bluuebunny/crossref_metadata_2025 huggingface dataset:
MELIOIDOSIS IN MYANMAR: FORGOTTEN BUT NOT GONE?
Authors: WUTHIEKANUN VANAPORN , LANGA SAYAN , SWADDIWUDHIPONG WITAYA , JEDSADAPANPONG WILARAT , KAENGNET YINGYOT , CHIERAKUL WIRONGRONG , DAY NICHOLAS P. , PEACOCK SHARON J.
Published: September 2018

A serologic survey of adults resident in Myanmar was conducted to define the presence of antibodies to Burkholderia pseudomallei, the cause of melioidosis. Antibodies were detectable by indirect hemagglutination assay (IHA) in 757 (78%) of 968 adults, of whom 69 (7%) had an IHA titer ≥0.
GEOGRAPHICAL DISTRIBUTION OF HANTAVIRUSES IN THAILAND AND POTENTIAL HUMAN HEALTH SIGNIFICANCE OF THAILAND VIRUS
Authors: PATTAMADILOK SIRIMA , LEE BYOUNG-HEE , KUMPERASART SANIT , YOSHIMATSU KUMIKO , OKUMURA MEGUMI , NAKAMURA ICHIRO , ARAKI KOICHI , KHOPRASERT YUVALUK , DANGSUPA PRAYADH , PANLAR PORNPITAK , JANDRIG BURKHARD , KRÜGER DETLEV H. , KLEMPA BORIS , JÄKEL THOMAS , SCHMIDT JONAS , ULRICH RAINER , KARIWA HIROAKI , ARIKAWA JIRO
Published: September 2018

Phylogenetic investigations, sequence comparisons, and antigenic cross-reactivity studies confirmed the classification of Thailand virus (THAIV) as a distinct hantavirus species. The examination of sera from 402 rodents trapped in 19 provinces of Thailand revealed that five greater bandicoot rats (Bandicota indica) and one lesser bandicoot rat (B. savilei) from four provinces were focus reduction neutralization test (FRNT) antibody-positive for THAIV. One of 260 patients from Surin province in Thailand (initially suspected of having contracted leptospirosis, but found to be negative) showed symptoms compatible with hemorrhagic fever with renal syndrome (HFRS). The serum of this patient showed high titers of hantavirus-reactive IgM and IgG. FRNT investigations confirmed virus-neutralizing antibodies against THAIV. These observations suggest that THAIV or THAI-like viruses occur throughout Indochina and may represent an additional causative agent of HFRS.
IN VITRO SUSCEPTIBILITY OF P. FALCIPARUM POPULATIONS FROM COLOMBIA AND TANZANIA TO A NEW SYNTHETIC PEROXIDE (OZ277)
Authors: OSORIO LYDA , MURILLO CLARIBEL , APONTE SAMANDA , MAYAGAYA VALERIANA , SCHEURER CHRISTIAN , BRUN RETO , MATILE HUGUES , WITTLIN SERGIO
Published: September 2018

Sensitivity of Plasmodium falciparum populations from Colombia (N = 38) and Tanzania (N = 45) to the newly developed, fully synthetic peroxide OZ277 was investigated using a standard isotopic microtest. OZ277 showed excellent activity against chloroquine-resistant isolates in Colombia with median IC50 [range] values of 2.5 ng/mL [0.34–8] (4.4 nM [0.6–14]) and Tanzania with 1.5 ng/mL [0.22–10] (2.65 nM [0.4–17.7]). The potency of OZ277 was similar to artesunate, showing median IC50 values of 1.5 ng/mL [0.42–8.6] (3.8 nM [1.1–22.3]) and 1.8 ng/mL [0.2–10] (4.7 nM [0.5–26.04]) in Colombia and Tanzania, respectively. These results support the development of this new antimalarial compound.
FACTORS INFLUENCING THE EFFECTIVENESS OF MALARIA CONTROL IN BIOKO ISLAND, EQUATORIAL GUINEA
Authors: KLEINSCHMIDT IMMO , TORREZ MIGUEL , SCHWABE CHRIS , BENAVENTE LUIS , SEOCHARAN ISHEN , JITUBOH DAVID , NSENG GLORIA , SHARP BRIAN
Published: September 2018

The Bioko Island Malaria Control Project (BIMCP) has carried out intensive interventions since early 2004 to reduce malaria transmission through indoor residual spraying (IRS) and case management. Annual parasite prevalence surveys have been carried out to monitor the effectiveness of the program. Significant overall reductions in prevalence of infection have been observed, with 42% fewer infections occurring in 2006 compared with baseline. Nevertheless, there is evidence of considerable heterogeneity in impact of the intervention. Prevalence of infection was significantly associated with spray status of the child’s house, spray coverage with effective insecticide of the neighborhood of the house, bed net use, and time elapsed since last spray. Careful scheduling of spray coverage is therefore essential to maximize the effectiveness of IRS and to ensure consistent reductions in parasite prevalence. This can only be achieved if comprehensive monitoring systems are in place for both the management and evaluation of the intervention.
VARIANT-SPECIFIC ANTIBODIES TO MEROZOITE SURFACE PROTEIN 2 AND CLINICAL EXPRESSION OF PLASMODIUM FALCIPARUM MALARIA IN RURAL AMAZONIANS
Authors: SCOPEL KÉZIA K. G. , SILVA-NUNES MÔNICA DA , MALAFRONTE ROSELY S. , BRAGA ÉRIKA M. , FERREIRA MARCELO U.
Published: September 2018

