bluuebunny/crossref_metadata_2025 huggingface dataset:
REPORT OF AN UNUSUAL CASE OF PERSISTENT BACTEREMIA BY BARTONELLA BACILLIFORMIS IN A SPLENECTOMIZED PATIENT
Authors: HENRÍQUEZ CÉSAR , HINOJOSA JUAN CARLOS , VENTOSILLA PALMIRA , INFANTE BERONICA , MERELLO JENNY , MALLQUI VANIA , VERASTEGUI MANUELA , MAGUIÑA CIRO
Published: September 2018

We report a case of a 56-year-old man with a history of splenectomy for idiopathic thrombocytopenic purpura who developed persistent bacteremia in the acute phase of human bartonellosis. This patient did not develop hemolytic anemia. Only after several courses of antibiotic treatment was the infection eradicated. This is an unusual case of overwhelming post-splenectomy infection by Bartonella bacilliformis, which provides clinical evidence that the spleen is a critical effector organ of clearance of this infection as well as the effector organ of bartonellosis-associated hemolytic anemia.
SYMPTOMS OF INTESTINAL SCHISTOSOMIASIS PRESENTING DURING TREATMENT OF LARGE B CELL LYMPHOMA
Authors: MONTES MARTIN , WHITE A. CLINTON , KONTOYIANNIS DIMITRIOS P.
Published: September 2018

We report a case of chronic intestinal schistosomiasis presenting in a previously asymptomatic 34-year-old woman from Saudi Arabia with large B cell lymphoma. The patient presented with abdominal pain, constipation, recurrent rectal bleeding, and persistent mild eosinophilia during chemotherapy. Stools were repeatedly negative for parasite ova, but duodenal and colonic biopsies demonstrated Schistosoma eggs and eosinophilic granulomatous inflammation. Immunosuppressed patients with schistosomiasis may have diminished egg excretion. Diagnosis requires a high index of suspicion since stool test results may be negative and intestinal biopsies may be needed to make the diagnosis.
SPATIAL AND TEMPORAL VARIABILITY IN SCHISTOSOME CERCARIAL DENSITY DETECTED BY MOUSE BIOASSAYS IN VILLAGE IRRIGATION DITCHES IN SICHUAN, CHINA
Authors: SPEAR ROBERT C. , ZHONG BO , MAO YONG , HUBBARD ALAN , BIRKNER MERRILL , REMAIS JUSTIN , QIU DONGCHUAN
Published: September 2018

A mouse bioassay was used monthly over the infection season of 2001 to determine the temporal and spatial variability of schistosome cercarial density in irrigation ditches in five villages in southwestern Sichuan Province in the People’s Republic of China. Analysis of variance showed that approximately half of the variability was due to the village and site within the village, with little contribution from air temperature, weekly average rainfall, or the month within the infection season in which the bioassay was performed. The location-specific variability in these data suggest that epidemiologic studies will generally have low power to detect the influence of water-contact intensity on human parasite burden without taking account of variations in cercarial density at sites of water contact.
DISSEMINATED CUTANEOUS LEISHMANIASIS DUE TO LEISHMANIA GUYANENSIS: CASE OF A PATIENT WITH 425 LESIONS
Authors: COUPPIÉ P. , CLYTI E. , SAINTE-MARIE D. , DEDET J. P. , CARME B. , PRADINAUD R.
Published: September 2018

Disseminated cutaneous leishmaniasis is characterized by the presence of a large (≥10) number of lesions at several anatomic sites (head, limbs, and trunk). Most of the lesions are small, papular, and appear simultaneously with or secondarily to one or several ulcerated lesions of localized cutaneous leishmaniasis. We report the first case of disseminated cutaneous leishmaniasis in French Guiana. It concerns a 24-year-old woman who tested negative for human immunodeficiency virus (HIV). The disease began with three lesions that became ulcerated. One week later, multiple papulo-nodular lesions appeared. We counted a total of 425 lesions. Leishmania were observed in the lesions. The species involved was L. guyanensis, which has never been described in a case of disseminated cutaneous leishmaniasis. The patient was rapidly cured by a single course of pentamidine. Disseminated cutaneous leishmaniasis should be distinguished from other types of leishmaniasis with multiple lesions. These include anergic diffuse cutaneous leishmaniasis, post-kala-azar leishmaniasis, and leishmaniasis associated with HIV infection.
COMPARISON OF THE BIOEQUIVALENCE OF THREE ORAL FORMULATIONS OF DIHYDROARTEMISININ BASED ON EX VIVO BLOOD SCHIZONTOCIDAL ACTIVITIES AGAINST PLASMODIUM FALCIPARUM
Authors: KONGTHAISONG MONTICHA , NA-BANGCHANG KESARA , MUNGTHIN MATHIRUT , SINCHAIPANID NUTTANAN , TAN-ARIYA PEERAPAN
Published: September 2018

Sera collected at various time intervals from healthy Thai male subjects after the administration of the three oral formulations of dihydroartemisinin (Cotecxin® manufactured in the People’s Republic of China, a formulation manufactured by Arenco n.v. Pharmaceutica in Belgium, and a formulation manufactured by the Faculty of Pharmacy of Mahidol University in Thailand) were investigated for their ex vivo blood schizontocidal activities against the K1 strain of Plasmodium falciparum. Blood schizontocidal activities of sera were evaluated using the maximum inhibitory dilution as a parameter. Sera obtained following the administration of the three formulations of dihydroartemisinin showed significantly distinct degree of ex vivo antimalarial activities. The differences may reflect the bioinequivalence between these three formulations of dihydroartemisinin. The ex vivo blood schizontocidal activity profiles generally coincided with plasma concentration-time profiles. Thus, the ex vivo model might be the useful tool for evaluating and comparing the bioequivalence of the interesting drugs especially where high-performance liquid chromatography with reductive electrochemical detection for drug analysis is not available. The effect of inoculum size of P. falciparum was shown in the ex vivo model as presented in the in vitro sensitivity test. To determine the effect of the inoculum size on the drug activity, the ex vivo model might be superior to the in vitro model since the pharmacokinetic profiles can be considered.
TRIGGERING OF HIGH-LEVEL RESISTANCE AGAINST SCHISTOSOMA MANSONI REINFECTION BY ARTEMETHER IN THE MOUSE MODEL
Authors: BERGQUIST ROBERT , UTZINGER JÜRG , CHOLLET JACQUES , SHU-HUA XIAO , WEISS NIKLAUS A. , TANNER MARCEL
Published: September 2018

