bluuebunny/crossref_metadata_2025 huggingface dataset:
INTESTINAL PARASITES AMONG AFRICAN REFUGEES RESETTLED IN MASSACHUSETTS AND THE IMPACT OF AN OVERSEAS PRE-DEPARTURE TREATMENT PROGRAM
Authors: GELTMAN PAUL L. , COCHRAN JENNIFER , HEDGECOCK CRESSIDA
Published: September 2018

This study analyzed the prevalence of intestinal parasitoses diagnosed shortly after arrival in the United States among African refugees before and after implementation of an overseas program of empirical treatment with albendazole. Variables included results of microscopy of a single stool specimen, age, sex, ethnicity, departure origin, and receipt of albendazole. Of 1,254 refugees, 56% had intestinal parasites. Fourteen percent had helminths, and 2% had multiple helminths. In addition, 52% had protozoans with 25% having multiple protozoans. The most common pathogens were Giardia lamblia (14%) and Trichuris trichiura (9%). Overall, refugees who arrived in Massachusetts after implementation of the treatment program were less likely to have any parasites (odds ratio [OR] =0.61, 95% confidence interval [CI] =0.47–0.78) and helminths (OR =0.15, 95% CI =0.09–0.24) than refugees who arrived previously. These more recently arrived refugees were also less likely to have hookworm (OR = 0.03, 95% CI = 0.00–0.29), Trichuris (OR = 0.05, 95% CI = 0.02–0.13), Ascaris (OR = 0.07, 95% CI = 0.01–0.58), and Entamoeba histolytica (OR = 0.47, 95% CI = 0.26–0.86). Empirically treating refugees prior to departure for the United States appears to have resulted in decreases in intestinal helminths and possibly some protozoans among African refugees tested shortly after arrival in this country.
AN OUTBREAK OF GNATHOSTOMIASIS AMONG KOREAN EMIGRANTS IN MYANMAR
Authors: CHAI JONG-YIL , HAN EUN-TAEK , SHIN EUN-HEE , PARK JAE-HWAN , CHU JONG-PHIL , HIROTA MASAKI , NAKAMURA-UCHIYAMA FUKUMI , NAWA YUKIFUMI
Published: September 2018

Thirty-eight (designated as cases) of 60 Korean emigrants who consumed raw fresh water fish in Yangon, Myanmar developed migratory swellings and creeping eruptions on the back, abdomen, flank, and other cutaneous areas 1–10 weeks later. The symptoms included itching, nodule formation, fatigue, urticaria, fever, pain on the skin, and erythematous plaques. Skin biopsies of two cases revealed no parasites. However, the mean ± SD peripheral blood eosinophilia among the cases was 6.3 ± 6.5% (n = 29) and 9.0 ± 9.8% (n = 26) in two examinations. An enzyme-linked immunosorbent assay of their serum samples, using Gnathostoma doloresi adult worms as the antigen, showed mean ± SD optical densities of 0.47 ± 0.29 (n = 28) and 0.32 ± 0.20 (n = 30) in two examinations and 0.12 ± 0.09 (n = 50) in healthy controls. Two advanced third-stage larvae of G. spinigerum were found in two of six catfish purchased at a local market in Yangon. The outbreak of the human infection is suggested to have been due to G. spinigerum, which is known to live out its life cycle in the Yangon area of Myanmar.
EVALUATING THE COMPLETENESS OF DEMOGRAPHIC SURVEILLANCE OF CHILDREN LESS THAN FIVE YEARS OLD IN WESTERN KENYA: A CAPTURE-RECAPTURE APPROACH
Authors: EISELE THOMAS P. , LINDBLADE KIM A. , ROSEN DANIEL H. , ODHIAMBO FRANK , VULULE JOHN M. , SLUTSKER LAURENCE
Published: September 2018

We evaluated the completeness and differential ascertainment of vital events in children less than five years old registered in two rounds of a demographic surveillance system (DSS) in western Kenya using a two-sample capture-recapture. The primary lists consisted of births and child deaths identified by two rounds of the DSS conducted in October 2000 and August 2001. The secondary lists consisted of births and child deaths identified independently from two surveys of 5,000 randomly selected households conducted immediately after each DSS round, covering the same population over the same time period. Analysis of the overlap between lists yielded the following sensitivities for the two DSS rounds: 62% and 49%, respectively, for identifying neonatal deaths (<1 month); 72% and 78%, respectively, for post-neonatal child deaths (1–59 months); and 88% and 78%, respectively, for identifying newborns. Female deaths were less likely to be reported than male deaths. The primary limitation of using capture-recapture in this setting was difficulty in matching between lists due to inconsistent dates of birth and death and variability in spelling of names. Assuming limitations of current methods are sufficiently addressed, capture-recapture appears to be a useful tool in evaluating DSS completeness and differential ascertainment of vital events.
UTILITY OF COMPARATIVE ANCHOR-TAGGED SEQUENCES AS PHYSICAL ANCHORS FOR COMPARATIVE GENOME ANALYSIS AMONG THE CULICIDAE
Authors: CHAMBERS ERIC W. , LOVIN DIANE D. , SEVERSON DAVID W.
Published: September 2018

The development of comparative genetic maps in multiple species of mosquitoes could prove extremely useful in the search for those genes that contribute to mosquito vector competence or genes associated with other phenotypes of interest. To effectively compare these gene maps, markers must be developed that are based on chromosomal regions conserved throughout the Culicidae. We designed 35 polymerase chain reaction (PCR) primer pairs based upon orthlogous exons in Aedes aegypti and Drosophila melanogaster or Anopheles gambiae. Twenty-three of the primers yielded a single PCR product in at least one dipteran, in addition to Ae. aegypti, when screened with genomic DNA from seven dipterans, including five mosquito species. Eight of the primers amplified a single PCR product in only Ae. aegypti, while four primer pairs gave no PCR product in any species. The 23 successful comparative anchor-tagged sequence primer pairs give broad genome coverage in Ae. aegypti, and more importantly demonstrate an efficient strategy for developing comparative anchor marker loci for any species of Culicidae.
INHIBITORY ACTIVITIES OF SULFATED PROTEOGLYCANS ON CHONDROITIN SULFATE A-MEDIATED CYTOADHERENCE OF PLASMODIUM FALCIPARUM ISOLATES FROM THAILAND
Authors: CHAISAVANEEYAKORN SUJITTRA , KONGTAWELERT PRACHYA , ANGKASEKWINAI PORNPIMON , McGREADY ROSE , NOSTEN FRANÇOIS , CHAIYAROJ SANSANEE C.
Published: September 2018