Naturally acquired antibodies to five variants of the merozoite surface protein 2 (MSP-2), a target of clinical immunity to Plasmodium falciparum malaria, were measured in a cohort of rural Amazonians. Local MSP-2 variants comprised both highly divergent families of alleles (FC27 and 3D7). Total IgG antibodies to two FC27-type antigens were found in 22–28% of subjects at baseline, with substantial cross-reactivity between variants and stable concentrations and specificities over time. The IgG antibodies to three 3D7-type antigens were less prevalent (6–7%), less cross-reactive, and short-lived; subsequent exposure to 3D7-type parasites rarely elicited homologous response. The clinical spectrum of 109 incident P. falciparum infections in our cohort ranged between asymptomatic infection and fully symptomatic but uncomplicated disease. Parasitemia at the time of diagnosis, rather than cumulative malaria exposure or acquired immunity (presence of variant-specific antibodies matching the MSP-2 type in infecting parasites), was a major predictor of perceived symptom severity.
DISTRIBUTION OF FREE UNTREATED BEDNETS BUNDLED WITH INSECTICIDE VIA AN INTEGRATED CHILD HEALTH CAMPAIGN IN LINDI REGION, TANZANIA: LESSONS FOR FUTURE CAMPAIGNS
Authors: SKARBINSKI JACEK , MASSAGA JULIUS J. , ROWE ALEXANDER K. , KACHUR S. PATRICK
Published: September 2018

Use of insecticide-treated bednets (ITNs) to prevent malaria remains low, and effective distribution strategies are needed. An integrated child health campaign with free distribution of 162,254 untreated bednets bundled with insecticide, measles vaccination, vitamin A, and mebendazole for children < 5 years old (“under-5s”) was conducted in Lindi Region, Tanzania. We conducted a representative household survey 3 months after the campaign. Altogether, 574 households with 354 under-5s were visited. In households with an under-5, possession of bednets and ITNs increased from 60.9% to 90.7% (P < 0.001) and from 16.5% to 37.3% (P < 0.001), respectively. Increases occurred in all wealth quintiles and equity improved. Reported bednet and ITN use the previous night among under-5s was 46.3% and 21.5%, respectively. Integrated campaigns rapidly and equitably increase bednet possession and use meriting continued large-scale implementation. However, our study found that bednets were rarely treated; thus, future campaigns should provide factory-treated long-lasting ITNs. Low ITN use underscores the need for further efforts to increase use after campaigns.
IN VITRO ANTIMALARIAL SUSCEPTIBILITY PROFILE AND PRCRT/PFMDR-1 GENOTYPES OF PLASMODIUM FALCIPARUM FIELD ISOLATES FROM MALAWI
Authors: NKHOMA STANDWELL , MOLYNEUX MALCOLM , WARD STEPHEN
Published: September 2018

We measured in vitro antimalarial drug susceptibility of 84 Plasmodium falciparum field isolates from Blantyre, Southern Malawi, using the WHO microtest and the lactate dehydrogenase assay. We also genotyped these isolates to investigate whether variation in their absolute drug sensitivity is associated with specific sets of pfcrt and pfmdr-1 mutations harbored by parasites. Our results show that nearly a decade after the withdrawal of chloroquine (CQ) as a first-line antimalarial in Malawi, most isolates are now sensitive to CQ and none is CQ-resistant as predicted by their drug sensitivity phenotype and pfcrt genotype. We also found that these isolates are uniformly sensitive to a range of quinoline-based antimalarials and artemisinin derivatives. These findings reinforce previous reports about a reduction in the proportion of CQ-resistant parasites after the withdrawal of CQ in 1993 and pave the way for reassessing the clinical usefulness of CQ, artemisinins and other quinoline-based antimalarials in Malawi.
PARENTERAL AMINOSIDINE IS NOT EFFECTIVE FOR PERUVIAN MUCOCUTANEOUS LEISHMANIASIS
Authors: LLANOS-CUENTAS ALEJANDRO , ECHEVARRIA JUAN , SEAS CARLOS , CHANG ELSA , CRUZ MARIA , ALVAREZ EUGENIA , ROSALES ERNESTO , CAMPOS PABLO , BRYCESON ANTHONY
Published: September 2018

Few therapeutic options are available for mucocutaneous leishmaniasis (MCL). We conducted a randomized open trial to evaluate the efficacy, safety, and tolerance of parenteral aminosidine sulphate (AS) 14 mg/kg/d for 21 days compared with intravenous meglumine antimonate (MA) 20 mg/kg/d for 28 days in patients with moderate MCL in Cuzco, Peru. Cure was defined as complete healing with re-epithelialization within 1 year of follow-up. The trial was stopped after 38 patients were enrolled (17 in the MA group and 21 in the AS group) because of marked differences in response. Study groups were comparable in baseline characteristics. Cure rates were 0/21 in the AS group compared with 8/17 (47%, 95% confidence interval: 23–71%) in the MA group (P < 0.001). Side effects and laboratory abnormalities were mild in both groups. We conclude that parenteral AS given on its own is not effective for MCL in Peru.
AN OUTBREAK OF DENGUE VIRUS SEROTYPE 1 INFECTION IN CIXI, NINGBO, PEOPLE’S REPUBLIC OF CHINA, 2004, ASSOCIATED WITH A TRAVELER FROM THAILAND AND HIGH DENSITY OF AEDES ALBOPICTUS
Authors: XU GUOZHANG , DONG HONGJUN , SHI NANFENG , LIU SHIJIAN , ZHOU AIMING , CHENG ZHIHUA , CHEN GUOHUA , LIU JIANYI , FANG TING , ZHANG HONGWEI , GU CHUNYING , TAN XIAOJIE , YE JIANJIE , XIE SHUYUN , CAO GUANGWEN
Published: September 2018

Autochthonous dengue infections have not been reported in Ningbo, People’s Republic of China since 1929. In August–October 2004, an outbreak of dengue fever was confirmed in Xiaolin, Cixi, Ningbo. Of 83 cases reported, 68 were laboratory confirmed. Fifty-three percent (34 of 64) of the cases had IgM antibodies to dengue virus. Dengue virus serotype-1 was isolated from two cases. The outbreak was linked to a traveler who returned from Thailand. Phylogenetic analysis showed that the Ningbo isolate was closely associated to strains from Thailand. Prevalence of dengue-specific IgG in asymptomatic residents was significantly higher in the epidemic-stricken area than in a control area. High density of Aedes albopictus, which resulted from waterlogging caused by Typhoon Rananim and lifestyle of local residents, was responsible for rapid spread of the virus. Eradication of mosquito infestation might interrupt transmission. This outbreak underscores the importance of maintaining surveillance and control of potential vectors for the control of emerging infectious diseases.
REGIONAL DIFFERENCES IN THE RESPONSE OF PLASMODIUM VIVAX MALARIA TO PRIMAQUINE AS ANTI-RELAPSE THERAPY
Authors: GOLLER JANE L. , JOLLEY DAMIEN , RINGWALD PASCAL , BIGGS BEVERLEY-ANN
Published: September 2018

