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Granzin J, Huang Y, Topbas C, Huang W, Wu Z, Misra S, Hazen SL, Blanton RE, Lee X, Weiergräber OH. Three-dimensional structure of a schistosome serpin revealing an unusual configuration of the helical subdomain. ACTA CRYSTALLOGRAPHICA. SECTION D, BIOLOGICAL CRYSTALLOGRAPHY 2012; 68:686-94. [PMID: 22683791 PMCID: PMC3370883 DOI: 10.1107/s0907444912008372] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2012] [Accepted: 02/24/2012] [Indexed: 11/10/2022]
Abstract
Parasitic organisms are constantly challenged by the defence mechanisms of their respective hosts, which often depend on serine protease activities. Consequently, protease inhibitors such as those belonging to the serpin superfamily have emerged as protective elements that support the survival of the parasites. This report describes the crystal structure of ShSPI, a serpin from the trematode Schistosoma haematobium. The protein is exposed on the surface of invading cercaria as well as of adult worms, suggesting its involvement in the parasite-host interaction. While generally conforming to the well established serpin fold, the structure reveals several distinctive features, mostly concerning the helical subdomain of the protein. It is proposed that these peculiarities are related to the unique biological properties of a small serpin subfamily which is conserved among pathogenic schistosomes.
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Blanton RE, Cooney RE, Joormann J, Eugène F, Glover GH, Gotlib IH. Pubertal stage and brain anatomy in girls. Neuroscience 2012; 217:105-12. [PMID: 22569152 DOI: 10.1016/j.neuroscience.2012.04.059] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2011] [Revised: 04/04/2012] [Accepted: 04/23/2012] [Indexed: 10/28/2022]
Abstract
Studies of puberty have focused primarily on changes in hormones and on observable physical bodily characteristics. Little is known, however, about the nature of the relation between pubertal status and brain physiology. This is particularly important given findings that have linked the onset of puberty with both changes in cognitive functioning and increases in the incidence of depression and anxiety. The present study examined relations between pubertal stage, as assessed by Tanner staging, and brain anatomy in a sample of 54 girls aged 9-15 years. Brain morphometric analysis was conducted using high-resolution magnetic resonance imaging (MRI). The hippocampus and amygdala were manually traced on MRI scans in all participants. Stepwise regression analyses were conducted with total intracranial volume (ICV), age, and pubertal status as the predictor variables and hippocampus and amygdala volumes as outcome variables. Pubertal status was significantly associated with left amygdala volume, after controlling for both age and ICV. In addition, puberty was related to right hippocampus and amygdala volumes, after controlling for ICV. In contrast, no significant associations were found between age and hippocampal and amygdala volumes after controlling for pubertal status and ICV. These findings highlight the importance of the relation between pubertal status and morphometry of the hippocampus and amygdala, and of limbic and subcortical structures that have been implicated in emotional and social behaviors.
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Conry SJ, Meng Q, Hardy G, Yonkers NL, Sugalski JM, Hirsch A, Davitkov P, Compan A, Falck-Ytter Y, Blanton RE, Rodriguez B, Harding CV, Anthony DD. Genetically associated CD16(+)56(-) natural killer cell interferon (IFN)-αR expression regulates signaling and is implicated in IFN-α-induced hepatitis C virus decline. J Infect Dis 2012; 205:1131-41. [PMID: 22351942 DOI: 10.1093/infdis/jis027] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Natural killer (NK) cells likely contribute to outcome of acute hepatitis C virus (HCV) infection and interferon (IFN)-induced control of chronic HCV infection. We previously observed IFN-αR and NKp30 expression associated with IFN-α-dependent NK cell activity. METHODS Here, we examined CD16(+)56(-), CD16(+)56(+), and CD16(-)56(+) NK cell subset IFN-αR and NKp30 expression in relation to magnitude of HCV genotype 1 decrease during pegylated IFN-α plus ribavirin therapy. RESULTS We observed greater baseline IFN-αR and NKp30 expression on CD16(+)56(+) and CD16(-)56(+) NK subsets in HCV-infected patients than in healthy control subjects. Baseline CD16(+)56(-) NK IFN-αR expression was associated with IFN-α-induced pSTAT1, and both were associated with magnitude of HCV decrease during pegylated IFN-α plus ribavirin therapy. Baseline CD16(+)56(-) NK IFN-αR expression was associated with race and interleukin 28B genotype, negatively associated with aspartate aminotransferase-to platelet ratio index, and positively associated with increase in NKp30 expression after in vivo IFN-α exposure. Finally, in vitro IFN-α2a-activated NK cytolysis of HCV-infected target cells was in part dependent on NKp30, and CD16(+)56(-) NK cell IFN-αR expression correlated with cytolytic activity. CONCLUSIONS IFN-αR expression on CD16(+)56(-) NK cells during chronic HCV infection may in part be genetically determined, and level of expression regulates IFN-α signaling, which in turn may contribute to control of HCV infection.
