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Ngobeni R, Gilchrist C, Samie A. Prevalence and Distribution of Cryptosporidium spp. and Giardia lamblia in Rural and Urban Communities of South Africa. Turkiye Parazitol Derg 2022; 46:14-19. [PMID: 35232700 DOI: 10.4274/tpd.galenos.2021.37039] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
OBJECTIVE Enteric diseases remain a serious health problem globally. High prevalence is evident in regions with poor socioeconomic conditions, poor sanitation, and inadequate clean water supply, such as South Africa. Designing an effective strategy, however, requires local knowledge, which can be particularly challenging to acquire in low-and middle-income countries. As the first step in this process, we investigated the prevalence and distribution of protozoan parasites Cryptosporidium and Giardia in the rural and urban gastrointestinal clinics of South Africa. METHODS A cross-sectional study was conducted to assess the prevalence of enteric parasites Cryptosporidium and G. lamblia in rural and urban communities of South Africa. Stool samples were collected from November 2013 to June 2015 from patients with diarrhea (n=227) and without diarrhea (n=257). DNA was extracted and a diagnostic Taqman qPCR assay was performed to detect these protozoan parasites, which was further confirmed by the Sanger sequencing of a few samples. RESULTS Of the 484 stool specimens collected, 34% (166/484) were positive for either Cryptosporidium spp. or Giardia lamblia parasites, with only 5% containing both parasites (22/484). In both study populations, Cryptosporidium was the most prevalent parasite (overall 25%) followed by Giardia (19%). CONCLUSION This study discovered that both Giardia and Cryptosporidium parasites might contribute to diarrheal disease in South Africa and are more prevalent in rural communities. Future studies are needed to identify the source of the infection and design appropriate interventions to reduce the burden of the disease. AMAÇ Enterik hastalıklar küresel olarak ciddi bir sağlık sorunu olmaya devam etmektedir. Güney Afrika gibi düşük sosyo-ekonomik koşulların, kötü sanitasyonun ve yetersiz temiz su kaynaklarının olduğu bölgelerde yüksek prevalans görülmektedir. Ancak etkili bir strateji tasarlamak için, düşük ve orta gelirli ülkelerde edinilmesi özellikle zor olabilecek yerel bir bilgi gerektirmektedir. Bu süreçte biz ilk adım olarak, Güney Afrika’nın kırsal ve kentsel gastrointestinal kliniklerinde protozoan parazitler Cryptosporidium ve Giardia’nın prevalansını ve dağılımını araştırdık. YÖNTEMLER Güney Afrika’nın kırsal ve kentsel topluluklarında Cryptosporidium ve G. lamblia enterik parazitlerinin sıklığını araştırmak için kesitsel bir çalışma yapıldı. İshali olan (n=227) ve olmayan (n=257) hastaların Kasım 2013-Haziran 2015 tarihleri arasında dışkı örnekleri toplandı. DNA ekstrakte edildi ve bu protozoan parazitleri saptamak için tanısal bir Taqman qPCR tahlili kullanılarak, birkaç örnek Sanger dizilimi ile daha da doğrulandı. BULGULAR Toplanan 484 dışkı örneğinin %34’ü (166/484) Cryptosporidium spp. veya Giardia lamblia parazitleri için pozitifti ve örneklerin sadece %5’i her iki paraziti de içeriyordu (22/484). Her iki çalışma popülasyonunda da Cryptosporidium en yaygın parazitti (toplam %25) ve bunu Giardia (%19) izledi. SONUÇ Bu çalışma, hem Giardia hem de Cryptosporidium parazitlerinin Güney Afrika’daki ishal hastalığına katkıda bulunabileceğini ve kırsal topluluklarda daha yaygın olduğunu göstermiştir. Hem enfeksiyonun kaynağını belirlemek hem de hastalığın yükünü azaltmak için uygun müdahaleleri tasarlamak için gelecekteki çalışmalara ihtiyaç vardır.