We used logistic regression to assess effectiveness of primaquine as Plasmodium vivax anti-relapse therapy using data extracted from studies of P. vivax relapses in Brazil, India, and Thailand. The risk of relapse in Thailand was 10 times that in India and twice that in Brazil. In comparison with no primaquine treatment, the risk of relapse decreased by approximately 80% for a total adult primaquine regimen of 210 mg and by ≥95% for regimens of 315 mg and 420 mg. In addition, we used logistic regression to estimate the risk of P. vivax relapse according to weight-based primaquine dose using data from case studies. There was a three-fold increase in the likelihood of successful treatment of each additional milligram of primaquine per kilogram of body weight. Tailoring primaquine therapy to a region requires consideration of factors including body weight, natural relapse rates, and local response to primaquine.
MEFLOQUINE TREATMENT FOR UNCOMPLICATED FALCIPARUM MALARIA IN YOUNG CHILDREN 6–24 MONTHS OF AGE IN NORTHERN GHANA
Authors: FRYAUFF DAVID J. , OWUSU-AGYEI SETH , UTZ GREGORY , BAIRD J. KEVIN , KORAM KWADWO A. , BINKA FRED , NKRUMAH FRANCIS , HOFFMAN STEPHEN L.
Published: September 2018

Mefloquine (MQ) single dose 20 mg/kg treatment of falciparum malaria was evaluated in 186 children of 6–24 months of age in northern Ghana. There were 15 RII/RIII-type parasitologic failures, all with Day 2 MQ blood levels significantly lower than children whose parasitemias cleared before Day 7 and remained clear through 28 days. Predictors of RII/RIII parasitologic response were vomiting after MQ dosing, Day 2 MQ levels < 500 ng/mL, and undetectable Day 2 levels of the carboxymefloquine metabolite. There were 50 cases of delayed RI parasitologic failure, but 71% of these cases had undetectable Day 28 blood levels of MQ and drug levels in the remaining 29% ranged below the 620 ng/mL level that suppresses MQ sensitive strains of P. falciparum. Drug levels among infants that tolerated MQ well were not associated with age, weight, hemoglobin, parasitemia, and pre-existing symptoms of vomiting or diarrhea. An observed recurrent parasitemia of 34,400 trophozoites/μL against a MQ blood concentration of 550 ng/mL was taken as indication of tolerance to suppressive levels of the drug at this location.
FATAL MALARIA INFECTION IN TRAVELERS: NOVEL IMMUNOHISTOCHEMICAL ASSAYS FOR THE DETECTION OF PLASMODIUM FALCIPARUM IN TISSUES AND IMPLICATIONS FOR PATHOGENESIS
Authors: GENRICH GILLIAN L. , GUARNER JEANNETTE , PADDOCK CHRISTOPHER D. , SHIEH WUN-JU , GREER PATRICIA W. , BARNWELL JOHN W. , ZAKI SHERIF R.
Published: September 2018

Plasmodium falciparum is a significant cause of morbidity and mortality in travelers to areas where the parasite is endemic. Non-specific clinical manifestations may result in failure to recognize malaria until autopsy, when it is often too late to obtain whole blood for microscopic evaluation. The use of immunohistochemical (IHC) assays in the detection of three P. falciparum antigens, histidine rich protein-2 (HRP-2), aldolase, and Plasmodium lactate dehydrogenase (pLDH), was evaluated in formalin-fixed paraffin-embedded autopsy tissues from five travelers to malaria-endemic areas, whose deaths were initially suspected to have been caused by other bacterial or viral hemorrhagic fevers. The HRP-2 assay was specific for P. falciparum, whereas the aldolase and pLDH assays also reacted with P. vivax. Immunostaining patterns were predominately cytoplasmic and membranous. P. falciparum antigens were detected in a variety of organs but were most abundant in the blood vessels of brain, heart, and lung tissues.
EPIDEMIOLOGY OF MALARIA AMONG UNITED STATES GOVERNMENT PERSONNEL ASSIGNED TO DIPLOMATIC POSTS
Authors: RATHNAM PRIYA JOY , BRYAN JOE P. , WOLFE MARTIN
Published: September 2018

The epidemiology of malaria among U.S. government personnel attached to diplomatic posts has not been reported. We reviewed malaria surveillance reports on persons with onset of symptoms between January 1988 and December 2004. Among 684 slide-proven cases, the median age was 36 years. There were 565 (82.6%) cases of Plasmodium falciparum malaria and 56 (8.2%) of P. vivax malaria. A total of 89.9% were infected in Africa and 5.8% were infected in Asia; 95% of the P. falciparum cases originated in sub-Saharan Africa. One-fourth of all cases were reported in 1990–1991. The average annual incidence (per 1,000 personnel) of Plasmodium between 1995 and 1999 was highest in west Africa (8.96), followed by central Africa (8.08), and east Africa (4.27). No or irregular chemoprophylaxis was reported by 58.5%. Among those who indicated regular prophylaxis, 78% took regimens no longer considered adequate. In sub-Saharan Africa, cases were reported in every month. There were three deaths. Prevention of malaria among U.S. Government employees attached to diplomatic posts should particularly focus on those serving in sub-Saharan Africa and malarious areas of Asia.
MALARIA IN U.S. MILITARY FORCES: A DESCRIPTION OF DEPLOYMENT EXPOSURES FROM 2003 THROUGH 2005
Authors: CIMINERA PAUL , BRUNDAGE JOHN
Published: September 2018

