bluuebunny/crossref_metadata_2025 huggingface dataset:
A Spatial Model of Shared Risk for Plague and Hantavirus Pulmonary Syndrome in the Southwestern United States
Authors: Eisen Rebecca J. , Glass Gregory E. , Eisen Lars , Cheek James , Enscore Russell E. , Ettestad Paul , Gage Kenneth L.
Published: September 2018

Plague and hantavirus pulmonary syndrome (HPS) are severe, often fatal diseases in humans that share a broad epidemiologic focus in the southwestern United States. Prevention of these diseases relies heavily on education and reducing rodent abundance in peridomestic environments. Resources for these activities are limited. Therefore, identifying areas sharing elevated risk for these two relatively rare but severe diseases could be useful for targeting limited public health resources. Using logistic regression and geographic information system–based modeling, we identified environmental predictors of elevated risk for plague (distance to piñon-juniper ecotones and amount of precipitation) and HPS (elevation and amount of precipitation) in northeastern Arizona and northwestern New Mexico. Our models accurately identified case locations as suitable (producer accuracies of 93% for plague and 96% for HPS) and indicated that approximately half of the coverage area was classified as suitable risk for either plague or HPS. The probability of a site being classified as suitable for plague was strongly correlated with its probability of being classified as suitable for HPS (ρs = 0.88). Increased risk for both diseases occurred for approximately 37% of the coverage area.
Patterns of Malaria: Cause-Specific and All-Cause Mortality in a Malaria-Endemic Area of West Africa
Authors: Becher Heiko , Kynast-Wolf Gisela , Sié Ali , Ndugwa Robert , Ramroth Heribert , Kouyaté Bocar , Müller Olaf
Published: September 2018

Information on cause-specific mortality is sparse in sub-Saharan Africa. We present seasonal patterns of malaria and all-cause mortality from a longitudinal study with 60,000 individuals in rural northwestern Burkina Faso. The study is based on a demographic surveillance system and covers the period 1999–2003. Overall, 3,492 deaths were observed. Cause of death was ascertained by verbal autopsy. Age-specific death rates by cause and month of death were calculated. Seasonal and temporal trends were modeled with parametric Poisson regression. Infant and children less than 5 years of age mortality was 60.6 (95% CI, 56.2–65.3) and 31.9 (95% CI, 30.4–33.5) per 1,000 for all causes and 23.4 (95% CI, 20.7–26.4) and 13.3 (95% CI, 12.3–14.3) for malaria, respectively. Mortality was significantly higher in the rainy season. It is well described parametrically with a sinusoidal function. In adults, the highest all-cause mortality rates were observed in the dry season. Here, HIV/AIDS has become a leading cause of mortality.
An Indigenous Case of Plasmodium ovale Infection in Sri Lanka
Authors: Wickremasinghe Renu , Galapaththy Gawrie N. L. , Fernando W. A. P. , de Monbrison Frederique , Wijesinghe Rushika S. , Mendis Kamini N. , Picot Stephane , Ringwald Pascal , Wickremasinghe Ananda R.
Published: September 2018

Plasmodium ovale, which is generally prevalent only in the African region, has been emerging in the Asian and southeast Asian regions. It has not been reported in Sri Lanka. We report, to our knowledge, an indigenous case of P. ovale infection in Sri Lanka. This patient, who was diagnosed by a polymerase chain reaction, had no history of travel overseas or receipt of a transfusion of blood or any blood products, which makes this a likely case of indigenous transmission. This incidental finding of a P. ovale infection has implications for malaria control in the country and highlights the need to rigorously monitor malaria incidence, as well as prevalent Plasmodium species, with newer and more reliable diagnostics.
First Record of Human Infection with the Tapeworm Diphyllobothrium nihonkaiense in North America
Authors: Wicht Barbara , Scholz Tomáš , Peduzzi Raffaele , Kuchta Roman
Published: September 2018

The tapeworm Diphyllobothrium nihonkaiense (Cestoda: Diphyllobothriidea), originally described from Japan, is reported from a man in North America for the first time. Species identification was based on sequences of ribosomal (partial 18S rRNA) and mitochondrial (partial Cytochrome c Oxidase subunit I) genes of proglottids expelled from a Czech tourist who ate raw Pacific sockeye salmon (Oncorhynchus nerka) from British Columbia, Canada.
HLA-DRB1*04 Allele Is Associated with Severe Malaria in Northern Ghana
Authors: Osafo-Addo Awo D. , Koram Kwadwo A. , Oduro Abraham R. , Wilson Michael , Hodgson Abraham , Rogers William O.
Published: September 2018

Several associations between specific HLA alleles and susceptibility or resistance to Plasmodium falciparum malaria have been previously reported, but no associations have been confirmed in multiple populations. We studied associations between HLA-A, -B, and DRB1 alleles and severe malaria in northern Ghana. We analyzed HLA-DRB1*04 in 4,032 subjects from a severe malaria case-control study, 790 severe malaria cases, 1,611 mild malaria controls, and 1631 asymptomatic controls. The presence of HLA-DRB1*04 was associated with severe malaria (OR = 2.42, 95% CI = 1.64, 3.58). The allele frequency of DRB1*04 was similar in the two major ethnic groups in the study population, Kassem (4.4%) and Nankam (4.7%), and the OR for the association between DRB1*04 and severe malaria was similar in both ethnic groups. These findings are consistent with results from Gabon suggesting that DRB1*04 is a risk factor for severe malaria.
Effect of Rice Cultivation on Malaria Transmission in Central Kenya
Authors: Muturi Ephantus J. , Muriu Simon , Shililu Josephat , Mwangangi Joseph , Jacob Benjamin G. , Mbogo Charles , Githure John , Novak Robert J.
Published: September 2018