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Affiliation(s)
- Renay Ngobeni
- Applied Microbial and Health Biotechnology Institute, Cape Peninsula University of Technology, Bellville, South Africa
| | | | - Amidou Samie
- Department of Microbiology, University of Venda, Private Bag, Limpopo, South Africa
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Messa A, Köster PC, Garrine M, Gilchrist C, Bartelt LA, Nhampossa T, Massora S, Kotloff K, Levine MM, Alonso PL, Carmena D, Mandomando I. Molecular diversity of Giardia duodenalis in children under 5 years from the Manhiça district, Southern Mozambique enrolled in a matched case-control study on the aetiology of diarrhoea. PLoS Negl Trop Dis 2021; 15:e0008987. [PMID: 33465074 PMCID: PMC7846004 DOI: 10.1371/journal.pntd.0008987] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Revised: 01/29/2021] [Accepted: 11/18/2020] [Indexed: 12/23/2022] Open
Abstract
Giardia duodenalis is an enteric parasite commonly detected in children. Exposure to this organism may lead to asymptomatic or symptomatic infection. Additionally, early-life infections by this protozoan have been associated with impaired growth and cognitive function in poor resource settings. The Global Enteric Multicenter Study (GEMS) in Mozambique demonstrated that G. duodenalis was more frequent among controls than in diarrhoeal cases (≥3 loosing stools in the previous 24 hours). However, no molecular investigation was conducted to ascertain the molecular variability of the parasite. Therefore, we describe here the frequency and genetic diversity of G. duodenalis infections in children younger than five years of age with and without diarrhoea from the Manhiça district in southern Mozambique enrolled in the context of GEMS. Genomic DNA from 757 G. duodenalis-positive stool samples by immunoassay collected between 2007-2012, were reanalysed by multiplex PCR targeting the E1-HP and C1-P21 genes for the differentiation of assemblages A and B. Overall, 47% (353) of the samples were successfully amplified in at least one locus. Assemblage B accounted for 90% (319/353) of all positives, followed by assemblage A (8%, 29/353) and mixed A+B infections (1%, 5/353). No association between the presence of a given assemblage and the occurrence of diarrhoea could be demonstrated. A total of 351 samples were further analysed by a multi-locus sequence genotyping (MLSG) approach at the glutamate dehydrogenase (gdh), ß-giardin (bg) and triose phosphate isomerase (tpi) genes. Overall, 63% (222/351) of samples were genotyped and/or sub-genotyped in at least one of the three markers. Sequence analysis revealed the presence of assemblages A (10%; 23/222) and B (90%; 199/222) with high molecular diversity at the nucleotide level within the latter; no mixed infections were identified under the MLSG scheme. Assemblage A sequences were assigned to sub-assemblages AI (0.5%, 1/222), AII (7%, 15/222) or ambiguous AII/AIII (3%, 7/222). Within assemblage B, sequences were assigned to sub-assemblages BIII (13%, 28/222), BIV (14%, 31/222) and ambiguous BIII/BIV (59%, 132/222). BIII/BIV sequences accumulated the majority of the single nucleotide polymorphisms detected, particularly in the form of double peaks at chromatogram inspection. This study demonstrated that the occurrence of gastrointestinal illness (diarrhoea) was not associated to a given genotype of G. duodenalis in Mozambican children younger than five years of age. The assemblage B of the parasite was responsible for nine out of ten infections detected in this paediatric population. The extremely high genetic diversity observed within assemblage B isolates was compatible with an hyperendemic epidemiological scenario where infections and reinfections were common. The obtained molecular data may be indicative of high coinfection rates by different G. duodenalis assemblages/sub-assemblages and/or genetic recombination events, although the exact contribution of both mechanisms to the genetic diversity of the parasite remains unknown.
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Affiliation(s)
- Augusto Messa
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique
| | - Pamela C. Köster
- Parasitology Reference and Research Laboratory, National Centre for Microbiology, Health Institute Carlos III, Majadahonda, Madrid, Spain
| | - Marcelino Garrine
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique
- Global Health and Tropical Medicine (GHTM), Instituto de Higiene e Medicina Tropical (IHMT), Universidade Nova de Lisboa (UNL), Lisbon, Portugal
| | - Carol Gilchrist
- University of Virginia, Charlottesville, Virginia, United States of America
| | - Luther A. Bartelt
- Division of Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Tacilta Nhampossa
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique
- Instituto Nacional de Saúde (INS), Ministério da Saúde, Maputo, Mozambique
| | - Sérgio Massora
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique
| | - Karen Kotloff
- Center for Vaccine Development (CVD), University of Maryland School of Medicine, Baltimore, Maryland, United States of America
| | - Myron M. Levine
- Center for Vaccine Development (CVD), University of Maryland School of Medicine, Baltimore, Maryland, United States of America
| | - Pedro L. Alonso
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique
- ISGlobal, Hospital Clínic-Universitat de Barcelona, Barcelona, Spain
| | - David Carmena
- Parasitology Reference and Research Laboratory, National Centre for Microbiology, Health Institute Carlos III, Majadahonda, Madrid, Spain
| | - Inácio Mandomando
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique
- Instituto Nacional de Saúde (INS), Ministério da Saúde, Maputo, Mozambique
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Burgess SL, Leslie JL, Uddin J, Oakland DN, Gilchrist C, Moreau GB, Watanabe K, Saleh M, Simpson M, Thompson BA, Auble DT, Turner SD, Giallourou N, Swann J, Pu Z, Ma JZ, Haque R, Petri WA. Gut microbiome communication with bone marrow regulates susceptibility to amebiasis. J Clin Invest 2020; 130:4019-4024. [PMID: 32369444 PMCID: PMC7410058 DOI: 10.1172/jci133605] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Accepted: 04/23/2020] [Indexed: 12/13/2022] Open
Abstract
The microbiome provides resistance to infection. However, the underlying mechanisms are poorly understood. We demonstrate that colonization with the intestinal bacterium Clostridium scindens protects from Entamoeba histolytica colitis via innate immunity. Introduction of C. scindens into the gut microbiota epigenetically altered and expanded bone marrow granulocyte-monocyte progenitors (GMPs) and resulted in increased intestinal neutrophils with subsequent challenge with E. histolytica. Introduction of C. scindens alone was sufficient to expand GMPs in gnotobiotic mice. Adoptive transfer of bone marrow from C. scindens-colonized mice into naive mice protected against amebic colitis and increased intestinal neutrophils. Children without E. histolytica diarrhea also had a higher abundance of Lachnoclostridia. Lachnoclostridia C. scindens can metabolize the bile salt cholate, so we measured deoxycholate and discovered that it was increased in the sera of C. scindens-colonized specific pathogen-free and gnotobiotic mice, as well as in children protected from amebiasis. Administration of deoxycholate alone increased GMPs and provided protection from amebiasis. We elucidated a mechanism by which C. scindens and the microbially metabolized bile salt deoxycholic acid alter hematopoietic precursors and provide innate protection from later infection with E. histolytica.
