151
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Babamale OA, Ugbomoiko US, Heukelbach J. High prevalence of Plasmodium falciparum and soil-transmitted helminth co-infections in a periurban community in Kwara State, Nigeria. J Infect Public Health 2017; 11:48-53. [PMID: 28442321 DOI: 10.1016/j.jiph.2017.03.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2016] [Revised: 02/10/2017] [Accepted: 03/25/2017] [Indexed: 10/19/2022] Open
Abstract
Prevalence of malaria and soil-transmitted helminth infections, and the burden of disease are enormous in sub-Saharan Africa. Co-infections aggravate the clinical outcome, but are common due to an overlap of endemic areas. A cross-sectional survey was conducted to assess prevalence, intensity of infection and association between malaria and soil-transmitted helminth infections in a typical periurban community in Kwara State. Fresh blood and faecal samples were examined using thick blood film and Kato-Katz smear techniques. A total of 383/471 study participants (81.3%) were infected with at least one parasite species, with the following prevalences and mean infection intensities: Plasmodium falciparum 63.7% (2313.6 parasites/μl); Ascaris lumbricoides 63.1% (3152.1 epg); Trichuris trichiura 53.3% (1043.5 epg); and hookworms 30.1% (981.7 epg). Sixty-three percent of the study population were co-infected with two or more parasite species. The prevalence of ascariasis was significantly higher in individuals infected with P. falciparum (adjusted OR: 5.87; 95% CI: 3.30-10.42). Heavy A. lumbricoides and T. trichiura infections were associated with high P. falciparum parasitaemia. Co-endemicity of malaria and soil transmitted helminth infections is an important public health problem in the study area. Multi-target integrated approaches focusing on disease intervention are essential to mitigate morbidity caused by multiple infections.
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Affiliation(s)
| | - Uade S Ugbomoiko
- Parasitology Unit, Department of Zoology, University of Ilorin, Ilorin, Nigeria.
| | - Jorg Heukelbach
- College of Public Health, Medical and Veterinary Sciences, Division of Tropical Health and Medicine, James Cook University, Townsville, Queensland, Australia; Department of Community Health, School of Medicine, Federal University of Ceará, Brazil
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152
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Passos LSA, Gazzinelli-Guimarães PH, Oliveira Mendes TAD, Guimarães ACG, Silveira Lemos DD, Ricci ND, Gonçalves R, Bartholomeu DC, Fujiwara RT, Bueno LL. Regulatory monocytes in helminth infections: insights from the modulation during human hookworm infection. BMC Infect Dis 2017; 17:253. [PMID: 28390393 PMCID: PMC5385058 DOI: 10.1186/s12879-017-2366-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2016] [Accepted: 03/29/2017] [Indexed: 12/25/2022] Open
Abstract
Background While the macrophage polarization is well characterized in helminth infections, the natural heterogeneity of monocytes with multiple cell phenotypes might influence the outcome of neglected diseases, such hookworm infection. Here, we report the profile of monocytes in human hookworm infections as a model to study the regulatory subpopulation of monocytes in helminth infections. Methods Blood samples were collected from 19 Necator americanus-infected individuals and 13 healthy individuals. Peripheral blood mononuclear cells (PBMCs) were isolated, and immunophenotyping was conducted by flow cytometry. The expressions of genes encoding human nitric oxide synthase (iNOS), interleukin 4 (IL-4), arginase-1 (Arg-1) and glyceraldehyde 3-phosphate dehydrogenase were quantified by qPCR. Plasma levels of IL-4 were determined by sandwich ELISA. Unpaired t-tests or Mann-Whitney tests were used depending on the data distribution. Results Hookworm infected individuals (HWI) showed a significant increase in the number of monocytes/mm3 (555.2 ± 191.0) compared to that of the non-infected (NI) individuals (120.4 ± 44.7) (p < 0.0001). While the frequencies of CD14+IL-10+ and CD14+IL-12+ cells were significantly reduced in the HWI compared to NI group (p = 0.0289 and p < 0.0001, respectively), the ratio between IL-10/IL-12 producing monocytes was significantly elevated in HWI (p = 0.0004), indicating the potential regulatory activity of these cells. Measurement of IL-4 levels and gene expression of IL-4 and Arg-1 (highly expressed in alternatively activated macrophages) revealed no significant differences between the NI and HWI groups. Interestingly, individuals from the HWI group had higher expression of the iNOS gene (associated with a regulatory profile) (20.27 ± 2.97) compared to the NI group (11.28 ± 1.18, p = 0.0409). Finally, individuals from the HWI group had a significantly higher frequency of CD206+CD23+IL-10+ (7.57 ± 1.96) cells compared to individuals from the NI group (0.35 ± 0.09) (p < 0.001), suggesting that activated monocytes are a potential source of regulatory cytokines during hookworm infection. Conclusions Natural hookworm infection induces a high frequency of circulating monocytes that present a regulatory profile and promote the downmodulation of the proinflammatory response, which may contribute to prolonged survival of the parasite in the host.
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Affiliation(s)
- Lívia Silva Araújo Passos
- Department of Parasitology, Laboratory of Immunology and Genomics of Parasites, Institute of Biological Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Pedro Henrique Gazzinelli-Guimarães
- Department of Parasitology, Laboratory of Immunology and Genomics of Parasites, Institute of Biological Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | | | - Ana Clara Gazzinelli Guimarães
- Department of Parasitology, Laboratory of Immunology and Genomics of Parasites, Institute of Biological Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Denise da Silveira Lemos
- Department of Parasitology, Laboratory of Immunology and Genomics of Parasites, Institute of Biological Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Natasha Delaqua Ricci
- Department of Parasitology, Laboratory of Immunology and Genomics of Parasites, Institute of Biological Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Ricardo Gonçalves
- Department of General Pathology, Institute of Biological Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Daniella Castanheira Bartholomeu
- Department of Parasitology, Laboratory of Immunology and Genomics of Parasites, Institute of Biological Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Ricardo Toshio Fujiwara
- Department of Parasitology, Laboratory of Immunology and Genomics of Parasites, Institute of Biological Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Lilian Lacerda Bueno
- Department of Parasitology, Laboratory of Immunology and Genomics of Parasites, Institute of Biological Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
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153
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Acosta Soto L, Santísima-Trinidad AB, Bornay-Llinares FJ, Martín González M, Pascual Valero JA, Ros Muñoz M. Quantitative PCR and Digital PCR for Detection of Ascaris lumbricoides Eggs in Reclaimed Water. BIOMED RESEARCH INTERNATIONAL 2017; 2017:7515409. [PMID: 28377928 PMCID: PMC5362715 DOI: 10.1155/2017/7515409] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/28/2016] [Revised: 01/10/2017] [Accepted: 01/16/2017] [Indexed: 12/13/2022]
Abstract
The reuse of reclaimed water from wastewater depuration is a widespread and necessary practice in many areas around the world and must be accompanied by adequate and continuous quality control. Ascaris lumbricoides is one of the soil-transmitted helminths (STH) with risk for humans due to its high infectivity and an important determinant of transmission is the inadequacy of water supplies and sanitation. The World Health Organization (WHO) recommends a limit equal to or lower than one parasitic helminth egg per liter, to reuse reclaimed water for unrestricted irrigation. We present two new protocols of DNA extraction from large volumes of reclaimed water. Quantitative PCR (qPCR) and digital PCR (dPCR) were able to detect low amounts of A. lumbricoides eggs. By using the first extraction protocol, which processes 500 mL of reclaimed water, qPCR can detect DNA concentrations as low as one A. lumbricoides egg equivalent, while dPCR can detect DNA concentrations as low as five A. lumbricoides egg equivalents. By using the second protocol, which processes 10 L of reclaimed water, qPCR was able to detect DNA concentrations equivalent to 20 A. lumbricoides eggs. This fact indicated the importance of developing new methodologies to detect helminth eggs with higher sensitivity and precision avoiding possible human infection risks.
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Affiliation(s)
- Lucrecia Acosta Soto
- Department of Soil and Water Conservation and Organic Waste Management, Centro de Edafologia y Biologia Aplicada del Segura (CEBAS-CSIC), Campus de Espinardo, P.O. Box 164, Espinardo, 30100 Murcia, Spain
- Área de Parasitología, Departamento de Agroquímica y Medio Ambiente, Universidad Miguel Hernández de Elche, Ctra Valencia Km 8.7, San Juan, 03550 Alicante, Spain
| | - Ana Belén Santísima-Trinidad
- Department of Soil and Water Conservation and Organic Waste Management, Centro de Edafologia y Biologia Aplicada del Segura (CEBAS-CSIC), Campus de Espinardo, P.O. Box 164, Espinardo, 30100 Murcia, Spain
| | - Fernando Jorge Bornay-Llinares
- Área de Parasitología, Departamento de Agroquímica y Medio Ambiente, Universidad Miguel Hernández de Elche, Ctra Valencia Km 8.7, San Juan, 03550 Alicante, Spain
| | | | - José Antonio Pascual Valero
- Department of Soil and Water Conservation and Organic Waste Management, Centro de Edafologia y Biologia Aplicada del Segura (CEBAS-CSIC), Campus de Espinardo, P.O. Box 164, Espinardo, 30100 Murcia, Spain
| | - Margarita Ros Muñoz
- Department of Soil and Water Conservation and Organic Waste Management, Centro de Edafologia y Biologia Aplicada del Segura (CEBAS-CSIC), Campus de Espinardo, P.O. Box 164, Espinardo, 30100 Murcia, Spain
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154
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Sarkar R, Rose A, Mohan VR, Ajjampur SSR, Veluswamy V, Srinivasan R, Muliyil J, Rajshekhar V, George K, Balraj V, Grassly NC, Anderson RM, Brooker SJ, Kang G. Study design and baseline results of an open-label cluster randomized community-intervention trial to assess the effectiveness of a modified mass deworming program in reducing hookworm infection in a tribal population in southern India. Contemp Clin Trials Commun 2017; 5:49-55. [PMID: 28424794 PMCID: PMC5389336 DOI: 10.1016/j.conctc.2016.12.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2016] [Revised: 10/25/2016] [Accepted: 12/03/2016] [Indexed: 11/17/2022] Open
Abstract
Introduction Hookworm infection is a leading cause of iron deficiency anemia and malnutrition in resource-poor settings. Periodic mass deworming with anthelminthic drugs remains the cornerstone of hookworm control efforts worldwide. Reinfection following treatment occurs, reflecting the human host's inability to acquire immunity following exposure to an untreated reservoir of infection. This cluster randomized trial will evaluate the effectiveness of a modified, population-based, mass deworming strategy in reducing hookworm infection in an endemic southern Indian population. Methods Forty five tribal villages were randomized into three groups: one received annual treatment; the second received two rounds of treatment at 1-month intervals; and the third received four rounds of treatment – two rounds 1 month apart at the beginning, followed by another two after 6 months. Stool samples collected through cross-sectional parasitological surveys pre- and post-intervention, and at 3-monthly intervals for a period of 1 year were tested for presence of hookworm ova. Long-term effectiveness of treatment will be assessed through another survey conducted 2 years after the last treatment cycle. Results From a population of 11,857 individuals, 8681 (73.2%) were found to be eligible and consented to participate, out-migration being the primary reason for non-participation. Baseline stool samples were obtained from 2082 participants, with 18.5% having hookworm infection, although majority were low intensity infections (<2000 eggs per gram of feces). Discussion This study will help identify the optimal mass deworming strategy that can achieve the greatest impact in the shortest period of time, particularly in settings where long-term program sustainability is a challenge.
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Affiliation(s)
- Rajiv Sarkar
- Division of Gastrointestinal Sciences, Christian Medical College, Vellore, 632004, Tamil Nadu, India
| | - Anuradha Rose
- Community Health Department, Christian Medical College, Vellore, 632002, Tamil Nadu, India
| | - Venkata R Mohan
- Community Health Department, Christian Medical College, Vellore, 632002, Tamil Nadu, India
| | - Sitara S R Ajjampur
- Division of Gastrointestinal Sciences, Christian Medical College, Vellore, 632004, Tamil Nadu, India
| | - Vasanthakumar Veluswamy
- Division of Gastrointestinal Sciences, Christian Medical College, Vellore, 632004, Tamil Nadu, India
| | - Rajan Srinivasan
- Division of Gastrointestinal Sciences, Christian Medical College, Vellore, 632004, Tamil Nadu, India
| | - Jayaprakash Muliyil
- Division of Gastrointestinal Sciences, Christian Medical College, Vellore, 632004, Tamil Nadu, India
| | - Vedantam Rajshekhar
- Department of Neurological Sciences, Christian Medical College, Vellore, 632004, Tamil Nadu, India
| | - Kuryan George
- Community Health Department, Christian Medical College, Vellore, 632002, Tamil Nadu, India
| | - Vinohar Balraj
- Society for Applied Studies, No. 14, Natteri Krishnamachari Street, Krishna Nagar, Vellore, 632001, Tamil Nadu, India
| | - Nicholas C Grassly
- Department of Infectious Disease Epidemiology, School of Public Health, Faculty of Medicine, Imperial College London, Norfolk Place, London, W2 1NY, United Kingdom
| | - Roy M Anderson
- Department of Infectious Disease Epidemiology, School of Public Health, Faculty of Medicine, Imperial College London, Norfolk Place, London, W2 1NY, United Kingdom
| | - Simon J Brooker
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, United Kingdom
| | - Gagandeep Kang
- Division of Gastrointestinal Sciences, Christian Medical College, Vellore, 632004, Tamil Nadu, India
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155
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Cooper AJR, Dholakia S, Holland CV, Friend PJ. Helminths in organ transplantation. THE LANCET. INFECTIOUS DISEASES 2017; 17:e166-e176. [PMID: 28233632 DOI: 10.1016/s1473-3099(16)30533-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/10/2016] [Revised: 11/06/2016] [Accepted: 11/15/2016] [Indexed: 12/26/2022]
Abstract
With transplantation becoming an increasingly routine form of treatment for diverse populations, and with international travel becoming ever more accessible and affordable, the danger of transplantation-mediated helminth infections, exacerbated by coincident immunosuppression, must be considered. In this Review, we attempt to catalogue all clinically-relevant helminthiases that have been reported to coincide with transplantation, whether by transplantation-mediated transmission, reactivation of latent infections in an immunosuppressed context, or possible de-novo infection during the immunosuppressed peritransplant period. Helminthiasis has been reported in cases of kidney, liver, bowel, pancreas, heart, lung, and stem-cell transplant, and blood transfusion. For each helminthiasis, known risk factors, symptoms, and suggested options for screening and treatment are given. We conclude that helminths are a small but important and potentially severe source of disease after transplantation, and, with options for diagnosis and treatment, these pathogens warrant greater consideration during organ implantation. The achievement of immunological tolerance using helminth-derived products is also an exciting future prospect.
