bluuebunny/crossref_metadata_2025 huggingface dataset:
Cholera: A New Homeland in Africa?
Authors: Gaffga Nicholas H. , Tauxe Robert V. , Mintz Eric D.
Published: September 2018

Cholera was largely eliminated from industrialized countries by water and sewage treatment over a century ago. Today it remains a significant cause of morbidity and mortality in developing countries, where it is a marker for inadequate drinking water and sanitation infrastructure. Death from cholera can be prevented through simple treatment—oral, or in severe cases, intravenous rehydration. The cholera case-fatality rate therefore reflects access to basic health care. We reviewed World Health Organization (WHO) data on cholera cases and deaths reported between 1960 and 2005. In the 1960s, at the beginning of the seventh and current cholera pandemic, cholera had an exclusively Asian focus. In 1970, the pandemic reached sub-Saharan Africa, where it has remained entrenched. In 1991, the seventh pandemic reached Latin America, resulting in nearly 1 million reported cases from the region within 3 years. In contrast to the persisting situation in Africa, cholera was largely eliminated from Latin America within a decade. In 2005, 31 (78%) of the 40 countries that reported indigenous cases of cholera to WHO were in sub-Saharan Africa. The reported incidence of indigenous cholera in sub-Saharan Africa in 2005 (166 cases/million population) was 95 times higher than the reported incidence in Asia (1.74 cases/million population) and 16,600 times higher than the reported incidence in Latin America (0.01 cases/million population). In that same year, the cholera case fatality rate in sub-Saharan Africa (1.8%) was 3 times higher than that in Asia (0.6%); no cholera deaths were reported in Latin America. The persistence or control of cholera in Africa will be a key indicator of global efforts to reach the Millennium Development Goals and of recent commitments by leaders of the G-8 countries to increase development aid to the region.
Aflatoxin Exposure and Hepatitis C Virus in Advanced Liver Disease in a Hepatitis C Virus–Endemic Area in Taiwan
Authors: Chen Chien-Hung , Wang Mei-Hui , Wang Jing-Houng , Hung Chao-Hung , Hu Tsung-Hui , Lee Shui-Cheng , Tung Hung-Da , Lee Chuan-Mo , Changchien Chi-Sin , Chen Pao-Fei , Hsu Mei-Chin , Lu Sheng-Nan
Published: September 2018

This community-based study evaluated the role of aflatoxin exposure in advanced liver disease in hepatitis C virus (HCV)-endemic townships. Preventive health examination was performed on 314 adults ≥ 40 years of age recruited from HCV-endemic townships in Tainan, Taiwan. Aflatoxin-albumin in serum was quantified by a new enzyme-linked immunosorbent assay method. After adjusting serum albumin levels and platelet counts, aflatoxin-Bi albumin adducts was still an independent risk factor for advanced liver disease among all 314 residents (> 8 versus ≤ 8 (AFBi)-albumin/albumin; OR = 2.29, 95% CI = 1.23–4.27, P = 0.009) and particularly in anti-HCV-positive subjects (OR = 2.09, 95% CI = 1.09–4.0, P = 0.026). Levels of AFB1-albumin/albumin were significantly related to ultrasonographic parenchyma scores (P < 0.001, one-way ANOVA) in all and anti-HCV–positive subjects. The findings indicated aflatoxin exposure may be associated with advanced liver disease in chronic hepatitis C patients in HCV-endemic regions in Taiwan.
Use of Traditional Herbal Medicine by AIDS Patients in Kabarole District, Western Uganda
Authors: Langlois-Klassen Deanne , Kipp Walter , Jhangri Gian S. , Rubaale Tom
Published: September 2018

The objective of this cross-sectional study was to assess the use of traditional herbal medicine by AIDS patients in Kabarole District, western Uganda. Using systematic sampling, 137 AIDS patients were selected from outpatient departments of 3 hospitals and interviewed via questionnaire. The questions related to such areas as type and frequency of herbal medicine intake, concomitant herb–pharmaceutical drug use (including herb–antiretroviral drug cotherapy), and the perceived effectiveness of herbal medicine. Overall, 63.5% of AIDS patients had used herbal medicine after HIV diagnosis. Same-day herbal medicine and pharmaceutical drugs use was reported by 32.8% of AIDS patients. Patterns of traditional herbal medicine use were quite similar between those on antiretroviral therapy and those who received supportive therapy only. The primary conclusion is that AIDS outpatients commonly use herbal medicine for the treatment of HIV/AIDS. Pharmacological interactions between antiretroviral drugs and traditional herbal medicines need to be further examined.
Glucose-6-Phosphate Dehydrogenase Deficiency and Antimalarial Drug Development
Authors: Beutler Ernest , Duparc Stephan , _ _
Published: September 2018

Glucose-6-phosphate dehydrogenase (G6PD) deficiency is relatively common in populations exposed to malaria. This deficiency appears to provide some protection from this infection, but it can also cause hemolysis after administration of some antimalarial drugs, especially primaquine. The risk of drug-induced G6PD deficiency-related hemolysis depends on a number of factors including the G6PD variant, the drug and drug dosage schedule, patient status, and disease factors. Although a great deal is known about the molecular biology of G6PD, determining the potential for drug-induced hemolysis in the clinical setting is still challenging. This report discusses the potential strategies for assessing drug-induced G6PD deficiency-related hemolytic risk preclinically and in early clinical trials. Additionally, the issues important for conducting larger clinical trials in populations in which G6PD deficiency is prevalent are examined, with a particular focus on antimalarial drug development.
Vivax Malaria: Neglected and Not Benign
Authors: Price Ric N. , Tjitra Emiliana , Guerra Carlos A. , Yeung Shunmay , White Nicholas J. , Anstey Nicholas M.
Published: September 2018