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Melo PRS, Domingo C, Santos SC, Cerqueira BA, Andrade LJ, Nunes JB, Ciuffo IA, Tenório A, Blanton RE, Reis MG. Molecular surveillance of dengue virus in Bahia State, Brazil. ACTA ACUST UNITED AC 2012. [DOI: 10.4236/ajmb.2012.21005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Blanton RE, Blank WA, Costa JM, Carmo TM, Reis EA, Silva LK, Barbosa LM, Test MR, Reis MG. Schistosoma mansoni population structure and persistence after praziquantel treatment in two villages of Bahia, Brazil. Int J Parasitol 2011; 41:1093-9. [PMID: 21784077 DOI: 10.1016/j.ijpara.2011.06.002] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2011] [Revised: 06/06/2011] [Accepted: 06/07/2011] [Indexed: 10/18/2022]
Abstract
Praziquantel has been used to treat schistosome infections since 1979 and currently is the only chemotherapeutic agent in production for this purpose, raising concerns about the potential for the emergence of drug resistance. In practice, 10-20% of infected patients will continue to excrete eggs after treatment. It is not understood to what degree this represents selection of a resistant population or incomplete elimination due to the presence of immature worms at the time of treatment. We used a population genetics approach to test whether or not persistent Schistosomamansoni parasites were drawn from the same population as susceptible parasites. In this study, stool samples were collected from 96% of individuals in two small Brazilian communities (populations 482 and 367) and examined for S.mansoni eggs. The combined prevalence of S.mansoni infections in the villages was 41%. Total egg DNA was extracted from each sample and was genotyped at 15 microsatellite markers. Day-to-day variation of the infrapopulation from an individual human host was low (median differentiation using Jost's D=0.010), so that a single stool was representative of the genotypes present in stool eggs, at least in the short term. Average pairwise analysis of D among all pre-treatment infrapopulations suggested moderate differentiation (mean D=0.082 and 0.122 for the two villages), whereas the pre-treatment component population differentiation between the two communities was 0.047. The differentiation of the component population remaining after treatment from the fully susceptible component population was low (mean D=0.007 and 0.020 for the two villages), suggesting that the persistent parasites were not selected by praziquantel treatment. We will continue to follow these communities for evidence of selection or changes in population structure.
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Blank WA, Liu SF, Prasad J, Blanton RE. Host mouse strain is not selective for a laboratory adapted strain of Schistosoma mansoni. J Parasitol 2011; 97:518-21. [PMID: 21506771 PMCID: PMC3882756 DOI: 10.1645/ge-2671.1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
We genotyped pooled adult worms of Schistosoma mansoni from infected CF1, C57BL/6, BALB/c, and BALB/c interferon gamma knockout mice in order to establish if mouse strain differences selected for parasite genotypes. We also compared differentiation in eggs collected from liver and intestines to determine if there was differential distribution of parasite strains in the vertebrate host that might account for any genotype selection. We found that mouse strains with differing immune responses did not differ in resistance to infection and did not select for parasite genotypes. Schistosoma mansoni egg allele frequencies were also equally distributed in tissues and the difference between adult and egg allele frequencies was negligible.
