bluuebunny/crossref_metadata_2025 huggingface dataset:
Malaria and Hepatocystis Species in Wild Macaques, Southern Thailand
Authors: Seethamchai Sunee , Putaporntip Chaturong , Malaivijitnond Suchinda , Cui Liwang , Jongwutiwes Somchai
Published: September 2018

Southeast Asian macaques are natural hosts for a number of nonhuman primate malaria parasites; some of these can cause diseases in humans. We conducted a cross-sectional survey by collecting 99 blood samples from Macaca fascicularis in southern Thailand. Giemsa-stained blood films showed five (5.1%) positive samples and six (6.1%) isolates had positive test results by polymerase chain reaction. A phylogenetic tree inferred from the A-type sequences of the small subunit ribosomal RNA gene confirmed Plasmodium inui in five macaques; one of these macaques was co-infected with P. coatneyi. Hepatocystis, a hemoprotozoan parasite transmitted by Culicoides, was identified in an isolate that was confirmed by analysis of mitochondrial cytochrome b sequences. All malaria-infected monkeys lived in mangrove forests, but no infected monkeys were found in an urban area. These findings indicate regional differences in malaria distribution among these macaques, as well as differences in potential risk of disease transmission to humans.
Combining Mosquito Vector and Human Disease Data for Improved Assessment of Spatial West Nile Virus Disease Risk
Authors: Winters Anna M. , Bolling Bethany G. , Beaty Barry J. , Blair Carol D. , Eisen Rebecca J. , Meyer Andrew M. , Pape W. John , Moore Chester G. , Eisen Lars
Published: September 2018

Assessments of spatial risk of exposure to vector-borne pathogens that combine vector and human disease data are needed for areas encompassing large tracts of public land with low population bases. We addressed this need for West Nile virus (WNV) disease in the northern Colorado Front Range by developing not only a spatial model for entomological risk of exposure to Culex tarsalis WNV vectors and an epidemiological risk map for WNV disease but also a novel risk-classification index combining data for these independently derived measures of entomological and epidemiological risk. Risk of vector exposure was high in the densely populated eastern plains portion of the Front Range but low in cooler montane areas to the west that are sparsely populated but used heavily for recreation in the summer. The entomological risk model performed well when applied to the western, mountainous part of Colorado and validated against epidemiologic data.
Choclo Virus Infection in the Syrian Golden Hamster
Authors: Eyzaguirre Eduardo J. , Milazzo Mary Louise , Koster Frederick T. , Fulhorst Charles F.
Published: September 2018

Andes virus and Choclo virus are agents of hantavirus pulmonary syndrome. Andes virus in hamsters almost always causes a disease that is pathologically indistinguishable from fatal hantavirus pulmonary syndrome. The purpose of this study was to assess the pathogenicity of Choclo virus in hamsters. None of 18 hamsters infected with Choclo virus exhibited any symptom of disease. No evidence of inflammation or edema was found in the lungs of the 10 animals killed on days 7, 9, 11, 13, and 16 post-inoculation or in the lungs of the 8 animals killed on day 28 post-inoculation; however, hantavirus antigen was present in large numbers of endothelial cells in the microvasculature of the lungs of the animals killed on days 7, 9, 11, and 13 post-inoculation. These results suggest that infection in the microvasculature of lung tissue alone does not result in the life-threatening pulmonary edema in hamsters infected with Andes virus.
Management of Travelers with Fever and Exanthema, Notably Dengue and Chikungunya Infections
Authors: Hochedez Patrick , Canestri Ana , Guihot Amélie , Brichler Ségolène , Bricaire François , Caumes Eric
Published: September 2018

Febrile exanthema frequently presents as an acute condition in travelers. Sixty-two travelers who presented with febrile exanthema were prospectively included over a 20-month period. Diagnostic tests were performed according to clinical presentation and risk exposures. Symptoms occurred after return in 56% of these travelers, and the median interval between return and symptom onset was 2 days. The 3 main travel destinations were the Indian Ocean (35%), Africa (21%), and Asia (18%). The 3 main etiologies were chikungunya (35%), dengue (26%), and African tick bite fever (ATBF) (10%). Travel to the Indian Ocean and South Africa was significantly associated with respectively chikungunya and ATBF. Arthralgias were significantly more frequent in chikungunya than in dengue, whereas leucopenia, neutropenia, and thrombopenia were significantly more frequent in dengue. Travelers presenting with febrile exanthema should therefore be screened for arboviral infections according to the area visited.
Evaluation of the Impact of Overseas Pre-departure Treatment for Infection with Intestinal Parasites among Montagnard Refugees Migrating from Cambodia to North Carolina
Authors: Shah J. Jina , Maloney Susan A. , Liu Yecai , Flagg Elaine W. , Johnston Stephanie P. , Young Suzanna A. , Weston Robert , Merritt Samuel , Wilkins Patricia P. , Keane Vincent , Calderon Jaime , Sharp Donald J. , Causer Louise , Maguire James H. , Cetron Martin S.
Published: September 2018

We evaluated the effectiveness of an overseas pre-departure regimen of five days of albendazole for presumptive treatment of intestinal parasites by examining stool specimens in treated and untreated Montagnard refugees after arrival in the United States. Among 815 refugees evaluated, fully treated refugees had a significantly lower prevalence of helminths (11 [1.4%] of 777), specifically hookworm and Ascaris lumbricoides, than untreated pregnant women (3 [20%] of 15) (P < 0.001). Multivariate analysis showed that treatment was associated with significantly lower rates of infection with helminths but not protozoa. Post-arrival gastrointestinal symptoms were not associated with findings on stool examination. Our evaluation suggests that although additional studies are needed to determine optimal treatment regimens for intestinal parasites, especially among young children and pregnant women, a five-day course of pre-departure albendazole was effective in reducing helminthic infection in treated refugees.
Extensive Multiparasitism in a Village of Yunnan Province, People’s Republic of China, Revealed by a Suite of Diagnostic Methods
Authors: Steinmann Peter , Du Zun-Wei , Wang Li-Bo , Wang Xue-Zhong , Jiang Jin-Yong , Li Lan-Hua , Marti Hanspeter , Zhou Xiao-Nong , Utzinger Jürg
Published: September 2018