A 12-month field study was conducted between April 2004 and March 2005 to determine the association between irrigated rice cultivation and malaria transmission in Mwea, Kenya. Adult mosquitoes were collected indoors twice per month in three villages representing non-irrigated, planned, and unplanned rice agro-ecosystems and screened for blood meal sources and Plasmodium falciparum circumsporozoite proteins. Anopheles arabiensis Patton and An. funestus Giles comprised 98.0% and 1.9%, respectively, of the 39,609 female anophelines collected. Other species including An. pharoensis Theobald, An. maculipalpis Giles, An. pretoriensis Theobald, An. coustani Laveran, and An. rufipes Gough comprised the remaining 0.1%. The density of An. arabiensis was highest in the planned rice village and lowest in the non-irrigated village and that of An. funestus was significantly higher in the non-irrigated village than in irrigated ones. The human blood index (HBI) for An. arabiensis was significantly higher in the non-irrigated village compared with irrigated villages. For An. funestus, the HBI for each village differed significantly from the others, being highest in the non-irrigated village and lowest in the planned rice village. The sporozoite rate and annual entomologic inoculation rate (EIR) for An. arabiensis was 1.1% and 3.0 infective bites per person, respectively with no significant difference among villages. Sporozoite positive An. funestus were detected only in planned rice and non-irrigated villages. Overall, 3.0% of An. funestus samples tested positive for Plasmodium falciparum sporozoites. The annual EIR of 2.21 for this species in the non-irrigated village was significantly higher than 0.08 for the planned rice village. We conclude that at least in Mwea Kenya, irrigated rice cultivation may reduce the risk of malaria transmission by An. funestus but has no effect on malaria transmission by An. arabiensis. The zoophilic tendency of malaria vectors in irrigated areas accounts partly for low malaria transmission rates despite the presence of higher vector densities, highlighting the potential of zooprophylaxis in malaria control.
Etiologic Agent of an Epidemic of Cutaneous Leishmaniasis in Tolima, Colombia
Authors: Rodríguez-Barraquer Isabel , Góngora Rafael , Prager Martín , Pacheco Robinson , Montero Luz Mery , Navas Adriana , Ferro Cristina , Miranda Maria Consuelo , Saravia Nancy G.
Published: September 2018

American cutaneous leishmaniasis (ACL) has been characterized as a zoonotic disease. However, peridomestic and domestic transmission have been recorded in at least nine countries in Central and South America. The present study was undertaken to identify the etiologic agent of a peridomestic epidemic of ACL in the Department of Tolima, Colombia. Leishmania isolates were obtained during the diagnosis of 56 patients with ACL who consulted the local leishmaniasis control program in three municipalities in Tolima. Species were identified using monoclonal antibodies and isoenzyme electrophoresis. A total of 53 (94.6%) of 56 isolates were identified as Leishmania (Viannia) guyanensis. Three isolates (5.4%) were identified as L. (V.) panamensis. Leishmania (V.) guyanensis is the probable etiologic agent of the largest epidemic of cutaneous leishmaniasis recorded in Colombia. This species has not previously been reported outside the Amazon and southeastern regions of Colombia, and has not been described in the peridomestic setting or linked with an epidemic.
Quantitative Assessment of the Benefits of Specific Information Technologies Applied to Clinical Studies in Developing Countries
Authors: Avilés William , Ortega Oscar , Kuan Guillermina , Coloma Josefina , Harris Eva
Published: September 2018

Clinical studies and trials require accessibility of large amounts of high-quality information in a timely manner, often daily. The integrated application of information technologies can greatly improve quality control as well as facilitate compliance with established standards such as Good Clinical Practice (GCP) and Good Laboratory Practice (GLP). We have customized and implemented a number of information technologies, such as personal data assistants (PDAs), geographic information system (GIS), and barcode and fingerprint scanning, to streamline a pediatric dengue cohort study in Managua, Nicaragua. Quantitative data was obtained to assess the actual contribution of each technology in relation to processing time, accuracy, real-time access to data, savings in consumable materials, and time to proficiency in training sessions. In addition to specific advantages, these information technologies benefited not only the study itself but numerous routine clinical and laboratory processes in the health center and laboratories of the Nicaraguan Ministry of Health.
Seroprevalence of Chikungunya Virus (CHIKV) Infection on Lamu Island, Kenya, October 2004
Authors: Sergon Kibet , Njuguna Charles , Kalani Rosalia , Ofula Victor , Onyango Clayton , Konongoi Limbaso S. , Bedno Sheryl , Burke Heather , Dumilla Athman M. , Konde Joseph , Njenga M. Kariuki , Sang Rosemary , Breiman Robert F.
Published: September 2018

An outbreak of Chikungunya virus (CHIKV) disease associated with high fever and severe protracted arthralgias was detected in Lamu, Kenya, peaking in July 2004. At least 1,300 cases were documented. We conducted a seroprevalence study to define the magnitude of transmission on Lamu Island. We conducted a systematic cross-sectional survey. We administered questionnaires and tested 288 sera from Lamu residents for IgM and IgG antibodies to CHIKV. Chikungunya virus infection (seropositivity) was defined as a person with IgG and/or IgM antibodies to CHIKV. IgM antibodies to CHIKV were detected in 18% (53/288) and IgG antibodies in 72% (206/288); IgM and/or IgG antibodies were present in 75% (215/288). The seroprevalence findings suggested that the outbreak was widespread, affecting 75% of the Lamu population; extrapolating the findings to the entire population, 13,500 (95% CI, 12,458–14328) were affected. Vector control strategies are needed to control the spread of this mosquito-borne infection.
Family Environment Is Associated with Endemic Burkitt Lymphoma: A Population-based Case-control Study
Authors: Rainey Jeanette J. , Rochford Rosemary , Sumba Peter O. , Kowuor Dickens , Wilson Mark L. , Moormann Ann M.
Published: September 2018