Artemether, a methyl ether derivative of dihydroartemisinin, not only exhibits antimalarial properties, but also possesses strong activity against schistosomula, the immature stages of a parasitic worm that can cause schistosomiasis. To test if the effect would be similar to that of irradiation with respect to the induction of immunologic protective responses, groups of mice were infected with Schistosoma mansoni cercariae and treated with artemether at 1–3 weeks post-infection. Control mice were either infected with normal cercariae or with cercariae exposed to radiation that permitted early development but not maturation of the parasites. The mice were challenged six weeks after the initial infection, and the mean numbers of schistosomes recovered in the various groups were calculated upon dissection eight weeks post-challenge. The administration of artemether two weeks after the initial infection resulted in 58% protection, while giving the drug three weeks post-infection increased the level of protection to 81%. This level of protection is as high as that normally obtained by immunization with irradiated cercariae (84% in the present study) and is superior to the level of resistance obtained with any individual schistosome vaccine candidate antigen thus far reported.
EFFICACY OF MIRAZID IN COMPARISON WITH PRAZIQUANTEL IN EGYPTIAN SCHISTOSOMA MANSONI–INFECTED SCHOOL CHILDREN AND HOUSEHOLDS
Authors: BOTROS SANAA , SAYED HANAN , EL-DUSOKI HOWAIDA , SABRY HODA , RABIE IBRAHIM , EL-GHANNAM MAGED , HASSANEIN MOATAZ , EL-WAHAB YEHIA ABD , ENGELS DIRK
Published: September 2018

This trial investigated the anti-schistosomal activity of mirazid in comparison with that of praziquantel in Schistosoma mansoni-infected Egyptian patients. The sample population was composed of 1,131 individuals (459 school children and 672 household members). Screening for S. mansoni was conducted using the standard Kato Katz technique. Four slides from a single stool sample were examined before treatment, and four slides per sample from stool samples obtained on three consecutive days were examined post-treatment. All positive eligible subjects were randomly assigned into two groups, the first received mirazid at a dose of 300 mg/day for three consecutive days, and the second received praziquantel at a single dose of 40 mg/kg. All treated subjects were examined 4–6 weeks post-treatment. Mirazid showed low cure rates of 9.1% and 8.9% in S. mansoni-infected school children and household members, respectively, compared with cure rates of 62.5% and 79.7%, respectively, in those treated with praziquantel. Therefore, we do not recommend mirazid as an agent to control schistosomiasis.
SEASONAL VARIATION OF TUNGIASIS IN AN ENDEMIC COMMUNITY
Authors: HEUKELBACH JÖRG , WILCKE THOMAS , HARMS GUNDEL , FELDMEIER HERMANN
Published: September 2018

Tungiasis (caused by the sand flea Tunga penetrans) is hyperendemic in many resource-poor communities in Brazil. To understand transmission dynamics of this parasitic skin disease in a typical endemic area, a longitudinal study was carried out in a slum in Fortaleza in northeastern Brazil. In a door-to-door survey, the population of a randomly selected area (n = 1,460) was examined on four occasions for the presence of embedded sand fleas. Prevalence rates were 33.6% in March (rainy season), 23.8% in June (end of the rainy season), 54.4% in September (peak of the dry season), and 16.8% in January (begin of the rainy season). Tungiasis was more common in males than in females. The intensity of infestation was correlated with the prevalence. The study shows that prevalence of tungiasis and parasite burden vary significantly during the year with a peak in the dry season. These findings have important consequences for the design of control measures.
RANDOMIZED, DOUBLE-BLIND, PHASE III, PIVOTAL FIELD TRIAL OF THE COMPARATIVE IMMUNOGENICITY, SAFETY, AND TOLERABILITY OF TWO YELLOW FEVER 17D VACCINES (ARILVAX™ AND YF-VAX®) IN HEALTHY INFANTS AND CHILDREN IN PERU
Authors: BELMUSTO-WORN VIVIAN E. , SANCHEZ JOSE L. , McCARTHY KAREN , NICHOLS RICHARD , BAUTISTA CHRISTIAN T. , MAGILL ALAN J. , PASTOR-CAUNA GIOVANNA , ECHEVARRIA CARLOS , LAGUNA-TORRES VICTOR A. , SAMAME BILLEY K. , BALDEON MARIA E. , BURANS JAMES P. , OLSON JAMES G. , BEDFORD PHILIP , KITCHENER SCOTT , MONATH THOMAS P.
Published: September 2018

We conducted a randomized, double-blind, phase III yellow fever (YF) vaccine trial among 1,107 healthy children in Sullana in northern Peru. The safety and efficacy (by measurement of geometric mean neutralizing antibody titer responses) were determined for two YF vaccines, ARILVAX™ (n = 738) and YF-VAX® (n = 369). Serocon-version rates were higher (94.9%) in ARILVAX™ than in YF-VAX® (90.6%) recipients. The two-sided 95% confidence interval (YF-VAX®–ARILVAX™) was (-12.8% to -2.5%), indicating that the higher seroconversion rate for Arilvax™ was significant. Post-vaccination (30-day) mean log10 neutralization indices were found to be similar for both products: 1.32 for ARILVAX™ and 1.26 for YF-VAX® (P = 0.1404, by analysis of variance). A similar number of subjects in each group reported at least one adverse event (AE); 441 (59.8%) for ARILVAX™ versus 211 (59.9%) for YF-VAX®. Most (591; 96.7%) of these were of a mild nature and resolved without treatment. There were no treatment-related serious AEs. This is the first randomized, double-blind comparison of two YF vaccines in a pediatric population; both vaccines were shown to be highly immunogenic and well-tolerated.
SPATIAL PATTERNS OF AND RISK FACTORS FOR SEROPOSITIVITY FOR DENGUE INFECTION
Authors: VAN BENTHEM BIRGIT H. B. , VANWAMBEKE SOPHIE O. , KHANTIKUL NARDLADA , BURGHOORN-MAAS CHANTAL , PANART KAMOLWAN , OSKAM LINDA , LAMBIN ERIC F. , SOMBOON PRADYA
Published: September 2018