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Silva LK, Blanton RE, Parrado AR, Melo PS, Morato VG, Reis EAG, Dias JP, Castro JM, Vasconcelos PFC, Goddard KAB, Barreto ML, Reis MG, Teixeira MG. Dengue hemorrhagic fever is associated with polymorphisms in JAK1. Eur J Hum Genet 2010; 18:1221-7. [PMID: 20588308 PMCID: PMC2950898 DOI: 10.1038/ejhg.2010.98] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2009] [Revised: 05/04/2010] [Accepted: 05/07/2010] [Indexed: 01/12/2023] Open
Abstract
To identify genes associated with the clinical presentation of dengue, 50 cases of probable or possible dengue hemorrhagic fever (DHF), 236 dengue fever (DF), and 236 asymptomatic infections were genotyped for 593 single-nucleotide polymorphisms (SNPs) in 56 genes across the type 1 interferon (IFN) response pathway as well as other important candidate genes. By single locus analysis comparing DHF with DF, 11 of the 51 markers with P<0.05 were in the JAK1 gene. Five markers were significantly associated by false discovery rate criteria (q<0.20 when P<6 × 10(-4)). The JAK1 SNPs showed differential distribution by ethnicity and ancestry consistent with epidemiologic observations in the Americas. The association remained significant after controlling for ancestry and income. No association was observed with markers in the gene encoding CD209 (DC-SIGN). An association between DHF and JAK1 polymorphisms is in agreement with expression profiles showing generalized decreased type 1 IFN-stimulated gene expression in these patients.
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Blank WA, Test MR, Liu SF, Lewis FA, Blanton RE. Long-term genetic stability and population dynamics of laboratory strains of Schistosoma mansoni. J Parasitol 2010; 96:900-7. [PMID: 20950096 PMCID: PMC3881424 DOI: 10.1645/ge-2463.1] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Measures of genetic differentiation between populations are useful tools for understanding the long-term dynamics of parasite communities. We followed the allele frequencies of microsatellite markers in samples taken over a period of 16 yr from the Case Western Reserve University-Naval Medical Research Institute (CWRU-NMRI) laboratory strain of Schistosoma mansoni. DNA was isolated from pooled samples of adults, eggs, or cercariae collected at 46 time points and genotyped for 14 tri- or tetranucleotide microsatellite markers. For comparison, 2 S. mansoni reference strains (Biomedical Research Institute-NMRI, which has a common origin with the CWRU line, and PR-1) were analyzed over shorter periods of time. We observed that the long-term allele frequencies are generally stable in large laboratory populations of this parasite, and a high degree of similarity was observed between the allele frequencies of consecutive samples from different developmental stages. The CWRU strain, however, showed 2 periods of marked deviation from stability as demonstrated using genetic differentiation measures. The first period corresponds to an admixture event with the BRI strain in which a new equilibrium was established as the "migrants" became blended into the existing CWRU population, consistent with 23% admixture from BRI. The second corresponds to a period of genetic drift when the CWRU population size was greatly reduced with an accompanying loss in genetic diversity. Having demonstrated the utility of pooled samples for the genetic analysis of population dynamics in laboratory strains of schistosomes, this approach will be useful for analyzing field samples to determine the impact of schistosomiasis control programs on parasite population structure. Accounting only for the intensity or prevalence of parasite populations may fail to register significant changes in population structure that could have implications for resistance, morbidity, and the design of control measures.
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Blank WA, Reis EAG, Thiong'o FW, Braghiroli JF, Santos JM, Melo PRS, Guimarães ICS, Silva LK, Carmo TMA, Reis MG, Blanton RE. Analysis of Schistosoma mansoni population structure using total fecal egg sampling. J Parasitol 2010; 95:881-9. [PMID: 20049994 DOI: 10.1645/ge-1895.1] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Many parasite populations are difficult to sample because they are not uniformly distributed between several host species and are often not easily collected from the living host, thereby limiting sample size and possibly distorting the representation of the population. For the parasite Schistosoma mansoni, we investigated the use of eggs, in aggregate, from the stools of infected individuals as a simple and representative sample. Previously, we demonstrated that microsatellite allele frequencies can be accurately estimated from pooled DNA of cloned S. mansoni adults. Here, we show that genotyping of parasite populations from reproductively isolated laboratory strains can be used to identify these specific populations based on characteristic patterns of allele frequencies, as observed by polyacrylamide gel electrophoresis and automated sequencer analysis of fluorescently labeled PCR products. Microsatellites used to genotype aggregates of eggs collected from stools of infected individuals produced results consistent with the geographic distribution of the samples. Preferential amplification of smaller alleles, and stutter PCR products, had negligible effect on measurement of genetic differentiation. Direct analysis of total stool eggs can be an important approach to questions of population genetics for this parasite by increasing the sample size to thousands per infected individual and by reducing bias.