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Affiliation(s)
- Stacey L. Burgess
- Division of Infectious Diseases and International Health, Department of Medicine, University of Virginia School of Medicine, Charlottesville, Virginia, USA
| | - Jhansi L. Leslie
- Division of Infectious Diseases and International Health, Department of Medicine, University of Virginia School of Medicine, Charlottesville, Virginia, USA
| | - Jashim Uddin
- Division of Infectious Diseases and International Health, Department of Medicine, University of Virginia School of Medicine, Charlottesville, Virginia, USA
| | - David N. Oakland
- Division of Infectious Diseases and International Health, Department of Medicine, University of Virginia School of Medicine, Charlottesville, Virginia, USA
| | - Carol Gilchrist
- Division of Infectious Diseases and International Health, Department of Medicine, University of Virginia School of Medicine, Charlottesville, Virginia, USA
| | - G. Brett Moreau
- Division of Infectious Diseases and International Health, Department of Medicine, University of Virginia School of Medicine, Charlottesville, Virginia, USA
| | - Koji Watanabe
- Division of Infectious Diseases and International Health, Department of Medicine, University of Virginia School of Medicine, Charlottesville, Virginia, USA
- AIDS Clinical Center, National Center for Global Health and Medicine, Shinjuku, Tokyo, Japan
| | - Mahmoud Saleh
- Division of Infectious Diseases and International Health, Department of Medicine, University of Virginia School of Medicine, Charlottesville, Virginia, USA
| | - Morgan Simpson
- Division of Infectious Diseases and International Health, Department of Medicine, University of Virginia School of Medicine, Charlottesville, Virginia, USA
| | - Brandon A. Thompson
- Division of Infectious Diseases and International Health, Department of Medicine, University of Virginia School of Medicine, Charlottesville, Virginia, USA
| | | | - Stephen D. Turner
- Department of Public Health Sciences, University of Virginia School of Medicine, Charlottesville, Virginia, USA
| | - Natasa Giallourou
- Division of Integrative Systems Medicine and Digestive Diseases, Imperial College London, London, United Kingdom
| | - Jonathan Swann
- Division of Integrative Systems Medicine and Digestive Diseases, Imperial College London, London, United Kingdom
| | - Zhen Pu
- Department of Statistics and
- Department of Public Health Sciences, University of Virginia, Charlottesville, Virginia, USA
| | - Jennie Z. Ma
- Department of Statistics and
- Department of Public Health Sciences, University of Virginia, Charlottesville, Virginia, USA
| | - Rashidul Haque
- International Centre for Diarrhoeal Diseases Research, Dhaka, Bangladesh
| | - William A. Petri
- Division of Infectious Diseases and International Health, Department of Medicine, University of Virginia School of Medicine, Charlottesville, Virginia, USA
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Korpe PS, Gilchrist C, Burkey C, Taniuchi M, Ahmed E, Madan V, Castillo R, Ahmed S, Arju T, Alam M, Kabir M, Ahmed T, Petri WA, Haque R, Faruque ASG, Duggal P. Case-Control Study of Cryptosporidium Transmission in Bangladeshi Households. Clin Infect Dis 2020; 68:1073-1079. [PMID: 30192924 PMCID: PMC6424084 DOI: 10.1093/cid/ciy593] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Accepted: 08/06/2018] [Indexed: 01/17/2023] Open
Abstract
Background Cryptosporidium is a leading contributor to diarrheal morbidity and mortality in under-5 children worldwide. As there is no vaccine and no effective drug therapy in young children for this infection, preventing infection is critical. We undertook a pilot case-control study to define the extent of person-to-person transmission of cryptosporidiosis within an urban and a rural community in Bangladesh. Methods We enrolled 48 case families with a Cryptosporidium-infected child aged 6–18 months. Controls were age- and sex-matched Cryptosporidium-negative children in 12 households. Children and household members were followed for 8 weeks with weekly illness survey and stool testing with quantitative polymerase chain reaction for Cryptosporidium. Results In the 24 urban case families, the secondary attack rate was 35.8% (19/53) vs 0% (0/11) in controls (P = .018, χ2 test). In contrast, in the 24 rural case families, the secondary attack rate was 7.8% (5/64) vs 0% (0/21) in controls (P = .19, χ2 test). Genotyping by gp60 demonstrated infection with the same subspecies in 5 families, and evidence of transmission in 2. Serologic response to Cryptosporidium infection was associated with younger age, longer duration of infection, and Cryptosporidium hominis gp60_IbA9G3R2 infection. Conclusions In the urban site, the high rate of secondary infection and infection with the same subspecies within families suggests that person-to-person transmission is a major source of Cryptosporidium infection for young children living in this region. Molecular genotyping can be applied to determine transmission of Cryptosporidium in endemic regions. Further work is needed to understand the differences in parasite transmissibility and immunity to different genotypes.