Intestinal multiparasitism, the accuracy of different diagnostic techniques, and the influence of sampling effort were studied among 215 individuals in a Bulang village, Yunnan province, People’s Republic of China. Behavioral, demographic, and socioeconomic data were obtained by questionnaire. Multiple stool specimens were examined by the Kato–Katz, Koga agar plate, Baermann, and ether–concentration methods. Eight helminth and 7 protozoa species were diagnosed. The prevalence of each of the 3 main soil-transmitted helminths (Ascaris lumbricoides, hookworm, and Trichuris trichiura) exceeded 85%. Blastocystis hominis was the most prevalent intestinal protozoan (20.0%). Over 80% of the individuals harbored 3 or more intestinal parasites concurrently. The infection intensities were predominantly light for hookworm and T. trichiura but moderate for A. lumbricoides. Examination of 3 instead of 1 stool specimen increased the sensitivity of helminth diagnosis, most notably for hookworm. Intestinal multiparasitism is rampant in this rural part of Yunnan province and calls for control measures.
Entomologic Investigations of a Chikungunya Virus Epidemic in the Union of the Comoros, 2005
Authors: Sang Rosemary C. , Ahmed Ouledi , Faye Ousmane , Kelly Cindy L. H. , Yahaya Ali Ahmed , Mmadi Ibrahim , Toilibou Ali , Sergon Kibet , Brown Jennifer , Agata Naftali , Yakouide Allarangar , Ball Mamadou D. , Breiman Robert F. , Miller Barry R. , Powers Ann M.
Published: September 2018

From January to April 2005, an epidemic of chikungunya virus (CHIKV) illness occurred in the Union of Comoros. Entomological studies were undertaken during the peak of the outbreak, from March 11 to March 31, aimed at identifying the primary vector(s) involved in transmission so that appropriate public health measures could be implemented. Adult mosquitoes were collected by backpack aspiration and human landing collection in homes and neighborhoods of clinically ill patients. Water-holding containers were inspected for presence of mosquito larvae. Adult mosquitoes were analyzed by RT-PCR and cultivation in cells for the presence of CHIK virus and/or nucleic acid. A total of 2,326 mosquitoes were collected and processed in 199 pools. The collection consisted of 62.8% Aedes aegypti, 25.5% Culex species, and 10.7% Aedes simpsoni complex, Eretmapodites spp and Anopheles spp. Seven mosquito pools were found to be positive for CHIKV RNA and 1 isolate was obtained. The single CHIKV mosquito isolate was from a pool of Aedes aegypti and the minimum infection rate (MIR) for this species was 4.0, suggesting that Ae. aegypti was the principal vector responsible for the outbreak. This was supported by high container (31.1%), household (68%), and Breteau (126) indices, with discarded tires (58.8%) and small cooking and water storage vessels (31.1%) registering the highest container indices.
Decreased Serum Paraoxonase-1 Activity during Intestinal Nematode (Nippostrongylus brasiliensis) Infection in Rats
Authors: Farid Ayman Samir , Nakahara Keiko , Murakami Noboru , Hayashi Toshiharu , Horii Yoichiro
Published: September 2018

Reduced paraoxonase-1 (PON1) activity has been observed in a number of pathological conditions; however, little is known about the effects of intestinal nematode infections, such as Nippostrongylus brasiliensis, on paraoxonase activity. We observed a significant reduction in serum paraoxonase and arylesterase activity after N. brasiliensis infection in Wistar rats from Day 6 until Day 12 post-infection (p.i.) for serum paraoxonase and from Day 3 until Day 24 p.i. for arylesterase. In addition, N. brasiliensis infection increased serum concentrations of pro-inflammatory cytokines (interleukin-1, interleukin-6, and tumor necrosis factor-α), with maximum concentrations observed on Day 9 p.i. These cytokines are known to inhibit the synthesis of hepatic PON1 mRNA. Thus, the observed reduction in PON1 activity during N. brasiliensis infection is likely associated with inflammatory reactions mounted against the parasites.
Inferring from the Cyt B Gene the Triatoma brasiliensis Neiva, 1911 (Hemiptera: Reduviidae: Triatominae) Genetic Structure and Domiciliary Infestation in the State of Paraíba, Brazil
Authors: Almeida Carlos Eduardo , Pacheco Raquel S. , Haag Karen , Dupas Stéphane , Dotson Ellen M. , Costa Jane
Published: September 2018

The Triatoma brasiliensis genetic structure was analyzed using the Cyt B gene in different geographic locations and ecotopes after a short and long period after insecticide treatment. Four different localities (16–40 km apart) in the state of Paraíba, Brazil, were sampled. Analysis of molecular variance (AMOVA) showed that grouping populations according to the geographic location or ecotope resulted in a higher variance among populations within groups (ΦSC ranging from 0.15 to 0.17) than among groups (ΦCT ranging from 0.04 to 0.07). The percentage of variation was reduced among populations within groups and increased among groups (ΦSC = 0.08, ΦCT = 0.16) by grouping 1) the domiciliary populations from each village and 2) all wild populations. These data indicated that T. brasiliensis is genetically structured both ecologically and at a smaller geographic scale for domiciliary populations. Re-infestations after insecticide treatment were composed of distinct populations, pointing to variable population sources for domiciliary infestations.
Dengue Hemorrhagic Fever Complicated with Acute Idiopathic Scrotal Edema and Polyneuropathy
Authors: Chen Tun-Chieh , Lu Po-Liang , Chen Yen-Hsu , Tsai Jih-Jin , Chen Tyen-Po
Published: September 2018

