bluuebunny/crossref_metadata_2025 huggingface dataset:
ASYMPTOMATIC CRYPTOSPORIDIUM HOMINIS INFECTION AMONG HUMAN IMMUNDEFICIENCY VIRUS–INFECTED PATIENTS IN TANZANIA
Authors: HOUPT ERIC R. , BUSHEN OLUMA Y. , SAM NOEL E. , KOHLI ANITA , ASGHARPOUR AMON , NG CHERIE T. , CALFEE DAVID P. , GUERRANT RICHARD L. , MARO VENANCE , OLE-NGUYAINE SENDUI , SHAO JOHN F.
Published: September 2018

Few data exist on the relative importance of individual Cryptosporidium species in acquired immunodeficiency syndrome cryptosporidiosis. We characterized 127 inpatients infected with human immunodeficiency virus (HIV) in Tanzania for their CD4 cell count and by stool analysis, including Cryptosporidium immunofluorescence and polymerase chain reaction-restriction fragment length polymorphism. Cryptosporidium was detected in patients both with and without diarrheal symptoms (defined as ≥ 3 liquid stools/day, 11 of 61 versus 11 of 66; P = not significant) and was a marker for low CD4 cell count (median = 124/μL versus 212/μL in Cryptosporidium-negative patients; P < 0.04). Cryptosporidium hominis was the predominant species in this region and was associated with a longer duration of symptoms, a higher rate of asymptomatic infection, and a lower CD4 cell count versus C. parvum-infected patients (P < 0.05). This study suggests there may be important differences in the natural history of Cryptosporidium infection in HIV-infected persons depending on parasite species.
EFFECT OF WATER RESOURCE DEVELOPMENT AND MANAGEMENT ON LYMPHATIC FILARIASIS, AND ESTIMATES OF POPULATIONS AT RISK
Authors: ERLANGER TOBIAS E. , KEISER JENNIFER , CALDAS DE CASTRO MARCIA , BOS ROBERT , SINGER BURTON H. , TANNER MARCEL , UTZINGER JÜRG
Published: September 2018

Lymphatic filariasis (LF) is a debilitating disease overwhelmingly caused by Wuchereria bancrofti, which is transmitted by various mosquito species. Here, we present a systematic literature review with the following objectives: (i) to establish global and regional estimates of populations at risk of LF with particular consideration of water resource development projects, and (ii) to assess the effects of water resource development and management on the frequency and transmission dynamics of the disease. We estimate that globally, 2 billion people are at risk of LF. Among them, there are 394.5 million urban dwellers without access to improved sanitation and 213 million rural dwellers living in close proximity to irrigation. Environmental changes due to water resource development and management consistently led to a shift in vector species composition and generally to a strong proliferation of vector populations. For example, in World Health Organization (WHO) subregions 1 and 2, mosquito densities of the Anopheles gambiae complex and Anopheles funestus were up to 25-fold higher in irrigated areas when compared with irrigation-free sites. Although the infection prevalence of LF often increased after the implementation of a water project, there was no clear association with clinical symptoms. Concluding, there is a need to assess and quantify changes of LF transmission parameters and clinical manifestations over the entire course of water resource developments. Where resources allow, integrated vector management should complement mass drug administration, and broad-based monitoring and surveillance of the disease should become an integral part of large-scale waste management and sanitation programs, whose basic rationale lies in a systemic approach to city, district, and regional level health services and disease prevention.
STATUS OF PLASMODIUM VIVAX MALARIA IN THE REPUBLIC OF KOREA DURING 2001–2003
Authors: YEOM JOON-SUP , RYU SEUNG-HO , OH SEJOONG , LEE WON-JA , KIM TAE-SEON , KIM KI-HWAN , KIM YOUNG-A , AHN SUN-YOUNG , CHA JE-EUN , PARK JAE-WON
Published: September 2018

The Republic of Korea experienced a re-emergence of Plasmodium vivax malaria in 1993. The incidence of this disease increased rapidly through 2000 with its geographic distribution expanding from the vicinity near the Demilitarized Zone to the adjacent outlying areas. However, the number of cases of P. vivax malaria since that time period has decreased. A total of 2,538 cases occurred in 2001, and this decreased to 1,761 cases and 1,164 cases in the two subsequent years. A total of 5,463 cases of P. vivax malaria were reported from 2001 through 2003; 25.26% (1,380) were reported among Republic of Korea military personnel, 27.48% (1,501) were among veterans who had been discharged from the military within two years, and 47.26% (2,582) were among the civilian population. Mosquito control activities by the North Korean and South Korean governments, chemoprophylaxis of Republic of Korea Army personnel, and the low level of Anopheles mosquitoes in 2001 may have been factors responsible for the decreasing number of malaria cases. However, local transmission might have taken place in urban regions of the malaria-risk areas that are within 30 km south of the Demilitarized Zone. Extensive intervention and continued surveillance are warranted to prevent the epidemic from re-expanding and to eliminate this disease in the Republic of Korea.
REDUCTION OF CHILDHOOD MALARIA BY SOCIAL MARKETING OF INSECTICIDE-TREATED NETS: A CASE-CONTROL STUDY OF EFFECTIVENESS IN MALAWI
Authors: MATHANGA DON P. , CAMPBELL CARL H. , TAYLOR TERRIE E. , BARLOW ROBIN , WILSON MARK L.
Published: September 2018

Use of an insecticide-treated net (ITN) is now the central focus for the Roll Back Malaria campaign, and disease-endemic countries have embarked on large-scale ITN distribution programs. We assessed the impact of an ITN social marketing program on clinical malaria in children less than five years of age. A case-control study was undertaken at Ndirande Health Center in the peri-urban area of the city of Blantyre, Malawi. Cases were defined by an axillary temperature ≥ 37.5°C or a history of fever within the last 48 hours and a positive blood smear for Plasmodium falciparum. The individual effectiveness of ITN use was 40% (95% confidence interval [CI] = 10–60%) when cases were compared with clinic controls and 50% (95% CI = 0–60%) in comparison with community controls. With ITN coverage of 42%, the community effectiveness of this program was estimated to range from 17% to 21%. This represents 1,480 malaria cases averted by the intervention in a population of 15,000 children. Our results show that the benefits of ITN social marketing programs in reducing malaria are enormous. Targeting the poor could increase those benefits.
HIGH COMPLEXITY OF PLASMODIUM VIVAX INFECTIONS IN PAPUA NEW GUINEAN CHILDREN
Authors: COLE-TOBIAN JENNIFER L. , BIASOR MOSES , KING CHRISTOPHER L.
Published: September 2018