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Affiliation(s)
- Poonum S Korpe
- Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland
| | | | - Cecelia Burkey
- University of Virginia School of Medicine, Charlottesville
| | - Mami Taniuchi
- University of Virginia School of Medicine, Charlottesville
| | - Emtiaz Ahmed
- International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Vikram Madan
- Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland
| | - Rachel Castillo
- Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland
| | - Shahnawaz Ahmed
- International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Tuhinur Arju
- International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Masud Alam
- International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Mamun Kabir
- International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Tahmeed Ahmed
- International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | | | - Rashidul Haque
- International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - A S G Faruque
- International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Priya Duggal
- Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland
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Ngobeni R, Samie A, Moonah S, Watanabe K, Petri WA, Gilchrist C. Entamoeba Species in South Africa: Correlations With the Host Microbiome, Parasite Burdens, and First Description of Entamoeba bangladeshi Outside of Asia. J Infect Dis 2019; 216:1592-1600. [PMID: 29236996 DOI: 10.1093/infdis/jix535] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2017] [Accepted: 10/05/2017] [Indexed: 12/25/2022] Open
Abstract
Background Diarrhea is frequent in communities without clean water, which include low-income South African populations in Giyani and Pretoria. In these populations, the amount of diarrhea caused by Entamoeba histolytica, inclusive of all ages, sexes, and human immunodeficiency virus status, is uncertain. Infection with E. histolytica can modulate the host microbiota, and a key species indicative of this is the Prevotella copri pathobiont. Methods A cross-sectional study of patients attending gastroenterology clinics was conducted to determine the frequency and burden of 4 Entamoeba species and P. copri. Results Entamoeba species were present in 27% of patients (129/484), with E. histolytica detected in 8.5% (41), E. dispar in 8% (38), E. bangladeshi in 4.75% (23), and E. moshkovskii in 0%. This is the first description of E. bangladeshi outside Bangladesh. In E. histolytica-positive samples, the levels of both the parasite and P. copri were lower in nondiarrheal samples, validating the results of a study in Bangladesh (P = .0034). By contrast, in E. histolytica-negative samples positive for either of the nonpathogenic species E. dispar or E. bangladeshi, neither P. copri nor Entamoeba levels were linked to gastrointestinal status. Conclusions Nonmorphologic identification of this parasite is essential. In South Africa, 3 morphologically identical Entamoeba were common, but only E. histolytica was linked to both disease and changes in the microbiota.
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Affiliation(s)
- Renay Ngobeni
- University of Venda, Thohoyandou, South Africa.,Department of Medicine/Division of Infectious Diseases, University of Virginia, Charlottesville
| | | | - Shannon Moonah
- Department of Medicine/Division of Infectious Diseases, University of Virginia, Charlottesville
| | - Koji Watanabe
- Department of Medicine/Division of Infectious Diseases, University of Virginia, Charlottesville.,AIDS Clinical Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - William A Petri
- Department of Medicine/Division of Infectious Diseases, University of Virginia, Charlottesville
| | - Carol Gilchrist
- Department of Medicine/Division of Infectious Diseases, University of Virginia, Charlottesville
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Gilchrist C, Eagen TJ, Herrera-Venson AP, Cameron KA. THE IMPACT OF EVIDENCE-BASED FALLS PREVENTION PROGRAMS ON VULNERABLE POPULATIONS. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.2286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- C Gilchrist
- National Council on Aging, Arlington, Virginia, United States
| | - T J Eagen
- University of Washington, Seattle, WA, USA; National Council on Aging, Arlington, VA, USA
| | | | - K A Cameron
- National Council on Aging, Arlington, VA, USA
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Schneider EC, Cameron KA, Herrera-Venson A, Gilchrist C. UNDERSTANDING THE NEW ACL/AOA EVIDENCE-BASED HEALTH PROMOTION AND DISEASE PREVENTION PROGRAM REVIEW PROCESS. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.3152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- E C Schneider
- University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States
| | - K A Cameron
- National Council on Aging, Center for Healthy Aging, Arlington, VA, USA
| | - A Herrera-Venson
- National Council on Aging,Center for Healthy Aging, Arlington, VA, USA
| | - C Gilchrist
- National Council on Aging, Center for Healthy Aging, Arlington, VA, USA