Spatial patterns of and risk factors for seropositivity of dengue infection were studied in three sites in northern Thailand. A survey was conducted in 2001 among 1,750 persons. Potential risk factors for dengue infection were measured by questionnaire and IgM antibodies against dengue were detected by an enzyme-linked immunosorbent assay. The role of landscape as a risk factor was studied using land cover maps and a geographic information system. Logistic regression identified risk factors for dengue seropositivity. Spatial patterns of seropositive cases were determined by cluster analyses. Six percent of the study population was seropositive. Risk factors for dengue seropositivity differed per site, demonstrating variation in local infection patterns. In the periurban site, seropositivity depended on human behavior and factors related to housing quality rather than environmental factors. In both rural sites, older persons had a higher risk of seropositivity and persons living in houses surrounded by natural and agricultural land covers had a lower risk of seropositivity.
SHORT REPORT: RAPID DNA EXTRACTION FROM ARCHIVE BLOOD SPOTS ON FILTER PAPER FOR GENOTYPING OF PLASMODIUM FALCIPARUM
Authors: BERECZKY SÁNDOR , MÅRTENSSON ANDREAS , GIL J. PEDRO , FÄRNERT ANNA
Published: September 2018

The practical advantages of sampling and storing blood on filter paper for analyses of human and pathogen genes highlight the need for reliable, sensitive, and cost-effective DNA extraction methods. We describe a new Tris-EDTA (TE) buffer-based method for extraction of DNA from blood dried on filter paper. The method was evaluated against the commonly used methanol and Chelex® methods, regarding polymerase chain reaction detection of Plasmodium falciparum parasites from samples stored for 1–2 years. The sensitivity of detection was dependent on the parasite density and type of filter paper. For 3MM® Whatman filter paper, the sensitivity was 100%, 73%, and 93% for the TE, methanol, and Chelex® methods, respectively. For the longer stored 903® Schleicher & Schuell filter paper, the sensitivity was 93%, 73%, and 0%, respectively. This rapid, simple, and inexpensive extraction method generated superior results from archived specimens compared with the two standard methods and may represent a useful tool in molecular epidemiologic studies.
DECREASED PREVALENCE OF THE PLASMODIUM FALCIPARUM CHLOROQUINE RESISTANCE TRANSPORTER 76T MARKER ASSOCIATED WITH CESSATION OF CHLOROQUINE USE AGAINST P. FALCIPARUM MALARIA IN HAINAN, PEOPLE’S REPUBLIC OF CHINA
Authors: WANG XINHUA , MU JIANBING , LI GUOQIAO , CHEN PEIQUAN , GUO XINGBO , FU LINCHUN , CHEN LIN , SU XINZHUAN , WELLEMS THOMAS E.
Published: September 2018

The use of chloroquine treatment for Plasmodium falciparum malaria was abandoned in China in 1979 because of widespread drug resistance. Subsequent studies found decreases in the prevalence of chloroquine-resistant strains. To evaluate these decreases and assess the current status of chloroquine sensitivity in Hainan, China, we determined the prevalence of the P. falciparum chloroquine resistance transporter (PfCRT) 76T marker in the DNA of blood samples collected from 1978 to 2001. Results showed the presence of PfCRT 76T in 101 of 112 samples (90%) from 1978 to 1981, 30 of 43 samples (70%) from 1986, 22 of 34 samples (65%) from 1997 to 1998, and 37 of 68 samples (54%) from 2001. The prevalence of PfCRT 76T thus progressively decreased after chloroquine was discontinued as a treatment for P. falciparum malaria (χ2 = 5.2, P < 0.022 [1978–1981 versus 1986]; χ2 = 7.4, P < 0.006 [1978–1981 versus 1997–1998]; and χ2 = 28.8, P < 0.0001 [1978–1981 versus 2001]). Reduced prevalence of the PfCRT 76T marker is consistent with greater rates of chloroquine sensitivity from in vitro drug assays of blood samples in 1997 and 2001. Monitoring for continued decreases will provide valuable information for future drug-use policies in China.
AMPLIFICATION OF HUMAN DNA BY PRIMERS TARGETED TO LEISHMANIA KINETOPLAST DNA AND POST-GENOME CONSIDERATIONS IN THE DETECTION OF PARASITES BY A POLYMERASE CHAIN REACTION
Authors: VERGEL CAROLINA , WALKER JOHN , SARAVIA NANCY G.
Published: September 2018

We evaluated the Leishmania Viannia-specific primers B1-B2 to detect Leishmania in normal skin and peripheral blood monocytes of patients with active cutaneous leishmaniasis. Southern blotting and sequencing of polymerase chain reaction (PCR) products confirmed the specificity of kinetoplast DNA (kDNA) amplification from tissue fluid from healthy skin, whereas the PCR with monocytes also amplified a human sequence of a size similar (718 basepairs) to the expected kDNA product (750 basepairs), resulting in false-positive results. Although B1 was not homologous to any human DNA sequence, B2 showed homology to a human chromosome 2 intergenic region (AC010878) at positions 35,881-36,599, which are spaced 718 nucleotides apart. Amplification of the human art3fact from monocyte DNA was confirmed using the primer B2 alone. Examination of other primers reported for the PCR of kDNA from various species of Leishmania showed that six of seven were homologous to human DNA sequences. These findings underscore the importance of exploiting sequencing, bioinformatics, and DNA probes to refine molecular amplification techniques and to validate the performance of primers when used for new applications.
FACTORS ASSOCIATED WITH HEMOGLOBIN CONCENTRATIONS IN PRE-SCHOOL CHILDREN IN WESTERN KENYA: CROSS-SECTIONAL STUDIES
Authors: DESAI MEGHNA R. , TERLOUW DIANNE J. , KWENA ARTHUR M. , PHILLIPS-HOWARD PENELOPE A. , KARIUKI SIMON K. , WANNEMUEHLER KATHLEEN A. , ODHACHA AMOS , HAWLEY WILLIAM A. , SHI YA PING , NAHLEN BERNARD L. , TER KUILE FEIKO O.
Published: September 2018

