1
|
Hernández-Castro C, Agudelo-López SDP, Medina-Lozano AP, López-García D, García-Tuberquia LA, Botero-Garcés JH, Orozco-Peláez MC, Bolaños-Muñoz M, Bejarano-Villafañe DA, Carmena D. The burden of intestinal parasitic infections in Antioquia, Colombia: Impact in childhood growth development and nutritional status. Acta Trop 2024; 251:107119. [PMID: 38195005 DOI: 10.1016/j.actatropica.2024.107119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 09/04/2023] [Accepted: 01/06/2024] [Indexed: 01/11/2024]
Abstract
Gastrointestinal protist (GP) and soil-transmitted helminth (STH) infections cause significant morbidity among children in poor-resource settings of tropical and sub-tropical countries including Colombia. Few prospective transversal studies investigating how GP and STH infections affect growth development and nutritional status during childhood have been conducted in this country, none of them in the Antioquia Department. This microscopy-based study estimated the prevalence of GP and helminth (including STH) infections in faecal samples from schoolchildren (n = 384) collected during April-May 2019 in three municipalities of the Antioquia Department. Demographic, epidemiological, and household data were elicited through face-to-face interviews. Parasite detection was carried out by direct microscopic examination of both fresh smears and concentrated faecal material. Children (aged 6-15 years) also had their haemoglobin (Hb) levels, height and weight data collected, and BMI estimated. Data were analysed using bivariate and multivariate logistic regression analysis. Overall, 60.7 % (233/384) of schoolchildren were infected by at least one intestinal parasitic species. Among GPs, Blastocystis sp. was the most common species found (47.7 %, 95 % CI: 42.6-52.8), followed by G. duodenalis (15.9 %, 95 % CI: 12.4-19.9). Cryptosporidium spp. and Cyclospora cayetanensis were sporadically identified (0.3 %, 95 % CI: 0.1-1.4 each). Among helminths, the most prevalent species found were Trichuris trichiura (6.0 %, 95 % CI: 3.8-8.9) and Enterobius vermicularis (1.0 %, 95 % CI: 0.3-2.6). Hookworms, Ascaris lumbricoides, and Strongyloides stercoralis were found at prevalence rates <1 %. Underweight, overweigh, or obese schoolchildren had 1.2 times greater chance of being infected with intestinal parasites than their counterparts with a healthy weight (P-value: 0.015). Variables significantly associated with an increased likelihood of being infected by intestinal parasites include living in a household with unfinished flouring, not wearing shoes, being in close proximity to rodents, and having improper waste disposal. Relatively simple interventional measures directed towards the improvement of household conditions, access to sanitary toilets, and promoting shoe wearing can significantly reduce childhood infections by GP and helminths in the Antioquia Department.
Collapse
Affiliation(s)
- Carolina Hernández-Castro
- Parasitology Group, Faculty of Medicine, Academic Corporation for the Study of Tropical Pathologies, University of Antioquia, Medellín 050010, Colombia; Parasitology Reference and Research Laboratory, National Centre for Microbiology, Madrid, Majadahonda 28220, Spain.
| | - Sonia Del Pilar Agudelo-López
- Parasitology Group, Faculty of Medicine, Academic Corporation for the Study of Tropical Pathologies, University of Antioquia, Medellín 050010, Colombia
| | - Angélica Patricia Medina-Lozano
- Parasitology Group, Faculty of Medicine, Academic Corporation for the Study of Tropical Pathologies, University of Antioquia, Medellín 050010, Colombia
| | - Diego López-García
- Parasitology Group, Faculty of Medicine, Academic Corporation for the Study of Tropical Pathologies, University of Antioquia, Medellín 050010, Colombia
| | - Luis Alfonso García-Tuberquia
- Parasitology Group, Faculty of Medicine, Academic Corporation for the Study of Tropical Pathologies, University of Antioquia, Medellín 050010, Colombia
| | - Jorge Humberto Botero-Garcés
- Parasitology Group, Faculty of Medicine, Academic Corporation for the Study of Tropical Pathologies, University of Antioquia, Medellín 050010, Colombia
| | - María Cenelia Orozco-Peláez
- Parasitology Group, Faculty of Medicine, Academic Corporation for the Study of Tropical Pathologies, University of Antioquia, Medellín 050010, Colombia
| | - Manuela Bolaños-Muñoz
- Parasitology Group, Faculty of Medicine, Academic Corporation for the Study of Tropical Pathologies, University of Antioquia, Medellín 050010, Colombia
| | - Daniel Antonio Bejarano-Villafañe
- Parasitology Group, Faculty of Medicine, Academic Corporation for the Study of Tropical Pathologies, University of Antioquia, Medellín 050010, Colombia
| | - David Carmena
- Parasitology Reference and Research Laboratory, National Centre for Microbiology, Madrid, Majadahonda 28220, Spain; Center for Biomedical Research Network (CIBER) in Infectious Diseases, Health Institute Carlos III, Madrid 28008, Spain
| |
Collapse
|
2
|
Alshammari A, Anwar FA, Mohamed SAA, Abdelsater N. Antihelimentic effect of Androctonus crassicauda scorpion venom against Trichuris arvicolae isolated from Psammomys obesus in Egypt. Saudi J Biol Sci 2023; 30:103713. [PMID: 37405137 PMCID: PMC10315999 DOI: 10.1016/j.sjbs.2023.103713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 06/06/2023] [Accepted: 06/09/2023] [Indexed: 07/06/2023] Open
Abstract
Trichuridae family has a genetic and morphological variability between species affecting rodents, but it is considerably hard to morphologically diagnose species within the genus of Trichuris and the individuals of these species are identified according to their host, as it is known that Trichuris spp. is strictly host-specific. However, some species lack host specificity. So, it is necessary to use molecular data in order to well identify the Trichuris spp. in Egyptian rodents. The host examined in the current research is Psammomys obesus and the molecularly identified species from its cecum is Trichuris arvicolae. In addition, Trichuris arvicolae was subjected to in vitro treatment with Androctonus crassicauda Crude Venom as a model of natural alternative treatment for gastrointestinal nematodes that increasingly develop anthelmintic drug resistance. The changes in Trichuris arvicolae were monitored using scanning electron microscopy, Androctonus crassicauda Crude Venom made a significant ultrastructural surface changes in Trichuris arvicolae, including marked cuticular sloughing, disintegrated bacillary glands, bursting of vulva and edema of anal region. This study was done for closer identification of Trichuris spp. infecting rodents in Egypt and evaluating the efficacy of Androctonus crassicauda Crude Venom in vitro.
Collapse
Affiliation(s)
- Ayed Alshammari
- Department of Biology, College of Science, University of Hafr Al-Batin, Hafr Al-Batin,39511 Saudi Arabia
| | - Fatma A.S. Anwar
- Department of Zoology, Faculty of Science, Assiut University, Assiut 71516, Egypt
| | - Sara Abdel-Aal Mohamed
- Department of Parasitology, Faculty of Veterinary Medicine, Assiut University, Assiut 71515, Egypt
| | - Naser Abdelsater
- Zoology Department, Faculty of Science, Al-Azhar University (Assiut Branch), Assiut 71524, Egypt
| |
Collapse
|
3
|
Enogiomwan IE, Offiong EE, Ukam UA. Environmental contamination by soil-transmitted helminths ova and subsequent infection in school-age children in Calabar, Nigeria. SCIENTIFIC AFRICAN 2023. [DOI: 10.1016/j.sciaf.2023.e01580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
|
4
|
Shen S, Ding B, Jiang X, Yang M, Yang Q, Dong L. Discovery of novel inhibitors targeting nematode chitinase C eCht1: Virtual screening, biological evaluation, and molecular dynamics simulation. Front Chem 2022; 10:1021295. [PMID: 36405330 PMCID: PMC9669442 DOI: 10.3389/fchem.2022.1021295] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Accepted: 10/18/2022] [Indexed: 04/19/2024] Open
Abstract
Plant-parasitic nematodes are a main limiting factor for worldwide agriculture. To reduce the global burden of nematode infections, chemical nematicides are still the most effective methods to manage nematodes. With the increasing resistance of nematodes, the development of new anti-nematicides drug is urgent. Nematode chitinases are found to play important roles in various physiological functions, such as larva moulting, hatching from eggshell, and host infection. Inhibition of nematode chitinase is considered a promising strategy for the development of eco-friendly nematicides. In this study, to develop novel nematode chitinase CeCht1 inhibitors, virtual screening of the ZINC database was performed using the pesticide-likeness rules, pharmacophore-based and docking-based approach in turn. Compounds HAU-4 and HAU-7 were identified as potent CeCht1 inhibitors with the IC50 values of 4.2 μM and 10.0 μM, respectively. Moreover, molecular dynamics simulations combined with binding free energy and free energy decomposition calculations were conducted to investigate the basis for the potency of the two inhibitors toward CeCht1. This work gives an insight into the future rational development of novel and potent nematode chitinase inhibitors.
Collapse
Affiliation(s)
- Shengqiang Shen
- Academy for Advanced Interdisciplinary Studies, Peking University, Beijing, China
| | - Baokang Ding
- State Key Laboratory of North China Crop Improvement and Regulation, College of Plant Protection, Hebei Agricultural University, Baoding, China
| | - Xi Jiang
- State Key Laboratory for Biology of Plant Diseases and Insect Pests, Institute of Plant Protection, Chinese Academy of Agricultural Sciences, Beijing, China
- Guangdong Laboratory for Lingnan Modern Agriculture (Shenzhen Branch), Agricultural Genomics Institute at Shenzhen, Chinese Academy of Agricultural Sciences, Shenzhen, China
| | - Meiling Yang
- State Key Laboratory of North China Crop Improvement and Regulation, College of Plant Protection, Hebei Agricultural University, Baoding, China
| | - Qing Yang
- State Key Laboratory for Biology of Plant Diseases and Insect Pests, Institute of Plant Protection, Chinese Academy of Agricultural Sciences, Beijing, China
- Guangdong Laboratory for Lingnan Modern Agriculture (Shenzhen Branch), Agricultural Genomics Institute at Shenzhen, Chinese Academy of Agricultural Sciences, Shenzhen, China
| | - Lili Dong
- State Key Laboratory of North China Crop Improvement and Regulation, College of Plant Protection, Hebei Agricultural University, Baoding, China
| |
Collapse
|
5
|
Abebew D, Sayedain FS, Bode E, Bode HB. Uncovering Nematicidal Natural Products from Xenorhabdus Bacteria. JOURNAL OF AGRICULTURAL AND FOOD CHEMISTRY 2022; 70:498-506. [PMID: 34981939 PMCID: PMC8778618 DOI: 10.1021/acs.jafc.1c05454] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 12/10/2021] [Accepted: 12/10/2021] [Indexed: 06/14/2023]
Abstract
Parasitic nematodes infect different species of animals and plants. Root-knot nematodes are members of the genus Meloidogyne, which is distributed worldwide and parasitizes numerous plants, including vegetables, fruits, and crops. To reduce the global burden of nematode infections, only a few chemical therapeutic classes are currently available. The majority of nematicides are prohibited due to their harmful effects on the environment and public health. This study was intended to identify new nematicidal natural products (NPs) from the bacterial genus Xenorhabdus, which exists in symbiosis with Steinernema nematodes. Cell-free culture supernatants of Xenorhabdus bacteria were used for nematicidal bioassay, and high mortality rates for Caenorhabditis elegans and Meloidogyne javanica were observed. Promoter exchange mutants of biosynthetic gene clusters encoding nonribosomal peptide synthetases (NRPS) or NRPS-polyketide synthase hybrids in Xenorhabdus bacteria carrying additionally a hfq deletion produce a single NP class, which have been tested for their bioactivity. Among the NPs tested, fabclavines, rhabdopeptides, and xenocoumacins were highly toxic to nematodes and resulted in mortalities of 95.3, 74.6, and 72.6% to C. elegans and 82.0, 90.0, and 85.3% to M. javanica, respectively. The findings of such nematicidal NPs can provide templates for uncovering effective and environmentally safe alternatives to commercially available nematicides.
Collapse
Affiliation(s)
- Desalegne Abebew
- Molekulare
Biotechnologie, Goethe Universität
Frankfurt, Max-von-Laue-Str. 9, Frankfurt am Main 60438, Germany
| | - Fatemeh S. Sayedain
- Department
of Natural Products in Organismic Interactions, Max-Planck-Institute for Terrestrial Microbiology, Marburg 35043, Germany
| | - Edna Bode
- Department
of Natural Products in Organismic Interactions, Max-Planck-Institute for Terrestrial Microbiology, Marburg 35043, Germany
| | - Helge B. Bode
- Molekulare
Biotechnologie, Goethe Universität
Frankfurt, Max-von-Laue-Str. 9, Frankfurt am Main 60438, Germany
- Department
of Natural Products in Organismic Interactions, Max-Planck-Institute for Terrestrial Microbiology, Marburg 35043, Germany
- Senckenberg
Gesellschaft für Naturforschung, Frankfurt am Main 60325, Germany
| |
Collapse
|
6
|
De la Cruz Mayhua JC, Rizvi B. Strongyloides Hyperinfection Causing Gastrointestinal Bleeding and Bacteremia in an Immunocompromised Patient. Cureus 2021; 13:e15902. [PMID: 34322346 PMCID: PMC8310433 DOI: 10.7759/cureus.15902] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/24/2021] [Indexed: 11/23/2022] Open
Abstract
Strongyloidiasis is a parasitic infestation caused by Strongyloides stercoralis (S. stercoralis). Most cases are asymptomatic or mildly symptomatic with respiratory, gastrointestinal, or non-specific cutaneous symptoms. However, in immunocompromised patients, such as patients on chronic corticosteroids, malignancy, or human immunodeficiency virus (HIV) infection, hyperinfection syndrome can occur. The following is a case of Strongyloides hyperinfection in an individual taking prednisone for uveitis who developed upper gastrointestinal (GI) bleed and gram-negative bacteremia.