Chondroitin sulfate A (CSA) is an important receptor for Plasmodium falciparum-infected erythrocytes in the placenta. To study the molecular interaction between parasitized erythrocytes (PE) to CSA, we performed in vitro cytoadherence inhibition assays of PE infected with wild and laboratory isolates of P. falciparum to CSA using various glycosaminoglycans (GAGs). Marked decrease in PE adhesion to immobilized CSA and CSA-expressed cells was achieved with soluble chondroitin sulfate D (CSD) and chondroitin sulfate E (CSE) at low concentrations. The effect was dose dependent with the degree of inhibition exceeded that of soluble CSA in certain clinical isolates. The results suggested the influence of oversulfation of CS variant chains on PE adherence to CSA. Interestingly, PE of the tested wild isolates could adhere to immobilized CSD and CSE at different levels while PE of CSA-selected laboratory lines could not. Partial inhibitory activity was observed when chondroitin sulfate C (CSC), chondroitin sulfate B (CSB), and polyolpolysulfate were used even at high concentrations. Keratan sulfate, colominic acid, and Suramine were unable to inhibit PE adherence. Taken together, the results confirm that the 4-sulfate amino sugar moiety, as well as the basic disaccharide structure of N-acetylgalactosamine linked to glucuronic acid, may influence the degree of this molecular interaction. However, other sulfation patterns that could influence the interaction could not be overlooked, as in the case of CSD which contains 2-O-sulfation at glucuronic acid. Studies using pentosan polysulfate, an oversulfated molecule with a xylan backbone, as an inhibitor also showed a reduction of PE adherence of most isolates tested. Thus, only the sulfate content and pattern of this molecule could affect the adhesive interactions. In addition, difference in capacity of low molecular weight heparins to inhibit CSA-mediated PE cytoadherence of clinical isolates was also observed, thereby providing evidence on the heterogeneity in cytoadherence characteristics of maternal parasite isolates as well as their therapeutic potentials.
INTRODUCED PLASMODIUM VIVAX MALARIA IN A BOLIVIAN COMMUNITY AT AN ELEVATION OF 2,300 METERS
Authors: RUTAR TINA , SALGUEIRO EDUARDO J. BALDOMAR , MAGUIRE JAMES H.
Published: September 2018

Tuntunani, Bolivia, a community of 199 persons situated at an elevation of 2,300 meters, experienced its first malaria outbreak in 1998. Blood smears from 63 of 183 symptomatic residents were examined, and 52 showed Plasmodium vivax. An investigation two years later indicated that the epidemic resulted from introduced transmission, since persons of all ages and both sexes were infected, and there had been no travel to low-lying endemic areas in the five months preceding the epidemic. Treatment became available only two months into the epidemic, at which time 58% of the people had been ill for three weeks or longer. This outbreak demonstrates the vulnerability of highland populations with poor access to health care to introduced malaria.
ASSESSMENT OF FAMILIES FOR EXCESS RISK OF LYMPHEDEMA OF THE LEG IN A LYMPHATIC FILARIASIS-ENDEMIC AREA
Authors: CUENCO KAREN T. , HALLORAN M. ELIZABETH , LAMMIE PATRICK J.
Published: September 2018

The influence of host genes on the distribution of lymphedema due to lymphatic filariasis is unknown. To assess this, pedigree and disease information were collected from lymphedema patients in a lymphatic filariasis-endemic area. These patients were female, with an average age of approximately 40 years, who were enrolled between June 1995 and July 1999 in a lymphedema treatment clinic, and from the rural Haitian community served by the clinic. Interviews were conducted between September 1998 and December 1999. Families with multiple lymphedema cases were of similar size, with an average of 15 members, as those families with only a single lymphedema case. We determined whether families observed to have multiple lymphedema cases had a higher prevalence of lymphedema than expected when stratified population estimates and family size were considered. Lymphedema of the leg was excessive in 15 of 43 families with multiple lymphedema cases. The number of families demonstrating excess disease was significantly different than was expected based on population estimates of lymphedema prevalence (P = 0.026). Families with multiple cases of lymphedema were not significantly larger in family size than families with a single lymphedema cases. Twelve of the 15 families had a male with lymphedema, which influenced the interpretation of the results. The significance of these results is discussed.
A RANDOMIZED CLINICAL TRIAL COMPARING SINGLE- AND MULTI-DOSE COMBINATION THERAPY WITH DIETHYLCARBAMAZINE AND ALBENDAZOLE FOR TREATMENT OF BANCROFTIAN FILARIASIS
Authors: EL SETOUHY MAGED , RAMZY REDA M. R. , AHMED EHAB S. , KANDIL AMR M. , HUSSAIN OMAR , FARID HODA A. , HELMY HANAN , WEIL GARY J.
Published: September 2018