In sub-Saharan Africa, the etiology of anemia in early childhood is complex and multifactorial. Three community-based cross-sectional surveys were used to determine the prevalence and severity of anemia. Regression methods were used to compare mean hemoglobin (Hb) concentrations across covariate levels to identify children at risk of low Hb levels in an area with intense malaria transmission. In a random sample of 2,774 children < 36 months old, the prevalence of anemia (Hb < 11g/dL) was 76.1% and 71%, respectively, in villages without and with insecticide-treated bed nets (ITNs); severe-moderate anemia (Hb < 7 g/dL) was observed in 11% (non-ITN) and 8.3% (ITN). The prevalence of anemia, high-density malaria parasitemia (21.7%), microcytosis (34.9%), underweight (21.9%), and diarrhea (54.8%) increased rapidly from age three months onwards and remained high until 35 months of age. Multivariate analyses showed that family size, history of fever, pale body, general body weakness, diarrhea, soil-eating, concurrent fever, stunting, and malaria parasitemia were associated with mean Hb levels. Prevention of severe anemia should start early in infancy and include a combination of micronutrient supplementation, malaria control, and possibly interventions against diarrheal illness.
EVALUATION OF A SELF-DETECTION TOOL FOR TAPEWORM CARRIERS FOR USE IN PUBLIC HEALTH
Authors: FLISSER ANA , VÁZQUEZ-MENDOZA ALBERTO , MARTÍNEZ-OCAÑA JOEL , GÓMEZ-COLÍN EMILIO , LEYVA RAFAEL SÁNCHEZ , MEDINA-SANTILLÁN ROBERTO
Published: September 2018

The current study was designed to evaluate a tool for the self-identification of tapeworm carriers. Clinical and animal health care practitioners and schoolteachers were trained regarding the life cycle, risk factors, and control measures related to infection with Taenia solium. More than 120 small glass bottles with a few tapeworm segments fixed in formaldehyde and an instructional guide were distributed among all clinical practitioners (physicians and nurses) working in health centers. The guide contained 10 key points on how to ask questions about tapeworm infections. Information on taeniosis and cysticercosis was also provided to the general population via different media. Seven tapeworm carriers were recorded in the official epidemiology surveillance system the year previous to the study, compared with the year after the study, when 41 tapeworm carriers (37 Taenia saginata; 4 Taenia solium) were recorded. Six times more tapeworm carriers were notified after the study. All four persons with Taenia solium were treated, thereby eliminating the parasite and subsequently preventing any new cases of human and swine cysticercosis that might have arisen from them.
EPIDEMIC MALARIA IN THE HIGHLANDS OF PAPUA NEW GUINEA
Authors: MUELLER IVO , NAMUIGI PIOTO , KUNDI JULIUS , IVIVI REX , TANDRAPAH TONY , BJORGE STEVEN , REEDER JOHN C.
Published: September 2018

As part of a larger study into the epidemiology of malaria in the highlands of Papua New Guinea, outbreak investigations were carried out at the end of the 2002 rainy season in 11 villages situated between 1,400 and 1,700 meters above sea level that had reported epidemics. Locations and timing of these epidemics corresponded largely to those reported in the pre-control era of the 1960s and 1970s. On average, 28.8% (range = 10.3–63.2%) of people in each of the 11 villages were found to be infected with malaria. Plasmodium falciparum accounted for 59% of all identified infections and P. vivax for 34%. The majority (53%) of infections were symptomatic. Although symptomatic infections were most common in children 2–9 years of age (36%), even in adults a prevalence of 20% was observed. A comparison with earlier non-epidemic data in three of the villages without easy access to health care showed markedly increased levels of morbidity, with 6–10-fold increases in parasite prevalence, a 3-fold increase in both measured and reported fevers, and a 12-fold increase in enlarged spleens. The average hemoglobin levels were reduced by 2.3–3.5 g/dL, with a concurrent increase in moderate to severe anemia (hemoglobin level < 7.5 g/dL) from 0.0–3.3% to 3.8–18.4%. These massive increases in morbidity have devastating impact on the affected communities and highlight that malaria epidemics are a serious and increasing public health problem in the highlands of Papua New Guinea.
SULFADOXINE-PYRIMETHAMINE PLUS CHLOROQUINE OR AMODIAQUINE FOR UNCOMPLICATED FALCIPARUM MALARIA: A RANDOMIZED, MULTISITE TRIAL TO GUIDE NATIONAL POLICY IN UGANDA
Authors: BAKYAITA NATHAN , DORSEY GRANT , YEKA ADOKE , BANEK KRISTIN , STAEDKE SARAH G. , KAMYA MOSES R. , TALISUNA AMBROSE , KIRONDE FRED , NSOBYA SAM , KILIAN ALBERT , REINGOLD ARTHUR , ROSENTHAL PHILIP J. , WABWIRE-MANGEN FRED
Published: September 2018

The use of combinations of inexpensive drugs for the treatment of malaria in Africa has been proposed as an interim policy while awaiting the widespread availability of more effective regimens. We compared sulfadoxine-pyrimethamine plus chloroquine or amodiaquine in three districts in Uganda. Patients aged 6 months or greater with uncomplicated falciparum malaria were enrolled and randomized to therapy. Safety, tolerability, and efficacy outcomes, adjusted by genotyping, were assessed over 28 days. Of 1,105 patients enrolled, 1,057 (96%) completed follow-up. For children less than 5 years old, the risk of clinical treatment failure adjusted by genotyping at the three sites ranged from 34% to 67% with chloroquine plus sulfadoxine-pyrimethamine and from 13% to 35% with amodiaquine plus sulfadoxine-pyrimethamine (risk differences 21–32%, P < 0.0001 at all sites). Serious adverse events were uncommon with both regimens. The risk of treatment failure with chloroquine plus sulfadoxine-pyrimethamine, the current standard in Uganda, was unacceptably high. Amodiaquine plus sulfadoxine-pyrimethamine was significantly more efficacious; however, existing levels of resistance raises concern about the useful therapeutic life-span of this regimen.
COLORIMETRIC ASSAY FOR SCREENING COMPOUNDS AGAINST LEISHMANIA AMASTIGOTES GROWN IN MACROPHAGES
Authors: BUCKNER FREDERICK S. , WILSON AARON J.
Published: September 2018