We report a case of an adult with dengue hemorrhagic fever who developed acute idiopathic scrotal edema and glove-and-stocking polyneuropathy. A 54-year-old man who had fever, chills, bone pain, and skin rash for 4 days was admitted. We diagnosed dengue hemorrhagic fever because of fever, gum bleeding, thrombocytopenia, and hemoconcentration, and confirmed the diagnosis by serology. The patient had scrotal and penile edema and distal limb numbness with a glove-and-stocking distribution. After supportive care, the scrotal edema and other symptoms subsided. Patients with dengue hemorrhagic fever may develop scrotal edema caused by plasma leakage.
Fatal Diffuse Thrombotic Microangiopathy after a Bite by the “Fer-de-Lance” Pit Viper (Bothrops lanceolatus) of Martinique
Authors: Malbranque Stéphane , Piercecchi-Marti Marie Dominique , Thomas Laurent , Barbey Christophe , Courcier Dominique , Bucher Bernard , Ridarch Alex , Smadja Didier , Warrell David A.
Published: September 2018

In Martinique, a man bitten two days earlier by a pit viper (Bothrops lanceolatus) was hospitalized with impaired consciousness and tetraplegia. Investigations confirmed cerebral and myocardial infarctions. Resolving thrombocytopenia was associated with virtually normal blood prothrombin time/activated partial thromboplastin time but increasing hyperfibrinogenemia. Despite specific antivenom treatment, he developed fatal left ventricular failure six days after the bite. At autopsy, multiple cerebral, myocardial and mesenteric infarctions were found. Rupture of mitral chordae tendinae was the likely cause of death. Histopathologic examination showed multi-focal thrombotic microangiopathy with intimal-medial dissection by thrombi extending from foci of endothelial damage in small cerebral, myocardial, pulmonary, mesenteric, and interlobular renal arteries and arterioles. These findings were the causes of infarctions. There was intense angiogenesis in organizing cerebral infarcts. Immunohistochemical analysis showed platelet aggregates and endothelial cells within microthrombi. Viperidae venoms contain vascular endothelial toxins, notably metalloproteinase hemorrhagins, but von Willebrand factor activators or vascular endothelial growth factor–type factors are more likely to have been implicated in this case.
Septicemic Plague in a Community Hospital in California
Authors: Margolis David A. , Burns Joseph , Reed Sharon L. , Ginsberg Michele M. , O’Grady Terrence C. , Vinetz Joseph M.
Published: September 2018

Diagnosis of a case of septicemic plague acquired in rural California was delayed because of a series of confounding events, resulting in concern about reliance on community hospitals as sentinels for detecting potential bioterrorism-related events. An epizootic study confirmed the peridomestic source of Yersinia pestis infection.
Detection of the Dihydrofolate Reductase–164L Mutation in Plasmodium falciparum Infections from Malawi by Heteroduplex Tracking Assay
Authors: Juliano Jonathan J. , Trottman Paul , Mwapasa Victor , Meshnick Steven R.
Published: September 2018

Standard polymerase chain reaction methods often cannot detect drug-resistance mutations in Plasmodium falciparum infections if the mutation is present in ≤ 20% of the parasites. A heteroduplex tracking assay was developed that can detect dihydrofolate reductase 164-L mutations in variants representing 1% of the parasites in an individual host. Using this assay, we confirmed the presence of the mutation in P. falciparum infections in Malawi.
Co-existence of Integumentary Lesions and Lung X-ray Abnormalities in Patients with Paracoccidioidomycosis (PCM)
Authors: Restrepo Angela , Tobón Angela M. , Agudelo Carlos A. , Ochoa Juan E. , Rosero David S. , Osorio Marta L. , Cano Luz E. , Alvarez Diego L.
Published: September 2018

In paracoccidioidomycosis (PCM), the primary lung infection remains silent. In this study, attempts were done to define the primary target organ by correlating lung radiographic abnormalities with the time course of mucosal/skin lesions concurrently exhibited at diagnosis by 63 patients in whom microscopy and/or isolation of Paracoccidioides brasiliensis from respiratory secretions had been positive. Mucosal and skin lesions were found in 65.1% and 12.7% of the patients, respectively. Odynophagia and dysphagia were present in 38.1% each. All patients had lung interstitial infiltrates, and 31.7% had also alveolar lesions; fibrosis was recorded in 46% of them. An inverse correlation was shown for fibrosis and presence of either odynophagia or dysphagia. Cluster analyzes strongly supported two sets of patients: those with mucosal damage, odynophagia/dysphagia, and alveolo-interstitial infiltrates and those with dermal lesions, dyspnea, and lung fibrosis. These groups may represent novel stages in the natural course of PCM.
Clostridium difficile in Adult Patients with Nosocomial Diarrhea in a Costa Rican Hospital
Authors: Zumbado-Salas Roberto , del Mar Gamboa-Coronado María , Rodríguez-Cavallini Evelyn , Chaves-Olarte Esteban
Published: September 2018

Stool samples from 104 adult patients with nosocomial antibiotic–associated diarrhea were analyzed for Clostridium difficile by cultivation, toxin A inmunoenzymatic detection, and toxin B cytotoxic detection. The isolates were additionally screened for the toxin genes by polymerase chain reaction. C. difficile was isolated from 26 samples, and the toxins were directly detected in another 5 samples. Toxin A and B genes were detected in all toxigenic bacterial isolates. The detection rate of 30% indicates that C. difficile is a major etiologic agent of nosocomial diarrhea in Costa Rica.
Microscopy Underestimates the Frequency of Plasmodium Falciparum Infection in Symptomatic Individuals in a Low Transmission Highland Area
Authors: Menge David M. , Ernst Kacey C. , Vulule John M. , Zimmerman Peter A. , Guo Hongfei , John Chandy C.
Published: September 2018

