bluuebunny/crossref_metadata_2025 huggingface dataset:
Isoenzyme clustering of Trypanosomatidae Colombian populations.
Authors: Montilla Marleny M , Guhl Felipe , Jaramillo Carlos , Nicholls Santiago , Barnabe Christian , Bosseno Marie F , Breniere Simone F
Published: May 2017

Thirty-six Trypanosomatidae stocks isolated from various hosts and geographical areas in Colombia and 7 others from Bolivia, Chile, Honduras and Panama have been surveyed by Multilocus Enzyme Electrophoresis (MLEE). Part of the Colombian stocks were previously characterized by morphology and biological behavior as belonging to Trypanosoma cruzi and Trypanosoma rangeli taxa, others were unknown species. The genetic variability observed at 13 different loci was considerable, since 38 zymodemes could be distinguished and 2 upper branches were observed. The first branch corresponded to T. cruzi and was divided in the two major phylogenetic subdivision of T. cruzi (T. cruzi I, T. cruzi II). The majority of the Colombian T. cruzi stocks (92%) felt into T. cruzi I. Only two stocks, isolated from sylvatic mammals, belonged to T. cruzi II. Among T. cruzi I, we did not observed any additional phylogenetic subdivision and host-dependent genotype specificity. The second branch was genetically very heterogeneous and included all T. rangeli stocks, the stocks isolated from bats and one stock isolated from a sylvatic R. prolixus vector. The stocks belonging to T. rangeli presented only one locus instead of two for the malic enzyme system. Since, the upper level of resolution of the isoenzyme method was exceeded, the current clustering study failed to draw a clear distinction between such a diverse set of Trypanosomatidae species.
Evaluation of the pyrogenic threshold for Plasmodium falciparum malaria in naive individuals.
Authors: Gatton Michelle L , Cheng Qin
Published: May 2017

A retrospective statistical analysis of two independent data sets was undertaken to determine the peripheral Plasmodium falciparum parasitemia associated with the onset of fever in naive human hosts, and to assess the dynamics of this threshold during the course of the infection and subsequent reinfection. Analysis indicated that there were significant differences between the thresholds for different P. falciparum strains in one data set, and significant interactions between host ethnicity and parasite strain in the other. During untreated infections, the parasitemia associated with the onset of the second fever episode was significantly higher than that causing the first fever (P < 0.02). The parasitemia associated with the first fever episode of a reinfection was elevated relative to the threshold for the first fever episode of the initial infection; however, this difference reached statistical significance only in one of the data sets. These results provide further information on the pyrogenic threshold of malaria.
Human leukocyte antigen class II control of the immune response to p126-derived amino terminal peptide from Plasmodium falciparum.
Authors: Banic Dalma M , Goldberg Anna Carla , Pratt-Riccio Lilian R , De Oliveira-Ferreira Joseli , Santos Fatima , Gras-Masse Helene , Camus Daniel , Kalil Jorge , Daniel-Ribeiro Claudio T
Published: May 2017

We investigated the relationships between class II human leukocyte antigens (HLA) and the antibody response to Plasmodium falciparum p126 protein and to its amino-terminal portion (Nt47) in 2 malaria-endemic villages in Brazil, Colina and Ribeirinha. All people from the endemic areas had anti-p126 antibodies, and the frequencies of anti-Nt47 antibodies were similar in both communities (66% for Colina and 75% for Ribeirinha). Typing of HLA showed that Colina and Ribeirinha groups had no significant differences in HLA antigen frequencies. However, in both groups, significant associations between positive response to anti-Nt47 and presence of HLA-DR4, as well as between absence of response and presence of HLA-DR15, were observed. The predominance of positive responses to Nt47 among HLA-DR4 people was independent of the presence of any particular allele. There was no evidence for association between HLA-DQB1 alleles and antibody response to Nt47. Thus, naturally exposed people with different HLA class II antigens seem to respond differently to Nt47, indicating that the choice of relevant peptide sequences may have important consequences for subunit vaccine development.
Neurotoxicity and efficacy of arteether related to its exposure times and exposure levels in rodents.
Authors: Li Q G , Mog S R , Si Y Z , Kyle D E , Gettayacamin M , Milhous W K
Published: May 2017

The neurotoxicity of beta-arteether (AE) is related to drug accumulation in blood due to slow and prolonged absorption from the intramuscular injection sites. In this efficacy and toxicity study of AE, the traditional sesame oil vehicle was replaced with cremophore to decrease the accumulation and toxicity of AE. Dihydroartemisinin (DQHS), a more toxic and active metabolite of AE, was also analyzed. When administered at a daily dosage of 25 mg/kg for seven days, blood accumulation of AE with sesame oil (AESO) was used had a 7.5-fold higher area under the curve (AUC) (on last versus first day dosing), while AE with cremophore (AECM) had only a 1.8-fold higher AUC. Although the accumulation of AECM was greatly reduced, its total exposure level (46.29 microg x h/ml) was 2.7-fold higher than with AESO (16.92 microg x h/ml) due to a higher bioavailability of AECM (74.5%) compared with AESO (20.3%). Total exposure time (calculated at over the minimal detected neurotoxicity level of 41.32 ng/ml) of AECM was 103 hours during the whole treatment period (192 hours), which was more than one-third (37%) less than with AESO (162 hours). Similar pharmacokinetic results were also shown with the active metabolite, DQHS. Anorexia and gastrointestinal toxicity with AESO were significantly more severe than with AECM (P < 0.001). Histopathologic examination of the brain demonstrated neurotoxic changes; the AESO rat group was significantly more severe than the AECM rat group. The brain injury scores with AECM were mild to moderate (2.3-3.0), and with AESO they were moderate to severe (3.0-4.7) on day 7 and day 10, respectively. In addition, the results of a 50% cure dose (CD50) against Plasmodium berghei in mice were 34.1 mg/kg for AESO and 14.2 mg/kg for AECM, indicating a significant higher efficacy was found in the AECM animals. Toxicity and efficacy of DQHS were also dependent on its exposure time and level, which was the same as its parent drug (AE). In conclusion, following the seven-day treatment in rats, AE and DQHS exposure time and level varied based on the vehicle used. The extension of drug exposure time and the low peak level of AE and DQHS were more associated with severe neurotoxicity and lower antimalarial efficacy, whereas the high level and short exposure time of AE and DQHS resulted in higher efficacy and milder toxicity.
Educational programs to enhance medical expertise in tropical diseases: the Gorgas Course experience 1996-2001.
Authors: Freedman David O , Gotuzzo Eduardo , Seas Carlos , Legua Pedro , Plier D Adam , Vermund Sten H , Casebeer Linda L
Published: May 2017