An estimated 12 million persons throughout the world suffer from the protozoan disease leishmaniasis. Current treatments have liabilities including poor activity against some forms of leishmaniasis, toxicity, or the need for parenteral administration. Higher throughput methods to screen chemical compounds are needed to facilitate the search for new antileishmania drugs. In the mammalian host, Leishmania parasites exist as amastigotes that replicate within macrophages. Therefore, an in vitro screening assay using intramacrophage amastigotes most closely represents the natural infection. We have transfected strains of Leishmania major and Leishmania amazonensis with the β-lactamase gene, which catalyzes a colorimetric reaction with the substrate nitrocephin. The growth of these β-lactamase–expressing Leishmania within macrophages was quantified in 96-well plates using an optical density plate reader, thus simplifying the methodology for scoring inhibitor assays. This simple and relatively inexpensive colorimetric assay helps improve throughput for screening compounds for antileishmania activity.
ELIMINATION OF DENGUE BY COMMUNITY PROGRAMS USING MESOCYCLOPS(COPEPODA) AGAINST AEDES AEGYPTI IN CENTRAL VIETNAM
Authors: NAM VU SINH , YEN NGUYEN THI , PHONG TRAN VU , NINH TRUONG UYEN , MAI LE QUYEN , LO LE VIET , NGHIA LE TRUNG , BEKTAS AHMET , BRISCOMBE ALISTAIR , AASKOV JOHN G. , RYAN PETER A. , KAY BRIAN H.
Published: September 2018

From September 2000 to June 2003, a community-based program for dengue control using local predacious copepods of the genus Mesocyclops was conducted in three rural communes in the central Vietnam provinces of Quang Nam, Quang Ngai, and Khanh Hoa. Post-project, three subsequent entomologic surveys were conducted until March 2004. The number of households and residents in the communes were 5,913 and 27,167, respectively, and dengue notification rates for these communes from 1996 were as high as 2,418.5 per 100,000 persons. Following knowledge, attitude, and practice evaluations, surveys of water storage containers indicated that Mesocyclops spp. already occurred in 3–17% and that large tanks up to 2,000 liters, 130–300-liter jars, wells, and some 220-liter metal drums were the most productive habitats for Aedes aegypti. With technical support, the programs were driven by communal management committees, health collaborators, schoolteachers, and pupils. From quantitative estimates of the standing crop of third and fourth instars from 100 households, Ae. aegypti were reduced by approximately 90% by year 1, 92.3–98.6% by year 2, and Ae. aegypti immature forms had been eliminated from two of three communes by June 2003. Similarly, from resting adult collections from 100 households, densities were reduced to 0–1 per commune. By March 2004, two communes with no larvae had small numbers but the third was negative; one adult was collected in each of two communes while one became negative. Absolute estimates of third and fourth instars at the three intervention communes and one left untreated had significant correlations (P = 0.009−< 0.001) with numbers of adults aspirated from inside houses on each of 15 survey periods. By year 1, the incidence of dengue disease in the treated communes was reduced by 76.7% compared with non-intervention communes within the same districts, and no dengue was evident in 2002 and 2003, compared with 112.8 and 14.4 cases per 100,000 at district level. Since we had similar success in northern Vietnam from 1998 to 2000, this study demonstrates that this control model is broadly acceptable and achievable at community level but vigilance is required post-project to prevent reinfestation.
MALARIA PREVALENCE AND ASSOCIATED RISK FACTORS IN ERITREA
Authors: SINTASATH DAVID M. , GHEBREMESKEL TEWOLDE , LYNCH MATTHEW , KLEINAU ECKHARD , BRETAS GUSTAVO , SHILILU JOSEPHAT , BRANTLY EUGENE , GRAVES PATRICIA M. , BEIER JOHN C.
Published: September 2018

A parasitological cross-sectional survey was undertaken from September 2000 through February 2001 to estimate the prevalence of malaria parasitemia in Eritrea. A total of 12,937 individuals from 176 villages were screened for both Plasmodium falciparum and Plasmodium vivax parasite species using the OptiMal Rapid Diagnostic Test. Malaria prevalence was generally low but highly focal and variable with the proportion of parasitemia at 2.2% (range: 0.4% to 6.5%). Despite no significant differences in age or sex-specific prevalence rates, 7% of households accounted for the positive cases and 90% of these were P. falciparum. Multivariate regression analyses revealed that mud walls were positively associated with malaria infection (OR [odds ratio] = 1.6 [95% CI: 1.2, 2.2], P < 0.008). For countries with low and seasonal malaria transmission, such information can help programs design improved strategic interventions.
RAPID MALARIA SCREENING AND TARGETED TREATMENT OF UNITED STATES–BOUND MONTAGNARD REFUGEES FROM CAMBODIA IN 2002
Authors: CAUSER LOUISE M. , BISHOP HENRY S. , SHARP DONALD J. , FLAGG ELAINE W. , CALDERON JAIME F. , KEANE VINCENT , SHAH J. JINA , MACARTHUR JOHN R. , MALONEY SUSAN A. , CETRON MARTIN S. , BLOLAND PETER B.
Published: September 2018

In 2002, a group of Montagnard refugees living in Cambodia was accepted for resettlement in the United States. Pre-departure malaria screening and targeted treatment was conducted to prevent morbidity, and minimize the potential for local malaria transmission post-arrival. We screened 902 of 906 refugees using rapid diagnostic tests (RDTs), microscopy, and polymerase chain reaction (PCR) analysis. Twelve (1.3%) RDT results were positive and 28 (3.1%) were indeterminate. Microscopy confirmed Plasmodium species in two of the positive RDT and one of the indeterminate results. Among a random 10% sample of negative RDT results (n = 86), none were positive by microscopy. The PCR confirmed the two microscopically (and RDT) positive specimens. The PCR result was negative for all other specimens tested. Eighteen (2.0%) refugees were treated with antimalarials. The RDTs were useful in this setting, facilitating timely, sensitive diagnosis and targeted treatment. Evaluations to determine the most appropriate interventions in other refugee settings should include cost-effectiveness analyses of alternative strategies.
CHARACTERIZATION OF A HUMAN REFERENCE STANDARD FOR ANTIBODY TO PLASMODIUM FALCIPARUM MEROZOITE SURFACE PROTEIN 142
Authors: YOON IN-KYU , ANGOV EVELINA , LARSON DAVID , HEPPNER D. GRAY , CUMMINGS JAMES F. , STEWART V. ANN
Published: September 2018