Although genetically distinct malaria parasites have been shown to simultaneously infect an individual, the total number of unique parasites has not been systematically studied. We examined multiple clones (8–38) from individual blood samples collected from Papua New Guinean children for polymorphisms in the Plasmodium vivax Duffy binding protein (dbpII) and the merozoite surface protein 3α (msp3α). We found a median of 4 (range = 2–6) and 12 (range = 2–23) unique genotypes based on dbpII and msp3α, respectively, per person at one time point and at least 12–33 unique genotypes per person over a four-month period. Control polymerase chain reactions (PCRs) detected 0–31% of clones with haplotypes that arose from PCR artifacts, indicating that caution must be taken when using PCR-based analysis to examine complex infections. To reduce artifacts from clones, analysis was based on haplotypes unlikely to have been generated by PCR artifacts or had been previously identified. Plasmodium vivax infections can be highly complex in disease-endemic areas, suggesting continual genetic mixing that could have significant implications for the use of antimalarial drugs and malaria vaccines.
HIV PREVALENCE AND RISK FACTORS IN WOMEN OF ACCRA, GHANA: RESULTS FROM THE WOMEN’S HEALTH STUDY OF ACCRA
Authors: DUDA ROSEMARY B. , DARKO RUDOLPH , ADANU RICHARD M. K. , SEFFAH JOSEPH , ANARFI JOHN K. , GAUTAM SHIVA , HILL ALLAN G.
Published: September 2018

The Women’s Health Study of Accra is a cross-sectional study designed to measure the burden of communicable and noncommunicable diseases in adult women residing in Accra, Ghana. This study assessed the prevalence rate of HIV and risk factors associated with HIV infection in 1,328 women age 18 years and older. The weighted overall HIV prevalence rate for women residing in Accra is 3.1%. The highest prevalence rate of HIV infections was identified in women age 25 to 29 years at 8.3%, OR (95%CI) 3.8 (1.68–8.33), P = 001. In addition to young age, other significant risk factors included sexually transmitted infection (STI) symptoms (OR 1.81 [1.14–2.87], P = 0.012) and mean number of lifetime sexual partners (P < 0.001). All HIV-positive women were sexually active. Other findings significantly associated with HIV-positive status included chills, oral lesions, tuberculosis, bloody sputum production, and intestinal parasite infections. There was a significant association with HIV-positive status and locality of residence in the city. There was no association with reported use of condoms, blood transfusions, surgery, reproductive health history including pregnancy or number of sexual partners, symptoms suggestive of AIDS, or self-perception of health. There was also no association with education level, religion, ethnicity, marital status, or socioeconomic level. This community-based study confirms the need to target young, sexually active women for HIV educational and preventive initiatives. A strong Ghanaian public health initiative to increase awareness of the risks of HIV and the link to STIs is critical at this time to prevent the further increase in HIV prevalence and the resultant HIV-associated illnesses.
5-DAY NONOBSERVED ARTESUNATE MONOTHERAPY FOR TREATING UNCOMPLICATED FALCIPARUM MALARIA IN YOUNG GABONESE CHILDREN
Authors: SCHWARZ NORBERT G. , OYAKHIROME SUNNY , PÖTSCHKE MARC , GLÄSER BENJAMIN , KLOUWENBERG PETER KLEIN , ALTUN HANDAN , ADEGNIKA AYOLA A. , ISSIFOU SAADOU , KUN JÜRGEN F. J. , KREMSNER PETER G. , GROBUSCH MARTIN P.
Published: September 2018

Despite different recommendations from WHO and national authorities, artesunate monotherapy is increasingly used for treating African children with malaria. A 5-day course of oral artesunate (first day: 4 mg/kg body weight, observed intake; and 2 mg/kg body weight on the following days with nonobserved drug intake) yielded a PCR-corrected Day 28 cure rate of 90% (45 of 50 patients; CI 78–97%) in Gabonese children aged between 2 and 18 months. Artesunate was well tolerated, and no severe adverse events were reported.
MALE SEX PHEROMONES AND THE PHYLOGEOGRAPHIC STRUCTURE OF THE LUTZOMYIA LONGIPALPIS SPECIES COMPLEX (DIPTERA: PSYCHODIDAE) FROM BRAZIL AND VENEZUELA
Authors: WATTS PHILLIP C. , HAMILTON J. GORDON C. , WARD RICHARD D. , NOYES HARRY A. , SOUZA NATALY A. , KEMP STEPHEN J. , FELICIANGELI M. DORA , BRAZIL REGINALDO , MAINGON RHAYZA D. C.
Published: September 2018

Lutzomyia longipalpis, a sibling complex, is the main vector of Leishmania chagasi/infantum. Discriminating between siblings is important as they may differ in vectorial capacity. Lutzomyia longipalpis populations display distinct male sex pheromone chemotypes. We investigated the phylogeographic pattern of variation at microsatellite loci from 11 populations from Brazil and Venezuela related to their male pheromone. Temporal genetic differentiation was mostly not significant at the same site. Spatial genetic differentiation was, however, strong, although there was only a weak relationship between genetic differentiation and the geographic distance separating the samples (r2 < 0.10); geographic separation explained a much greater (54–97%) percentage of the genetic differences among populations when samples with the same pheromone type were analyzed separately. A cluster analysis showed five groups: Lu. cruzi (Brazil) and Lu. pseudolongipalpis (Venezuela) as separate species, two (mostly 9-methyl-germacrene-B) Venezuelan and Brazilian groups, and a very distinct cluster of Brazilian cembrene populations.
FINDING NEEDLES IN THE HAYSTACK: SINGLE COPY MICROSATELLITE LOCI FOR AEDES JAPONICUS (DIPTERA: CULICIDAE)
Authors: WIDDEL ANDREA K. , MCCUISTON LINDA J. , CRANS WAYNE J. , KRAMER LAURA D. , FONSECA DINA M.
Published: September 2018

