bluuebunny/crossref_metadata_2025 huggingface dataset:
COPRO-DIAGNOSIS OF ECHINOCOCCUS GRANULOSUS INFECTION IN DOGS BY AMPLIFICATION OF A NEWLY IDENTIFIED REPEATED DNA SEQUENCE
Authors: ABBASI IBRAHIM , BRANZBURG ANNA , CAMPOS-PONCE MAIZA , HAFEZ SAMI K. ABDEL , RAOUL FRANCIS , CRAIG PHILIP S. , HAMBURGER JOSEPH
Published: September 2018

Diagnosis of Echinococcus granulosus infection in dogs by detecting adult worms recovered post mortem or purged from the intestines after treatment with arecoline is not suitable for mass screening. Large-scale diagnosis by detection of copro-antigens is useful but only with relatively high intensity infections, and only by genus. To provide a more sensitive and specific diagnosis, a polymerase chain reaction (PCR) assay was developed, that amplified a target repeated sequence (EgG1 Hae III) newly identified in the genome of the common sheep strain of E. granulosus. This repeated sequence consists of approximately 6,900 copies, arranged in tandem, in groups of 2–6 repeats. The corresponding primers used in the PCR easily detected a single egg with no cross-amplification of DNA from closely related cestodes, including E. multilocularis and Taenia spp. Fecal samples from naturally infected dogs, with 2–10,000 E. granulosus worms at necropsy, were all PCR positive, while E. multilocularis or Taenia spp. positive controls as well as non-endemic controls were all PCR negative. This copro-PCR assay was demonstrated to be 100% specific and also detected all necropsy-positive E. granulosus-infected dogs. It is suggested that this copro-PCR assay has the potential for pre-mortem diagnosis of E. granulosus infection even in areas where E. granulosus and E. multilocularis are co-endemic.
EPIDEMIOLOGIC AND CLINICAL CHARACTERISTICS OF ACUTE DIARRHEA WITH EMPHASIS ON ENTAMOEBA HISTOLYTICA INFECTIONS IN PRESCHOOL CHILDREN IN AN URBAN SLUM OF DHAKA, BANGLADESH
Authors: HAQUE RASHIDUL , MONDAL DINESH , KIRKPATRICK BETH D. , AKTHER SELIM , FARR BARRY M. , SACK R. BRADLEY , PETRI WILLIAM A.
Published: September 2018

The epidemiology, clinical features, nutritional status, and causative agents of diarrhea were studied in 289 Bangladeshi children (147 boys and 142 girls) 2–5 years old. The use of improved diagnostic tests for amebiasis enabled for the first time analysis of the contribution of Entamoeba histolytica to total diarrheal illness in this community setting. The average incidence rate of diarrhea was 1.8/child-year, and the average number of diarrheal days was 3.7 days/child-year over an average observation period of 2.8 years/child. Seventy-five percent of the diarrheal episodes were ≤ 2 days in duration. Persistent diarrhea was relatively uncommon (0.2% of the children) and chronic diarrhea was observed in only one episode. Compared with malnourished and/or stunted children, better-nourished children experienced significantly fewer diarrheal episodes. The diarrheal incidence rate for children with blood group A was significantly less that that of the children with blood groups O and AB. The most frequent bacterial enteropathogens isolated from diarrheal stool specimens were enterotoxigenic Escherichia coli (9%) and Aeromonas species (9%), followed by Plesimonas shigelloides (4%) and Shigella flexneri (3.8%). Rotavirus was the most common viral agent isolated from diarrheal stool samples (5%). Giardia lamblia, Cryptosporidium parvum, and E. histolytica were identified in 11%, 8.4%, and 8%, respectively, of the diarrheal stool specimens. Dysentery was observed in 7.7% of all diarrheal episodes. The most common pathogens isolated from dysenteric stool were S. flexneri (11.6%), Aeromonas sp. (10%), E. histolytica (8.7%), Campylobacter jejunii (5.8%), P. shigelloides (4.3%), and A. caviae (4.3%). The overall incidence rate of E. histolytica-associated diarrhea was 0.08/child-year. Visible blood and hemoccult test-detected blood loss was found in 7% and 25%, respectively, of cases of E. histolytica-associated diarrhea. Children who had recovered from a diarrheal episode with E. histolytica, but not E. dispar, had half the chance of developing subsequent E. histolytica-associated diarrhea, consistent with the development of species-specific acquired immunity. In conclusion, the use of modern diagnostic tests demonstrated that E. histolytica contributed to overall morbidity from diarrheal illness. Understanding the etiology, frequency, and consequences of acute diarrhea in children from a developing country should aid in the design of interventions to improve child health.
OCCURRENCE OF ORIENTIA TSUTSUGAMUSHI IN SMALL MAMMALS FROM THAILAND
Authors: COLEMAN RUSSELL E. , MONKANNA TAWEESAK , LINTHICUM KENNETH J. , STRICKMAN DANIEL A. , FRANCES STEPHEN P. , TANSKUL PANITA , KOLLARS THOMAS M. , INLAO INKAM , WATCHARAPICHAT POCHAMAN , KHLAIMANEE NITTAYA , PHULSUKSOMBATI DUANGPORN , SANGJUN NOPPADON , LERDTHUSNEE KRIANGKRAI
Published: September 2018