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Eagen T, Herrera-Venson A, Gilchrist C, Schneider E, Cameron K. REACH OF NATIONAL EVIDENCE-BASED FALLS PREVENTION PROGRAMS AMONG TRIBAL COMMUNITIES: RESULTS AND LESSONS LEARNED. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.2832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
| | | | | | | | - K Cameron
- National Council on Aging, Center for Healthy Aging
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Ngobeni R, Samie A, Moonah S, Watanabe K, Petri W, Gilchrist C. Entamoeba in South Africa: correlations with the host Microbiome, parasite burden and first description of E. Bangladeshi outside of Asia. Int J Infect Dis 2018. [DOI: 10.1016/j.ijid.2018.04.4133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Grant CC, Crane J, Mitchell EA, Sinclair J, Stewart A, Milne T, Knight J, Gilchrist C, Camargo CA. Vitamin D supplementation during pregnancy and infancy reduces aeroallergen sensitization: a randomized controlled trial. Allergy 2016; 71:1325-34. [PMID: 27060679 DOI: 10.1111/all.12909] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/04/2016] [Indexed: 02/06/2023]
Abstract
BACKGROUND Vitamin D has immune-modulating effects. We determined whether vitamin D supplementation during pregnancy and infancy prevents aeroallergen sensitization and primary care respiratory illness presentations. METHODS A randomized, double-blind, placebo-controlled parallel-group trial. We assigned pregnant women, from 27-week gestation to birth, and then their infants, from birth to 6 months, to placebo or one of two dosages of daily oral vitamin D. Woman/infant pairs were randomized to: placebo/placebo, 1000 IU/400 IU or 2000 IU/800 IU. When the children were 18 months old, we measured serum-specific IgE antibodies and identified acute primary care visits described by the doctor to be due to a cold, otitis media, an upper respiratory infection, croup, asthma, bronchitis, bronchiolitis, a wheezy lower respiratory infection or fever and cough. RESULTS Specific IgE was measured on 185 of 260 (71%) enrolled children. The proportion of children sensitized differed by study group for four mite antigens: Dermatophagoides farinae (Der-f1, Der-f2) and Dermatophagoides pteronyssinus (Der-p1, Der-p2). With results presented for placebo, lower dose, and higher dose vitamin D, respectively (all P < 0.05): Der-f1 (18%, 10%, 2%), Der-f2 (14%, 3%, 2%), Der-p1 (19%, 14%, 3%) and Der-p2 (12%, 2%, 3%). There were study group differences in the proportion of children with primary care visits described by the doctor as being for asthma (11%, 0%, 4%, P = 0.002), but not for the other respiratory diagnoses. CONCLUSIONS Vitamin D supplementation during pregnancy and infancy reduces the proportion of children sensitized to mites at age 18 months. Preliminary data indicate a possible effect on primary care visits where asthma is diagnosed.
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Affiliation(s)
- C. C. Grant
- Department of Paediatrics: Child & Youth Health; University of Auckland; Auckland New Zealand
- Starship Children's Hospital; Auckland New Zealand
| | - J. Crane
- Medicine; University of Otago; Wellington New Zealand
| | - E. A. Mitchell
- Department of Paediatrics: Child & Youth Health; University of Auckland; Auckland New Zealand
| | - J. Sinclair
- Starship Children's Hospital; Auckland New Zealand
| | - A. Stewart
- Epidemiology & Biostatistics; University of Auckland; Auckland New Zealand
| | - T. Milne
- Department of Paediatrics: Child & Youth Health; University of Auckland; Auckland New Zealand
| | - J. Knight
- Epidemiology & Biostatistics; University of Auckland; Auckland New Zealand
| | - C. Gilchrist
- Department of Paediatrics: Child & Youth Health; University of Auckland; Auckland New Zealand
| | - C. A. Camargo
- Emergency Medicine; Massachusetts General Hospital; Harvard Medical School; Boston Massachusetts USA
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Korpe PS, Haque R, Gilchrist C, Valencia C, Niu F, Lu M, Ma JZ, Petri SE, Reichman D, Kabir M, Duggal P, Petri WA. Natural History of Cryptosporidiosis in a Longitudinal Study of Slum-Dwelling Bangladeshi Children: Association with Severe Malnutrition. PLoS Negl Trop Dis 2016; 10:e0004564. [PMID: 27144404 PMCID: PMC4856361 DOI: 10.1371/journal.pntd.0004564] [Citation(s) in RCA: 68] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2015] [Accepted: 03/01/2016] [Indexed: 12/18/2022] Open
Abstract
Background Cryptosporidiosis is a common cause of infectious diarrhea in young children worldwide, and is a significant contributor to under-five mortality. Current treatment options are limited in young children. In this study, we describe the natural history of Cryptosporidium spp. infection in a birth cohort of children in Bangladesh and evaluate for association with malnutrition. Methodology/Principal Findings This is a longitudinal birth cohort study of 392 slum-dwelling Bangladeshi children followed over the first two years of life from 2008 to 2014. Children were monitored for diarrheal disease, and stool was tested for intestinal protozoa. Anthropometric measurements were taken at 3-month intervals. A subset of Cryptosporidium positive stools were genotyped for species and revealed that C. hominis was isolated from over 90% of samples. In the first two years of life, 77% of children experienced at least one infection with Cryptosporidium