First identified in three North American states in 1998, Aedes japonicus japonicus, the Asian bush mosquito, has since spread to 21 states, plus Ontario in Canada, northern France, and Belgium. Analyses of the introduction and expansion of this potentially deadly disease vector will be radically improved by including powerful genetic markers like microsatellites. Useful microsatellite loci have, however, been difficult to identify for mosquitoes in the genus Aedes because of the high amount of repetitive DNA in these species. We isolated single-copy DNA from Ae. j. japonicus and then used a standard enrichment method to identify regions containing microsatellites. Here we describe seven polymorphic microsatellite loci that were tested in American populations of Ae. j. japonicus. These loci were also found to be polymorphic in two other of the four Ae. japonicus subspecies and in Aedes koreicus.
CLINICAL CORRELATES OF FILARIAL INFECTION IN HAITIAN CHILDREN: AN ASSOCIATION WITH INTERDIGITAL LESIONS
Authors: FOX LEANNE M. , WILSON SUSAN F. , ADDISS DAVID G. , LOUIS-CHARLES JACKY , DE ROCHARS MADSEN V. BEAU , LAMMIE PATRICK J.
Published: September 2018

To assess clinical findings associated with Wuchereria bancrofti infection, 192 school children in a filariasis-endemic area of Haiti underwent physical and ultrasonographic examinations and testing for circulating filarial antigen (CFA). The CFA-positive children were more likely than CFA-negative children to have severe interdigital lesions (≥1 macerated lesion with involvement of ≥4 toe web spaces) (P < 0.0001) and inguinal (P = 0.003) or crural (P = 0.004) lymph node pathology. In multivariate analysis, CFA positivity remained a significant predictor for severe interdigital lesions (P = 0.006) and inguinal lymph node pathology (P = 0.05). Ultrasound detected adult worms and lymphangectasia (diameter = 2.0–4.0 mm) in 11 (10.8%) CFA-positive children. Among CFA-positive children, ultrasonographic detection of adult worms was associated with inguinal (P = 0.01) and crural (P = 0.004) lymph node pathology and advanced pubertal stage (sexual maturity rating = 3–5) (P = 0.02). This is the first study to associate interdigital lesions with filarial infection in children.
SERODIAGNOSIS OF NEUROCYSTICERCOSIS USING SYNTHETIC 8-KD PROTEINS: COMPARISON OF ASSAY FORMATS
Authors: SCHEEL CHRISTINA M. , KHAN AZRA , HANCOCK KATHY , GARCIA HECTOR H. , GONZALEZ ARMANDO E. , GILMAN ROBERT H. , TSANG VICTOR C. W. , _ _
Published: September 2018

The assay of choice for serological detection of cysticercosis in humans and pigs is the enzyme-linked immunoelectrotransfer blot (EITB), a Western blot assay that relies on the use of seven lentil-lectin–purified glycoproteins (LLGPs) derived from Taenia solium metacestodes. The EITB is has a sensitivity of 98% and a specificity of 100% in detecting cysticercosis, yet scarcity of native source material and the labor-intensive process of metacestode purification hinder its practicality. These limitations have necessitated the reproduction of the EITB antigens in synthetic forms. Four chemically synthesized LLGP antigens, TS14, TS18var1, TSRS1, and TSRS2var1, were assayed individually by enzyme-linked immunosorbent assay (ELISA) and Western blot for immunoreactivity against a large cohort of sera from clinically defined neurocysticercosis patients. The sensitivity and specificity of all four of these antigens using the ELISA format were well below the standards set by the LLGP EITB, whereas results of the Western blot format closely mirrored those of the LLGP EITB.
RELATIONSHIP BETWEEN INTENSITY OF SOIL-TRANSMITTED HELMINTH INFECTIONS AND ANEMIA DURING PREGNANCY
Authors: LAROCQUE RENEE , CASAPIA MARTIN , GOTUZZO EDUARDO , GYORKOS THERESA W.
Published: September 2018

A direct relationship exists between the intensity of hookworm infection and blood loss. Other parasites may also contribute to blood loss. Our objective was to assess the relationship between the intensity of soil-transmitted helminth infections and anemia in pregnant women in a highly endemic area of Peru. Recruitment occurred between April and November 2003. Overall, 47.31% of 1,042 women had anemia (hemoglobin < 11 g/dL), 47.22% were infected with hookworm and 82.25% with Trichuris. Prevalences of infections were not associated with anemia. However, those infected with moderate and heavy intensities of hookworm infection (OR = 1.84; 95% CI: 1.06, 3.17) and those with moderate and heavy intensities of both hookworm and Trichuris infections (OR = 2.13; 95% CI: 1.10, 4.13) were more likely to suffer from anemia than women having no or light intensities. These results support routine anthelminthic treatment within prenatal care programs in highly endemic areas.
SUCCESSFUL TREATMENT OF REFRACTORY CUTANEOUS LEISHMANIASIS WITH GM-CSF AND ANTIMONIALS
Authors: ALMEIDA ROQUE P. , BRITO JUSSAMARA , MACHADO PAULO L. , DE JESUS AMÉLIA R. , SCHRIEFER ALBERT , GUIMARÃES LUIZ HENRIQUE , CARVALHO EDGAR M.
Published: September 2018

Therapeutic failure in the treatment of cutaneous leishmaniasis (CL) occurs in 5% of patients infected by Leishmania braziliensis. This study evaluates the use of topically applied granulocyte macrophage colony-stimulating factor (GM-CSF) combined with the standard dose of antimony to treat refractory cases of CL. Five patients who had received three courses or more of antimony were enrolled in an open-label clinical trial. One to 2 mL of the GM-CSF solution (10 μg/mL in 0.9% saline) was reapplied topically, and dressings were changed three times per week for 3 weeks, associated with standard parenteral antimony (20 mg kg−1 day−1 for 20 days). All the patients healed their CL ulcers; 3 healed within 50 days (21, 27, and 44 days) and 2 in 118 and 120 days after beginning therapy. There were no side effects. This study shows that combined topically applied GM-CSF and antimony can be effective and well tolerated in the treatment of relapsed CL.
NUCLEOTIDE AND AMINO ACID CHANGES IN WEST NILE VIRUS STRAINS EXHIBITING RENAL TROPISM IN HAMSTERS
Authors: DING XIAOHUA , WU XIAOYAN , DUAN TAO , SIIRIN MARINA , GUZMAN HILDA , YANG ZHANQIU , TESH ROBERT B. , XIAO SHU-YUAN
Published: September 2018