Extensive sampling of small mammals was conducted in eight provinces of Thailand between September 9, 1992 and April 29, 2001. A total of 3,498 specimens representing 22 species were collected. Eighty-eight percent (3,089 of 3,498) of the animals were collected from a region in Chiangrai Province, which is commonly recognized as endemic for human scrub typhus. Blood and tissue samples from each animal were tested for the presence of Orientia tsutsugamushi, the etiologic agent of scrub typhus. The predominant species collected were Rattus rattus (53%, n = 1,863), R. losea (18%, n = 638), Bandicota indica (16%, n = 564), and R. exulans (4%, n = 146). Orientia tsutsugamushi was detected in 10 of the 22 species of mammals that included R. bukit (25% infected, 1 of 4), R. rattus (23%, 419 of 1,855), R. argentiventer (22%, 5 of 23), R. berdmorei (22%, 2 of 9), R. losea (13%, 82 of 638), B. indica (9%, 52 of 564), R. koratensis (8%, 1 of 12), B. savilei (3%, 1 of 30), R. exulans (1%, 2 of 146), and Tupaia glis (2%, 1 of 49). Infected animals were found in Chiangrai (18% infected, 563 of 3,084), Bangkok (11%, 1 of 9), Sukothai (3%, 1 of 30), and Nonthaburi (1%, 1 of 69) Provinces. The implications towards scrub typhus maintenance and transmission are discussed.
CHLOROQUINE-RESISTANT PLASMODIUM VIVAX MALARIA IN PERU
Authors: RUEBUSH TRENTON K. , ZEGARRA JORGE , CAIRO JAVIER , ANDERSEN ELLEN M. , GREEN MICHAEL , PILLAI DYLAN R. , MARQUIÑO WILMER , HUILCA MARÍA , ARÉVALO ERNESTO , GARCIA CORALITH , SOLARY LELY , KAIN KEVIN C.
Published: September 2018

Reports from several sites in South America suggest the presence of isolated cases of chloroquine-resistant Plasmodium vivax malaria. To investigate the possibility of chloroquine-resistant P. vivax in Peru, we conducted 28-day in vivo drug efficacy trials at three sites in the Amazon region and one site on the northern Pacific Coast between 1998 and 2001. A total of 242 patients between the ages of 2 and 60 years were enrolled (177 from the Amazon region and 65 from the northern coast). All subjects received directly observed therapy with chloroquine, 25 mg/kg, over a three-day period. On enrollment, 49% had a documented fever and 96% had a history of fever; their geometric mean parasite density was 5,129 parasites/μL. A total of 212 (88%) of the 242 subjects completed their 28-day follow-up. Four of the 177 patients from the Amazon region had a recurrence of P. vivax parasitemia on days 21 and 28 after treatment was initiated. Two of these patients had chloroquine-resistant infections, based on polymerase chain reaction-single-stranded conformational polymorphism genotyping and chloroquine-desethylchloroquine blood levels, which were ≥97 ng/mL at the time of the reappearance of parasitemia. None of the subjects studied on the northern Pacific Coast had recurrent parasitemia.
EVALUATION OF THE BINAX NOW® ICT TEST VERSUS POLYMERASE CHAIN REACTION AND MICROSCOPY FOR THE DETECTION OF MALARIA IN RETURNED TRAVELERS
Authors: FARCAS GABRIELLA A. , ZHONG KATHLEEN J. Y. , LOVEGROVE FIONA E. , GRAHAM CHRISTOPHER M. , KAIN KEVIN C.
Published: September 2018

Microscopic detection of Plasmodium species has been the reference standard for the diagnosis of malaria for more than a century. However, maintaining a sufficient level of expertise in microscopic diagnosis can be challenging, particularly in non-endemic countries. The objective of this study was to compare a new rapid malaria diagnostic device (NOW® ICT Malaria Test; Binax, Inc., Portland, ME) to polymerase chain reaction (PCR) and expert microscopy for the diagnosis of malaria in 256 febrile returned travelers. Compared with PCR, the NOW® ICT test showed a sensitivity of 94% for the detection of P. falciparum malaria (96% for pure P. falciparum infection) and 84% for non-P. falciparum infections (87% for pure P. vivax infections and 62% for pure P. ovale and P. malariae infections), with an overall specificity of 99%. The Binax NOW® ICT may represent a useful adjunct for the diagnosis of P. falciparum and P. vivax malaria in febrile returned travelers.
THE USE OF ANTI-MALARIAL DRUGS TO PREVENT MALARIA IN THE POPULATION OF MALARIA-ENDEMIC AREAS
Authors: GREENWOOD BRIAN
Published: September 2018

Anti-malarial drugs have been used in various ways to prevent malaria in the resident populations of endemic areas for nearly 100 years. The primary aim of most early studies was to interrupt transmission. This was rarely achieved, but administration of anti-malarial drugs either through medication of salt or by mass administration frequently led to a marked reduction in the prevalence of malaria infection and in the incidence of clinical attacks. Chemoprophylaxis is highly effective in reducing mortality and morbidity from malaria in young children and pregnant women living in endemic areas, but is difficult to sustain and, in some studies, has impaired the development of naturally acquired immunity. Intermittent preventive treatment, in which full therapeutic doses of a drug are given at defined intervals, has the potential to provide some of the benefits of sustained chemoprophylaxis in pregnant women and young children without some of its drawbacks and is a promising new approach to malaria control.
PLASMODIUM FALCIPARUM IN VIVO RESISTANCE TO QUININE: DESCRIPTION OF TWO RIII RESPONSES IN FRENCH GUIANA
Authors: DEMAR MAGALIE , CARME BERNARD
Published: September 2018

The resistance of Plasmodium falciparum to antimalarial drugs is one of the most worrisome problems in tropical medicine, but few clinical studies or observations have described confirmed cases of therapeutic failure. We report two cases of in vivo P. falciparum resistance (RIII response) to quinine in French Guiana, an Amazonian focal zone in which multi-resistant malaria is endemic. Both patients presented with uncomplicated malaria and were initially treated with intravenous quinine. Although absorption was normal, the treatment was not effective and the patients still had fever and significant parasitemia three days after the onset of treatment (day 3). The addition of intravenous tetracycline completely resolved the parasitemia within approximately 96 hours. These clinical reports confirm the necessity to combine quinine with tetracycline in this area, as recommended by the recent French regional antimalarial policy.
EPIDEMIOLOGY OF MALARIA IN A HYPOENDEMIC BRAZILIAN AMAZON MIGRANT POPULATION: A COHORT STUDY
Authors: DUARTE ELISABETH CARMEN , GYORKOS THERESA W. , PANG LORRIN , ABRAHAMOWICZ MICHAL
Published: September 2018