Collapse
Affiliation(s)
| | - Bisharah Rizvi
- Internal Medicine, Saint Agnes Medical Center, Fresno, USA
| |
Collapse
|
7
|
Ayele A, Tegegne Y, Derso A, Eshetu T, Zeleke AJ. Prevalence and Associated Factors of Intestinal Helminths Among Kindergarten Children in Gondar Town, Northwest Ethiopia. Pediatric Health Med Ther 2021; 12:35-41. [PMID: 33574727 PMCID: PMC7873616 DOI: 10.2147/phmt.s290265] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Accepted: 01/27/2021] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Intestinal parasitic infections (IPIs) are small organisms that infect the gastro-intestinal tract of human beings. Causes malnutrition, iron deficiency anemia, impairment of physical and mental development in children. The aim of this study was to determine the prevalence of intestinal helminthiasis and associated factors among Kindergarten (KG) children in Gondar Town, northwest Ethiopia. METHODS Institution-based cross-sectional study was conducted on 390 Kindergarten children in Gondar town, Northwest, Ethiopia from March to May 2019. Study subjects were selected using systematic random sampling method. Data were gathered through direct interview by using a pretested questionnaire. Stool specimens were collected and examined using Kato Katz technique. Chi square was used to assess the association between variables and p-value less than 0.05 was taken as a statistical significance. RESULTS The overall prevalence of intestinal helminthiasis was 16.7%, while those of participants infected by soil-transmitted helminths (STHs) and intestinal Schistosomiasis were 13.8% and 5.9%, respectively. Ascaris lumbricoides was the predominant STHs (9%) followed by Trichuris trichiura (2.3%) and hookworm (1.5%). Light infection was observed in almost all of the infected study participants. Intestinal helminthiasis was found to be significantly associated with age, KG level of children, maternal occupation, and educational status of parents. CONCLUSION A significant number of children were infected by intestinal parasites in the study area. A. lumbricoides and intestinal Schistosomiasis were the most predominant of the isolated parasites.
Collapse
Affiliation(s)
- Abiy Ayele
- Department of Immunology and Molecular Biology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Yalewayker Tegegne
- Department of Medical Parasitology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Adane Derso
- Department of Medical Parasitology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Tegegne Eshetu
- Department of Medical Parasitology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Ayalew Jejaw Zeleke
- Department of Medical Parasitology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| |
Collapse
|
8
|
Kalinda C, Mindu T, Chimbari MJ. A systematic review and meta-analysis quantifying schistosomiasis infection burden in pre-school aged children (PreSAC) in sub-Saharan Africa for the period 2000-2020. PLoS One 2020; 15:e0244695. [PMID: 33373405 PMCID: PMC7771669 DOI: 10.1371/journal.pone.0244695] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Accepted: 12/14/2020] [Indexed: 12/22/2022] Open
Abstract
INTRODUCTION Following the adoption of the World Health Assembly Resolution WHA 65.21 and Neglected Tropical Diseases road map 2021-2030, schistosomiasis control programmes have shifted from morbidity control to disease elimination. However, several gaps continue to be observed in the implementation of control programmes with certain age groups omitted from these campaigns increasing health inequalities and risks of reinfections to previously treated groups. We used the Inverse Variance Heterogeneity (IVhet) model to estimate the prevalence of schistosomiasis infection among preschool-aged children. METHODS We did a systematic review of peer-reviewed literature on schistosomiasis in sub-Saharan Africa for the period January 1, 2000 to November 30, 2020. Quantitative data for cases of schistosomiasis infection were extracted, including country and region where the studies were done, year of publication and specific schistosome species observed. The IVhet model was used to estimate the pooled prevalence estimate (PPE), the heterogeneity and publication bias. RESULTS We screened 2601 articles to obtain 47 eligible studies containing quantitative data on preschool-aged children. Of the selected studies, 44.7% (n = 22) were from East Africa while the least number of studies obtained (2.1%, n = 1) was from Central Africa. 21712 subjects were screened for infection due to Schistosoma spp; 13924 for S. mansoni and 7788 for S. haematobium. The PPE for schistosomiasis among PreSAC was 19% (95% CI: 11-28). Infection due to S. mansoni (IVhet PPE: 22% (95% CI: 9-36) was higher than that due to S. haematobium (15%; 95% CI: 6-25). A Luis Furuya-Kanamori index of 1.83 indicated a lack of publication bias. High level of heterogeneity was observed (I2 > 90%) and this could not be reduced through subgroup analysis. CONCLUSION Schistosomiasis infection among pre-school aged children 6 years old and below is high. This indicates the importance of including this age group in treatment programmes to reduce infection prevalence and long-term morbidities associated with prolonged schistosome infection.
Collapse
Affiliation(s)
- Chester Kalinda
- University of Namibia, Katima Mulilo, Namibia
- Department of Public Health, College of Health Sciences, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa
| | - Tafadzwa Mindu
- Department of Public Health, College of Health Sciences, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa
| | - Moses John Chimbari
- Department of Public Health, College of Health Sciences, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa
| |
Collapse
|
9
|
Abe EM, Echeta OC, Ombugadu A, Ajah L, Aimankhu PO, Oluwole AS. Helminthiasis among School-Age Children and Hygiene Conditions of Selected Schools in Lafia, Nasarawa State, Nigeria. Trop Med Infect Dis 2019; 4:E112. [PMID: 31362367 PMCID: PMC6789766 DOI: 10.3390/tropicalmed4030112] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Revised: 07/22/2019] [Accepted: 07/23/2019] [Indexed: 11/17/2022] Open
Abstract
The burden of soil-transmitted helminths (STHs) infections in Nigeria is enormous with serious public health significance. This study, therefore, assessed helminthiasis among school-age children and the hygiene conditions of schools in Lafia, Nasarawa State, Nigeria between December 2015 and April 2016 from four randomly selected primary schools. Stool samples were collected from 200 primary school pupils including 80 males (40%) and 120 females (60%) between five and 16 years, using clean sample bottles and a standard parasitology examination technique at the central laboratory at the Federal University, Lafia. An overall prevalence of 33.5% (67/200) helminths infections was recorded. A checklist of Ascaris lumbricoides, hookworm, Trichuris trichiura, and Strongyloides stercoralis was generated from the pooled data of the four studied schools in which A. lumbricoides occurred highest with 13% (26/200) while S. stercoralis was the least prevalent at 2.50% (5/200). Among the schools sampled, St. James Pilot Science Primary School's children were the most infected at 44% (22/50). Multiple infections were observed in three of the four schools sampled. There was no significant difference (p > 0.05) in prevalence rates of different STHs infections in relation to age group and gender across schools. Our findings showed that the hygiene conditions in the studied schools were poor without water, hand washing materials, refuse bins, as well as poor sanitary conditions. This study also identified ova and larvae of STHs parasites in the analyzed soil samples from the studied schools. Most school-age children had knowledge about contamination but few among them washed their hands with water and soap. The obtained result indicated a negative association between the prevalence of STHs and the proportion of pupils that cleaned up with water after defection. We, therefore, advise that hygiene conditions in schools be improved and that the government should prioritize enrolling all primary schools in Nasarawa state for the school health program so as to reduce the burden of STHs among school-age children in the state.
Collapse
Affiliation(s)
- Eniola M Abe
- National Institute of Parasitic Diseases (NIPD), Chinese Centre for Disease Control and Prevention, World Health Organization Collaborating Centre for Tropical Diseases, Shanghai 200025, China.
| | - Onyinye C Echeta
- Department of Zoology, Federal University of Lafia, P.M.B 146, Lafia 950101, Nigeria
| | - Akwashiki Ombugadu
- Department of Zoology, Federal University of Lafia, P.M.B 146, Lafia 950101, Nigeria
| | - Linus Ajah
- Department of Zoology, Federal University of Lafia, P.M.B 146, Lafia 950101, Nigeria
| | - Peter O Aimankhu
- Department of Zoology, Federal University of Lafia, P.M.B 146, Lafia 950101, Nigeria
| | - Akinola S Oluwole
- Department of Pure and Applied Zoology, Federal University of Agriculture Abeokuta, P.M.B 2240, Abeokuta 110124, Nigeria
| |
Collapse
|
10
|
Hussain A, Younis EZ, Elamami AH, Jelodar M, Mishra T, Shivaramaiah G. Prevalence of Intestinal Parasitic Infestation Among Expatriate Workers. Cureus 2019; 11:e4894. [PMID: 31423373 PMCID: PMC6689474 DOI: 10.7759/cureus.4894] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Background Parasitic infestations of the gastrointestinal tract remain a common problem in third-world countries. Poverty, illiteracy, poor hygiene, scarcity of potable water, as well as the hot and humid tropical climate, are all contributing factors associated with intestinal parasitic infestation. Objective This cross-sectional study aims to evaluate the prevalence of intestinal parasitic infestation amongst expatriate workers in Benghazi City, Libya. Patients and methods A total of 250 stool samples (200 male and 50 female) were randomly collected between October 2017 to April 2018 from expatriate workers in Benghazi City, Libya. The samples examined were used to detect the presence of intestinal parasitic infestation while the study utilized a pre-tested structure. Cases were matched based on demographic parameters, such as age, gender, and nationality, while the history of diarrhea was recorded using direct smear microscopy for the detection of intestinal parasitic infestation. Results Of the 250 immigrants looking for work, 95 (38%) were found to be infested with two or more intestinal parasites. The protozoa included: Blastocystis hominis, Giardia lamblia, Entamoeba histolytica, Entamoeba dispar, and Cryptosporidium parvum (47.4%, 38.9%, 17.9%, 17.9%, and 4.2%, respectively); the non-pathogenic protozoa included the prevalence of Entamoeba coli (E. coli), which is 12.6%, and the helminth Ascaris lumbricoidesis 1.1%. Conclusion The prevalence of parasitic infection was relatively high (38%) and was affected by individual hygiene. Therefore, comprehensive healthcare education aimed at reducing parasitic infestation is needed.
Collapse
Affiliation(s)
- Azhar Hussain
- Medicine, Xavier University School of Medicine, Oranjestad, ABW
| | - Eman Z Younis
- Laboratory Medicine, University of Benghazi, Benghazi, LBY
| | | | - Mehrdad Jelodar
- Internal Medicine, Xavier University School of Medicine, Oranjestad, ABW
| | - Tulika Mishra
- Health Biotech, Immunology, Microbiology, Xavier University School of Medicine, Oranjestad, ABW
| | | |
Collapse
|
11
|
Maeda Y, Palomares-Rius JE, Hino A, Afrin T, Mondal SI, Nakatake A, Maruyama H, Kikuchi T. Secretome analysis of Strongyloides venezuelensis parasitic stages reveals that soluble and insoluble proteins are involved in its parasitism. Parasit Vectors 2019; 12:21. [PMID: 30626426 PMCID: PMC6327390 DOI: 10.1186/s13071-018-3266-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2018] [Accepted: 12/12/2018] [Indexed: 11/22/2022] Open
Abstract
Background Parasites excrete and secrete a wide range of molecules that act as the primary interface with their hosts and play critical roles in establishing parasitism during different stages of infection. Strongyloides venezuelensis is a gastrointestinal parasite of rats that is widely used as a laboratory model and is known to produce both soluble and insoluble (adhesive) secretions during its parasitic stages. However, little is known about the constituents of these secretions. Results Using mass spectrometry, we identified 436 proteins from the infective third-stage larvae (iL3s) and 196 proteins from the parasitic females of S. venezuelensis. The proteins that were secreted by the iL3s were enriched with peptidase activity, embryo development and the oxidation-reduction process, while those of the parasitic females were associated with glycolysis, DNA binding (histones) and other unknown functions. Trypsin inhibitor-like domain-containing proteins were identified as the main component of the adhesive secretion from parasitic females. An absence of secretion signals in many of the proteins indicated that they are secreted via non-classical secretion pathways. Conclusions We found that S. venezuelensis secretes a wide range of proteins to establish parasitism. This includes proteins that have previously been identified as being involved in parasitism in other helminths as well as proteins that are unique to this species. These findings provide insights into the molecular mechanisms underlying Strongyloides parasitism. Electronic supplementary material The online version of this article (10.1186/s13071-018-3266-x) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Yasunobu Maeda
- Division of Parasitology, Faculty of Medicine, University of Miyazaki, Miyazaki, 889-1692, Japan
| | - Juan Emilio Palomares-Rius
- Division of Parasitology, Faculty of Medicine, University of Miyazaki, Miyazaki, 889-1692, Japan.,Instituto de Agricultura Sostenible, Consejo Superior de Investigaciones Científicas (CSIC), Avda. Menéndez Pidal s/n, 14004, Córdoba, Spain
| | - Akina Hino
- Division of Parasitology, Faculty of Medicine, University of Miyazaki, Miyazaki, 889-1692, Japan.,Department of Environmental Parasitology, Tokyo Medical and Dental University, Yushima, Bunkyo-ku, Tokyo, Japan
| | - Tanzila Afrin
- Division of Parasitology, Faculty of Medicine, University of Miyazaki, Miyazaki, 889-1692, Japan
| | - Shakhinur Islam Mondal
- Division of Parasitology, Faculty of Medicine, University of Miyazaki, Miyazaki, 889-1692, Japan
| | - Ayako Nakatake
- HTLV-1/ATL Research Facility, Faculty of Medicine, University of Miyazaki, Miyazaki, 889-1692, Japan
| | - Haruhiko Maruyama
- Division of Parasitology, Faculty of Medicine, University of Miyazaki, Miyazaki, 889-1692, Japan
| | - Taisei Kikuchi
- Division of Parasitology, Faculty of Medicine, University of Miyazaki, Miyazaki, 889-1692, Japan.