Recent studies have shown that West Nile virus (WNV) can induce an asymptomatic persistent infection in the kidneys of experimentally infected hamsters. The chronically infected rodents shed virus in their urine for up to 8 months, despite the disappearance of viremia and the development of high levels of neutralizing antibodies. WNV, like most members of the Japanese encephalitis virus complex (Flavivirus; Flaviviridae), is assumed to be mainly neurotropic; little is known about the genetic basis for its renal tropism. In this study, complete sequence analyses were done to compare four WNV isolates from the urines of persistently infected hamsters with the wild-type parent virus (NY 385-99). Nucleotide changes, ranging from 0.05% to 0.09%, were identified in all of the WNV isolates from urine; most of the changes were in coding regions, causing amino acid substitutions in the E, NS1, NS2B, and NS5 proteins. The genetic changes associated with renal tropism were also accompanied by a loss of virulence for hamsters and a change in plaque morphology.
AMODIAQUINE, SULFADOXINE-PYRIMETHAMINE, AND COMBINATION THERAPY FOR UNCOMPLICATED FALCIPARUM MALARIA: A RANDOMIZED CONTROLLED TRIAL FROM BURKINA FASO
Authors: ZONGO ISSAKA , DORSEY GRANT , ROUAMBA NOEL , DOKOMAJILAR CHRISTIAN , LANKOANDE MOISE , OUEDRAOGO JEAN-BOSCO , ROSENTHAL PHILIP J.
Published: September 2018

Increasing resistance to chloroquine necessitates the evaluation of other antimalarial therapies in Africa. We compared the efficacies of amodiaquine (AQ), sulfadoxine-pyrimethamine (SP), and AQ + SP for the treatment of uncomplicated falciparum malaria in a randomized trial of patients 6 months of age or older in Bobo-Dioulasso, Burkina Faso. Of the 944 patients enrolled, 829 (88%; 53% under 5 years of age) were assigned 28-day efficacy outcomes. For all regimens, early treatment failures were uncommon (< 2%). Considering all treatment failures based on WHO criteria, AQ + SP was most efficacious (failures in 4.2%), followed by SP (9.1%) and AQ (17.9%; P < 0.02 for all pairwise comparisons). Considering only clinical failures, relative efficacies were similar (failures in 2.1% with AQ + SP, 6.5% with SP, and 13.2% with AQ; P < 0.02 for all pairwise comparisons). The risk of recrudescence was lower with AQ + SP (2.1%) compared with SP (6.1%, P = 0.02) and AQ (8.1%, P = 0.001). Risks of new infection were lower with AQ + SP (2.1%) and SP (2.4%) compared with AQ (9.1%, P < 0.001 for both comparisons). No serious adverse events were seen. AQ + SP appears to offer a highly effective, inexpensive, and available therapy for the treatment of uncomplicated malaria in Burkina Faso.
EVALUATION OF A RAPID DIAGNOSTIC TEST FOR ASSESSING THE BURDEN OF MALARIA AT DELIVERY IN INDIA
Authors: SINGH NEERU , SAXENA AJAY , AWADHIA S. B. , SHRIVASTAVA RITA , SINGH M. P.
Published: September 2018

All pregnant women who came for delivery at a district hospital in Mandla and a civil hospital in Maihar were screened for Plasmodium falciparum (placental parasitemia using a rapid test and microscopy and peripheral and umbilical cord parasitemia using microscopy alone). Two rapid diagnostic tests (RDTs), Paracheck Pf and ParaHITf, were used. At Mandla, the sensitivity and specificity of the Paracheck Pf for P. falciparum were 93% and 84%, respectively. The positive predictive values (PPVs) and negative predictive values (NPVs) were 50% and 99%, respectively. At Maihar, the sensitivity and specificity of the ParaHITf for P. falciparum were 87.5% and 97%, respectively. The PPVs and NPVs were 75.4% and 98.7%, respectively. Placental infection was significantly associated with low birth weight. The RDTs for the identification of P. falciparum were more sensitive in placental blood than the placental blood smear by microscopy. Thus, the RDTs should be useful for rapid assessment of malaria at delivery.
PROTECTIVE EFFICACY OF LAMBDA-CYHALOTHRIN TREATED NETS IN ANOPHELES GAMBIAE PYRETHROID RESISTANCE AREAS OF CÔTE D’IVOIRE
Authors: HENRY MARIE-CLAIRE , ASSI SERGE-BRICE , ROGIER CHRISTOPHE , DOSSOU-YOVO JOËL , CHANDRE FABRICE , GUILLET PIERRE , CARNEVALE PIERRE
Published: September 2018

The efficacy of nets treated with lambda-cyhalothrin, a pyrethroid insecticide, on malaria infection and disease was assessed for the first time at the community level in Anopheles gambiae pyrethroid resistance areas. The study was carried out in northern Côte d’Ivoire, which is an area of kdr resistance. Four pairs of villages were selected and matched according to demographic, sociological, and ecological criteria. Among each pair, a village was randomly allocated to receive mosquito nets. More than 80% of beds were covered with nets treated with lambda-cyhalothrin and retreated after 6 months. In each village, 54 children aged 0–59 months were randomly selected and clinically monitored for 8 periods of 7 days throughout the year. Results showed that the efficacy of treated nets was maintained with a reduction of the prevalence of asymptomatic malaria infection by 12% and an estimated protective efficacy against malaria disease of 56%.
COMPARATIVE INFECTIVITY OF BABESIA DIVERGENS AND A ZOONOTIC BABESIA DIVERGENS–LIKE PARASITE IN CATTLE
Authors: HOLMAN PATRICIA J. , SPENCER ANGELA M. , TELFORD SAM R. , GOETHERT HEIDI K. , ALLEN ANDREW J. , KNOWLES DONALD P. , GOFF WILL L.
Published: September 2018