Endemic Burkitt’s lymphoma (eBL) has been linked to Epstein-Barr virus and holoendemic Plasmodium falciparum malaria. These co-infections, however, are insufficient to explain the non-random occurrence of Endemic Burkitt’s lymphoma within Equatorial Africa. To explore whether this distribution could be explained by household characteristics and family environment, we conducted a case-control study using 41 hospitalized incident endemic Burkitt’s lymphoma cases and 91 healthy controls identified through a population-based multistage cluster-sampling scheme in Nyanza Province, Kenya. In a multivariate analysis, odds ratios associated with having one, two, and three or more younger siblings compared with none were 0.28 (90% CI: 0.09, 0.83), 0.59 (90% CI: 0.16, 2.23) and 0.15 (90% CI: 0.03, 0.67) respectively, suggesting that children with endemic Burkitt’s lymphoma were more likely than controls to be last-born. Children with endemic Burkitt’s lymphoma were also more likely to live in non-monogamous families (OR=3.12, 90% CI:1.19, 8.17) and to have at least one deceased parent (OR=3.38, 90% CI: 1.18, 9.64). Household characteristics, especially sibship relationships, may contribute to endemic Burkitt’s lymphoma and therefore warrant further study.
Biochemical Alterations as Markers of Dengue Hemorrhagic Fever
Authors: Villar-Centeno Luis Angel , Díaz-Quijano Fredi Alexander , Martínez-Vega Ruth Aralí
Published: September 2018

We evaluated biochemical alterations as predictors of dengue hemorrhagic fever (DHF). Patients with confirmed infection with dengue virus were prospectively evaluated for the first seven days of disease to determine their final clinical outcome. Serum samples taken 48–96 hours after onset of fever were used for biochemical tests. Of 199 patients, 30 developed DHF. Cases of DHF had higher levels of lactate dehydrogenase (LDH), creatine kinase (CK), and aspartate aminotransferase, and lower levels of albumin, total cholesterol, and triglycerides. Multivariate analysis showed that early alterations of CK (hazard ratio [HR] = 6.98, 95% confidence interval [CI] = 2.34–20.85, P = 0.001), LDH (HR = 3.19, 95% CI = 1.01–10.12, P < 0.05), and albumin (HR = 2.54, 95% CI = 1.09–5.92, P = 0.03) were associated with DHF. Triglyceride levels > 160 mg/dL were negatively associated with developing DHF (HR = 0.07, 95% CI = 0.01–0.59, P = 0.01). Early alterations of biochemical markers can predict DHF in patients with acute fever caused by dengue.
Intestinal Parasites in Kaposi Sarcoma Patients in Uganda: Indication of Shared Risk Factors or Etiologic Association
Authors: Lin Cynthia J. , Katongole-Mbidde Edward , Byekwaso Tadeos , Orem Jackson , Rabkin Charles S. , Mbulaiteye Sam M.
Published: September 2018

Kaposi sarcoma (KS) is endemic in Uganda and shares several risk factors with intestinal parasite infestation, including rural residence, contact with surface water, and walking barefoot, however, the significance of these ecologic relationships is unknown. We investigated these relationships among 1,985 Ugandan patients with cancer. Odds ratios (OR) were calculated using logistic regression. KS patients had higher carriage of Strongyloides stercoralis larvae (OR 2.1, 95% CI 1.2–3.7) and lower carriage of hookworm ova (0.6, 0.4–1.0) and Entamoeba coli cysts (0.7, 0.5–1.0), after adjusting for region of residence, age, gender, and diagnosis. While our findings may be due to confounding, they are compatible with shared risk factors or etiological association between parasites and KS, and warrant well-designed follow up studies.
Susceptibility of Florida Mosquitoes to Infection with Chikungunya Virus
Authors: Reiskind Michael H. , Pesko Kendra , Westbrook Catherine J. , Mores Christopher N.
Published: September 2018

Chikungunya virus (CHIKV) has caused recent, large epidemics on islands in the Indian Ocean, raising the possibility of more widespread CHIKV epidemics. Historically, CHIKV has been vectored by Aedes aegypti, but these outbreaks likely also involved Ae. albopictus. To examine the potential for an outbreak of CHIKV in Florida, we determined the susceptibility to CHIKV of F1 Ae. aegypti and Ae. albopictus from Florida. In addition, we also evaluated two well-characterized laboratory strains (Rockefeller and Lake Charles) of these species. We determined infection and dissemination rates as well as total body titer of mosquitoes 7 days post-exposure (pe) (Ae. albopictus) and 3, 7, and 10 days pe (Ae. aegypti). All mosquito strains were susceptible to both infection and dissemination, with some variation between strains. Our results suggest Florida would be vulnerable to transmission of CHIKV in urban and rural areas where the two vector species occur.
High Subclinical West Nile Virus Incidence among Nonvaccinated Horses in Northern California Associated with Low Vector Abundance and Infection
Authors: Nielsen Carrie F. , Reisen William K. , Armijos M. Veronica , MacLachlan N. James , Scott Thomas W.
Published: September 2018