The present study describes aspects of the epidemiology of malaria in a migrant population living in a hypoendemic area in Brazil using an open cohort study design. Rural settlement residents in Leonislândia, Peixoto de Azevedo, Mato Grosso, Brazil were followed from September 1996 to April 1997. At baseline, an interview and malaria diagnoses were carried out and spleen size was measured. Incident cases were detected through follow-up visits and laboratory records. Cox regression was used to assess risk factors for time to malaria onset. Eighty percent (n = 414) of the study population (n = 521) contributed follow-up data. Overall, malaria prevalence during any study visit ranged from 0.3% to 5.4% and the malaria incidence rate (IR) was 4.49 (95% confidence interval = 3.66, 5.46) per 100 person-months. The IR of Plasmodium vivax malaria was approximately four times higher than the IR for P. falciparum malaria during follow-up. Among individuals who had had malaria during his or her lifetime, 14.03% reported hospitalization (median duration = 3 days) and 70.1% reported days of work lost (median duration = 4 days for P. falciparum malaria and 3 days for P. vivax malaria) related to the last malaria episode. No important risk factor was associated with the malaria IR. The fact that neither work-related factors nor age was associated with the risk of malaria indicates that indoor/peri-domiciliary transmission by the local vector is more important or as important as workplace-related transmission.
PERIDOMESTIC SMALL MAMMALS ASSOCIATED WITH CONFIRMED CASES OF HUMAN HANTAVIRUS DISEASE IN SOUTHCENTRAL CHILE
Authors: TORRES-PÉREZ FERNANDO , NAVARRETE-DROGUETT JORGE , ALDUNATE REBECA , YATES TERRY L. , MERTZ GREGORY J. , VIAL PABLO A. , FERRÉS MARCELA , MARQUET PABLO A. , PALMA R. EDUARDO
Published: September 2018

Cases of human hantavirus disease have been reported in Chile since 1995, most of them in people living in rural and periurban areas. We conducted a peridomestic study of small mammals to evaluate the relationships between the presence of rodents with antibodies to Andes virus confirmed human cases of hantavirus pulmonary syndrome in southcentral Chile. The results of 20 sampled sites, which involved the capture of 272 mice over an 18-month period, showed the occurrence of 10 small mammal species, of which Oligoryzomys longicaudatus was the only seropositive species for hantavirus, with an intra-specific serologic rate of 10.4%.
MYIASIS IN KUWAIT: NOSOCOMIAL INFECTIONS CAUSED BY LUCILIA SERICATA AND MEGASELIA SCALARIS
Authors: HIRA PARSOTAM R. , ASSAD REEM M. , OKASHA GHUFRAN , AL-ALI FAIZA M. , IQBAL JAMSHAID , MUTAWALI KAMAL E. H. , DISNEY R. HENRY L. , HALL MARTIN J. R.
Published: September 2018

Myiasis, the invasion of live human tissue by larvae of Diptera, is reported in the nasopharynx and a leg wound in two patients who were hospitalized for more than 72 hours in Mubarak Al-Kabeer Teaching Hospital in Kuwait City, Kuwait. On the fourth and fifth days after a 10-year-old Kuwaiti boy was admitted to the hospital intensive care unit in a bloodied and comatose state following a traffic accident, ‘worms’ that came out of his nostrils were fixed, cleared, and identified as second and third instar of Lucilia sericata (Diptera: Calliphoridae). After 14 days, ‘worms’ were seen in the original dressing of a 35-year-old Iranian man admitted to the Orthopedic Unit of the hospital with multiple lacerations and fractures. The larvae, in various stages of development, were identified as those of Megaselia scalaris (Diptera: Phoridae). Since the presence of larvae in both patients was recorded after a stay of at least 3–4 days in the hospital, by definition, these infestations are considered nosocomial.
MOLECULAR EPIDEMIOLOGY OF MALARIA IN CAMEROON. XX. EXPERIMENTAL STUDIES ON VARIOUS FACTORS OF IN VITRO DRUG SENSITIVITY ASSAYS USING FRESH ISOLATES OF PLASMODIUM FALCIPARUM
Authors: BASCO LEONARDO K.
Published: September 2018

The influence of several factors on parasite growth and 50% inhibitory concentration (IC50) for chloroquine was assessed. Most isolates stored at 4°C up to 72 hours grew when they were subsequently cultivated. However, parasite viability sharply decreased from 24 hours, and the mean chloroquine IC50 decreased significantly (P < 0.05). There was no evidence for selection of pre-culture populations due to storage alone. The time point when 3H-hypoxanthine was added (0 versus 18 hours) had no effect on the IC50 during the 42-hour incubation, but was associated with a lower IC50 when 3H-hypoxanthine was added after the initial 42-hour incubation during the 72-hour incubation. An increase in 3H-hypoxanthine incorporation and chloroquine IC50 was observed as the hematocrit was increased from 1.0% to 2.5%. For the same isolates, chloroquine IC50 values were generally similar when the initial parasitemia was between 0.1% and 0.5% but increased at higher (>0.75%) parasitemias. Based on these results, we recommend immediate cultivation after blood collection, a 42-hour incubation period with the addition of 3H-hypoxanthine at the beginning of incubation, a 1.5% hematocrit, and an initial parasitemia 0.1-0.5%. Further studies on serum substitutes, gas mixture, and comparison of isotopic and non-isotopic assays are needed to establish a standardized in vitro assay protocol.
FACTORS INFLUENCING THE TRANSMISSION OF SCHISTOSOMA JAPONICUM IN THE MOUNTAINS OF SICHUAN PROVINCE OF CHINA
Authors: SPEAR ROBERT C. , SETO EDMUND , LIANG SONG , BIRKNER MERRILL , HUBBARD ALAN , QIU DONGCHUAN , YANG CHANGHONG , ZHONG BO , XU FASHEN , GU XUEGUANG , DAVIS GEORGE M.
Published: September 2018

Twenty villages in the Anning River Valley of southwestern Sichuan China were surveyed for Schistosoma japonicum infections in humans and domestic animals. Also surveyed were human water contact patterns, snail populations, cercarial risk in irrigation systems, and agricultural land use. Few animals were infected, while village prevalence of infection in humans ranged from 3% to 68% and average village eggs per gram of stool ranged from 0 to 110. Except for occupation and education, individual characteristics were not strong determinants of infection intensity within a village. Differences in human infection intensity between these villages are strongly associated with crop type, with low-intensity villages principally growing rice, in contrast to villages devoting more land to vegetables and tobacco. Cercarial risk in village irrigation systems is associated with snail density and human infection intensity through the use of manure-based fertilizer. Some of the agricultural and environmental factors associated with infection risk can be quantified using remote sensing technology.
SEASONAL VARIATION IN THE RISK AND CAUSES OF MATERNAL DEATH IN THE GAMBIA: MALARIA APPEARS TO BE AN IMPORTANT FACTOR
Authors: ANYA SAMUEL E.
Published: September 2018