Babesia divergens–like parasites identified in human babesiosis cases in Missouri and Kentucky and in eastern cottontail rabbits (Sylvilagus floridanus) on Nantucket Island, Massachusetts, share identical small subunit ribosomal RNA gene sequences. This sequence is 99.8% identical to that of Babesia divergens, suggesting that the U.S. parasite may be B. divergens, a causative agent of human and bovine babesiosis in Europe. Holstein-Friesian calves were inoculated with cultured Nantucket Island Babesia sp. (NR831) and B. divergens parasites and monitored by clinical signs, Giemsa-stained blood films, PCR, and culture. The NR831 recipients did not exhibit clinical signs of infection and remained negative for all assays. The B. divergens recipients developed clinical infections and became positive by all assays. NR831 recipients were fully susceptible upon challenge inoculation with B. divergens. This study confirms that the Nantucket Island Babesia sp. is not conspecific with B. divergens based on host specificity for cattle.
CONCOMITANT PARASITISM: BANCROFTIAN FILARIASIS AND INTESTINAL HELMINTHS AND RESPONSE TO ALBENDAZOLE
Authors: SAHOO PRAKASH K. , SATAPATHY ASHOK K. , MICHAEL EDWIN , RAVINDRAN BALACHANDRAN
Published: September 2018

Subjects in an disease-endemic area in Orissa, India concomitantly infected with filariasis and intestinal helminths had significantly lower intensity of filarial infection in comparison with those who were infected only with filariasis. Administration of albendazole resulted in a significant decrease in the prevalence of filarial antigenemia in subjects concomitantly infected with intestinal helminths, but produced little change in this infection measure in subjects infected only with Wuchereria bancrofti. These results indicate that intestinal helminths could play a role in the anti-filarial activity of albendazole, most probably by depressing filarial infection intensity in co-infected individuals. Confirmation of these findings in a larger cohort may yield important new insights regarding the role of using albendazole in the ongoing intervention programs for the control of lymphatic filariasis.
EFFECTS OF IVERMECTIN AND DIETHYLCARBAMAZINE ON MICROFILARIAE AND OVERALL MICROFILARIA PRODUCTION IN BANCROFTIAN FILARIASIS
Authors: STOLK WILMA A. , VAN OORTMARSSEN GERRIT J. , PANI S. P. , DE VLAS SAKE J. , SUBRAMANIAN S. , DAS P. K. , HABBEMA J. DIK F.
Published: September 2018

Ivermectin and diethylcarbamazine (DEC) are used in mass treatment programs for the elimination of lymphatic filariasis because of their strong effects on microfilaremia. However, the effects of treatment on adult worms and the degree of individual variation in efficacy are unclear. We analyzed series of microfilaria (Mf) counts from individuals treated with a single dose of 400 μg/kg ivermectin or 6 mg/kg DEC (N = 23 in each group; 1 year follow-up). For each individual, we estimated the microfilaricidal effect and the reduction in overall Mf production (e.g., caused by death or sterilization of worms, or inhibited Mf release from the female worm uterus). Ivermectin on average killed 96% of Mf and reduced Mf production by 82%. DEC killed 57% of Mf and reduced Mf production by 67%, with some individuals responding very poorly. The strong reduction in overall Mf production is good news for control of lymphatic filariasis, but the prospects of elimination will be diminished if part of the population systematically responds poorly to treatment.
ACANTHAMOEBA INFECTION AS A CAUSE OF SEVERE KERATITIS IN A SOFT CONTACT LENS WEARER IN JAMAICA
Authors: WYNTER-ALLISON ZOE , MORALES JACOB LORENZO , CALDER DONOVAN , RADLEIN KRAIG , ORTEGA-RIVAS ANTONIO , LINDO JOHN F.
Published: September 2018

We report the case of a 29-year-old Jamaican patient who presented with severe pain, redness, and swelling of both eyes. She was a regular soft contact lens wearer who did not maintain standard lens care. She was treated for a possible microbial/viral keratitis using topical ciprofloxacin drops, topical acyclovir ointment, and topical atropine drops. The response was inadequate, and scrapings from her cornea, contact lens cases, and both lenses revealed Acanthamoeba on microscopy, which was shown to be Acanthamoeba polyphaga using polymerase chain reaction. She was treated using chlorhexidine 0.02% hourly, ciprofloxacin every 4 hours, and atropine 1% every 12 hours, along with oral ketoconazole 200 mg twice daily with a dramatic response. However, she subsequently suffered slow corneal epithelial regrowth with severe scarring, vascularization, and cortical lens opacification and was referred for penetrating keratoplasty and cataract surgery. This is the first case of severe keratitis caused by Acanthamoeba to be reported from Jamaica and demonstrates that this emerging pathogen can be a cause of severe keratitis in the tropics.
PROTECTION AGAINST SCRUB TYPHUS BY A PLASMID VACCINE ENCODING THE 56-KD OUTER MEMBRANE PROTEIN ANTIGEN GENE
Authors: NI YI-SHENG , CHAN TEIK-CHYE , CHAO CHIEN-CHUNG , RICHARDS ALLEN L. , DASCH GREGORY A. , CHING WEI-MEI
Published: September 2018

The 56-kD outer membrane protein of Orientia tsutsugamushi has previously been shown to be the immunodominant antigen in scrub typhus infections. Its gene was cloned into the DNA vaccine vector pVR1012 as a vaccine candidate (pKarp56). The in vitro expression of this 56-kD antigen by pKarp56 was confirmed in tissue culture by an indirect fluorescence assay and Western blot analysis. The initial antibody responses of mice immunized with varied doses of the pKarp56 were barely detected, but increases were observed after each of three subsequent booster immunizations. Although no protection was observed with a single immunization of pKarp56, after four immunizations, 60% of the mice survived a 1,000 × 50% lethal dose (LD50) challenge. These results specifically confirm the importance of the 56-kD protein antigen in protective immunity against O. tsutsugamushi and demonstrate the feasibility of DNA vaccines for the prevention of scrub typhus.
ENUMERATING LEPTOSPIRES USING THE COULTER COUNTER
Authors: HUMBERD CHRISTINA M. , MURRAY CLINTON K. , STUART SAUNDRA K. , REEB BARBARA A. , HOSPENTHAL DUANE R.
Published: September 2018