In an area with unstable malaria transmission, detection of Plasmodium falciparum infection in 379 symptomatic individuals was assessed by microscopy and three polymerase chain reaction (PCR) methodologies. P. falciparum infection was detected in 25% of patients by microscopy, 37% by nested PCR, 41% by merozoite surface protein-2 (MSP-2) PCR, and 45% by a ligase detection reaction-fluorescent microsphere assay (LDR-FMA). Of the 64 individuals who were LDR-FMA positive, microscopy negative and did not receive treatment, 8 (12.5%) had persistent symptoms and returned for treatment. Malaria attributable fraction (MAF) in symptomatic individuals was 14.6% by microscopy (95% confidence interval [CI] = 6.6–21.8%) and 28.2% by nested PCR (95% CI = 17.9–37.2%). In this highland area, P. falciparum infection in symptomatic individuals is detected more frequently by PCR than microscopy, and most frequently by LDR-FMA. P. falciparum infection appears to resolve without treatment in most LDR-FMA-positive, microscopy-negative individuals, but is persistent in a subset of these individuals and requires treatment.
Effects of Plasmodium falciparum Mixed Infections on In Vitro Antimalarial Drug Tests and Genotyping
Authors: Liu Shengfa , Mu Jianbing , Jiang Hongying , Su Xin-zhuan
Published: September 2018

Studying drug resistance in Plasmodium falciparum requires accurate measurement of parasite response to a drug. Factors such as mixed infection of drug-resistant and -sensitive parasites can influence drug test outcome. Polymorphic DNA sequences are frequently used to detect mixed infections; infections with a single genotype or having a minor allele smaller than a subjectively selected cut-off value are often considered single infection. We studied the effects of mixed parasite populations containing various ratios of parasites resistant and sensitive to chloroquine on outcomes of drug tests and how ratios of parasite mixtures correlated with genotypes using polymerase chain reaction–based methods. Our results show that a mixture with a resistant population as low as 10% could greatly impact a drug test outcome. None of the genotyping methods could reliably detect minor DNA alleles at ≤ 10%. Mixed infection presents a serious problem for drug tests, and genotyping using microsatellite or other methods may not reliably reflect true ratios of alleles.
Enterocytozoon bieneusi Genotypes in Dogs in Bogota, Colombia
Authors: Santín Mónica , Vecino Jesús A. Cortés , Fayer Ronald
Published: September 2018

Enterocytozoon bieneusi was detected in dogs in Bogota, Colombia for the first time. Of 120 dogs, 15% were positive by polymerase chain reaction (PCR). Infected dogs ranged from 2 to 14 years of age, and more male than female dogs were infected with E. bieneusi (20% versus 5%). All PCR-positive specimens were sequenced and three genotypes were identified. A dog-specific genotype (PtEbIX) was identified in feces from 16 dogs. For two dogs, the nucleotide sequences obtained were genetically identical to the E. bieneusi Peru 5 and K genotypes previously reported as human pathogens. This is the first time that Peru 5 and K genotypes have been identified in dogs. This study confirms that dogs are infected with both human pathogenic and host-specific genotypes.
Aedes aegypti in Senegal: Genetic Diversity and Genetic Structure of Domestic and Sylvatic Populations
Authors: Huber Karine , Ba Yamar , Dia Ibrahima , Mathiot Christian , Sall Amadou A. , Diallo Mawlouth
Published: September 2018

Aedes aegypti is the main vector of dengue viruses. The epidemiology of dengue fever remains poorly understood in Senegal. A sylvatic transmission seems to predominate. However, despite the sylvatic circulation of the dengue virus and the presence of vectors in urban areas, only sporadic cases have been reported. Ae. aegypti is a polytypic species. In Senegal, a purely sylvatic form is found in the forest gallery areas and a domestic form is found in the villages in savannah and sahelian areas and in urban areas. Using allozymes, we analyzed the genetic diversity and the genetic structure of Ae. aegypti populations differing in their ecological characteristics. Populations from Senegal were significantly structured but with a low level of genetic differentiation. Ae. aegypti from the “domestic” populations show a decreased genetic diversity and a lower genetic differentiation compared with “sylvatic” populations. These findings suggest that environmental conditions, ecological factors, and human activities may impact the genetic structure of Ae. aegypti populations in Senegal.
Isolation and Identification of a Novel Spotted Fever Group Rickettsia, Strain IG-1, from Ixodes granulatus Ticks Collected on Orchid Island (Lanyu), Taiwan
Authors: Tsai Kun-Hsien , Wang Hsi-Chieh , Chen Chun-Hsien , Huang Jyh-Hsiung , Lu Hsiu-Ying , Su Chien-Ling , Shu Pei-Yun
Published: September 2018

A novel species of spotted fever group (SFG) rickettsia, Rickettsia spp. IG-1, was identified and isolated from adult Ixodes granulatus ticks collected from Orchid Island (Lanyu), an islet located in southeastern Taiwan. Serum samples collected from the rodent host Rattus losea and SFG-positive human serum reacted with IG-1 using an immunofluorescence assay (IFA). Pairwise nucleotide sequence analysis of 16S rRNA (rrs), gltA, ompA, ompB, and sca4 shows that IG-1 belongs to SFG rickettsiae and had the highest nucleotide sequence similarities to Rickettsia slovaca and R. sibirica. Phylogenetic analysis of the ompA, ompB genes and sca4 shows that IG-1 is most closely related to R. honei. The results showed the sequence divergence of this novel isolate from those rickettsiae previously characterized using the criteria proposed by Fournier and others. Whether IG-1 is pathogenic for humans remains to be studied.
The Effects of Midgut Serine Proteases on Dengue Virus Type 2 Infectivity of Aedes aegypti
Authors: Brackney Doug E. , Foy Brian D. , Olson Ken E.
Published: September 2018