spp. Non-diarrheal infection (67%) was more common than diarrheal infection (6.3%) although 27% of children had both types of infection. Extreme poverty was associated with higher rates of infection (chi-square, 49.7% vs 33.3%, p = 0.006). Malnutrition was common in this cohort, 56% of children had stunted growth by age two. Children with Cryptosporidium spp. infection had a greater than 2-fold increased risk of severe stunting at age two compared to uninfected children (odds ratio 2.69, 95% CI 1.17, 6.15, p = 0.019) independent of sex, income, maternal body-mass index, maternal education and weight for age adjusted z (WAZ) score at birth. Conclusions/Significance Cryptosporidium infection is common (77%) in this cohort of slum-dwelling Bangladeshi children, and both non-diarrheal and diarrheal infections are significantly associated with a child’s growth at 2 years of age. Diarrheal disease is a leading cause of death in young children worldwide. Cryptosporidium species are responsible for a large proportion of global burden of diarrhea. This study describes the natural history of cryptosporidiosis in a birth cohort of impoverished Bangladeshi children. Children were enrolled at birth and monitored for diarrhea twice a week for two years. Stool samples were tested for enteric protozoa. Children in this cohort had significant rates of malnutrition compared to the W.H.O. reference population, and extreme poverty was common. A majority of children were infected with Cryptosporidium spp, and we found that children who had at least one infection with Cryptosporidium spp during the two year follow up period were significantly more likely to have growth faltering by age 24 months. Cryptosporidiosis is a common infection in this cohort, and is associated with poverty and reduced growth during the first two years of life.
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Affiliation(s)
- Poonum S. Korpe
- Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, Maryland, United States of America
- * E-mail:
| | - Rashidul Haque
- International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Carol Gilchrist
- Department of Medicine, Division of Infectious Diseases, University of Virginia, Charlottesville, Virginia, United States of America
| | - Cristian Valencia
- Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, Maryland, United States of America
| | - Feiyang Niu
- Department of Statistics, University of Virginia, Charlottesville, Virginia, United States of America
| | - Miao Lu
- Department of Statistics, University of Virginia, Charlottesville, Virginia, United States of America
| | - Jennie Z. Ma
- Division of Biostatistics, Department of Public Health Sciences, University of Virginia, Charlottesville, Virginia, United States of America
| | - Sarah E. Petri
- Department of Animal and Veterinary Sciences, Cummings School of Veterinary Medicine, Tufts University, North Grafton, Massachusetts, United States of America
| | - Daniel Reichman
- Emory University School of Medicine, Atlanta, Georgia, United States of America
| | - Mamun Kabir
- International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Priya Duggal
- Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, Maryland, United States of America
| | - William A. Petri
- Department of Medicine, Division of Infectious Diseases, University of Virginia, Charlottesville, Virginia, United States of America
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Asgharpour A, Gilchrist C, Baba D, Hamano S, Houpt E. Resistance to intestinal Entamoeba histolytica infection is conferred by innate immunity and Gr-1+ cells. Infect Immun 2005; 73:4522-9. [PMID: 16040963 PMCID: PMC1201199 DOI: 10.1128/iai.73.8.4522-4529.2005] [Citation(s) in RCA: 68] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Establishment of intestinal infection with Entamoeba histolytica depends on the mouse strain; C57BL/6 mice are highly resistant, and C3H/HeJ mice are relatively susceptible. We found that resistance to intestinal infection was independent of lymphocyte activity or H-2 haplotype and occurred in the first hours to days postchallenge according to in vivo imaging. At 18 h postchallenge, the ceca of resistant C57BL/6 mice were histologically unremarkable, in contrast to the severe inflammation observed in susceptible C3H/HeJ mice. Comparison of cecal gene expression in C3H/HeJ and C57BL/6 mice demonstrated that there was parasite-induced upregulation of proinflammatory and neutrophil chemotaxis transcripts and there was downregulation of transforming growth factor beta signaling molecules. Pretreatment with dexamethasone abrogated the partial resistance of C3H/HeJ or CBA mice through an innate, lymphocyte-independent mechanism, but it had no effect on the high-level resistance of C57BL/6 mice. Similarly, administration of a neutrophil-depleting anti-Gr-1 monoclonal antibody (RB6-8C5) decreased the partial resistance of CBA mice and led to severe pathology compared to control antibody-treated mice, but it had no effect on C57BL/6 resistance. These data indicate that there are discrete mechanisms of innate resistance to E. histolytica depending on the host background and, in contrast to other reports, imply that neutrophils are protective and not damaging in intestinal amebiasis.