The currently accepted gold standard for enumeration of leptospires is tabulation of organisms using a Petroff-Hausser counting chamber and dark-field microscopy, a technically demanding, time-consuming technique. Quantification of leptospires with a Coulter counter produced reliable and reproducible counts, comparable to the counting chamber. This experiment demonstrates that the faster, less technically demanding Coulter counter may be an alternative to determine numbers of leptospires.
TETRODOTOXICATION WITH NASSAURIS GLANS: A POSSIBILITY OF TETRODOTOXIN SPREADING IN MARINE PRODUCTS NEAR PRATAS ISLAND
Authors: YIN HSIN L. , LIN HUNG S. , HUANG CHIH C. , HWANG DENG F. , LIU JIA S. , CHEN WEI H.
Published: September 2018

Tetrodotoxication was observed in six patients who ate gastropods from the South China Sea near Pratas Island. The pathogenic gastropod was Nassauris glans, which had not been previously mentioned in human tetrodotoxication. An extremely high level of tetrodotoxin was found in the causative gastropods, and a variety of clinical signs were observed in the survivors. The postmortem autopsy of two patients showed severe distension and hypersecretion of the alimentary tract, suggestive of a cholinergic crisis as the cause of their early death. A recognition of education regarding the risk of tetrodotoxication by N. glans in the study area is important to prevent further tragedy. A retrospective review of the tetrodotoxication in this region may aid in understanding the changes and route of tetrodotoxication in marine products, and provide valuable information for preventive measures.
LEPIDOPTERISM DUE TO EXPOSURE TO THE MOTH HYLESIA METABUS IN NORTHEASTERN VENEZUELA
Authors: RODRIGUEZ-MORALES ALFONSO J. , ARRIA MELISSA , ROJAS-MIRABAL JOSE , BORGES EDUARDO , BENITEZ JESUS A. , HERRERA MELFRAN , VILLALOBOS CARLOS , MALDONADO ANDREA , RUBIO NESTOR , FRANCO-PAREDES CARLOS
Published: September 2018

Lepidopterism refers to a spectrum of medical conditions in humans that usually involves the skin and results from contact with the adult or larval forms of certain butterflies and moths. We analyzed the epidemiologic and clinical features associated with exposure to the moth Hylesia metabus between 1970 and 2002 in the Cajigal district, Sucre, Venezuela. Fifty cases of lepidopterism mostly affecting individuals under 18 years of age were identified during this period and manifested as pruritic dermatitis with or without associated respiratory symptoms. With increased travel to endemic areas of lepidopterism, travel and tropical medicine practitioners should be aware of the clinical spectrum of this condition.
VARIATION IN TRYPANOSOMA CRUZI CLONAL COMPOSITION DETECTED IN BLOOD PATIENTS AND XENODIAGNOSIS TRIATOMINES: IMPLICATIONS IN THE MOLECULAR EPIDEMIOLOGY OF CHILE
Authors: CORONADO XIMENA , ZULANTAY INES , ALBRECHT HELENA , ROZAS MARLENE , APT WERNER , ORTIZ SYLVIA , RODRIGUEZ JORGE , SANCHEZ GITTITH , SOLARI ALDO
Published: September 2018

To identify Trypanosoma cruzi clones from chronically infected individuals, they were transferred to triatomines by the xenodiagnosis test (XD) with Triatoma infestans. Polymerase chain reaction (PCR) and hybridization assays were performed to detect minicircle DNA in human blood samples and triatomine feces, using probes to determine the T. cruzi clones present. T. cruzi clone 19 (TcI) resulted the most prevalent in humans, with a frequency of 0.70 compared with a frequency of 0.53 in triatomines. T. cruzi clone 39 (TcIId) was the most prevalent in T. infestans, with a frequency of 0.65 compared with 0.33 in humans. The T. cruzi clone 43 (TcIIe) was not detected in blood samples; nevertheless, it was present at a rate of 0.17 in T. infestans feces. In conclusion, the T. cruzi clones are associated to each host, suggesting that selective amplification of clones occurs in human and triatomines.
HIGHER SEROPREVALENCE OF ENTAMOEBA HISTOLYTICA INFECTION IS ASSOCIATED WITH HUMAN IMMUNODEFICIENCY VIRUS TYPE 1 INFECTION IN TAIWAN
Authors: TSAI JIH-JIN , SUN HSIN-YUN , KE LIANG-YIN , TSAI KEH-SUNG , CHANG SUI-YUAN , HSIEH SZU-MIN , HSIAO CHIN-FU , YEN JENG-HSIEN , HUNG CHIEN-CHING , CHANG SHAN-CHWEN
Published: September 2018

We assessed the seroprevalence of Entamoeba histolytica infection using indirect hemagglutination antibody (IHA) assay among 667 HIV-infected persons (group A), 1,311 asymptomatic HIV-uninfected persons seeking anonymous HIV testing (group B), 616 HIV-uninfected controls with gastrointestinal symptoms (diarrhea and/or liver abscess) seeking medical care (group C), and 2,500 healthy controls undergoing health check-up (group D). An IHA titer ≥ 128 was detected in 7.1% of group A, 2.5% of group B, 1.8% of group C, and 0.1% of group D (P < 0.0001). The highest seroprevalence (11.2%) was noted among HIV-infected persons who were men having sex with men (MSM) 30–39 years of age. Compared with persons with gastrointestinal symptoms, the adjusted odds ratio for having high IHA titers among HIV-infected persons was 3.206 (95% confidence interval, 1.433, 7.176; P = 0.005). These findings show that HIV-infected persons, especially MSM 30–39 years of age, are at significantly higher risk of E. histolytica infection.
SPREAD OF EQUINE WEST NILE VIRUS ENCEPHALOMYELITIS DURING THE 2002 TEXAS EPIDEMIC
Authors: WARD MICHAEL P.
Published: September 2018