An increase in maternal mortality risk during peak malaria transmission in endemic countries is thought to implicate malaria in maternal deaths. The purpose of this study was to evaluate changes in risk and causes of maternal death in relation to the malaria season at the main referral hospital in The Gambia. During the malaria season, there was a 168% increase in the maternal mortality ratio (MMR), a three-fold increase in the proportion of deaths due to anemia, and an eight-fold increase in the anemia MMR. Apart from a 5.4-fold increase in eclampsia, there was no significant change in the contribution of other causes of death. It is estimated that malaria may account for up to 93 maternal deaths per 100,000 live births.
BURULI ULCER DISEASE IN CAMEROON REDISCOVERED
Authors: NOESKE JÜRGEN , KUABAN CHRISTOPHER , RONDINI SIMONA , SORLIN PHILIPPE , CIAFFI LAURA , MBUAGBAW JOSEPHINE , PORTAELS FRANÇOISE , PLUSCHKE GERD
Published: September 2018

To assess the magnitude of the Buruli ulcer (BU) problem in Cameroon, we conducted a cross-sectional survey in the Nyong River basin and identified on clinical grounds a total of 436 cases of active or inactive BU (202 and 234, respectively). Swab specimens were taken from 162 active cases with ulcerative lesions and in 135 of these (83.3%) the clinical diagnosis was confirmed by the IS2404 polymerase chain reaction. Most lesions (93%) were located on the extremities, with lower limbs being twice as commonly involved as upper limbs. The age of patients with active BU ranged from 2 to 90 years with a median age of 14.5 years. Vaccination with bacilli Calmette-Guérin appeared to protect children against more severe forms of BU with multiple lesions. We conclude that in Cameroon BU is endemic, at least in the study area, and that a comprehensive control program for BU in Cameroon is urgently needed.
ANTIGEN-SPECIFIC ANTIBODY ISOTYPE PATTERNS TO SCHISTOSOMA JAPONICUM RECOMBINANT AND NATIVE ANTIGENS IN A DEFINED POPULATION IN LEYTE, THE PHILIPPINES
Authors: ACOSTA LUZ P. , MCMANUS DONALD P. , ALIGUI GEMILIANO DL. , OLVEDA REMIGIO M. , TIU WILFRED U.
Published: September 2018

We describe antibody isotype patterns resulting from Schistosoma japonicum infection among 155 individuals 5–76 years old from a community in Leyte, The Philippines. Their exposure, infection, and reinfection status had been observed in a previously described water contact study used to categorically classify them as putative resistant or susceptible individuals. Antigens tested for specific antibody isotype responses were soluble worm antigen preparation (SWAP) and soluble egg antigen (SEA) and a panel of recombinant molecules. The study was aimed primarily at evaluating antigen-specific antibody responses and their potential in inducing protection among putative resistant individuals. Specific antibody responses suggestive of an involvement in protection were an IgE response to SWAP among females less than 20 years of age (5–19) and IgA responses to SWAP in the younger (5–19 years) age groups. Compatible with other studies on human schistosomes, IgM reactivities to SWAP and SEA in the 5–19-year-old age group predicted susceptibility as did IgG4 responses to recombinant paramyosin.
SHORT REPORT: LETHAL MALARIA IN CYTOSOLIC PHOSPHOLIPASE A2- AND PHOSPHOLIPASE A2IIA-DEFICIENT MICE
Authors: ISHIKAWA SHUMPEI , UOZUMI NAONORI , SHIIBASHI TAKASHI , IZUMI TAKASHI , FUKAYAMA MASASHI , SHIMIZU TAKAO , WATANABE JUNICHI , NOGAMI SADAO
Published: September 2018

Lipid mediators play important roles in the pathogenesis of malaria. Phospholipase A2s are enzymes involved in the production of these mediators, and they function in inflammation. Among them, cytosolic phospholipase A2 (cPLA2) is a key enzyme in the metabolism of arachidonic acid, the first intermediate in the production of lipid mediators. Plasmodium berghei ANKA causes cerebral malaria in CL57B/6 mice, and we recently produced cPLA2-deficient mice with this background. With the expectation of reduced pathogenicity, we performed experimental infection in these mice. Unexpectedly, the infected mice developed cerebral malaria and died at the same time as the control mice, while the parasitemia progressed similarly in both groups. These observations suggest that secretory PLA2s rather than cPLA2 may be involved in the aggravation, although possible compensation by the induction of other enzymes has not been excluded. The present findings are expected to help clarify the involvement of various phospholipase A2s in malaria.
SHORT REPORT: HIGH INCIDENCE OF SHIGELLOSIS AMONG PERUVIAN SOLDIERS DEPLOYED IN THE AMAZON RIVER BASIN
Authors: JONES FRANCA R. , SANCHEZ JOSE L. , MEZA RINA , BATSEL TANIS M. , BURGA ROSA , CANAL ENRIQUE , BLOCK KARLA , PEREZ JUAN , BAUTISTA CHRISTIAN T. , ESCOBEDO JORGE , WALZ STEPHEN E.
Published: September 2018