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Affiliation(s)
- Andrew J R Cooper
- Department of Zoology, School of Natural Sciences, Trinity College, Dublin, Ireland.
| | - Shamik Dholakia
- Nuffield Department of Surgical Sciences and Oxford Transplant Centre, University of Oxford and Oxford University Hospitals NHS Trust, Oxford, UK
| | - Celia V Holland
- Department of Zoology, School of Natural Sciences, Trinity College, Dublin, Ireland
| | - Peter J Friend
- Nuffield Department of Surgical Sciences and Oxford Transplant Centre, University of Oxford and Oxford University Hospitals NHS Trust, Oxford, UK
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156
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Müller N, Heistermann M, Strube C, Schülke O, Ostner J. Age, but not anthelmintic treatment, is associated with urinary neopterin levels in semi-free ranging Barbary macaques. Sci Rep 2017; 7:41973. [PMID: 28155915 PMCID: PMC5290464 DOI: 10.1038/srep41973] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2016] [Accepted: 12/28/2016] [Indexed: 02/07/2023] Open
Abstract
Studying host parasite interactions and their implications for evolution and ecology recently received increasing attention, particularly with regard to host physiology and immunity. Here we assess variation of urinary neopterin (uNEO), a marker of cellular immune activation and iummunosenescence, in response to age and anthelmintic treatment in semi-free ranging Barbary macaques (Macaca sylvanus). Urinary NEO levels were measured via enzyme-immunoassay from 179 urine samples of 43 individuals between 5–29 years of age. Efficiency of treatment was assessed by Mc Master flotation on repeated faecal samples, including 18 untreated individuals as control group. We used linear mixed models with age and parasite status as main effects, controlling for sex and physical condition, assessed through urinary C-Peptide-levels, with social group and ID as random factors. Urinary NEO levels significantly increased with age, suggesting that changes in aging Barbary macaque immune responses are consistent with immunosenescence described in human and nonhuman primates and can be detected via uNEO measurements. Anthelmintic treatment, however, had no influence on uNEO levels, potentially due to quick reinfections or attenuated immune responses in repeated infections. We conclude that uNEO is a potential non-invasive marker for immune function and particularly immunosenescence in wildlife.
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Affiliation(s)
- Nadine Müller
- Department of Behavioral Ecology, Johann-Friedrich-Blumenbach Institute for Zoology and Anthropology, Georg August University Göttingen, Göttingen, Germany
| | - Michael Heistermann
- Endocrinology Laboratory, German Primate Centre, Leibniz Institute for Primate Research, Göttingen, Germany
| | - Christina Strube
- Institute for Parasitology, Centre for Infection Medicine, University of Veterinary Medicine Hannover, Hannover, Germany
| | - Oliver Schülke
- Department of Behavioral Ecology, Johann-Friedrich-Blumenbach Institute for Zoology and Anthropology, Georg August University Göttingen, Göttingen, Germany.,Research Group Primate Social Evolution, German Primate Centre, Leibniz Institute for Primate Research, Göttingen, Germany
| | - Julia Ostner
- Department of Behavioral Ecology, Johann-Friedrich-Blumenbach Institute for Zoology and Anthropology, Georg August University Göttingen, Göttingen, Germany.,Research Group Primate Social Evolution, German Primate Centre, Leibniz Institute for Primate Research, Göttingen, Germany
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157
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Clarke NE, Clements ACA, Doi SA, Wang D, Campbell SJ, Gray D, Nery SV. Differential effect of mass deworming and targeted deworming for soil-transmitted helminth control in children: a systematic review and meta-analysis. Lancet 2017; 389:287-297. [PMID: 27979381 DOI: 10.1016/s0140-6736(16)32123-7] [Citation(s) in RCA: 74] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2016] [Revised: 09/27/2016] [Accepted: 09/28/2016] [Indexed: 11/27/2022]
Abstract
BACKGROUND Soil-transmitted helminth infections are a major global health issue, causing substantial morbidity in the world's poorest populations. Regular delivery of anthelmintic drugs is the mainstay for global soil-transmitted helminth control. Deworming campaigns are often targeted to school-aged children, who are at high risk of soil-transmitted-helminth-associated morbidity. However, findings from modelling studies suggest that deworming campaigns should be expanded community-wide for effective control of soil-transmitted helminth transmission. We aimed to do a systematic review and meta-analysis to compare the effect of mass (community-wide) and targeted (children only) anthelmintic delivery strategies on soil-transmitted helminth prevalence in school-aged children. METHODS In this systematic review and meta-analysis, we searched MEDLINE, Embase, and Web of Science for articles published on or before Nov 5, 2015, reporting soil-transmitted helminth prevalence before and after distribution of albendazole or mebendazole, either targeted to children or delivered to the whole community. We excluded studies in which drug delivery was restricted to infected individuals or to a subset of the community or school, or if follow-up time was less than 3 months or greater than 18 months after drug delivery. We extracted data on study year, country, drug administration strategy, drug dose, number of deworming rounds, treatment coverage, diagnostic method, follow-up interval, and soil-transmitted helminth prevalence before and after treatment. We used inverse variance weighted generalised linear models, with prevalence reduction as the outcome variable, to examine the effect of mass versus targeted drug administration, as well as baseline prevalence, number of drug doses, and follow-up time. This study is registered with PROSPERO, number CRD42016026929. FINDINGS Of 10 538 studies identified, 56 studies were eligible for the systematic review and 38 of these were included in meta-analysis. Results of the regression models showed that mass deworming led to a significantly greater reduction in prevalence in children than targeted deworming, for both hookworm (odds ratio 4·6, 95% CI 1·8-11·6; p=0·0020) and Ascaris lumbricoides (16·4, 2·1-125·8; p=0·0092), with no effect seen for Trichuris trichiura. There was significant heterogeneity across studies; for targeted studies I2 was 97% for A lumbricoides and hookworm, and 96% for T trichiura, and for mass studies, I2 was 89% for A lumbricoides, 49% for hookworm, and 66% for T trichiura. INTERPRETATION The results of this meta-analysis suggest that expanding deworming programmes community-wide is likely to reduce the prevalence of soil-transmitted helminths in the high-risk group of school-aged children, which could lead to improved morbidity outcomes. These findings are in support of recent calls for re-evaluation of global soil-transmitted helminth control guidelines. FUNDING None.
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Affiliation(s)
- Naomi E Clarke
- Research School of Population Health, Australian National University, Canberra, ACT, Australia.
| | - Archie C A Clements
- Research School of Population Health, Australian National University, Canberra, ACT, Australia
| | - Suhail A Doi
- Research School of Population Health, Australian National University, Canberra, ACT, Australia; College of Medicine, Qatar University, Doha, Qatar; School of Agricultural, Computational and Environmental Sciences, University of Southern Queensland, Toowoomba, QLD, Australia
| | - Dongxu Wang
- Research School of Population Health, Australian National University, Canberra, ACT, Australia
| | - Suzy J Campbell
- Research School of Population Health, Australian National University, Canberra, ACT, Australia
| | - Darren Gray
- Research School of Population Health, Australian National University, Canberra, ACT, Australia
| | - Susana V Nery
- Research School of Population Health, Australian National University, Canberra, ACT, Australia
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158
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Loukas A, Hotez PJ, Diemert D, Yazdanbakhsh M, McCarthy JS, Correa-Oliveira R, Croese J, Bethony JM. Hookworm infection. Nat Rev Dis Primers 2016; 2:16088. [PMID: 27929101 DOI: 10.1038/nrdp.2016.88] [Citation(s) in RCA: 161] [Impact Index Per Article: 20.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Hookworms are soil-transmitted nematode parasites that can reside for many years in the small intestine of their human hosts; Necator americanus is the predominant infecting species. Adult worms feed on the blood of a host and can cause iron deficiency anaemia, especially in high-risk populations (children and women of childbearing age). Almost 500 million people in developing tropical countries are infected, and simulation models estimate that hookworm infection is responsible for >4 million disability-adjusted life years lost annually. Humans mount an immune response to hookworms, but it is mostly unsuccessful at removing adult worms from the bowel. Accordingly, the host switches to an immune-tolerant state that enables hookworms to reside in the gut for many years. Although anthelmintic drugs are available and widely used, their efficacy varies and the drugs do not prevent reinfection. Thus, other control strategies aimed at improving water quality, sanitation and hygiene are needed. In addition, efforts are underway to develop a human hookworm vaccine through public-private partnerships. However, hookworms could also be a resource; as hookworms have the capability to regulate the host's inflammation, researchers are experimentally infecting patients to treat some inflammatory diseases as an approach to discover new anti-inflammatory molecules. This area of endeavour might well yield new biotherapeutics for autoimmune and allergic diseases.
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Affiliation(s)
- Alex Loukas
- Centre for Biodiscovery and Molecular Development of Therapeutics, Australian Institute of Tropical Health and Medicine, Building E4, James Cook University, McGregor Rd, Smithfield, Cairns, Queensland 4878, Australia
| | - Peter J Hotez
- Departments of Pediatrics and Molecular Virology and Microbiology, National School of Tropical Medicine, Baylor College Of Medicine, Houston, Texas, USA.,Sabin Vaccine Institute, Houston, Texas, USA.,Texas Children's Hospital Center for Vaccine Development, Houston, Texas, USA
| | - David Diemert
- Department of Microbiology, Tropical Medicine and Immunology, George Washington University, Washington DC, USA.,Sabin Vaccine Institute, Washington DC, USA
| | - Maria Yazdanbakhsh
- Department of Parasitology, Leiden University Medical Centre, Leiden, The Netherlands
| | - James S McCarthy
- Queensland Institute of Medical Research (QIMR) Berghofer Medical Research Institute, Brisbane, Queensland, Australia.,University of Queensland, Brisbane, Queensland, Australia
| | | | - John Croese
- Centre for Biodiscovery and Molecular Development of Therapeutics, Australian Institute of Tropical Health and Medicine, Building E4, James Cook University, McGregor Rd, Smithfield, Cairns, Queensland 4878, Australia.,Department of Gastroenterology, Prince Charles Hospital, Brisbane, Queensland, Australia
| | - Jeffrey M Bethony
- Department of Microbiology, Tropical Medicine and Immunology, George Washington University, Washington DC, USA
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159
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Bello-Manga H, DeBaun MR, Kassim AA. Epidemiology and treatment of relative anemia in children with sickle cell disease in sub-Saharan Africa. Expert Rev Hematol 2016; 9:1031-1042. [PMID: 27677923 DOI: 10.1080/17474086.2016.1240612] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
INTRODUCTION Sickle cell disease (SCD) is the most common inherited hemoglobinopathy in the world, with the majority of cases in sub-Saharan Africa. Concomitant nutritional deficiencies, infections or exposure to environmental toxins exacerbate chronic anemia in children with SCD. The resulting relative anemia is associated with increased risk of strokes, poor cognitive function and impaired growth. It may also attenuate optimal response to hydroxyurea therapy, the only effective and practical treatment option for SCD in sub-Saharan Africa. This review will focus on the epidemiology, clinical sequelae, and treatment of relative anemia in children with SCD living in low and middle-income countries in sub-Saharan Africa. Areas covered: The causes and treatment of relative anemia in children with SCD in sub-Saharan Africa. The MEDLINE database was searched using medical subject headings (MeSH) and keywords for articles regarding relative anemia in children with SCD in sub-Saharan Africa. Expert commentary: Anemia due to nutritional deficiencies and infectious diseases such as helminthiasis and malaria are prevalent in sub-Saharan Africa. Their co-existence in children with SCD increases morbidity and mortality. Therefore, preventing, diagnosing and treating the underlying cause of this relative anemia will improve SCD-related outcomes in children in sub-Saharan Africa.
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Affiliation(s)
- Halima Bello-Manga
- a Department of Hematology and Blood Transfusion , Barau Dikko Teaching hospital/Kaduna State University , Kaduna , Nigeria
| | - Michael R DeBaun
- b Department of Pediatrics, Division of Hematology/Oncology, Vanderbilt-Meharry Center for Excellence in Sickle Cell Disease , Vanderbilt University Medical Center , Nashville , TN , USA
| | - Adetola A Kassim
- c Department of Medicine, Division of Hematology/Oncology, Vanderbilt-Meharry Center for Excellence in Sickle Cell Disease , Vanderbilt University Medical Center , Nashville , TN , USA
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160
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Deardorff K, Ray W, Winterstein E, Brown M, McCornack J, Cardenas-Garcia B, Jones K, McNutt S, Fulkerson S, Ferreira D, Gény C, Chen X, Belofsky G, Dondji B. Phenolic Metabolites of Dalea ornata Affect Both Survival and Motility of the Human Pathogenic Hookworm Ancylostoma ceylanicum. JOURNAL OF NATURAL PRODUCTS 2016; 79:2296-303. [PMID: 27584977 PMCID: PMC5260846 DOI: 10.1021/acs.jnatprod.6b00444] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
Hookworms are ubiquitous human parasites, infecting nearly one billion people worldwide, and are the leading cause of anemia and malnutrition in resource-limited countries. Current drug treatments rely on the benzimidazole derivatives albendazole and mebendazole, but there is emerging resistance to these drugs. As part of a larger screening effort, using a hamster-based ex vivo assay, anthelmintic activity toward Ancylostoma ceylanicum was observed in the crude extract of aerial parts of Dalea ornata. These studies have led to the isolation and characterization of phenolic metabolites 1-10. The structures were determined by 1D and 2D NMR spectroscopy, and the absolute configuration of 1 was assigned using electronic circular dichroism data. The new compound, (2S)-8-(3-methylbut-2-en-1-yl)-6,7,4'-trihydroxyflavanone (1), was weakly active at 7.3 μM, with 17% reduction in survival of the hookworms after 5 days. The rotenoids deguelin (9) and tephrosin (10), predictably perhaps, were the most active, with complete worm mortality observed by day 4 (or earlier) at 6.3 and 6.0 μM, respectively. The effects of 1-10 on hookworm motility and on toxicity to hamster splenocytes were also explored as important measures of treatment potential.