Plasmodium vivax threatens almost 40% of the world’s population, resulting in 132–391 million clinical infections each year. Most of these cases originate from Southeast Asia and the Western Pacific, although a significant number also occurs in Africa and South America. Although often regarded as causing a benign and self-limiting infection, there is increasing evidence that the overall burden, economic impact, and severity of disease from P. vivax have been underestimated. Malaria control strategies have had limited success and are confounded by the lack of access to reliable diagnosis, emergence of multidrug resistant isolates, the parasite’s ability to transmit early in the course of disease and relapse from dormant liver stages at varying time intervals after the initial infection. Progress in reducing the burden of disease will require improved access to reliable diagnosis and effective treatment of both blood-stage and latent parasites, and more detailed characterization of the epidemiology, morbidity, and economic impact of vivax malaria. Without these, vivax malaria will continue to be neglected by ministries of health, policy makers, researchers, and funding bodies.
A Large Cluster of Imported Plasmodium falciparum Malaria among Nigerian Expatriate Students
Authors: Kang Mei L. , Hsu Liyang , Kurup Asok
Published: September 2018

Singapore reported the elimination of malaria in 1982, but this country remains vulnerable to imported malaria. We describe a large cluster of 16 cases of imported Plasmodium falciparum malaria in visiting Nigerian students. More than half were asymptomatic and diagnosed only on screening. Although early diagnosis and treatment of patients averted local transmission of disease, our report illustrates the vulnerability of malaria-free countries to the introduction of malaria in this age of increasing globalization and ease of travel.
Cutaneous Anthrax in the Artibonite Valley of Haiti: 1992–2002
Authors: Peck Robert N. , Fitzgerald Daniel W.
Published: September 2018

More cutaneous anthrax cases were noted at Hospital Albert Schweitzer (HAS) in the Artibonite Valley of Haiti. We examine the incidence of anthrax in the Artibonite between 1992 and 2002, describe the clinical presentation of cutaneous anthrax, and determine risk factors for anthrax. In 1992 HAS reported 1 case of anthrax for an incidence of 4 cases per million persons/year. In 2002, there were 20 cases of anthrax for an incidence of 72 cases per million persons/year. This is a 17-fold increase (P = 0.0002). Causes of death from anthrax included asphyxiation from edema of the neck with tracheal compression and concurrent gastrointestinal anthrax. Butchering cattle that had died of illness was identified as a risk factor. The incidence of human anthrax has increased in the Artibonite Valley and is a cause of significant mortality. Control of anthrax in humans depends on improved animal vaccination programs.
Prospective Clinical Evaluation of the Accuracy of 16S rRNA Real-Time PCR Assay for the Diagnosis of Melioidosis
Authors: Chantratita Narisara , Wuthiekanun Vanaporn , Limmathurotsakul Direk , Thanwisai Aunchalee , Chantratita Wasun , Day Nicholas P. J. , Peacock Sharon J.
Published: September 2018

The accuracy of a Burkholderia pseudomallei 16s rRNA real-time PCR assay was evaluated against culture for the diagnosis of melioidosis in Thailand. A total of 846 samples were obtained from 383 patients with suspected melioidosis. One or more specimens were PCR positive for 47 of 77 patients with culture-proven melioidosis (sensitivity 61.0%, 95% CI: 49.2–72.0%). PCR was negative for all 306 patients who were culture negative for B. pseudomallei (specificity 100%, 95% CI: 98.8–100%). Diagnostic sensitivity of PCR was 22.7% for patients who were culture positive for blood only, compared with 79.4% for patients who were culture positive for samples other than blood. The median (interquartile range) B. pseudomallei colony count in blood for 44 of 77 patients with positive blood cultures was 2.4 CFU/ml (0.2–13.5 CFU/ml); this may explain the low sensitivity of PCR for this specimen. The PCR assay described here is not sufficiently sensitive to replace culture in our clinical setting.
Mycobacterium leprae DNA Associated with Type 1 Reactions in Single Lesion Paucibacillary Leprosy Treated with Single Dose Rifampin, Ofloxacin, and Minocycline
Authors: Sousa Ana Lucia O. M. , Stefani Mariane M. A. , Pereira Gisner A. S. , Costa Mauricio B. , Rebello Paula F. , Gomes Maria Katia , Narahashi Kazue , Gillis Thomas P. , Krahenbuhl James L. , Martelli Celina M. T.
Published: September 2018

Leprosy affects skin and peripheral nerves, and acute inflammatory type 1 reactions (reversal reaction) can cause neurologic impairment and disabilities. Single skin lesion paucibacillary leprosy volunteers (N = 135) recruited in three Brazilian endemic regions, treated with single-dose rifampin, ofloxacin, and minocycline (ROM), were monitored for 3 years. Poor outcome was defined as type 1 reactions with or without neuritis. IgM anti-phenolic glycolipid I, histopathology, Mitsuda test, and Mycobacterium leprae DNA polymerase chain reaction (ML-PCR) were performed at baseline. χ2 test, Kaplan-Meir curves, and Cox proportional hazards were applied. The majority of volunteers were adults with a mean age of 30.5 ± 15.4 years; 44.4% were ML-PCR positive. During follow-up, 14.8% of the patients had a poor clinical outcome, classified as a type 1 reaction. Older age (≥40 years), ML-PCR positivity, and lesion size > 5cm were associated with increased risk. In multivariate analysis, age (≥40 years) and ML-PCR positivity remained baseline predictors of type 1 reaction among monolesion leprosy patients.
Environmental and Health-Related Risk Factors for Mycobacterium ulcerans Disease (Buruli Ulcer) in Benin
Authors: Nackers Fabienne , Johnson Roch C. , Glynn Judith R. , Zinsou Claude , Tonglet René , Portaels Françoise
Published: September 2018