Although horse cases frequently are reported during West Nile virus (WNV) outbreaks, few investigations have focused on the epidemiology of this transmission. From April to October 2003 to 2005, mosquito abundance and infection were monitored 3 days per week at an equine research facility at the University of California, Davis. Thirty-two nonvaccinated horses enrolled as controls in a vaccine study were bled monthly, and their serum was tested for evidence of WNV infection by plaque reduction neutralization test (PRNT). In 2004, one positive Culex pipiens pool was associated with a single horse that presented with confirmed WNV disease in late September. The annual incidence of clinical and subclinical WNV infection in the nonvaccinated horses was 16%, with an apparent to inapparent ratio of 1:4 among infected horses. In 2005, two Culex tarsalis and two Cx. pipiens WNV-positive pools were associated with an equine infection incidence of 62%, with an apparent to inapparent ratio of 1:17. The majority (79%) of 70 blood-engorged Cx. pipiens fed on birds and the remaining on equines (21%). Conversely, Cx. tarsalis fed primarily on equines (n = 23, 74%), followed by birds (n = 7, 23%) and 1 (3%) fed on a lagomorph. These data indicated that nonvaccinated horses were a sensitive indicator of WNV activity and that their risk of infection was associated with the presence of infection in Cx. pipiens and Cx. tarsalis, which served as both enzootic and bridge vectors amplifying WNV among birds and transmitting WNV to horses.
The Molecular Epidemiology of Ocular Chlamydia trachomatis Infections in Western Australia: Implications for Trachoma Control
Authors: Porter Michelle , Mak Donna , Chidlow Glenys , Harnett Gerald B. , Smith David W.
Published: September 2018

We studied the serovar distribution of Chlamydia trachomatis in patients with clinical eye disease in Western Australia. Most disease occurred in indigenous communities and was caused by trachoma serovars Ba and C. Serovar Ba was genetically homogeneous throughout Western Australia and identical to strains previously described in indigenous communities in Northern Territory. This finding probably results from movement of these populations, and suggests that a widely coordinated, rather than local or regional, approach is needed to control trachoma in mobile populations. Serovar C strains within Western Australia were homogeneous but distinct from those in Northern Territory, possibly because of inherent differences in transmissibility or differences in population movements among communities carrying the different serovars. Genital serovars were occasional causes of eye diseases in infants, adolescents, and adults in trachoma-endemic areas. These serovars should be considered in the differential diagnosis of acute follicular conjunctivitis in these groups.
Noma in Laos: Stigma of Severe Poverty in Rural Asia
Authors: Srour M. Leila , Watt Bryan , Phengdy Bounthom , Khansoulivong Keutmy , Harris Jim , Bennett Christopher , Strobel Michel , Dupuis Christian , Newton Paul N.
Published: September 2018

Noma, or cancrum oris, is a debilitating necrotizing ulcerative stomatitis that destroys the mouth and face. It usually starts in early childhood and is associated with severe poverty, malnutrition, and infections. It is most frequently described from sub-Saharan Africa but is under-reported. There have been very few reports from Asia. We describe the clinical and social features of a series of 12 patients with noma from remote poor villages in rural Lao People’s Democratic Republic (Laos). Noma is an ominous stigma of severe poverty and the description of this disease emphasizes the importance of poverty reduction and nutritional improvement in Lao development. In the meantime, more awareness of the problem and the importance of early therapy in acute noma by primary health care workers may reduce mortality and prevent progression to severe disfigurement.
Encephalopathy after Ivermectin Treatment in a Patient Infected with Loa Loa and Plasmodium spp.
Authors: Kamgno Joseph , Boussinesq Michel , Labrousse François , Nkegoum Blaise , Thylefors Björn I. , Mackenzie Charles D.
Published: September 2018

Despite over 350 million people being safely treated with ivermectin, there have been rare cases of death post-treatment; these events are most often associated with high Loa loa microfilaremia. This first autopsy description of an encephalopathy case following the administration of ivermectin involves a 45-year-old male who became comatose 3 days after treatment. He slowly deteriorated over 5 weeks and died at 54 days after the anthelminthic treatment, probably as a result of a secondary skin or pulmonary infection exacerbated by malnutrition. The major pre- and post-autopsy findings included the presence of high loads of Loa loa, positivity for Plasmodium, the presence of a longstanding respiratory condition, and vascular pathology in the brain. The central nervous system lesions have similarities with those described in previously reported cases of Loa loa-associated death following diethylcarbamazine treatment.
Impaired Clinical Response in a Patient with Uncomplicated Falciparum Malaria Who Received Poor-Quality and Underdosed Intramuscular Artemether
Authors: Keoluangkhot Valy , Green Michael D. , Nyadong Leonard , Fernández Facundo M. , Mayxay Mayfong , Newton Paul N.
Published: September 2018

We describe an adult with uncomplicated Plasmodium falciparum malaria who did not improve clinically despite 5 days of intramuscular artemether therapy. He was prescribed a lower dose (kg body weight) than that recommended, and a vial from the packet contained only 74% of the artemether dose as stated by the manufacturer. The combination of underdosing, poor-quality drug, and the intrinsic low bioavailability of artemether may have contributed to his poor clinical response. Analysis of the packaging and chemical “fingerprinting” of the artemether suggested that the drug was genuine but was either substandard or had deteriorated after manufacture.
Pathophysiology of Jaundice in Amoebic Liver Abscess
Authors: Singh Virendra , Bhalla Ashish , Sharma Navneet , Mahi Sushil Kumar , Lal Anupam , Singh Paramjeet
Published: September 2018