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Blanton RE, Silva LK, Morato VG, Parrado AR, Dias JP, Melo PRS, Reis EAG, Goddard KAB, Nunes MRT, Rodrigues SG, Vasconcelos PFC, Castro JM, Reis MG, Barreto ML, Teixeira MG. Genetic ancestry and income are associated with dengue hemorrhagic fever in a highly admixed population. Eur J Hum Genet 2008; 16:762-5. [DOI: 10.1038/ejhg.2008.4] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
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de Cássia Ribeiro Silva R, Barreto ML, Assis AMO, de Santana MLP, Parraga IM, Reis MG, Blanton RE. The relative influence of polyparasitism, environment, and host factors on schistosome infection. Am J Trop Med Hyg 2007; 77:672-675. [PMID: 17978069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2023] Open
Abstract
Where prevalence of geohelminths and schistosomes is high, co-infections with multiple parasite species are common. Previous studies have shown that the presence of geohelminths either promotes or is a marker for greater prevalence and intensity of Schistosoma mansoni infections. Some of this apparent synergy may simply represent shared conditions for exposure, such as poor sanitation, and may not suggest a direct biologic interaction. We explored this question in a study of 13,279 school children in Jequié, Bahia, Brazil, with a survey of demographic characteristics and stool examinations. Cross-sectional analysis revealed a statistically significant increase in the prevalence and intensity of S. mansoni infection with increasing numbers of geohelminth species (OR 2.5, 95% CI 1.38-3.64). Less than 20% of the strength of this association was contributed by socioeconomic status or environmental conditions. Thus, polyparasitism itself, as well as intrinsic host factors, appears to produce greater susceptibility to additional helminth infections.
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de Cássia Ribeiro Silva R, Reis MG, Blanton RE, Barreto ML, Assis AMO, de Santana MLP, Parraga IM. The Relative Influence of Polyparasitism, Environment, and Host Factors on Schistosome Infection. Am J Trop Med Hyg 2007. [DOI: 10.4269/ajtmh.2007.77.672] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Brito LL, Barreto ML, Silva RDCR, Assis AMO, Reis MG, Parraga IM, Blanton RE. Moderate- and low-intensity co-infections by intestinal helminths and Schistosoma mansoni, dietary iron intake, and anemia in Brazilian children. Am J Trop Med Hyg 2006; 75:939-44. [PMID: 17123992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/12/2023] Open
Abstract
To determine the role of moderate- and low-intensity infections with Schistosoma mansoni and intestinal helminths (hookworm, Trichuris trichiura, Ascaris lumbricoides) on the prevalence of anemia and their relationship to iron consumption, a cross-section of 1,709 children in rural Brazil was studied. All participants were selected for infection with one or multiple helminthic parasites, and demographic, anthropometric, and dietary intake were surveyed. The prevalence and intensity were as follows: hookworm infection, 15.7% and 8.6 eggs/g; T. trichiura, 74.8% and 190.5 eggs/g; A. lumbricoides, 63% and 1,905.5 eggs/g; S. mansoni, 44.5% and 60.3 eggs/g. There was no increase in odds ratio for anemia with any combination of intestinal helminths without S. mansoni infection. By logistic regression, the odds ratio for having anemia when infected with S. mansoni and two intestinal helminths was 1.7 (95% CI, 1.1-2.5) and for S. mansoni and three intestinal helminths was 2.4 (95% CI, 1.2-4.6) compared with children with a single parasite species. Children with an adequate intake of iron had no increased odds of anemia independent of the combination of parasite infections.
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Reis EAG, Reis MG, Silva RDCR, Carmo TMA, Assis AMO, Barreto ML, Parraga IM, Santana MLP, Blanton RE. Biochemical and immunologic predictors of efficacy of treatment or reinfection risk for Schistosoma mansoni. Am J Trop Med Hyg 2006; 75:904-9. [PMID: 17123985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/12/2023] Open
Abstract
Most Schistosoma mansoni infections are egg-negative after a single dose of oxamniquine. A cohort of 661 infected children was treated at 6-month intervals and assessed for nutritional and parasitological status. Initial biochemical and immunologic markers were measured in a subset of 84 children. All were treated at the start of therapy and at 6 months. Immunoglobulins only served as markers for active infection. No markers were predictive of cure or reinfection, except initial infection intensity and serum low-density lipoprotein. Ten percent were persistently infected and had no change in infection intensity at any time-point. Several factors suggest that this group was biologically different. In addition to failing to reduce their worm burden, they had significantly higher initial intensity of infection (100 versus 65 eggs/g, P = 0.001) and significantly lower initial serum low-density lipoprotein (72 versus 104 mg/dL, P = 0.045). The biologic plausibility of this observation is discussed.