We conducted a case-control study to investigate the association between Buruli ulcer (BU) and environmental- and health-related behaviors in southern Benin. Hospital BU cases (N = 324) and sex- and age-matched neighborhood controls (N = 1,173) answered a questionnaire. Regular use of soap for washing, treating injuries with soap or antibiotic powder, and frequent contact with flowing water appeared protective against BU.
Development of Taqman-Based Real-Time PCR Assays for Diagnostic Detection of Babesia bovis and Babesia bigemina
Authors: Kim Chulmin , Iseki Hiroshi , Herbas Maria Shirley , Yokoyama Naoaki , Suzuki Hiroshi , Xuan Xuenan , Fujisaki Kozo , Igarashi Ikuo
Published: September 2018

Two TaqMan-based real-time polymerase chain reaction (PCR) assays devised for the detection of two bovine Babesia parasites, Babesia bovis and B. bigemina, were evaluated for their diagnostic utility using cultured parasites and 92 field bovine blood samples collected from cattle living in Brazil. The real-time PCR assays were compared with previously established nested-PCR assays. The detection limits of both B. bovis- and B. bigemina–real-time PCR assays were identical at the value of 2.5 parasites/μL of the infected blood. When 92 field bovine blood samples were tested using the real-time assays, B. bovis-positive signals were observed in 30 samples among 31 B. bovis-positive blood samples in the nested-PCR assay (96.9% sensitivity and 100% specificity), whereas the B. bigemina–real-time PCR assay could detect the parasite from all of 45 B. bigemina-positive blood samples in the nested-PCR assay (100% sensitivity and specificity). The real-time assays using the TaqMan-system can therefore be practically implemented in the epidemiologic survey for bovine babesiosis. Further studies will be necessary to investigate the clinical value of this technique, especially for the quantitative detections of the parasites.
Trimeresurus stejnegeri Envenoming during Pregnancy
Authors: Chen Yen-Chia , Chen Min-Hui , Yang Chen-Chang , Chen Yen-Wen , Wang Lee-Min , Huang Chun-I
Published: September 2018

Snake envenoming in pregnancy may cause fetal death and maternal mortality or morbidity. However, little is known about the toxic effects and optimal management of snake envenoming because of the rarity of cases. We report three cases in Taiwan in the past 15 years of pregnant women who were treated successfully after being bitten by Trimeresurus stejnegeri with local envenoming. Two of the three patients received treatment with equine-derived hemotoxic bivalent F(ab′)2 antivenom without development of any adverse effects. All three women recovered uneventfully and subsequently had normal deliveries. Telephone follow-up of the three children 6–10 years later showed no developmental delay of the children.
Cellular Analysis of Cutaneous Leishmaniasis Lymphadenopathy: Insights into the Early Phases of Human Disease
Authors: Bomfim Glória , Andrade Bruno B. , Santos Silvane , Clarêncio Jorge , Barral-Netto Manoel , Barral Aldina
Published: September 2018

Lymphadenopathy is an early clinical sign in cutaneous leishmaniasis (CL), caused by Viannia parasites, and may help to understand the initial host response to these species of Leishmania. We report on characteristics of cells obtained from lymph nodes from cutaneous leishmaniasis patients with lymphadenopathy without ulceration (early phase, N = 21) or lymphadenopathy and ulceration (late phase, N = 29). Early-phase patients exhibited a higher proportion of neutrophils, eosinophils, and CD8+ T cells. Conversely, CD19+ B lymphocytes and plasma cells were more frequently observed in late-phase patients. The signal for IL-10 was significantly higher in late-phase patients; signals for IFN-γ or IL-4 were similar in both groups. These data reinforce observations of an initial mixed Th1–Th2 profile as well as the early role of the CD8 T cell in cutaneous leishmaniasis. Additionally, there is a chronologic relationship between ulcer development and B-cell increase. IL-10 also increases at a late stage and may be important in limiting tissue damage.
A Cluster-Randomized Bovine Intervention Trial against Schistosoma japonicum in the People’s Republic of China: Design and Baseline Results
Authors: Gray Darren J. , Williams Gail M. , Li Yuesheng , Chen Honggen , Li Robert S. , Forsyth Simon J. , Barnett Adrian G. , Guo Jiagang , Feng Zheng , McManus Donald P.
Published: September 2018

We describe the design and report baseline results of a cluster-randomized intervention to determine the importance of bovines for Schistosoma japonicum transmission in southern China. The study involves four matched village pairs in Hunan and Jiangxi Provinces, with a village within each pair randomly selected as intervention (human and bovine praziquantel treatment) or control (human praziquantel treatment only). Total study population prevalences at baseline were 12.4% (n = 5,390) and 15.2% (n = 1,573) for humans and bovines, respectively; village prevalences were similar within pairs. Bovine contamination index calculations showed that bovines less than 24 months of age were responsible for 74% of daily bovine environmental contamination with S. japonicum eggs. The village characteristics and baseline results underpin a rigorous study, which has major implications for deployment of a transmission-blocking bovine vaccine against S. japonicum. The combination of such a vaccine with other control strategies could potentially eliminate S. japonicum from southern China.
Autochthonous Hepatitis E Infection in a Slaughterhouse Worker
Authors: Pérez-Gracia Maria Teresa , Mateos Maria Luisa , Galiana Carolina , Fernández-Barredo Salceda , García Angel , Gómez Maria Teresa , Moreira Victor
Published: September 2018