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Affiliation(s)
- Kaitlin Deardorff
- Laboratory of Cellular Immunology and Parasitology, Department of Biological Sciences, Central Washington University, Ellensburg, Washington 98926, United States
| | - William Ray
- Department of Chemistry, Central Washington University, Ellensburg, Washington 98926, United States
| | - Eric Winterstein
- Department of Chemistry, Central Washington University, Ellensburg, Washington 98926, United States
| | - MacKenzie Brown
- Department of Chemistry, Central Washington University, Ellensburg, Washington 98926, United States
| | - Jocelyn McCornack
- Laboratory of Cellular Immunology and Parasitology, Department of Biological Sciences, Central Washington University, Ellensburg, Washington 98926, United States
| | - Brianda Cardenas-Garcia
- Laboratory of Cellular Immunology and Parasitology, Department of Biological Sciences, Central Washington University, Ellensburg, Washington 98926, United States
| | - Kiah Jones
- Laboratory of Cellular Immunology and Parasitology, Department of Biological Sciences, Central Washington University, Ellensburg, Washington 98926, United States
| | - Sarah McNutt
- Laboratory of Cellular Immunology and Parasitology, Department of Biological Sciences, Central Washington University, Ellensburg, Washington 98926, United States
| | - Shannon Fulkerson
- Laboratory of Cellular Immunology and Parasitology, Department of Biological Sciences, Central Washington University, Ellensburg, Washington 98926, United States
| | - Daneel Ferreira
- Department of BioMolecular Sciences, Division of Pharmacognosy, and the Research Institute of Pharmaceutical Sciences, School of Pharmacy, The University of Mississippi, University, Mississippi 38677, United States
| | - Charlotte Gény
- Department of Drug Discovery and Biomedical Sciences, The Medical University of South Carolina, Charleston, South Carolina 29425, United States
| | - Xiaoyan Chen
- Department of Drug Discovery and Biomedical Sciences, The Medical University of South Carolina, Charleston, South Carolina 29425, United States
| | - Gil Belofsky
- Department of Chemistry, Central Washington University, Ellensburg, Washington 98926, United States
- Corresponding Authors. Tel: 509-963-2882. Fax: 509-963-1050. . Tel: 509-963-2715. Fax: 509-963-2370.
| | - Blaise Dondji
- Laboratory of Cellular Immunology and Parasitology, Department of Biological Sciences, Central Washington University, Ellensburg, Washington 98926, United States
- Corresponding Authors. Tel: 509-963-2882. Fax: 509-963-1050. . Tel: 509-963-2715. Fax: 509-963-2370.
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Bartsch SM, Hotez PJ, Asti L, Zapf KM, Bottazzi ME, Diemert DJ, Lee BY. The Global Economic and Health Burden of Human Hookworm Infection. PLoS Negl Trop Dis 2016; 10:e0004922. [PMID: 27607360 PMCID: PMC5015833 DOI: 10.1371/journal.pntd.0004922] [Citation(s) in RCA: 84] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2016] [Accepted: 07/23/2016] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Even though human hookworm infection is highly endemic in many countries throughout the world, its global economic and health impact is not well known. Without a better understanding of hookworm's economic burden worldwide, it is difficult for decision makers such as funders, policy makers, disease control officials, and intervention manufacturers to determine how much time, energy, and resources to invest in hookworm control. METHODOLOGY/PRINCIPLE FINDINGS We developed a computational simulation model to estimate the economic and health burden of hookworm infection in every country, WHO region, and globally, in 2016 from the societal perspective. Globally, hookworm infection resulted in a total 2,126,280 DALYs using 2004 disability weight estimates and 4,087,803 DALYs using 2010 disability weight estimates (excluding cognitive impairment outcomes). Including cognitive impairment did not significantly increase DALYs worldwide. Total productivity losses varied with the probability of anemia and calculation method used, ranging from $7.5 billion to $138.9 billion annually using gross national income per capita as a proxy for annual wages and ranging from $2.5 billion to $43.9 billion using minimum wage as a proxy for annual wages. CONCLUSION Even though hookworm is classified as a neglected tropical disease, its economic and health burden exceeded published estimates for a number of diseases that have received comparatively more attention than hookworm such as rotavirus. Additionally, certain large countries that are transitioning to higher income countries such as Brazil and China, still face considerable hookworm burden.
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Affiliation(s)
- Sarah M. Bartsch
- Public Health Computational and Operational Research (PHICOR), Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
- Global Obesity Prevention Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - Peter J. Hotez
- National School of Tropical Medicine, and Departments of Pediatrics and Molecular Virology & Microbiology, Baylor College of Medicine, Houston, Texas, United States of America
- Sabin Vaccine Institute, Washington, D.C., United States of America
| | - Lindsey Asti
- Public Health Computational and Operational Research (PHICOR), Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
- Global Obesity Prevention Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - Kristina M. Zapf
- Public Health Computational and Operational Research (PHICOR), Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
- Global Obesity Prevention Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - Maria Elena Bottazzi
- National School of Tropical Medicine, and Departments of Pediatrics and Molecular Virology & Microbiology, Baylor College of Medicine, Houston, Texas, United States of America
- Sabin Vaccine Institute, Washington, D.C., United States of America
| | - David J. Diemert
- Sabin Vaccine Institute, Washington, D.C., United States of America
- Department of Microbiology, Immunology and Tropical Medicine, The George Washington University Medical Center, Washington, D.C., United States of America
| | - Bruce Y. Lee
- Public Health Computational and Operational Research (PHICOR), Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
- Global Obesity Prevention Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
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Mariani M, Miragliuolo A, Mussi B, Russo GF, Ardizzone G, Pace DS. Analysis of the natural markings of Risso’s dolphins (Grampus griseus) in the central Mediterranean Sea. J Mammal 2016. [DOI: 10.1093/jmammal/gyw109] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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163
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Wu F, Xu Y, Xia M, Ying G, Shou Z. Hookworm Anemia in a Peritoneal Dialysis Patient in China. THE KOREAN JOURNAL OF PARASITOLOGY 2016; 54:315-7. [PMID: 27417086 PMCID: PMC4977793 DOI: 10.3347/kjp.2016.54.3.315] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/11/2016] [Revised: 03/29/2016] [Accepted: 04/03/2016] [Indexed: 11/23/2022]
Abstract
Hookworm infections as well as other intestinal nematodiases are endemic in China. In this case, a 70-year-old male showed symptoms of chest tightness, shortness of breath, and both lower extremities edema. The diagnostic result was chronic renal insufficiency, chronic kidney disease (5th stage), and renal anemia at first. Then, he received treatment with traditional drugs. However, this treatment did not help to alleviate the symptoms of the patient significantly. The results of gastroendoscopy showed hookworms in the duodenum, also confirmed by pathology examination. Anemia was markedly ameliorated after eliminating the parasites. The results mentioned above suggested that ancylostomiasis was the leading causes of anemia in this patient, and the etiology of anemia in uremic patients should be systematically considered. Especially when anemia could not be cured by regular treatments, rare diseases should be investigated.
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Affiliation(s)
- Fuquan Wu
- Nephrology Department, School of Medicine, The First Affiliated Hospital of Zhejiang University, Ningbo, Zhejiang, China
| | - Ying Xu
- Kidney Disease Center, School of Medicine, The First Affiliated Hospital of Zhejiang University, Hangzhou, Zhejiang, China
| | - Min Xia
- Nephrology Department, School of Medicine, The First Affiliated Hospital of Zhejiang University, Ningbo, Zhejiang, China
| | - Guanghui Ying
- Nephrology Department, School of Medicine, The First Affiliated Hospital of Zhejiang University, Ningbo, Zhejiang, China
| | - Zhangfei Shou
- Kidney Disease Center, School of Medicine, The First Affiliated Hospital of Zhejiang University, Hangzhou, Zhejiang, China
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164
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Kunwar R, Acharya L, Karki S. Decreasing prevalence of intestinal parasitic infections among school-aged children in Nepal: a systematic review and meta-analysis. Trans R Soc Trop Med Hyg 2016; 110:324-32. [PMID: 27268711 DOI: 10.1093/trstmh/trw033] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2016] [Accepted: 04/22/2016] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND In the last two decades there have been several studies describing the prevalence of intestinal parasites in Nepal; however, there is a lack of surveillance data in the country. METHODS We searched literature in PubMed, MEDLINE, EMBASE, Google Scholar and local peer-reviewed journals published from 1990 to 2015 for studies describing prevalence of intestinal parasites among school-aged children. We conducted meta-regression to understand the trend over time and pooled the prevalence using 'metaprop' command in STATA 12.1. RESULTS Thirty-one studies examining 12 080 fecal specimens were included. The prevalence of intestinal parasitic infections showed a significantly decreasing trend (OR 0.56; 95% CI 0.43-0.73 for each consecutive 5 years) and was similar in males and females. The pooled prevalence in years 1996-2000, 2001-2005, 2006-2010 and 2011-2015 was 61.1% (95% CI 51.47-70.26), 53.2% (95% CI 20.94-83.99), 32.7% (95% CI 26.57-39.21) and 20.4% (95% CI 15.04-26.25), respectively. The proportion of helminths among total intestinal parasites was higher in rural areas 57.6% (95% CI 43.54-71.61), and proportion of protozoa among total intestinal parasites was higher in urban areas 68.4% (95% CI 63.23-73.62). Poly-parasitism was observed in 7.7% (95% CI 5.57-9.73) of children. CONCLUSION We observed a significantly decreasing trend in prevalence of intestinal parasitic infections among school-aged children in Nepal over the last two decades.
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Affiliation(s)
- Ritu Kunwar
- School of Public Health and Community Medicine, University of New South Wales (UNSW), Australia
| | | | - Surendra Karki
- School of Public Health and Community Medicine, University of New South Wales (UNSW), Australia
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165
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Hotez PJ, Beaumier CM, Gillespie PM, Strych U, Hayward T, Bottazzi ME. Advancing a vaccine to prevent hookworm disease and anemia. Vaccine 2016; 34:3001-3005. [DOI: 10.1016/j.vaccine.2016.03.078] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2015] [Accepted: 03/11/2016] [Indexed: 01/30/2023]
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166
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Gang SS, Hallem EA. Mechanisms of host seeking by parasitic nematodes. Mol Biochem Parasitol 2016; 208:23-32. [PMID: 27211240 DOI: 10.1016/j.molbiopara.2016.05.007] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2015] [Revised: 05/13/2016] [Accepted: 05/16/2016] [Indexed: 10/21/2022]
Abstract
The phylum Nematoda comprises a diverse group of roundworms that includes parasites of vertebrates, invertebrates, and plants. Human-parasitic nematodes infect more than one billion people worldwide and cause some of the most common neglected tropical diseases, particularly in low-resource countries [1]. Parasitic nematodes of livestock and crops result in billions of dollars in losses each year [1]. Many nematode infections are treatable with low-cost anthelmintic drugs, but repeated infections are common in endemic areas and drug resistance is a growing concern with increasing therapeutic and agricultural administration [1]. Many parasitic nematodes have an environmental infective larval stage that engages in host seeking, a process whereby the infective larvae use sensory cues to search for hosts. Host seeking is a complex behavior that involves multiple sensory modalities, including olfaction, gustation, thermosensation, and humidity sensation. As the initial step of the parasite-host interaction, host seeking could be a powerful target for preventative intervention. However, host-seeking behavior remains poorly understood. Here we review what is currently known about the host-seeking behaviors of different parasitic nematodes, including insect-parasitic nematodes, mammalian-parasitic nematodes, and plant-parasitic nematodes. We also discuss the neural bases of these behaviors.
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Affiliation(s)
- Spencer S Gang
- Department of Microbiology, Immunology, and Molecular Genetics and Molecular Biology Institute, University of California, Los Angeles, Los Angeles, CA 90095, United States.
| | - Elissa A Hallem
- Department of Microbiology, Immunology, and Molecular Genetics and Molecular Biology Institute, University of California, Los Angeles, Los Angeles, CA 90095, United States.
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167
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Kunwar R, Acharya L, Karki S. Trends in prevalence of soil-transmitted helminth and major intestinal protozoan infections among school-aged children in Nepal. Trop Med Int Health 2016; 21:703-19. [PMID: 27097973 DOI: 10.1111/tmi.12700] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
OBJECTIVES To assess the trends in prevalence of soil-transmitted helminths (STHs), Entamoeba histolytica and Giardia lamblia among school-aged children in Nepal between 1990 and 2015. METHODS Systematic literature search in PubMed, MEDLINE, EMBASE, Google Scholar and local peer-reviewed journals for papers published between 1990 and December 2015. We conducted metaregression and meta-analyses to pool studies where applicable. RESULTS Thirty-nine studies that examined a total of 14 729 stool specimens were included in the meta-analyses. The metaregression of prevalence of hookworms, roundworm, and whipworm showed a significantly decreasing trend over time. In or after 2004, the pooled prevalence of hookworm infections was 1.53% (95% CI, 0.73-2.59), of roundworm 4.31% (95% CI, 2.52-6.53) and of whipworm 2.89% (95% CI, 1.33-4.97) vs. 16.54% (95% CI, 7.64-27.97) for hookworm, 25.20% (95% CI, 13.59-38.97) for roundworm and 11.54% (95% CI 4.25-21.76) for whipworm in 1993-2003. E. histolytica and G. lamblia had stable prevalence since early 1990s, with a pooled prevalences of 4.12% (95% CI, 2.73-5.77) and 9.40% (95% CI, 7.15-11.92), respectively. The prevalence of G. lamblia was significantly higher in urban areas. CONCLUSIONS We observed a sharp decrease in prevalence of STHs among school-aged children in Nepal in the past decade with prevalences dropping below 5% for STHs with no variation in prevalence in rural and urban areas. However, the prevalence of E. histolytica and G. lamblia remained stable over time. These results suggest that school-based deworming programmes rolled out during the study period had an observable impact on prevalence of STHs.