In 1995, the American Society of Tropical Medicine and Hygiene (ASTMH) adopted defined criteria for accreditation of clinical training programs in tropical diseases. The first data on the development, enrollment, and outcomes of such a program are presented. A nine-week Diploma course, the Gorgas Course in Clinical Tropical Medicine, given on-site in the tropics (Lima, Cusco, and Iquitos, Peru) has trained 157 individuals from 38 countries from 1996 through 2001. The average age of participants was 38.3 with 11.3 years since graduation. Graduates were 44.5% primary care physicians, 22.2% infectious diseases specialists, 12.7% emergency medicine specialists, 13.5% other specialists, and 7.1% nurses. Residents and fellows accounted for 32.8% and full-time academic faculty for 11.0%. Approximately half of all eligible Gorgas graduates have taken the ASTMH certification examination. In response to the enrollees' profiles and needs, adult learning theory has been extensively used in course design. Stable professional relationships between multiple educational partners are required for an endeavor of this scope.
High levels of IgG4 to Schistosoma mansoni egg antigens in individuals with periportal fibrosis.
Authors: Silveira Alda M S , Bethony Jeffrey , Gazzinelli Andrea , Kloos Helmut , Fraga Lucia Alves de Oliveira , Alvares Maria Carolina B , Prata Aluizio , Guerra Henrique L , Loverde Philip T , Correa-Oliveira Rodrigo , Gazzinelli Giovanni
Published: May 2017

Specific IgG4 and IgE responses to adult worm antigen and soluble egg antigen (SEA) were examined in 267 individuals from an area in which schistosomiasis mansoni is endemic. Based on information obtained from clinical and sonographic examinations of this sample, the individuals were divided in three groups: 1) 204 individuals without periportal fibrosis, and liver and spleen enlargements; 2) 41 individuals without periportal fibrosis, but presenting with organopathy, with or without organomegaly; and 3) 22 individuals with periportal fibrosis, regardless of their status as having hepatomegaly and/or splenomegaly. Levels of IgG4 to SEA were significantly higher in sera from patients with fibrosis compared with the patients from the other two groups. We also found significantly higher levels of IgG4 against SEA in egg-negative patients with fibrosis compared with egg-negative patients from the other two groups. This report demonstrates a specific humoral response in patients presenting with initial fibrosis, a form of schistosomiasis transient between intestinal and severe hepatosplenic.
Bancroftian filariasis infection, disease, and specific antibody response patterns in a high and a low endemicity community in East Africa.
Authors: Simonsen Paul E , Meyrowitsch Dan W , Jaoko Walter G , Malecela Mwele N , Mukoko Dunstan , Pedersen Erling M , Ouma John H , Rwegoshora Rwehumbisa T , Masese Naftal , Magnussen Pascal , Estambale Benson B A , Michael Edwin
Published: May 2017

Bancroftian filariasis infection, disease and specific antibody response patterns in a high and a low endemicity community in East Africa were analyzed and compared to assess the relationship between these parameters and community transmission intensity. Overall prevalences of microfilaremia and circulating filarial antigenemia were 24.9% and 52.2% in the high and 2.7% and 16.5% in the low endemicity community, respectively. A positive history of acute attacks of adenolymphangitis was given by 12.2% and 7.1% of the populations, 4.0% and 0.9% of the adult (> or = 20 years old) individuals presented with limb lymphedema, and 25.3% and 5.3% of the adult males had hydrocele, in the high and the low endemicity community, respectively. Both infection and disease appeared earlier and reached much higher levels in the high than in the low endemicity community. The observed overall and age-specific infection and disease patterns in the two communities were in agreement with the view that these are primarily shaped by transmission intensity. No statistically significant relationships between infection status of fathers and mothers and that of their children were observed in any of the communities for either microfilaremia or for circulating filarial antigenemia. The overall levels (prevalence and geometric mean intensity) of filarial-specific IgG1, IgG2, IgG4, and IgE were significantly higher in the high endemicity community than in the low endemicity dommunity. Surprisingly, the opposite pattern was found for IgG3. Community transmission intensity thus appears to be an important determinant of observed inter-community variation in infection, disease, and host response patterns in Bancroftian filariasis.
Case report: Ocular gnathostomiasis in northwestern Mexico.
Authors: Baquera-Heredia Javier , Cruz-Reyes Alejandro , Flores-Gaxiola Adrian , LÃ³pez-Pulido Guillermo , DÃ­az-Simental Eligio , Valderrama-Valenzuela Leonor
Published: May 2017