The Global Program for Elimination of Lymphatic Filariasis calls for mass drug administration for endemic populations outside of sub-Saharan Africa with a single dose of diethylcarbamazine (DEC) and albendazole (Alb) annually for 4–6 years. Single-dose DEC/Alb dramatically reduces blood microfilaria (MF) counts, but most treated subjects fail to completely clear MF after a single dose. A more effective regimen might reduce the number of years required for elimination programs. We performed a randomized clinical trial in Egyptian adults with asymptomatic microfilaremia to compare treatment with seven daily doses of oral DEC (6 mg/kg) and Alb (400 mg) with a single dose of the same combination. We also studied the effect of re-treatment with single-dose DEC/Alb 12 months after the first treatment course. Multi-dose DEC/Alb was significantly more effective than single-dose therapy for reducing and clearing microfilaremia (mean reduction in MF/ml relative to pretreatment counts at 12 months, 99.6% versus 85.7%, with complete clearance in 75% versus 23.1%). The two regimens had similar activity against adult filarial worms, as indicated by serial ultrasound assessments. Neither regimen resulted in complete clearance of filarial antigenemia. There was no difference in adverse events, which were mild to moderate. Blood microfilaria and parasite antigen clearance rates increased following re-treatment. Multi-dose DEC/Alb may be a useful option for filariasis elimination programs, especially in the first year (when enthusiasm for mass drug administration and coverage rates are high), to quickly reduce community MF loads and transmission rates.
MOLECULAR ANALYSIS OF PLASMODIUM FALCIPARUM RECRUDESCENT MALARIA INFECTIONS IN CHILDREN TREATED WITH CHLOROQUINE IN NIGERIA
Authors: HAPPI C. T. , GBOTOSHO G. O. , SOWUNMI A. , FALADE C. O. , AKINBOYE D. O. , GERENA L. , KYLE D. E. , MILHOUS W. , WIRTH D. F. , ODUOLA A. M. J.
Published: September 2018

Parasite genotyping by a polymerase chain reaction was used to distinguish recrudescent from newly acquired Plasmodium falciparum infections in 50 of 160 Nigerian children taking part in a chloroquine efficacy study in Ibadan, Nigeria. A finger prick blood sample was taken from each child before and after treatment to identify recrudescent parasites. By investigating allelic variation in three polymorphic antigen loci, merozoite surface protein-1 (MSP-1), MSP-2, and glutamate-rich protein (GLURP), we determined parasite diversity in the population and in the infected host. DNA from pretreatment and post-treatment samples from 47 of the 50 patients who failed therapy was successfully amplified by the PCR. The MSP-1, MSP-2, and GLURP genotypes in all samples showed extensive diversity, indicating polyclonal infections. The average number of clones per infection in pre-treatment sample was 2.5 with MSP-1, 4.9 with MSP-2, and 2 with GLURP. The extent of multiplicity decreased significantly (P = 0.016) in post-treatment samples. Multiplicity of infection and initial parasite density were not age dependent. Comparison of the variant alleles in pretreatment and post-treatment samples of each patient indicates that 26 of the 47 children had genuinely recrudescent disease. Conversely, post-treatment samples from five children showed completely new genotypes, indicating either a previously sequestered population of parasites or a newly acquired infection. Overall, this study has shown the diversity and complexity of P. falciparum population in Ibadan, Nigeria. The study has also shown the dynamics of P. falciparum infections in this population before and after chloroquine treatment in an area of high malaria transmission.
MATERNAL TRYPANOSOMA CRUZI INFECTION, PREGNANCY OUTCOME, MORBIDITY, AND MORTALITY OF CONGENITALLY INFECTED AND NON-INFECTED NEWBORNS IN BOLIVIA
Authors: TORRICO FAUSTINO , ALONSO-VEGA CRISTINA , SUAREZ EDUARDO , RODRIGUEZ PATRICIA , TORRICO MARY-CRUZ , DRAMAIX MICHÈLE , TRUYENS CARINE , CARLIER YVES
Published: September 2018

This work compares the results of two epidemiologic and clinical surveys on the consequences of maternal chronic Trypanosoma cruzi infection. They were conducted in 1992–1994 and 1999–2001 in the same maternity clinic in Bolivia, a country highly endemic for infection with this parasite. In both surveys, the materno-fetal transmission of parasites occurred in 5-6% of the infected mothers. Maternal chronic T. cruzi infection had no effect on pregnancy outcome and health of newborns when there was no materno-fetal transmission of parasites. Comparisons between the older and the more recent surveys highlighted significant reductions in frequencies of symptomatic cases (from 54% to 45%), Apgar scores <7, and low birth weights and prematurity (from 32–50% to 6–16%) among congenitally infected babies. Neonatal mortality related to congenital Chagas disease also decreased from 13% to 2% in the interval between both studies. These results suggest that the decrease in poverty that has occurred in Bolivia between both surveys might have contributed to reduce the morbidity and mortality, but not the transmission rate of T. cruzi congenital infection, which remains a serious public health problem in this country.
MOLECULAR EPIDEMIOLOGY OF MALARIA IN CAMEROON. XVIII. POLYMORPHISMS OF THE PLASMODIUM FALCIPARUM MEROZOITE SURFACE ANTIGEN-2 GENE IN ISOLATES FROM SYMPTOMATIC PATIENTS
Authors: BASCO LEONARDO K. , TAHAR RACHIDA , ESCALANTE ANANIAS
Published: September 2018

Merozoite surface antigen-2 (MSA-2) is a polymorphic genetic marker that is highly discriminatory for characterizing Plasmodium falciparum field isolates. Genetic diversity of isolates obtained from symptomatic patients residing in Yaounde, Cameroon was analyzed by an allele-specific polymerase chain reaction and direct sequencing of amplification products. Of 137 isolates, 25 (18%) had only FC27-type alleles, 40 (29%) had only 3D7-type alleles, and 72 (53%) had multiple parasite populations with both alleles. Of 295 fragments, 145 (49.2%) and 150 (50.8%) belonged to FC27 and 3D7 alleles, respectively. There were 23 different MSA-2 alleles (10 FC27-type and 13 3D7-type that yielded 44 different combinations in multiple infections). DNA sequencing showed distinct individual sequences. Sequences belonging to the FC27 allelic family were relatively conserved, with most of the polymorphism arising from differences in the number of repeat units. In contrast, the sequences within the GSA-rich region in 3D7 allelic family were less conserved, but many of the sequences in Cameroonian isolates have been identified in other isolates from geographically distant origins. Our results show an extensive diversity of the central region of MSA-2 in size, allelic family, combinations of these two features in multiple infections, and sequence variations underlying the complex population structure of P. falciparum clinical isolates in Yaounde, Cameroon.
MOLECULAR ANALYSIS OF PLASMODIUM FALCIPARUM FROM DRUG TREATMENT FAILURE PATIENTS IN PAPUA NEW GUINEA
Authors: CASEY GERARD J. , GINNY MEZA , URANOLI MEROLYN , MUELLER IVO , REEDER JOHN C. , GENTON BLAISE , COWMAN ALAN F.
Published: September 2018