Volunteers vaccinated with a candidate malaria vaccine containing merozoite surface protein 142 (MSP-142) exhibit antibodies to MSP-142 that are measured by enzyme-linked immunosorbent assay (ELISA). The purpose of this study was to make a human reference standard for MSP-142 antibody measured in absolute quantity units using pooled plasma samples known to contain high titers of MSP-142 antibody based on previous ELISA results. Immobilized metal affinity chromatography was used to determine the amount of MSP-142 antibody in this plasma pool. Hexahistidine-tagged MSP-142 antigen adsorbed to nickel-chelating resin was used to capture MSP-142 antibody from the plasma pool. The intact MSP-142 antibody-antigen complexes were eluted and total IgG was measured by an ELISA standardized against purified human IgG. In this way, the human reference standard was determined to contain 48.3 μg/mL of MSP-142 antibody. This reference standard may be useful as a quantitative working standard for measuring MSP-142 antibody response in future vaccine clinical trials involving MSP-1.
EARLY DETECTION OF DENGUE INFECTIONS USING CLUSTER SAMPLING AROUND INDEX CASES
Authors: BECKETT CHARMAGNE G. , KOSASIH HERMAN , FAISAL INDRA , NURHAYATI  , TAN RATNA , WIDJAJA SUSANA , LISTIYANINGSIH ERLIN , MA’ROEF CHAIRIN , WURYADI SUHARYONO , BANGS MICHAEL J. , SAMSI TATANG K. , YUWONO DJOKO , HAYES CURTIS G. , PORTER KEVIN R.
Published: September 2018

A two-year study using a cluster investigation method was conducted in West Jakarta, Indonesia to demonstrate the detection of dengue cases prior to onset of clinical illness. The clusters consisted of family members and neighbors of 53 hospitalized dengue index cases. Among 785 adult and child volunteers enrolled, 17 (2.2%) post-enrollment dengue (PED) infections were identified. Eight PED cases were asymptomatic and nine were symptomatic. Symptomatic cases included eight with dengue fever and one with dengue hemorrhagic fever (DHF) (grade II). Among the eight asymptomatic PED cases, viremia was detected in two. Eleven volunteers had acute dengue infections at the time of enrollment. Four of the 11 developed DHF, resulting in a total of five DHF cases detected during the investigation. This study design can serve as a benchmark for future investigations that seek to define early immunologic events following dengue infections that contribute to the development of DHF.
CLINICAL SURVEY OF HANTAVIRUS IN SOUTHERN BRAZIL AND THE DEVELOPMENT OF SPECIFIC MOLECULAR DIAGNOSIS TOOLS
Authors: RABONI SONIA M. , RUBIO GISÉLIA , DE BORBA LUANA , ZEFERINO AURÉLIO , SKRABA IRENE , GOLDENBERG SAMUEL , DOS SANTOS CLAUDIA N. DUARTE
Published: September 2018

Hantavirus pulmonary syndrome (HPS) is an emerging disease caused by an increasing number of distinct hantavirus serotypes found worldwide. It is also a very severe immune disease. It progresses quickly and is associated with a high mortality rate. At the prodrome phase, hantavirosis symptoms can resemble those of other infectious diseases such as leptospirosis and influenza. Thus, prognosis could be improved by developing a rapid and sensitive diagnostic test for hantavirus infection, and by improving knowledge about clinical aspects of this disease. This study describes clinical features and laboratory parameters throughout the course of HPS in 98 patients. We report the seasonality and regional distribution of this disease in Paraná State, Brazil during the last seven years. In addition, we evaluated a specific molecular diagnostic test based on a nested reverse transcriptase-polymerase chain reaction for the detection of hantaviruses circulating in Brazil.
SENSITIVITY OF BONE MARROW ASPIRATES IN THE DIAGNOSIS OF VISCERAL LEISHMANIASIS
Authors: DA SILVA MAURO ROBERTO B. , STEWART JAY M. , COSTA CARLOS HENRIQUE N.
Published: September 2018

Bone marrow aspirates are believed to provide a safer but less sensitive method in the diagnosis of visceral leishmaniasis (VL) compared with splenic aspirates. We examined the effect of the number of fields and the time of observation on bone marrow smear sensitivity and compared it to our experience with spleen aspiration. Bone marrow smears of 98 patients and splenic aspirates from 120 patients were examined. Among 87 patients with VL, the sensitivity of bone marrow aspirates was 40.2%, 65.5%, 89.7%, 92%, and 95.4% at 1, 5, 20, 30, and 60 minutes, respectively. The sensitivity of spleen aspirate examination was 93% for 114 patients. One patient died of shock after spleen aspiration. A bone marrow smear is very sensitive if examined thoroughly, reaching a sensitivity similar to that of spleen aspirate. We propose that a bone marrow smear be established as the technique of choice for the parasitologic diagnosis of VL.
LOCALIZED CUTANEOUS LEISHMANIASIS DUE TO LEISHMANIA DONOVANI AND LEISHMANIA TROPICA: PRELIMINARY FINDINGS OF THE STUDY OF 161 NEW CASES FROM A NEW ENDEMIC FOCUS IN HIMACHAL PRADESH, INDIA
Authors: SHARMA NAND LAL , MAHAJAN VIKRAM K. , KANGA ANIL , SOOD ANURADHA , KATOCH VISHWA M. , MAURICIO ISABEL , SINGH CHAUHAN D. , PARWAN UTTAM C. , SHARMA VIJAY K. , SHARMA RAMESH C.
Published: September 2018

