-microtest may contribute to a revived interest in using in vitro methods to survey resistance to antimalarial drugs, so as to better predict future in vivo drug failures and provide public health recommendations.
Maintenance therapy of melioidosis with ciprofloxacin plus azithromycin compared with cotrimoxazole plus doxycycline.
Authors: Chetchotisakd P , Chaowagul W , Mootsikapun P , Budhsarawong D , Thinkamrop B
Published: May 2017

This is a report of a randomized, open, labeled study of the maintenance treatment of melioidosis using a combination of ciprofloxacin and azithromycin (Regimen A) for 12 weeks versus a combination of cotrimoxazole and doxycycline (Regimen B) for 20 weeks. The study was conducted at two tertiary-care hospitals in northeast Thailand. A total 65 patients were enrolled, 36 and 29, respectively, between August 1997 and July 1998. Subjects were randomly allocated to each arm of the trial, resulting in 32 treated under Regimen A and 33 in B. The main outcome was a culture-proven relapse in melioidosis. There were more relapses under Regimen A at 22% (7 of 32) than in Regimen B, 3% (1 of 33). The 19% difference in the rates was significant (95% confidence interval [CI]: 3% to 34%; exact P-value = 0.027). Based on our data, a combination of cotrimoxazole and doxycycline treatment for 20 weeks should be given further consideration as the maintenance therapy of choice for melioidosis.
The use of IS2404 restriction fragment length polymorphisms suggests the diversity of Mycobacterium ulcerans from different geographical areas.
Authors: Chemlal K , De Ridder K , Fonteyne P A , Meyers W M , Swings J , Portaels F
Published: May 2017

Buruli ulcer, caused by Mycobacterium ulcerans, has been reported in five continents: Africa, Asia, Australia, and North and South America. In the present study, restriction fragment length polymorphism with the recently described M. ulcerans specific insertion sequence IS2404 as a probe, was applied to Mycobacterium shinshuense, Mycobacterium marinum, and 14 clinical M. ulcerans isolates originating from six geographic areas: Africa (n = 6), Australia (n = 2), Mexico (n = 1), south Asia (n = 2), Asia (n = 1), and South America (n = 2). Using this probe, six subtypes of M. ulcerans, related to the six geographic origins of the isolates were distinguished, confirming that M. ulcerans can be divided into subgroups corresponding to different geographic variants of the same species.
Case report: Acute myocardial infarction complicating a viper bite.
Authors: Saadeh A M
Published: May 2017

Myocardial infarction is a rare complication of snakebite. The present report describes a 40-year-old Jordanian farmer who developed an acute myocardial infarction several hours after a snakebite. The diagnosis of myocardial infarction was confirmed by a typical history of retrosternal chest pain, characteristic electrocardiographic changes, and elevated serum creatinine kinase (MB-CK). The patient had no risk factors for coronary artery disease and the coronary arteries were normal on cardiac catheterization. The possible mechanisms leading to myocardial infarction following snakebite are discussed.
Specific heterologous F(ab')2 antibodies revert blood incoagulability resulting from envenoming by Lonomia obliqua caterpillars.
Authors: Rocha-Campos A C , GonÃ§alves L R , Higashi H G , Yamagushi I K , Fernandes I , Oliveira J E , Ribela M T , Sousa-E-Silva M C , da Silva W D
Published: May 2017