We investigated the etiology of acute diarrhea among Peruvian military recruits undergoing three months of basic combat training near the Amazonian city of Iquitos. From January through September 2002, 307 of 967 recruits were seen at the Health Post for diarrhea (attack rate [AR] = 31.8%, incidence = 1.28 95% confidence interval [CI] = 1.14–1.43] episodes/person-year). Shigella spp. were the most common bacterial pathogen recovered from recruits experiencing diarrhea episodes. These bacteria were isolated from 89 (40%) of 225 diarrheal stools examined (AR = 7.6%, incidence = 0.30 [95% CI = 0.24–0.38] episodes/person-year). Most (83 of 90; 92%) of the Shigella isolates were S. flexneri, of which 57 (69%) were serotype 2a. Seventy-six percent of Shigella isolates were resistant to sulfamethoxazole/trimethoprim and all were sensitive to ciprofloxacin. Peruvian soldiers may be an excellent population in which to test the efficacy of S. flexneri vaccines in advanced development.
HIGH SEROPREVALENCE OF HANTAVIRUS INFECTION ON THE AZUERO PENINSULA OF PANAMA
Authors: ARMIEN BLAS , PASCALE JUAN MIGUEL , BAYARD VICENTE , MUNOZ CARLOS , MOSCA ITZA , GUERRERO GLADIS , ARMIEN ANIBAL , QUIROZ EVELIA , CASTILLO ZOILA , ZALDIVAR YAMIZEL , GRACIA FERNANDO , HJELLE BRIAN , KOSTER FREDERICK
Published: September 2018

The first outbreak of hantavirus pulmonary syndrome (HPS) in Central America was documented on the Azuero peninsula of Panama in late 1999 and 2000. Reverse transcriptase–polymerase chain reaction evidence implicated only Choclo virus in symptomatic HPS with a mortality rate of 20%, although two rodent-borne hantaviruses (Choclo virus and Calabazo virus) were identified in the peridomestic habitat. Neighborhood serosurveys around case households found seroprevalence rates as high as 30%, the highest in the Americas except for western Paraguay. We report here population-based serosurveys for 1,346 adults and children in four communities, three on the Azuero peninsula and one in adjacent central Panama. Overall seroprevalence ranged from 33.2% in a population engaged in farming and fishing on Isla de Cañas, to 16.3% and 21.2% in two mainland agricultural communities, to 3.1% in central Panama, with a modest male predominance of 1.2:1. Nine percent of children 4–10 years old were seropositive, and seroprevalence increased with age in all communities, with highest levels of 52% in those 41–50 years old cohort on Isla de Cañas. Univariate analysis identified correlations between seroprevalence and multiple agricultural and animal husbandry activities. However, stepwise logistic regression models identified only raising animals (cows, pigs, goats, poultry) and fishing as significant independent variables. Human infection with hantavirus on the Azuero peninsula, either with Choclo virus or combined with Calabazo virus, is frequent but rarely results in hospitalization due to respiratory illnesses resembling HPS.
HEMATOLOGIC AND CLINICAL INDICES OF MALARIA IN A SEMI-IMMUNE POPULATION OF WESTERN THAILAND
Authors: ERHART LAURA M. , YINGYUEN KRITSANAI , CHUANAK NIPHON , BUATHONG NILAWAN , LAOBOONCHAI ANINTITA , MILLER R. SCOTT , MESHNICK STEVEN R. , GASSER ROBERT A. , WONGSRICHANALAI CHANSUDA
Published: September 2018

This study examines hematologic profiles of persons with acute Plasmodium falciparum or P. vivax infection in Maesod on Thailand’s western border with Myanmar compared with febrile, non-parasitemic persons also reporting to malaria clinics. Nine hundred seventy-nine subjects were malaria-negative, 414 were infected with P. falciparum, and 646 were infected with P. vivax. Persons with patent parasitemia tended to have significantly lower white blood cell, red blood cell, platelet, and hemoglobin levels than those who were malaria-negative. For the first time, a parallel trend in thrombocytopenia with parasitemia was found to be associated with both P. falciparum, and P. vivax infection. Using logistic regression, persons with platelet counts < 150,000/μL were 12–15 times more likely to have malaria than persons with platelet counts ≥ 150,000/μL. This study supplements previous literature on the hematologic effects of malaria and helps define those alterations for a semi-immune population. Thrombocytopenia is identified as a key indicator of malaria in these febrile patients.
SEQUENTIAL CHANGES OF SERUM AMINOTRANSFERASE LEVELS IN PATIENTS WITH SEVERE ACUTE RESPIRATORY SYNDROME
Authors: WU KENG-LIANG , LU SHENG-NAN , CHANGCHIEN CHI-SIN , CHIU KING-WAH , KUO CHUNG-HUANG , CHUAH SENG-KEE , LIU JIEN-WEI , LIN MENG-CHIH , ENG HOCK-LIEW , CHEN SHUN-SHENG , LEE CHUAN-MO , CHEN CHAO-LONG
Published: September 2018

Severe acute respiratory syndrome (SARS) is a newly emerging infectious disease. To describe the hepatic injury caused by this disease, we report the sequential changes of serum transaminase in probable SARS patients during a hospital outbreak in southern Taiwan. From April to June, 2003, 52 probable SARS patients were hospitalized. Serial serum aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels were retrospectively analyzed and hepatitis B surface antigen (HBsAg) was also evaluated to correlate with the progression of this disease. Fifty-three percent of the patients had abnormal liver function during hospitalization. More than 70% of abnormal transaminase levels were mildly elevated. Most elevated levels were noted during the second week after onset of fever. Neither transaminase elevation nor HBsAg was related to the prognosis of SARS, and only advanced age was an independent predictor of poor outcome. Our study suggested that coronavirus causing SARS might induce liver damage.
PROVIDING PRACTICAL ESTIMATES OF MALARIA BURDEN FOR HEALTH PLANNERS IN RESOURCE-POOR COUNTRIES
Authors: AGYEPONG IRENE AKUA , KANGEYA-KAYONDA JANE
Published: September 2018

In many countries in sub-Saharan Africa, estimates of malaria occurrence used by health planners at all levels are based on data from formal sector health facilities. Since the majority of fever episodes are treated at home and within the community, the burden estimates obtained this way are the tips of the iceberg. A case study from Ghana comparing household data on acute morbidity and treatment-seeking behavior in two districts with health facility data is used as an illustration. For every case of febrile illness seen in the health facilities, there were approximately 4-5 in the community. Many sub-Saharan African countries recommend that all febrile episodes, especially in children, be treated with an antimalarial. Since several countries extend malaria treatment to include the community and the home through public and private, formal and informal sectors, the need for more comprehensive burden estimates becomes urgent.
GENETIC COMPLEXITY OF PLASMODIUM FALCIPARUM IN TWO ETHNIC GROUPS OF BURKINA FASO WITH MARKED DIFFERENCES IN SUSCEPTIBILITY TO MALARIA
Authors: PAGANOTTI GIACOMO M. , BABIKER HAMZA A. , MODIANO DAVID , SIRIMA BIENVENU S. , VERRA FEDERICA , KONATÉ AMADOU , OUÉDRAOGO ANDRÉ L. , DIARRA AMIDOU , MACKINNON MARGARET J. , COLUZZI MARIO , WALLIKER DAVID
Published: September 2018