| |
Collapse
|
12
|
Moser W, Bärenbold O, Mirams GJ, Cools P, Vlaminck J, Ali SM, Ame SM, Hattendorf J, Vounatsou P, Levecke B, Keiser J. Diagnostic comparison between FECPAKG2 and the Kato-Katz method for analyzing soil-transmitted helminth eggs in stool. PLoS Negl Trop Dis 2018; 12:e0006562. [PMID: 29864132 PMCID: PMC6002127 DOI: 10.1371/journal.pntd.0006562] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Revised: 06/14/2018] [Accepted: 05/25/2018] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Over one billion people are infected with soil-transmitted helminths (STH), i.e. Ascaris lumbricoides, hookworm and Trichuris trichiura. For estimating drug efficacy and monitoring anthelminthic drug resistance, accurate diagnostic methods are critical. FECPAKG2 is a new remote-diagnostic tool used in veterinary medicine, which produces an image of the stool sample that can be stored on an internet cloud. We compared for the first time FECPAKG2 with the recommended Kato-Katz method. METHODOLOGY/PRINCIPAL FINDINGS Two stool samples were collected from adolescent participants (age 15-18 years) at baseline and 14 to 21 days after treatment in the framework of a randomized clinical trial on Pemba Island, Tanzania. Stool samples were analyzed with different diagnostic efforts: i) one or ii) two Kato-Katz thick smears from the first sample, iii) two Kato-Katz thick smears from two samples and iv) FECPAKG2 from the first sample. Parameters were calculated based on a hierarchical Bayesian egg count model. Complete data for all diagnostic efforts were available from 615 participants at baseline and 231 hookworm-positive participants at follow-up. At baseline FECPAKG2 revealed a sensitivity of 75.6% (72.0-77.7) for detecting A. lumbricoides, 71.5% (67.4-95.3) for hookworm and 65.8% (64.9-66.2) for T. trichiura, which was significantly lower (all p<0.05) than any of the Kato-Katz methods and highly dependent on infection intensity. Despite that the egg counts based on FECPAKG2 were relatively lower compared to Kato-Katz by a ratio of 0.38 (0.32-0.43) for A. lumbricoides, 0.36 (0.33-0.40) for hookworm and 0.08 (0.07-0.09) for T. trichiura, the egg reduction rates (ERR) were correctly estimated with FECPAKG2. CONCLUSIONS/SIGNIFICANCE The sensitivity to identify any STH infection was considerably lower for FECPAKG2 compared to Kato-Katz. Following rigorous development, FECPAKG2 might be an interesting tool with unique features for epidemiological and clinical studies.
Collapse
Affiliation(s)
- Wendelin Moser
- Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Basel Switzerland
- University of Basel, Basel, Switzerland
| | - Oliver Bärenbold
- University of Basel, Basel, Switzerland
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
| | | | - Piet Cools
- Department of Virology, Parasitology and Immunology, Faculty of Veterinary Medicine, Ghent University, Ghent, Belgium
| | - Johnny Vlaminck
- Department of Virology, Parasitology and Immunology, Faculty of Veterinary Medicine, Ghent University, Ghent, Belgium
| | - Said M. Ali
- Laboratory Division, Public Health Laboratory-Ivo de Carneri, Chake Chake, Tanzania
| | - Shaali M. Ame
- Laboratory Division, Public Health Laboratory-Ivo de Carneri, Chake Chake, Tanzania
| | - Jan Hattendorf
- University of Basel, Basel, Switzerland
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
| | - Penelope Vounatsou
- University of Basel, Basel, Switzerland
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
| | - Bruno Levecke
- Department of Virology, Parasitology and Immunology, Faculty of Veterinary Medicine, Ghent University, Ghent, Belgium
| | - Jennifer Keiser
- Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Basel Switzerland
- University of Basel, Basel, Switzerland
| |
Collapse
|
13
|
Deb B, Uddin A, Mazumder GA, Chakraborty S. Analysis of codon usage pattern of mitochondrial protein-coding genes in different hookworms. Mol Biochem Parasitol 2018; 219:24-32. [DOI: 10.1016/j.molbiopara.2017.11.005] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2017] [Revised: 11/14/2017] [Accepted: 11/16/2017] [Indexed: 12/11/2022]
|
14
|
Stevens DP, Surapaneni A, Thodupunuri R, O'Connor NA, Smith D. Helminth log reduction values for recycling water from sewage for the protection of human and stock health. WATER RESEARCH 2017; 125:501-511. [PMID: 28942117 DOI: 10.1016/j.watres.2017.08.069] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/16/2017] [Revised: 07/15/2017] [Accepted: 08/24/2017] [Indexed: 06/07/2023]
Abstract
The LRVs required to decrease HE concentrations in raw sewage to an acceptable level to manage the risk to human and livestock health were determined. An LRV of 3.0 was required to meet the HBT of 1 μDALY pppy in SE Australia where human helminth infections are not endemic. In comparison, a similar exposure volume and LRV in endemic regions would result in a HBT of 100 μDALY pppy. The risks posed by cattle- and pig-related helminths were also managed acceptably with the treatment of sewage providing an LRV of 3.0. New design equations were derived to determine LRVs based on hydraulic residence times (HRTs) in an activated sludge plant (ASP) and lagoons. The new equation for lagoons indicated that an LRV of 3.0 could be achieved with a HRT of 18 days or less.
Collapse
Affiliation(s)
- Daryl P Stevens
- Atura Pty Ltd, PO Box 434, Preston, Victoria 3072, Australia.
| | | | | | - Nicholas A O'Connor
- Ecos Environmental Consulting Pty Ltd, PO Box 1064G, North Balwyn, Victoria 3104, Australia
| | - David Smith
- South East Water, 101 Wells Street, Frankston, Victoria 3199, Australia
| |
Collapse
|
15
|
|
16
|
Paige SB, Friant S, Clech L, Malavé C, Kemigabo C, Obeti R, Goldberg TL. Combining Footwear with Public Health Iconography to Prevent Soil-Transmitted Helminth Infections. Am J Trop Med Hyg 2016; 96:205-213. [PMID: 27821692 DOI: 10.4269/ajtmh.15-0910] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2015] [Accepted: 10/06/2016] [Indexed: 12/26/2022] Open
Abstract
Shoes are effective for blocking soil-transmitted helminths (STHs) that penetrate the skin. Unfortunately, shoe-wearing is uncommon in many areas where STHs are prevalent, in part because local populations are unaware of the health benefits of wearing shoes. This is especially true in low-literacy populations, where information dissemination through written messages is not possible. We launched a public health intervention that combines a public health image with sandals. The image is a "lenticular image" that combines two alternating pictures to depict the efficacy of shoes for preventing STH infection. This image is adhered to the shoe, such that the message is linked directly to the primary means of prevention. To create a culturally appropriate image, we conducted five focus group discussions, each with a different gender and age combination. Results of focus group discussions reinforced the importance of refining public health messages well in advance of distribution so that cultural acceptability is strong. After the image was finalized, we deployed shoes with the image in communities in western Uganda where hookworm is prevalent. We found that the frequency of shoe-wearing was 25% higher in communities receiving the shoes than in control communities. Microscopic analyses of fecal samples for parasites showed a sustained reduction in infection intensity for parasites transmitted directly through the feet when people received shoes with a public health image. Our results show that combining culturally appropriate images with public health interventions can be effective in low-literacy populations.
Collapse
Affiliation(s)
- Sarah B Paige
- Global Health Institute, University of Wisconsin-Madison, Madison, Wisconsin
| | - Sagan Friant
- Department of Pathobiological Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, Wisconsin.,Nelson Institute for Environmental Studies, University of Wisconsin-Madison, Madison, Wisconsin
| | - Lucie Clech
- Department of Anthropology, Stanford University, Stanford, California
| | - Carly Malavé
- Department of Pathobiological Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, Wisconsin
| | | | - Richard Obeti
- Kabarole District Health Office, Fort Portal, Uganda
| | - Tony L Goldberg
- Global Health Institute, University of Wisconsin-Madison, Madison, Wisconsin. .,Department of Pathobiological Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, Wisconsin
| |
Collapse
|
17
|
Odeniran PO, Ademola IO. Zoonotic Parasites of Wildlife in Africa: A Review. AFRICAN JOURNAL OF WILDLIFE RESEARCH 2016. [DOI: 10.3957/056.046.0001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Affiliation(s)
- Paul O. Odeniran
- Department of Veterinary Parasitology and Microbiology, Faculty of Veterinary Medicine, University of Ibadan, Ibadan, Oyo, Nigeria
| | - Isaiah O. Ademola
- Department of Veterinary Parasitology and Microbiology, Faculty of Veterinary Medicine, University of Ibadan, Ibadan, Oyo, Nigeria
| |
Collapse
|
18
|
Speich B, Moser W, Ali SM, Ame SM, Albonico M, Hattendorf J, Keiser J. Efficacy and reinfection with soil-transmitted helminths 18-weeks post-treatment with albendazole-ivermectin, albendazole-mebendazole, albendazole-oxantel pamoate and mebendazole. Parasit Vectors 2016; 9:123. [PMID: 26935065 PMCID: PMC4776366 DOI: 10.1186/s13071-016-1406-8] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2015] [Accepted: 02/24/2016] [Indexed: 11/12/2022] Open
Abstract
Background Preventive chemotherapy with albendazole or mebendazole is the current strategy to control soil-transmitted helminth (STH) infections (i.e. Ascaris lumbricoides, hookworm and Trichuris trichiura). STH reinfections, in particular A. lumbricoides and T. trichiura occur rapidly after treatment with the standard drugs. However, their low efficacy against T. trichiura, made an accurate assessment of reinfection patterns impossible. Methods In 2013 a randomised controlled trial was conducted on Pemba Island, Tanzania. School-aged children diagnosed positive for T. trichiura, were randomly allocated to (i) albendazole-ivermectin; (ii) albendazole-mebendazole; (iii) albendazole-oxantel pamoate; or (iv) mebendazole. Here we report the efficacy [cure rates (CR) and egg-reduction rates (ERR)], reinfection rates and new infections determined 18 weeks post-treatment. Results For a total of 405 children complete baseline and follow-up data were available. Similar to the efficacy determined after 3 weeks, 18 weeks after treatment albendazole-oxantel pamoate showed a significantly higher efficacy against T. trichiura (CR: 54.0 %, 95 % CI: 43.7–64.0; ERR: 98.6 %, 95 % CI: 97.8–99.2) compared to the other treatment arms. Children treated with albendazole-oxantel pamoate or albendazole-ivermectin had fewer moderate infections compared to children treated with albendazole. The reinfection rates 18 weeks post-treatment among all treatment arms were 37.2 % for T. trichiura (95 % CI: 28.3–46.8), 34.6 % for A. lumbricoides (95 % CI: 27.3–42.3) and 25.0 % for hookworms (95 % CI: 15.5–36.6). Conclusion The moderate reinfection rates with STHs 18 weeks post-treatment support the concept of regular anthelminthic treatment in highly endemic settings. Combination chemotherapy might achieve decreased morbidity in children since in the albendazole plus oxantel pamoate and albendazole plus ivermectin treatment arms only few moderate T. trichiura infections remained. Further trials should investigate the long term efficacy of albendazole-oxantel pamoate (i.e. 6 and 12 month post-treatment) and after several rounds of treatment in order to develop recommendations for appropriate control approaches for STH infections. Trial registration Current Controlled Trials ISRCTN80245406 Electronic supplementary material The online version of this article (doi:10.1186/s13071-016-1406-8) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Benjamin Speich
- Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Basel, Switzerland. .,University of Basel, Basel, Switzerland.
| | - Wendelin Moser
- Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Basel, Switzerland. .,University of Basel, Basel, Switzerland.
| | - Said M Ali
- Laboratory Division, Public Health Laboratory-Ivo de Carneri, Chake Chake, Tanzania.
| | - Shaali M Ame
- Laboratory Division, Public Health Laboratory-Ivo de Carneri, Chake Chake, Tanzania.
| | | | - Jan Hattendorf
- University of Basel, Basel, Switzerland. .,Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland.
| | - Jennifer Keiser
- Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Basel, Switzerland. .,University of Basel, Basel, Switzerland.
| |
Collapse
|
19
|
Hunt VL, Tsai IJ, Coghlan A, Reid AJ, Holroyd N, Foth BJ, Tracey A, Cotton JA, Stanley EJ, Beasley H, Bennett HM, Brooks K, Harsha B, Kajitani R, Kulkarni A, Harbecke D, Nagayasu E, Nichol S, Ogura Y, Quail MA, Randle N, Xia D, Brattig NW, Soblik H, Ribeiro DM, Sanchez-Flores A, Hayashi T, Itoh T, Denver DR, Grant W, Stoltzfus JD, Lok JB, Murayama H, Wastling J, Streit A, Kikuchi T, Viney M, Berriman M. The genomic basis of parasitism in the Strongyloides clade of nematodes. Nat Genet 2016; 48:299-307. [PMID: 26829753 PMCID: PMC4948059 DOI: 10.1038/ng.3495] [Citation(s) in RCA: 174] [Impact Index Per Article: 21.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2015] [Accepted: 12/23/2015] [Indexed: 12/19/2022]
Abstract
Soil-transmitted nematodes, including the Strongyloides genus, cause one of the most prevalent neglected tropical diseases. Here we compare the genomes of four Strongyloides species, including the human pathogen Strongyloides stercoralis, and their close relatives that are facultatively parasitic (Parastrongyloides trichosuri) and free-living (Rhabditophanes sp. KR3021). A significant paralogous expansion of key gene families--families encoding astacin-like and SCP/TAPS proteins--is associated with the evolution of parasitism in this clade. Exploiting the unique Strongyloides life cycle, we compare the transcriptomes of the parasitic and free-living stages and find that these same gene families are upregulated in the parasitic stages, underscoring their role in nematode parasitism.