Localized cutaneous leishmaniasis (LCL) in India is due mostly to Leishmania tropica. It is mainly endemic in the deserts of Rajasthan. Recently, Himachal Pradesh has been identified as a new endemic focus for the disease. In the last few years, the number of new cases has been increasing almost to epidemic proportions. This report presents the preliminary findings of clinico-epidemiologic and investigative results of 161 new localized cases of LCL seen between May 2001 and December 2003. The study populaton was composed of 80 males and 81 females between 10 months and 75 years of age. All were indigenous to the sub-alpine valley along the Satluj River in the mountainous region of the Kinnaur District (altitude = 700–2,900 meters). Most patients were seen from April to September and had 1–8 lesions (duration = 1–6 months) that involved mainly the face. Tissue smears were positive for amastigotes in 37% and histopathology showed non-caseating epitheloid cell granuloma in 77% of the cases. Analysis by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) of the ribosomal gene region of 10 biopsy specimens showed amplicons indistinguishable from L. donovani in eight cases and L. tropica in two cases. Leishmania was cultured on modified Nicole-Novy-McNeal (NNN) medium containing RPMI 1640 medium and heat-inactivated fetal bovine serum from 13 of 38 biopsy samples. Three of these isolated strains were identified as L. donovani while a fourth was L. tropica by PCR-RFLP of the ribosomal internal transcribed spacer region. One strain had a gp63 sequence identical to that of east African strains. Another strain had a unique gp63 sequence that has not been found in L. donovani complex strains. Sand flies trapped in the cattle sheds of a few patients were identified as Phlebotomus longiductus (Parrot 1928). Treatment with intralesional sodium stibogluconate was effective in all patients without any major side effects. One patient developed lupoid leishmaniasis that responded to higher dose of sodium stibogluconate. Though rarely reported as a cause of LCL, L. donovani seems to be the predominant pathogen in this new focus of cutaneous leishmaniasis. Phlebotomus longiductus is a possible vector, albeit based on circumstantial evidence.
NORWEGIAN SCABIES IN PERU: THE IMPACT OF HUMAN T CELL LYMPHOTROPIC VIRUS TYPE I INFECTION
Authors: BLAS MAGALY , BRAVO FRANCISCO , CASTILLO WENCESLAO , CASTILLO WENCESLAO J. , BALLONA ROSALÍA , NAVARRO PEDRO , CATACORA JOSÉ , CAIRAMPOMA ROSARIO , GOTUZZO EDUARDO
Published: September 2018

Isolates cases and groups of patients co-infected with human T cell lymphotropic virus type I (HTLV-I) and Norwegian scabies have been previously reported. Peru is considered to be endemic for HTLV-I. Between June 1999 and December 2000, 23 patients with Norwegian scabies were enrolled in this study after written informed consent was obtained. Antibodies against HTLV-I were detected by an enzyme-linked immunosorbent assay and confirmatory Western blot. Patients ranged in age from 3 months to 84 years; 15 (65.2%) were female. Infection with HTLV-I was found in 16 (69.6%) patients. Comorbid features included corticosteroid therapy (8.6%), malnutrition (8.6%), and Down’s syndrome (4.3%). Among those who consented to be tested for human immunodeficiency virus (n = 13, 56.5%), no one had a positive result. The three patients that reported one or more prior episodes of Norwegian scabies were infected with HTLV-I and two of these HTLV-I-positive patients died. Infection with HTLV-I is an important co-factor related to Norwegian scabies in Peru. In our setting, the evaluation for HTLV-I in all Norwegian scabies cases is highly recommended, especially when no other risk factors are apparent.
Q FEVER AND PLASMODIUM FALCIPARUM MALARIA CO-INFECTION IN A PATIENT RETURNING FROM THE COMOROS ARCHIPELAGO
Authors: BROUQUI PHILIPPE , ROLAIN JEAN MARC , FOUCAULT CEDRIC , RAOULT DIDIER
Published: September 2018

Although Plasmodium falciparum malaria and Q fever are both prevalent in Africa, there have been no reports of co-infection to date. We report a case who returned from the Comoros archipelago diagnosed by serologic analysis as well as detection of Coxiella burnetii DNA in acute-phase serum. Thus, Q fever may be associated with malaria infection in travelers returning from disease-endemic countries. This diagnosis should be considered when the response to malaria treatment is incomplete.
ASSESSMENT OF THE WORLD HEALTH ORGANIZATION SCHEME FOR CLASSIFICATION OF DENGUE SEVERITY IN NICARAGUA
Authors: BALMASEDA ANGEL , HAMMOND SAMANTHA NADIA , PÉREZ MARIA ANGELES , CUADRA RICARDO , SOLANO SORAYA , ROCHA JULIO , IDIAQUEZ WENDY , HARRIS EVA
Published: September 2018

The World Health Organization (WHO) scheme for classification of dengue severity was evaluated in a three-year study of 1,671 confirmed dengue cases in three Nicaraguan hospitals. The WHO classification of dengue hemorrhagic fever (DHF) and dengue shock syndrome (DSS) was compared with the presence of hemorrhagic manifestations, signs of vascular permeability, marked thrombocytopenia, and shock in 114 infants, 1,211 children, and 346 adults. We found that strict application of the WHO criteria fails to detect a significant number of patients with severe manifestations of dengue, especially in adults.
EFFECTS OF COMBINED DIETHYLCARBAMAZINE AND ALBENDAZOLE TREATMENT OF BANCROFTIAN FILARIASIS ON PARASITE UPTAKE AND DEVELOPMENT IN CULEX PIPIENS L.
Authors: FARID HODA A. , HAMMAD RAGAA E. , HASSAN MARAH M. , RAMZY REDA M. R. , EL SETOUHY MAGED , WEIL GARY J.
Published: September 2018