We have characterized Plasmodium falciparum genotypes among the Mossi and Fulani sympatric ethnic groups in villages in Burkina Faso during the rainy season. Differences in clinical malaria presentation and in immune responses to malaria occur between the two groups. Asexual parasite rate, density, and gametocyte rate were higher among the Mossi than the Fulani. There was no difference in frequencies of alleles of the P. falciparum merozoite surface protein 1 (msp-1), msp-2, and glutamate-rich protein (glurp) genes among the parasites in each group. However, there were significant differences in the mean number of P. falciparum clones in the two populations, with there being more in the Mossi than in the Fulani. This effect was especially marked in older children. These differences can most probably be attributed to genetic differences in immune responsiveness to malaria between the two ethnic groups.
SEROEPIDEMIOLOGY OF TOXOCARA CANIS INFECTION AMONG MOUNTAIN ABORIGINAL ADULTS IN TAIWAN
Authors: FAN CHIA-KWUNG , LAN HUNG-SHUE , HUNG CHIEN-CHING , CHUNG WEN-CHENG , LIAO CHIEN-WEI , DU WEN-YUAN , SU KUA-EYRE
Published: September 2018

Seroepidemiology of Toxocara canis infection among adults of one ethnic Han and five aboriginal populations residing in mountainous areas of Taiwan was conducted by detecting serum IgG (≥1:64) using a T. canis larval excretory-secretory antigen-based enzyme-linked immunosorbent assay. A short questionnaire interview was conducted to obtain data concerning their age, sex, occupation, consumption of raw pig liver, and possession of dogs. The overall seroprevalence (46.0%, 247 of 537) in the five aboriginal populations was significantly higher than that of ethnic Han population (30.2%, 13 of 43) (P = 0.04). Age, but not sex, seemed to be a factor related to positive serology. Aboriginal adults who had histories of eating raw pig liver (odds ratio [OR] = 1.65, P < 0.01), raising dogs (OR = 1.76, P < 0.01), or whose occupation was a laborer (OR = 1.78, P < 0.01) seemed to be more apt to be infected by T. canis than those without such histories and unemployed persons.
RELATIONSHIP OF ANTI-MICROBIAL ACTIVITY OF TETRACYCLINES TO THEIR ABILITY TO BLOCK THE L3 TO L4 MOLT OF THE HUMAN FILARIAL PARASITE BRUGIA MALAYI
Authors: RAJAN T. V.
Published: September 2018

The nematode parasites Wuchereria bancrofti, Brugia malayi, and B. timori cause a human disease known as lymphatic filariasis, which afflicts approximately 120 million people worldwide. These organisms are known to contain endosymbiotic bacteria (Wolbachia) that are related to rickettsiae. It has been previously reported that tetracycline blocks the L3 to L4 molt of the filarial parasite B. malayi, and suggested that this was related to their known anti-rickettsial activity. However, this interpretation was tempered by several observations. First, Wolbachia DNA could still be detected in nematodes from tetracycline-treated cultures. In addition, chloramphenicol, which has anti-rickettsial and anti-chlamydial activity, failed to inhibit the molt. These observations could not rule out the possibility that the anti-molting activity of tetracycline is due to pharmacologic activities unrelated to its anti-rickettsial functions. This study shows that chemically modified tetracycline, which does not to have anti-microbial activity, also blocks molting.
TYING UP LIONS: MULTILATERAL INITIATIVE ON MALARIA COMMUNICATIONS: THE FIRST CHAPTER OF A MALARIA RESEARCH NETWORK IN AFRICA
Authors: ROYALL JULIA , BENNETT MARK , VAN SCHAYK INGEBORG , ALILIO MARTIN
Published: September 2018

“When spider webs unite, they can tie up a lion” (Ethiopian folk adage). The Multilateral Initiative on Malaria Communications Network (MIMCom) facilitates a new way of doing research in Africa and African scientists’ participation in the international scientific community. The MIMCom supports full access to the Internet and the resources of the WorldWide Web at 19 research sites in 11 African countries. Furthermore, the MIMCom project comprises two websites: one includes links to resources, databases, and publications as well as a document delivery service for full text journal articles, and the other is a research agenda specific website with a server for a research network desiring to share raw data. Other important components of MIMCom are training and evaluation components. The MIMCom was conceived in 1997 by African researchers and has been designed, implemented, and overseen by the U.S. National Library of Medicine in collaboration with partners in Africa, the United States, and the United Kingdom. This project demonstrates clearly that it can make a positive difference in the functioning of remote research sites in Africa, in terms of site growth and productivity and in the professional lives of individual researchers. This report reviews the project’s background, methods of operation with an emphasis on local needs and priorities, cost effectiveness, and local responsibility; results focusing on a technical network; documentation of the system and two-way exchange of information; the MIMCom website; a network approach to research; and financial sustainability. The report concludes with summaries of evaluations by an independent panel, the Multilateral Initiative on Malaria Secretariat, and the U.S. National Library of Medicine.
BURULI ULCER AND SCHISTOSOMIASIS: NO ASSOCIATION FOUND
Authors: STIENSTRA YMKJE , VAN DER WERF TJIP S. , VAN DER GRAAF WINETTE T. A. , SECOR W. EVAN , KIHLSTROM STACEY L. , DOBOS KAREN M. , ASAMOA KWAME , QUARSHI ERIC , ETUAFUL SAMUAL N. , KLUTSE ERASMUS Y. , KING C. HAROLD
Published: September 2018