A 42-year-old woman from Culiacan in the Sinaloa State of Mexico presented with a four-year history of migratory, pruritic, painful swellings of the face. Palpebral edema with conjunctival erythema developed when lesions developed near the eye. Routine eye examination showed a mobile worm in the anterior chamber. Following surgical removal, the parasite was identified by light and electron microscopy as an advanced third-stage larva of Gnathostoma sp. This prevalence of this helminthiasis may be increasing in areas where eating freshwater raw fish ("cebiche") is customary.
The perforation problem in hydatid disease.
Authors: SÃ¶zÃ¼er ErdoÄŸan M , Ok Engin , Arslan Mehmet
Published: May 2017

Hydatidosis (echinococcosis) is endemic in the Mediterranean region, including Turkey. We evaluated the problem of perforation in hydatidosis. The clinical data on 21 patients with intra-abdominal hydatid cyst perforation who were treated in the last 10 years were evaluated retrospectively. Twelve patients (57%) were men and nine (43%) were women. Their average age was 40 (range = 20-65). Blunt trauma was the etiologic mechanism in four cases (19%). Except for a case with a cyst in the left inguinal region, most (95%) of the patients had primary hepatic hydatidosis (95%). The procedures used on the 30 cysts found in 21 patients were as follows: partial cystectomy and drainage in 21 (70%), total cystectomy in 5 (17%), partial cystectomy plus omentopexy in 2 (7%), and drainage plus vacuum obliteration in 2 (7%). The average postoperative hospital stay was 12 days (range = 6-30). Two patients (10%) had complications: an incisional hernia developed in one patient, and a gastrocutaneous fistula developed in the other. Albendazole (10 mg/kg/day) was prescribed for two months. The mean follow-up time was 80 months (range = 6-131). Three patients (14%) underwent additional surgery for recurrence at various times. The morbidity and mortality associated with perforated hydatid cysts were higher when compared with that of nonperforated cysts. Hydatidosis is endemic in Turkey and traffic accidents are common. When these factors coexist, hydatid perforation should be considered in trauma patients with stable hemodynamics, but suspicious abdominal findings. The choice of the operative approach should be based on the experience of the surgeon and regional characteristics.
Diarrhea prevention through household-level water disinfection and safe storage in Zambia.
Authors: Quick Robert E , Kimura Akiko , Thevos Angelica , Tembo Mathias , Shamputa Isidore , Hutwagner Lori , Mintz Eric
Published: May 2017

A water quality intervention that consists of water treatment, safe storage, and community education was field tested in Kitwe, Zambia. A total of 166 intervention households were randomly selected from one community and 94 control households from another. Baseline surveys were conducted and the intervention was distributed. Weekly active diarrhea surveillance, biweekly water testing, and a follow-up survey were conducted. Compliance was high in intervention households: 97% reported using disinfectant and 72-95% had measurable chlorine in their water in biweekly testing. The percentage of intervention households storing water safely increased from 41.5% to 89.2%. Stored water in intervention households was significantly less contaminated with Escherichia coli than water in control households (P < 0.001). Diarrheal disease risk for individuals in intervention households was 48% lower than for controls (95% confidence interval = 0.3, 0.9). This intervention is a useful tool for preventing waterborne diseases in families in developing countries who lack access to potable water.
Population-based case-control investigation of risk factors for leptospirosis during an urban epidemic.
Authors: Sarkar Urmimala , Nascimento Simone F , Barbosa Rosan , Martins Ridalva , Nuevo Hector , Kalofonos Ippolytos , Kalafanos Ippolytos , Grunstein Itamar , Flannery Brendan , Dias Juarez , Riley Lee W , Reis Mitermayer G , Ko Albert I
Published: May 2017

Between March and October 2000, 157 suspected cases of leptospirosis hospitalized with complications of Weil's syndrome and a mortality of 8% were identified in Salvador, Brazil. We conducted a population-based case-control study to identify risk factors for acquisition of leptospirosis in neighborhoods with high endemicity during the rainy season-associated urban epidemic. Sixty-six (65%) of 101 laboratory-confirmed cases and 125 age and sex-matched healthy neighborhood controls were interviewed. Residence in proximity to an open sewer (matched odds ratio [OR] = 5.15, 95% confidence interval [CI] = 1.80-14.74), peri-domiciliary sighting of rats (OR = 4.49, 95% CI = 1.57-12.83), sighting groups of five or more rats (OR = 3.90, 95% CI = 1.35-11.27), and workplace exposure to contaminated environmental sources (OR = 3.71, 95% CI = 1.35-10.17) were found to be independent risk factors for acquiring disease. Some of these risk factors are amenable to focused interventions, which include provision of closed drainage systems for sewage and reduction of rodent populations in the peri-domicilary environment. Environmental control of transmission may help to greatly reduce the incidence of severe leptospirosis.
Genetic and ecologic characteristics of Bartonella communities in rodents in southern China.
Authors: Ying Bai , Kosoy Michael Y , Maupin Gary O , Tsuchiya Kiyotaka R , Gage Kenneth L
Published: May 2017

Ecologic and bacteriologic observations of small mammals captured in Yunnan Province in the People's Republic of China indicated that Bartonella infections occurred at a high prevalence among some rodent species. Sequence analyses of the citrate synthase genes of these Bartonella demonstrated that rodents in this region harbored a diverse assemblage of strains. The Bartonella isolates obtained from Apodemus, Eothenomys, and Rattus typically clustered separately by genus of rodent host. Cultures obtained from Rattus rats were genetically related to Bartonella elizabethae, a recognized human pathogen. The finding of Bartonella species in a high proportion of the rodent samples from Yunnan suggests the need to investigate whether these agents might be responsible for cases of febrile illnesses of unknown etiology in southern China and elsewhere in southeastern Asia.
Hepatitis c in a community in Upper Egypt: risk factors for infection.
Authors: Medhat Ahmed , Shehata Magda , Magder Laurence S , Mikhail Nabiel , Abdel-Baki Laila , Nafeh Mohamed , Abdel-Hamid Mohamed , Strickland G Thomas , Fix Alan D
Published: May 2017