U.S. service members are often deployed to regions endemic for malaria. Preventive measures play an important role in mitigating the risk of disease and adverse effects on mission performance. Currently, a large contingent of U.S. forces is deployed in malarious regions in southeast and southwest Asia. The purpose of this study was to describe malaria cases reported by the tri-service reportable medical events system in terms of exposure (deployment history) and latency of infection. We conducted a retrospective analysis of population health data routinely collected for disease surveillance. All malaria reports received into the Defense Medical Surveillance System by January 3, 2006 with a date of onset between January 1, 2000 and December 31, 2005 in which the individual diagnosed is a member of the active or reserve military components linked to personnel and deployment data were analyzed to determine assignment and deployment history. The main outcome measure was the ICD9-CM diagnosis of malaria (Plasmodium vivax, P. falciparum, P. ovale, P. malaria, and unspecified malaria) by date of onset and days from exposure. A total of 423 cases of malaria were reported during the study period. The Army (n = 325) and the Marine Corps (n = 46) had the highest number of reported cases. Plasmodium vivax (n = 242) and P. falciparum (n = 92) caused nearly four-fifths of all reported cases. During the period from 2003 through 2005, 34% of deployed cases were exposed to more than one malaria-endemic region. Seventy-four cases had been assigned in the Republic of Korea, and all were present in Korea during the high risk transmission period. Seventy-eight cases had documented service in Afghanistan; only 4 had off-season exposure and no other documented exposures. Sixty cases had documented exposure during Operation Iraqi Freedom (OIF). Only six seasonally exposed and six off seasonally exposed OIF cases had no other documented exposure. Fifty percent of Korean cases were diagnosed during an exposure season, and only 3% of Afghan cases were diagnosed during an exposure season. Soldiers in today’s military can be exposed to more than one malaria-endemic region prior to diagnosis. This presents new complexities for disease monitoring and prevention policy development.
EXPERIMENTAL TRANSMISSION OF CHANDIPURA VIRUS BY PHLEBOTOMUS ARGENTIPES (DIPTERA: PSYCHODIDAE)
Authors: MAVALE MANGALA S. , FULMALI PRADIP V. , GHODKE YUVRAJ S. , MISHRA AKHILESH C. , KANOJIA PHOOLCHAND , GEEVARGHESE G.
Published: September 2018

Experiments were carried out to demonstrate the susceptibity and transmission potential of Phlebotomus argentipes (Annandale & Brunetti) for Chandipura virus (CHPV). In India, P. argentipes is one of the predominant species found in many areas endemic for CHPV. Although its laboratory colonization is difficult, we have demonstrated that 65% of P. argentipes were susceptible to CHPV infection by the oral route. Transmission experiments were carried out by intrathoracic inoculation because of re-feeding problems with this species. After incubation for 24 hours, efficient transmission of CHPV to mice was observed. The estimated minimum transmission rate among the inoculated flies was 32%. CHPV in sand flies as well as in mice was detected and confirmed by immunofluorescent antibody assay and reverse transcription–polymerase chain reaction, respectively. The susceptibility of P. argentipes to CHPV and its potential to transmit the virus by bite has importance in epidemiology of CHPV.
ENVIRONMENTAL PREDICTORS OF THE SEASONALITY OF MALARIA TRANSMISSION IN AFRICA: THE CHALLENGE
Authors: MABASO MUSAWENKOSI L. H. , CRAIG MARLIES , ROSS AMANDA , SMITH THOMAS
Published: September 2018

A description of malaria seasonality is important for planning and optimizing malaria control in both time and space, but adequate malariologic data are not available for many disease-endemic areas. We analyzed the relationship between seasonality in the entomologic inoculation rate (EIR) and environmental factors in sites across sub-Saharan Africa with the objective of predicting seasonality from environmental data. The degree of EIR seasonality in each site was quantified using an index previously used for rainfall. The results showed that seasonality of rainfall, minimum temperature, and irrigation are important determinants of seasonality in EIR. Model fit was poor in areas characterized by two rainfall peaks and by irrigation activities. Two rainfall peaks probably dampen seasonality and irrigation creates perennial breeding habitats for vectors independent of rainfall. This complex interplay between the seasonal dynamics of environmental determinants and malaria pose a great challenge and highlights the need for improved models of malaria seasonality.
SUBMICROSCOPIC PLASMODIUM FALCIPARUM GAMETOCYTE DENSITIES FREQUENTLY RESULT IN MOSQUITO INFECTION
Authors: SCHNEIDER PETRA , BOUSEMA J. TEUN , GOUAGNA LOUIS C. , OTIENO SILAS , VAN DE VEGTE-BOLMER MARGA , OMAR SABAH A. , SAUERWEIN ROBERT W.
Published: September 2018

Submicroscopic Plasmodium falciparum gametocytemia (< 5,000 gametocytes/mL) is common and may result in mosquito infection. We assessed the relation between gametocyte density and mosquito infection under experimental and field conditions using real-time quantitative nucleic acid sequence-based amplification (QT-NASBA) for gametocyte quantification. Serial dilutions of NF54 P. falciparum gametocytes showed a positive association between gametocyte density and the proportion of infected mosquitoes (β = 6.1; 95% confidence interval [CI], 2.7–9.6; P = 0.001). Successful infection became unlikely below an estimated density of 250–300 gametocytes/mL. In the field, blood samples of 100 naturally infected children showed a positive association between gametocyte density and oocyst counts in mosquitoes (β = 0.38; 95% CI, 0.14–0.61; P = 0.002). The relative contribution to malaria transmission was similar for carriers with submicroscopic and microscopic gametocytemia. Our results show that transmission occurs efficiently at submicroscopic gametocyte densities and that carriers harboring submicroscopic gametocytemia constitute a considerable proportion of the human infectious reservoir.
TAFENOQUINE FOR THE TREATMENT OF RECURRENT PLASMODIUM VIVAX MALARIA
Authors: KITCHENER SCOTT , NASVELD PETER , EDSTEIN MICHAEL D.
Published: September 2018