Using reports of clinical West Nile virus (WNV) encephalomyelitis in Texas equids during 2002, the distribution of disease was analyzed using cluster statistics and spatial modeling to develop hypotheses of disease spread during the first year of its detection. Significant (P < 0.05) clusters of cases reported early during the outbreak were identified in east, northcentral, and north Texas, and significant (P < 0.05) clusters late during the outbreak were detected in central, south, and west Texas. Two counties on the south Texas coast first reported disease significantly (P < 0.05) earlier than their 10 nearest neighboring counties. The estimated incidence of disease was greatest in the high plains of north Texas and in northcentral Texas. Higher rates were also estimated in eastern and southern areas of the Gulf Coast. The spatial and temporal distribution observed indicates that the equine WNV epidemic began in two parts of Texas and spread elsewhere throughout the state. The mechanism of introduction and spread remains speculative.
CLINICAL LABORATORY, VIROLOGIC, AND PATHOLOGIC CHANGES IN HAMSTERS EXPERIMENTALLY INFECTED WITH PIRITAL VIRUS (ARENAVIRIDAE): A RODENT MODEL OF LASSA FEVER
Authors: SBRANA ELENA , MATEO ROSA I. , XIAO SHU-YUAN , POPOV VSEVOLOD L. , NEWMAN PATRICK C. , TESH ROBERT B.
Published: September 2018

The clinical laboratory, virologic, and pathologic changes occurring in hamsters after infection with Pirital virus (Arenaviridae) are described. Pirital virus infection in the hamsters was characterized by high titered viremia, leukocytosis, coagulopathy, pulmonary hemorrhage and edema, hepatocellular and splenic necrosis, and marked elevation of serum transaminase levels. All of the animals died within 9 days. The clinical and histopathological findings in the Pirital virus–infected hamsters were very similar to those reported in severe human cases of Lassa fever, suggesting that this new animal model could serve as a low-cost and relatively safe alternative for studying the pathogenesis and therapy of Lassa fever.
FOUR MALARIA SUCCESS STORIES: HOW MALARIA BURDEN WAS SUCCESSFULLY REDUCED IN BRAZIL, ERITREA, INDIA, AND VIETNAM
Authors: BARAT LAWRENCE M.
Published: September 2018

While many countries struggle to control malaria, four countries, Brazil, Eritrea, India, and Vietnam, have successfully reduced malaria burden. To determine what led these countries to achieve impact, published and unpublished reports were reviewed and selected program and partner staff were interviewed to identify common factors that contributed to these successes. Common success factors included conducive country conditions, a targeted technical approach using a package of effective tools, data-driven decision-making, active leadership at all levels of government, involvement of communities, decentralized implementation and control of finances, skilled technical and managerial capacity at national and sub-national levels, hands-on technical and programmatic support from partner agencies, and sufficient and flexible financing. All these factors were essential in achieving success. If the goals of Roll Back Malaria are to be achieved, governments and their partners must take the lessons learned from these program successes and apply them in other affected countries.
PREVALENCE OF INTESTINAL PARASITES INCLUDING MICROSPORIDIA IN HUMAN IMMUNODEFICIENCY VIRUS–INFECTED ADULTS IN CAMEROON: A CROSS-SECTIONAL STUDY
Authors: SARFATI CLAUDINE , BOURGEOIS ANKE , MENOTTI JEAN , LIEGEOIS FLORIAN , MOYOU-SOMO ROGER , DELAPORTE ERIC , DEROUIN FRANCIS , NGOLE EITEL MPOUDI , MOLINA JEAN-MICHEL
Published: September 2018

To assess the prevalence of intestinal parasites in a cohort of human immunodeficiency virus (HIV)–infected adults in Cameroon, a cross-sectional study was conducted. Detection of parasites was performed in 181 stool samples from 154 HIV-infected patients with a mean CD4 cell count of 238 cells/mm3. Only 35 patients (22%) were receiving antiretroviral therapy at the time of stool sampling, and 46 (29%) had diarrhea. Opportunistic protozoa were found in 15 patients (9.7%), 8 of whom (53%) had diarrhea. Enterocytozoon bieneusi was found in eight patients, C. parvum in six patients, and Isospora belli in three patients. All E. bieneusi isolates tested belonged to the same genotype. The prevalence of opportunistic protozoa among patients with CD4 cell counts less than 50/mm3 was 32%.
QUANTITATIVE ANALYSIS OF LA CROSSE VIRUS TRANSCRIPTION AND REPLICATION IN CELL CULTURES AND MOSQUITOES
Authors: KEMPF BRIAN J. , BLAIR CAROL D. , BEATY BARRY J.
Published: September 2018

La Crosse (LAC) virus (family Bunyaviridae, genus Orthobunyavirus) small (S) segment negative-sense RNA genome (vRNA), positive-sense full-length RNA complement (vcRNA), and subgenomic mRNA were assayed in infected cell cultures and female Aedes (Ochlerotatus) triseriatus mosquito tissues using quantitative PCR (Q-PCR). During persistent infection of C6/36 (Aedes albopictus) and MAT (Aedes triseriatus) cultured cells and cytolytic infection of BHK-21 cultured cells, LAC vRNA was the most abundant RNA species, followed by mRNA and vcRNA. RNA copy numbers per cell were quantified and vRNA correlated to virus titer in cell culture medium. The Q-PCR assay proved more sensitive than reverse transcription (RT)-PCR and immunofluorescence assays (IFA) for detecting LAC virus infection of mosquitoes. After infection of female mosquitoes orally, quantities of LAC RNA increased in ovaries for 6 days, and as ovarian biosynthetic activity quiesced, LAC RNA quantities decreased then remained detectable at a low level. After a second, noninfectious blood meal, quantities of LAC RNA in ovaries increased significantly, quantitatively confirming correlation of LAC virus RNA synthesis with vector metabolic activity. Coregulation of viral replication and mosquito ovary metabolic activity may condition efficient transovarial transmission.
IMMUNOGENICITY OF A LOCALLY PRODUCED HEPATITIS B VACCINE WITH THE BIRTH DOSE STORED OUTSIDE THE COLD CHAIN IN RURAL VIETNAM
Authors: HIPGRAVE DAVID B. , TRAN TRUNG NAM , HUONG VU MINH , DAT DO TUAN , NGA NGUYEN TUYET , LONG HOANG THUY , VAN NGUYEN THU , MAYNARD JAMES E. , BIGGS BEVERLEY-ANN
Published: September 2018