A study was conducted in Papua New Guinea to analyze Plasmodium falciparum drug resistance polymorphisms in patients presenting with resistant malaria. One hundred ninety-nine P. falciparum-positive patients were recruited at two sites, Madang and Maprik. Exposure to the 4-aminoquinolines chloroquine and amodiaquine was uniformly high, at 84% overall. However, 59% of these were taken in various combinations of sulfadoxine/pyrimethamine and/or primaquine and/or quinine. Two markers for 4-aminoquinoline resistance, P. falciparum chloroquine resistance transporter 76T and P. falciparum multidrug resistance 1, were fixed in the population and two markers for pyrimethamine resistance, dihydrofolate reductase (dhps) 59R and 108N, were found at moderate to high levels, overall 60% and 75%, respectively. No polymorphisms in dhps associated with sulfadoxine resistance were present. Differences between the two sites are analyzed. The study period encompasses a change in standard malaria treatment policy. These findings stress the need for regular monitoring of the effects of standard drug treatment of uncomplicated malaria in Papua New Guinea.
DIFFERENTIATION OF MEMBERS OF THE ANOPHELES FLUVIATILIS SPECIES COMPLEX BY AN ALLELE-SPECIFIC POLYMERASE CHAIN REACTION BASED ON 28S RIBOSOMAL DNA SEQUENCES
Authors: SINGH O. P. , CHANDRA DINESH , NANDA NUTAN , RAGHAVENDRA K. , SUNIL SUJATHA , SHARMA S. K. , DUA V. K. , SUBBARAO SARALA K.
Published: September 2018

Anopheles fluviatilis, one of the major vectors of malaria in India, is a complex of at least three cryptic species provisionally designated as species S, T, and U. Identification of the cryptic species of An. fluviatilis complex is of paramount importance in disease control program due to contrasting differences in their vectorial efficiency, preference for feeding on humans, and resting behavior. Species S, T, and U are morphologically indistinguishable at any stage of their life cycle and can be identified only by the examination of species-specific fixed inversions in the polytene chromosomes. We report an allele-specific polymerase chain reaction assay for the differentiation of members of An. fluviatilis complex, which is based on differences in nucleotide sequences in D3 domain of 28S ribosomal DNA. The assay was evaluated against chromosomally examined individuals from different localities with different sympatric associations and was found to differentiate unambiguously all the members of the complex.
IMMUNOGENICITY AND SAFETY OF A VARICELLA VACCINE (OKAVAX™) AND A TRIVALENT MEASLES, MUMPS, AND RUBELLA VACCINE (TRIMOVAX™) ADMINISTERED CONCOMITANTLY IN HEALTHY FILIPINO CHILDREN 12–24 MONTHS OLD
Authors: GATCHALIAN SALVACION , TABORA CHARISSA , BERMAL NANCY , LEBOULLEUX DIDIER , DESAUZIERS ERIC
Published: September 2018

The immunogenicity and safety of Okavax™ varicella vaccine, when administered concomitantly with Trimovax™ measles, mumps, and rubella (MMR) vaccine, were assessed in 300 Filipino children 12–24 months old. Three groups received Okavax only, Trimovax only, or both vaccines concomitantly. In sera obtained six weeks after vaccination, high varicella antibody geometric mean titers (GMTs) (115 and 79.8 mIU/mL, respectively) and seroconversion rates (≥ 91.9%) were similar for Okavax given alone or concomitantly with Trimovax. High MMR GMTs and seroconversion rates (mumps ≥ 94.6%, measles and rubella ≥ 98.6%) were not affected by concomitant administration of Trimovax with Okavax. Solicited local and systemic reactions recorded by parents were slightly more numerous after concomitant administration, but the majority of all reactions were mild and transient. The good tolerance and high immunogenicity observed supports the concomitant administration of Okavax and Trimovax to children in their second year of life to protect against four life-threatening diseases while simplifying childhood immunization programs.
NEGATIVE EFFECT OF ANTIBODIES AGAINST MAXADILAN ON THE FITNESS OF THE SAND FLY VECTOR OF AMERICAN VISCERAL LEISHMANIASIS
Authors: MILLERON RANIA S. , RIBEIRO JOSE M. C. , ELNAIME DIA , SOONG LYNN , LANZARO GREGORY C.
Published: September 2018

Lutzomyia longipalpis expresses a salivary protein called maxadilan (MAX) that functions to dilate vertebrate blood vessels and thereby to facilitate the sand fly’s acquisition of blood. We hypothesized that antibodies specific for one of many MAX variants would inhibit vasodilatory function of that variant. In vitro and in vivo experiments showed that antibodies against a specific MAX variant decreased vasodilatory function. More specifically, antibodies against MAX blocked vasodilation of a constricted rabbit aorta. Additionally, a strain of Lu. longipalpis, with a nearly uniform MAX genotype, obtained a larger blood meal from naive BALB/c mice compared with mice that were either immunized with a homologous MAX genotype or sensitized to bites of flies from the same strain. Those flies taking blood from mice sensitized by sand fly bites also laid significantly fewer eggs than when they took blood from naive mice. These results have potential epidemiologic importance in light of the potential use of MAX in a vaccine or as part of a diagnostic test because they imply that a uniform MAX genotype is selected against by the vertebrate host immune response and that antigenic diversity is selected for.
FREQUENCY OF VISCERAL LEISHMANIASIS RELAPSES IN HUMAN IMMUNODEFICIENCY VIRUS–INFECTED PATIENTS RECEIVING HIGHLY ACTIVE ANTIRETROVIRAL THERAPY
Authors: MIRA JOSE A. , CORZO JUAN E. , RIVERO ANTONIO , MACIAS JUAN , DE LEON FERNANDO LOZANO , TORRE-CISNEROS JULIAN , GOMEZ-MATEOS JESUS , JURADO RAFAEL , PINEDA JUAN A.
Published: September 2018