Dengue viruses (DENV) cause significant morbidity and mortality worldwide and are transmitted by the mosquito Aedes aegypti. Mosquitoes become infected after ingesting a viremic bloodmeal, and molecular mechanisms involved in bloodmeal digestion may affect the ability of DENV to infect the midgut. We used RNA interference (RNAi) to silence expression of four midgut serine proteases and assessed the effect of each RNAi phenotype on DENV-2 infectivity of Aedes aegypti. Silencing resulted in significant reductions in protease mRNA levels and correlated with a reduction in activity except in the case of late trypsin. RNA silencing of chymotrypsin, early and late trypsin had no effect on DENV-2 infectivity. However, silencing of 5G1 or the addition of soybean trypsin inhibitor to the infectious bloodmeals significantly increased midgut infection rates. These results suggest that some midgut serine proteases may actually limit DENV-2 infectivity of Ae. aegypti.
Drug Use Careers and Blood-borne Pathogen Risk Behavior in Male and Female Tanzanian Heroin Injectors
Authors: Ross Michael W. , McCurdy Sheryl A. , Kilonzo G. P. , Williams Mark L. , Leshabari M. T.
Published: September 2018

Injection drug use in sub-Saharan Africa is a relatively new phenomenon that expands the repertoire of human immunodeficiency virus (HIV)–associated risk behaviors in Africa. We carried out a study of 537 injection drug users (56% men and 44% women) in Dar es Salaam, Tanzania, to examine their HIV risk behaviors and their drug-using careers that had culminated in injecting heroin. Data were collected in 2005–2006 using the Swahili version of the Tanzanian AIDS Prevention Project questionnaire. Marijuana, alcohol, and heroin were the first drugs reported for both men and women. Most drug milestones appeared in a similar order for men and women. Mandrax, khat, and injecting appeared close to one another in chronological time for both men and women, suggesting they were introduced into the country and appeared on the drug scene at about the same (real) time. Drug careers for women were shorter than for men, and time from first use of heroin to first injection was shorter for women. Years of injecting suggested that injecting had increased in males approximately five years prior to data collection, with males injecting earlier, but females being increasingly introduced to injecting in the previous two years. Injecting appears at a mean of five years (men) and three years (women) into their heroin-using career. Heroin use appears to occur in binges, with women being more likely to have sex during a binge. In this sample, more than 90% of women but only 2% of men reported ever trading sex for money. More than 90% of men and women reported using new needles for injection. These data confirm that heroin injecting is well established in large cities in east Africa, and that HIV prevention in the region must now include drug injectors and other drug users.
Local Drinking Water Filters Reduce Diarrheal Disease in Cambodia: A Randomized, Controlled Trial of the Ceramic Water Purifier
Authors: Brown Joe , Sobsey Mark D. , Loomis Dana
Published: September 2018

A randomized, controlled intervention trial of two household-scale drinking water filters was conducted in a rural village in Cambodia. After collecting four weeks of baseline data on household water quality, diarrheal disease, and other data related to water use and handling practices, households were randomly assigned to one of three groups of 60 households: those receiving a ceramic water purifier (CWP), those receiving a second filter employing an iron-rich ceramic (CWP-Fe), and a control group receiving no intervention. Households were followed for 18 weeks post-baseline with biweekly follow-up. Households using either filter reported significantly less diarrheal disease during the study compared with a control group of households without filters as indicated by longitudinal prevalence ratios CWP: 0.51 (95% confidence interval [CI]: 0.41–0.63); CWP-Fe: 0.58 (95% CI: 0.47–0.71), an effect that was observed in all age groups and both sexes after controlling for clustering within households and within individuals over time.
Determinants of Success in National Programs to Eliminate Lymphatic Filariasis: A Perspective Identifying Essential Elements and Research Needs
Authors: Kyelem Dominique , Biswas Gautam , Bockarie Moses J. , Bradley Mark H. , El-Setouhy Maged , Fischer Peter U. , Henderson Ralph H. , Kazura James W. , Lammie Patrick J. , Njenga Sammy M. , Ottesen Eric A. , Ramaiah Kapa D. , Richards Frank O. , Weil Gary J. , Williams Steven A.
Published: September 2018

The Global Programme to Eliminate Lymphatic Filariasis (GPELF) was launched in 2000. To understand why some national programs have been more successful than others, a panel of individuals with expertise in LF elimination efforts met to assess available data from programs in 8 countries. The goal was to identify: 1) the factors determining success for national LF elimination programs (defined as the rapid, sustained reduction in microfilaremia/antigenemia after repeated mass drug administration [MDA]); 2) the priorities for operational research to enhance LF elimination efforts.

Of more than 40 factors identified, the most prominent were 1) initial level of LF endemicity; 2) effectiveness of vector mosquitoes; 3) MDA drug regimen; 4) population compliance.

Research important for facilitating program success was identified as either biologic (i.e., [1] quantifying differences in vectorial capacity; [2] identifying seasonal variations affecting LF transmission) or programmatic (i.e., [1] identifying quantitative thresholds, especially the population compliance levels necessary for success, and the antigenemia or microfilaremia prevalence at which MDA programs can stop with minimal risk of resumption of transmission; [2] defining optimal drug distribution strategies and timing; [3] identifying those individuals who are “persistently non-compliant” during MDAs, the reasons for this non-compliance and approaches to overcoming it).