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Silva LK, Liu S, Blanton RE. Microsatellite analysis of pooled Schistosoma mansoni DNA: an approach for studies of parasite populations. Parasitology 2005; 132:331-8. [PMID: 16255835 DOI: 10.1017/s0031182005009066] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2005] [Revised: 06/18/2005] [Accepted: 08/25/2005] [Indexed: 02/07/2023]
Abstract
Human parasites are often distributed in metapopulations, which makes random sampling for genetic epidemiology difficult. The typical approach to sampling Schistosoma mansoni involves laboratory passage to obtain individual worms with small sample size and selection bias as a consequence. By contrast, the naturally pooled samples from egg output in stool or urine directly represent the genetic composition of current populations. To test whether pooled samples could be used to estimate population allele frequencies, DNA from individual cloned parasites was pooled and amplified by PCR for 7 microsatellites. By polyacrylamide gel analysis, the relative band intensities of the products from the major alleles in the pooled samples differed by 0-6% from the summed intensities of the individual clones (mean = 2.1%+/-2.1% S.D.). The number of PCR cycles (25-40) did not influence the accuracy of the estimate. Varying the frequency of 1 allele in pooled samples from 32 to 69% likewise did not affect accuracy. Allele frequency estimates from aggregate samples such as eggs will be a better foundation for studies of parasite population dynamics as well as the basis for large-scale association studies of host and parasite characteristics.
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Blanton RE, Salam EA, Ehsan A, King CH, Goddard KA. Schistosomal hepatic fibrosis and the interferon gamma receptor: a linkage analysis using single-nucleotide polymorphic markers. Eur J Hum Genet 2005; 13:660-8. [PMID: 15756299 DOI: 10.1038/sj.ejhg.5201388] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
A minority of individuals infected with the parasite Schistosoma mansoni develops hepatic fibrosis. HLA studies in Egypt and a candidate gene search in a Sudanese population indicate that the host's genetics contribute to disease susceptibility. In an Egyptian community, 32.7% of individuals 11 years and older had significant fibrosis by WHO ultrasound criteria. Linkage to 10 candidate genes was tested using 89 affected sibling pairs from 40 pedigrees in this community. The candidates included genes that initiate fibrosis, participate in collagen synthesis, or control collagen degradation. Two to four single-nucleotide polymorphisms (SNPs) were genotyped per locus, and 188 individuals were genotyped at 48 markers. Model-free modified Haseman-Elston analysis identified linkage to a SNP in the interferon gamma receptor locus (P=0.000001). There was also weak evidence for linkage to the interleukin 13-4 region and tissue growth factor beta 1.
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Assis AMO, Prado MS, Barreto ML, Reis MG, Conceição Pinheiro SM, Parraga IM, Blanton RE. Childhood stunting in Northeast Brazil: the role of Schistosoma mansoni infection and inadequate dietary intake. Eur J Clin Nutr 2004; 58:1022-9. [PMID: 15220944 DOI: 10.1038/sj.ejcn.1601926] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE To evaluate the relationship between stunting, Schistosoma mansoni infection and dietary intake in schoolchildren. DESIGN This is a cross-sectional study. Two stool samples were obtained from each child and examined quantitatively for the presence of S. mansoni, Ascaris lumbricoides and Trichuris trichiuria eggs. Information on dietary intake, and demographic, biologic and socioeconomic variables was elicited during the in-home survey. Logistic regression was used to evaluate the association between stunting (height for age < -2s.d.), parasitic infection and food consumption. SETTING The study was carried out in the city of Nazaré, located in the Recôncavo region of the State of Bahia, Northeastern Brazil. SUBJECTS The sample consisted of 461 children 7-14 y old, 228 boys and 233 girls, recruited from public schools. RESULTS Of the children studied, 55.1% presented with S. mansoni infection and 22.1% were stunted. The median protein, lipid and carbohydrates intake were 47.8, 36.0 and 248.2 g/day, respectively. The median caloric consumption was 1527.0 kcal (6388.97 kJ/day). The analysis indicated that children heavily infected (> or = 400 eggs/g of stool) with S. mansoni had a 2.74-fold (95% CI: 1.32-5.67) higher risk of stunting than uninfected children, and those with inadequate intake of lipid (< 36 g/day) had a 1.83-fold (95% CI: 1.05-3.20) increased risk of stunting compared to those with adequate diets. CONCLUSION Heavy S. mansoni infection and inadequate dietary intake of fat in schoolchildren play a significant and independent role in the development of stunting. This meaning that nutritional interventions in this age group in S. mansoni endemic areas must include the diagnosis and treatment of the infection associated with dietary measures. SPONSORSHIP This study was supported by the Thrasher Foundation. Sandra Maria Conceição Pinheiro is a National Council on Technological Development Scholarship Awardee (CNPq), #302228/81-0.