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Affiliation(s)
- Amon Asgharpour
- Division of Infectious Diseases and International Health, MR4 Building, Room 2144, University of Virginia, Charlottesville, VA 22908-1363, USA
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Loftus B, Anderson I, Davies R, Alsmark UCM, Samuelson J, Amedeo P, Roncaglia P, Berriman M, Hirt RP, Mann BJ, Nozaki T, Suh B, Pop M, Duchene M, Ackers J, Tannich E, Leippe M, Hofer M, Bruchhaus I, Willhoeft U, Bhattacharya A, Chillingworth T, Churcher C, Hance Z, Harris B, Harris D, Jagels K, Moule S, Mungall K, Ormond D, Squares R, Whitehead S, Quail MA, Rabbinowitsch E, Norbertczak H, Price C, Wang Z, Guillén N, Gilchrist C, Stroup SE, Bhattacharya S, Lohia A, Foster PG, Sicheritz-Ponten T, Weber C, Singh U, Mukherjee C, El-Sayed NM, Petri WA, Clark CG, Embley TM, Barrell B, Fraser CM, Hall N. The genome of the protist parasite Entamoeba histolytica. Nature 2005; 433:865-8. [PMID: 15729342 DOI: 10.1038/nature03291] [Citation(s) in RCA: 624] [Impact Index Per Article: 32.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2004] [Accepted: 12/02/2004] [Indexed: 11/08/2022]
Abstract
Entamoeba histolytica is an intestinal parasite and the causative agent of amoebiasis, which is a significant source of morbidity and mortality in developing countries. Here we present the genome of E. histolytica, which reveals a variety of metabolic adaptations shared with two other amitochondrial protist pathogens: Giardia lamblia and Trichomonas vaginalis. These adaptations include reduction or elimination of most mitochondrial metabolic pathways and the use of oxidative stress enzymes generally associated with anaerobic prokaryotes. Phylogenomic analysis identifies evidence for lateral gene transfer of bacterial genes into the E. histolytica genome, the effects of which centre on expanding aspects of E. histolytica's metabolic repertoire. The presence of these genes and the potential for novel metabolic pathways in E. histolytica may allow for the development of new chemotherapeutic agents. The genome encodes a large number of novel receptor kinases and contains expansions of a variety of gene families, including those associated with virulence. Additional genome features include an abundance of tandemly repeated transfer-RNA-containing arrays, which may have a structural function in the genome. Analysis of the genome provides new insights into the workings and genome evolution of a major human pathogen.
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Affiliation(s)
- Brendan Loftus
- TIGR, 9712 Medical Center Drive, Rockville, Maryland 20850, USA.
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Cameron MR, Hart SP, Sahlu T, Gilchrist C, Coleman SW, Goetsch AL. Effects of Gender and Age on Performance and Harvest Traits of Boer × Spanish Goats. Journal of Applied Animal Research 2001. [DOI: 10.1080/09712119.2001.9706748] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
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Browning ST, Gilchrist C. A Minimally-Invasive Method of Ligating the Anterior Ethmoid Artery. MINIM INVASIV THER 2000. [DOI: 10.3109/13645700009093711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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McKnight A, Steele K, Mills K, Gilchrist C, Taggart H. Bone mineral density in relation to medical and lifestyle risk factors for osteoporosis in premenopausal, menopausal and postmenopausal women in general practice. Br J Gen Pract 1995; 45:317-20. [PMID: 7619589 PMCID: PMC1239268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND Interest in the prevention of osteoporosis is increasing and thus there is a need for an acceptable osteoporosis prevention programme in general practice. AIM A study was undertaken to identify a cohort of middle-aged women attending a general practice who would be eligible for a longitudinal study looking at bone mineral density, osteoporosis and the effectiveness of hormone replacement therapy. This study aimed to describe the relationship between medical and lifestyle risk factors for osteoporosis and the initial bone density measurements in this group of women. METHOD A health visitor administered a questionnaire to women aged between 48 and 52 years registered with a Belfast general practice. The main outcome measures were menopausal status, presence of medical and lifestyle risk factors and bone mineral density measurements. RESULTS A total of 358 women our of 472 (76%) took part in the study which was conducted in 1991 and 1992. A highly significant difference was found between the mean bone mineral density of premenopausal, menopausal and postmenopausal women within the narrow study age range, postmenopausal women having the lowest bone mineral density. A significant relationship was found between body mass index and bone mineral density, a greater bone mineral density being found among women with a higher body mass index. Risk factors such as smoking and sedentary lifestyle were common (reported by approximately one third of respondents) but a poor relationship was found between these two and all the other risk factors and bone mineral density in this age group. CONCLUSION Risk of osteoporosis cannot be identified by the presence of risk factors in women aged between 48 and 52 years. In terms of a current prevention strategy for general practice it would be better to take a population-based approach except for those women known to be at high risk of osteoporosis: women with early menopause or those who have had an oophorectomy.
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Affiliation(s)
- A McKnight
- Department of General Practice, Queen's University Belfast
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18
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Munday PE, Thomas BJ, Gilroy CB, Gilchrist C, Taylor-Robinson D. Infrequent detection of Chlamydia trachomatis in a longitudinal study of women with treated cervical infection. Genitourin Med 1995; 71:24-6. [PMID: 7750948 PMCID: PMC1195364 DOI: 10.1136/sti.71.1.24] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
OBJECTIVE To determine how often Chlamydia trachomatis cervical infections are detected in women following completion of a currently recommended treatment regimen and the reason for recurrence. METHODS A longitudinal follow-up study of 43 initially C trachomatis-positive women for periods of up to two years. RESULTS C trachomatis was detected in three women, 19, 16 and about four months, respectively after completion of treatment. All specimens from the other 40 women which were taken during visits two to seven, that is periods of three to 700 days after treatment, were chlamydia-negative. CONCLUSION Although C trachomatis is usually eradicated from the genital tract by conventional treatment, occasionally it may be found again. It is difficult to determine whether detection after treatment is due to persistence or reinfection and further studies are required.