There are contradictory data about whether highly active antiretroviral therapy (HAART) prevents visceral leishmaniasis (VL) relapses in human immunodeficiency virus type 1 (HIV-1)-infected patients. The aim of this study was to assess the frequency of VL relapses in individuals receiving HAART. Thirty-one patients who received HAART after developing VL were included in a retrospective cohort study. Ten of them received secondary chemoprophylaxis and the rest did not. Eight (38%) patients without secondary chemoprophylaxis showed a VL relapse. None of the seven subjects with VL relapses and 6 of 11 without recurrence (P = 0.038), in whom all scheduled data were available, showed an increase of more than 100 CD4+ cells/mm3 during the follow-up. Patients with relapse showed higher levels of HIV RNA viral load at their last visit (P = 0.047). The frequency of VL relapses in patients receiving HAART is high. Relapses of VL are observed only in individuals with uncontrolled HIV replication and/or poor immunologic responses.
WOUNDING: THE PRIMARY MODE OF SEOUL VIRUS TRANSMISSION AMONG MALE NORWAY RATS
Authors: HINSON ELLA R. , SHONE SCOTT M. , ZINK M. CHRISTINE , GLASS GREGORY E. , KLEIN SABRA L.
Published: September 2018

In rodent populations, males are more likely to be infected with hantaviruses and to engage in aggression than are females. To assess the relationship between aggression and Seoul virus infection, Norway rats were trapped in Baltimore, Maryland and wounding, infection status, and steroid hormone concentrations were examined. Older males and males with high-grade wounds were more likely to have IgG antibody to Seoul, to shed virus in saliva, urine, and feces, and to have viral RNA in organs than either juveniles or adult males with less severe wounds. In contrast, neither age nor wounding predicted virus shedding among females. Although viral antigen was not identified in the brain, viral protein was detected in the gonads and adrenal glands of adult males. Males with more severe wounds had higher testosterone concentrations than males with no or low-grade wounds. Because wounding, testosterone, and virus shedding are associated among males, aggression may be the primary mode of Seoul virus transmission among male, but not female, Norway rats.
DEVELOPMENT OF A QUESTIONNAIRE ASSESSING BURULI ULCER–INDUCED FUNCTIONAL LIMITATION
Authors: STIENSTRA YMKJE , DIJKSTRA PIETER U. , GUÉDÉNON AUGUSTIN , JOHNSON R. CHRISTIAN , AMPADU EDWIN O. , MENSAH THOMAS , KLUTSE ERASMUS Y. , ETUAFUL SAMUAL , DEEPAK SUNIL , VAN DER GRAAF WINETTE T. A. , VAN DER WERF TJIP S.
Published: September 2018

Buruli ulcer, a disease with long-term consequences, is emerging in west Africa. Thus, a functional limitation scoring system is needed to assess its nature and severity. A list of daily activities was developed for this disease. Following treatment of Buruli ulcer, persons in Benin (n = 47) and Ghana (n = 41) were investigated. Nineteen items were identified with good internal consistency. Participants (median age = 14 years) could not perform 23% of their daily activities. Twenty-nine participants did not have any functional limitation. The average limitation score was 31% in Benin and 15% in Ghana (P = 0.006). The mean limitation score in participants without visible contractures (n = 65) was 13%, whereas patients with visible contractures (n = 20) or an amputation (n = 3) had a score of more than 50%. Validity and reliability should be further analyzed to optimize the scale for use in individual evaluation, as an end point in intervention trials, and in planning of resources needed for the care of patients with functional limitations.
COMPARATIVE FIELD EVALUATION OF THE MBITA TRAP, THE CENTERS FOR DISEASE CONTROL LIGHT TRAP, AND THE HUMAN LANDING CATCH FOR SAMPLING OF MALARIA VECTORS IN WESTERN KENYA
Authors: MATHENGE EVAN M. , OMWERI GEORGE O. , IRUNGU LUCY W. , NDEGWA PAUL N. , WALCZAK ELIZABETH , SMITH TOM A. , KILLEEN GERRY F. , KNOLS BART G. J.
Published: September 2018

The mosquito sampling efficiency of a new bed net trap (the Mbita trap) was compared with that of the Centers for Disease Control miniature light trap (hung adjacent to an occupied bed net) and the human landing catch in western Kenya. Overall, the Mbita trap caught 48.7 ± 4.8% (mean ± SEM) the number of Anopheles gambiae Giles sensu lato caught in the human landing catch and 27.4 ± 8.2% of the number caught by the light trap. The corresponding figures for Anopheles funestus Giles were 74.6 ± 1.3% and 39.2 ± 1.9%, respectively. Despite the clear differences in the numbers of mosquitoes caught by each method, both the Mbita trap and light trap catches were directly proportional to human landing catches regardless of mosquito density. No significant differences in parity or sporozoite incidence were observed between mosquitoes caught by the three methods for either An. gambiae s.l. or An. funestus. Identification of the sibling species of the An. gambiae complex by a polymerase chain reaction indicated that the ratio of An. gambiae Giles sensu stricto to An. arabiensis Patton did not vary according to the sampling method used. It is concluded that the Mbita trap is a promising tool for sampling malaria vector populations since its catch can be readily converted into equivalent human biting catch, it can be applied more intensively, it requires neither expensive equipment nor skilled personnel, and it samples mosquitoes in an exposure-free manner. Such intensive sampling capability will allow cost-effective surveillance of malaria transmission at much finer spatial and temporal resolution than has been previously possible.
MULTIFARIOUS CHARACTERIZATION OF LEISHMANIA TROPICA FROM A JUDEAN DESERT FOCUS, EXPOSING INTRASPECIFIC DIVERSITY AND INCRIMINATING PHLEBOTOMUS SERGENTI AS ITS VECTOR
Authors: SCHNUR LIONEL F. , NASEREDDIN ABDELMAGEED , EISENBERGER CAROL L. , JAFFE CHARLES L. , EL FARI MUSTAFA , AZMI KIFAYA , ANDERS GERLIND , KILLICK-KENDRICK MIREILLE , KILLICK-KENDRICK ROBERT , DEDET JEAN-PIERRE , PRATLONG FRANCINE , KANAAN MOIEN , GROSSMAN TAMAR , JACOBSON RAYMOND L. , SCHONIAN GABRIELLE , WARBURG ALON
Published: September 2018