Collapse
Affiliation(s)
- Vicky L. Hunt
- School of Biological Sciences, University of Bristol, Bristol, BS8 1TQ, UK
| | - Isheng J. Tsai
- Biodiversity Research Center, Academia Sinica, Taipei 11529, Taiwan
- Division of Parasitology, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan
| | - Avril Coghlan
- Wellcome Trust Sanger Institute, Wellcome Genome Campus, Hinxton, CB10 1SA, UK
| | - Adam J. Reid
- Wellcome Trust Sanger Institute, Wellcome Genome Campus, Hinxton, CB10 1SA, UK
| | - Nancy Holroyd
- Wellcome Trust Sanger Institute, Wellcome Genome Campus, Hinxton, CB10 1SA, UK
| | - Bernardo J. Foth
- Wellcome Trust Sanger Institute, Wellcome Genome Campus, Hinxton, CB10 1SA, UK
| | - Alan Tracey
- Wellcome Trust Sanger Institute, Wellcome Genome Campus, Hinxton, CB10 1SA, UK
| | - James A. Cotton
- Wellcome Trust Sanger Institute, Wellcome Genome Campus, Hinxton, CB10 1SA, UK
| | - Eleanor J. Stanley
- Wellcome Trust Sanger Institute, Wellcome Genome Campus, Hinxton, CB10 1SA, UK
| | - Helen Beasley
- Wellcome Trust Sanger Institute, Wellcome Genome Campus, Hinxton, CB10 1SA, UK
| | - Hayley M. Bennett
- Wellcome Trust Sanger Institute, Wellcome Genome Campus, Hinxton, CB10 1SA, UK
| | - Karen Brooks
- Wellcome Trust Sanger Institute, Wellcome Genome Campus, Hinxton, CB10 1SA, UK
| | - Bhavana Harsha
- Wellcome Trust Sanger Institute, Wellcome Genome Campus, Hinxton, CB10 1SA, UK
| | - Rei Kajitani
- Graduate School of Bioscience and Biotechnology, Tokyo Institute of Technology, Meguro-ku, Tokyo, Japan
| | - Arpita Kulkarni
- Max Planck Institute for Developmental Biology, Tübingen, Germany
| | | | - Eiji Nagayasu
- Division of Parasitology, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan
| | - Sarah Nichol
- Wellcome Trust Sanger Institute, Wellcome Genome Campus, Hinxton, CB10 1SA, UK
| | - Yoshitoshi Ogura
- Department of Bacteriology, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Michael A. Quail
- Wellcome Trust Sanger Institute, Wellcome Genome Campus, Hinxton, CB10 1SA, UK
| | - Nadine Randle
- Department of Infection Biology, Institute of Infection and Global Health and School of Veterinary Science, University of Liverpool, Liverpool, UK
| | - Dong Xia
- Department of Infection Biology, Institute of Infection and Global Health and School of Veterinary Science, University of Liverpool, Liverpool, UK
| | - Norbert W. Brattig
- Department of Molecular Medicine, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany
| | - Hanns Soblik
- Department of Molecular Medicine, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany
| | - Diogo M. Ribeiro
- Wellcome Trust Sanger Institute, Wellcome Genome Campus, Hinxton, CB10 1SA, UK
| | - Alejandro Sanchez-Flores
- Wellcome Trust Sanger Institute, Wellcome Genome Campus, Hinxton, CB10 1SA, UK
- Unidad de Secuenciación Masiva y Bioinformática, Instituto de Biotecnología, Universidad Nacional Autónoma de México, Cuernavaca, Morelos, México, 62210
| | - Tetsuya Hayashi
- Department of Bacteriology, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Takehiko Itoh
- Graduate School of Bioscience and Biotechnology, Tokyo Institute of Technology, Meguro-ku, Tokyo, Japan
| | - Dee R. Denver
- Department of Intergrative Biology, Oregon State University, Corvallis, Oregon, USA
| | - Warwick Grant
- Department of Animal, Plant and Soil Sciences, La Trobe University, Melbourne, Victoria, Australia
| | - Jonathan D. Stoltzfus
- Department of Pathobiology, School of Veterinary Medicine, University of Pennsylvania, 3800 Spruce Street, Philadelphia 19104, PA, USA
| | - James B. Lok
- Department of Pathobiology, School of Veterinary Medicine, University of Pennsylvania, 3800 Spruce Street, Philadelphia 19104, PA, USA
| | - Haruhiko Murayama
- Division of Parasitology, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan
| | - Jonathan Wastling
- Department of Infection Biology, Institute of Infection and Global Health and School of Veterinary Science, University of Liverpool, Liverpool, UK
- Faculty of Natural Sciences, University of Keele, Keele, Staffordshire, ST5 5BG, UK
| | - Adrian Streit
- Max Planck Institute for Developmental Biology, Tübingen, Germany
| | - Taisei Kikuchi
- Division of Parasitology, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan
| | - Mark Viney
- School of Biological Sciences, University of Bristol, Bristol, BS8 1TQ, UK
| | - Matthew Berriman
- Wellcome Trust Sanger Institute, Wellcome Genome Campus, Hinxton, CB10 1SA, UK
| |
Collapse
|
20
|
Moser W, Ali SM, Ame SM, Speich B, Puchkov M, Huwyler J, Albonico M, Hattendorf J, Keiser J. Efficacy and safety of oxantel pamoate in school-aged children infected with Trichuris trichiura on Pemba Island, Tanzania: a parallel, randomised, controlled, dose-ranging study. THE LANCET. INFECTIOUS DISEASES 2015; 16:53-60. [PMID: 26388169 DOI: 10.1016/s1473-3099(15)00271-6] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2015] [Revised: 08/07/2015] [Accepted: 08/10/2015] [Indexed: 10/23/2022]
Abstract
BACKGROUND Commonly used drugs for preventive chemotherapy against soil-transmitted helminths (ie, albendazole and mebendazole) show low efficacy against Trichuris trichiura. Recent studies with oxantel pamoate revealed good cure rates and high egg-reduction rates against T trichiura. We aimed to assess the nature of the dose-response relation to determine the optimum dose. METHODS We did a parallel, randomised, placebo-controlled, single-blind trial with oxantel pamoate in school-aged children (aged 6-14 years) infected with T trichiura on Pemba Island, Tanzania. Children were asked to provide two stool samples and children positive for T trichiura were eligible to participate in the trial. Children were excluded if they suffered from any systematic illness. Children were randomly assigned to six different oxantel pamoate doses (5-30 mg/kg) or a placebo. Randomisation was stratified by baseline infection intensity using random block sizes of seven and 14. The primary endpoints were cure rates and egg-reduction rates against T trichiura, both analysed by available case. Drug safety was assessed 2 h and 24 h after treatment. The trial is registered at www.isrctn.com, number ISRCTN86603231. FINDINGS Between Oct 14, and Nov 28, 2014, we enrolled 480 participants and randomly assigned 350 children to the different oxantel pamoate doses or the placebo. 5 mg/kg oxantel pamoate was the minimum effective dose (10 of 46 children cured [cure rate 22%, 95% CI 11-36]; egg-reduction rate 85·0%, 64·5-92·9). An increased probability of being cured and reduced egg counts with escalating doses was recorded. At 25 mg/kg oxantel pamoate 27 of 45 children were cured (cure rate 60%, 95% CI 44-65) with an egg-reduction rate of 97·5% (94·4-98·9), and at 30 mg/kg 27 of 46 children were cured (59%, 43-73) with an egg-reduction rate of 98·8% (96·8-99·6). Oxantel pamoate was well tolerated across all treatment groups; only mild adverse events were reported by the participants 2 h (27 [10%]) and 24 h (12 [4%]) after treatment. INTERPRETATION Our dose-finding study revealed an excellent tolerability profile of oxantel pamoate in children infected with T trichiura. An optimum therapeutic dose range of 15-30 mg/kg oxantel pamoate was defined. With a weight independent dose of 500 mg oxantel pamoate 95% of children aged 7-14 years in sub-Saharan Africa would receive doses of 11·7-32·0 mg/kg. Future research should include studies with oxantel pamoate in younger children and on different continents with the ultimate goal to be able to add oxantel pamoate to soil-transmitted helminth control programmes. FUNDING Swiss National Science Foundation.
Collapse
Affiliation(s)
- Wendelin Moser
- Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, and University of Basel, Basel, Switzerland
| | - Said M Ali
- Laboratory Division, Public Health Laboratory-Ivo de Carneri, Chake Chake, Tanzania
| | - Shaali M Ame
- Laboratory Division, Public Health Laboratory-Ivo de Carneri, Chake Chake, Tanzania
| | - Benjamin Speich
- Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, and University of Basel, Basel, Switzerland
| | - Maxim Puchkov
- Department of Pharmaceutical Sciences, Division of Pharmaceutical Technology, University of Basel, Basel, Switzerland
| | - Jörg Huwyler
- Department of Pharmaceutical Sciences, Division of Pharmaceutical Technology, University of Basel, Basel, Switzerland
| | | | - Jan Hattendorf
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, and University of Basel, Basel, Switzerland
| | - Jennifer Keiser
- Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, and University of Basel, Basel, Switzerland.
| |
Collapse
|
21
|
Toledo R, Muñoz-Antoli C, Esteban JG. Strongyloidiasis with emphasis on human infections and its different clinical forms. ADVANCES IN PARASITOLOGY 2015; 88:165-241. [PMID: 25911368 DOI: 10.1016/bs.apar.2015.02.005] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Strongyloidiasis (caused by Strongyloides stercoralis, and to a lesser extent by Strongyloides fuelleborni) is one of the most neglected tropical diseases with endemic areas and affecting more than 100 million people worldwide. Chronic infections in endemic areas can be maintained for decades through the autoinfective cycle with the L3 filariform larvae. In these endemic areas, misdiagnosis, inadequate treatment and the facilitation of the hyperinfection syndrome by immunosuppression are frequent and contribute to a high mortality rate. Despite the serious health impact of strongyloidiasis, it is a neglected disease and very little is known about this parasite and the disease when compared to other helminth infections. Control of the disease is difficult because of the many gaps in our knowledge of strongyloidiasis. We examine the recent literature on different aspects of strongyloidiasis with emphasis in those aspects that need further research.
Collapse
Affiliation(s)
- Rafael Toledo
- Departamento de Parasitología, Universidad de Valencia, Valencia, Spain
| | | | | |
Collapse
|
22
|
Chaudhary S, Garg T, Rath G, Murthy RR, Goyal AK. Enhancing the bioavailability of mebendazole by integrating the principles solid dispersion and nanocrystal techniques, for safe and effective management of human echinococcosis. ARTIFICIAL CELLS NANOMEDICINE AND BIOTECHNOLOGY 2015; 44:937-42. [DOI: 10.3109/21691401.2014.1000493] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
|
23
|
Harris JR, Worrell CM, Davis SM, Odero K, Mogeni OD, Deming MS, Mohammed A, Montgomery JM, Njenga SM, Fox LM, Addiss DG. Unprogrammed deworming in the Kibera slum, Nairobi: implications for control of soil-transmitted helminthiases. PLoS Negl Trop Dis 2015; 9:e0003590. [PMID: 25763577 PMCID: PMC4357447 DOI: 10.1371/journal.pntd.0003590] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2014] [Accepted: 02/04/2015] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Programs for control of soil-transmitted helminth (STH) infections are increasingly evaluating national mass drug administration (MDA) interventions. However, "unprogrammed deworming" (receipt of deworming drugs outside of nationally-run STH control programs) occurs frequently. Failure to account for these activities may compromise evaluations of MDA effectiveness. METHODS We used a cross-sectional study design to evaluate STH infection and unprogrammed deworming among infants (aged 6-11 months), preschool-aged children (PSAC, aged 1-4 years), and school-aged children (SAC, aged 5-14 years) in Kibera, Kenya, an informal settlement not currently receiving nationally-run MDA for STH. STH infection was assessed by triplicate Kato-Katz. We asked heads of households with randomly-selected children about past-year receipt and source(s) of deworming drugs. Local non-governmental organizations (NGOs) and school staff participating in school-based deworming were interviewed to collect information on drug coverage. RESULTS Of 679 children (18 infants, 184 PSAC, and 477 SAC) evaluated, 377 (55%) reported receiving at least one unprogrammed deworming treatment during the past year. PSAC primarily received treatments from chemists (48.3%) or healthcare centers (37.7%); SAC most commonly received treatments at school (55.0%). Four NGOs reported past-year deworming activities at 47 of >150 schools attended by children in our study area. Past-year deworming was negatively associated with any-STH infection (34.8% vs 45.4%, p = 0.005). SAC whose most recent deworming medication was sourced from a chemist were more often infected with Trichuris (38.0%) than those who received their most recent treatment from a health center (17.3%) or school (23.1%) (p = 0.05). CONCLUSION Unprogrammed deworming was received by more than half of children in our study area, from multiple sources. Both individual-level treatment and unprogrammed preventive chemotherapy may serve an important public health function, particularly in the absence of programmed deworming; however, they may also lead to an overestimation of programmed MDA effectiveness. A standardized, validated tool is needed to assess unprogrammed deworming.