Contact with Lonomia obliqua caterpillars results in a bleeding syndrome characterized by hemorrhage and blood coagulation disturbances. Conventional therapy using antifibrinolytics or cryoprecipitates has been unable to treat pathophysiologic alterations. As antivenoms are effective therapy for treatment of victims of venomous animals, a process of manufacturing a specific antilonomic serum by immunizing horses with Lonomia caterpillar bristle extracts (LBE) was developed. Lonomia caterpillar bristle extracts exhibited several protein bands on SDS-PAGE, induced blood coagulation abnormalities and lethality in mice, and stimulated specific antibody production in horses. Sera obtained from immunized horses were rich in anti-LBE specific antibodies distributed among the horse IgG isotypes. These antibodies had the ability to recognize various LBE antigens as well as to neutralize their coagulopathy-inducing activity. The antivenom manufactured by the developed process was composed of purified and sterilized F(ab')2 with ED50 = 38.61 microl, potency = 0.29 mg/ml, and 95% confidence limit of potency 0.20-1.36.
Multiplex polymerase chain reaction amplification and differentiation of Entamoeba histolytica and Entamoeba dispar DNA from stool samples.
Authors: NÃºÃ±ez Y O , FernÃ¡ndez M A , Torres-NÃºÃ±ez D , Silva J A , Montano I , Maestre J L , Fonte L
Published: May 2017

Due to the clinical importance of differentiating the two species of the Entamoeba histolytica/Entamoeba dispar complex, we developed a multiplex polymerase chain reaction (PCR) method that overcomes time-consuming and laborious procedures. We report here a DNA extraction protocol using non-fixed stool samples that avoid long lysis-incubation periods through the combined use of zirconium beads and a lysis-supporting buffer. We characterized 49 of 52 stool specimens from Cuban patients with amoebiosis. Among them, 36 (75.5%) were infected only with E. dispar (the nonpathogenic species), while 13 (24.5%) displayed a mixed infection with both E. dispar and E. histolytica. The multiplex PCR protocol showed a specificity of 1.00 and a sensitivity of 0.94. Furthermore, the entire procedure can be performed in one day. This approach is therefore reliable and applicable in the field for epidemiologic studies.
Case report: Unusual location of Dirofilaria immitis in a 28-year-old man necessitates orchiectomy.
Authors: Theis J H , Gilson A , Simon G E , Bradshaw B , Clark D
Published: May 2017

The fourth case of zoonotic Dirofilaria immitis infection in a California resident is reported. This case was unique in that it involved the spermatic cord, produced significant symptoms, and upon physical examination was suspected of being an incarcerated inguinal hernia. At surgery frozen sections were inconclusive regarding neoplasia and cord involvement precluded removal of the mass without orchiectomy, which was done. Histopathology revealed a well-preserved immature male D. immitis, the canine heartworm, in a branch of the spermatic artery. The morphological identification of the worm was confirmed by polymerase chain reaction (PCR) studies. This case illustrates that D. immitis infections can complicate differential diagnosis of extrapulmonary lesions and suggests that the public health significance of this vector-borne filarial worm needs to be evaluated through appropriate epidemiological studies in enzootic areas.
Comparison of direct and membrane feeding methods to infect Anopheles arabiensis with Plasmodium falciparum.
Authors: Awono-Ambene H P , Diawara L , Robert V
Published: May 2017

Two standard methods are available to infect mosquitoes with malaria parasites: direct feeding through the skin of the gametocyte carrier, and membrane feeding. Anopheles arabiensis collected at larval stages and reared in an insectary were fed in parallel by feeding on Plasmodium falciparum gametocyte carriers and by membrane feeding on venous blood of the same gametocyte carriers. Infection of mosquitoes was assessed at Day 7 post bloodmeal by oocyst count of the mosquito midguts. The following parameters were not significantly different between the two methods: the percentage of gametocyte carriers infective for at least one mosquito (52.4% through the skin versus 57.1% through the membrane), the mean infection rate of mosquitoes (10.0% versus 11.3%), the geometric mean oocyst number per mosquito (2.51 versus 3.83). In conclusion, infection of mosquitoes by membrane feeding was similar to infection by direct feeding. Most of the volunteers preferred venipuncture to mosquito bites.
Short report: documentation of iodine deficiency in Haitian schoolchildren: implication for lymphatic filariasis elimination in Haiti.
Authors: Beach M J , Streit T G , Houston R , May W A , Addiss D G , Lammie P J
Published: May 2017