We studied effects of combined diethylcarbamazine (DEC) and albendazole (ALB) treatment on Wuchereria bancrofti microfilaria (MF) uptake and development of infective larvae (L3) in Culex pipiens. Consenting Egyptian adults with microfilaremia (MF > 300/mL) were treated with one or seven daily doses of DEC/ALB. Laboratory-reared mosquitoes were fed on subjects before and after treatment. MF uptake and infectivity (assessed by mosquito dissection) were reduced by 89.6% and 82.9%, respectively, 12 months after single-dose treatment and by 96.2% and 99.7%, respectively, after multi-dose treatment. The L3:mosquito ratio decreased by 88% to 0.082 after single-dose treatment and by 99.8% to 0.001 after multi-dose treatment. If high coverage rates can be achieved for several annual cycles, mass drug administration (MDA) with DEC/ALB has the potential to decrease transmission to unsustainable levels and eliminate filariasis in populations. Multi-dose MDA (especially in the first year) might interrupt transmission with fewer cycles than single-dose treatment.
APPLICATION OF A POLYMERASE CHAIN REACTION TO DETECT BURKHOLDERIA PSEUDOMALLEI IN CLINICAL SPECIMENS FROM PATIENTS WITH SUSPECTED MELIOIDOSIS
Authors: GAL DANIEL , MAYO MARK , SPENCER EMMA , CHENG ALLEN C. , CURRIE BART J.
Published: September 2018

The diagnostic potential of a Burkholderia pseudomallei type three secretion system (TTS1) polymerase chain reaction (PCR) was examined on clinical specimens from 27 patients with sepsis in the Northern Territory of Australia, a region endemic for melioidosis. The TTS1 PCR was conducted on DNA extracted from a range of clinical specimens (blood, sputum, urine, joint, pericardial and pleural fluid, and swabs from skin lesions, throat, nose, and rectum). The PCR sensitivity in culture-positive clinical specimens from the nine confirmed patients with melioidosis was 65% and the specificity was 100%, with no PCR-positive results in specimens from 18 patients without melioidosis. The PCR based on the B. pseudomallei TTS1 has the potential to substantially improve the timeliness of diagnosis of melioidosis.
GENETIC POLYMORPHISMS OF EOSINOPHIL-DERIVED NEUROTOXIN AND EOSINOPHIL CATIONIC PROTEIN IN TROPICAL PULMONARY EOSINOPHILIA
Authors: KIM YAE-JEAN , KUMARASWAMI V. , CHOI EUNHWA , MU JIANBING , FOLLMANN DEAN A. , ZIMMERMAN PETER , NUTMAN THOMAS B.
Published: September 2018

Because eosinophil-derived neurotoxin (EDN) and eosinophil cationic protein (ECP) are critical in the pathogenesis of tropical pulmonary eosinophilia (TPE), we analyzed genetic polymorphisms of both in 181 individuals from southern India with varying clinical manifestations of Wuchereria bancrofti infection (including 26 with TPE). Using haplotype frequency analysis, we identified four known (of nine) and two novel haplotypes for EDN (1, 2, 7, 8, 10, and 11). For ECP, five (of seven known) haplotypes (1–5) were identified. Although we found no significant association between frequencies of EDN and ECP polymorphisms and TPE development, we observed a unique pattern of EDN and ECP polymorphism distribution among this population. Genotype TT at locus 1088 of ECP in one TPE patient was not observed in any other clinical group. Although the EDN and ECP polymorphisms appear unlikely to be associated with the development of TPE, further analyses will be more definitive.
A MOLECULAR SURVEY OF BIOMPHALARIA IN EGYPT: IS B. GLABRATA PRESENT?
Authors: LOTFY WAEL M. , DEJONG RANDALL J. , ABDEL-KADER AHMED , LOKER ERIC S.
Published: September 2018

Two species of Biomphalaria are reported from Egypt, the indigenous Biomphalaria alexandrina and Biomphalaria glabrata, the latter believed to be introduced during the past few decades. Both are known to be excellent hosts of Schistosoma mansoni, the human-infecting blood fluke common in Egypt. Given the concerns regarding the spread of the exotic B. glabrata, this study was carried out to get a more current picture of the status of Biomphalaria in Egypt. Snail collections were undertaken during 2002–2003 from regions between Alexandria and Ismailia in the north of the Nile Delta, to as far south as Abu Simbel at Lake Nasser. Biomphalaria snails were found in 37 out of 76 sampled localities and were widely distributed in the Nile Delta and along the Nile as far south as Aswan. According to the results of species-specific polymerase chain reaction assays that sampled both nuclear and mitochondrial genomes, and according to DNA sequence data, all Biomphalaria collected during this survey were B. alexandrina. There was no evidence of the presence of B. glabrata or of hybridization of B. alexandrina with B. glabrata in the examined sites. The results were surprising given that some field-collected snails strongly resembled B. glabrata in both size and conchology and that previous survey work suggested B. glabrata had established in Egypt. Continued scrutiny to ascertain the possible presence of B. glabrata in Egypt is warranted. Also, the planorbid Helisoma duryi was detected in the Delta and as far south as Aswan, so it is important for Egyptian schistosomiasis workers to accurately distinguish this non-schistosome-transmitting snail from Biomphalaria.
CASE-CONTROL STUDY OF MOSQUITO NETS AGAINST MALARIA IN THE AMAZON REGION OF COLOMBIA
Authors: ALEXANDER NEAL , RODRÍGUEZ MAURICIO , PÉREZ LIGIA , CAICEDO JUAN CARLOS , CRUZ JESÚS , PRIETO GUILLERMO , ARROYO JOSÉ ANTONIO , COTACIO MARIA CRISTINA , SUÁREZ MARTHA , DE LA HOZ FERNANDO , HALL ANDREW J.
Published: September 2018

The degree of effectiveness of mosquito nets against malaria in the Americas has remained uncertain. We carried out a case-control study of net use and mild malaria in the Amazonas state of Colombia. Two hundred ninety cases were enrolled via the Health Department services, and 977 community-based controls matched for age, sex, and place of residence. We found that a large proportion of the population (96% of controls) slept under nets. Nevertheless, we found a benefit of impregnated nets compared with no net use: adjusted odds ratio (OR) for mild malaria 0.44, 95% confidence interval (CI) 0.20–0.98. Nonimpregnated nets had a benefit that was only slightly smaller but not statistically significant (OR for mild malaria 0.54, 95% CI 0.25–1.18). Travel in the previous month had an odds ratio of 6.2 (95% CI 3.1–8.8) and a population attributable fraction of 13% compared with 11% for failure to use an impregnated net. We conclude that, in the Amazon region, promotion of mosquito net use and impregnation is justified, and that there is a need for measures to protect travelers from malaria.