We report the first hepatitis E infection case detected in a slaughterhouse worker. The identified strain belonged to genotype 3, subtype 3f. Partial sequence analysis of the strain isolated from his serum showed a percentage of nucleotide homology ranging from 83.4% up to 97.3% compared with European human and swine strains, respectively. These findings point strongly to hepatitis E virus as a vocationally acquired illness by means of the manipulation of infected organs from pigs.
Analysis of Repeat Hospital Admissions for Dengue to Estimate the Frequency of Third or Fourth Dengue Infections Resulting in Admissions and Dengue Hemorrhagic Fever, and Serotype Sequences
Authors: Gibbons Robert V. , Kalanarooj Siripen , Jarman Richard G. , Nisalak Ananda , Vaughn David W. , Endy Timothy P. , Mammen Mammen P. , Srikiatkhachorn Anon
Published: September 2018

Immunity to a single dengue virus (DENV) infection does not provide heterologous immunity to subsequent infection. In fact, the greatest risk for dengue hemorrhagic fever (DHF) is with a second DENV serotype exposure. The risk for DHF with a third or fourth dengue infection relative to a first or second exposure is not known. An analysis of our database of children admitted to the Queen Sirikit National Institute of Child Health and Kamphaeng Phet Provincial Hospital with suspected dengue illness revealed that the number of dengue admissions caused by a third or fourth DENV infection was extremely low (0.08–0.8%). Once admitted, the risk for DHF relative to dengue fever was not different for those experiencing third or fourth DENV infections over those experiencing a second DENV infection. We document new dengue serotype infection sequences leading to DHF of 1–4, 2–3, 3–1, and 3–4.
Azithromycin/Chloroquine Combination Does Not Increase Cardiac Instability despite an Increase in Monophasic Action Potential Duration in the Anesthetized Guinea Pig
Authors: Fossa Anthony A. , Wisialowski Todd , Duncan J. Neil , Deng Shibing , Dunne Michael
Published: September 2018

Prolongation of the electrocardiogram QT interval by some, but not all drugs, has been associated with increased incidence of sudden cardiac death. Current preclinical regulatory assays cannot discriminate the arrhythmia liability of these drugs. Consequently, many new medications that prolong the QT interval are not developed despite their potential therapeutic benefit. Alternans (action potential duration alternations) is a measure of cardiac instability in humans and animals associated with the onset of ventricular fibrillation. Due to potential arrhythmia risk from observed QT prolongation, alternans was assessed in the anesthetized guinea pig after azithromycin or chloroquine alone and after combination treatment at clinically relevant concentrations proposed for the management of malaria. Chloroquine alone, but not azithromycin, caused a profound increase in action potential duration but with only minimal effects on alternans (~10 ms). Azithromycin alone and in combination with chloroquine showed no increase in alternans beyond vehicle baseline responses indicating no additional arrhythmia liability.
High Prevalence of Asymptomatic Plasmodium falciparum Infection in Gabonese Adults
Authors: Dal-Bianco Matthias P. , Köster Kai B. , Kombila Ulrich D. , Kun Jürgen F. J. , Grobusch Martin P. , Ngoma Ghyslain Mombo , Matsiegui Pierre B. , Supan Christian , Ospina Salazar Carmen L. , Missinou Michel A. , Issifou Saadou , Lell Bertrand , Kremsner Peter
Published: September 2018

Plasmodium falciparum, the most common malarial parasite in sub-Saharan Africa, accounts for a high number of deaths in children less than five years of age. In malaria-endemic countries with stable transmission, semi-immunity is usually acquired after childhood. For adults, severe malaria is rare. Infected adults have either uncomplicated malaria or asymptomatic parasitemia. During a period of one year, we screened 497 afebrile males to investigate the prevalence of asymptomatic P. falciparum parasitemia in villages near Lambaréné, Gabon by use of three different methods. A total of 52% of the individuals had parasites detected by a subtelomeric variable open reading frame polymerase chain reaction (stevor-PCR), 27% of the rapid diagnostic test results were positive, and 12% of the thick blood smears with low parasitemias had P. falciparum. Most positive cases were only detected by the stevor-PCR. Asymptomatic P. falciparum parasitemia in adults living in a malaria-endemic country is frequent.
Intra-household Mosquito Net Use in Ethiopia, Ghana, Mali, Nigeria, Senegal, and Zambia: Are Nets Being Used? Who in the Household Uses Them?
Authors: Baume Carol A. , Marin M. Celeste
Published: September 2018

Mosquito net ownership is rising in sub-Saharan Africa but will substantially reduce malaria only if nets are used and the most vulnerable household members sleep under them. We used data from 9 large-scale household surveys conducted in 6 African countries from 2000 to 2004 that enumerated all household members and nets owned, analyzing only net-owning households. Across countries, women of reproductive age and children under 5 (without gender bias) were most likely to use the net; least likely were children of age 5–14 and adult males. Nets commonly covered 2–3 people. If a baby net was used, fewer people used the family net. Pregnant women were more likely to use a net in 2004 than in 2000. In several countries, a sizable minority of nets owned were not used. Understanding intra-household net-use patterns helps malaria control programs more effectively direct their efforts to increase their public health impact.
Demographic and Dispersal Constraints for Domestic Infestation by Non-Domicilated Chagas Disease Vectors in the Yucatan Peninsula, Mexico
Authors: Gourbière Sébastien , Dumonteil Eric , Rabinovich Jorge E. , Minkoue Raissa , Menu Frédéric
Published: September 2018