The predominant sand fly species collected inside houses in Kfar Adumim, an Israeli village in the Judean Desert that is a focus of cutaneous leishmaniasis, was Phlebotomus papatasi, which was also caught attempting to bite humans. Phlebotomus sergenti, which is rarely seen inside houses, constituted the predominant sand fly species in caves near the village. Leishmania isolates from Ph. sergenti and humans typed as Leishmania tropica. Sand fly and human isolates produced similar small nodular cutaneous lesions in hamsters. Isolates produced excreted factor (EF) of subserotypes A9 or A9B2, characteristic of L. tropica and reacted with L. tropica-specific monoclonal antibodies. Isoenzyme analysis consigned the strains to the L. tropica zymodemes MON-137 and MON-275. Molecular genetic analyses confirmed the strains were L. tropica and intraspecific microheterogeneity was observed. Genomic fingerprinting using a mini-satellite probe separated the L. tropica strains into two clusters that were not entirely congruent with geographic distribution. These results support the heterogeneous nature of L. tropica and incriminate Ph. sergenti as its vector in this Judean Desert focus.
POLYMERASE CHAIN REACTION MONITORING OF TRANSMISSION OF ONCHOCERCA VOLVULUS IN TWO ENDEMIC STATES IN MEXICO
Authors: RODRÍGUEZ-PÉREZ MARIO A. , LILLEY BRUCE G. , DOMÍNGUEZ-VÁZQUEZ ALFREDO , SEGURA-ARENAS RAMÓN , LIZARAZO-ORTEGA CRISTIAN , MENDOZA-HERRERA ALBERTO , REYES-VILLANUEVA FILIBERTO , UNNASCH THOMAS R.
Published: September 2018

To investigate the impact of mass ivermectin treatments in Mexico on Onchocerca volvulus transmission, entomologic surveys were carried out in the two endemic states of Oaxaca and Chiapas. The data suggest that substantial progress towards the goal of elimination has been made. A comparison pre- and post-ivermectin data from a community in Southern Chiapas showed a 97% decrease in seasonal transmission potential, but some level of polymerase chain reaction positivity was still detectable. In other communities from northern Chiapas and Oaxaca where there are no baseline data, there was an absence or near absence of infective flies. Residual transmission was not evenly distributed because differences were seen in the infection and infective rates from different catch points. These findings suggest that while substantial progress towards elimination has been made in Mexico, it may be necessary to modify ivermectin distribution strategies to eliminate transmission in areas where transmission persists.
IN VITRO EFFICACY OF ANTIMALARIAL DRUGS AGAINST PLASMODIUM VIVAX ON THE WESTERN BORDER OF THAILAND
Authors: CHOTIVANICH KESINEE , UDOMSANGPETCH RACHANEE , CHIERAKUL WIRONGRONG , NEWTON PAUL N. , RUANGVEERAYUTH RONATRAI , PUKRITTAYAKAMEE SASITHON , LOOAREESUWAN SORNCHAI , WHITE NICHOLAS J.
Published: September 2018

The susceptibility of 20 isolates of Plasmodium vivax on the Thailand-Myanmar border to seven antimalarial drugs was evaluated using the schizont maturation inhibition technique. The geometric mean 50% inhibition concentration (IC50) values were quinine = 308 ng/mL, amodiaquine =14 ng/mL, chloroquine =50 ng/mL, mefloquine = 127 ng/mL, sulfadoxine/pyrimethamine (80:1) = 800/10 ng/mL, pyrimethamine = 8 ng/mL, and artesunate = 0.5 ng/mL. Compared with P. falciparum in this area, P. vivax was more sensitive to chloroquine and artesunate, equally sensitive to quinine, and more resistant to mefloquine.
THE EFFECTS OF PLASMODIUM FALCIPARUM AND P. VIVAX INFECTIONS ON PLACENTAL HISTOPATHOLOGY IN AN AREA OF LOW MALARIA TRANSMISSION
Authors: McGREADY ROSE , DAVISON BILLIE B. , STEPNIEWSKA KASIA , CHO THEIN , SHEE HTEE , BROCKMAN ALAN , UDOMSANGPETCH RACHANEE , LOOAREESUWAN SORNCHAI , WHITE NICHOLAS J. , MESHNICK STEVE R. , NOSTEN FRANÇOIS
Published: September 2018

Placental histopathology was studied in a cohort of 204 women living in an area of low Plasmodium falciparum and P. vivax malaria transmission. Detection of malaria antenatally was active, by weekly peripheral blood smears, and all infections were treated. Significant histopathologic placental malaria changes (increased malaria pigment, cytotrophoblastic prominence, and presence of parasites) were found only in a minority of women who had P. falciparum infections in pregnancy. These changes were significantly more frequent in women with evidence of peripheral blood infection close to delivery and only in these cases were placental inflammatory cells increased. Antenatal P. vivax infection was associated only with the presence of malaria pigment in the placenta. All placental infections diagnosed by blood smear and 32.4% (12 of 37) diagnosed by histopathology were associated with patent peripheral parasitemia. This study indicates that prompt treatment of peripheral parasitemias during pregnancy limits placental pathology. The effect on birth weight reduction may not result from irreversible placental changes but from the acute insult of infection. These findings emphasize the importance of treating malaria in pregnancy promptly with effective antimalarial drugs.
MALARIA: 30 YEARS OF EXPERIENCE AT A NEW YORK CITY TEACHING HOSPITAL
Authors: KAMBILI CHRISPIN , MURRAY HENRY W. , GOLIGHTLY LINNIE M.
Published: September 2018