In this study we documented unexpected moderate-to-severe iodine deficiency in Haitian schoolchildren although they live in a coastal community where presumably they have access to iodine-containing seafood. This fact combined with the lack of an iodized salt supply and endemic lymphatic filariasis makes community distribution of diethylcarbamazine-fortified, iodized salt an attractive strategy for elimination of lymphatic filariasis and iodine deficiency disorders in this area of Haiti. Combining lymphatic filariasis elimination with other public health interventions is one strategy to increase its public health benefit and maximize the impact of limited public health resources.
Ecological studies of enzootic Venezuelan equine encephalitis in north-central Venezuela, 1997-1998.
Authors: Salas R A , Garcia C Z , Liria J , Barrera R , Navarro J C , Medina G , Vasquez C , Fernandez Z , Weaver S C
Published: May 2017

From 1997-1998, we investigated the possible continuous circulation of epizootic Venezuelan equine encephalitis (VEE) virus suggested by a 1983 subtype IC interepizootic mosquito isolate made in Panaquire, Miranda State, Venezuela. The study area was originally covered by lowland tropical rainforest but has been converted into cacao plantations. Sentinel hamsters, small mammal trapping, mosquito collections, and human serosurveys were used to detect active or recent virus circulation. Six strains of subtype ID VEE virus were isolated from hamsters that displayed no apparent disease. Four other arboviruses belonging to group A (Togaviridae: Alphavirus), two Bunyamwera group (Bunyaviridae), and three Gamboa group (Bunyaviridae) arboviruses were also isolated from hamsters, as well as 8 unidentified viruses. Venezuelan equine encephalitis-specific antibodies were detected in 5 small mammal species: Proechimys guairae, Marmosa spp., and Didelphis marsupialis. Mosquito collections comprised of 38 different species, including 8 members of the subgenus Culex (Melanoconion), did not yield any virus isolates. Sera from 195 humans, either workers in the cacao plantation or nearby residents, were all negative for VEE virus antibodies. Sequences of 1,677 nucleotides from the P62 gene of 2 virus isolates indicated that they represent a subtype ID lineage that is distinct from all others characterized previously, and are unrelated to epizootic VEE emergence.
Limited polymorphism in Plasmodium falciparum sexual-stage antigens.
Authors: Niederwieser I , Felger I , Beck H P
Published: May 2017

In areas highly endemic for malaria, individuals are frequently found to be infected simultaneously with multiple Plasmodium falciparum clones. This raises the question of whether all parasite clones produce gametocytes equally or whether gametocytogenesis is suppressed in some clones. In order to assess this in epidemiological studies, polymorphic genes specifically expressed in gametocytes could be analyzed by both amplification of genomic DNA from blood samples and by reverse transcribed polymerase chain reaction amplifying expressed gametocyte-specific genes only. Here we report the analysis of diversity in the three gametocyte-specific genes Pfs16, Pfs48/45, and Pfs230. In addition to the previously published data, limited polymorphism was found in the coding sequences of Pfs16 and Pfs48/45. Larger polymorphism was identified in Pfs230, which might allow the development of a discriminating PCR-based genotyping scheme for transmission studies. However, the limited polymorphism in Pfs16 and Pfs48/45 renders these molecules poorly useful for such studies.
Trocara virus: a newly recognized Alphavirus (Togaviridae) isolated from mosquitoes in the Amazon Basin.
Authors: Travassos da Rosa A P , Turell M J , Watts D M , Powers A M , Vasconcelos P F , Jones J W , Klein T A , Dohm D J , Shope R E , Degallier N , Popov V L , Russell K L , Weaver S C , Guzman H , Calampa C , Brault A C , Lemon A P , Tesh R B
Published: May 2017

This report describes Trocara virus, a newly recognized member of the genus Alphavirus, that has been isolated from Aedes serratus mosquitoes collected at two widely separated sites in the Amazon Basin. Biological, antigenic and genetic characteristics of the new virus are given. Results of these studies indicate that Trocara virus is the first member of a newly discovered antigenic complex within the family Togaviridae genus Alphavirus. The public health and veterinary importance of Trocara virus is still unknown.