Jaundice in patients with amoebic liver abscess is a frequent occurrence. However, the pathophysiology of jaundice in these patients is not fully understood. Hepatic necrosis leads to damage to bile ducts as well as various vascular structures, which in turn leads to biliovascular fistula and jaundice. We studied the mechanism of jaundice in patients with amoebic liver abscess. We prospectively evaluated 12 patients with amoebic liver abscess and jaundice from February 2002 to August 2007. All patients underwent various investigations, including imaging studies. There were 11 males and 1 female patient with a mean age of 41.3 years. Mean duration of illness before presentation was 13.8 days. All patients had fever and jaundice. We detected damaged hepatic veins and bile ducts in all patients with amoebic liver abscess causing biliovascular fistula and hyperbilirubinemia, which reverted to normal after biliary diversion with nasobiliary drainage. Jaundice in patients with amoebic liver abscess is caused by biliovascular fistula resulting from hepatic necrosis leading to damage to bile ducts and hepatic veins.
Ecoepidemiology of Tularemia in the Southcentral United States
Authors: Eisen Rebecca J. , Mead Paul S. , Meyer Andrew M. , Pfaff Liza E. , Bradley Kristy K. , Eisen Lars
Published: September 2018

We combined county-based data for tularemia incidence from 1990 to 2003 for a nine-state region (Arkansas, Illinois, Indiana, Kansas, Kentucky, Missouri, Nebraska, Oklahoma, and Tennessee) in the southcentral United States with Geographic Information System (GIS)-based environmental data to determine associations between coverage by different habitats (especially dry forest representing suitable tick habitat) and tularemia incidence. High-risk counties (> 1 case per 100,000 person-years) clustered in Arkansas-Missouri and far eastern Oklahoma and Kansas. County tularemia incidence was positively associated with coverage by dry forested habitat suitable for vector ticks for Oklahoma-Kansas-Nebraska and Arkansas-Missouri but not for Illinois-Indiana-Kentucky-Tennessee. A multivariate logistic regression model predicting presence of areas with risk of tularemia based on GIS-derived environmental data was developed for the Arkansas-Missouri tularemia focus. The study shows the potential for research on tularemia ecoepidemiology and highlights the need for further modeling efforts based on acarologic data and more fine-scale point or zip code/census tract epidemiologic data.
The Value of Molecular Studies for the Diagnosis of Congenital Chagas Disease in Northeastern Argentina
Authors: Diez Cristina N. , Manattini Silvia , Zanuttini Juan Carlos , Bottasso Oscar , Marcipar Iván
Published: September 2018

Polymerase chain reaction (PCR) as a diagnostic tool for congenital Chagas disease is scarcely used. To assess the usefulness of PCR, a study in neonates was carried out to compare PCR with standard methods; that is bloodstream parasites by microhematocrit, and/or seroconversion by two conventional procedures. Seventeen neonates, born to mothers with positive Trypanosoma cruzi serology were analyzed by serologic, parasitological and molecular procedures, in blood samples taken at birth, and when aged 2–4 and 9 months. For a better comparison of sensitivity between both parasitological methods (microhematocrit and PCR), the number of samples of neonates studied at birth extended to 121. In children followed-up until 9 months of age, a 100% correlation between PCR and routine diagnosis was found, with PCR showing its highest sensitivity from Month 2 onwards. Comparative analysis between both parasitological methods, on samples taken at birth, showed a higher sensitivity of PCR respect the microhematocrit (P < 0.0008).
Association of pfcrt But Not pfmdr1 Alleles with Chloroquine Resistance in Iranian Isolates of Plasmodium falciparum
Authors: Zakeri Sedigheh , Afsharpad Mandana , Kazemzadeh Tahmineh , Mehdizadeh Kambiz , Shabani Ashraf , Djadid Navid Dinparast
Published: September 2018

This study was designed to analyze the Plasmodium falciparum chloroquine resistance transporter (pfcrt) and P. falciparum multidrug resistance 1 (pfmdr1) mutations as markers of chloroquine (CQ) resistance in 200 blood samples collected from malaria patients in south-eastern Iran during 2002–2005. Among these, 25 (post-treatment) fulfilled the 28-day follow-up study. A high number of Iranian P. falciparum (97%) strains harbored quadruple mutations at codons 76T, 220S, 326D, and 356L. All post-treatment isolates harbored the mutant allele 76T, but low rates of the mutant allele 86Y (44%) of the pfmdr1 gene were detected. No wild haplotype of pfcrt (72-CVMNKAQNIR-371) was found in post-treatment samples; however, 56% of clinical “failure” samples carried the wild type of pfmdr1 (NYSND). The present results suggest a strong association between pfcrt 76T, but not pfmdr1 86Y mutation and in vivo CQ resistance. Furthermore, we found the CQ resistance-associated SVMNT haplotype, which previously had been seen in South American isolates. Although Iran is located more proximally to Southeast Asia than to South America, no CQ resistance-associated CVIET haplotye has been observed in this region. Therefore, these results were not consistent with the earlier presumed spread of CQR parasites from Southeast Asia to Africa via the Indian subcontinent. In conclusion, P. falciparum mutations associated with resistance to CQ are abundant in south-eastern Iran and this finding strongly supports that CQ as the first line drug is inadequate for treatment of uncomplicated falciparum malaria in Iran.
Limited Interdecadal Variation in Mosquito (Diptera: Culicidae) and Avian Host Competence for Western Equine Encephalomyelitis Virus (Togaviridae: Alphavirus)
Authors: Reisen William K. , Fang Ying , Brault Aaron C.
Published: September 2018