Collapse
Affiliation(s)
- Julie R. Harris
- Parasitic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Caitlin M. Worrell
- Parasitic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Stephanie M. Davis
- Division of Global HIV/AIDS, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Kennedy Odero
- Kenya Medical Research Institute, Centre for Global Health Research, Nairobi, Kenya
| | - Ondari D. Mogeni
- Kenya Medical Research Institute, Centre for Global Health Research, Nairobi, Kenya
| | - Michael S. Deming
- Parasitic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Aden Mohammed
- Public Health Department, School Health Program, Nairobi County, Nairobi, Kenya
| | - Joel M. Montgomery
- Division of Global Health Protection, Centers for Disease Control and Prevention, Nairobi, Kenya
| | - Sammy M. Njenga
- Kenya Medical Research Institute, Centre for Global Health Research, Nairobi, Kenya
- Eastern and Southern Africa Centre of International Parasite Control, Kenya Medical Research Institute, Nairobi, Kenya
| | - LeAnne M. Fox
- Parasitic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - David G. Addiss
- Children Without Worms, Task Force for Global Health, Decatur, Georgia, United States of America
| |
Collapse
|
24
|
Quality control in the diagnosis of Trichuris trichiura and Ascaris lumbricoides using the Kato-Katz technique: experience from three randomised controlled trials. Parasit Vectors 2015; 8:82. [PMID: 25652120 PMCID: PMC4326492 DOI: 10.1186/s13071-015-0702-z] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2014] [Accepted: 01/27/2015] [Indexed: 12/21/2022] Open
Abstract
Background An accurate diagnosis of soil-transmitted helminthiasis is important for individual patient management, for drug efficacy evaluation and for monitoring control programmes. The Kato-Katz technique is the most widely used method detecting soil-transmitted helminth eggs in faecal samples. However, detailed analyses of quality control, including false-positive and faecal egg count (FEC) estimates, have received little attention. Methods Over a 3-year period, within the frame of a series of randomised controlled trials conducted in Pemba, United Republic of Tanzania, 10% of randomly selected Kato-Katz thick smears were re-read for Trichuris trichiura and Ascaris lumbricoides eggs. In case of discordant result (i.e. positive versus negative) the slides were re-examined a third time. A result was assumed to be false-positive or false-negative if the result from the initial reading did not agree with the quality control as well as the third reading. We also evaluated the general agreement in FECs between the first and second reading, according to internal and World Health Organization (WHO) guidelines. Results From the 1,445 Kato-Katz thick smears subjected to quality control, 1,181 (81.7%) were positive for T. trichiura and 290 (20.1%) were positive for A. lumbricoides. During quality control, very low rates of false-positive results were observed; 0.35% (n = 5) for T. trichiura and 0.28% (n = 4) for A. lumbricoides. False-negative readings of Kato-Katz thick smears were obtained in 28 (1.94%) and 6 (0.42%) instances for T. trichiura and A. lumbricoides, respectively. A high frequency of discordant results in FECs was observed (i.e. 10.0-23.9% for T. trichiura, and 9.0-11.4% for A. lumbricoides). Conclusions Our analyses show that the rate of false-positive diagnoses of soil-transmitted helminths is low. As the probability of false-positive results increases after examination of multiple stool samples from a single individual, the potential influence of false-positive results on epidemiological studies and anthelminthic drug efficacy studies should be determined. Existing WHO guidelines for quality control might be overambitious and might have to be revised, specifically with regard to handling disagreements in FECs.
Collapse
|
25
|
Tefera E, Mohammed J, Mitiku H. Intestinal helminthic infections among elementary students of Babile town, eastern Ethiopia. Pan Afr Med J 2015; 20:50. [PMID: 26090008 PMCID: PMC4449975 DOI: 10.11604/pamj.2015.20.50.5251] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2014] [Accepted: 10/31/2014] [Indexed: 11/11/2022] Open
Abstract
INTRODUCTION Intestinal helminthic infections are important public health problems in developing countries. In Ethiopia, intestinal parasitic infections are highly prevalent because of low living standards and poor environmental sanitation. There are several areas in Ethiopia from which epidemiological information is lacking including Babile town. The aim of this study was to determine the prevalence of intestinal helminthic infection among students of Babile town. METHODS A cross sectional study was conducted from May 14 to June 08, 2012. Stool samples collected from 644 students were examined by the McMaster method. Data were analyzed using SPSS version 16.0. Univariate analysis was carried out using the Chi-square test to check for presence or absence of association between exposure and the presence of infection and odds ratios with 95% CI were computed to measure the strength of association. Logistic regression was used to calculate predictors of helminthic infection. Statistical significance was set at P<0.05. RESULTS The prevalence of intestinal helminths was 13.8%, of which three students were infected with soil transmitted helminths with a prevalence rate of 0.47%. The prevalence of Hymenolepis nana, Enterobius vermicularis, hookworm, and Trichiura trichiura infections were 13, 0.6, 0.3, and 0.2% respectively. Intestinal helminthic infection was significantly associated with grade and sex of the school children. CONCLUSION The prevalence of intestinal helminths was low. Health information dissemination is recommended. Since infection by Hymenolepis nana is a long term health problem in the area, provision of regular treatment by anthelminthic drug of choice for hymenolepiasis is also recommended.
Collapse
Affiliation(s)
- Ephrem Tefera
- Department of Medical Laboratory Sciences, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Jemal Mohammed
- Department of Medical Laboratory Sciences, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Habtamu Mitiku
- Department of Medical Laboratory Sciences, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| |
Collapse
|
26
|
Speich B, Ali SM, Ame SM, Bogoch II, Alles R, Huwyler J, Albonico M, Hattendorf J, Utzinger J, Keiser J. Efficacy and safety of albendazole plus ivermectin, albendazole plus mebendazole, albendazole plus oxantel pamoate, and mebendazole alone against Trichuris trichiura and concomitant soil-transmitted helminth infections: a four-arm, randomised controlled trial. THE LANCET. INFECTIOUS DISEASES 2015; 15:277-84. [PMID: 25589326 DOI: 10.1016/s1473-3099(14)71050-3] [Citation(s) in RCA: 90] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND Existing anthelmintic drugs (eg, albendazole and mebendazole) have low efficacy against the intestinal nematode species Trichuris trichiura and the drug pipeline is exhausted. We aimed to investigate the strategy of combination chemotherapy with existing drugs to establish whether their efficacy could be enhanced and broadened. METHODS In this randomised controlled trial, we compared three drug combinations and one standard drug alone in children aged 6-14 years in two schools on Pemba Island, Tanzania infected with T trichiura and concomitant intestinal nematodes. We assigned children, via a randomisation list with block sizes of either four or eight, to orally receive albendazole (400 mg) plus ivermectin (200 μg/kg); albendazole (400 mg) plus mebendazole (500 mg); albendazole (400 mg) plus oxantel pamoate (20 mg/kg); or mebendazole (500 mg) alone. The primary endpoints were the proportion of children cured of T trichiura infection and the reduction of T trichiura eggs in stool based on geometric means, both analysed by available case. This study is registered with ISRCTN, number ISRCTN80245406. FINDINGS We randomly assigned 440 eligible children infected with T trichiura between Sept 2, and Oct 18, 2013, to one of the four treatment groups (110 children per group). Data for 431 children were included in the analysis for the primary endpoints. Albendazole plus oxantel pamoate (74 of 108 children cured [68·5%, 95% CI 59·6-77·4]; egg reduction 99·2%, 98·7-99·6) and albendazole plus ivermectin (30 of 109 cured [27·5%, 19·0-36·0]; egg reduction 94·5%, 91·7-96·3) were significantly more effective against T trichiura than mebendazole alone (nine of 107 cured [8·4%, 3·1-13·8]; egg reduction 58·5%, 45·2-70·9). Albendazole plus mebendazole had similar low efficacy (nine of 107 cured [8·4%, 3·1-13·8; egg reduction 51·6%, 35·0-65·3) to mebendazole alone. About a fifth of the children reported adverse events, which were mainly mild. Abdominal cramps and headache were the most common adverse events after treatment; abdominal cramps were reported by 13 (12·0%) children for albendazole plus ivermectin, 10 (9·3%) for albendazole plus mebendazole, 20 (18·2%) for albendazole plus oxantel pamoate, and 16 (14·5%) for mebendazole; headaches were reported by 5 (4·6%) children for albendazole plus ivermectin, 6 (5·6%) for albendazole plus mebendazole, 12 (10·9%) for albendazole plus oxantel pamoate, and 7 (6·4%) for mebendazole. INTERPRETATION Our head-to-head comparison of three combination chemotherapies showed the highest efficacy for albendazole plus oxantel pamoate for the treatment of infection with T trichiura. Further studies should investigate the combination of albendazole plus oxantel pamoate so that it can be considered for soil-transmitted helminthiasis control programmes. FUNDING Medicor Foundation and Swiss National Science Foundation.
Collapse
Affiliation(s)
- Benjamin Speich
- Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, and University of Basel, Basel, Switzerland
| | - Said M Ali
- Laboratory Division, Public Health Laboratory-Ivo de Carneri, Chake Chake, Tanzania
| | - Shaali M Ame
- Laboratory Division, Public Health Laboratory-Ivo de Carneri, Chake Chake, Tanzania
| | - Isaac I Bogoch
- Divisions of Internal Medicine and Infectious Diseases, Toronto General Hospital, Toronto, ON, Canada
| | - Rainer Alles
- Department of Pharmaceutical Sciences, Division of Pharmaceutical Technology, University of Basel, Basel, Switzerland
| | - Jörg Huwyler
- Department of Pharmaceutical Sciences, Division of Pharmaceutical Technology, University of Basel, Basel, Switzerland
| | | | - Jan Hattendorf
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, and University of Basel, Basel, Switzerland
| | - Jürg Utzinger
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, and University of Basel, Basel, Switzerland
| | - Jennifer Keiser
- Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, and University of Basel, Basel, Switzerland.
| |
Collapse
|
27
|
Tomczyk S, Deribe K, Brooker SJ, Clark H, Rafique K, Knopp S, Utzinger J, Davey G. Association between footwear use and neglected tropical diseases: a systematic review and meta-analysis. PLoS Negl Trop Dis 2014; 8:e3285. [PMID: 25393620 PMCID: PMC4230915 DOI: 10.1371/journal.pntd.0003285] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2014] [Accepted: 09/22/2014] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND The control of neglected tropical diseases (NTDs) has primarily focused on preventive chemotherapy and case management. Less attention has been placed on the role of ensuring access to adequate water, sanitation, and hygiene and personal preventive measures in reducing exposure to infection. Our aim was to assess whether footwear use was associated with a lower risk of selected NTDs. METHODOLOGY We conducted a systematic review and meta-analysis to assess the association between footwear use and infection or disease for those NTDs for which the route of transmission or occurrence may be through the feet. We included Buruli ulcer, cutaneous larva migrans (CLM), leptospirosis, mycetoma, myiasis, podoconiosis, snakebite, tungiasis, and soil-transmitted helminth (STH) infections, particularly hookworm infection and strongyloidiasis. We searched Medline, Embase, Cochrane, Web of Science, CINAHL Plus, and Popline databases, contacted experts, and hand-searched reference lists for eligible studies. The search was conducted in English without language, publication status, or date restrictions up to January 2014. Studies were eligible for inclusion if they reported a measure of the association between footwear use and the risk of each NTD. Publication bias was assessed using funnel plots. Descriptive study characteristics and methodological quality of the included studies were summarized. For each study outcome, both outcome and exposure data were abstracted and crude and adjusted effect estimates presented. Individual and summary odds ratio (OR) estimates and corresponding 95% confidence intervals (CIs) were calculated as a measure of intervention effect, using random effects meta-analyses. PRINCIPAL FINDINGS Among the 427 studies screened, 53 met our inclusion criteria. Footwear use was significantly associated with a lower odds of infection of Buruli ulcer (OR=0.15; 95% CI: 0.08-0.29), CLM (OR=0.24; 95% CI: 0.06-0.96), tungiasis (OR=0.42; 95% CI: 0.26-0.70), hookworm infection (OR=0.48; 95% CI: 0.37-0.61), any STH infection (OR=0.57; 95% CI: 0.39-0.84), strongyloidiasis (OR=0.56; 95% CI: 0.38-0.83), and leptospirosis (OR=0.59; 95% CI: 0.37-0.94). No significant association between footwear use and podoconiosis (OR=0.63; 95% CI: 0.38-1.05) was found and no data were available for mycetoma, myiasis, and snakebite. The main limitations were evidence of heterogeneity and poor study quality inherent to the observational studies included. CONCLUSIONS/SIGNIFICANCE Our results show that footwear use was associated with a lower odds of several different NTDs. Access to footwear should be prioritized alongside existing NTD interventions to ensure a lasting reduction of multiple NTDs and to accelerate their control and elimination. PROTOCOL REGISTRATION PROSPERO International prospective register of systematic reviews CRD42012003338.