While addressing these challenges is important, many key determinants of program success are already clearly understood; operationalizing these as soon as possible will greatly increase the potential for national program success.
Cost-effectiveness of Implementation Methods for ELISA Serology Testing of Trypanosoma cruzi in California Blood Banks
Authors: Wilson Leslie S. , Ramsey Janine M. , Koplowicz Yelena B. , Valiente-Banuet Leopoldo , Motter Christi , Bertozzi Stefano M. , Tobler Leslie H.
Published: September 2018

The first U.S. ELISA test for T. cruzi antibodies was licensed by the Food and Drug Administration (FDA) on December 13, 2006. Blood banks have begun screening in absence of FDA recommendations for best implementation methods. We surveyed 2,029 blood donors at five California sites with three risk-based Chagas risk-screening questions. Semi-Markov models compared the cost-effectiveness of three testing strategies. 30% of donors screened positively. Screening all dominated doing nothing, being less costly, and saving more lives. The choice to “screen and test” compared with “testing all” varied by Chagas prevalence, “screening and testing” being cost-effective for high (0.004) and low (0.00004) prevalences, and “testing all” cost-effective for moderate risk (0.0004). It is cost-effective to screen by ELISA rather than do nothing. The best strategy depends on site-specific risk. Census estimates of Hispanics do not predict donor risk well. We suggest using our screening questions to determine risk level and most cost-effective testing strategy.
A Severe Eosinophilic Meningoencephalitis Caused by Infection of Angiostrongylus cantonensis
Authors: Li Hua , Xu Feng , Gu Jin-Bao , Chen Xiao-Guang
Published: September 2018

This paper reports a severe case of eosinophilic meningoencephalitis after infection with Angiostrongylus cantonensis.
Enzyme-linked Immunosorbent Assay to Detect Urinary Antibody Against Recombinant rKRP42 Antigen Made from Leishmania donovani for the Diagnosis of Visceral Leishmaniasis
Authors: Islam Mohammad Zahidul , Itoh Makoto , Takagi Hidekazu , Islam Anwar Ul , Ekram A. R. M. Saifuddin , Rahman Ajijur , Takesue Atsuhide , Hashiguchi Yoshihisa , Kimura Eisaku
Published: September 2018

We recently reported the production of the recombinant kinesin-related protein of Leishmania donovani with a molecular weight of 42 kd (rKRP42) and the value of the antigen in serum-based ELISA for the diagnosis of visceral leishmaniasis (VL). In this study, the rKRP42 antigen was validated with ELISA using urine samples (rKRP42 urine ELISA). The urine-based ELISA showed 94% sensitivity (108 positives among 115 VL samples) and 99.6% specificity (239 negatives among 240 non-VL samples). The sensitivity and specificity are almost similar to our previous results by ELISA with acetone-treated L. donovani promastigote antigen and direct agglutination test, both methods being done by use of urine samples. A comparison of the rKRP42 urine ELISA with the commercially available urinary antigen detection kit (KAtex) using 108 VL samples showed much higher sensitivity of the ELISA (96.3%) than KAtex (55.6%). The use of the rKRP42 antigen with urine samples will facilitate epidemiologic studies.
Genetic Evidence for Plasmodium falciparum Resistance to Chloroquine and Pyrimethamine in Indochina and the Western Pacific between 1984 and 1998
Authors: Saito-Nakano Yumiko , Tanabe Kazuyuki , Kamei Kiseko , Iwagami Moritoshi , Komaki-Yasuda Kanako , Kawazu Shin-ichiro , Kano Shigeyuki , Ohmae Hiroshi , Endo Takuro
Published: September 2018

Plasmodium falciparum resistance to chloroquine and pyrimethamine is widely distributed in malaria-endemic areas. The origin and geographic spread of this drug resistance have been inferred mainly from records of clinical resistance (treatment failure). Identification of the Plasmodium falciparum chloroqunie resistance transporter (pfcrt) gene and the dihydrofolate reductase (dhfr) gene as target genes of chloroquine and pyrimethamine, respectively, has made it possible to trace the history of genetic resistance to these two drugs. However, evidence for genetic resistance has been limited because of scarcity of archival specimens. We examined genotypes of pfcrt and dhfr in Indochina (Thailand, Myanmar, and Laos) and the Western Pacific (the Philippines, Indonesia, and Papua New Guinea) between 1984 and 1998 by testing samples obtained from malaria cases imported to Japan. Results show that 96% (28 of 29) and 77% (20 of 26) of samples had resistant genotypes of pfcrt and dhfr, respectively, substantiating the inferred history of clinical resistance in these geographic areas during this period.
Burden of Cerebral Malaria in Central India (2004–2007)
Authors: Jain Vidhan , Nagpal Avinash C. , Joel Pradeep K. , Shukla Manmohan , Singh Mrigendra P. , Gupta Rasik B. , Dash Aditya P. , Mishra Saroj K. , Udhayakumar Venkatachalam , Stiles Jonathan K. , Singh Neeru
Published: September 2018

A study on the clinicoepidemiology of cerebral malaria (CM) and mild malaria (MM) among adults and children attending NSCB medical college hospital Jabalpur and civil hospital Maihar, Satna, in central India was undertaken. Of 1,633 patients, 401 were Plasmodium falciparum and 18 P. vivax. Of 401, 199 CM patients and 112 MM patients were enrolled. Severe complications among CM patients were jaundice (26%), acute renal failure (22%), respiratory distress (22%), severe malaria anemia (18%), hypotension (17%), hepatic encephalopathy (7.0%), and hematuria (5%). Among CM cases, seizures and severe malaria anemia were significantly higher in children (P < 0.0001) compared with adults, whereas jaundice (P < 0.0025), acute renal failure (P < 0.0001), and hematuria (P ≤ 0.05) were significantly higher among adults. Mortality was high among adults with multiple organ failures. Overall case fatality rate was 21%. Neurologic sequelae at discharge from the hospital were 3%, whereas at follow-up, only 1% had persistent neurologic sequelae.
Role of Aquaglyceroporin (AQP1) Gene and Drug Uptake in Antimony-resistant Clinical Isolates of Leishmania donovani
Authors: Maharjan Mahendra , Singh Sushma , Chatterjee Mitali , Madhubala Rentala
Published: September 2018