Historically, western equine encephalomyelitis virus (WEEV) caused large equine and human epidemics in the Americas from Canada into Argentina. Despite recent enhanced surveillance for West Nile virus, there have been few reports of equine or human cases and little documented enzootic activity of WEEV. During the past three years, WEEV has been active again in California, but without human or equine cases. In the current study, we compared host and vector competence of representative WEEV isolates made during each decade over the past 60 years using white-crowned sparrows, house sparrows, and Culex tarsalis Coquillett as representative hosts. Results indicated limited time-related change in virulence among WEEV strains in birds and little difference in vector competence in Cx. tarsalis. Although temporal and spatial genetic changes have been documented, these seem to present limited phenotypic change in host competence and cannot explain the absence of equine and human cases.
In Vitro Activity of Artemisinin in Combination with Clotrimazole or Heat-treated Amphotericin B against Plasmodium falciparum
Authors: Bhattacharya Amit , Mishra Lokesh C. , Bhasin Virendra K.
Published: September 2018

Currently available artemisinin-based combination therapies (ACTs) for malaria are inadequate. There remains an enormous unmet need for alternate artemisinin-based combination therapies. One of the fastest methods to identify promising artemisinin-based combination therapies is to look for synergistic or additive antimalarial interaction between artemisinin and an alternate drug against P. falciparum in vitro. Amphotericin B and clotrimazole are known drugs for treatment of human fungal infections. We repurposed clotrimazole or heat-treated amphotericin B in fixed ratio combination with artemisinin for antimalarial properties. Isobologram results show synergistic/additive interaction in both of the cases at therapeutically safe concentrations. Artemisinin, clotrimazole, and their synergistic combinations also decrease hemozoin production in parasitized erythrocytes. New permeation pathways induced in infected cells remain unaffected by drug combinations as indicated by sorbitol lysis. It would be interesting to extend the studies’ in vivo system.
The Propensity of Different Borrelia burgdorferi sensu stricto Genotypes to Cause Disseminated Infections in Humans
Authors: Dykhuizen Daniel E. , Brisson Dustin , Sandigursky Sabina , Wormser Gary P. , Nowakowski John , Nadelman Robert B. , Schwartz Ira
Published: September 2018

Lineages of Borrelia burgdorferi, the bacterium that causes Lyme disease, can be characterized by distinct alleles at the outer surface protein C (ospC) locus. The lineages marked by ospC genotypes have been shown to be differentially invasive in different species of mammals, including humans; genotypes A, B, I, and K effectively disseminate to human blood and cerebrospinal fluid. In this report, we extend the sample of genotypes isolated from human blood to include genotypes N, H, C, M, and D, and rank each by their probability of disseminating from ticks to the blood of humans. Our results demonstrate that only some genotypes of B. burgdorferi present in ticks have a high propensity to disseminate in humans.
Local Environmental Predictors of Cholera in Bangladesh and Vietnam
Authors: Emch Michael , Feldacker Caryl , Yunus Mohammad , Streatfield Peter Kim , DinhThiem Vu , Canh Do Gia , Ali Mohammad
Published: September 2018

Environmental factors have been shown to be related to cholera and thus might prove useful for prediction. In Bangladesh and Vietnam, temporal cholera distributions are related to satellite-derived and in-situ environmental time series data in order to examine the relationships between cholera and the local environment. Ordered probit models examine associations in Bangladesh; probit models examine associations at 2 sites in Vietnam. Increases in ocean chlorophyll concentration are related to an increased magnitude of cholera in Bangladesh. Increases in sea surface temperature are most influential in Hue, Vietnam, whereas increases in river height have a significant role in Nha Trang, Vietnam. Cholera appearance and epidemic magnitude are related to the local environment. Local environmental parameters have consistent effects when cholera is regular and more prevalent in endemic settings, but in situations where cholera epidemics are rare there are differential environmental effects.
High HPV 16 Viral Load is Associated with Increased Cervical Dysplasia in Honduran Women
Authors: Tábora Nelba , Ferrera Annabelle , Bakkers Judith M. J. E. , Massuger Leon F. A. G. , Melchers Willem J. G.
Published: September 2018

Cervical cancer is believed to have a co-factorial etiology in which high-risk human papillomavirus (HPV) infections are considered an essential factor and other elements play an ancillary role. Besides the importance of specific HPV genotypes, other viral cofactors as viral load may influence the progression likelihood. In this study the relationship between HPV 16 viral load with respect to the grade of cervical disease in Honduran women was investigated. A real-time PCR allowing quantification of both HPV 16 genome and β-globin gene to normalize the measuring HPV 16 load in cervical cells was used. The data in 87 women with cervical dysplasia or cervical cancer and in 23 women with a negative Pap smear were evaluated. The highest average of HPV 16 viral load was detected in women with High Squamous Intraepithelial Lesions (HSIL). An increasing amount of HPV in higher cervical lesions was found, which could indicate a dose-response association between viral load and precancerous lesion grade.
Quality of Life of Dengue Patients
Authors: Lum Lucy C. S. , Suaya Jose A. , Tan Lian H. , Sah Binod K. , Shepard Donald S.
Published: September 2018