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Affiliation(s)
- Ritu Kunwar
- School of Public Health and Community Medicine, University of New South Wales, New South Wales, Australia
| | - Lokendra Acharya
- Kathmandu Medical College, Kathmandu University, Kathmandu, Nepal
| | - Surendra Karki
- School of Public Health and Community Medicine, University of New South Wales, New South Wales, Australia
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Campbell SJ, Nery SV, Doi SA, Gray DJ, Soares Magalhães RJ, McCarthy JS, Traub RJ, Andrews RM, Clements ACA. Complexities and Perplexities: A Critical Appraisal of the Evidence for Soil-Transmitted Helminth Infection-Related Morbidity. PLoS Negl Trop Dis 2016; 10:e0004566. [PMID: 27196100 PMCID: PMC4873196 DOI: 10.1371/journal.pntd.0004566] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Soil-transmitted helminths (STH) have acute and chronic manifestations, and can result in lifetime morbidity. Disease burden is difficult to quantify, yet quantitative evidence is required to justify large-scale deworming programmes. A recent Cochrane systematic review, which influences Global Burden of Disease (GBD) estimates for STH, has again called into question the evidence for deworming benefit on morbidity due to STH. In this narrative review, we investigate in detail what the shortfalls in evidence are. METHODOLOGY/PRINCIPAL FINDINGS We systematically reviewed recent literature that used direct measures to investigate morbidity from STH and we critically appraised systematic reviews, particularly the most recent Cochrane systematic review investigating deworming impact on morbidity. We included six systematic reviews and meta-analyses, 36 literature reviews, 44 experimental or observational studies, and five case series. We highlight where evidence is insufficient and where research needs to be directed to strengthen morbidity evidence, ideally to prove benefits of deworming. CONCLUSIONS/SIGNIFICANCE Overall, the Cochrane systematic review and recent studies indicate major shortfalls in evidence for direct morbidity. However, it is questionable whether the systematic review methodology should be applied to STH due to heterogeneity of the prevalence of different species in each setting. Urgent investment in studies powered to detect direct morbidity effects due to STH is required.
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Affiliation(s)
- Suzy J. Campbell
- Research School of Population Health, College of Medicine, Biology, and Environment, The Australian National University, Canberra, Australian Captial Territory, Australia
| | - Susana V. Nery
- Research School of Population Health, College of Medicine, Biology, and Environment, The Australian National University, Canberra, Australian Captial Territory, Australia
| | - Suhail A. Doi
- Research School of Population Health, College of Medicine, Biology, and Environment, The Australian National University, Canberra, Australian Captial Territory, Australia
| | - Darren J. Gray
- Research School of Population Health, College of Medicine, Biology, and Environment, The Australian National University, Canberra, Australian Captial Territory, Australia
- Molecular Parasitology Laboratory, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | - Ricardo J. Soares Magalhães
- Children's Health and Environment Program, Queensland Children's Medical Research Institute, The University of Queensland, Brisbane, Queensland, Australia
- School of Veterinary Science, The University of Queensland, Gatton, Queensland, Australia
| | - James S. McCarthy
- School of Population Health, University of Queensland, Brisbane, Queensland, Australia
- Clinical Tropical Medicine Laboratory, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | - Rebecca J. Traub
- Faculty of Veterinary and Agricultural Science, The University of Melbourne, Melbourne, Victoria, Australia
| | - Ross M. Andrews
- Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia
| | - Archie C. A. Clements
- Research School of Population Health, College of Medicine, Biology, and Environment, The Australian National University, Canberra, Australian Captial Territory, Australia
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Giacomin P, Croese J, Krause L, Loukas A, Cantacessi C. Suppression of inflammation by helminths: a role for the gut microbiota? Philos Trans R Soc Lond B Biol Sci 2016; 370:rstb.2014.0296. [PMID: 26150662 PMCID: PMC4528494 DOI: 10.1098/rstb.2014.0296] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Multiple recent investigations have highlighted the promise of helminth-based therapies for the treatment of inflammatory disorders of the intestinal tract of humans, including inflammatory bowel disease and coeliac disease. However, the mechanisms by which helminths regulate immune responses, leading to the amelioration of symptoms of chronic inflammation are unknown. Given the pivotal roles of the intestinal microbiota in the pathogenesis of these disorders, it has been hypothesized that helminth-induced modifications of the gut commensal flora may be responsible for the therapeutic properties of gastrointestinal parasites. In this article, we review recent progress in the elucidation of host-parasite-microbiota interactions in both animal models of chronic inflammation and humans, and provide a working hypothesis of the role of the gut microbiota in helminth-induced suppression of inflammation.
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Affiliation(s)
- Paul Giacomin
- Centre for Biodiscovery and Molecular Development of Therapeutics, Australian Institute of Tropical Health and Medicine, James Cook University, Smithfield 4878, Australia
| | - John Croese
- Department of Gastroenterology and Hepatology, The Prince Charles Hospital, Brisbane 4007, Australia
| | - Lutz Krause
- Translational Research Institute, University of Queensland Diamantina Institute, Woolloongabba, Australia
| | - Alex Loukas
- Centre for Biodiscovery and Molecular Development of Therapeutics, Australian Institute of Tropical Health and Medicine, James Cook University, Smithfield 4878, Australia
| | - Cinzia Cantacessi
- Department of Veterinary Medicine, University of Cambridge, Cambridge CB3 0ES, UK
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Matijašić M, Meštrović T, Perić M, Čipčić Paljetak H, Panek M, Vranešić Bender D, Ljubas Kelečić D, Krznarić Ž, Verbanac D. Modulating Composition and Metabolic Activity of the Gut Microbiota in IBD Patients. Int J Mol Sci 2016; 17:ijms17040578. [PMID: 27104515 PMCID: PMC4849034 DOI: 10.3390/ijms17040578] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2016] [Revised: 04/13/2016] [Accepted: 04/13/2016] [Indexed: 02/06/2023] Open
Abstract
The healthy intestine represents a remarkable interface where sterile host tissues come in contact with gut microbiota, in a balanced state of homeostasis. The imbalance of gut homeostasis is associated with the onset of many severe pathological conditions, such as inflammatory bowel disease (IBD), a chronic gastrointestinal disorder increasing in incidence and severely influencing affected individuals. Despite the recent development of next generation sequencing and bioinformatics, the current scientific knowledge of specific triggers and diagnostic markers to improve interventional approaches in IBD is still scarce. In this review we present and discuss currently available and emerging therapeutic options in modulating composition and metabolic activity of gut microbiota in patients affected by IBD. Therapeutic approaches at the microbiota level, such as dietary interventions alone or with probiotics, prebiotics and synbiotics, administration of antibiotics, performing fecal microbiota transplantation (FMT) and the use of nematodes, all represent a promising opportunities towards establishing and maintaining of well-being as well as improving underlying IBD symptoms.
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Affiliation(s)
- Mario Matijašić
- Center for Translational and Clinical Research, University of Zagreb School of Medicine, 10000 Zagreb, Croatia.
| | - Tomislav Meštrović
- Clinical Microbiology and Parasitology Unit, Polyclinic "Dr. Zora Profozić", Bosutska 19, 10000 Zagreb, Croatia.
| | - Mihaela Perić
- Center for Translational and Clinical Research, University of Zagreb School of Medicine, 10000 Zagreb, Croatia.
| | - Hana Čipčić Paljetak
- Center for Translational and Clinical Research, University of Zagreb School of Medicine, 10000 Zagreb, Croatia.
| | - Marina Panek
- Center for Translational and Clinical Research, University of Zagreb School of Medicine, 10000 Zagreb, Croatia.
| | - Darija Vranešić Bender
- Department of Internal Medicine, Division of Clinical Nutrition, Clinical Hospital Centre Zagreb, 10000 Zagreb, Croatia.
| | - Dina Ljubas Kelečić
- Department of Internal Medicine, Division of Clinical Nutrition, Clinical Hospital Centre Zagreb, 10000 Zagreb, Croatia.
| | - Željko Krznarić
- Department of Internal Medicine, Division of Clinical Nutrition, Clinical Hospital Centre Zagreb, 10000 Zagreb, Croatia.
- Department of Internal Medicine, Division of Gastroenterology and Hepatology, Clinical Hospital Centre Zagreb, 10000 Zagreb, Croatia.
- Department of Internal Medicine, University of Zagreb School of Medicine, 10000 Zagreb, Croatia.
| | - Donatella Verbanac
- Center for Translational and Clinical Research, University of Zagreb School of Medicine, 10000 Zagreb, Croatia.
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Na-Ek P, Sanpool O, Jongthawin J, Anamnart W, Intapan PM, Chamavit P, Maleewong W. Restoration of hookworm egg development after prolonged storage in stool suspension. Parasitol Res 2016; 115:2817-23. [PMID: 27053130 DOI: 10.1007/s00436-016-5031-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2016] [Accepted: 03/23/2016] [Indexed: 11/25/2022]
Abstract
Hookworm infection is still prevalent in southern Thailand despite control measures. Hookworm eggs submerged for an extended period under water from rainfall or in latrines may not survive, but they may recover their ability to develop into infective larvae when exposed to atmospheric air. This study examined the survival of the hookworm eggs in stool suspension and the restoration of development capability after prolonged storage. In stool mass, eggs developed normally and yielded infective filariform larvae (FL) in 7 days. On the contrary, in 1:10 stool suspension, hookworm eggs were found to remain at the 4-8 cell stage; degenerated eggs were observed after 15 days of storage, and the number of degenerated eggs reached 80 % on day 30. Aeration of the suspension, or transferring to a Petri dish or agar plate, restored the capacity of eggs stored for up to 15 days to develop into FL; thereafter, the capacity declined sharply. Retardation of egg development under water or in stool suspension may be due to a lack of atmospheric air. Use of "night soil" from latrines as fertilizer may be one factor in maintaining hookworm transmission, as worm eggs can undergo normal development upon exposure to atmospheric air.
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Affiliation(s)
- Prasit Na-Ek
- School of Medicine, Walailak University, Thasala, Nakhon Si Thammarat, Thailand
| | - Oranuch Sanpool
- Department of Parasitology and Research and Diagnostic Center for Emerging Infectious Diseases, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Jurairat Jongthawin
- Department of Parasitology and Research and Diagnostic Center for Emerging Infectious Diseases, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Witthaya Anamnart
- School of Allied Health Sciences and Public Health, Walailak University, Thasala, Nakhon Si Thammarat, Thailand
| | - Pewpan M Intapan
- Department of Parasitology and Research and Diagnostic Center for Emerging Infectious Diseases, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Pennapa Chamavit
- Department of Parasitology, Faculty of Medical Technology, Huachiew Chalermprakiet University, Samut Prakan, Thailand
| | - Wanchai Maleewong
- Department of Parasitology and Research and Diagnostic Center for Emerging Infectious Diseases, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.
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PAWELEK KASIAA, LIU SHENGQIANG, LOLLA MADHURIU. MODELING THE SPREAD OF HOOKWORM DISEASE AND ASSESSING CHEMOTHERAPY PROGRAMS: MATHEMATICAL ANALYSIS AND COMPARISON WITH SURVEILLANCE DATA. J BIOL SYST 2016. [DOI: 10.1142/s0218339016500091] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Soil-transmitted helminthes including hookworm infections result in a major disease burden worldwide. Periodic chemotherapy treatments with anthelminthic drugs remain major intervention strategy in highly endemic areas and currently there is no approved human vaccine. We developed a model to study the spread of the hookworm infection in the population level having a variety of parasite development stages. We investigated long-term effectiveness of selective and mass chemotherapy, scenarios in which the therapy becomes less effective, and is interrupted. We analyzed the mathematical model, which includes determining the basic reproductive number and steady states, defining model initial conditions, proving positiveness and boundedness of solutions, local and global stability of the disease-free and endemic steady states, and uniform persistence of the system. We fitted our model using field data from hookworm control programs in endemic areas in China and Zimbabwe. The model provided accurate predictions of disease prevalence for all considered locations for multiple years of utilizing deworming programs. We demonstrated that administration of the deworming therapy is an effective method in terms of controlling the hookworm infection. Nevertheless, the chemotherapy programs do not eradicate the disease in the villages and the infection occurrence promptly increases once the program is interrupted, thus ultimately leading to the pre-treatment levels. Our modeling results suggest that the deworming programs should be maintained at least once per year to control the infection.
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Affiliation(s)
- KASIA A. PAWELEK
- Department of Mathematics and Computational Science, University of South Carolina Beaufort, 1 University Boulevard, Bluffton, SC 29909, USA
| | - SHENGQIANG LIU
- The Academy of Fundamental and Interdisciplinary Science, Harbin Institute of Technology, 92 Xidazhi Street, Harbin 150080, P. R. China
| | - MADHURI U. LOLLA
- Department of Mathematics and Statistics, University of North Carolina Charlotte, 9201 University City Boulevard, Charlotte, NC 28223, USA
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173
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Grilo Bensusan I, Herrera Martín P. Diarrhea caused by multiparasitic infection. REVISTA ESPANOLA DE ENFERMEDADES DIGESTIVAS 2016; 108:233-234. [PMID: 26856992 DOI: 10.17235/reed.2016.4100/2015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Diarrhoea caused by multiple nematode infection is uncommon in Spain, therefore we are not very familiar with the diagnosis and treatment of these patients.
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174
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Wiśniewski M, Jaros S, Bąska P, Cappello M, Długosz E, Wędrychowicz H. Hamsters vaccinated with Ace-mep-7 DNA vaccine produced protective immunity against Ancylostoma ceylanicum infection. Exp Parasitol 2016; 163:1-7. [DOI: 10.1016/j.exppara.2016.01.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2015] [Revised: 01/06/2016] [Accepted: 01/15/2016] [Indexed: 10/22/2022]
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Bartsch SM, Hotez PJ, Hertenstein DL, Diemert DJ, Zapf KM, Bottazzi ME, Bethony JM, Brown ST, Lee BY. Modeling the economic and epidemiologic impact of hookworm vaccine and mass drug administration (MDA) in Brazil, a high transmission setting. Vaccine 2016; 34:2197-206. [PMID: 27002501 DOI: 10.1016/j.vaccine.2016.03.018] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2015] [Revised: 03/03/2016] [Accepted: 03/09/2016] [Indexed: 10/22/2022]
Abstract
BACKGROUND Although mass drug administration (MDA) has helped reduce morbidity attributed to soil-transmitted helminth infections in children, its limitations for hookworm infection have motivated the development of a human hookworm vaccine to both improve morbidity control and ultimately help block hookworm transmission leading to elimination. However, the potential economic and epidemiologic impact of a preventive vaccine has not been fully evaluated. METHODS We developed a dynamic compartment model coupled to a clinical and economics outcomes model representing both the human and hookworm populations in a high transmission region of Brazil. Experiments simulated different implementation scenarios of MDA and vaccination under varying circumstances. RESULTS Considering only intervention costs, both annual MDA and vaccination were highly cost-effective (ICERs ≤ $790/DALY averted) compared to no intervention, with vaccination resulting in lower incremental cost-effectiveness ratios (ICERs ≤ $444/DALY averted). From the societal perspective, vaccination was economically dominant (i.e., less costly and more effective) versus annual MDA in all tested scenarios, except when vaccination was less efficacious (20% efficacy, 5 year duration) and MDA coverage was 75%. Increasing the vaccine's duration of protection and efficacy, and including a booster injection in adulthood all increased the benefits of vaccination (i.e., resulted in lower hookworm prevalence, averted more disability-adjusted life years, and saved more costs). Assuming its target product profile, a pediatric hookworm vaccine drastically decreased hookworm prevalence in children to 14.6% after 20 years, compared to 57.2% with no intervention and 54.1% with MDA. The addition of a booster in adulthood further reduced the overall prevalence from 68.0% to 36.0% and nearly eliminated hookworm infection in children. CONCLUSION Using a human hookworm vaccine would be cost-effective and in many cases economically dominant, providing both health benefits and cost-savings. It could become a key technology in effecting control and elimination efforts for hookworm globally.