Helminth infections elicit an immune response potentially enhancing susceptibility to mycobacterial diseases. Schistosomiasis and infection with Mycobacterium ulcerans show a remarkable similarity in epidemiologic characteristics in Ghana. In 2000, a case-control study was conducted in three districts in Ghana endemic for M. ulcerans. One hundred six patients with confirmed M. ulcerans disease and 106 matched community controls were included. Schistosome infection of these patients and controls was measured by an enzyme-linked immunosorbent assay that detected circulating anodic antigen in serum. Fifty percent of the participants tested positive for schistosomiasis. There was no difference in detection rates among patients and matched controls. Similarly, there were no differences in worm burden between patients and controls. These results do not support the hypothesis that susceptibility to M. ulcerans disease is driven by a co-infection with schistosomes.
PORCINE ANTIBODY RESPONSES TO TAENIA SOLIUM ANTIGENS RGP50 AND STS18VAR1
Authors: HANDALI SUKWAN , GONZALEZ ARMANDO E. , HANCOCK KATHY , GARCIA HECTOR H. , ROBERTS JACQUELIN M. , GILMAN ROBERT H. , TSANG VICTOR C. W.
Published: September 2018

Cysticercosis, a disease caused by the larval form of Taenia solium, is diagnosed by detection of specific antibodies or by imaging techniques. Our preferred immunologic assay for cysticercosis is the enzyme-linked immunoelectrodifusion transfer blot, or immunoblot, using the lentil lectin bound antigens from larval cysts. Antibody reactivity with any one of seven glycoproteins is diagnostic for cysticercosis. To develop a simple antibody detection assay for field use, we have synthesized an 8-kD diagnostic antigen, sTs18var1 (a secreted protein with a mature size of 67 amino acids), and expressed a 50-kD membrane protein antigen, rGp50. We used these two diagnostic proteins in a quantitative Falcon assay screening test–enzyme-linked immunosorbent assay (FAST-ELISA) to measure the antibody responses in Peruvian pigs with cysticercosis. Three study designs were used. First, we followed the kinetics of antibody responses against these two diagnostic proteins in pigs with cysticercosis that were treated with oxfendazole. Second, we measured antibody response in naive experimentally infected pigs. Third, we followed the maternal antibodies against rGp50 and sTs18var1 in piglets born from sows with cysticercosis. These studies showed that antibody responses against the two diagnostic proteins in the FAST-ELISA are quantitatively correlated with infection by viable cysts, with anti-sTs18var1 activity being most responsive to the status of infection.
SHORT REPORT: ENDEMIC FOCUS OF CYSTIC ECHINOCOCCOSIS IN A COASTAL CITY OF PERU
Authors: MORO PEDRO L. , LOPERA LUIS , CABRERA MILAGROS , CABRERA GRACE , SILVA BERNABE , GILMAN ROBERT H. , MORO MANUEL H.
Published: September 2018

No evidence of Echinococcus granulosus infection has been described in the coastal region of Peru, with the exception of the capital city of Lima. Anecdotal evidence suggests the existence of a focus of echinococcosis in the coastal city of Chincha, located south of Lima. We conducted a preliminary epidemiologic study in Chincha, which included an ultrasound, chest radiography, and serologic survey of abattoir workers, a review of medical records from local hospitals, and examination of the intestines of stray dogs to determine the presence of canine echinococcosis. Among 25 abattoir workers examined for the presence of cystic echinococcosis, we found three (12%) subjects with echinococcal cysts. A review of medical records showed a surgical incidence of 32/100,000 for the period 1996–1998. Three of 48 dogs (6.25%) were found to be infected with E. granulosus tapeworms. This study demonstrates the existence of an undocumented endemic focus of E. granulosus previously unknown in the coastal region of Peru.
LARGE-SCALE CANDIDATE GENE STUDY OF LEPROSY SUSCEPTIBILITY IN THE KARONGA DISTRICT OF NORTHERN MALAWI
Authors: FITNESS JODENE , FLOYD SIAN , WARNDORFF DAVID K. , SICHALI LIFTED , MWAUNGULU LORREN , CRAMPIN AMELIA C. , FINE PAUL E. M. , HILL ADRIAN V. S.
Published: September 2018

We present a large case-control candidate gene study of leprosy susceptibility. Thirty-eight polymorphic sites from 13 genes were investigated for their role in susceptibility to leprosy by comparing 270 cases with 452 controls in Karonga district, northern Malawi. Homozygotes for a silent T→C change in codon 352 of the vitamin D receptor gene appeared to be at high risk (odds ratio [OR] = 4.3, 95% confidence interval [CI] = 1.6–11.4, P = 0.004), while homozygotes for the McCoy b blood group defining variant K1590E in exon 29 of the complement receptor 1 (formerly CD35) gene appeared to be protected (OR = 0.3, 95% CI = 0.1–0.8, P = 0.02). Borderline evidence for association with leprosy susceptibility was found for seven polymorphic sites in an additional six genes. Some of these apparent associations may be false-positive results from multiple comparisons, and several associations suggested by studies in other populations were not replicated here. These data provide evidence of inter-population heterogeneity in leprosy susceptibility.
THE CONTRIBUTION OF MALARIA IN PREGNANCY TO PERINATAL MORTALITY
Authors: VAN GEERTRUYDEN JEAN-PIERRE , THOMAS FLORENCE , ERHART ANNETTE , D’ALESSANDRO UMBERTO
Published: September 2018

The link between malaria and perinatal mortality was explored by systematically reviewing 117 studies published between 1948 and 2002. The mean perinatal mortality rate was higher in malaria endemic countries (61.1/1,000, 95% confidence interval [CI] = 52.1–70.1) than in non-endemic countries (25.8/1,000, 95% CI = 21.1–30.6). Similarly, the fetal mortality rate was higher in endemic countries (40.1/1,000, 95% CI = 32.1–48.0) than in non-endemic countries (20.0/1,000, 95% CI = 13.2–26.8) countries. Considering that perinatal mortality is an important indicator of obstetric care quality and socioeconomic development, further analysis was restricted to countries with a human development index between 500 and 800. In this category, the perinatal mortality rate was also significantly higher in endemic countries (50.5/1,000, 95% CI = 35.5–65.5) than in non-endemic countries (30.0/1,000, 95% CI = 25.7–34.3). In some publications, the occurrence of placental malaria and stillbirth was available. Placental malaria was significantly associated with a higher risk for stillbirth, regardless of parity (odds ratio = 2.19, 95% CI = 1.49–3.22, P < 0.001). Despite the limitations involved in this kind of review, all information found indicates that in endemic countries, malaria is an important determinant of perinatal mortality. Preventive measures such as intermittent preventive treatment or insecticide-treated bed nets could substantially reduce perinatal mortality and fetal wastage.
CONTAMINATION OF HAND WASH DETERGENT LINKED TO OCCUPATIONALLY ACQUIRED MELIOIDOSIS
Authors: GAL DANIEL , MAYO MARK , SMITH-VAUGHAN HEIDI , DASARI PALLAVE , MCKINNON MELITA , JACUPS SUSAN P. , URQUHART ANDREW I. , HASSELL MARILYN , CURRIE BART J.
Published: September 2018