Antimonial-containing drugs are the first line of treatment against Leishmaniasis. Resistance to antimonials in Leishmania is proposed to be due to reduced uptake of trivalent antimony (SbIII) through the aquaglyceroporin (AQP1). We investigated the uptake of SbIII and involvement of aquaglyceroporin in developing antimony resistance phenotype in Leishmania donovani clinical isolates. SbIII accumulation, copy number of AQP1 gene, and transcript levels were compared in antimony-sensitive versus -resistant isolates. Antimony-resistant field isolates showed reduced uptake of SbIII. The copy number of AQP1 gene showed higher copy number in the antimony-resistant isolates when compared with the sensitive isolates and did not correlate to the reduced uptake of SbIII. Downregulation of AQP1 RNA levels was not consistently found in the antimony-resistant isolates. Our studies indicate that while downregulation of AQP1 may be one of the mechanisms of antimony resistance, it is however not an invariable feature.
Use of Ceramic Water Filtration in the Prevention of Diarrheal Disease: A Randomized Controlled Trial in Rural South Africa and Zimbabwe
Authors: du Preez Martella , Conroy Ronán M. , Wright James A. , Moyo Sibonginkosi , Potgieter Natasha , Gundry Stephen W.
Published: September 2018

To determine the effectiveness of ceramic filters in reducing diarrhea, we conducted a randomized controlled trial in Zimbabwe and South Africa, in which 61 of 115 households received ceramic filters. Incidence of non-bloody and bloody diarrhea was recorded daily over 6 months using pictorial diaries for children 24–36 months of age. Poisson regression was used to compare incidence rates in intervention and control households. Adjusted for source quality, intervention household drinking water showed reduced Escherichia coli counts (relative risk, 0.67; 95% CI, 0.50–0.89). Zero E. coli were obtained for drinking water in 56.9% of intervention households. The incidence rate ratio for bloody diarrhea was 0.20 (95% CI, 0.09–0.43; P < 0.001) and for non-bloody diarrhea was 0.17 (95% CI, 0.08–0.38; P < 0.001), indicating much lower diarrhea incidence among filter users. The results suggest that ceramic filters are effective in reducing diarrheal disease incidence.
Identification of Cryptosporidium Species Infecting Humans in Tunisia
Authors: Essid Rym , Mousli Mohamed , Aoun Karim , Abdelmalek Rim , Mellouli Fethi , Kanoun Fakher , Derouin Francis , Bouratbine Aïda
Published: September 2018

Prevalence and species distribution of Cryptosporidium spp. were determined among 633 immunocompetent children less than five years of age and 75 patients hospitalized for immunodeficiency who lived in northern Tunisia. Microscopy was used for initial screening to detect positive samples and a nested polymerase chain reaction and restriction fragment length polymorphism analysis was used to determine the species. Cryptosporidium spp. was identified in 2.7% of cases (19 stool samples), and there was a significant difference between samples collected from immunocompromised patients and those collected from healthy children (10.7% versus 1.7%). Prevalence was also significantly higher in diarrheal specimens than in formed specimens (6.3% versus 1.6%). Cryptosporidium hominis and C. parvum were responsible for most Cryptosporidium spp. infections (78.9%). Cryptosporidium hominis was more prevalent in children from urban areas than in those from rural areas, and C. parvum was found with similar prevalence rates in the two populations. Cryptosporidium meleagridis was identified in four children on farms.
Molecular Mass Screening to Incriminate Sand Fly Vectors of Andean-type Cutaneous Leishmaniasis in Ecuador and Peru
Authors: Kato Hirotomo , Cáceres Abraham G. , Gomez Eduardo A. , Mimori Tatsuyuki , Uezato Hiroshi , Marco Jorge D. , Barroso Paola A. , Iwata Hiroyuki , Hashiguchi Yoshihisa
Published: September 2018

Sand flies from the Andean areas of Ecuador and Peru were examined for Leishmania infections by using our recently established molecular mass screening method. Leishmanial minicircle DNA-positive sand flies were detected in 3 of 192 and 1 of 462 samples from Ecuador and Peru, respectively. Sand fly species were identified by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) of the 18S ribosomal RNA (rRNA) gene, and the positive flies were Lutzomyia (Lu.) ayacuchensis and Lu. peruensis, respectively. Furthermore, cytochrome b and mannose-phosphate isomerase gene sequence analyses identified the parasites from Ecuador and Peru as Leishmania (Leishmania) mexicana and L. (Viannia) peruviana, respectively. Thus, the mass screening method was confirmed to be a powerful tool for sand fly research.
Characteristics of Schistosomiasis in Travelers Reported to the GeoSentinel Surveillance Network 1997–2008
Authors: Nicolls Deborah J. , Weld Leisa H. , Schwartz Eli , Reed Christie , von Sonnenburg Frank , Freedman David O. , Kozarsky Phyllis E. , _ _
Published: September 2018

Among ill returned travelers to Schistosoma-endemic areas reported to the GeoSentinel Surveillance Network over a decade 410 schistosomiasis diagnoses were identified: 102 Schistosoma mansoni, 88 S. haematobium, 7 S. japonicum, and 213 Schistosoma unknown human species. A total of 83% were acquired in Africa. Unlike previous large case series, individuals born in endemic areas were excluded. Controlling for age and sex, those traveling for missionary or volunteer work, or as expatriates were more likely to be diagnosed with schistosomiasis. Sixty-three percent of those with schistosomiasis presented within six months of travel. Those seen early more often presented with fever and respiratory symptoms compared with those who presented later. One-third of patients with schistosomiasis were asymptomatic at diagnosis. Half of those examined for schistosomiasis were diagnosed with infection. Screening for schistosomiasis should be encouraged for all potentially exposed travelers and especially for missionaries, volunteers, and expatriates.
Measles-specific Neutralizing Antibodies in Rural Mozambique: Seroprevalence and Presence in Breast Milk
Authors: Mandomando Inácio M. , Naniche Denise , Pasetti Marcela F. , Vallès Xavier , Cuberos Lilian , Nhacolo Ariel , Kotloff Karen L. , Martins Helder , Levine Myron M. , Alonso Pedro
Published: September 2018