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King CH, Blanton RE, Muchiri EM, Ouma JH, Kariuki HC, Mungai P, Magak P, Kadzo H, Ireri E, Koech DK. Low heritable component of risk for infection intensity and infection-associated disease in urinary schistosomiasis among Wadigo village populations in Coast Province, Kenya. Am J Trop Med Hyg 2004; 70:57-62. [PMID: 14971699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/28/2023] Open
Abstract
To estimate their heritable component of risk for Schistosoma haematobium infection intensity and disease, we performed a community-based family study among an endemic population in coastal Kenya. Demography and family linkages were defined by house-to-house interviews, and infection prevalence and disease severity were assessed by standard parasitologic testing and by ultrasound. The total population was 4,408 among 912 households, with 241 identified pedigree-household groups. Although age- and sex-adjusted risk for greater infection intensity was clustered within households (odds ratio = 2.7), analysis of extended pedigree-household groups indicated a relatively low heritability score for this trait (h2 = 0.199), particularly after adjustment for common household exposure effects (adjusted h2 = 0.086). Statistical evidence was slightly stronger (h2 = 0.353) for familial clustering of bladder morbidity, with an adjusted h2 = 0.142 after accounting for household exposure factors. We conclude that among long-established populations of coastal Kenya, heritable variation in host susceptibility is low, and likely plays a minimal role in determining individual risk for infection or disease.
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Brito LL, Barreto ML, Silva RDCR, Assis AMO, Reis MG, Parraga I, Blanton RE. Fatores de risco para anemia por deficiência de ferro em crianças e adolescentes parasitados por helmintos intestinais. Rev Panam Salud Publica 2003; 14:422-31. [PMID: 14769159 DOI: 10.1590/s1020-49892003001100007] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE To investigate risk factors for iron-deficiency anemia in children and adolescents (7 to 17 years of age) with intestinal helminthic infections. METHODS A cross-sectional study was carried out with 1 709 children and adolescents living in Jequié, a town in the state of Bahia, Brazil, who had mild to moderate infection by Schistosoma mansoni, Ascaris lumbricoides, Trichuris trichiura, or hookworms. We obtained data concerning hemoglobin levels (using a portable hemoglobinometer), dietary habits (24-hour dietary recall), parasitic infections (Kato-Katz method), sanitary conditions (water supply, sewage connection, garbage collection), housing conditions (type of construction, number of persons per room), income, and amount of schooling of the parents or guardians. The risk factors for anemia were studied based on a hierarchical model of causality. RESULTS The prevalence of parasitic infection was 74.8% for T. trichiura, 63.0% for A. lumbricoides, 55.5% for S. mansoni, and 15.7% for hookworms. Among the children and adolescents studied 32.2% were anemic. After adjustment for confounding variables, the results of the multivariate analysis showed that the following variables were significantly associated with anemia: per capita family income below US$ 27 (equal to one fourth of the Brazilian minimum wage), male sex, age of 7 to 9 years, and inadequate intake of bioavailable iron. CONCLUSIONS The initiatives to control anemia in the group at greatest risk, as identified in this study, should seek to increase the consumption of iron-rich foods, boost the bioavailability of the iron ingested, and improve socioenvironmental conditions.