This investigation's objective was to identify risk factors for hepatitis C virus (HCV) in a village in Upper Egypt with a moderately high prevalence (8.7%) of antibodies to HCV (anti-HCV). A representative sample of 6,012 (63%) of the 9,581 village inhabitants was included in the study. A questionnaire solicited information regarding risk factors for infection, and blood samples were tested for anti-HCV. Parenteral risks identified in age-adjusted analysis included blood transfusions, dental procedures, hospital admission, surgery, complicated deliveries, history of injection therapy for schistosomiasis, and history of frequent injections. Circumcision was pervasive and was not associated per se with ant-HCV; however, circumcision by an informal, rather than formal, health care provider was associated with anti-HCV among young men and boys. The results did not reveal any unique community-acquired exposures that caused HCV infections: inhabitants who had tattoos, who smoked goza, who were shaved by a community barber, or who had their ears pierced were not at greater risk for anti-HCV than those who did not. Risks identified in multivariate analysis for both those older and younger than 30 years included prior parenteral therapy for schistosomiasis and blood transfusion; for those 30 or younger, circumcision by an informal rather than formal health care provider, and frequent injections; and for those older than 30, never attending college, invasive medical procedures, and complicated deliveries. Selecting for those with blood transfusion, prior parenteral therapy for schistosomiasis, and invasive medical procedures would identify less than half of those infected. Inclusion of frequent injections would identify 80% of those infected with HCV, but as a result of the pervasive use of injections, it would not discriminate from those uninfected. Nonetheless, general reduction of these exposures and assuring sterile practices are logical goals for intervention.
New emerging Plasmodium falciparum genotypes in children during the transition phase from asymptomatic parasitemia to malaria.
Authors: Kun JÃ¼rgen F J , Missinou Michel A , Lell Bertrand , Sovric Milena , Knoop Hanna , Bojowald Birgit , Dangelmaier Oliver , Kremsner Peter G
Published: May 2017

Semi-immunity against Plasmodium falciparum occurs after many infections. In areas of high malaria transmission, the prevalence of asymptomatic parasite carriers increases with age. We investigated P. falciparum genotypes in a cohort of asymptomatic carriers who were followed until they became symptomatic. Blood spots on filter paper and blood smears were collected daily from 10 children in LambarÃ©nÃ©, Gabon. The parasite genotypes present on successive days were determined by a polymerase chain reaction using the polymorphic region of the merozoite surface antigen-2 for typing. The same parasite genotypes persisted in eight out of ten children and parasite densities were low throughout the asymptomatic phase indicating inhibition of parasite growth. Appearance of symptoms was associated with an increase in parasitemia and appearance of novel parasite genotypes. The results suggest that the parasites causing a clinical episode are those against which a child has not yet mounted an efficient protective immune response.
Short report: therapeutic efficacy of chloroquine combined with primaquine against Plasmodium falciparum in northeastern Papua, Indonesia.
Authors: Baird J Kevin , Wiady Iwa , Sutanihardja Awalludin , Suradi  , Purnomo  , Basri Hasan , Sekartuti  , Ayomi Ester , Fryauff David J , Hoffman Stephen L
Published: May 2017

Chloroquine combined with primaquine was evaluated for therapy of uncomplicated malaria caused by Plasmodium falciparum in nonimmune Javanese migrants to northeastern Papua, Indonesia. Subjects were randomized to treatment with standard chloroquine therapy (25 mg/kg in 3 doses over the course of 48 hours) with 30 mg primaquine administered daily for 28 days (n = 25) or a placebo of primaquine (n = 28). The 14-day cumulative incidence of therapeutic failure was 56% with primaquine and 79% with placebo (odds ratio [OR], 0.35; 95% confidence interval [CI], 0.1-1.3; P = 0.08). Primaquine administered daily created a marginally significant improvement in therapeutic efficacy at day 14, but not at day 7 (20% versus 36%; OR, 0.2; 95% CI, 0.1-1.8; P = 0.2) or day 28 (82% versus 93%; OR, 0.31; 95% Cl, 0.04-2.1; P = 0.23). This report corroborates studies suggesting that therapeutic doses of primaquine exert no discernible effect on parasitemia by P. falciparum.
Anemia in parasite- and recombinant protein-immunized aotus monkeys infected with Plasmodium falciparum.
Authors: Jones Trevor R , Stroncek David F , Gozalo Alfonso S , Obaldia Nicanor , Andersen Ellen M , Lucas Carmen , Narum David L , Magill Alan J , Sim B K L , Hoffman Stephen L
Published: May 2017

Plasmodium falciparum-induced anemia was characterized in Aotus monkeys repeatedly immunized by infection with P. falciparum (FVO strain) parasites, then cross-challenged with CAMP strain, or in monkeys receiving blood stage challenges as part of malaria vaccine trials. In 4 studies, 25 (30.5%) of 82 monkeys had at least a 50% reduction in hematocrit; mean day of maximum parasitemia was 12.5, whereas the mean day of minimum hematocrit was 18.8 (P < 0.0009). Decreased hematocrit levels were not associated with reticulocytosis until parasite densities decreased significantly from peak levels. Direct antibody tests to detect IgG and C3d on the surface of erythrocytes were negative. Nonantibody/noncomplement-mediated lysis of uninfected erythrocytes seems to be the principal cause of the anemia, and it also seems that bone marrow suppression and lysis of infected erythrocytes contributed to the anemia. Partial immunity-whether induced by repeated immunization with whole parasites or with vaccine-seems important to the development of anemia.
Prognostic value of thrombocytopenia in African children with falciparum malaria.
Authors: GÃ©rardin Patrick , Rogier Christophe , Ka Amadou S , Jouvencel Philippe , Brousse Valentine , Imbert Patrick
Published: May 2017