Collapse
Affiliation(s)
- Sara Tomczyk
- Institute of Tropical Medicine, Antwerp, Belgium
| | - Kebede Deribe
- Brighton & Sussex Medical School, Brighton, United Kingdom
- School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia
| | - Simon J. Brooker
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Hannah Clark
- Brighton & Sussex Medical School, Brighton, United Kingdom
| | - Khizar Rafique
- Brighton & Sussex Medical School, Brighton, United Kingdom
| | - Stefanie Knopp
- Wolfson Wellcome Biomedical Laboratories, Department of Life Sciences, Natural History Museum, London, United Kingdom
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Jürg Utzinger
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Gail Davey
- Brighton & Sussex Medical School, Brighton, United Kingdom
| |
Collapse
|
28
|
Chehayeb JF, Robertson AP, Martin RJ, Geary TG. Proteomic analysis of adult Ascaris suum fluid compartments and secretory products. PLoS Negl Trop Dis 2014; 8:e2939. [PMID: 24901219 PMCID: PMC4046973 DOI: 10.1371/journal.pntd.0002939] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2013] [Accepted: 04/29/2014] [Indexed: 01/10/2023] Open
Abstract
Background Strategies employed by parasites to establish infections are poorly understood. The host-parasite interface is maintained through a molecular dialog that, among other roles, protects parasites from host immune responses. Parasite excretory/secretory products (ESP) play major roles in this process. Understanding the biology of protein secretion by parasites and their associated functional processes will enhance our understanding of the roles of ESP in host-parasite interactions. Methodology/Principal Findings ESP was collected after culturing 10 adult female Ascaris suum. Perienteric fluid (PE) and uterine fluid (UF) were collected directly from adult females by dissection. Using SDS-PAGE coupled with LC-MS/MS, we identified 175, 308 and 274 proteins in ESP, PE and UF, respectively. Although many proteins were shared among the samples, the protein composition of ESP was distinct from PE and UF, whereas PE and UF were highly similar. The distribution of gene ontology (GO) terms for proteins in ESP, PE and UF supports this claim. Comparison of ESP composition in A. suum, Brugia malayi and Heligmosoides polygyrus showed that proteins found in UF were also secreted by males and by larval stages of other species, suggesting that multiple routes of secretion may be used for homologous proteins. ESP composition of nematodes is both phylogeny- and niche-dependent. Conclusions/Significance Analysis of the protein composition of A. suum ESP and UF leads to the conclusion that the excretory-secretory apparatus and uterus are separate routes for protein release. Proteins detected in ESP have distinct patterns of biological functions compared to those in UF. PE is likely to serve as the source of the majority of proteins in UF. This analysis expands our knowledge of the biology of protein secretion from nematodes and will inform new studies on the function of secreted proteins in the orchestration of host-parasite interactions. Ascaris lumbricoides, the most prevalent metazoan parasite of humans, is a public health concern in resource-limited countries. Survival of this parasite in its host is mediated at least in part by parasite materials secreted into the host. Little is known about the composition of these secretions; defining their contents and functions will illuminate host-parasite interactions that lead to parasite establishment. Ascaris suum, a parasite of pigs, was used as a model organism because its genome has been sequenced and it is very closely related to A. lumbricoides. Excretory/secretory products (ESP), uterine fluid (UF) and perienteric fluid (PE) were collected from adult A. suum. Proteins were subjected to LC-MS/MS. ESP proteins (the ‘secretome’) included many also present in UF. Proteins in ESP but not in UF had considerably different characteristics than those in PE or UF, which were similar to each other. We conclude that proteins released from the secretory apparatus have distinct patterns of biological function and that UF proteins are likely derived from PE. Comparing the protein composition of A. suum ESP to ESP from B. malayi and H. polygyrus suggests that the secretome is conserved at the level of both phylogeny and host predilection site.
Collapse
Affiliation(s)
- James F. Chehayeb
- Institute of Parasitology and Centre for Host-Parasite Interactions, McGill University, Ste-Anne-de-Bellevue, Quebec, Canada
| | - Alan P. Robertson
- Department of Biomedical Sciences, College of Veterinary Medicine, Iowa State University, Ames, Iowa, United States of America
| | - Richard J. Martin
- Department of Biomedical Sciences, College of Veterinary Medicine, Iowa State University, Ames, Iowa, United States of America
| | - Timothy G. Geary
- Institute of Parasitology and Centre for Host-Parasite Interactions, McGill University, Ste-Anne-de-Bellevue, Quebec, Canada
- * E-mail:
| |
Collapse
|
29
|
Enhancing a search for traditional medicinal plants with anthelmintic action by using wild type and stress reporter Caenorhabditis elegans strains as screening tools. Int J Parasitol 2014; 44:291-8. [DOI: 10.1016/j.ijpara.2014.01.008] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2013] [Revised: 12/20/2013] [Accepted: 01/09/2014] [Indexed: 11/23/2022]
|
30
|
Speich B, Ame SM, Ali SM, Alles R, Huwyler J, Hattendorf J, Utzinger J, Albonico M, Keiser J. Oxantel pamoate-albendazole for Trichuris trichiura infection. N Engl J Med 2014; 370:610-20. [PMID: 24521107 DOI: 10.1056/nejmoa1301956] [Citation(s) in RCA: 75] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND Infections with soil-transmitted helminths (Ascaris lumbricoides, hookworm, and Trichuris trichiura) are widespread and often occur concomitantly. These parasitic-worm infections are typically treated with albendazole or mebendazole, but both drugs show low efficacy against T. trichiura. Albendazole is the drug of choice against hookworm. METHODS In this double-blind trial conducted on Pemba Island, Tanzania, we randomly assigned children, 6 to 14 years of age, to receive one of four treatments: oxantel pamoate at a dose of 20 mg per kilogram of body weight, plus 400 mg of albendazole, administered on consecutive days; oxantel pamoate at a single dose of 20 mg per kilogram; albendazole at a single dose of 400 mg; or mebendazole at a single dose of 500 mg. We assessed the efficacy and safety profile of oxantel pamoate-albendazole when used in the treatment of T. trichiura infection (primary outcome) and concomitant soil-transmitted helminth infection (secondary outcome). Efficacy was determined by means of assessment of the cure rate and egg-reduction rate. Adverse events were assessed four times after treatment. RESULTS Complete data were available for 458 children, of whom 450 were infected with T. trichiura, 443 with hookworm, and 293 with A. lumbricoides. The cure rate of T. trichiura infection was significantly higher with oxantel pamoate-albendazole than with mebendazole (31.2% vs. 11.8%, P=0.001), as was the egg-reduction rate (96.0% [95% confidence interval {CI}, 93.5 to 97.6] vs. 75.0% [95% CI, 64.2 to 82.0]). The cure rate with albendazole (2.6%) and the egg-reduction rate with albendazole (45.0%; 95% CI, 32.0 to 56.4) were significantly lower than the rates with mebendazole (P=0.02 for the comparison of cure rates). Oxantel pamoate had low efficacy against hookworm and A. lumbricoides. Adverse events (mainly mild) were reported by 30.9% of all children. CONCLUSIONS Treatment with oxantel pamoate-albendazole resulted in higher cure and egg-reduction rates for T. trichiura infection than the rates with standard therapy. (Funded by the Medicor Foundation and the Swiss National Science Foundation; Current Controlled Trials number, ISRCTN54577342.).
Collapse
Affiliation(s)
- Benjamin Speich
- From the Departments of Medical Parasitology and Infection Biology (B.S., J.K.) and Epidemiology and Public Health (J. Hattendorf, J.U.), Swiss Tropical and Public Health Institute, and the Department of Pharmaceutical Sciences, Division of Pharmaceutical Technology, University of Basel (R.A., J. Huwyler) - all in Basel, Switzerland; the Laboratory Division, Public Health Laboratory-Ivo de Carneri, Chake Chake, Tanzania (S.M. Ame, S.M. Ali); and the Ivo de Carneri Foundation, Milan (M.A.)
| | | | | | | | | | | | | | | | | |
Collapse
|
31
|
Sah RB, Bhattarai S, Yadav S, Baral R, Jha N, Pokharel PK. A study of prevalence of intestinal parasites and associated risk factors among the school children of Itahari, Eastern Region of Nepal. Trop Parasitol 2014; 3:140-4. [PMID: 24470999 PMCID: PMC3889092 DOI: 10.4103/2229-5070.122143] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2013] [Accepted: 11/26/2013] [Indexed: 12/02/2022] Open
Abstract
Introduction: Intestinal parasitic infestation is a major public health problem in children of developing countries Because of poor socio-economic conditions and lack of good hygienic living. The aims of this study were to measure the prevalence of intestinal parasitic infestations and to identify risk factors associated with parasitic infestations among the school children of Itahari Municipality. Materials and Methods: The cross-sectional study was conducted in Grade VI, VII and VIII in Government and private schools of Itahari Municipality. Stratified random sampling method was applied to choose the schools and the study subjects. Semi-structured questionnaire was administered to the study subjects and microscopic examination of stool was done. The Chi-square test was used to measure the association of risk factors and parasitic infestation. Results: Overall intestinal parasitic infestation was found to be 31.5%. Around 13% of the study population was found to be infested with helminthes and 18.5% of the study population was protozoa infected. Not using soap after defecation, not wearing sandals, habit of nail biting and thumb sucking were found to be significantly associated with parasitic infection. Conclusions: The prevalence of intestinal parasitic infestation was found to be high in school children of Itahari. Poor sanitary condition, lack of clean drinking water supply and education is supposed to play an important role in establishing intestinal parasitic infections.
Collapse
Affiliation(s)
- Ram Bilakshan Sah
- Department of School of Public Health and Community Medicine, B.P. Koirala Institute of Health Sciences, Dharan, Nepal
| | - Sailesh Bhattarai
- Department of School of Public Health and Community Medicine, B.P. Koirala Institute of Health Sciences, Dharan, Nepal
| | - Satish Yadav
- Department of Pediatrics, B.P. Koirala Institute of Health Sciences, Dharan, Nepal
| | - Ratna Baral
- Department of Microbiology, B.P. Koirala Institute of Health Sciences, Dharan, Nepal
| | - Nilambar Jha
- Department of School of Public Health and Community Medicine, B.P. Koirala Institute of Health Sciences, Dharan, Nepal
| | - Paras Kumar Pokharel
- Department of School of Public Health and Community Medicine, B.P. Koirala Institute of Health Sciences, Dharan, Nepal
| |
Collapse
|
32
|
Comparative study of the prevalence of intestinal parasites in low socioeconomic areas from South chennai, India. J Parasitol Res 2014; 2014:630968. [PMID: 24587897 PMCID: PMC3918716 DOI: 10.1155/2014/630968] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2013] [Accepted: 11/29/2013] [Indexed: 12/19/2022] Open
Abstract
Intestinal parasites cause one of the most important health problems through their effects in causing undernourishment morbidity and incapacitation due to their behavior particularly in children compared to adults. This study was intended to state the prevalence of intestinal parasites between the slum dwellers of different areas in south Chennai. Among the total of 256 samples collected between the ages of 0-50 yrs, 194 samples were positive. Standard laboratory techniques for parasitological diagnosis were carried out for each sample. Entamoeba coli (23%), Cyclospora sp. (22.2%), Entamoeba histolytica (21.8%), Giardia intestinalis (14.4%), Ascaris lumbricoides (6.2%), Trichuris trichiura (1.1%), and Hymenolepis nana (2.7%) were found in the dwellers of low socioeconomic areas. The data on the prevalence of parasites with respect to sex and age showed that the females harbored more numbers of parasites when compared to males. Further, with respect to age, children and teenagers had surplus parasites compared to old age groups. The percentage of educational status showed a reduction in the number of parasites in the higher education dwellers. These parasites could be prevented by possible grouping of better ecological design and hygiene. Conclusively, the examination of personal hygiene as well as routine medical examination and treatment is strongly recommended in the low socio-economic areas.
Collapse
|
33
|
Liu GH, Zhou DH, Zhao L, Xiong RC, Liang JY, Zhu XQ. The complete mitochondrial genome of Toxascaris leonina: Comparison with other closely related species and phylogenetic implications. INFECTION GENETICS AND EVOLUTION 2013; 21:329-33. [PMID: 24316156 DOI: 10.1016/j.meegid.2013.11.022] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/13/2013] [Revised: 11/11/2013] [Accepted: 11/26/2013] [Indexed: 01/15/2023]
Abstract
Adults of Toxascaris leonina (Nematoda: Ascarididae) live in the gastrointestinal tract of both dogs and cats, and cause significant economic losses and potential public health problem worldwide. Although many studies have given insights into this significant pathogen, to date, the complete mitochondrial (mt) genome sequence is still not available for T. leonina. Here, we sequenced the complete mt genome of T. leonina. This AT-rich (71.53%) mt genome (14,310bp) is circular and consists of 36 genes, including 12 genes for proteins, 2 genes for rRNA and 22 genes for tRNA. All mt genes of T. leonina are transcribed in the same direction. The gene order is the same as those of Ascaris spp. (Ascarididae), Toxocara spp. (Toxocaridae), Anisakis simplex and Contracaecum rudolphii B (Anisakidae), but distinct from that of Ascaridia spp. (Ascaridiidae). Phylogenetic analyses using concatenated amino acid sequences of 12 protein-coding genes by Bayesian inference (BI) showed distinct groups with high statistical support, and our data confirm that T. leonina is a member of the Ascarididae, and that this family is more closely related to the Toxocaridae rather than the Anisakidae within the Ascaridoidea. The determination of mt genome sequences of T. leonina provides novel genetic markers for studies into the systematics, population genetics and epidemiology of this parasite.