In Mozambique, as in many sub-Saharan countries, measles remains a public health problem. We conducted cross-sectional surveys in which we assessed measles-specific antibodies in serum and breast milk by plaque reduction neutralization (PRN) assay and measles secretory IgA in breast milk by enzyme-linked immunosorbent assay. A total of 151 persons < 1 month to 23 years of age were surveyed; 81 (53.6%) of 151 had PRN titers equal to or above the protective level (≥ 200 mIU/mL). We found many serosusceptible persons, including 20.5% in whom no PRN antibody was detected. Almost all (96%) infants 6–8 months of age had non-protective PRN titers. Overall, 20.7% (6 of 29) of persons known to have received measles vaccine had non-protective titers. The geometric mean titer (GMT) of breast milk PRN antibodies was 41.6 mIU/mL (95% confidence interval [CI] = 34.0–51.0 mIU/mL) and the secretory IgA GMT was 227.6 (EU/mL) (95% CI = 179.1–289.1 EU/mL). The PRN titers of breast milk tended to increase with age. A notable proportion of the population in Manhiça, Mozambique apparently remains susceptible to clinical measles despite recent mass vaccination campaigns.
Prevention of Gynecologic Contact Bleeding and Genital Sandy Patches by Childhood Anti-schistosomal Treatment
Authors: Kjetland Eyrun Floerecke , Ndhlovu Patricia D. , Kurewa Edith Nyaradzai , Midzi Nicholas , Gomo Exnevia , Mduluza Takafira , Friis Henrik , Gundersen Svein Gunnar
Published: September 2018

Schistosoma haematobium infection may cause genital mucosal pathology in women with and without urinary schistosomiasis. This report seeks to explore the long-term effect of anti-schistosomal treatment on the clinical manifestations of S. haematobium infection in the lower genital tract. Prior treatment was reported by 248 (47%) of 527 women. Treatment received before the age of 20 years was significantly associated with the absence of sandy patches and contact bleeding, and this association was independent of current waterbody contact. Treatment in the past five years did not influence the prevalence of gynecologic schistosoma-induced lesions. The study indicates that early treatment may be more efficient for gynecologic morbidity control. Findings warrant an exploration into several chemotherapeutic agents administered at an early age, as well as in adults.
An Urban Epidemic of Human Myiasis Caused by Dermatobia hominis in French Guiana
Authors: Clyti Emmanuel , Deligny Christophe , Nacher Mathieu , del Giudice Pascal , Sainte-Marie Dominique , Pradinaud Roger , Couppie Pierre
Published: September 2018

We report the onset of an urban epidemic of human myiasis caused by Dermatobia hominis. To our knowledge, this is the first urban epidemic described for D. hominis. The epidemic was most likely related to exceptional weather conditions and notably high rainfall in January 2000, which may have facilitated the maturation of the pupae.
Blood Feeding Patterns of Potential Arbovirus Vectors of the Genus Culex Targeting Ectothermic Hosts
Authors: Burkett-Cadena Nathan D. , Graham Sean P. , Hassan Hassan K. , Guyer Craig , Eubanks Micky D. , Katholi Charles R. , Unnasch Thomas R.
Published: September 2018

Reptiles and amphibians constitute a significant portion of vertebrate biomass in terrestrial ecosystems and may be important arbovirus reservoirs. To investigate mosquito preference for ectothermic hosts, feeding indices were calculated from data collected in Tuskegee National Forest, Alabama, USA. Four mosquito species fed upon ectothermic hosts, with Culex peccator and Cx. territans feeding primarily upon ectotherms. These two species appeared to target distinct species with little overlap in host choice. Culex peccator was a generalist in its feeding patterns within ectotherms, and Cx. territans appeared to be a more specialized feeder. Six of eleven ectotherm species fed upon by Cx. territans were fed upon more often than predicted based upon abundance. Spring peepers were highly preferred over other host species by Cx. territans. Blood meals taken from each host species varied temporally, with some hosts being targeted fairly evenly throughout the season and others being fed upon in seasonal peaks.
Detection of Leishmania infantum Kinetoplast DNA in the Whole Blood of Asymptomatic Individuals by PCR-ELISA and Comparison with Other Infection Markers in Endemic Areas, Southern Iran
Authors: Alborzi Abdolvahab , Pourabbas Bahman , Shahian Frahad , Mardaneh Jalal , Pouladfar Gholam R. , Ziyaeyan Mazyar
Published: September 2018

Visceral leishmaniasis (VL), caused by Leishmania infantum, is endemic in southern Iran. To detect asymptomatic individuals, we used kinetoplast DNA (kDNA) polymerase chain reaction (PCR)-ELISA methods on 388 blood samples of healthy persons in two endemic loci and compared the results with the leishmanin skin test (LST) and the immunofluorescent antibody test (IFAT). kDNA PCR, LST, and IFAT were positive in 95 (24.5%), 132 (34%), and 212 (54.6%) cases, respectively. Fifty-five (21.4%) individuals that were LST negative were PCR positive. All PCR-positive individuals had a titer of ≥ 1:20, whereas 45% of those that were IFAT positive were PCR positive. For a reliable index of prevalence rate of infection, LST alone is not sufficient and needs to be accompanied by PCR-ELISA. The high rate of kDNA-positive results may indicate the possibility of humans being a reservoir and source of transmission. In endemic areas, kDNA PCR-ELISA is not a reliable test for the diagnosis of active VL.