Two previous reviews summarized the New York Hospital experience with 110 cases of malaria from 1968 to 1990. We have extended these studies to include 59 cases of malaria seen from 1991 to 1999 and analyze trends over the past 30 years. Plasmodium falciparum remains the most common species, 38 (64%) of the 59 cases, with the majority of them, 34 (89%) of 38 cases, being acquired in Africa. Of the 59 cases, 22 (37%) were immigrants living in the United States who had visited their countries of origin. Only five (8%) of 59 patients reported using chemoprophylaxis. This represents a marked decrease from the previous reviews. None of the immigrants or their children used chemoprophylaxis. Diagnosis was prompt, and patients responded well to therapy. Complications of malaria were low and no deaths were reported, as was the case in the previous reviews. The low use of chemoprophylaxis, particularly among immigrants, is a major concern.
RESPONSES OF SMALL INTESTINAL ARCHITECTURE AND FUNCTION OVER TIME TO ENVIRONMENTAL FACTORS IN A TROPICAL POPULATION
Authors: KELLY PAUL , MENZIES IAN , CRANE ROGER , ZULU ISAAC , NICKOLS CAROLE , FEAKINS ROGER , MWANSA JAMES , MUDENDA VICTOR , KATUBULUSHI MAX , GREENWALD STEVE , FARTHING MICHAEL
Published: September 2018

To determine the response of the small intestinal mucosa to environmental conditions, we studied changes in mucosal architecture and function in a longitudinal cohort study in African adults. Over three consecutive years, 238 adults submitted monthly stool samples for parasitologic and bacteriologic analysis and underwent an annual endoscopic jejunal biopsy for mucosal morphometry. Absorption and permeability assays were performed on the same day as the enteroscopy. Variation in mucosal architecture and function was correlated with environmental factors and stool microbiology. The whole cohort had structural and functional evidence of tropical enteropathy, but structure and function were only weakly correlated. There were marked changes over time, and seasonal variation was observed in villous height (16%), xylose recovery (16%), and permeability (28%). Asymptomatic intestinal infections were common. Enteropathy was more severe in participants with Citrobacter rodentium or hookworm ova in the stool sample taken one month before the investigations were performed.
EFFECT OF MATERNAL ANEMIA AT HIGH ALTITUDE ON INFANT HEMATOCRIT AND OXYGENATION
Authors: RAMIREZ-CARDICH MARIA E. , SAITO MAYUKO , GILMAN ROBERT H. , ESCATE LUIS E. , STROUSE JOHN J. , KABRHEL CHRISTOPHER , JOHNSON COLLEEN , GALCHEN RIVKA , BAUTISTA CHRISTIAN T.
Published: September 2018

Hematocrit levels were determined in 36 mothers living at high altitudes (3,750 meters) and their infant cord bloods to determine the effect of maternal anemia on the infant. The arterial oxygen saturation (SaO2) and respiratory rate of the infants were also followed during the first four months of life. There was a negative correlation between maternal hematocrit and infant hematocrit (rs = − 0.57). Nineteen babies born to anemic women (hematocrit < 41%) had a significantly higher mean hematocrit (59.9%) than those born to non-anemic mothers (55.8%; P = 0.003). The SaO2 levels and respiratory rates of infants were not different between infants born to non-anemic and anemic mothers. At high altitudes, infants from mothers with anemia have higher hematocrits than those born to non-anemic mothers.
PREVALENCE AND DIVERSITY OF BARTONELLA IN RODENTS OF NORTHERN THAILAND: A COMPARISON WITH BARTONELLA IN RODENTS FROM SOUTHERN CHINA
Authors: CASTLE KEVIN T. , KOSOY MICHAEL , LERDTHUSNEE KRIANGKRAI , PHELAN LORI , BAI YING , GAGE KENNETH L. , LEEPITAKRAT WARISA , MONKANNA TAWEESAK , KHLAIMANEE NITTAYA , CHANDRANOI KIRKVICH , JONES JAMES W. , COLEMAN RUSSELL E.
Published: September 2018

We report results of the first study to investigate the distribution and diversity of Bartonella in rodents from Thailand. Whole blood from 195 rodents, representing six species, was tested for the presence of Bartonella species using standard culture techniques. Isolates were obtained from 17 (8.7%) of the samples, and 14 of those isolates represented distinct strains, based upon partial sequencing of the citrate synthase (gltA) gene. Phylogenetic analysis of the isolates and other Bartonella species indicated that five unique isolates from Bandicota indica form a cluster that may represent a new Bartonella species. Two additional isolates from B. indica clustered together, and were nearly identical to an isolate from Apodemus draco collected in southern China. Importantly, a number of the isolates from Thailand rodents are closely related to B. grahamii and B. elizabethae, species which have been associated with human illness.
SPATIAL PATTERNS OF URINARY SCHISTOSOMIASIS INFECTION IN A HIGHLY ENDEMIC AREA OF COASTAL KENYA
Authors: CLENNON JULIE A. , KING CHARLES H. , MUCHIRI ERIC M. , KARIUKI H. CURTIS , OUMA JOHN H. , MUNGAI PETER , KITRON URIEL
Published: September 2018

Urinary schistosomiasis remains a major contributor to the disease burden along the southern coast of Kenya. Selective identification of transmission hot spots offers the potential for more effective, highly-focal snail control and human chemotherapy to reduce Schistosoma haematobium transmission. In the present study, a geographic information system was used to integrate demographic, parasitologic, and household location data for an endemic village and neighboring households with the biotic, abiotic, and location data for snail collection/water contact sites. A global spatial statistic was used to detect area-wide trends of clustering for human infection at the household level. Local spatial statistics were then applied to detect specific household clusters of infection, and, as a focal spatial statistic, to evaluate clustering of infection around a putative transmission site. High infection intensities were clustered significantly around a water contact site with high numbers of snails shedding S. haematobium cercariae. When age was considered, clustering was found to be significant at different distances for different age groups.
COMPARATIVE EFFICACY OF CHLOROQUINE AND SULFADOXINE-PYRIMETHAMINE FOR UNCOMPLICATED PLASMODIUM FALCIPARUM MALARIA AND IMPACT ON GAMETOCYTE CARRIAGE RATES IN THE EAST NUSATENGGARA PROVINCE OF INDONESIA
Authors: SUTANTO INGE , SUPRIYANTO SRI , RÜCKERT PAUL , PURNOMO  , MAGUIRE JASON D. , BANGS MICHAEL J.
Published: September 2018