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King CH, Magak P, Salam EA, Ouma JH, Kariuki HC, Blanton RE. Measuring morbidity in schistosomiasis mansoni: relationship between image pattern, portal vein diameter and portal branch thickness in large-scale surveys using new WHO coding guidelines for ultrasound in schistosomiasis. Trop Med Int Health 2003; 8:109-17. [PMID: 12581434 DOI: 10.1046/j.1365-3156.2003.00994.x] [Citation(s) in RCA: 66] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
OBJECTIVE World Health Organization consensus meetings on 'Ultrasound in Schistosomiasis' in 1996 and 1997 anticipated further challenges in the global implementation of a standardized protocol for morbidity assessment in schistosomiasis mansoni. We evaluated the performance of the qualitative and quantitative components of the new Niamey criteria. METHOD Use of the Niamey protocol among 3954 subjects in two linked, cross-sectional ultrasound surveys of Schistosoma mansoni-endemic populations in Egypt and Kenya. RESULTS There were significant differences between Egyptian and Kenyan sites in prevalence and age distribution of S. mansoni-related hepatic fibrosis (36%vs. 3%, P < 0.001). Protocol image pattern scoring could be performed quickly and was stable to interobserver variation. However, there were unintended but systematic differences between study sites in the measurement of portal vein diameter (PVD) and wall thickness. By Niamey criteria, a high prevalence of portal dilation was scored for normal Egyptian subjects, which reduced the predictive value of image pattern for portal hypertension. Using alternative height-indexing of PVD, image pattern plus PVD findings predicted 15% of Egyptians and 2.5% of Kenyans were at risk for variceal bleeding, whereas locally derived PVD norms estimated 25% of Egyptians and 12% of Kenyans to be at possible risk. CONCLUSION Niamey scoring criteria performed acceptably as a relative grading system for disease in schistosomiasis mansoni, but failed to account fully for site-to-site variation in test performance and morbidity prevalence. Consequently, standardized image pattern scoring appears to provide the most useful tool for detection and comparison of S. mansoni-associated morbidity in large-scale surveys.
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Santos DN, Borges APV, Pereira PS, Chalhub AA, Happé F, Silva RCR, Assis AMO, Blanton RE, Parraga IM, Reis MG, Almeida Filho NM, Barreto ML. Epidemiologia do desenvolvimento cognitivo de escolares em Jequié, Bahia, Brasil: procedimentos de avaliação e resultados gerais. CAD SAUDE PUBLICA 2002. [DOI: 10.1590/s0102-311x2002000300016] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Este artigo descreve metodologia, aplicação e utilidade do teste das Matrizes Progressivas de Raven e do Teste de Sondagem Intelectual (TSI), comparando-os ainda com o rendimento escolar do aluno, em Jequié, Bahia. O Raven, que avalia o raciocínio não-verbal, foi aplicado a 374 escolares (7 a 17 anos). Somente 231 TSI foram respondidos porque requeriam habilidades de leitura e escrita. Foram coletadas notas escolares para todos os participantes. Um questionário avaliando recursos da escola e perfil do professor foi respondido por duzentos professores. Os escores dos testes Raven e TSI apresentaram uma boa correlação entre si (r = 0,53, p < 0,001) porém menor com as médias escolares (r = 0,22, p < 0,001 e r = 0,12, p < 0,07 respectivamente). Os escores do Raven e do TSI apresentaram baixas correlações com os conceitos escolares. A média de escores, tanto no teste Raven como no TSI, foi maior entre os meninos, sendo superior o desempenho das meninas nas notas escolares. De maneira geral o nível de desempenho cognitivo encontrado está aquém do esperado em crianças do grupo de idade analisada.
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Blanton RE, Salam EA, Kariuki HC, Magak P, Silva LK, Muchiri EM, Thiongo F, Abdel-Meghid IE, Butterworth AE, Reis MG, Ouma JH. Population-based differences in Schistosoma mansoni- and hepatitis C-induced disease. J Infect Dis 2002; 185:1644-9. [PMID: 12023771 DOI: 10.1086/340574] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2001] [Revised: 01/22/2002] [Indexed: 11/03/2022] Open
Abstract
Two populations with differing histories of Schistosoma mansoni and hepatitis C infection were compared directly for severity of disease and extent of comorbidity. Demographic, parasitologic, and ultrasound surveys were conducted on 2038 Egyptians and on 2120 Kenyans. Hepatitis B and C serologies and transaminase levels were obtained from a subset at each site. Despite significantly lower prevalence and intensity of infection, Egyptians had a higher prevalence of severe schistosomal fibrosis than Kenyans (36.8% vs. 4.6%). Hepatitis C infection was 3 times more prevalent among Egyptians, and evidence of hepatocellular damage was significantly greater among Egyptians. There was no interaction between S. mansoni infection or disease and the prevalence or severity of hepatitis C. For both infections, the intensity or prevalence of infection was a poor predictor of morbidity. The prevalence of disease in the Egyptian population from different pathogens suggests a generalized susceptibility to inflammatory liver disease.