Chagas disease is one of the most important diseases in Latin America. Insecticides have been sprayed to control domiciliated vectors. However, some triatomine species are not strictly domiciliated, and the transmission risk posed by immigrants is identified as a major challenge. The design of new control strategies requires disentangling the importance of demography and immigration in vector occurrence inside houses. Using a population dynamics model, we confirmed that dispersal can explain satisfactorily the domestic abundance of Triatoma dimidiata in Yucatan, Mexico. A surprisingly low fecundity was also required (no more than one to two female offspring per female per trimester). A wide range of survival probabilities was possible, although the best fit was obtained for a very low immature survival (≤ 0.01/trimester). Our model predicted that domestic populations are not sustainable, and up to 90% of the individuals found in houses are immigrants. We discuss the potential of different strategies to control the transmission of Chagas disease by non-domiciliated vectors.
Evidence for Suppression of Onchocerca volvulus Transmission in the Oaxaca Focus in Mexico
Authors: Rodríguez-Pérez Mario A. , Lizarazo-Ortega Cristian , Hassan Hassan K. , Domínguez-Vásquez Alfredo , Méndez-Galván Jorge , Lugo-Moreno Patricia , Sauerbrey Mauricio , Richards Frank , Unnasch Thomas R.
Published: September 2018

Entomologic and serologic surveys were performed in four sentinel communities in the Oaxaca focus in southern Mexico to assess the level of transmission and exposure incidence to Onchocerca volvulus. All communities have been receiving ivermectin mass treatment twice per year since 1997. In one community, parasite DNA was detected by polymerase chain reaction–enzyme-linked immunosorbent assay in 2004 in one pool of 50 vector heads of 170 such pools (8,500 flies) examined, which indicated an estimated transmission potential of 6.7 third-stage larvae/person/year. No evidence for transmission was found in the three other communities in 13,650 flies examined. All persons in a cohort consisting of 117 children in the four communities remained serologically negative for antibodies recognizing a cocktail of recombinant antigens over a four-year period from 2001 to 2004, which indicated an exposure incidence of 0%. Taken together, these data suggest that transmission has been suppressed in the four communities.
Distribution and Chromosomal Characterization of the Anopheles gambiae Complex in Angola
Authors: Calzetta Maria , Santolamazza Federica , Carrara Gian Carlo , Cani Pedro J. , Fortes Filomeno , Di Deco Maria Angela , Torre Alessandra della , Petrarca Vincenzo
Published: September 2018

Mosquitoes of the Anopheles gambiae complex (N = 1,336) were sampled (2001–2005) across Angola to identify taxa, study inversion polymorphisms, and detect the circumsporozoite protein of Plasmodium falciparum. Anopheles gambiae s.s. was found in all sites; it was characterized as M-form in localities of the tropical dry and semi-desertic belts, whereas the S-form was predominant in comparatively more humid and less anthropized sites. Both forms were characterized by low degrees of chromosomal polymorphism based solely on the 2La inversion, a pattern usually associated with An. gambiae populations from forested, humid, and derived savanna areas. Unexpectedly, this pattern was also observed in M-form populations collected in dry/pre-desertic areas, where this form largely predominates over An. arabiensis, which was also detected in central/inland sites. Anopheles melas was found in northern coastal sites. Three of 534 An. gambiae s.s. were positive for P. falciparum CS-protein, whereas none of the 105 An. melas were positive.
Atypical Toxoplasma gondii Strain from a Free-living Jaguar (Panthera onca) in French Guiana
Authors: Demar M. , Ajzenberg D. , Serrurier B. , Dardé M. L. , Carme B.
Published: September 2018

Like domestic cats, wild felids are involved in the complete infective cycle of Toxoplasma gondii because they can host in their gastrointestinal tract sexually mature parasites and shed infective oocysts in their feces. We report, to our knowledge, the first isolation and molecular characterization of a T. gondii strain from the heart tissue of a free-living jaguar (Panthera onca) in French Guiana. Sequencing at six polymorphic markers indicated that the jaguar isolate had an atypical genotype, including an allele at TgM-A previously found only in isolates from South America, and an allele at GRA6, which was previously reported only in Californian sea otter isolates. These findings are consistent with the recent description of atypical T. gondii strains involved in severe toxoplasmoses in immunocompetent patients in French Guiana that seemed to be linked to a neotropical forest-based cycle involving wild cats and their prey.
Consensus Guidelines for Dosing of Amoxicillin-Clavulanate in Melioidosis
Authors: Cheng Allen C. , Chierakul Wirongrong , Chaowagul Wipada , Chetchotisakd Ploenchan , Limmathurotsakul Direk , Dance David A. B. , Peacock Sharon J. , Currie Bart J.
Published: September 2018

Melioidosis is an infectious disease endemic to northern Australia and Southeast Asia. In response to clinical confusion regarding the appropriate dose of amoxicillin-clavulanate, we have developed guidelines for the appropriate dosing of this second-line agent. For eradication therapy for melioidosis, we recommend 20/5 mg/kg orally, three times daily.
Treatment of Acute Uncomplicated Falciparum Malaria with Artemether-Lumefantrine in Non-immune Populations: A Safety, Efficacy, and Pharmacokinetic Study
Authors: Hatz Christoph , Soto Jaime , Nothdurft Hans Dieter , Zoller Thomas , Weitzel Thomas , Loutan Louis , Bricaire Francois , Gay Frederick , Burchard Gerd-Dieter , Andriano Kim , Lefèvre Gilbert , De Palacios Patricia Ibarra , Genton Blaise
Published: September 2018