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Affiliation(s)
- Sarah M Bartsch
- Public Health Computational and Operational Research (PHICOR), Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, Baltimore, MD 21205, USA; Global Obesity Prevention Center, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, Baltimore, MD 21205, USA
| | - Peter J Hotez
- National School of Tropical Medicine, and Departments of Pediatrics and Molecular Virology & Microbiology, Baylor College of Medicine, One Baylor Plaza, BCM113, Houston, TX 77030, USA; Sabin Vaccine Institute, 2000 Pennsylvania Avenue NW, Washington, DC 20006, USA
| | - Daniel L Hertenstein
- Public Health Computational and Operational Research (PHICOR), Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, Baltimore, MD 21205, USA; Global Obesity Prevention Center, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, Baltimore, MD 21205, USA
| | - David J Diemert
- Sabin Vaccine Institute, 2000 Pennsylvania Avenue NW, Washington, DC 20006, USA; Department of Microbiology, Immunology and Tropical Medicine, The George Washington University Medical Center, Washington, DC 20037, USA
| | - Kristina M Zapf
- Public Health Computational and Operational Research (PHICOR), Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, Baltimore, MD 21205, USA; Global Obesity Prevention Center, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, Baltimore, MD 21205, USA
| | - Maria Elena Bottazzi
- National School of Tropical Medicine, and Departments of Pediatrics and Molecular Virology & Microbiology, Baylor College of Medicine, One Baylor Plaza, BCM113, Houston, TX 77030, USA; Sabin Vaccine Institute, 2000 Pennsylvania Avenue NW, Washington, DC 20006, USA
| | - Jeffrey M Bethony
- Sabin Vaccine Institute, 2000 Pennsylvania Avenue NW, Washington, DC 20006, USA; Department of Microbiology, Immunology and Tropical Medicine, The George Washington University Medical Center, Washington, DC 20037, USA
| | - Shawn T Brown
- Pittsburgh Supercomputing Center, Carnegie Mellon University, 300S Craig St, Pittsburgh, PA 15213, USA
| | - Bruce Y Lee
- Public Health Computational and Operational Research (PHICOR), Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, Baltimore, MD 21205, USA; Global Obesity Prevention Center, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, Baltimore, MD 21205, USA.
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176
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[Small bowel obstruction secondary to massive hookworm infestation complicated by fatal plurimicrobial bacteriemia]. Rev Med Interne 2016; 37:705-707. [PMID: 26971967 DOI: 10.1016/j.revmed.2015.12.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2011] [Revised: 06/29/2015] [Accepted: 12/24/2015] [Indexed: 11/20/2022]
Abstract
INTRODUCTION Intestinal symptoms (cramping, flatulence) and iron deficient anemia are classical presenting manifestations of duodenal hookworm infestation in patients living in endemic area. CASE REPORT We report a 45-year-old immunocompetent metropolitan man who presented with intestinal obstruction secondary to massive hookworm infestation complicated by fatal plurimicrobial bacteriemia with refractory septic shock. CONCLUSION We report a case of acute surgical abdominal presentation with septicemia and refractory shock syndrome due to ileal translocation secondary to massive hookworm infestation. To the best of our knowledge, such a case has not yet been reported.
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Seidelman J, Zuo R, Udayakumar K, Gellad ZF. Caught on Capsule: Iron-deficiency Anemia Due to Hookworm Infection. Am J Med 2016; 129:167-9. [PMID: 26299322 DOI: 10.1016/j.amjmed.2015.08.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2015] [Revised: 08/13/2015] [Accepted: 08/13/2015] [Indexed: 10/23/2022]
Affiliation(s)
| | - Rena Zuo
- Department of Medicine, Duke University Medical Center, Durham, NC
| | | | - Ziad F Gellad
- Department of Medicine, Duke University Medical Center, Durham, NC; Durham Veterans Affairs Medical Center, Durham, NC
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178
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Mehta AC, Jain P, Gildea TR. Parasitic Diseases of the Lung. DISEASES OF THE CENTRAL AIRWAYS 2016. [PMCID: PMC7122070 DOI: 10.1007/978-3-319-29830-6_11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Parasitic infection is a major healthcare problem that affects millions of the world’s population. Immigration and global warming have changed the natural distribution of parasitic diseases far removed from endemic areas. The respiratory system can be affected by a broad spectrum of helminthic and protozoal parasitic diseases. The diagnosis of parasitic infection of the respiratory system may be delayed due to myriad clinical and radiographic presentations of parasitic diseases which make the diagnosis of these entities challenging. Pulmonologists need to be familiar with the epidemiology, clinical presentation, pathophysiology, and bronchoscopic findings of parasitic lung diseases, in order to provide proper management in a timely fashion. This review provides a comprehensive view of both helminthic and protozoal parasitic diseases that affect the respiratory system, especially the central airways.
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Affiliation(s)
- Atul C. Mehta
- Family Endowed Chair in Lung Transplanta, Lerner College of Medicine Buoncore, Clevland, Ohio USA
| | - Prasoon Jain
- Louis A Johnson VA Medical Center, Fairmont, West Virginia USA
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179
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Hapeshi A, Waterfield NR. Photorhabdus asymbiotica as an Insect and Human Pathogen. Curr Top Microbiol Immunol 2016; 402:159-177. [PMID: 27726002 DOI: 10.1007/82_2016_29] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Photorhabdus asymbiotica is a species of bacterium that is pathogenic to humans whilst retaining the ability to infect insect hosts. Currently, there are two recognised subspecies, P. asymbiotica subsp. asymbiotica and P. asymbiotica subsp. australis with strains isolated from various locations in the USA, Australia, Thailand, Nepal and Europe. Like other species of Photorhabdus, P. asymbiotica subsp. australis was shown to form a symbiotic relationship with a Heterorhabditis nematode. In contrast to most strains of Photorhabdus luminescens, P. asymbiotica can grow at 37 °C and this is a defining factor in its ability to cause human disease. Insights into other adaptations it has undergone that have enabled host switching to occur have come from whole genome sequencing and transcriptomic studies. P. asymbiotica has a smaller genome compared to P. luminenscens with a lower diversity of insecticidal toxins. However, it has acquired plasmids and several pathogenicity islands in its genome. These encode genes with similarity to effectors or systems found in other known human pathogens such as Salmonella and Yersinia and are therefore likely to contribute to human pathogenicity. Of crucial importance to virulence is the fact that P. asymbiotica undergoes a large metabolic shift at the human host temperature.
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Affiliation(s)
- Alexia Hapeshi
- Warwick Medical School, University of Warwick, Coventry, UK
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180
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Fuaad AAHA, Skwarczynski M, Toth I. The Use of Microwave-Assisted Solid-Phase Peptide Synthesis and Click Chemistry for the Synthesis of Vaccine Candidates Against Hookworm Infection. Methods Mol Biol 2016; 1403:639-653. [PMID: 27076158 DOI: 10.1007/978-1-4939-3387-7_36] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
A protein-based vaccine approach against hookworm infection has failed to deliver the expected outcome, due to a problem with an allergic response in the patient or difficulties in the proteins' production. This implication could be overcome by using a chemically synthesized peptide-based vaccine approach. This approach utilizes minimal pathogenic components that are necessary for the stimulation of the immune response without triggering adverse side effects. To boost the peptide's immunogenicity, a lipid core peptide (LCP) system can be utilized as a carrier molecule/immunostimulant. This chapter describes in detail the synthesizing of protected lipoamino acid, the self-adjuvanting moiety (LCP core), the peptide epitope, and the final vaccine candidate. The subunit peptide and the LCP core were synthesized using microwave-assisted solid-phase peptide synthesis (SPPS). Then the final hookworm vaccine construct was assembled using the copper-catalyzed azide-alkyne cycloaddition, or "click," reaction.
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Affiliation(s)
- Abdullah A H Ahmad Fuaad
- School of Chemistry and Molecular Biosciences, The University of Queensland, Brisbane, St Lucia, QLD, 4072, Australia
| | - Mariusz Skwarczynski
- School of Chemistry and Molecular Biosciences, The University of Queensland, Brisbane, St Lucia, QLD, 4072, Australia.
| | - Istvan Toth
- School of Chemistry and Molecular Biosciences, The University of Queensland, Brisbane, St Lucia, QLD, 4072, Australia
- School of Pharmacy, The University of Queensland, Woolloongabba, QLD, 4102, Australia
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Abstract
PURPOSE OF REVIEW The workup of chronic unexplained diarrhea can be equally frustrating for care providers and patients. It carries a physical, financial, and social toll. In this review we provide a sensible approach to evaluating and managing chronic diarrhea. RECENT FINDINGS Bile acid diarrhea is becoming increasingly recognized as a potential cause behind some cases of chronic diarrhea. SUMMARY A detailed history and physical examination can provide clues that guide a logical approach to the evaluation. We suggest a cost-effective approach to the workup and management of chronic diarrhea based on individual patient factors related to clinical history and physical exam. We find that this approach leads to initiation of treatment in a time-efficient fashion and avoids unnecessary testing.
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182
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Shepherd C, Navarro S, Wangchuk P, Wilson D, Daly NL, Loukas A. Identifying the immunomodulatory components of helminths. Parasite Immunol 2015; 37:293-303. [PMID: 25854639 DOI: 10.1111/pim.12192] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2015] [Accepted: 03/18/2015] [Indexed: 12/13/2022]
Abstract
Immunomodulatory components of helminths offer great promise as an entirely new class of biologics for the treatment of inflammatory diseases. Here, we discuss the emerging themes in helminth-driven immunomodulation in the context of therapeutic drug discovery. We broadly define the approaches that are currently applied by researchers to identify these helminth molecules, highlighting key areas of potential exploitation that have been mostly neglected thus far, notably small molecules. Finally, we propose that the investigation of immunomodulatory compounds will enable the translation of current and future research efforts into potential treatments for autoimmune and allergic diseases, while at the same time yielding new insights into the molecular interface of host-parasite biology.
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Affiliation(s)
- C Shepherd
- Centre for Biodiscovery and Molecular Development of Therapeutics, Australian Institute of Tropical Health and Medicine, James Cook University, Cairns, Qld, Australia
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183
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Influence of Schistosoma mansoni and Hookworm Infection Intensities on Anaemia in Ugandan Villages. PLoS Negl Trop Dis 2015; 9:e0004193. [PMID: 26513151 PMCID: PMC4626098 DOI: 10.1371/journal.pntd.0004193] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2015] [Accepted: 10/05/2015] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The association of anaemia with intestinal schistosomiasis and hookworm infections are poorly explored in populations that are not limited to children or pregnant women. METHODS We sampled 1,832 individuals aged 5-90 years from 30 communities in Mayuge District, Uganda. Demographic, village, and parasitological data were collected. Infection risk factors were compared in ordinal logistic regressions. Anaemia and infection intensities were analyzed in multilevel models, and population attributable fractions were estimated. FINDINGS Household and village-level predictors of Schistosoma mansoni and hookworm were opposite in direction or significant for single infections. S. mansoni was found primarily in children, whereas hookworm was prevalent amongst the elderly. Anaemia was more prevalent in individuals with S. mansoni and increased by 2.86 fold (p-value<0.001) with heavy S. mansoni infection intensity. Individuals with heavy hookworm were 1.65 times (p-value = 0.008) more likely to have anaemia than uninfected participants. Amongst individuals with heavy S. mansoni infection intensity, 32.0% (p-value<0.001) of anaemia could be attributed to S. mansoni. For people with heavy hookworm infections, 23.7% (p-value = 0.002) of anaemia could be attributed to hookworm. A greater fraction of anaemia (24.9%, p-value = 0.002) was attributable to heavy hookworm infections in adults (excluding pregnant women) as opposed to heavy hookworm infections in school-aged children and pregnant women (20.2%, p-value = 0.001). CONCLUSION Community-based surveys captured anaemia in children and adults affected by S. mansoni and hookworm infections. For areas endemic with schistosomiasis or hookworm infections, WHO guidelines should include adults for treatment in helminth control programmes.
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184
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Siza JE, Kaatano GM, Chai JY, Eom KS, Rim HJ, Yong TS, Min DY, Chang SY, Ko Y, Changalucha JM. Prevalence of Schistosomes and Soil-Transmitted Helminths among Schoolchildren in Lake Victoria Basin, Tanzania. THE KOREAN JOURNAL OF PARASITOLOGY 2015; 53:515-24. [PMID: 26537030 PMCID: PMC4635830 DOI: 10.3347/kjp.2015.53.5.515] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/23/2015] [Revised: 09/30/2015] [Accepted: 10/04/2015] [Indexed: 12/02/2022]
Abstract
The objectives of this study was to conduct a survey on schistosomiasis and soil-transmitted helminth (STH) infections in order to come up with feasible control strategies in Lake Victoria basin, Tanzania. Depending on the size of the school, 150-200 schoolchildren were recruited for the study. Duplicate Kato-Katz stool smears were prepared from each child and microscopically examined for Schistosoma mansoni and STHs. Urine specimens were examined for Schistosoma haematobium eggs using the filtration technique. After the survey, mass drug administration was done using praziquantel and albendazole for schistosomiasis and STHs infections, respectively. A total of 5,952 schoolchildren from 36 schools were recruited for the study and had their stool and urine specimens examined. Out of 5,952 schoolchildren, 898 (15.1%) were positive for S. mansoni, 754 (12.6%) for hookworms, 188 (3.2%) for Ascaris lumblicoides, and 5 (0.008%) for Trichuris trichiura. Out of 5,826 schoolchildren who provided urine samples, 519 (8.9%) were positive for S. haematobium eggs. The results revealed that intestinal schistosomiasis, urogenital schistosomiasis, and STH infections are highly prevalent throughought the lake basin. The high prevalence of intestinal and urogenital schistosomisiasis in the study area was a function of the distance from Lake Victoria, the former being more prevalent at localities close to the lake, whilst the latter is more so away from it. Control of schistosomiasis and STHs in the study area requires an integrated strategy that involves provision of health education to communities, regular treatments, and provision of adequate safe water supply and sanitation facilities.