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Santos DN, Borges APV, Pereira PS, Chalhub AA, Happe F, Silva RCR, Assis AMO, Blanton RE, Parraga IM, Reis MG, Almeida Filho NM, Barreto ML. [Epidemiology of schoolchildren's cognitive development in Jequié, Bahia State, Brazil: assessment procedures and general results]. CAD SAUDE PUBLICA 2002; 18:723-33. [PMID: 12048598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2023] Open
Abstract
This paper describes the methodology, applicability and utility of the Raven Progressive Matrix (Raven Test) and the Brazilian Intellectual Probe (TSI), comparing them with school achievement in a typical medium-size urban community of Northeastern Brazil. 388 schoolchildren (7-17 years old) were examined, with 371 Raven tests applied. Only 231 TSIs were completed, since 106 students were illiterate. School grades were obtained for all participants. A questionnaire evaluating school resources, and teacher profiles was answered by 200 teachers. Raven and TSI test scores were highly correlated (r = 0.53, p < 0.001), but both correlated weakly with overall school grade (r = 0.22, p < 0.001 and r = 0.12, p < 0.07 respectively). For individual school grades, the Raven scores showed statistically significant correlation with all subjects, while the Brazilian TSI presented statistically significant correlation only with geography, history and sciences. Boys' mean scores were higher than girls' for both the Raven and the TSI Tests, but for the school grades girls performed better. In general, level of cognitive development was below that expected for children in the age-group analyzed.
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Levitt JG, Blanton RE, Caplan R, Asarnow R, Guthrie D, Toga AW, Capetillo-Cunliffe L, McCracken JT. Medial temporal lobe in childhood-onset schizophrenia. Psychiatry Res 2001; 108:17-27. [PMID: 11677064 DOI: 10.1016/s0925-4927(01)00108-1] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
The majority of anatomic and neuroimaging studies in adult-onset schizophrenia demonstrate decreased volumes of the medial temporal lobe when compared with findings in normal individuals. The goal of this study was to investigate the hypothesis that subjects with childhood-onset schizophrenia would show decreased volumes of the medial temporal lobe when compared to normal children. Thirteen children meeting DSM-III-R criteria for schizophrenia (mean age 14.2+/-3.8 years) and 20 normal children (mean age 12.0+/-2.8 years) were investigated. MRI scans were performed on a 1.5-T GE Signa MR scanner using a coronal plane SPGR at 1.4-mm slice thickness. Volumes were assessed by manually tracing bilateral hippocampus, amygdala and temporal lobes. After adjustment for age and total brain volume, the amygdala was significantly larger in the schizophrenics than in the control subjects, and this volume increase was more pronounced on the left side. Hippocampus volumes did not differ significantly across groups. There was a nearly significant left-greater-than-right asymmetry of the amygdala in the schizophrenic group but not in the normal group. A nearly significant right-greater-than-left asymmetry was found in the anterior hippocampus for both schizophrenic and control groups. These findings are consistent with previous reports of at least initial sparing of temporal lobe regions in childhood-onset schizophrenia.
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Toga AW, Thompson PM, Mega MS, Narr KL, Blanton RE. Probabilistic approaches for atlasing normal and disease-specific brain variability. ANATOMY AND EMBRYOLOGY 2001; 204:267-82. [PMID: 11720233 DOI: 10.1007/s004290100198] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The extreme variability in the structural conformation of the human brain poses significant challenges for the creation of population-based atlases. The ability to statistically and visually compare and contrast brain image data from multiple individuals is essential to understanding normal variability within a particular population as well as differentiating normal from diseased populations. This paper introduces the application of probabilistic atlases that describe specific subpopulations, measures their variability and characterizes the structural differences between them. Utilizing data from structural MRI, we have built atlases with defined coordinate systems creating a framework for mapping data from functional, histological and other studies of the same population. This paper describes the basic approach and a brief description of the underlying mathematical constructs that enable the calculation of probabilistic atlases and examples of their results from several different normal and diseased populations.
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