Tafenoquine was used to treat Plasmodium vivax malaria cases who had previously failed treatment with chloroquine and primaquine. Chloroquine was followed by a loading dose of tafenoquine (200 mg base/day for 3 days) and 200 mg a week was given for 8 weeks. One of 27 treated patients relapsed after 6 months of observation. A standard course of chloroquine administered with 8 weeks of tafenoquine may be more effective than chloroquine with primaquine (22.5 mg/day for 14 days) in preventing additional P. vivax relapses. Larger studies are required to optimize the combination, but our findings suggest that an extended use of tafenoquine may be required to prevent relapses of primaquine-tolerant strains of P. vivax malaria.
PERIDOMICILARY HABITAT AND RISK FACTORS FOR TRIATOMA INFESTATION IN A RURAL COMMUNITY OF THE MEXICAN OCCIDENT
Authors: WALTER ANNIE , LOZANO-KASTEN FELIPE , BOSSENO MARIE-FRANCE , RUVALCABA ELOY GUALBERTO CASTILLO , GUTIERREZ MARGARITA SOTO , LUNA CHRISTIAN ELOY MONTAÑO , BAUNAURE FRANÇOISE , PHÉLINAS PASCALE , MAGALLÓN-GASTÉLUM EZEQUIEL , BRENIÈRE SIMONE F.
Published: September 2018

An examination of peridomestic area organization and triatomine collection in an endemic village for Chagas disease (Jalisco State) identified the habitat of Triatoma longipennis (dominant species) and the risk factors of peridomestic infestation. In 100 visited peridomestic areas, 369 structures (permanent, temporary, and natural) were submitted to active manual research of triatomines. Storage shelters had a higher infestation of T. longipennis than piles of brick and tile; baked clay material had higher degrees of infestation than others. The secondary species Triatoma barberi shares a wide range of peridomicilary habitats with T. longipennis. Peridomestic area infestation risks (evaluated with multivariate logistic regression analysis) are number of closed storage shelters, number of brick and tile piles, number of houses per peridomestic areas, and distance of peridomicile from natural environment. Because both species present great adaptability to different artificial habitats, strategies of control must involved improving the overall management of peridomestic areas to prevent stable colonization.
HIGH PREVALENCE OF ENTEROINVASIVE ESCHERICHIA COLI ISOLATED IN A REMOTE REGION OF NORTHERN COASTAL ECUADOR
Authors: VIEIRA NADIA , BATES SARAH J. , SOLBERG OWEN D. , PONCE KARINA , HOWSMON REBECCA , CEVALLOS WILLIAM , TRUEBA GABRIEL , RILEY LEE , EISENBERG JOSEPH N. S.
Published: September 2018

Enteroinvasive Escherichia coli (EIEC) causes dysentery; however, it is less widely reported than other etiological agents in studies of diarrhea worldwide. Between August 2003 and July 2005, stool samples were collected in case-control studies in 22 rural communities in northwestern Ecuador. Infection was assessed by PCR specific for LT and STa genes of enterotoxigenic E. coli (ETEC), the bfp gene of enteropathogenic E. coli (EPEC), and the ipaH gene of both enteroinvasive E. coli and Shigellae. The pathogenic E. coli most frequently identified were EIEC (3.2 cases/100 persons) and Shigellae (1.5 cases/100 persons), followed by ETEC (1.3 cases/100 persons), and EPEC (0.9 case/100 persons). EIEC exhibited similar risk-factor relationships with other pathotypes analyzed but different age-specific infection rates. EIEC was the predominant diarrheagenic bacteria isolated in our community-based study, a unique observation compared with other regions of the world.
HELICOBACTER PYLORI INFECTION IS ASSOCIATED WITH SEVERE ANEMIA OF PREGNANCY ON PEMBA ISLAND, ZANZIBAR
Authors: FARAG TAMER H. , STOLTZFUS REBECCA J. , KHALFAN SABRA S. , TIELSCH JAMES M.
Published: September 2018

Helicobacter pylori infection has recently been associated with iron deficiency and anemia in developed countries. To determine the association of H. pylori and anemia in a tropical region, we measured hemoglobin concentration (Hb) and H. pylori infection by the 13C urea breath test among 857 pregnant women attending antenatal care clinics. Parasitology, anthropometry, obstetric history, sociodemographic and dietary variables were also assessed. Logistic regression showed an odds ratio of 7.63 (95% confidence interval = 1.73–33.55) for H. pylori infection comparing women with and without severe anemia (Hb < 7 g/dL), controlling for hookworm infection, body mass index and parity, but only among women with a diet low in foods containing heme iron. Infection with H. pylori with low bacterial load was associated with lower Hb concentration while high bacterial load was associated with higher Hb concentration. Further research is needed to establish causality because high worldwide prevalence means that even a small associated risk would be of public health significance.
LOW SERUM LEVELS OF DEHYDROEPIANDROSTERONE AND CORTISOL IN HUMAN DIFFUSE CUTANEOUS LEISHMANIASIS BY LEISHMANIA MEXICANA
Authors: GALINDO-SEVILLA NORMA , SOTO NORMA , MANCILLA JAVIER , CERBULO ARTURO , ZAMBRANO ELENA , CHAVIRA ROBERTO , HUERTO JAIME
Published: September 2018

Low levels of dehydroepiandrosterone (DHEA) and cortisol hormones produced by the suprarenal cortex have been associated with diseases involving chronic inflammation, low interferon (IFN)-γ, and high interleukin (IL)-6. Diffuse cutaneous leishmaniasis (DL), a long-lasting intracellular parasitic infectious disease, can spread unknown levels of DHEA and cortisol. Serum concentrations of both were measured in 5 patients with DL, in 15 patients with localized lesions produced by Leishmania (LL), and in 20 healthy volunteers. Leishmania mexicana mexicana was identified as the causal agent in patients with DL and LL. Hormone levels were lower in DL compared with controls and LL. Furthermore, we detected a lower percentage of IFN-γ–positive cells with higher levels of IL-6 and higher titers of anti-Leishmania antibodies in patients with DL, whereas patients with LL were similar to controls. These data suggest that patients with DL may be good candidates for DHEA and cortisol supplementation.
CEREBRAL TOXOCARIASIS AFTER CONSUMPTION OF RAW DUCK LIVER
Authors: HOFFMEISTER BODO , GLAESER SVEN , FLICK HOLGER , PORNSCHLEGEL SEBASTIAN , SUTTORP NORBERT , BERGMANN FRANK
Published: September 2018