Although the disease burden of dengue is increasing, the impact on the quality of life (QoL) has not been investigated. A study to determine the QoL of confirmed dengue patients using the EuroQol visual thermometer scale was carried out at the University Malaya Medical Center. Of the 207 participants, 40% were ambulatory and 60% were hospitalized. Of eight health domains, 6.2 and 5.0 domains were affected in the hospitalized and ambulatory cohorts, respectively (P < 0.001), with cognition and interpersonal activities affected most. All patients experienced a drastic decrease in their QoL from the onset of symptoms. The QoL deteriorated to the lowest point (40% of healthy status) between the third and seventh days of illness. The duration of impaired QoL (9 days for ambulatory or 13 days for hospitalized patients) was longer than the duration of fever (5 and 7 days, respectively). Symptomatic dengue has major effects on patients’ health.
Development of a Model of Hookworm Infection Exhibiting Salient Characteristics of Human Infection
Authors: Griffiths Gareth D. , Brown Alan P. , Hooi Doreen S. W. , Pearce Peter C. , Hornby Rebecca J. , Scott Leah , Pritchard David I.
Published: September 2018

Patent and pathologic infections of the human hookworm Necator americanus were established in the common marmoset (Callithrix jacchus). In a pilot study, a laboratory strain of N. americanus was compared with a fresh field isolate. Pathology was more severe in animals infected with a fresh isolate. In all animals, infection was associated with increased total plasma IgE and production of IgG specific to adult worm excretory/secretory (ES) products. Histamine was released by basophils in response to IgE, ES products, and a recombinant hookworm allergen, calreticulin. The pilot study indicated the potential of this animal model of hookworm infection and led us to investigate the consequences of infecting a further cohort with the fresh field isolate. This second study confirmed our initial findings, that it is possible to investigate the human hookworm N. americanus in a model exhibiting many of the characteristics of the immunology of hookworm infection in its definitive host.
Genetic Variability of the 45W Gene Family between Chinese and Mexican Taenia solium
Authors: Zheng Yadong , Cai Xuepeng , Luo Xuenong , Zhang Dongfeng , Jing Zhizhong
Published: September 2018

Taenia solium 45W proteins are good candidates for development of anti-cysticercosis vaccines. However, the genetic characteristics of the 45 gene family are still unclear between different isolates. We investigated the polymorphism of the 45 gene family between Chinese and Mexican T. solium. Alignment showed that TSO45-4B and TSO45-1C antigens were conserved absolutely, whereas other TSO45 proteins varied between these two isolates. It is informative to guide using of recombinant 45W vaccines to control porcine cysticercosis caused by Asiatic or African/ Latin American T. solium.
Canine Infection by Rickettsiae and Ehrlichiae in Southern Brazil
Authors: Saito Taís B. , Cunha-Filho Nilton A. , Pacheco Richard C. , Ferreira Fernando , Pappen Felipe G. , Farias Nara A. R. , Larsson Carlos E. , Labruna Marcelo B.
Published: September 2018

This study evaluated the infection caused by Rickettsia and Ehrlichia agents among dogs in southern Brazil. A total of 389 dogs were tested by the indirect immunofluorescence assay (IFA) for Rickettsia rickettsii, Rickettsia parkeri, Rickettsia amblyommii, Rickettsia rhipicephali, Rickettsia bellii, and Ehrlichia canis. Overall, 42.4% (165/389) of the dogs were seroreactive to at least one Rickettsia species, but only 11 canine sera reacted with another Rickettsia species without reacting with R. parkeri. A total of 100 (25.7%) canine sera showed titers to R. parkeri at least 4-fold higher than those to any of the other rickettsial antigens, allowing us to consider that these dogs were infected by R. parkeri. Dogs that had direct contact with pasture or forest areas were > 2 times more likely to be seroreactive to Rickettsia than dogs with no such direct contact. Only 19 (4.8%) of the 389 dogs were seroreactive to E. canis.
Pre-departure and Post-arrival Management of P. falciparum Malaria in Refugees Relocating from Sub-Saharan Africa to the United States
Authors: Stauffer William M. , Weinberg Michelle , Newman Robert D. , Causer Louise M. , Hamel Mary J. , Slutsker Laurence , Cetron Martin S.
Published: September 2018

Plasmodium infection, often sub-clinical, is common in migrating sub-Saharan refugee populations. Refugees who subsequently develop clinical malaria suffer illness and exact a cost on state and local health care facilities. Untreated infection is also of public health concern because of the potential for local transmission. In response to increasing numbers of refugees originating in sub-Saharan Africa guidelines for the management of malaria in refugees migrating to the United States have been broadened and updated. The guidelines are based on available evidence-based literature and recent public health experience. These guidelines were critically reviewed, assessed, and approved by multiple National and State entities as well as outside experts. These consensus guidelines recommend that sub-Saharan African refugees relocating to the United States receive presumptive treatment of P. falciparum malaria before departure or during the domestic refugee medical screening after arrival. Presumptive therapy is not currently recommended for either non-falciparum malaria or for refugees relocating from areas outside sub-Saharan Africa.
Mycobacterium marinum Presenting as Large Verrucous Plaques on the Lower Extremity of a South Pacific Islander
Authors: Lillis Joseph V. , Winthrop Kevin L. , White Clifton R. , Simpson Eric L.
Published: September 2018