Thrombocytopenia is a common finding in malaria, but its prognostic value has not been addressed in children. The relationship between thrombocytopenia (platelet count < 100,000/mm3 on admission) and severity and outcome was investigated prospectively in children hospitalized with falciparum malaria in Dakar, Senegal, an area that is hypoendemic for malaria. Of 288 falciparum cases, 215 matched the 2000 World Health Organization definition of severe malaria. Median platelet counts were lower (98,000/mm3 versus 139,000/mm3; P < 0.02) among severe cases than in mild cases, and in children who died than among those who recovered (68,500/mm3 versus 109,000/mm3; P < 0.002). In severe cases, children presenting with a platelet count < 100,000/mm3 were more likely to die (odds ratio [OR] = 6.31, 95% confidence interval [CI] = 2.0-26.0). Moreover, multivariate analysis identified thrombocytopenia as an independent predictor of death (OR = 13.3, 95% CI = 3.2-55.1). Our data show an association between thrombocytopenia and either severity or prognosis in childhood falciparum malaria.
Genetic complexity of Plasmodium falciparum gametocytes isolated from the peripheral blood of treated Gambian children.
Authors: Sutherland Colin J , Alloueche Ali , McRobert Louisa , Ord Rosalynn , Leggat Jamie , Snounou Georges , Pinder Margaret , Targett Geoffrey A T
Published: May 2017

The genetic complexity of Plasmodium falciparum gametocytes isolated from Gambian children participating in a controlled trial of anti-malarial therapy was investigated. RNA and DNA were prepared from gametocyte-positive blood, which was also used in transmission experiments with Anopheles gambiae mosquitoes. Amplification by a reverse transcriptase-polymerase chain reaction (RT-PCR) of transcripts from the genes for the ring-infected erythrocyte surface antigen and the 16-kD antigen, which exhibit asexual and sexual stage-specific expression, was used to identify 30 post-treatment gametocyte isolates in which trophozoites persisted below the threshold of detection by microscopy. These included isolates from children who received sulfadoxine/pyrimethamine plus artesunate. Twenty-nine gametocyte-positive isolates that were free of subpatent trophozoites were examined further by PCR amplification of polymorphic genomic loci. We estimate that an average minimum of 2.3 genotypes occurred in these gametocyte-only isolates, and many of these were shown to be infective to mosquitoes. Thus, meiotic recombination between different genotypes is predicted to be a common event in this study area.
Progressive Chagas' cardiomyopathy is associated with low selenium levels.
Authors: Rivera Maria Teresa , de Souza Andréa P , Hasslocher Moreno Alejandro M , Xavier Sergio S , Gomes Juliana A S , Rocha Manoel Otávio C , Correa-Oliveira Rodrigo , Nève Jean , Vanderpas Jean , Araújo-Jorge Tania C
Published: May 2017

Selenium (Se) deficiency is linked with some cardiomyopathies. Its status was determined in 170 patients with chronic Chagas' disease from 2 Brazilian regions (Rio de Janeiro and Belo Horizonte), clinically stratified into groups as follows: indeterminate or asymptomatic (IND); cardiac asymptomatic (CARDa); cardiac symptomatic with moderate to severe heart dysfunction (CARDb); and healthy adults (HA), used for comparison. In most HA, Se levels were normal, excluding an overall Se deficiency. Se was significantly lower in CARDb than in HA, IND, or CARDa patients. This was not associated with a concomitant decrease in activity of glutathione peroxidase. Thyrotropin was normal, excluding iodine deficiency. Se correlated positive and significantly with ventricular ejection fraction (assessed via echocardiography). Asymptomatic children with acute Chagas' disease had normal Se as well as 5 noninfectious cases of cardiomyopathy. Low Se was found in 6 of 10 chagasic patients with digestive megasyndromes. Thus, the decrease in Se in chagasic patients seems to be a biological marker for Trypanosoma cruzi infection and related to the progression of pathology.
Serology and eosinophil count in the diagnosis and management of strongyloidiasis in a non-endemic area.
Authors: Loutfy Mona R , Wilson Marianna , Keystone Jay S , Kain Kevin C
Published: May 2017

Strongyloidiasis is a chronic infection that may result in significant morbidity; however, diagnosis and management remain problematic. The objective of this study was to 1) evaluate the demographic, clinical, and laboratory features of 76 consecutive individuals who had Strongyloides stercoralis larvae identified in their fecal specimens; 2) determine the sensitivity of the Centers for Disease Control and Prevention (CDC) enzyme immunoassay (EIA) for detecting antibodies to Strongyloides in those with confirmed infection; and 3) assess the serologic responses and changes in eosinophil counts following treatment. Most (96%) cases occurred in immigrants, but some patients had immigrated as long as 40 years earlier. The CDC Strongyloides EIA had a sensitivity of 94.6% (95% confidence interval = 92.0-97.2%) in this patient population with proven infection. Serologic and eosinophil counts decreased after therapy, suggesting that they may be useful markers of treatment success.
Short report: a rapid method for the differentiation of Burkholderia pseudomallei and Burkholderia thailandensis.
Authors: Wuthiekanun Vanaporn , Anuntagool Narisara , White Nicholas J , Sirisinha Stitaya
Published: May 2017