The efficacy and safety of artemether-lumefantrine for the treatment of malaria in nonimmune populations are not well defined. In this study, 165 nonimmune patients from Europe and non-malarious areas of Colombia with acute, uncomplicated falciparum malaria or mixed infection including P. falciparum were treated with the six-dose regimen of artemether-lumefantrine. The parasitologic cure rate at 28 days was 96.0% for the per protocol population (119/124 patients). Median times to parasite clearance and fever clearance were 41.5 and 36.8 hours, respectively. No patient had gametocytes after Day 7. Treatment was well tolerated; most adverse events were mild to moderate and seemed to be related to malaria. There were few serious adverse events, none of which were considered to be drug-related. No significant effects on ECG or laboratory parameters were observed. In conclusion, the six-dose regimen of artemether-lumefantrine was effective and well tolerated in the treatment of acute uncomplicated falciparum malaria in nonimmune patients.
Identification and Geographic Distribution of the ACE-1R Mutation in the Malaria Vector Anopheles gambiae in South-Western Burkina Faso, West Africa
Authors: Djogbénou Luc , Dabiré Roch , Diabaté Abdoulaye , Kengne Pierre , Akogbéto Martin , Hougard Jean Marc , Chandre Fabrice
Published: September 2018

Resistance of Anopheles gambiae to organophosphate and carbamate insecticides was first reported in Côte d’Ivoire, West Africa. Subsequent studies revealed that it resulted from a single point mutation in the oxyanion hole of the acetycholinesterase enzyme (ace-1R mutation). We investigated the distribution and prevalence of the ace-1R mutation in An. gambiae s.l. populations from seven locations in south-western Burkina Faso. The ace-1R mutation was found in both M and S molecular forms of An. gambiae s.s., but it was absent in An. arabiensis. Its frequency ranged from 0.25 to 0.5 in S form and 0.04 to 0.13 in M form, though they were sympatric. The lack of homozygous resistance indicated a strong genetic cost associated with the mutation. These data suggest that organophosphate and carbamate resistance conferred by target site insensitivity is spreading in populations of An. gambiae s.s. from West Africa.
A One-Step DNA PCR-based Method for the Detection of Mycobacterium tuberculosis Complex Grown on Lowenstein-Jensen Media
Authors: Elbir Haitham , Abdel-Muhsin Abdel-Muhsin , Babiker Ahmed
Published: September 2018

A simple, rapid, and sensitive direct colony polymerase chain reaction (PCR) method to detect Mycobacterium tuberculosis complex grown on Lowenstein-Jensen media is described. M. tuberculosis is killed by treating it for 2 hours with 70% ethanol. Whole Mycobacterium cells inactivated by ethanol are added to a PCR mix that is designed to amplify the IS6110 insertion sequence. All 44 isolates tested were positive by this method. Our results show that PCR can be performed directly on bacterial colonies without the need for DNA extraction before PCR. Moreover, inactivation of M. tuberculosis before DNA amplification reduces the potential exposure of workers to viable M. tuberculosis. The exclusion of DNA extraction and inactivation of colonies before PCR provide a safe and low-cost preparatory technique for PCR reaction compared with expensive conventional extraction protocols that are based on chemical and enzymatic lysis, especially for countries with limited resources.
Socio-demographic and Climatic Factors as Correlates of Mediterranean Spotted Fever (MSF) in Northern Sardinia
Authors: Vescio Maria Fenicia , Piras Maria Adriana , Ciccozzi Massimo , Carai Antonina , Farchi Francesca , Maroli Michele , Mura Maria S. , Rezza Giovanni , _ _
Published: September 2018

Mediterranean spotted fever (MSF) is endemic in the Mediterranean area. We carried out a retrospective study to investigate the association between socio-demographic and climatic factors and MSF incidence in northern Sardinia. We found that maximum temperature levels during the previous summer were associated with increases in MSF incidence.
Occupational Risk of Exposure to Rodent-borne Hantavirus at US Forest Service Facilities in California
Authors: Levine Jessica R. , Fritz Curtis L. , Novak Mark G.
Published: September 2018

Hantavirus cardiopulmonary syndrome (HCPS) is a frequently fatal viral disease transmitted through rodent secretions and excretions. Working around deer mice can increase risk of infection. This study assessed potential risk of HCPS at facilities occupied by the US Forest Service (USFS) in California. In 2004–2005, 18 USFS facilities in eight National Forests in California were evaluated for evidence of rodent infestation and circulation of hantavirus. Structural deficiencies and evidence of rodent infestation were observed at 18 facilities. Serum antibodies to hantavirus were detected in 50 of 255 deer mice collected from 15 facilities. Seroprevalence was higher at elevations > 1,600 m (22%). Employees at 14 facilities had received training in rodent-borne disease prevention. Risk of HCPS among USFS employees should motivate inclusion of disease prevention information into employee safety training.
Epidemic Dengue and Dengue Hemorrhagic Fever at the Texas–Mexico Border: Results of a Household-based Seroepidemiologic Survey, December 2005
Authors: Ramos Mary M. , Mohammed Hamish , Zielinski-Gutierrez Emily , Hayden Mary H. , Lopez Jose Luis Robles , Fournier Marta , Trujillo Alfredo Rodríguez , Burton Roy , Brunkard Joan M. , Anaya-Lopez Luis , Banicki Allison Abell , Morales Pablo Kuri , Smith Brian , Muñoz Jorge L. , Waterman Stephen H. , _ _
Published: September 2018