Two mechanics working at a garage in tropical northern Australia simultaneously developed upper limb melioidosis ulcers. Both patients had Burkholderia pseudomallei of identical pulsed-field gel electrophoresis (PFGE) type (Spe I). Environmental sampling identified B. pseudomallei in a container of commercial hand wash detergent as the likely source of infection, although there were multiple isolates of different PFGE types to the clinical isolates.
TRAVEL HISTORIES AS RISK FACTORS IN THE ANALYSIS OF URBAN MALARIA IN COLOMBIA
Authors: OSORIO LYDA , TODD JIM , BRADLEY DAVID J.
Published: September 2018

Self-reported travel histories were used in a case-control study to determine whether movement of local residents to neighboring endemic areas was a risk factor for malaria in the town of Quibdo, Colombia. Multivariate analyses showed that among residents of Quibdo, traveling to an endemic area 8–14 days before disease onset was the strongest risk factor for both Plasmodium falciparum (adjusted odds ratio [OR] = 28.96, 95% confidence interval [CI] = 13.9–60.32) and P. vivax (adjusted OR = 14.24, 95% CI = 5.27–38.46) malaria. For P. falciparum, individuals who did not travel outside Quibdo during the 8–14 days before disease onset, but who reported traveling 1–7, 15–21, or 22–30 days before disease onset also had an increased risk of malaria. Conversely, use of protection against mosquitoes was negatively associated with P. falciparum. These results highlight the need for malaria control measures that target mobile populations. A definition of imported malaria that allows distinction of imported from autochthonous cases in Quibdo town is proposed.
SHORT REPORT: FLUORESCENT LEISHMANIA: APPLICATION TO ANTI-LEISHMANIAL DRUG TESTING
Authors: SINGH NEELOO , DUBE ANURADHA
Published: September 2018

Classic techniques for detecting the susceptibility of Leishmania to different drugs are time-consuming, laborious, and require the use of macrophages. The use of flow cytometry for monitoring Leishmania susceptibility to drugs is beginning to be implemented. Using green fluorescent protein (GFP), we have improved and simplified the screening procedure. We introduced a GFP marker into field strains of Leishmania causing kala-azar (visceral leishmaniasis) and explored the suitability of transgenic L. donovani promastigotes that constitutively express GFP in their cytoplasm as target cells for in vitro screening of anti-leishmanial drugs.
COMMUNITY-WIDE REDUCTION IN PREVALENCE AND INTENSITY OF INTESTINAL HELMINTHS AS A COLLATERAL BENEFIT OF LYMPHATIC FILARIASIS ELIMINATION PROGRAMS
Authors: DE ROCHARS MADSEN BEAU , DIRENY ABDEL N. , ROBERTS JACQUELIN M. , ADDISS DAVID G. , RADDAY JEANNE , BEACH MICHAEL J. , STREIT THOMAS G. , DARDITH DESIRE , LAFONTANT JACK GUY , LAMMIE PATRICK J.
Published: September 2018

Annual mass treatment with antifilarial drugs is the cornerstone of the global program to eliminate lymphatic filariasis (LF). Although the primary goal of the program is to interrupt transmission of LF, additional public health benefits also are expected because of the known anthelminthic properties of these drugs. Since rapid re-infection with intestinal helminths occurs following treatment, annual de-worming may not be sufficient to produce a lasting reduction in the prevalence and intensity of these infections. We conducted stool examinations in four sentinel communities before and approximately nine months after each of two rounds of mass drug administration (MDA) with diethylcarbamazine and albendazole in the context of an LF elimination program in Leogane, Haiti. At baseline, overall Ascaris, Trichuris, and hookworm infection prevalences were 20.9%, 34.0%, and 11.2%, respectively (n = 2,716 stools). Nine months after the second MDA, Ascaris, Trichuris and hookworm prevalences had decreased significantly, to 14.1%, 14.6%, and 2.0%, respectively (n = 814 stools). Infection intensity decreased significantly for all three parasites as well. These results demonstrate that substantial reductions in intestinal helminth infections are associated with mass treatment of filariasis in Haiti and are consistent with the conclusion that high levels of coverage for the LF program can decrease transmission of geohelminths.
RISK FACTORS FOR HUMAN ANTHRAX AMONG CONTACTS OF ANTHRAX-INFECTED LIVESTOCK IN KAZAKHSTAN
Authors: WOODS CHRISTOPHER W. , OSPANOV KENES , MYRZABEKOV AKYLBEK , FAVOROV MICHAEL , PLIKAYTIS BRIAN , ASHFORD DAVID A.
Published: September 2018

A retrospective cohort analysis was conducted in Kazakhstan to define modifiable risk factors during seven outbreaks of human anthrax. Fifty-three cases and 255 non-ill persons with an epidemiologic link to an infected animal were enrolled. Cases were 58% male and had a median age of 35 years (range = 5–71). Nearly all cases had cutaneous disease (96%). Two patients (4%) were diagnosed with gastrointestinal disease. Although all cases had some contact with an infected animal other than consumption, in multivariable analysis the act of butchering an animal (relative risk [RR] = 3.6, 95% confidence interval [CI] = 1.5–9.6) and the presence of visible cuts on the hands were associated with anthrax (RR = 3.0, 95% CI = 0.9–9.6). Contact with infected livestock, in particular butchering, is associated with developing anthrax. The risk may be exacerbated by the presence of cuts on the hands at the time of contact with the animal or animal products.