Collapse
Affiliation(s)
- Guo-Hua Liu
- State Key Laboratory of Veterinary Etiological Biology, Key Laboratory of Veterinary Parasitology of Gansu Province, Lanzhou Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Lanzhou, Gansu Province 730046, PR China; College of Veterinary Medicine, Hunan Agricultural University, Changsha, Hunan Province 410128, PR China
| | - Dong-Hui Zhou
- State Key Laboratory of Veterinary Etiological Biology, Key Laboratory of Veterinary Parasitology of Gansu Province, Lanzhou Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Lanzhou, Gansu Province 730046, PR China.
| | - Lei Zhao
- State Key Laboratory of Veterinary Etiological Biology, Key Laboratory of Veterinary Parasitology of Gansu Province, Lanzhou Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Lanzhou, Gansu Province 730046, PR China; College of Animal Science and Technology, Jilin Agriculture University, Changchun 130118, PR China
| | - Rong-Chuan Xiong
- Chengdu Institute of Biology, Chinese Academy of Sciences, Chengdu 610041, PR China
| | - Jian-Ying Liang
- State Key Laboratory of Veterinary Etiological Biology, Key Laboratory of Veterinary Parasitology of Gansu Province, Lanzhou Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Lanzhou, Gansu Province 730046, PR China; College of Veterinary Medicine, South China Agricultural University, Guangzhou, Guangdong Province 510642, PR China
| | - Xing-Quan Zhu
- State Key Laboratory of Veterinary Etiological Biology, Key Laboratory of Veterinary Parasitology of Gansu Province, Lanzhou Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Lanzhou, Gansu Province 730046, PR China; College of Veterinary Medicine, Hunan Agricultural University, Changsha, Hunan Province 410128, PR China; College of Animal Science and Technology, Jilin Agriculture University, Changchun 130118, PR China.
| |
Collapse
|
34
|
Santos FLN, Souza AMGCD, Soares NM. HOOKWORM AND THREADWORM INFECTIONS AND THEIR ASSOCIATION WITH HEMOGLOBIN AND EOSINOPHIL CONCENTRATIONS IN RESIDENTS OF SALVADOR-BAHIA, BRAZIL. Rev Inst Med Trop Sao Paulo 2013. [DOI: 10.1590/s0036-46652013000400003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
SUMMARY Parasitic infections are responsible for substantial mortality and morbidity worldwide. In most healthy individuals, little overt pathology is observed during infection with S. stercoralis. However, the symptoms in advanced cases may include gastrointestinal bleeding. Anemia is most commonly associated with hookworm infection, especially when several hundred worms are present. Our study evaluates the relationship between the hookworm or S. stercoralis infection status and the hemoglobin concentration of individuals examined by a private network of laboratories in Salvador, Bahia, Brazil. We examined 374,120 samples from middle-class individuals living in Salvador City from January 2004 to April 2008. The stool samples were analyzed by the Lutz and Baermann-Moraes methods, and the blood samples were analyzed for hemoglobin concentration and eosinophil counting. The prevalence of hookworm and S. stercoralis were 0.27% (1,027) and 0.34% (1,286), respectively. The prevalence of hookworm and S. stercoralis infection was significantly higher in males than in females and increased with age. Eosinophilia was a common laboratorial finding in individuals infected with hookworm and S. stercoralis. The hemoglobin concentration was lower in the hookworm-infected individuals than in non-infected ones, but none of the examined patients were anemic. Lack of anemia could be a consequence of the socioeconomic status of these patients.
Collapse
|
35
|
Salikov RF, Platonov DN, Frumkin AE, Lipilin DL, Tomilov YV. Synthesis of 2,3-dihydro-1H-pyrrolo[1,2-a]benzimidazoles via the cyclopropyliminium rearrangement of substituted 2-cyclopropylbenzimidazoles. Tetrahedron 2013. [DOI: 10.1016/j.tet.2013.02.021] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
36
|
Schön T, Lerm M, Stendahl O. Shortening the 'short-course' therapy- insights into host immunity may contribute to new treatment strategies for tuberculosis. J Intern Med 2013; 273:368-82. [PMID: 23331325 DOI: 10.1111/joim.12031] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Achieving global control of tuberculosis (TB) is a great challenge considering the current increase in multidrug resistance and mortality rate. Considerable efforts are therefore being made to develop new effective vaccines, more effective and rapid diagnostic tools as well as new drugs. Shortening the duration of TB treatment with revised regimens and modes of delivery of existing drugs, as well as development of new antimicrobial agents and optimization of the host response with adjuvant immunotherapy could have a profound impact on TB cure rates. Recent data show that chronic worm infection and deficiencies in micronutrients such as vitamin D and arginine are potential areas of intervention to optimize host immunity. Nutritional supplementation to enhance nitric oxide production and vitamin D-mediated effector functions as well as the treatment of worm infection to reduce immunosuppressive effects of regulatory T (Treg) lymphocytes may be more suitable and accessible strategies for highly endemic areas than adjuvant cytokine therapy. In this review, we focus mainly on immune control of human TB, and discuss how current treatment strategies, including immunotherapy and nutritional supplementation, could be optimized to enhance the host response leading to more effective treatment.
Collapse
Affiliation(s)
- T Schön
- Department of Infectious Diseases, Kalmar County Hospital, Kalmar, Sweden
| | | | | |
Collapse
|
37
|
Ngui R, Lim YAL, Chua KH. Rapid detection and identification of human hookworm infections through high resolution melting (HRM) analysis. PLoS One 2012; 7:e41996. [PMID: 22844538 PMCID: PMC3406038 DOI: 10.1371/journal.pone.0041996] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2012] [Accepted: 06/28/2012] [Indexed: 02/07/2023] Open
Abstract
Background Hookworm infections are still endemic in low and middle income tropical countries with greater impact on the socioeconomic and public health of the bottom billion of the world's poorest people. In this study, a real-time polymerase chain reaction (PCR) coupled with high resolution melting-curve (HRM) analysis was evaluated for an accurate, rapid and sensitive tool for species identification focusing on the five human hookworm species. Methods Real-time PCR coupled with HRM analysis targeting the second internal transcribed spacer (ITS-2) of nuclear ribosomal DNA as the genetic marker was used to identify and distinguish hookworm species in human samples. Unique and distinct characteristics of HRM patterns were produced for each of the five hookworm species. The melting curves were characterized by peaks of 79.24±0.05°C and 83.00±0.04°C for Necator americanus, 79.12±0.10°C for Ancylostoma duodenale, 79.40±0.10°C for Ancylostoma ceylanicum, 79.63±0.05°C for Ancylostoma caninum and 79.70±0.14°C for Ancylostoma braziliense. An evaluation of the method's sensitivity and specificity revealed that this assay was able to detect as low as 0.01 ng/µl hookworm DNA and amplification was only recorded for hookworm positive samples. Conclusion The HRM assay developed in this study is a rapid and straightforward method for the diagnosis, identification and discrimination of five human hookworms. This assay is simple compared to other probe-based genotyping methods as it does not require multiplexing, DNA sequencing or post-PCR processing. Therefore, this method offers a new alternative for rapid detection of human hookworm species.
Collapse
Affiliation(s)
- Romano Ngui
- Department of Parasitology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Yvonne A. L. Lim
- Department of Parasitology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Kek Heng Chua
- Department of Molecular Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
- * E-mail:
| |
Collapse
|
38
|
Ngui R, Ching LS, Kai TT, Roslan MA, Lim YAL. Molecular identification of human hookworm infections in economically disadvantaged communities in Peninsular Malaysia. Am J Trop Med Hyg 2012; 86:837-42. [PMID: 22556084 DOI: 10.4269/ajtmh.2012.11-0446] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Species identification of human hookworm infections among eight communities in rural areas of Peninsular Malaysia was determined during 2009-2011. Fecal samples were examined by microscopy and subsequently, the internal transcribed spacer 2 and 28S ribosomal RNA region of Necator americanus and Ancylostoma spp. were sequenced. Overall, 9.1% (58 of 634) were identified positive by microscopy for hookworm infection, and 47 (81.0%) of 58 were successfully amplified and sequenced. Sequence comparison found that N. americanus (87.2%) was the most predominant hookworm identified, followed by Ancylostoma ceylanicum (23.4%). No A. duodenale infection was detected in this study. Detection of A. ceylanicum in humans highlighted the zoonotic transmission among humans living near dogs. Thus, implementation of effective control measures for hookworm infections in future should seriously consider this zoonotic implication.
Collapse
Affiliation(s)
- Romano Ngui
- Department of Parasitology, Faculty of Medicine, University of Malaya, Kuala Lumpur Malaysia.
| | | | | | | | | |
Collapse
|
39
|
Speich B, Ame SM, Ali SM, Alles R, Hattendorf J, Utzinger J, Albonico M, Keiser J. Efficacy and safety of nitazoxanide, albendazole, and nitazoxanide-albendazole against Trichuris trichiura infection: a randomized controlled trial. PLoS Negl Trop Dis 2012; 6:e1685. [PMID: 22679525 PMCID: PMC3367984 DOI: 10.1371/journal.pntd.0001685] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2012] [Accepted: 04/27/2012] [Indexed: 12/02/2022] Open
Abstract
Background The currently used anthelmintic drugs, in single oral application, have low efficacy against Trichuris trichiura infection, and hence novel anthelmintic drugs are needed. Nitazoxanide has been suggested as potential drug candidate. Methodology The efficacy and safety of a single oral dose of nitazoxanide (1,000 mg), or albendazole (400 mg), and a nitazoxanide-albendazole combination (1,000 mg–400 mg), with each drug administered separately on two consecutive days, were assessed in a double-blind, randomized, placebo-controlled trial in two schools on Pemba, Tanzania. Cure and egg reduction rates were calculated by per-protocol analysis and by available case analysis. Adverse events were assessed and graded before treatment and four times after treatment. Principal Findings Complete data for the per-protocol analysis were available from 533 T. trichiura-positive children. Cure rates against T. trichiura were low regardless of the treatment (nitazoxanide-albendazole, 16.0%; albendazole, 14.5%; and nitazoxanide, 6.6%). Egg reduction rates were 54.9% for the nitazoxanide-albendazole combination, 45.6% for single albendazole, and 13.4% for single nitazoxanide. Similar cure and egg reduction rates were calculated using the available case analysis. Children receiving nitazoxanide had significantly more adverse events compared to placebo recipients. Most of the adverse events were mild and had resolved within 24 hours posttreatment. Conclusions/Significance Nitazoxanide shows no effect on T. trichiura infection. The low efficacy of albendazole against T. trichiura in the current setting characterized by high anthelmintic drug pressure is confirmed. There is a pressing need to develop new anthelmintics against trichuriasis. Trial Registration Controlled-Trials.com ISRCTN08336605 More than 5 billion people are at risk of infection with one of the three most common intestinal worms, the roundworm Ascaris lumbricoides, the whipworm Trichuris trichiura, and two different kinds of hookworms. The global strategy to control these intestinal worm infections is through the regular administration of deworming drugs to school-aged children (albendazole, 400 mg; mebendazole, 500 mg). However, especially against T. trichiura, a low treatment response is observed with single doses of both drugs. We tested the antiprotozoal drug nitazoxanide, which had shown promising trichuricidal properties in in vitro experiments. A randomized controlled trial was carried out on the island of Pemba in Tanzania. Four treatment arms were included: (i) single albendazole (400 mg), (ii) single nitazoxanide (1,000 mg), (iii) nitazoxanide-albendazole combination (1,000 mg–400 mg) with each drug given separately on two consecutive days, and (iv) placebo. Children were asked for adverse events at several time points after treatment. Nitazoxanide showed no ability to cure T. trichiura-infected children and caused significantly more mild adverse events than placebo. Albendazole and the nitazoxanide-albendazole combination showed only a minimal effect against T. trichiura. Our results emphasize the urgent need to develop new, safe, and effective anthelmintic drugs against T. trichiura.
Collapse
Affiliation(s)
- Benjamin Speich
- Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Shaali M. Ame
- Public Health Laboratory (Pemba) - Ivo de Carneri, Chake Chake, Tanzania
| | - Said M. Ali
- Public Health Laboratory (Pemba) - Ivo de Carneri, Chake Chake, Tanzania
| | - Rainer Alles
- Division of Pharmaceutical Technology, Department of Pharmaceutical Sciences, University of Basel, Basel, Switzerland
| | - Jan Hattendorf
- University of Basel, Basel, Switzerland
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
| | - Jürg Utzinger
- University of Basel, Basel, Switzerland
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
| | | | - Jennifer Keiser
- Department of Medical Parasitology and Infection Biology, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
- * E-mail:
| |
Collapse
|
40
|
Characterization of genes with a putative key role in the parasitic lifestyle of the nematode Strongyloides ratti. Parasitology 2012; 139:1317-28. [DOI: 10.1017/s0031182012000637] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
SUMMARYParasitic nematodes are significant pathogens of humans and other animals. The molecular and genetic basis of animal parasitism is not yet fully understood. Strongyloides spp. are a genus of gastrointestinal nematodes of which species infect approximately 100–200 million people worldwide. S. ratti is a natural parasite of the rat, and a useful and amenable laboratory model. Previous EST and microarray analyses of the S. ratti life cycle have identified genes whose expression was specific, or biased, to the parasitic adult stage, suggesting that they may play a key role in parasitism in this species. Here we have further investigated the expression of these genes (by RT-PCR) throughout the S. ratti life-cycle. We produced recombinant proteins in vitro for a subset of these genes, which were used in Western blot analyses to investigate the distribution of the gene products among different stages of the S. ratti life cycle. We tested the efficacy of these recombinant proteins as anti-S. ratti vaccines. One of the proteins was detected in the excretory/secretory products of the parasitic stages.
Collapse
|
41
|
Ngui R, Lim YAL, Traub R, Mahmud R, Mistam MS. Epidemiological and genetic data supporting the transmission of Ancylostoma ceylanicum among human and domestic animals. PLoS Negl Trop Dis 2012; 6:e1522. [PMID: 22347515 PMCID: PMC3274503 DOI: 10.1371/journal.pntd.0001522] [Citation(s) in RCA: 105] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2011] [Accepted: 12/23/2011] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Currently, information on species-specific hookworm infection is unavailable in Malaysia and is restricted worldwide due to limited application of molecular diagnostic tools. Given the importance of accurate identification of hookworms, this study was conducted as part of an ongoing molecular epidemiological investigation aimed at providing the first documented data on species-specific hookworm infection, associated risk factors and the role of domestic animals as reservoirs for hookworm infections in endemic communities of Malaysia. METHODS/FINDINGS A total of 634 human and 105 domestic canine and feline fecal samples were randomly collected. The overall prevalence of hookworm in humans and animals determined via microscopy was 9.1% (95% CI = 7.0-11.7%) and 61.9% (95% CI = 51.2-71.2%), respectively. Multivariate analysis indicated that participants without the provision of proper latrine systems (OR = 3.5; 95% CI = 1.53-8.00; p = 0.003), walking barefooted (OR = 5.6; 95% CI = 2.91-10.73; p<0.001) and in close contact with pets or livestock (OR = 2.9; 95% CI = 1.19-7.15; p = 0.009) were more likely to be infected with hookworms. Molecular analysis revealed that while most hookworm-positive individuals were infected with Necator americanus, Ancylostoma ceylanicum constituted 12.8% of single infections and 10.6% mixed infections with N. americanus. As for cats and dogs, 52.0% were positive for A. ceylanicum, 46.0% for Ancylostoma caninum and 2.0% for Ancylostoma braziliense and all were single infections. CONCLUSION This present study provided evidence based on the combination of epidemiological, conventional diagnostic and molecular tools that A. ceylanicum infection is common and that its transmission dynamic in endemic areas in Malaysia is heightened by the close contact of human and domestic animal (i.e., dogs and cats) populations.