The efficacy of chloroquine (CQ) and sulfadoxine-pyrimethamine (SP) was evaluated in 89 subjects greater than one year of age with uncomplicated P. falciparum malaria in the East Nusatenggara Province of Indonesia. Fever clearance time was longer in the SP group than in the CQ group. However, parasite clearance time was extended in subjects who received CQ compared with those who received SP. Major adverse events were not observed in either group, and no hospitalizations were required during the study. Treatment failure rates at day 28 were 69% for CQ and 8.5% for SP. In both treatment groups, gametocytemia developed during the follow-up period, but was more pronounced in the SP group, peaking at 94% on day 7. Regardless of treatment group, children < 10 years of age had significantly higher treatment failure rates than subjects ≥10 years of age (relative risk = 2.49), suggesting that acquired immunity influenced treatment outcomes in the presence of parasite drug resistance. Although a highly effective alternative to CQ for clearing infection, SP treatment also presented some potential drawbacks (e.g., increased and persistent gametocytemia). Replacement of CQ with SP as a first-line therapy, either alone or in combination with CQ, in those areas of Indonesia with high levels of CQ resistance should significantly improve treatment outcomes, particularly in vulnerable populations lacking clinical immunity. More efficacious and rapidly acting asexual stage treatments are generally associated with increased gametocyte clearance and combination therapy in areas where drug resistance is high or emerging may provide an additional means for reducing transmission.
A GLOBAL INDEX REPRESENTING THE STABILITY OF MALARIA TRANSMISSION
Authors: KISZEWSKI ANTHONY , MELLINGER ANDREW , SPIELMAN ANDREW , MALANEY PIA , SACHS SONIA EHRLICH , SACHS JEFFREY
Published: September 2018

To relate stability of malaria transmission to biologic characteristics of vector mosquitoes throughout the world, we derived an index representing the contribution of regionally dominant vector mosquitoes to the force of transmission. This construct incorporated published estimates describing the proportion of blood meals taken from human hosts, daily survival of the vector, and duration of the transmission season and of extrinsic incubation. The result of the calculation was displayed globally on a 0.5° grid. We found that these biologic characteristics of diverse vector mosquitoes interact with climate to explain much of the regional variation in the intensity of transmission. Due to the superior capacity of many tropical mosquitoes as vectors of malaria, particularly those in sub-Saharan Africa, antimalaria interventions conducted in the tropics face greater challenges than were faced by formerly endemic nations in more temperate climes.
PREDICTING TRIATOMA DIMIDIATA ABUNDANCE AND INFECTION RATE: A RISK MAP FOR NATURAL TRANSMISSION OF CHAGAS DISEASE IN THE YUCATÁN PENINSULA OF MEXICO
Authors: DUMONTEIL ERIC , GOURBIÈRE SÉBASTIEN
Published: September 2018

Chagas disease, a major public health problem in Latin America, is caused by the protozoan parasite Trypanosoma cruzi and transmitted by hematophageous insects from the Triatominae subfamily. Control of this disease is based on domestic vector control with insecticides and improvements in housing. As with other vector-borne diseases, the identification of areas of high risk of disease transmission is a major prerequisite for the planning and implementation of cost-effective control programs. In this study, we explored the relationship between Triatoma dimidiata geographic distribution and bioclimatic factors in the Yucatán peninsula in Mexico, using geographic information systems, and developed predictive models of T. dimidiata domestic abundance and of its infection rates by T. cruzi. These predictions were then used to build the first natural transmission risk map for Chagas disease in the Yucatán peninsula, a tool that should prove very valuable for the implementation of effective vector control programs in the region.
SUSPECTED SMALL-SCALE INTERPERSONAL TRANSMISSION OF MYCOBACTERIUM TUBERCULOSIS IN WARDS OF AN URBAN HOSPITAL IN DELHI, INDIA
Authors: BHANU N. VIJAYA , BANAVALIKAR J. N. , KAPOOR S. K. , SETH PRADEEP
Published: September 2018

Genotypes of Mycobacterium tuberculosis causing disease were investigated in pulmonary tuberculosis patients admitted to two adjacent wards of a tuberculosis hospital in Delhi, India. Genetic markers, the insertion sequence IS6110, a direct repeat sequence, and a polymorphic GC-rich sequence supported the circumstantial epidemiologic link between eight strains of M. tuberculosis, suggesting their possible involvement in small-scale, interpersonal transmission of both drug-sensitive and drug-resistant tuberculosis. This is the first report of a suspected acquisition of M. tuberculosis among hospitalized patients in India. The use of multiple molecular typing markers and techniques unequivocally identified the exact clonality of strains isolated from the hospital. The result of this study emphasizes the need for more comprehensive investigation of high-risk situations for tuberculosis transmission and long-term follow-up analysis for identifying such instances of unsuspected transmission.
ETIOLOGY OF DIARRHEA IN CHILDREN LESS THAN FIVE YEARS OF AGE IN IFAKARA, TANZANIA
Authors: VARGAS MARTHA , GASCÓN JOAQUIM , CASALS CLIMENT , SCHELLENBERG DAVID , URASSA HONORATI , KAHIGWA ELISEUS , RUIZ JOAQUIM , VILA JORDI
Published: September 2018

A total of 451 stool specimens were collected from children less than five years of age with acute diarrhea from Ifakara, Tanzania and processed to detect bacterial enteropathogens, parasites, and rotaviruses. These specimens were divided into 348 from the dry season and 103 from the rainy season. Overall, diarrheogenic Escherichia coli (35.7%) were the predominant enteropathogens, with enterotoxigenic E. coli, enteroaggregative E. coli, and enteropathogenic E. coli being the most prevalent. Moreover, enteroaggregative E. coli (63% versus 35.5%; P < 0.05), Shigella spp. (24% versus 12%; P < 0.05), and rotavirus (23% versus 4%; P < 0.05) were more prevalent in the dry season than in the rainy season and enterotoxigenic E. coli (51.6% versus 20%; P < 0.05) and Giardia lamblia (14% versus 1%; P < 0.05) were more prevalent in the rainy season.