The heat stability of hepatitis B vaccine (HepB vaccine) should enable its storage outside the cold chain (OCC), increasing access to the birth dose in areas lacking refrigeration. We compared the immunogenicity of a locally produced vaccine among infants who received three doses stored within the cold chain (n = 358) or for whom the first dose was stored OCC for up to one month (n = 748). Serum was collected from these infants at age 9–18 months. The vaccine was protective in 80.3% of all infants. There were no differences in the prevalence of a protective level of antibody or antibody titer among groups of infants according to storage strategy. Differences in antibody titer between certain groups of infants could be explained by different vaccination schedules. Where birth dose coverage will be improved, HepB vaccine can be taken OCC for up to one month without affecting its immunogenicity.
ORIGIN OF DENGUE TYPE 3 VIRUSES ASSOCIATED WITH THE DENGUE OUTBREAK IN DHAKA, BANGLADESH, IN 2000 AND 2001
Authors: PODDER GOUTAM , BREIMAN ROBERT F. , AZIM TASNIM , THU HLAING MYAT , VELATHANTHIRI NILUKA , MAI LE QUYNH , LOWRY KYM , AASKOV JOHN G.
Published: September 2018

Dengue and dengue hemorrhagic fever re-emerged in Bangladesh in 2000 and 2001 and nearly all viruses isolated were dengue type 3. Phylogenetic analyses of the envelope genes of examples of these viruses indicated that they were most closely related to recently emerged dengue type 3 viruses from neighboring Thailand and Myanmar but distinct from those from India and Sri Lanka. Since this strain of dengue virus type 3 had not been associated with unusual patterns of disease in Thailand or Myanmar, it suggested that the outbreak in Bangladesh was due to local factors after the introduction of viruses from countries to the east rather than to the evolution of an unusually virulent strain of virus in Bangladesh.
SEROPREVALENCE OF LEPTOSPIROSIS AMONG HIGH-RISK POPULATION OF ANDAMAN ISLANDS, INDIA
Authors: SHARMA SAMEER , VIJAYACHARI PALURU , SUGUNAN ATTAYOOR P. , NATARAJASEENIVASAN KALIMUTHUSAMY , SEHGAL SUBHASH C.
Published: September 2018

Leptospirosis is a severe spirochetal zoonosis in the world. It is considered an occupational disease of persons engaged in agriculture, sewage works, forestry, and animal slaughtering. A study was conducted with an objective of assessing the seroprevalence of leptospirosis among the high-risk groups of Andaman Islands. A total of 611 sera samples from different high-risk populations were collected and tested by microscopic agglutination test (MAT). Genetic characterization of the isolate was done by randomly amplified polymorphic DNA (RAPD) fingerprinting, and serological characterization was done using monoclonal antibody technique. Antibodies to leptospires were detected in 322 samples giving an overall seroprevalence of 52.7%. The seroprevalence was highest among agriculture workers (62.5%) followed by sewage workers (39.4%), animal handlers (37.5%), forest workers (27.3%), and butchers (30.0%). Seroprevalence among control population was 14.7%, which was comparatively less than that of the high-risk population groups. Subject sera were most commonly reacted with organisms of the serogroup Grippotyphosa followed by Australis, and the pattern was similar in control group. Four leptospires were isolated from agriculture workers who were admitted to the public health center (PHC) with complaints of fever and body ache. Human isolates were compared with two rodent (Rattus norvegicus) isolates from the same area of agriculture workers to get initial information about the transmission cycle of leptospirosis in the study community. Randomly amplified polymorphic DNA fingerprinting pattern of the strains recovered from the rodents and human patients were identified as belonged to genomo-species Leptospira interrogans. The antigenic characterization of the strains recovered from them belonged to serovar Valbuzzi of serogroup Grippotyphosa. The study showed that people engaged in high-risk activities such as agriculture, sewage cleaning, animal handling, animal slaughtering, and forestry are frequently exposed to leptospirosis, and hence control strategies targeting these populations could be more effective.
LACK OF A PHARMACOKINETIC INTERACTION BETWEEN AZITHROMYCIN AND CHLOROQUINE
Authors: COOK JACK A. , RANDINITIS EDWARD J. , BRAMSON CANDACE R. , WESCHE DAVID L.
Published: September 2018

A study was conducted to investigate a possible pharmacokinetic interaction between azithromycin and chloroquine. Twenty-four subjects received azithromycin, 1,000 mg a day for three days, followed by a washout period, then azithromycin, 1,000 mg plus chloroquine 600 mg base on days 1 and 2, and azithromycin, 1,000 mg plus chloroquine 300 mg base on day 3 of the final period. A second group of 16 subjects received chloroquine, 600 mg base on days 1 and 2, then 300 mg base on day 3. Blood samples were obtained serially up to 624 hours after the day 3 dose in each period. Log transformed maximum concentration and area under the curve values of azithromycin and chloroquine were compared using 90% confidence intervals calculated from appropriate analysis of variance models. Ninety percent confidence intervals for all pharmacokinetic parameters were contained within the interval 80–125%, which indicates the absence of a clinically relevant pharmacokinetic interaction.
CD4 T CELL ACTIVATION AS A PREDICTOR FOR TREATMENT FAILURE IN UGANDANS WITH PLASMODIUM FALCIPARUM MALARIA
Authors: EGGENA MARK P. , HOPKINS HEIDI , BARUGAHARE BANSON , OKELLO MARTIN , SSALI FRANCIS , MUGYENYI PETER , ROSENTHAL PHILIP J. , CAO HUYEN , DORSEY GRANT
Published: September 2018

Host immunity plays an important role in response to antimalarial therapy but is poorly understood. To test whether T cell activation is a risk factor for antimalarial treatment failure, we studied CD4+ and CD8+ T cell activation in 31 human immunodeficiency virus–negative Ugandan patients 5–37 years of age who were treated for uncomplicated Plasmodium falciparum malaria. Increased CD4+ T cell activation, as indicated by co-expression of HLA-DR and CD38, was an independent risk factor for treatment failure (hazard ratio = 2.45, 95% confidence interval = 1.02–5.89, P = 0.05) in multivariate analysis controlling for age, baseline temperature, and pre-treatment parasite density. The results provide insight into the role of cellular immunity in response to antimalarial therapy and underscore the need to investigate the mechanisms behind immune activation.