Collapse
Affiliation(s)
- Romano Ngui
- Department of Parasitology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Yvonne A. L. Lim
- Department of Parasitology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Rebecca Traub
- School of Veterinary Science, The University of Queensland, Gatton, Queensland, Australia
| | - Rohela Mahmud
- Department of Parasitology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Mohd Sani Mistam
- Department of Orang Asli Development, Ministry of Rural and Regional Development, Kuala Lumpur, Malaysia
| |
Collapse
|
42
|
Abstract
Parasites and parasitism is common. Worm macroparasites have evolved life-history traits that allow them to successfully transmit between spatially and temporally separated patches of host resource and to survive within these environments. Macroparasites have common life-history strategies to achieve this, but these general themes are modified in a myriad of ways related to the specific biology of their hosts. Parasite life histories are also dynamic, responding to conditions inside and outside of hosts, and they continue to evolve, especially in response to our attempts to control them and the harm that they cause.
Collapse
Affiliation(s)
- Mark Viney
- School of Biological Sciences, University of Bristol, Bristol, BS8 1UG, UK.
| | | |
Collapse
|
43
|
Bhutia KL, Dey S, Singh V, Gupta A. Ascaris lumbricoides causing infarction of the mesenteric lymph nodes and intestinal gangrene in a child: a case report. GERMAN MEDICAL SCIENCE : GMS E-JOURNAL 2011; 9:Doc12. [PMID: 21698086 PMCID: PMC3118692 DOI: 10.3205/000135] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/13/2010] [Revised: 03/25/2011] [Indexed: 11/30/2022]
Abstract
Ascaris lumbricoides or round worm infestation is quite common in the developing world. It affects all age groups but is more common in children. Most of the cases remain asymptomatic. The usual presentation is an intestinal obstruction. The physicians should be aware of this condition and consider it in the differential diagnosis when faced with such a case. The rare fatal complications include bleeding, perforation and gangrene.
Collapse
Affiliation(s)
- Kincho Lhasong Bhutia
- Department of General Surgery, Sikkim Manipal Institute of Medical Sciences, Sikkim Manipal University, Sikkim, India.
| | | | | | | |
Collapse
|
44
|
CRUMP A, ŌMURA S. Ivermectin, 'wonder drug' from Japan: the human use perspective. PROCEEDINGS OF THE JAPAN ACADEMY. SERIES B, PHYSICAL AND BIOLOGICAL SCIENCES 2011; 87:13-28. [PMID: 21321478 PMCID: PMC3043740 DOI: 10.2183/pjab.87.13] [Citation(s) in RCA: 186] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
Discovered in the late-1970s, the pioneering drug ivermectin, a dihydro derivative of avermectin--originating solely from a single microorganism isolated at the Kitasato Institute, Tokyo, Japan from Japanese soil--has had an immeasurably beneficial impact in improving the lives and welfare of billions of people throughout the world. Originally introduced as a veterinary drug, it kills a wide range of internal and external parasites in commercial livestock and companion animals. It was quickly discovered to be ideal in combating two of the world's most devastating and disfiguring diseases which have plagued the world's poor throughout the tropics for centuries. It is now being used free-of-charge as the sole tool in campaigns to eliminate both diseases globally. It has also been used to successfully overcome several other human diseases and new uses for it are continually being found. This paper looks in depth at the events surrounding ivermectin's passage from being a huge success in Animal Health into its widespread use in humans, a development which has led many to describe it as a "wonder" drug.
Collapse
Affiliation(s)
| | - Satoshi ŌMURA
- The Kitasato Institute, Tokyo, Japan
- Correspondence should be addressed to S. Ōmura, The Kitasato Institute, 5-9-1 Shirokane, Minato-ku, Tokyo 108-8642, Japan (e-mail: )
| |
Collapse
|
45
|
Abstract
INTRODUCTION The neglected tropical diseases (NTDs) are infectious diseases that principally impact the world's poorest people. They have been neglected for decades, initially as part of a general disregard for the developing world, and more recently due to the intensity of focus on HIV/AIDS, tuberculosis and malaria. SOURCES OF DATA Primary research and review articles were selected for inclusion using searches of PubMed and our existing collections. RESULTS There have been recent notable successes in NTD control. Dracunculiasis is approaching eradication. Leprosy and onchocerciasis are in decline. There are ambitious plans to eliminate trachoma and lymphatic filariasis. Investment in NTD control has high rates of economic return. CONCLUSION Although there are proven strategies to control several NTDs, these diseases continue to cause a massive burden of morbidity. There is urgent need for more basic and operational research, drug and vaccine development, and greater prioritization by governments and international agencies.
Collapse
Affiliation(s)
- Nick Feasey
- Department of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, Keppel St., London, UK
| | | | | | | |
Collapse
|
46
|
Stothard JR, French MD, Khamis IS, Basáñez MG, Rollinson D. The epidemiology and control of urinary schistosomiasis and soil-transmitted helminthiasis in schoolchildren on Unguja Island, Zanzibar. Trans R Soc Trop Med Hyg 2009; 103:1031-44. [DOI: 10.1016/j.trstmh.2009.03.024] [Citation(s) in RCA: 69] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2008] [Revised: 03/11/2009] [Accepted: 03/11/2009] [Indexed: 11/26/2022] Open
|
47
|
Galimberti R, Pontón A, Zaputovich FA, Velasquez L, Galimberti G, Torre A, Kowalczuk A. Disseminated strongyloidiasis in immunocompromised patients - report of three cases. Int J Dermatol 2009; 48:975-8. [DOI: 10.1111/j.1365-4632.2009.04082.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
48
|
Fenwick A. Host-parasite relations and implications for control. ADVANCES IN PARASITOLOGY 2009; 68:247-61. [PMID: 19289197 DOI: 10.1016/s0065-308x(08)00610-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
This paper considers the various measures available to control several of the neglected tropical diseases (NTDs). To develop the optimum methods for controlling the parasites that cause these NTDs, knowledge of the life cycles of both the parasites and their vectors are essential. Each NTD requires its own strategy for control based on detailed knowledge of the life cycle, and vector control, chemotherapy, better water supplies and better hygiene are all components that may be appropriate. For some diseases, improved drugs are urgently required, for some the tools are available for elimination, while uniquely guinea worm could be eradicated without any chemotherapeutic drug being used. Several NTDs lend themselves to mass drug administration (MDA) in which human populations are annually offered safe, effective and usually donated drugs with a view to morbidity control and/or elimination. The drugs could and should be used to improve the quality of millions of lives, prevent suffering, stigma, disfigurement and early death. The role of pharmaceutical companies who have donated their drugs for the treatment of millions of disadvantaged people in the developing world is acknowledged. One result of such drug pressure however is that evolutionary change may result, and it is incumbent on scientists during monitoring and evaluation of control programmes to ensure that such changes are recognised. One other unfortunate development is that a paucity of newly trained vector-borne disease experts may constrain future control efforts.
Collapse
Affiliation(s)
- Alan Fenwick
- Department of Infectious Disease Epidemiology, Faculty of Medicine, St Mary's Campus Imperial College, Paddington, United Kingdom
| |
Collapse
|
49
|
Fujiwara RT, Cançado GGL, Freitas PA, Santiago HC, Massara CL, Carvalho ODS, Corrêa-Oliveira R, Geiger SM, Bethony J. Necator americanus infection: a possible cause of altered dendritic cell differentiation and eosinophil profile in chronically infected individuals. PLoS Negl Trop Dis 2009; 3:e399. [PMID: 19308259 PMCID: PMC2654967 DOI: 10.1371/journal.pntd.0000399] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2008] [Accepted: 02/26/2009] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Hookworms survive for several years (5 to 7 years) in the host lumen, inducing a robust but largely ineffective immune response. Among the most striking aspects of the immune response to hookworm (as with many other helminths) is the ablation of parasite-specific T cell proliferative response (hyporesponsiveness). While the role of the adaptive immune response in human helminth infection has been well investigated, the role of the innate immune responses (e.g., dendritic cells and eosinophils) has received less attention and remains to be clearly elucidated. METHODOLOGY/PRINCIPAL FINDINGS We report on the differentiation/maturation of host dendritic cells in vitro and the eosinophil activation/function associated with human hookworm infection. Mature DCs (mDCs) from Necator americanus (Necator)-infected individuals showed an impaired differentiation process compared to the mDCs of non-infected individuals, as evidenced by the differential expression of CD11c and CD14. These same hookworm-infected individuals also presented significantly down-regulated expression of CD86, CD1a, HLA-ABC, and HLA-DR. The lower expression of co-stimulatory and antigen presentation molecules by hookworm-infected-derived mDCs was further evidenced by their reduced ability to induce cell proliferation. We also showed that this alternative DC differentiation is partially induced by excreted-secreted hookworm products. Conversely, eosinophils from the same individuals showed a highly activated status, with an upregulation of major cell surface markers. Antigen-pulsed eosinophils from N. americanus-infected individuals induced significant cell proliferation of autologous PBMCs, when compared to non-infected individuals. CONCLUSION Chronic N. americanus infection alters the host's innate immune response, resulting in a possible modulation of the maturation process of DCs, a functional change that may diminish their ability for antigen presentation and thus contribute to the ablation of the parasite-specific T cell proliferative response. Interestingly, a concomitant upregulation of the major cell surface markers of eosinophils was observed in hookworm-infected individuals, indicative of antigen-specific immune responses, especially antigen presentation. We showed that in addition to the postulated role of the eosinophils as effector cells against helminth infection, activated cells may also be recruited to sites of inflammation and contribute to the immune response acting as antigen presenting cells.
Collapse
Affiliation(s)
- Ricardo T. Fujiwara
- Laboratory of Cellular and Molecular Immunology, Instituto René Rachou, Oswaldo Cruz Foundation, Belo Horizonte, Minas Gerais, Brazil
- Department of Microbiology, Immunology and Tropical Medicine, The George Washington University, Washington, D.C., United States of America
- Department of Parasitology, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Guilherme G. L. Cançado
- Laboratory of Cellular and Molecular Immunology, Instituto René Rachou, Oswaldo Cruz Foundation, Belo Horizonte, Minas Gerais, Brazil
| | - Paula A. Freitas
- Laboratory of Cellular and Molecular Immunology, Instituto René Rachou, Oswaldo Cruz Foundation, Belo Horizonte, Minas Gerais, Brazil
| | - Helton C. Santiago
- Department of Microbiology, Immunology and Tropical Medicine, The George Washington University, Washington, D.C., United States of America
| | - Cristiano Lara Massara
- Laboratory of Helminthology and Medical Malacology, Instituto René Rachou, Oswaldo Cruz Foundation, Belo Horizonte, Minas Gerais, Brazil
| | - Omar dos Santos Carvalho
- Laboratory of Helminthology and Medical Malacology, Instituto René Rachou, Oswaldo Cruz Foundation, Belo Horizonte, Minas Gerais, Brazil
| | - Rodrigo Corrêa-Oliveira
- Laboratory of Cellular and Molecular Immunology, Instituto René Rachou, Oswaldo Cruz Foundation, Belo Horizonte, Minas Gerais, Brazil
| | - Stefan M. Geiger
- Laboratory of Cellular and Molecular Immunology, Instituto René Rachou, Oswaldo Cruz Foundation, Belo Horizonte, Minas Gerais, Brazil
| | - Jeffrey Bethony
- Department of Microbiology, Immunology and Tropical Medicine, The George Washington University, Washington, D.C., United States of America
| |
Collapse
|
50
|
Fatal Outcome of Disseminated Strongyloidiasis despite Detectable Plasma and Cerebrospinal Levels of Orally Administered Ivermectin. J Parasitol Res 2009; 2009. [PMID: 20798874 PMCID: PMC2925211 DOI: 10.1155/2009/818296] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2008] [Accepted: 02/06/2009] [Indexed: 12/22/2022] Open
Abstract
Strongyloides stercoralis affects over 100 million people worldwide. Those people most susceptible to infection are those with an immunocompromising condition, such as cancer or human immunodeficiency virus (HIV). Local disease may spread throughout the body of the host, causing a condition termed disseminated strongyloidiasis. Standard treatment for Strongyloides stercoralis infection is oral ivermectin. We describe a patient with chronic lymphocytic leukemia diagnosed with disseminated strongyloidiasis two weeks after initial presentation. After repeated dosing of oral ivermectin with no clinical response, serum and cerebral spinal fluid (CSF) concentrations of ivermectin were measured to assess absorption. The peak serum concentration of 49.3 ng/mL correlated with a CSF concentration of 0.14 ng/mL. Despite these concentrations, the patient eventually succumbed to multi-system organ failure. We discuss the reasons for treatment failure and explore the utility of measuring ivermectin concentrations.
Collapse
|