A rapid method for the identification and differentiation of Burkholderia pseudomallei and Burkholderia thailandensis colonies is described. It consists of simultaneous use of 2 monoclonal antibody-based latex agglutination test systems. The anti-lipopolysaccharide test reacts with both species, whereas the anti-exopolysaccharide reacts only with B. pseudomallei. Compared with classical biochemical tests, the method is highly reproducible and accurate. It is particularly useful for the identification of the organisms in environmental specimens, which may contain both of these Burkholderia species.
Discrimination between active and inactive neurocysticercosis by metacestode excretory/secretory antigens of Taenia solium in an enzyme-linked immunosorbent assay.
Authors: Molinari JosÃ© L , GarcÃ­a-Mendoza Esperanza , de la Garza Yazmin , RamÃ­rez JosÃ© A , Sotelo Julio , Tato Patricia
Published: May 2017

To detect IgG antibodies to Taenia solium, a controlled double-blind study was conducted using 91 coded cerebrospinal fluid samples from patients with neurocysticercosis (NCC) and other neurologic disorders. Samples were tested in an enzyme-linked immunosorbent assay (ELISA) using metacestode excretion/secretion antigens. The results were correlated with data from medical records on the diagnosis of NCC (based on computed tomography and magnetic resonance imaging criteria) and other neurologic disorders. The ELISA results were positive in 22 of the 24 cases with active NCC. In contrast, six cases with calcified cysts (inactive NCC), as well as one case in a transitional stage, were negative. One case with a calcified granuloma and another with a granuloma plus calcifications (classified as inactive NCC) had positive results. The remaining negative results corresponded to other neurologic disorders (58 cases). The results of the ELISA showed a significant difference between active and inactive NCC (P = 0.0034).
Hyperendemic Cryptosporidium and Giardia in households lacking municipal sewer and water on the United States-Mexico border.
Authors: Redlinger Thomas , Corella-Barud VerÃ³nica , Graham Jay , Galindo Adriana , Avitia Raquel , Cardenas Victor
Published: May 2017

This study identified differences in the epidemiology of Giardia and Cryptosporidium infection for low-income populations residing on the United States-Mexico border. Participation included 77 households in three communities lacking adequate municipal water and sewage services. The household was the unit of analysis and sampling was from household biosolid waste from newly installed composting toilets. The proportion of households positive for Giardia and Cryptosporidium was high, 82% and 70%, respectively, and this was in contrast to the few households (14%) reporting at least one individual with diarrhea symptoms. This finding indicated that most of the participant families were chronically infected but asymptomatic. In the multivariate analysis, there was a statistically significant protective effect for Cryptosporidium in those households that purified drinking water but not for Giardia. Those households with children less than five years of age were 1.3 times at risk for Giardia infection. Our findings highlighted differences in the transmission mode of these two pathogens and underscore the need for interventions addressing hygiene, water supply, and sanitation.
Fourteen-year seroepidemiological study of zoonoses in a Greek village.
Authors: Antoniou Maria , Economou Irene , Wang Xiaoying , Psaroulaki Anna , Spyridaki Ioanna , Papadopoulos Byron , Christidou Athanasia , Tsafantakis Emanuel , Tselentis Yiannis
Published: May 2017

A seroepidemiological study carried out in a high-risk village in Crete in 1985-1987 and 1998 showed that although the awareness of the people concerning zoonoses had increased during this period, the situation did not improve: there was a significant increase of the spread of seroprevalence in time and space of Coxiella burnetii, Rickettsia typhi, Brucella sp., and Entamoeba histolytica. Toxoplasma gondii, Rickettsia conorii, Borrelia burgdorferi, Echinococcus granulosus, Leishmania sp., and Fasciola hepatica stayed at the same levels. This first study of Bartonella henselae in Crete showed that 15.9% of the children tested were seropositive. The results indicate that reservoirs and vectors of the pathogens studied are widespread in the environment, and the way of life of the people favors contact with them. Seven of 30 milk samples were positive for Brucella sp. by seminested polymerase chain reaction.
Isolation of Coxiella burnetii by a centrifugation shell-vial assay from ticks collected in Cyprus: detection by nested polymerase chain reaction (PCR) and by PCR-restriction fragment length polymorphism analyses.
Authors: Spyridaki Ioanna , Psaroulaki Anna , Loukaides Fidias , Antoniou Maria , Hadjichristodolou Christos , Tselentis Yannis
Published: May 2017

Ticks are the principal vectors and reservoirs of Coxiella burnetii. The identification of isolates is necessary for understanding the clinical diversity of Q fever in different geographic areas. This is the first report of isolation of C. burnetii from ticks by the shell-vial assay and by nested polymerase chain reaction (PCR) assay for the detection of this pathogen in ticks. Of 141 ticks collected in Cyprus (Rhipicephalus sanguineus and Hyalloma spp.), 10% were found to be infected with C. burnetii. Three ticks were positive by hemolymph test, and 11 triturated ticks were positive by nested PCR. Three isolates were obtained by the centrifugation shell-vial technique. Analysis by PCR, then restriction fragment length polymorphism showed that the 3 Cyprus isolates had identical restriction profiles to reference strains Nine Mile and Q212. The methods described are useful in studying the epidemiology and ecology of C. burnetii.
Experimental infection of the Sigmodon alstoni cotton rat with CaÃ±o Delgadito virus, a South American hantavirus.
Authors: Fulhorst Charles F , Milazzo Mary L , Duno Gloria , Salas Rosa Alba
Published: May 2017