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Affiliation(s)
- Julius E Siza
- National Institute of Medical Research, P.O. Box 1462, Mwanza, Tanzania
| | - Godfrey M Kaatano
- National Institute of Medical Research, P.O. Box 1462, Mwanza, Tanzania
| | - Jong-Yil Chai
- Department of Parasitology and Tropical Medicine, Seoul National University College of Medicine, Seoul 03080, Korea
| | - Keeseon S Eom
- Department of Parasitology and Medical Research Institute, Chungbuk National University School of Medicine, Cheongju 28644, Korea
| | - Han-Jong Rim
- Department of Parasitology, College of Medicine, Korea University, Seoul 02841, Korea
| | - Tai-Soon Yong
- Department of Environmental Medical Biology and Institute of Tropical Medicine, Yonsei University College of Medicine, Seoul 03722, Korea
| | - Duk-Young Min
- Department of Microbiology and Immunology, Eulji University College of Medicine, Daejeon 35233, Korea
| | - Su Young Chang
- Good Neighbors International, Tanzania Western Chapter, P.O. Box 367, Mwanza, Tanzania
| | - Yunsuk Ko
- Good Neighbors International, Tanzania Western Chapter, P.O. Box 367, Mwanza, Tanzania
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185
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Feasibility of controlling hookworm infection through preventive chemotherapy: a simulation study using the individual-based WORMSIM modelling framework. Parasit Vectors 2015; 8:541. [PMID: 26489659 PMCID: PMC4618856 DOI: 10.1186/s13071-015-1151-4] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2015] [Accepted: 10/07/2015] [Indexed: 12/31/2022] Open
Abstract
Background Globally, hookworms infect 440 million people in developing countries. Especially children and women of childbearing age are at risk of developing anaemia as a result of infection. To control hookworm infection and disease (i.e. reduce the prevalence of medium and heavy infection to <1 %), the World Health Organization has set the target to provide annual or semi-annual preventive chemotherapy (PC) with albendazole (ALB) or mebendazole (MEB) to at least 75 % of all children and women of childbearing age in endemic areas by 2020. Here, we predict the feasibility of achieving <1 % prevalence of medium and heavy infection, based on simulations with an individual-based model. Methods We developed WORMSIM, a new generalized individual-based modelling framework for transmission and control of helminths, and quantified it for hookworm transmission based on published data. We simulated the impact of standard and more intense PC strategies on trends in hookworm infection, and explored the potential additional impact of interventions that improve access to water, sanitation, and hygiene (WASH). The individual-based framework allowed us to take account of inter-individual heterogeneities in exposure and contribution to transmission of infection, as well as in participation in successive PC rounds. Results We predict that in low and medium endemic areas, current PC strategies (including targeting of WCBA) will achieve control of hookworm infection (i.e. the parasitological target) within 2 years. In highly endemic areas, control can be achieved with semi-annual PC with ALB at 90 % coverage, combined with interventions that reduce host contributions to the environmental reservoir of infection by 50 %. More intense PC strategies (high frequency and coverage) can help speed up control of hookworm infection, and may be necessary in some extremely highly endemic settings, but are not a panacea against systematic non-participation to PC. Conclusions Control of hookworm infection by 2020 is feasible with current PC strategies (including targeting of WCBA). In highly endemic areas, PC should be combined with health education and/or WASH interventions. Electronic supplementary material The online version of this article (doi:10.1186/s13071-015-1151-4) contains supplementary material, which is available to authorized users.
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186
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Chirapongsathorn S, Kamath PS. Iron-Deficiency Anemia With an Itch. Mayo Clin Proc 2015; 90:1458. [PMID: 26434973 DOI: 10.1016/j.mayocp.2015.07.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2015] [Accepted: 07/09/2015] [Indexed: 11/30/2022]
Affiliation(s)
- Sakkarin Chirapongsathorn
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN; Division of Gastroenterology, Department of Medicine, Phramongkutklao Hospital and College of Medicine, Royal Thai Army, Bangkok, Thailand
| | - Patrick S Kamath
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN.
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Soares Magalhães RJ, Salamat MS, Leonardo L, Gray DJ, Carabin H, Halton K, McManus DP, Williams GM, Rivera P, Saniel O, Hernandez L, Yakob L, McGarvey ST, Clements ACA. Mapping the Risk of Soil-Transmitted Helminthic Infections in the Philippines. PLoS Negl Trop Dis 2015; 9:e0003915. [PMID: 26368819 PMCID: PMC4569387 DOI: 10.1371/journal.pntd.0003915] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2015] [Accepted: 06/16/2015] [Indexed: 11/19/2022] Open
Abstract
Background In order to increase the efficient allocation of soil-transmitted helminth (STH) disease control resources in the Philippines, we aimed to describe for the first time the spatial variation in the prevalence of A. lumbricoides, T. trichiura and hookworm across the country, quantify the association between the physical environment and spatial variation of STH infection and develop predictive risk maps for each infection. Methodology/Principal Findings Data on STH infection from 35,573 individuals across the country were geolocated at the barangay level and included in the analysis. The analysis was stratified geographically in two major regions: 1) Luzon and the Visayas and 2) Mindanao. Bayesian geostatistical models of STH prevalence were developed, including age and sex of individuals and environmental variables (rainfall, land surface temperature and distance to inland water bodies) as predictors, and diagnostic uncertainty was incorporated. The role of environmental variables was different between regions of the Philippines. This analysis revealed that while A. lumbricoides and T. trichiura infections were widespread and highly endemic, hookworm infections were more circumscribed to smaller foci in the Visayas and Mindanao. Conclusions/Significance This analysis revealed significant spatial variation in STH infection prevalence within provinces of the Philippines. This suggests that a spatially targeted approach to STH interventions, including mass drug administration, is warranted. When financially possible, additional STH surveys should be prioritized to high-risk areas identified by our study in Luzon. Soil-transmitted helminth (STH) infections with A. lumbricoides, T. trichiura and hookworms are endemic in all 80 provinces of the Philippines, but the spatial variation in the prevalence of these infections has not been previously described. This analysis revealed that while A. lumbricoides and T. trichiura infections were widespread and highly endemic, hookworm infections were more circumscribed to smaller foci in the Visayas and Mindanao. The results also suggest that it may be necessary to place greater emphasis on improving the provision of water, sanitation and the promotion of behavioral change for improved hygiene for the control and prevention of STH infections, particularly for hookworm.
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Affiliation(s)
- Ricardo J. Soares Magalhães
- School of Veterinary Science, The University of Queensland, Gatton Campus, Gatton, Australia
- Children’s Health and Environment Program, Queensland Children’s Medical Research Institute, The University of Queensland, Herston Campus, Herston, Australia
- University of Queensland, Infectious Disease Epidemiology Unit, School of Population Health, Herston, Queensland, Australia
- * E-mail:
| | - Maria S. Salamat
- University of the Philippines Manila, College of Public Health, Department of Parasitology, Manila, Philippines
| | - Lydia Leonardo
- University of the Philippines Manila, College of Public Health, Department of Parasitology, Manila, Philippines
| | - Darren J. Gray
- University of Queensland, Infectious Disease Epidemiology Unit, School of Population Health, Herston, Queensland, Australia
- Research School of Population Health, The Australian National University, Canberra, Australian Capital Territory, Australia
| | - Hélène Carabin
- Department of Biostatistics and Epidemiology, College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, United States of America
| | - Kate Halton
- Institute for Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Queensland, Australia
| | - Donald P. McManus
- Infectious Disease Division, QIMR-Berghoffer Medical Research Institute, Herston, Queensland, Australia
| | - Gail M. Williams
- University of Queensland, Infectious Disease Epidemiology Unit, School of Population Health, Herston, Queensland, Australia
| | - Pilarita Rivera
- University of the Philippines Manila, College of Public Health, Department of Parasitology, Manila, Philippines
| | - Ofelia Saniel
- University of the Philippines Manila, College of Public Health, Department of Epidemiology and Biostatistics, Manila, Philippines
| | - Leda Hernandez
- Philippine Department of Health, National Center for Disease Prevention and Control, Manila, Philippines
| | - Laith Yakob
- London School of Hygiene & Tropical Medicine, Department of Disease Control, London, United Kingdom
| | - Stephen T. McGarvey
- International Health Institute, Brown University, Providence, Rhode Island, United States of America
| | - Archie C. A. Clements
- University of Queensland, Infectious Disease Epidemiology Unit, School of Population Health, Herston, Queensland, Australia
- Research School of Population Health, The Australian National University, Canberra, Australian Capital Territory, Australia
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188
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Yee B, Chi NW, Hansen LA, Lee RR, U HS, Savides TJ, Vinetz JM. Strongyloides stercoralis Hyperinfection Syndrome Presenting as Severe, Recurrent Gastrointestinal Bleeding, Leading to a Diagnosis of Cushing Disease. Am J Trop Med Hyg 2015. [PMID: 26195463 DOI: 10.4269/ajtmh.15-0355] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
A 50-year-old male immigrant from Ethiopia presented for consultation after 3 years of hematochezia/melena requiring > 25 units of blood transfusions. Physical examination revealed severe proximal muscle wasting and weakness, central obesity, proptosis, and abdominal striae, accompanied by eosinophilia, elevated hemoglobin A1c, elevated 24-hour urinary cortisol, lack of suppression of 8 am cortisol levels by 1 mg dexamethasone, and inappropriately elevated random adrenocorticotropic hormone (ACTH) level. Histopathological examination of gastrointestinal biopsies showed large numbers of Strongyloides stercoralis, indicating Strongyloides hyperinfection. Treatment with 2 days of ivermectin led to resolution of gastrointestinal bleeding. This syndrome was due to chronic immunosuppression from a pituitary ACTH (corticotroph) microadenoma, of which resection led to gradual normalization of urine cortisol, improved glycemic control, resolution of eosinophilia, and no recurrence of infection.
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Affiliation(s)
- Brittany Yee
- Department of Medicine, University of California San Diego School of Medicine, La Jolla, California; Division of Endocrinology, Department of Medicine, University of California San Diego School of Medicine, La Jolla, California; Department of Pathology, University of California San Diego School of Medicine, La Jolla, California; Department of Radiology, University of California San Diego School of Medicine, La Jolla, California; Department of Neurosurgery, University of California San Diego School of Medicine, La Jolla, California; Division of Gastroenterology, Department of Medicine, University of California San Diego School of Medicine, La Jolla, California; Division of Infectious Diseases, Department of Medicine, University of California San Diego School of Medicine, La Jolla, California; Instituto de Medicina Tropical "Alexander von Humboldt," Universidad Peruana Cayetano Heredia, Lima, Peru; Departamento de Ciencias Celulares y Moleculares, Facultad de Ciencias y Filosofia, Universidad Peruana Cayetano Heredia, Lima, Peru; Laboratorio de Investigación y Desarrollo, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Nai-Wen Chi
- Department of Medicine, University of California San Diego School of Medicine, La Jolla, California; Division of Endocrinology, Department of Medicine, University of California San Diego School of Medicine, La Jolla, California; Department of Pathology, University of California San Diego School of Medicine, La Jolla, California; Department of Radiology, University of California San Diego School of Medicine, La Jolla, California; Department of Neurosurgery, University of California San Diego School of Medicine, La Jolla, California; Division of Gastroenterology, Department of Medicine, University of California San Diego School of Medicine, La Jolla, California; Division of Infectious Diseases, Department of Medicine, University of California San Diego School of Medicine, La Jolla, California; Instituto de Medicina Tropical "Alexander von Humboldt," Universidad Peruana Cayetano Heredia, Lima, Peru; Departamento de Ciencias Celulares y Moleculares, Facultad de Ciencias y Filosofia, Universidad Peruana Cayetano Heredia, Lima, Peru; Laboratorio de Investigación y Desarrollo, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Lawrence A Hansen
- Department of Medicine, University of California San Diego School of Medicine, La Jolla, California; Division of Endocrinology, Department of Medicine, University of California San Diego School of Medicine, La Jolla, California; Department of Pathology, University of California San Diego School of Medicine, La Jolla, California; Department of Radiology, University of California San Diego School of Medicine, La Jolla, California; Department of Neurosurgery, University of California San Diego School of Medicine, La Jolla, California; Division of Gastroenterology, Department of Medicine, University of California San Diego School of Medicine, La Jolla, California; Division of Infectious Diseases, Department of Medicine, University of California San Diego School of Medicine, La Jolla, California; Instituto de Medicina Tropical "Alexander von Humboldt," Universidad Peruana Cayetano Heredia, Lima, Peru; Departamento de Ciencias Celulares y Moleculares, Facultad de Ciencias y Filosofia, Universidad Peruana Cayetano Heredia, Lima, Peru; Laboratorio de Investigación y Desarrollo, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Roland R Lee
- Department of Medicine, University of California San Diego School of Medicine, La Jolla, California; Division of Endocrinology, Department of Medicine, University of California San Diego School of Medicine, La Jolla, California; Department of Pathology, University of California San Diego School of Medicine, La Jolla, California; Department of Radiology, University of California San Diego School of Medicine, La Jolla, California; Department of Neurosurgery, University of California San Diego School of Medicine, La Jolla, California; Division of Gastroenterology, Department of Medicine, University of California San Diego School of Medicine, La Jolla, California; Division of Infectious Diseases, Department of Medicine, University of California San Diego School of Medicine, La Jolla, California; Instituto de Medicina Tropical "Alexander von Humboldt," Universidad Peruana Cayetano Heredia, Lima, Peru; Departamento de Ciencias Celulares y Moleculares, Facultad de Ciencias y Filosofia, Universidad Peruana Cayetano Heredia, Lima, Peru; Laboratorio de Investigación y Desarrollo, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Hoi-Sang U
- Department of Medicine, University of California San Diego School of Medicine, La Jolla, California; Division of Endocrinology, Department of Medicine, University of California San Diego School of Medicine, La Jolla, California; Department of Pathology, University of California San Diego School of Medicine, La Jolla, California; Department of Radiology, University of California San Diego School of Medicine, La Jolla, California; Department of Neurosurgery, University of California San Diego School of Medicine, La Jolla, California; Division of Gastroenterology, Department of Medicine, University of California San Diego School of Medicine, La Jolla, California; Division of Infectious Diseases, Department of Medicine, University of California San Diego School of Medicine, La Jolla, California; Instituto de Medicina Tropical "Alexander von Humboldt," Universidad Peruana Cayetano Heredia, Lima, Peru; Departamento de Ciencias Celulares y Moleculares, Facultad de Ciencias y Filosofia, Universidad Peruana Cayetano Heredia, Lima, Peru; Laboratorio de Investigación y Desarrollo, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Thomas J Savides
- Department of Medicine, University of California San Diego School of Medicine, La Jolla, California; Division of Endocrinology, Department of Medicine, University of California San Diego School of Medicine, La Jolla, California; Department of Pathology, University of California San Diego School of Medicine, La Jolla, California; Department of Radiology, University of California San Diego School of Medicine, La Jolla, California; Department of Neurosurgery, University of California San Diego School of Medicine, La Jolla, California; Division of Gastroenterology, Department of Medicine, University of California San Diego School of Medicine, La Jolla, California; Division of Infectious Diseases, Department of Medicine, University of California San Diego School of Medicine, La Jolla, California; Instituto de Medicina Tropical "Alexander von Humboldt," Universidad Peruana Cayetano Heredia, Lima, Peru; Departamento de Ciencias Celulares y Moleculares, Facultad de Ciencias y Filosofia, Universidad Peruana Cayetano Heredia, Lima, Peru; Laboratorio de Investigación y Desarrollo, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Joseph M Vinetz
- Department of Medicine, University of California San Diego School of Medicine, La Jolla, California; Division of Endocrinology, Department of Medicine, University of California San Diego School of Medicine, La Jolla, California; Department of Pathology, University of California San Diego School of Medicine, La Jolla, California; Department of Radiology, University of California San Diego School of Medicine, La Jolla, California; Department of Neurosurgery, University of California San Diego School of Medicine, La Jolla, California; Division of Gastroenterology, Department of Medicine, University of California San Diego School of Medicine, La Jolla, California; Division of Infectious Diseases, Department of Medicine, University of California San Diego School of Medicine, La Jolla, California; Instituto de Medicina Tropical "Alexander von Humboldt," Universidad Peruana Cayetano Heredia, Lima, Peru; Departamento de Ciencias Celulares y Moleculares, Facultad de Ciencias y Filosofia, Universidad Peruana Cayetano Heredia, Lima, Peru; Laboratorio de Investigación y Desarrollo, Universidad Peruana Cayetano Heredia, Lima, Peru
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189
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Turner HC, Truscott JE, Hollingsworth TD, Bettis AA, Brooker SJ, Anderson RM. Cost and cost-effectiveness of soil-transmitted helminth treatment programmes: systematic review and research needs. Parasit Vectors 2015; 8:355. [PMID: 26137945 PMCID: PMC4499443 DOI: 10.1186/s13071-015-0885-3] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2015] [Accepted: 05/05/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In this time of rapidly expanding mass drug administration (MDA) coverage and the new commitments for soil-transmitted helminth (STH) control, it is essential that resources are allocated in an efficient manner to have the greatest impact. However, many questions remain regarding how best to deliver STH treatment programmes; these include which age-groups should be targeted and how often. To perform further analyses to investigate what the most cost-effective control strategies are in different settings, accurate cost data for targeting different age groups at different treatment frequencies (in a range of settings) are essential. METHODS Using the electronic databases PubMed, MEDLINE, and ISI Web of Knowledge, we perform a systematic review of costing studies and cost-effectiveness evaluations for potential STH treatment strategies. We use this review to highlight research gaps and outline the key future research needs. RESULTS We identified 29 studies reporting costs of STH treatment and 17 studies that investigated its cost-effectiveness. The majority of these pertained to programmes only targeting school-aged children (SAC), with relatively few studies investigating alternative preventive chemotherapy (PCT) treatment strategies. The methods of cost data collection, analysis and reporting were highly variable among the different studies. Only four of the costing studies were found to have high applicability for use in forthcoming economic evaluations. There are also very few studies quantifying the costs of increasing the treatment frequency. CONCLUSIONS The absence of cost data and inconsistencies in the collection and analysis methods constitutes a major research gap for STH control. Detailed and accurate costs of targeting different age groups or increasing treatment frequency will be essential to formulate cost-effective public health policy. Defining the most cost-effective control strategies in different settings is of high significance during this period of expanding MDA coverage and new resource commitments for STH control.