Human toxocariasis is usually contracted by exposure to contaminated soil. This disease is rarely transmitted by raw meat or giblets of paratenic animals, such as chickens, lambs, or cows. We present a case of isolated cerebral toxocariasis presumably caused by the consumption of raw duck liver. This 55-year-old woman had sudden-onset hemiparesis of the right leg, eosinophilia of 30%, and markedly elevated total serum IgE levels. Magnetic resonance imaging demonstrated multiple cerebral hyperintense lesions on T2-weighed images. Tests for antibodies to Toxocara in serum and cerebrospinal fluid yielded highly positive results. Repeated courses of albendazole and corticosteroids led to significant clinical improvement.
MACROPHAGE KILLING OF LEISHMANIA AMAZONENSIS AMASTIGOTES REQUIRES BOTH NITRIC OXIDE AND SUPEROXIDE
Authors: MUKBEL RAMI M. , PATTEN CALVIN , GIBSON KATHERINE , GHOSH MOUSUMI , PETERSEN CHRISTINE , JONES DOUGLAS E.
Published: September 2018

The requirements for effective and efficient intracellular killing of Leishmania amazonensis by activated macrophages are unknown. Despite resistance to the arginase inhibitor LOHA by intracellular L. amazonensis amastigotes, enhanced replication did not account for the relative resistance of this parasite to macrophage activation. Herein we report that the presence of both superoxide and nitric oxide is necessary for efficient killing of L. amazonensis amastigotes within LPS/IFN-γ–activated bone marrow-derived macrophages generated from C3H mice. Addition of an extracellular signal-regulated kinase (ERK) inhibitor to L. amazonensis-infected macrophages increased the ability of these activated macrophages to kill L. amazonensis amastigotes. This enhanced macrophage killing through addition of ERK inhibitor was abrogated by inhibition of superoxide or iNOS, whereas inhibiting superoxide had no effect on the killing of L. major. These results suggest that ERK activation may modulate effective macrophage killing, leading to the ability of L. amazonensis to resist elimination within activated macrophages.
LACK OF RESISTANCE AFTER RE-EXPOSURE OF CATTLE CURED OF ONCHOCERCA OCHENGI INFECTION WITH OXYTETRACYCLINE
Authors: NFON CHARLES K. , MAKEPEACE BENJAMIN L. , NJONGMETA LEO M. , TANYA VINCENT N. , TREES ALEXANDER J.
Published: September 2018

Although vector control and ivermectin chemotherapy have led to a dramatic reduction in the incidence of river blindness (onchocerciasis), there is a consensus that additional control tools are required to sustain and extend this success. The recognition of endosymbiotic bacteria (Wolbachia) in filariae and their targeting by antibiotics constitutes the most significant and practicable opportunity for a macrofilaricidal therapy in the short-to-medium-term. Using Onchocerca ochengi in cattle, an analog of human onchocerciasis, we have previously shown that oxytetracycline is macrofilaricidal, and protective immunity exists naturally in a subset of animals termed putatively immune. Here, we report that although 24 weeks of weekly oxytetracycline treatment eliminated adult worms, cured animals remained susceptible to re-infection by natural challenge when compared with putatively immune cattle. However, their susceptibility was not significantly different from that of concurrently exposed, heavily infected animals. Thus, cattle cured by oxytetracycline are neither hypo-susceptible nor hyper-susceptible.
DHORI VIRUS (ORTHOMYXOVIRIDAE: THOGOTOVIRUS) INFECTION IN MICE: A MODEL OF THE PATHOGENESIS OF SEVERE ORTHOMYXOVIRUS INFECTION
Authors: MATEO ROSA I. , XIAO SHU-YUAN , LEI HAO , DA ROSA AMELIA P. A. TRAVASSOS , TESH ROBERT B.
Published: September 2018

After intranasal, subcutaneous, or intraperitoneal infection with Dhori virus (DHOV), adult mice developed a fulminant and uniformly fatal illness with many of the clinical and pathologic findings seen in mice infected with H5N1 highly pathogenic avian influenza A virus. Histopathologic findings in lungs of DHOV-infected mice consisted of hemorrhage, inflammation, and thickening of the interstitium and the alveolar septa and alveolar edema. Extra-pulmonary findings included hepatocellular necrosis and steatosis, widespread severe fibrinoid necrosis in lymphoid organs, marked lymphocyte loss and karyorrhexis, and neuronal degeneration in brain. Similar systemic histopathologic findings have been reported in the few fatal human H5N1 cases examined at autopsy. Because of the relationship of DHOV to the influenza viruses, its biosafety level 2 status, and its similar pathology in mice, the DHOV-mouse model may offer a low-cost, relatively safe, and realistic animal model for studies on the pathogenesis and management of H5N1 virus infection.
HABITAT SEGREGATION OF DENGUE VECTORS ALONG AN URBAN ENVIRONMENTAL GRADIENT
Authors: COX JONATHAN , GRILLET MARIA E. , RAMOS OLGA M. , AMADOR MANUEL , BARRERA ROBERTO
Published: September 2018