A dengue-2 epidemic causing dengue hemorrhagic fever (DHF) occurred in the contiguous border cities of Matamoros, Tamaulipas (Mexico), and Brownsville, TX, in 2005. In December, we conducted a household-based epidemiologic survey to determine the incidence and seroprevalence of dengue infection among Matamoros and Brownsville residents and to identify risk factors associated with infection. Antibodies to dengue were measured in 273 individuals. The estimated incidence of recent dengue infection was 32% and 4% among Matamoros and Brownsville participants, respectively. The estimated prevalence of past dengue infection was 77% and 39% among Matamoros and Brownsville participants, respectively. The Breteau index was 28 in Matamoros and 16 in Brownsville, reflecting an abundant winter population of Aedes mosquitoes. Discarded waste tires and buckets were the two largest categories of infested containers found in both cities. Our results underscore the risk for epidemic dengue and DHF in the Texas-Mexico border region.
A Case of Erysipeloid Cutaneous Leishmaniasis: Atypical and Unusual Clinical Variant
Authors: Ceyhan Ali M. , Yildirim Mehmet , Basak Pinar Y. , Akkaya Vahide B. , Erturan Ijlal
Published: September 2018

Cutaneous leishmaniasis has a number of morphologic variants such as acute paronychial, chancriform, annular, palmoplantar, zosteriform, and eczematoid, which depend on the immune condition of the patients, the subspecies of the Leishmania, and the area of the localization. In recent times, the number of reports of new and rare variants of cutaneous leishmaniasis has been increasing. In this report, we describe a very rare variant of Cutaneous leishmaniasis, presented with ulceration on glabellar region and infiltrative erythematous lesions covering the center of the face, resembling erysipelas.
Malaria in Pregnancy in the Solomon Islands: Barriers to Prevention and Control
Authors: Appleyard Bridget , Tuni Makiva , Cheng Qin , Chen Nanhua , Bryan Joan , McCarthy James S.
Published: September 2018

A study of malaria in pregnancy (MIP) was undertaken in Marovo Lagoon, Solomon Islands, to evaluate pregnancy-specific control strategies for malaria. Peripheral parasitemia was present in 18% (19/106) of women: 15 Plasmodium falciparum and 4 P. vivax. Primigravidae were twice as likely to be parasitemic as multigravidae (31% versus 14%; relative risk: 2.24; 95% confidence interval: 1.01–4.96; P = 0.05). Although ante-natal clinic attendance was high, women booked late (mean, 19.7 weeks) and attended irregularly. Free insecticide-treated nets (ITN) were not distributed despite government policy. Primigravidae were less likely to have an ITN in their homes than multigravidae (relative risk: 2.13; 95% confidence interval: 1.03–4.40). Coverage with chloroquine prophylaxis was low. This study revealed barriers to control of MIP at both the health service and client level. To develop an evidence-based malaria control policy in pregnancy for this region, further study of the epidemiology of malaria and its effects, including social and behavioral aspects, is needed.
Geographical Distribution of Amino Acid Mutations in Plasmodium vivax DHFR and DHPS from Malaria Endemic Areas of Thailand
Authors: Rungsihirunrat Kanchana , Sibley Carol Hopkins , Mungthin Mathirut , Na-Bangchang Kesara
Published: September 2018

Both malaria treatment and prophylaxis target the parasite dihydropteroate synthase (DHPS) and dihydrofolate reductase (DHFR) enzymes. Specific point mutations in these genes confer resistance to sulfadoxine-pyrimethamine (SP) in both Plasmodium falciparum and P. vivax. We used direct sequencing to examine the prevalence of point mutations in pvdhps and pvdhfr in 160 P. vivax isolates collected from areas along the international borders of Thailand. Results show that the majority of the isolates harbored a quadruple mutant allele of pvdhfr and a double mutant allele of pvdhps, but the distribution was not uniform. The highly mutant allele combination was especially prevalent along the Thai-Myanmar border, whereas the majority of the isolates from areas along the Thai-Cambodian and Thai-Malaysian borders carried double mutant alleles of pvdhfr and single mutant alleles of pvdhps. Novel mutations that have not been identified previously at codon 512 of pvdhps (K512M, K512E, K512T) were also found.
Two Triatoma dimidiata Clades (Chagas Disease Vector) Associated with Different Habitats in Southern Mexico and Central America
Authors: Tamay-Segovia Paulino , Alejandre-Aguilar Ricardo , Martínez Fernando , Villalobos Guiehdani , de la Serna Francisco J. Zavala-Díaz , de la Torre Patricia , Laclette Juan Pedro , Blum-Domínguez Selene , Espinoza Bertha
Published: September 2018

Triatoma dimidiata is the only reported Chagas disease vector in Campeche, Mexico. The purpose of this study was to determine the genetic variability of vectors from Campeche coastal and rain forest areas and establish a phylogenetic relationship with other T. dimidiata populations by analyzing the internal transcribed spacer-2 (ITS-2) region. The sequence length of samples from Campeche ranged from 469 to 478 basepairs. The ITS-2 variability among the populations enabled us to classify them into two clades with an 18–22 nucleotide difference. The genetic distance (0.042) between them confirms this divergence. Phylogenetic analysis of gene genealogies confirmed these two clades. Furthermore, the population genetic analyses showed two groups with little genetic similarity or migration between them. One group was associated with the tropical forest area and the other group was associated with a mainly coastal distribution. This correlation was also observed when T. dimidiata from other regions of Mexico and Central America were analyzed.
Soluble Tumor Necrosis Factor (TNF) Receptors (sTNF-R1 and -R2) in Pregnant Women Chronically Infected with Trypanosoma cruzi and their Children
Authors: García Miriam Martin , De Rissio Ana Maria , Villalonga Ximena , Mengoni Eleonora , Cardoni Rita L.
Published: September 2018