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Affiliation(s)
- Hugo C Turner
- London Centre for Neglected Tropical Disease Research, Department of Infectious Disease Epidemiology, School of Public Health, Faculty of Medicine, St Marys Campus, Imperial College London, Norfolk Place, London, W2 1PG, UK.
| | - James E Truscott
- London Centre for Neglected Tropical Disease Research, Department of Infectious Disease Epidemiology, School of Public Health, Faculty of Medicine, St Marys Campus, Imperial College London, Norfolk Place, London, W2 1PG, UK.
| | - T Déirdre Hollingsworth
- Mathematics Institute, University of Warwick, Coventry, CV4 7AL, UK. .,School of Life Sciences, University of Warwick, Coventry, CV4 7AL, UK.
| | - Alison A Bettis
- London Centre for Neglected Tropical Disease Research, Department of Infectious Disease Epidemiology, School of Public Health, Faculty of Medicine, St Marys Campus, Imperial College London, Norfolk Place, London, W2 1PG, UK.
| | - Simon J Brooker
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK. .,Kenya Medical Research Institute, Nairobi, Kenya.
| | - Roy M Anderson
- London Centre for Neglected Tropical Disease Research, Department of Infectious Disease Epidemiology, School of Public Health, Faculty of Medicine, St Marys Campus, Imperial College London, Norfolk Place, London, W2 1PG, UK.
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190
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Jejaw A, Zemene E, Alemu Y, Mengistie Z. High prevalence of Schistosoma mansoni and other intestinal parasites among elementary school children in Southwest Ethiopia: a cross-sectional study. BMC Public Health 2015; 15:600. [PMID: 26135566 PMCID: PMC4488975 DOI: 10.1186/s12889-015-1952-6] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2014] [Accepted: 06/19/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Intestinal parasitic infections (IPIs) pose significant public health challenges in school children in developing countries. The aim of this study is to determine prevalence of intestinal parasites among elementary school children in Mizan-Aman town, southwest Ethiopia. METHODS Institution-based cross-sectional study involving 460 elementary school children in Mizan-Aman Town was conducted from May to June 2013. The school children were selected using multistage sampling technique. Data on demography and predisposing factors of IPIs were collected using pretested questionnaire. Moreover, single stool specimen was examined microscopically after wet mount and formol-ether sedimentation concentration procedures. Infection intensity of Schistosoma mansoni and soil-transmitted helminths (STHs) was estimated using Kato-Katz egg counting method. RESULTS Age of the children ranged from 5 to 17 years. Overall, 76.7% (95%CI: 72.8-80.6) of the children harbored at least one species of intestinal parasite. Eight species of intestinal parasites were detected with S. mansoni (44.8%) and Ascaris lumbricoides (28.7%) being predominant. Helminths and pathogenic intestinal protozoa were detected in 73.9 and 7.8% of the children, respectively. After adjusting for other variables, age between 5 and 9 years (AOR, 2.6, 95%CI, 1.552-4.298), male gender (AOR, 2.1, 95%CI, 1.222-3.526), attending public school (AOR, 0.1, 95%CI, 0.060-0.256), using river/well water (AOR, 2.4, 95%CI, 0.912-6.191), irregular washing of hands before meal (AOR, 0.5, 95%CI, 0.254-0.865), consuming street food (AOR, 2.3, 95%CI, 1.341-3.813) and raw vegetables (AOR, 2.7, 95%CI, 1.594-4.540) were significantly associated with IPIs in the study participants. CONCLUSION Prevalence of intestinal parasites among the school children was high. Deworming of the school children and continuous follow up is required.
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Affiliation(s)
- Ayalew Jejaw
- Department of Biomedical Science, College of Health Sciences, Mizan-Tepi University, Mizan, Ethiopia.
| | - Endalew Zemene
- Department of Medical Laboratory Sciences and Pathology, College of Health Sciences, Jimma University, Jimma, Ethiopia.
| | - Yayehirad Alemu
- Department of Biomedical Science, College of Health Sciences, Mizan-Tepi University, Mizan, Ethiopia.
| | - Zemenu Mengistie
- Department of Biomedical Science, College of Health Sciences, Mizan-Tepi University, Mizan, Ethiopia.
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191
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Abstract
Infectious diseases of the skin have become rarer in industrialized nations, but they still affect a considerable part of the population in tropical regions. Skin diseases induced by protozoa, worms and ectoparasites are among the 17 "neglected tropical diseases" defined by the WHO (leishmaniasis, dracunculiasis, lymphatic filariasis, onchocerciasis). Skin symptoms in travellers returning from the tropics may challenge dermatologists in Germany regarding differential diagnostic assessment and therapy. Among the 12 most frequent skin diseases in travellers are cutaneous larva migrans, leishmaniasis and myiasis. In this review, diagnosis, treatment and prevention of some the most relevant tropical dermatoses due to protozoa, worms and ectoparasites are discussed.
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Affiliation(s)
- S Schliemann
- Klinik für Hautkrankheiten, Universitätsklinikum Jena, Erfurter Str. 35, 07743, Jena, Deutschland,
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192
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Failoc-Rojas VE, Molina-Ayasta C, Rodriguez-Morales AJ. [Hookworm infection: An imported disease in Spain]. Enferm Infecc Microbiol Clin 2015; 33:700-1. [PMID: 25980616 DOI: 10.1016/j.eimc.2015.04.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2015] [Accepted: 04/07/2015] [Indexed: 11/26/2022]
Affiliation(s)
- Virgilio E Failoc-Rojas
- Universidad Nacional Pedro Ruíz Gallo, Lambayeque, Perú; Grupo y Semillero de Investigación Salud Pública e Infección, Facultad de Ciencias de la Salud, Universidad Tecnológica de Pereira, Pereira, Risaralda, Colombia
| | | | - Alfonso J Rodriguez-Morales
- Grupo y Semillero de Investigación Salud Pública e Infección, Facultad de Ciencias de la Salud, Universidad Tecnológica de Pereira, Pereira, Risaralda, Colombia.
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193
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Marcus AD, Higgins DP, Gray R. Ivermectin treatment of free-ranging endangered Australian sea lion (Neophoca cinerea) pups: effect on hookworm and lice infection status, haematological parameters, growth, and survival. Parasitol Res 2015; 114:2743-55. [DOI: 10.1007/s00436-015-4481-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2015] [Accepted: 04/09/2015] [Indexed: 02/03/2023]
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194
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Forrer A, Vounatsou P, Sayasone S, Vonghachack Y, Bouakhasith D, Utzinger J, Akkhavong K, Odermatt P. Risk profiling of hookworm infection and intensity in southern Lao People's Democratic Republic using Bayesian models. PLoS Negl Trop Dis 2015; 9:e0003486. [PMID: 25822794 PMCID: PMC4378892 DOI: 10.1371/journal.pntd.0003486] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2014] [Accepted: 12/17/2014] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Among the common soil-transmitted helminth infections, hookworm causes the highest burden. Previous research in the southern part of Lao People's Democratic Republic (Lao PDR) revealed high prevalence rates of hookworm infection. The purpose of this study was to predict the spatial distribution of hookworm infection and intensity, and to investigate risk factors in the Champasack province, southern Lao PDR. METHODOLOGY A cross-sectional parasitological and questionnaire survey was conducted in 51 villages. Data on demography, socioeconomic status, water, sanitation, and behavior were combined with remotely sensed environmental data. Bayesian mixed effects logistic and negative binomial models were utilized to investigate risk factors and spatial distribution of hookworm infection and intensity, and to make predictions for non-surveyed locations. PRINCIPAL FINDINGS A total of 3,371 individuals were examined with duplicate Kato-Katz thick smears and revealed a hookworm prevalence of 48.8%. Most infections (91.7%) were of light intensity (1-1,999 eggs/g of stool). Lower hookworm infection levels were associated with higher socioeconomic status. The lowest infection levels were found in preschool-aged children. Overall, females were at lower risk of infection, but women aged 50 years and above harbored the heaviest hookworm infection intensities. Hookworm was widespread in Champasack province with little evidence for spatial clustering. Infection risk was somewhat lower in the lowlands, mostly along the western bank of the Mekong River, while infection intensity was homogeneous across the Champasack province. CONCLUSIONS/SIGNIFICANCE Hookworm transmission seems to occur within, rather than between villages in Champasack province. We present spatial risk maps of hookworm infection and intensity, which suggest that control efforts should be intensified in the Champasack province, particularly in mountainous areas.
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Affiliation(s)
- Armelle Forrer
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Penelope Vounatsou
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Somphou Sayasone
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
- National Institute of Public Health, Ministry of Health, Vientiane, Lao People’s Democratic Republic
| | - Youthanavanh Vonghachack
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
- Faculty of Basic Sciences, University of Health Sciences, Vientiane, Lao People’s Democratic Republic
| | - Dalouny Bouakhasith
- Faculty of Basic Sciences, University of Health Sciences, Vientiane, Lao People’s Democratic Republic
| | - Jürg Utzinger
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Kongsap Akkhavong
- National Institute of Public Health, Ministry of Health, Vientiane, Lao People’s Democratic Republic
| | - Peter Odermatt
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
- * E-mail:
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195
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Kinung'hi SM, Magnussen P, Kishamawe C, Todd J, Vennervald BJ. The impact of anthelmintic treatment intervention on malaria infection and anaemia in school and preschool children in Magu district, Tanzania: an open label randomised intervention trial. BMC Infect Dis 2015; 15:136. [PMID: 25887977 PMCID: PMC4391149 DOI: 10.1186/s12879-015-0864-5] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2014] [Accepted: 03/02/2015] [Indexed: 01/12/2023] Open
Abstract
Background Some studies have suggested that helminth infections increase the risk of malaria infection and are associated with increased number of malaria attacks and anaemia. Thus interventions to control helminth infections may have an impact on incidence of clinical malaria and anaemia. The current study assessed the impact of two anthelmintic treatment approaches on malaria infection and on anaemia in school and pre-school children in Magu district, Tanzania. Methods A total of 765 children were enrolled into a prospective randomized anthelmintic intervention trial following a baseline study of 1546 children. Enrolled children were randomized to receive either repeated treatment with praziquantel and albendazole four times a year (intervention group, 394 children) or single dose treatment with praziquantel and albendazole once a year (control group, 371 children). Follow up examinations were conducted at 12 and 24 months after baseline to assess the impact of the intervention. Stool and urine samples were collected and examined for schistosome and soil transmitted helminth infections. Blood samples were also collected and examined for malaria parasites and haemoglobin concentrations. Monitoring of clinical malaria attacks was performed at each school during the two years of the intervention. Results Out of 1546 children screened for P. falciparum, S. mansoni, S. haematobium, hookworm and T. Trichiura at baseline, 1079 (69.8%) were infected with at least one of the four parasites. There was no significant difference in malaria infection (prevalence, parasite density and frequency of malaria attacks) and in the prevalence of anaemia between the repeated and single dose anthelmintic treatment groups at 12 and 24 months follow up (p > 0.05). However, overall, there was significant improvement in mean haemoglobin concentrations (p < 0.001) from baseline levels of 122.0g/L and 123.0g/L to 136.0g/L and 136.8g/L for the repeated and single dose treatment groups, respectively, at 24 months follow-up which resulted in significant reduction in prevalence of anaemia. Conclusions These results suggest that repeated anthelmintic treatment did not have an impact on malaria infection compared to single dose treatment. However, both treatment approaches had overall impact in terms of improvements of haemoglobin levels and hence reductions in prevalence of anaemia.