Differential distributions of Aedes aegypti and Ae. mediovittatus (potential inter-epidemic dengue vector) and other mosquitoes colonizing bamboo pots in San Juan, Puerto Rico were studied along an urban-rural gradient. City regions (urban, suburban, and rural) and landscape elements within regions (forest [F], low-density housing [LDH], and high-density housing [HDH]) were identified using satellite imagery. Aedes species extensively overlapped in LDH of urban, suburban, and rural areas. Mosquito species showed their high specificity for landscape elements (96.6% correct classification by discriminant analysis); absence of Ae. mediovittatus in HDH or absence of Ae. aegypti in forests were the main indicator variables. The gradient was explained using a canonical correspondence analysis, which showed the association of Ae. aegypti with HDH in urban areas, Culex quinquefasciatus with LDH in suburbs, and Ae. mediovittatus and other native mosquitoes (Cx. antillummagnorum, Toxorhynchites portoricencis) with less disturbed habitats (forests, LDH).
RISK FACTORS FOR TRYPANOSOMA CRUZI HUMAN INFECTION IN BARINAS STATE, VENEZUELA
Authors: FELICIANGELI M. DORA , SÁNCHEZ-MARTÍN MARIA J. , SUÁREZ BENNY , MARRERO ROSALBA , TORRELLAS ANNHYMARIET , BRAVO ARTURO , MEDINA MEHUDY , MARTÍNEZ CINDA , HERNANDEZ MAYELI , DUQUE NEIDI , TOYO JOSÉ , RANGEL ROBERTO
Published: September 2018

This study attempted to quantify the transmission of Trypanosoma cruzi in children less than 15 years of age in Barinas State, Venezuela and investigate risk factors for infection. Among 3,296 children, 4 (0.12%) were seropositive. The mother of one child also was also seropositive, which suggested that congenital transmission is a possible risk factor for Chagas disease in this area. Seroprevalence among the dwellers of 10 localities was 3.3%. Rhodnius prolixus was detected in 7 localities and in 8% of 125 dwellings. A multivariate logistic regression model showed that infection was associated with age, a dirt floor, and distance from houses to palm trees. The risk of infection is increased by the presence of adventitious sylvatic R. prolixus and transient or residual colonies. Insecticide spraying does not seem justified in this scenario, a finding that was also observed in other Latin American countries. New methods are therefore needed for Chagas disease control programs.
Prevalence and Chloroquine Sensitivity of Plasmodium malariae in Madagascar
Authors: Barnadas Céline , Ratsimbasoa Arsène , Ranaivosoa Hanitra , Ralaizandry Didier , Raveloariseheno Diamondra , Rabekotonorina Vony , Picot Stephane , Ménard Didier
Published: September 2018

We report the results of clinical studies carried out at six sites in Madagascar, between January and October 2006. The aims were (i) to update our knowledge of the burden of Plasmodium malariae infection and (ii) to assess the therapeutic efficacy of chloroquine for uncomplicated quartan malaria. Our findings confirm that P. malariae is the third leading cause of malaria, accounting for 1.1% of all malarial infections. They also demonstrate that chloroquine—currently recommended for the home management of presumed malaria in children under the age of five years and commonly used by adults—remains highly effective in patients with uncomplicated P. malariae infection.
Permethrin and DDT Resistance in the Malaria Vector Anopheles arabiensis from Eastern Sudan
Authors: Himeidan Yousif E. , Chen Hong , Chandre Fabrice , Donnelly Martin J. , Yan Guiyan
Published: September 2018

Assessment of resistance to DDT and permethrin insecticides and molecular detection of knockdown resistance (kdr) alleles were conducted in three populations of Anopheles arabiensis from eastern Sudan. Bioassay mortalities ranged from 96.9% to 99.6% for 4% DDT and from 98.4% to 100% for 1% permethrin. The L1014F and L1014S alleles were detected in 25 of 498 mosquitoes. The overall kdr frequencies ranged from 7.0% in the area where insecticide-treated nets were used to 3.0% in the area with agricultural insecticide use. The presence of the kdr alleles in An. arabiensis in Sudan emphasizes the need to develop appropriate resistance monitoring and management strategies for An. arabiensis.
Intensity of Schistosoma Mansoni, Hepatitis B, Age, and Sex Predict Levels of Hepatic Periportal Thickening/Fibrosis (PPT/F): A Large-Scale Community-Based Study in Ethiopia
Authors: Berhe Nega , Myrvang Bjørn , Gundersen Svein G.
Published: September 2018

To elucidate determinants of morbidity in schistosomiasis mansoni, a community-based study was undertaken involving 2,451 subjects (mean age, 18.8 ± 15.3 [SD] years) from four endemic sites in Ethiopia. Overall prevalence of infection was 65.9%, reported blood in stools was 35.8%, and schistosomal periportal thickening/fibrosis (PPT/F) was 4.6%. Similarly, 43.2% were positive for at least one marker of hepatitis B virus (HBV), 5.3% were HBsAg positive, and 1.3% were anti-hepatitis C virus (HCV) positive. Prevalence of PPT/F increased significantly with increasing community prevalence and intensity of S. mansoni infection. In a multiple logistic regression analysis, intensity of egg excretion, markers of HBV infection, age, and male sex were significantly associated with PPT/F, whereas co-infection with other intestinal helminths was associated with lower odds for PPT/F. HCV was not associated with S. mansoni infection or with schistosomal PPT/F. In conclusion, integrated helminth control targeting school-aged children, who have the highest burden infection, should be used to substantially reduce the risk of periportal fibrosis.
Detection and Isolation of Japanese Encephalitis Virus From Blood Clots Collected During the Acute Phase of Infection
Authors: Sapkal Gajanan N. , Wairagkar Nitin S. , Ayachit Vijay M. , Bondre Vijay P. , Gore Milind M.
Published: September 2018

Clinical specimens from an encephalitis outbreak in the Lakhimpur area of Uttar Pradesh, India, were investigated for identification and characterization of the etiologic agent. IgM capture ELISA showed recent Japanese encephalitis virus (JEV) infection. JEV isolation was attempted from white blood cells (WBCs) separated from blood clots of 12 patients (9 IgM positive and 3 negative) by serial co-culturing with phytohemagglutinin P–stimulated peripheral blood mononuclear leukocytes (PBMCs) obtained from pre-screened JEV sero-negative healthy individuals. JEV was isolated from two IgM-positive blood clots. Isolate 014178 was detected in WBCs and in the first passage of PBMCs by ELISA and reverse transcriptase-polymerase chain reaction. Isolate 014173 was detectable only after a second passage in PBMC co-culture. Sequence analysis of 346 nt of the C-prM region showed homology with JEV strain GP78. This is the first report on isolation of JEV from patient blood clots. Our study shows that the co-cultures of PBMCs separated from patient blood clots provide an additional source for JEV isolation.
A Review of Malaria Diagnostic Tools: Microscopy and Rapid Diagnostic Test (RDT)
Authors: Wongsrichanalai Chansuda , Barcus Mazie J. , Muth Sinuon , Sutamihardja Awalludin , Wernsdorfer Walther H.
Published: September 2018