Forty-eight Sigmodon alstoni (Alston's cotton rat) were inoculated with CaÃ±o Delgadito (CDG) virus to extend our knowledge and understanding of the natural host relationships of the hantaviruses indigenous to the Americas. Infectious CDG virus was recovered from oropharyngeal secretions, urine, or solid tissues of nine of 12 animals killed on day 9 post-inoculation (PI), 14 of 24 animals killed on day 18 or 27 PI, and none of 12 animals killed on day 54 PI. In addition, virus-specific RNA was detected in the kidneys of six of the 12 animals killed on day 54 PI, and adult cotton rats inoculated with the kidneys of four animals killed on day 54 PI developed antibody to CDG virus. Collectively, the results indicate that CDG virus can establish lengthy (perhaps lifelong) infections in Alston's cotton rat and thus support the concept that S. alstoni is the principal host of CDG virus.
First molecular evidence of new Bartonella spp. in fleas and a tick from Peru.
Authors: Parola Philippe , Shpynov Stanislav , Montoya Manuel , Lopez Martha , Houpikian Pierre , Zeaiter Zaher , Guerra Humberto , Raoult Didier
Published: May 2017

Fleas, lice, and ticks collected in Peru in a suburban area of Cusco in November 1998 were tested by polymerase chain reaction for the presence of Bartonella DNA using primers amplifying a fragment of the intergenic spacer region (ITS) gene. Three new Bartonella genotypes were detected in Pulex fleas self-collected from the beds and clothes of schoolchildren and adults. A fourth new genotype was also detected from a tick found on a sheep in the same area. One of the genotypes is closely related to B. vinsoni subsp. berkhoffii, and the others seem to originate from unknown Bartonella species, whose medical importance has yet to be clarified.
Clinical outcomes of hepatitis B virus (HBV) genotypes B and C in Japanese patients with chronic HBV infection.
Authors: Furusyo Norihiro , Nakashima Hisashi , Kashiwagi Kenichiro , Kubo Norihiko , Hayashida Kazuhiro , Usuda Sadakazu , Mishiro Shunji , Kashiwagi Seizaburo , Hayashi Jun
Published: May 2017

The aims of this retrospective survey were to determine the epidemiologic distribution of hepatitis B virus (HBV) genotypes and analyze the genotype-related clinical differences among Japanese patients with chronic HBV infection. The 158 surveyed patients with chronic HBV infection lived in Fukuoka and Okinawa were serially tested for serum alanine aminotransferase (ALT) and hepatitis B e antigen (HBeAg). Follow-up was for a period of 10.8 +/- 6.4 years (mean +/- SD). The HBV genotypes were determined in sera by an enzyme-linked immunosorbent assay and detection of HBV DNA in serum was done by the transcription-mediated amplification-hybridization protection assay. Genotypes B and C were found in 58 (36.7%) and 100 (63.3%) of the patients, respectively. Genotype B was predominant in Okinawa (B = 86.9%, C = 13.1%), whereas genotype C was predominant in Fukuoka (B = 5.2%, C = 94.8%). The HBeAg positivity and ALT abnormality rates at the start of the observation period were significantly higher in patients with genotype C (66.0% and 84.0%) than in patients with genotype B (34.5% and 22.4%) (P < 0.05, respectively). The annual rate of spontaneous HBeAg disappearance in patients with genotype B was much higher than in patients with genotype C (8.38% versus 2.34%, respectively). Patients with genotype C who were continuously HBeAg negative from entry had a significantly higher ALT abnormality (58.8%) than those with genotype B (19.2%) (P < 0.05). Interestingly, patients with genotype C who became HBeAg negative after treatment with interferon had a high ALT abnormality (58.8%). All patients with an ALT abnormality were positive for HBV DNA in their serum. These findings indicate that patients with HBV genotype C have more severe liver deterioration because of the delay of HBeAg disappearance and continued HBV replication after HBeAg disappearance.
Scrub typhus in Japan: epidemiology and clinical features of cases reported in 1998.
Authors: Ogawa Motohiko , Hagiwara Toshikatsu , Kishimoto Toshio , Shiga Sadashi , Yoshida Yoshiya , Furuya Yumiko , Kaiho Ikuo , Ito Tadahiko , Nemoto Haruyasu , Yamamoto Norishige , Masukawa Kunihiko
Published: May 2017

Surveillance for scrub typhus was conducted in Japan in 1998 using a questionnaire. A total of 462 cases were reported. Scrub typhus occurred in both the fall and spring in the northern part of Honshu (the main island), and in the fall in the central part of Honshu and on the island of Kyushu. The occurrence of the disease varied with age, gender, and activity. Seventy-six percent of the patients were more than 51 years old, and 36% and 16% of the patients were engaged in farm work and forestry, respectively. Fever, rash, and eschar were detected in 98%, 93%, and 97% of the patients, respectively. Elevated levels of C-reactive protein, aspartate transaminase, and alanine transaminase were detected in 96%, 87%, and 77% of the patients, respectively. Disseminated intravascular coagulation developed in 34 cases and had a unique regional distribution. This study shows the status of scrub typhus in Japan in 1998 and provides important information for diagnosis and prevention.
The safety and efficacy of sulfadoxine-pyrimethamine, amodiaquine, and their combination in the treatment of uncomplicated Plasmodium falciparum malaria.
Authors: Schellenberg David , Kahigwa Elizeus , Drakeley Chris , Malende Athumani , Wigayi John , Msokame Chris , Aponte John J , Tanner Marcel , Mshinda Hassan , Menendez Clara , Alonso Pedro L
Published: May 2017