Mycobacterium marinum is an environmental, nontuberculous mycobacteria found in fresh and salt water, causing disease in humans through traumatized skin. We describe a young, healthy South Pacific Islander with chronic, progressive large verrucous plaques on the left lower extremity, with cultures positive for M. marinum. This morphology, distribution, and disease course is likely representative of an atypical presentation of M. marinum infection in South Pacific Islanders.
Spatial Distribution of Mosquito Larvae and the Potential for Targeted Larval Control in The Gambia
Authors: Majambere Silas , Fillinger Ulrike , Sayer David R. , Green Clare , Lindsay Steven W.
Published: September 2018

We examined the distribution of aquatic stages of malaria vectors in a 400-km2 area in rural Gambia to assess the practicality of targeting larval control. During the rainy season, the peak period of malaria transmission, breeding sites were 70% more likely to have anopheline larvae in the floodplain of the Gambia River than upland sites (P < 0.001). However, mosquitoes were found in some examples of all habitats, apart from moving water. Habitats most often colonized by anopheline larvae were the largest water bodies, situated near the landward edge of the flood-plain, where culicine larvae were present. In the wet season, 49% of sites had anophelines versus 19% in the dry season (P < 0.001). Larval control targeted at specific habitats is unlikely to be successful in this setting. Nonetheless, larval control initiated at the end of the dry season and run throughout the rainy season could help reduce transmission.
Genetic Analysis of Echinococcus multilocularis Originating from a Patient with Alveolar Echinococcosis Occurring in Minnesota in 1977
Authors: Yamasaki Hiroshi , Nakao Minoru , Nakaya Kazuhiro , Schantz Peter M. , Ito Akira
Published: September 2018

To date, only a single proven case of autochthonous human alveolar echinococcosis has been recorded in Minnesota in 1977. At that time, echinococcal lesions removed from the patient were experimentally inoculated into voles, and the parasite materials obtained from the voles were preserved as histopathologic specimens for 30 years. In this study, retrospective genetic analysis of larval Echinococcus multilocularis originating in the human case was performed using the histopathologic specimens. DNA was extracted from the hematoxylin and eosin–stained specimens, and mitochondrial cytochrome c oxidase subunit 1 gene (cox1) was amplified by polymerase chain reaction. Subsequently, 20 small fragments (100~216 bp) covering almost the entire sequences (97%) of the cox1 were successfully amplified, and the nucleotide sequence analysis showed that the E. multilocularis isolate from Minnesota was almost identical to an isolate from South Dakota rather than isolates from contiguous Alaska.
Tracking Eastern Equine Encephalitis Virus Perpetuation in the Northeastern United States by Phylogenetic Analysis
Authors: Armstrong Philip M. , Andreadis Theodore G. , Anderson John F. , Stull Jason W. , Mores Christopher N.
Published: September 2018

Epidemics and epizootics of eastern equine encephalitis virus (EEEV) occur sporadically in temperate regions where transmission is seasonal from late summer to early fall. These outbreaks may derive from virus that overwinters locally or perhaps results from reintroduction of virus from other sites. To evaluate these possibilities, we compared the phylogenetic relationships of EEEV isolates obtained from mosquitoes collected during statewide arbovirus surveillance in Connecticut, in addition to isolates from concurrent outbreaks in southern New Hampshire and upstate New York. In Connecticut, viral isolates grouped into temporally discrete clades by year of isolation or over 2 years of sampling. Two or more clades arose in 2000, 2001, 2003, 2004, and 2006, possibly the result of separate introduction events into the state, whereas viruses from upstate New York and New Hampshire segregated into single clades that persisted for 2 or more years. New Hampshire viruses shared recent common ancestry to those isolated in Connecticut suggesting viral dispersal among these regions. These results provide additional evidence for independent episodes of EEEV overwintering in northern foci.
Clinical Management of Cystic Echinococcosis: State of the Art, Problems, and Perspectives
Authors: Junghanss Thomas , da Silva Antonio Menezes , Horton John , Chiodini Peter L. , Brunetti Enrico
Published: September 2018

Clinical management of cystic echinococcosis (CE) has evolved over decades without adequate evaluation of important features such as efficacy, effectiveness, rate of adverse reactions, relapse rate, and cost. CE occurs in health care environments as different as Europe/North America and resource-poor countries of the South and the East. This creates setting-specific problems in the management of patients. Furthermore, studies carried out in either of the two fundamentally different environments lack external validity, i.e., results obtained in one setting may be different from those in the other and practices that can work in one may not be applicable to the other. In this paper, we review the current management procedures of CE with particular emphasis on the evidence base and setting-specific problems.
Eosinophil Cationic Protein, Soluble Egg Antigen, Circulating Anodic Antigen, and Egg Excretion in Male Urogenital Schistosomiasis
Authors: Leutscher Peter D. C. , van Dam Govert T. J. , Reimert Claus M. , Ramarakoto Charles-Emile , Deelder André M. , Ørnbjerg Niels
Published: September 2018

Markers of male genital schistosomiasis (MGS) are needed to elucidate the consequences for reproductive health. Eosinophil cationic protein (ECP) and soluble egg antigen (SEA) in urine and semen, and circulating anodic antigen (CAA) in serum were assessed as MGS markers. Egg counts, ECP, and SEA in urine and CAA in serum, correlated positively. Seminal egg excretion exhibited marked day-to-day variations, but counts correlated positively with urinary egg counts and SEA in semen and with CAA. Positive predictive values with reference to seminal egg excretion were as follows: seminal ECP (52%), seminal SEA (83%), CAA (97%), and urinary egg excretion (82%). SEA in semen and CAA in serum constitute potential markers of MGS. However, urine egg counts as an indirect marker of MGS remains the preferred diagnostic method from a public health perspective.