The absolute necessity for rational therapy in the face of rampant drug resistance places increasing importance on the accuracy of malaria diagnosis. Giemsa microscopy and rapid diagnostic tests (RDTs) represent the two diagnostics most likely to have the largest impact on malaria control today. These two methods, each with characteristic strengths and limitations, together represent the best hope for accurate diagnosis as a key component of successful malaria control. This review addresses the quality issues with current malaria diagnostics and presents data from recent rapid diagnostic test trials. Reduction of malaria morbidity and drug resistance intensity plus the associated economic loss of these two factors require urgent scaling up of the quality of parasite-based diagnostic methods. An investment in anti-malarial drug development or malaria vaccine development should be accompanied by a parallel commitment to improve diagnostic tools and their availability to people living in malarious areas.
Prevalence of Risk Factors and Severity of Active Trachoma in Southern Sudan: An Ordinal Analysis
Authors: Ngondi Jeremiah , Matthews Fiona , Reacher Mark , Onsarigo Alice , Matende Ibrahim , Baba Samson , Brayne Carol , Zingeser James , Emerson Paul
Published: September 2018

We aimed to investigate prevalence of potential risk factors, and associations between risk factors and active trachoma in southern Sudan. Surveys were undertaken in ten sites and children aged 1–9 years examined for trachoma. Risk factors were assessed through interviews and observations. Using ordinal logistic regression, associations between severity of active trachoma and risk factors were explored. Trachomatous inflammation-intense (TI) was considered more severe than trachomatous inflammation-follicular (TF). A total of 7,418 children were included in the analysis. Risk factors and prevalences were unclean face, 52.3%; face washed less than twice daily, 50.8%; water collection > 30 minutes, 38.1%; absence of latrines, 95.4%; garbage disposal within 20 m, 74.4%; cattle ownership, 69.2%; and flies, 83.3%. After adjusting for age and sex, unclean face, less frequent face washing, cattle ownership, and increasing fly density were found to be independently associated with severity of active trachoma. Our study suggests that facial hygiene and environmental sanitation are priority trachoma-control interventions in southern Sudan.
Comparing Serologic Response against Enteric Pathogens with Reported Diarrhea to Assess the Impact of Improved Household Drinking Water Quality
Authors: Crump John A. , Mendoza Carlos E. , Priest Jeffrey W. , Glass Roger I. , Monroe Stephan S. , Dauphin Leslie A. , Bibb William F. , Lopez M. Beatriz , Alvarez Maricruz , Mintz Eric D. , Luby Stephen P.
Published: September 2018

We evaluated enteric infection serology as an alternative outcome measure to diarrhea prevalence in a randomized controlled trial of household-based drinking water treatment; 492 households were randomly assigned to 5 household-based water treatment interventions or control. Individuals were followed weekly over 52 weeks to measure diarrhea prevalence. Study subjects of age ≤ 6 months and < 24 months had blood drawn at entry and exit from the study or age cohort. Serologic assays for Cryptosporidium parvum, Giardia intestinalis, enterotoxigenic Escherichia coli (ETEC), and Norovirus were done. Of 343 subjects eligible for the study, the proportions of subjects experiencing serologic responses were 56% for Norovirus, 24% for C. parvum, 10% for ETEC, and 16% for G. intestinalis. Serologic response was associated with increased diarrhea prevalence only for G. intestinalis (P = 0.0134). Serologic response to the antigens tested for G. intestinalis but not for Norovirus, C. parvum, and ETEC may be a useful health-effect measure. Larger intervention studies that yield a more marked effect on diarrheal disease, use additional and improved serologic assays, and that collect serum samples at more frequent intervals are needed.
Responding to the Challenge of Antimalarial Drug Resistance by Routine Monitoring to Update National Malaria Treatment Policies
Authors: Vestergaard Lasse S. , Ringwald Pascal
Published: September 2018

Reduced sensitivity of Plasmodium falciparum to formerly recommended cheap and well-known antimalarial drugs places an increasing burden on malaria control programs and national health systems in endemic countries. The high costs of the new artemisinin-based combination treatments underline the use of rational and updated malaria treatment policies, but defining and updating such policies requires a sufficient volume of high-quality drug-resistance data collected at national and regional levels. Three main tools are used for drug resistance monitoring, including therapeutic efficacy tests, in vitro tests, and analyses of molecular markers. Data obtained with the therapeutic efficacy test conducted according to the standard protocol of the World Health Organization are most useful for updating national treatment policies, while the in vitro test and molecular markers can provide important additional information about changing patterns of resistance. However, some of the tests are technically demanding, and thus there is a need for more resources for training and capacity building in endemic countries to be able to adequately respond to the challenge of drug resistance.
Inequities in Valuation of Benefits, Choice of Drugs, and Mode of Payment for Malaria Treatment Services Provided by Community Health Workers in Nigeria
Authors: Onwujekwe Obinna , Ojukwu Juliana , Shu Elvis , Uzochukwu Benjamin
Published: September 2018

This study determined inequities of using community health workers (CHWs) for timely and appropriate treatment of malaria in terms of: 1) valuation of benefits; 2) actual purchase of drugs; and 3) payment modality in southeast Nigeria. Socioeconomic status (SES) influenced the valuation of benefits. Also, the poorest households consumed more of the cheaper drug and less of the more expensive drug (P < 0.05). The least poor households mostly paid in full, whereas the poorest households paid mostly through installments (P < 0.05). The use of CHWs improved overall geographic but not socioeconomic equity to the drugs. Hence, interventions for timely and appropriate treatment of malaria should be accompanied by drug delivery and payment strategies that would ensure SES equity in consumption of appropriate malaria treatment services.