The safety and efficacy of amodiaquine (AQ), sulfadoxine-pyrimethamine (SP), and coadministered AQ+SP was assessed in 351 Tanzanian children (age range, 6-59 months) with uncomplicated Plasmodium falciparum malaria. This open, randomized study followed the 28-day World Health Organization (WHO) protocol and evaluated safety using clinical and laboratory parameters. Children receiving SP were more likely to vomit during follow-up (32% vs. 17%: P = 0.03), and SP alone resulted in prolonged fever clearance times. Although Day 7 and Day 14 clinical and parasitological cure rates were similar, by Day 28 45% of children treated with AQ demonstrated R1 resistance and 27.5% were clinical failures compared with 25% and 6.3%, respectively, for SP alone. Coadministered AQ+SP was safe, combined the greater clinical (96.2%) and parasitological (64.2%) efficacy of SP with the more rapid symptom resolution of AQ, and reduced the incidence of gametocytemia during follow-up (AQ+SP 12.6% vs. SP 29.9%; P = 0.001). The level of R1 resistance to SP may herald a rapid decline in its efficacy as SP drug pressure increases. Coadministration of AQ+SP may delay this.
Geographic distribution of Triatoma dimidiata and transmission dynamics of Trypanosoma cruzi in the Yucatan peninsula of Mexico.
Authors: Dumonteil Eric , GourbiÃ¨re Sebastien , Barrera-PÃ©rez Mario , Rodriguez-FÃ©lix Eugenia , Ruiz-PiÃ±a Hugo , BaÃ±os-Lopez OthÃ³n , Ramirez-Sierra MarÃ­a JesÃºs , Menu FrÃ©dÃ©ric , Rabinovich Jorge E
Published: May 2017

Chagas disease represents a major public health concern in most of Latin America, and its control is currently based on vector control and blood bank screening. We investigated the geographic distribution and seasonal variations in triatomine populations in the Yucatan peninsula of Mexico to obtain entomologic data for the optimization of potential control programs. We collected domiciliated and peri-domiciliated Triatoma dimidiata from 115 houses in 23 villages distributed throughout most of the peninsula. A high abundance of bugs was observed in the northern part of the peninsula, indicating a prioritary area for vector control. Part of this distribution could be attributed to the type of vegetation. We also documented strong seasonal variations in T. dimidiata populations, with a higher abundance during the hot and dry season in April-June. These variations, associated with reduced year-round colonization of houses and the analysis of developmental stage structure, suggest that flying adults seasonally invading houses may play a larger role than domiciliated bugs in transmission of Trypanosoma cruzi to humans. The importance of this transmission dynamics may not be limited to the Yucatan peninsula, but may be a general mechanism contributing to natural transmission that should be taken into account in other regions for the design and optimization of control strategies.
Repellency of live potted plants against Anopheles gambiae from human baits in semi-field experimental huts.
Authors: Seyoum Aklilu , Kabiru Ephantus W , Lwande Wilber , Killeen Gerry F , Hassanali Ahmed , Knols Bart G J
Published: May 2017

The repellency of potted plants against the malaria vector Anopheles gambiae sensu stricto Giles was quantified in experimental huts under semi-field conditions inside a screen-walled greenhouse. Ocimum americanum Linnaeus (Labiatae), Lantana camara L. (Verbenaceae), and Lippia uckambensis Spreng (Verbenaceae) repelled at an average of 39.7% (95% confidence interval [CI] = 29.6-48.4%), 32.4% (95% CI = 19.7-43.1%), and 33.3% (95% CI = 21.5-43.3%) of the mosquitoes, respectively (P < 0.0001 for all treatments). This was determined by logistic regression, allowing for variations associated with different bait hosts, sampling huts, and replicate test nights. In contrast, Ocimum kilimandscharicum Guerke (Labiatae), Ocimum suave Willd. (Labiatae), Corymbia citriodora Hook (Myrtaceae), Azadirachta indica A. Juss (Meliaceae), Tagetes minuta L. (Asteraceae), and Hyptis suaveolens Poit. (Lamiaceae) did not significantly repel mosquitoes. The combination of O. americanum with either L. camara or L. uckambensis repelled 31.6% (95% CI = 19.7-41.7%) and 45.2% (95% CI = 34.7-54.0%) of the mosquitoes, respectively (P < 0.0001 for both treatments). This study is the first to show that live intact plants can reduce domestic exposure to malaria vector mosquitoes. As such, they may represent a new, sustainable and readily applicable malaria vector control tool for incorporation into integrated vector management programs.
Ectopic localization of tungiasis.
Authors: Heukelbach JÃ¶rg , Wilcke Thomas , Eisele Margit , Feldmeier Hermann
Published: May 2017

Tungiasis is caused by the penetration of the female sand flea Tunga penetrans into the epidermis. It is generally assumed that lesions are confined to the feet. To determine to what degree tungiasis occurs at other topographic sites, 1,184 inhabitants of a poor neighborhood in northeastern Brazil were examined; 33.6% were found to have tungiasis (95% confidence interval = 30.9-36.4%). Six percent presented lesions at locations other than the feet, with the hands being the most common ectopic site (5.5%). Other sites were the elbows, thighs, and gluteal region. Ectopic tungiasis was significantly associated with the total number of lesions (P < 0.001) and an age less than 15 years old (P = 0.02). In 86 patients actively recruited with lesions on their feet, ectopic localizations were observed in 25.6%. Since untreated sand flea lesions are prone to become superinfected, clinicians should be aware of not missing any ectopic localization of tungiasis.