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Affiliation(s)
- Safari M Kinung'hi
- National Institute for Medical Research (NIMR), Mwanza Centre, Isamilo Road, PO Box 1462, Mwanza, Tanzania.
| | - Pascal Magnussen
- Department of Veterinary Disease Biology, Faculty of Health and Medical Sciences, University of Copenhagen, Grønnegårdsvej 15 DK-1870 Frederiksberg C, Copenhagen, Denmark.
| | - Coleman Kishamawe
- National Institute for Medical Research (NIMR), Mwanza Centre, Isamilo Road, PO Box 1462, Mwanza, Tanzania.
| | - Jim Todd
- Depatment of Population Health, London School of Hygiene and Tropical Medicine, Keppel Street, WC1E, 7HT, London, UK.
| | - Birgitte J Vennervald
- Department of Veterinary Disease Biology, Faculty of Health and Medical Sciences, University of Copenhagen, Grønnegårdsvej 15 DK-1870 Frederiksberg C, Copenhagen, Denmark.
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196
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Mireku MO, Boivin MJ, Davidson LL, Ouédraogo S, Koura GK, Alao MJ, Massougbodji A, Cot M, Bodeau-Livinec F. Impact of helminth infection during pregnancy on cognitive and motor functions of one-year-old children. PLoS Negl Trop Dis 2015; 9:e0003463. [PMID: 25756357 PMCID: PMC4355614 DOI: 10.1371/journal.pntd.0003463] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2014] [Accepted: 12/08/2014] [Indexed: 01/10/2023] Open
Abstract
OBJECTIVE To determine the effect of helminth infection during pregnancy on the cognitive and motor functions of one-year-old children. METHODS Six hundred and thirty five singletons born to pregnant women enrolled before 29 weeks of gestation in a trial comparing two intermittent preventive treatments for malaria were assessed for cognitive and motor functions using the Mullen Scales of Early Learning, in the TOVI study, at twelve months of age in the district of Allada in Benin. Stool samples of pregnant women were collected at recruitment, second antenatal care (ANC) visit (at least one month after recruitment) and just before delivery, and were tested for helminths using the Kato-Katz technique. All pregnant women were administered a total of 600 mg of mebendazole (100 mg two times daily for 3 days) to be taken after the first ANC visit. The intake was not directly observed. RESULTS Prevalence of helminth infection was 11.5%, 7.5% and 3.0% at first ANC visit, second ANC visit and at delivery, respectively. Children of mothers who were infected with hookworms at the first ANC visit had 4.9 (95% CI: 1.3-8.6) lower mean gross motor scores compared to those whose mothers were not infected with hookworms at the first ANC visit, in the adjusted model. Helminth infection at least once during pregnancy was associated with infant cognitive and gross motor functions after adjusting for maternal education, gravidity, child sex, family possessions, and quality of the home stimulation. CONCLUSION Helminth infection during pregnancy is associated with poor cognitive and gross motor outcomes in infants. Measures to prevent helminth infection during pregnancy should be reinforced.
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Affiliation(s)
- Michael O. Mireku
- Université Pierre et Marie Curie (UPMC- Paris VI), Paris, France
- Ecole des Hautes Etudes en Santé Publique, Département d’Épidémiologie et des Biostatistiques, Rennes, France
- Institut de Recherche pour le Développement (IRD), Mère et Enfant face aux Infections Tropicales, Paris, France
- * E-mail:
| | - Michael J. Boivin
- Michigan State University, Departments of Psychiatry and Neurology/Ophthalmology, East Lansing, Michigan, United States of America
| | - Leslie L. Davidson
- Columbia University, Mailman School of Public Health and the College of Physicians and Surgeons, New York, New York, United States of America
| | - Smaïla Ouédraogo
- Institut de Recherche pour le Développement (IRD), Mère et Enfant face aux Infections Tropicales, Paris, France
- Centre Hospitalier Universitaire Yalgado Ouédraogo, Ouagadougou, Burkina Faso
| | - Ghislain K. Koura
- Union Internationale Contre la Tuberculose et les Maladies Respiratoires, Département Tuberculose et VIH, Paris, France
| | - Maroufou J. Alao
- Hôpital de la Mère et de l’Enfant Lagune de Cotonou, Service de Pédiatrie, Cotonou, Bénin
| | | | - Michel Cot
- Institut de Recherche pour le Développement (IRD), Mère et Enfant face aux Infections Tropicales, Paris, France
- PRES Sorbonne Paris Cité, Université Paris Descartes, Faculté des Sciences Pharmaceutiques et Biologiques, Paris, France
| | - Florence Bodeau-Livinec
- Ecole des Hautes Etudes en Santé Publique, Département d’Épidémiologie et des Biostatistiques, Rennes, France
- Inserm UMR 1153, Obstetrical, Perinatal and Pediatric Epidemiology Research Team (Epopé), Center for Epidemiology and Statistics Sorbonne Paris Cité, DHU Risks in Pregnancy, Paris Descartes University, Paris, France
- New York University Medical Center, Division of Parasitology, Department of Microbiology, New York, New York, United States of America
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197
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García-Parra CJ, Cano-Ballesteros JC, Ortega-Sánchez E, Martín-Rabadán P. Varón brasileño de 19años con anemia ferropénica grave. Enferm Infecc Microbiol Clin 2015; 33:211-2. [DOI: 10.1016/j.eimc.2014.05.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2014] [Revised: 05/19/2014] [Accepted: 05/25/2014] [Indexed: 10/24/2022]
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198
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Wang Z, Stoltzfus J, You YJ, Ranjit N, Tang H, Xie Y, Lok JB, Mangelsdorf DJ, Kliewer SA. The nuclear receptor DAF-12 regulates nutrient metabolism and reproductive growth in nematodes. PLoS Genet 2015; 11:e1005027. [PMID: 25774872 PMCID: PMC4361679 DOI: 10.1371/journal.pgen.1005027] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2014] [Accepted: 01/27/2015] [Indexed: 12/22/2022] Open
Abstract
Appropriate nutrient response is essential for growth and reproduction. Under favorable nutrient conditions, the C. elegans nuclear receptor DAF-12 is activated by dafachronic acids, hormones that commit larvae to reproductive growth. Here, we report that in addition to its well-studied role in controlling developmental gene expression, the DAF-12 endocrine system governs expression of a gene network that stimulates the aerobic catabolism of fatty acids. Thus, activation of the DAF-12 transcriptome coordinately mobilizes energy stores to permit reproductive growth. DAF-12 regulation of this metabolic gene network is conserved in the human parasite, Strongyloides stercoralis, and inhibition of specific steps in this network blocks reproductive growth in both of the nematodes. Our study provides a molecular understanding for metabolic adaptation of nematodes to their environment, and suggests a new therapeutic strategy for treating parasitic diseases.
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Affiliation(s)
- Zhu Wang
- Deparment of Pharmacology, University of Texas Southwestern Medical Center at Dallas, Dallas, Texas, United States of America
| | - Jonathan Stoltzfus
- Department of Pathology, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
| | - Young-jai You
- Department of Molecular Biology, University of Texas Southwestern Medical Center at Dallas, Dallas, Texas, United States of America
| | - Najju Ranjit
- Department of Pathology, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
| | - Hao Tang
- Department of Clinical Science, University of Texas Southwestern Medical Center at Dallas, Dallas, Texas, United States of America
| | - Yang Xie
- Department of Clinical Science, University of Texas Southwestern Medical Center at Dallas, Dallas, Texas, United States of America
| | - James B. Lok
- Department of Pathology, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
| | - David J. Mangelsdorf
- Deparment of Pharmacology, University of Texas Southwestern Medical Center at Dallas, Dallas, Texas, United States of America
- Howard Hughes Medical Institute, University of Texas Southwestern Medical Center at Dallas, Dallas, Texas, United States of America
| | - Steven A. Kliewer
- Deparment of Pharmacology, University of Texas Southwestern Medical Center at Dallas, Dallas, Texas, United States of America
- Department of Molecular Biology, University of Texas Southwestern Medical Center at Dallas, Dallas, Texas, United States of America
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199
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Sharma B, Mohapatra S, Kumar AM, Deb M. Diagnostic dilemma in hookworm infection: An unusual case report. Indian J Med Microbiol 2015; 33:179-80. [DOI: 10.4103/0255-0857.148418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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200
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Pearson MS, Jariwala AR, Abbenante G, Plieskatt J, Wilson D, Bottazzi ME, Hotez PJ, Keegan B, Bethony JM, Loukas A. New tools for NTD vaccines: A case study of quality control assays for product development of the human hookworm vaccine Na-APR-1M74. Hum Vaccin Immunother 2015; 11:1251-7. [PMID: 26018444 PMCID: PMC4514234 DOI: 10.4161/21645515.2014.980199] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2014] [Revised: 08/26/2014] [Accepted: 09/06/2014] [Indexed: 11/19/2022] Open
Abstract
Na-APR-1(M74) is an aspartic protease that is rendered enzymatically inactive by site-directed mutagenesis and is a candidate antigen component in the Human Hookworm Vaccine. The mutant protease exerts vaccine efficacy by inducing antibodies that neutralize the enzymatic activity of wild type enzyme (Na-APR-1wt) in the gut of the hookworm, thereby depriving the worm of its ability to digest its blood meal. Previously, canines immunized with Na-APR-1(M74) and challenged with Ancylostoma caninum were partially protected against hookworm challenge infection, especially from the loss in hemoglobin observed in control canines and canine immunoglobulin (Ig) G raised against Na-APR-1 was shown to inhibit the enzymatic activity of Na-APR-1 wt in vitro, thereby providing proof of concept of Na-APR-1(M74) as a vaccine antigen. The mutated version, Na-APR-1(M74), was then expressed at the cGMP level using a Nicotiana benthamiana expression system (Fraunhofer, CMB, Delaware, MD), formulated with Alhydrogel®, and used to immunize mice in a dose-ranging study to explore the enzyme-neutralizing capacity of the resulting anti- Na-APR-1(M74) IgG. As little as 0.99 μg of recombinant Na-APR-1(M74) could induce anti Na-APR-1(M74) IgG in mice that were capable of inhibiting Na-APR-1w t-mediated digestion of a peptide substrate by 89%. In the absence of enzymatic activity of Na-APR-1(M74) as a surrogate marker of protein functionality, we developed an assay based on the binding of a quenched fluorescence-labeled inhibitor of aspartic proteases, BODIPY-FL pepstatin A (BDP). Binding of BDP in the active site of Na-APR-1 wt was demonstrated by inhibition of enzymatic activity, and competitive binding with unlabelled pepstatin A. BDP also bound to Na-APR-1(M74) which was assessed by fluorescence polarization, but with an ∼ 50-fold reduction in the dissociation constant. Taken together, these assays comprise a "toolbox" that could be useful for the analyses of Na-APR-1(M74) as it proceeds through the clinical development as part of the Human Hookworm Vaccine pipeline.
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MESH Headings
- Adjuvants, Immunologic/administration & dosage
- Aluminum Hydroxide/administration & dosage
- Ancylostoma/enzymology
- Ancylostoma/immunology
- Ancylostomiasis/prevention & control
- Animals
- Antibodies, Helminth/blood
- Antibodies, Neutralizing/blood
- Antigens, Helminth/genetics
- Antigens, Helminth/immunology
- Aspartic Acid Proteases/genetics
- Aspartic Acid Proteases/immunology
- Drug Discovery/methods
- Female
- Hookworm Infections/prevention & control
- Mice, Inbred BALB C
- Mutant Proteins/genetics
- Mutant Proteins/immunology
- Plants, Genetically Modified/genetics
- Plants, Genetically Modified/metabolism
- Quality Control
- Recombinant Proteins/genetics
- Recombinant Proteins/immunology
- Nicotiana/genetics
- Nicotiana/metabolism
- Vaccines, Synthetic/administration & dosage
- Vaccines, Synthetic/genetics
- Vaccines, Synthetic/immunology
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Affiliation(s)
- Mark S Pearson
- Centre for Biodiscovery and Molecular Development of Therapeutics; Australian Institute of Tropical Health and Medicine; James Cook University; Cairns, Queensland, Australia
| | - Amar R Jariwala
- Department of Microbiology; Immunology and Tropical Medicine; George Washington University; Washington, DC USA
| | | | - Jordan Plieskatt
- Department of Microbiology; Immunology and Tropical Medicine; George Washington University; Washington, DC USA
| | - David Wilson
- Centre for Biodiscovery and Molecular Development of Therapeutics; Australian Institute of Tropical Health and Medicine; James Cook University; Cairns, Queensland, Australia
| | - Maria Elena Bottazzi
- Sabin Vaccine Institute and Texas Children's Hospital Center for Vaccine Development; Baylor College of Medicine; Houston, TX USA
| | - Peter J Hotez
- Sabin Vaccine Institute and Texas Children's Hospital Center for Vaccine Development; Baylor College of Medicine; Houston, TX USA
| | - Brian Keegan
- Sabin Vaccine Institute and Texas Children's Hospital Center for Vaccine Development; Baylor College of Medicine; Houston, TX USA
| | - Jeffrey M Bethony
- Department of Microbiology; Immunology and Tropical Medicine; George Washington University; Washington, DC USA
- These authors equally contributed to this work.
| | - Alex Loukas
- Centre for Biodiscovery and Molecular Development of Therapeutics; Australian Institute of Tropical Health and Medicine; James Cook University; Cairns, Queensland, Australia
- These authors equally contributed to this work.
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