Most congenital transmissions of Trypanosoma cruzi are not detected. As the levels of mediators regulating the immune response might be different in the absence or in the presence of transmission, we explored the levels of tumor necrosis factor (TNF) and soluble TNF receptors TNF-R1 and -R2 in T. cruzi–infected pregnant women and the neonates. We previously found that the circulating levels of TNF were higher in non-transmitting than in transmitting pregnant women. This observation has now been extended to the spontaneous release of TNF by peripheral blood leukocytes (PBLs) that was also higher in non-transmitting than in transmitting pregnant women. As their mothers, non-infected neonates had higher circulating levels of TNF than congenitally infected children. The circulating levels of sTNF-R1 increased in non-transmitting and transmitting mothers and in infected and non-infected neonates. The circulating levels of sTNF-R2 were ∼60% higher in infected than in non-infected neonates (1,635 ± 101 and 1,027 ± 100 pg/mL, respectively) and remained higher at 1 year of age. This important increase, only observed in infected neonates, could be useful to orientate to the presence of vertical transmission of T. cruzi infection.
Rapid Detection of Brugia malayi in Mosquito Vectors Using a Real-time Fluorescence Resonance Energy Transfer PCR and Melting Curve Analysis
Authors: Thanchomnang Tongjit , Intapan Pewpan M. , Lulitanond Viraphong , Choochote Wej , Manjai Anonglak , Prasongdee Thidarat K. , Maleewong Wanchai
Published: September 2018

We developed real-time fluorescence resonance energy transfer (FRET) polymerase chain reaction (PCR) combined with melting curve analysis for detection of Brugia malayi DNA in blood-fed mosquitoes. Real-time FRET PCR is based on a fluorescence melting curve analysis of hybrid formed between amplicons generated from a family of repeated DNA element, 153-bp HhaI repeated sequence, specific to genus Brugia and specific fluorophore-labeled probes. The B. malayi–infected mosquitoes were differentiated from Wuchereria bancrofti–infected and uninfected mosquitoes and from genomic DNA of Dirofilaria immitis– and Plasmodium falciparum–infected human red blood cells and human leukocytes by their melting temperature. Sensitivity and specificity were both 100%. Melting curve analysis produces a rapid, accurate, and sensitive alternative for specific detection of B. malayi in mosquitoes, allows high throughput, and can be performed on small samples. This method has the potential for endemic area mapping or monitoring effect of brugian filariasis mass treatment programs.
Risk Factors Associated with Human Infection during the 2006 West Nile Virus Outbreak in Davis, a Residential Community in Northern California
Authors: Nielsen Carrie F. , Armijos M. Veronica , Wheeler Sarah , Carpenter Tim E. , Boyce Walter M. , Kelley Kara , Brown David , Scott Thomas W. , Reisen William K.
Published: September 2018

We collected a total of 15,329 mosquitoes during weekly sampling in Davis, CA, from April through mid-October 2006 at 21 trap sites uniformly spaced 1.5 km apart over an area of ∼26 km2. Of these mosquitoes, 1,355 pools of Culex spp. were tested by multiplex reverse transcriptase-polymerase chain reaction, of which 16 pools (1.2%) were positive for West Nile virus (WNV). A degree-day model with a developmental threshold of 14.3°C accurately predicted episodic WNV transmission after three extrinsic incubation periods after initial detection. Kriging interpolation delineated that Culex tarsalis were most abundant at traps near surrounding agriculture, whereas Cx. pipiens clustered within residential areas and greenbelt systems in the old portion of Davis. Spatial-temporal analyses were performed to test for clustering of locations of WNV-infected dead birds and traps with WNV-positive Cx. tarsalis and Cx. pipiens; human case incidence was mapped by census blocks. Significant multivariate spatial-temporal clustering was detected among WNV-infected dead birds and WNV-positive Cx. tarsalis, and a WNV-positive Cx. pipiens cluster overlapped areas with high incidences of confirmed human cases. Spatial analyses of WNV surveillance data may be an effective method to identify areas with an increased risk for human infection and to target control efforts to reduce the incidence of human disease.
Expanded Range of Burkholderia Species in Australia
Authors: Levy Avram , Merritt Adam J. , Aravena-Roman Max , Hodge Meredith M. , Inglis Timothy J. J.
Published: September 2018

This study describes the isolation and characterization of several Burkholderia species from soil in northern Australia. Phenotypic and molecular tests indicate that these isolates belong to the species Burkholderia thailandensis and Burkholderia ubonensis. These observations significantly extend our knowledge of the geographic distribution of these 2 species. Evidence of these species in Australia has implications for bacterial identification in clinical laboratories, diagnostic serology tests, and environmental biodiversity studies.
Rapid Active Assay for the Detection of Antibodies to West Nile Virus in Chickens
Authors: Groves Stephanie S. , Turell Michael J. , Bailey Charles L. , Morozov Victor N.
Published: September 2018

To reduce the assay time for detecting virus-specific antibodies in serum, we developed microarray-based active immunoassay techniques for detecting West Nile virus (WNV)-specific IgM molecules in chicken blood. The assay uses electrophoretic concentration of IgM molecules onto WNV antigens arrayed on a dialysis membrane followed by detection of bound IgM molecules with functionalized magnetic beads as active labels. This assay takes only 15 minutes and has the same sensitivity as a commercially available human WNV IgM antibody-capture enzyme-linked immunosorbent assay (commonly called a MAC-ELISA) modified for use with chicken sera.
Pharmacokinetics of Dihydroartemisinin in a Murine Malaria Model
Authors: Batty Kevin T. , Gibbons Peter L. , Davis Timothy M. E. , Ilett Kenneth F.
Published: September 2018

Pharmacokinetic properties of dihydroartemisinin (DHA) were determined in mice given 100 mg/kg intraperitoneal DHA. Half-life, CL/F, and V/F were 25 min, 61.3 L/hr/kg, and 36.3 L/kg in malaria-infected mice and 19 min, 50.9 L/hr/kg, and 23.0 L/kg in controls. These data are valuable for pharmacokinetic–pharmacodynamic evaluations of DHA in murine models.