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Affiliation(s)
- P E Munday
- Department of Genitourinary Medicine, Watford General Hospital, Herts, UK
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Stacey CM, Munday PE, Taylor-Robinson D, Thomas BJ, Gilchrist C, Ruck F, Ison CA, Beard RW. A longitudinal study of pelvic inflammatory disease. Br J Obstet Gynaecol 1992; 99:994-9. [PMID: 1477024 DOI: 10.1111/j.1471-0528.1992.tb13705.x] [Citation(s) in RCA: 42] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
OBJECTIVE To study the microbiology and long term prognosis of pelvic inflammatory disease (PID). DESIGN A prospective study of women with laparoscopically confirmed PID. SETTING Teaching hospital in central London. SUBJECTS 23 women with PID. OUTCOME MEASURES Microbiological investigations at the time of diagnosis and at follow up; subsequent fertility and the occurrence of pelvic pain. RESULTS PID diagnosed by laparoscopy was regarded as moderate to severe in 15 cases. Neisseria gonorrhoeae, Chlamydia trachomatis, Mycoplasma hominis and Ureaplasma urealyticum or a combination of these micro-organisms were detected most frequently in the cervix, less often in the endometrium and least in the tubes, C. trachomatis being the micro-organism found most commonly in the tubes. There was serological evidence of acute chlamydial infection in 13 of 20 cases in which paired sera were available and a serological response to M. hominis in 9 of 12 cases in which it was possible to evaluate the results. On the basis of microbiological and serological results, C. trachomatis appeared to be the most important aetiological agent in 10 cases, N. gonorrhoeae in four cases, M. hominis in three cases and U. urealyticum in none; in five cases, two of these micro-organisms appeared to be of equal importance. After 1 to 3 years, 33% of the women were having difficulty conceiving and 56% continued to complain of pelvic pain. CONCLUSION It is difficult to be certain of the infectious cause of PID in any given case. However, the evidence that N. gonorrhoeae and C. trachomatis are pathogens is very strong. M. hominis may be responsible for a few cases on its own or together with other micro-organisms.
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Affiliation(s)
- C M Stacey
- Jefferiss Wing, St Mary's Hospital, Paddington, London, UK
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Hay PE, Thomas BJ, Gilchrist C, Palmer HM, Gilroy CB, Taylor-Robinson D. A reappraisal of chlamydial and nonchlamydial acute non-gonococcal urethritis. Int J STD AIDS 1992; 3:191-5. [PMID: 1616966 DOI: 10.1177/095646249200300307] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
A cohort of 112 men presenting with acute non-gonococcal urethritis (NGU) was investigated for the presence of Chlamydia trachomatis. Men with 3 or more episodes of NGU in the preceding 12 months, or who had received treatment for NGU in the preceding 3 months were excluded. C. trachomatis was sought by examination of urethral smears by direct immunofluorescence, and by examination of the centrifuged deposit from a first pass urine (FPU) sample by direct immunofluorescence, IDEIA, and the polymerase chain reaction. Urethral samples from 48 men were positive for CT, and the FPU samples from an additional 7 men were positive by at least 2 assays. With such intensive investigation it is likely that those men identified as chlamydia-negative were genuinely free from the infection. The clinical history and response to treatment of those men who were chlamydia-positive were compared with those of the chlamydia-negative men. They differed in that a larger proportion of the chlamydia-positive men reported having had intercourse with more than one partner in the previous 3 months, and having had fewer previous episodes of NGU. Moreover, in contrast to some previous studies, after one week of treatment with doxycycline, a larger proportion (65%) of the chlamydia-negative men than the chlamydia-positive men (40%) was cured, although the difference was not sustained following later treatment.
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Affiliation(s)
- P E Hay
- Division of Sexually Transmitted Diseases, Clinical Research Centre, Harrow, Middlesex, UK
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Thomas B, Gilchrist C, Taylor-Robinson D. Detection of Chlamydia trachomatis by direct immunofluorescence improved by centrifugation of specimens. Eur J Clin Microbiol Infect Dis 1991; 10:659-62. [PMID: 1748121 DOI: 10.1007/bf01975821] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
During a study of women with laparoscopically investigated pelvic pain, genital tract specimens were examined for Chlamydia trachomatis using a direct fluorescent antibody (DFA) technique (MicroTrak, Syva) and culture. Some smears, particularly those from the upper genital tract, contained an inadequate number of cells when examined by the DFA technique and many cell monolayers were destroyed by the specimens. To obtain results for such samples, or to confirm the original DFA result, additional specimens which had been frozen at -70 degrees C or in liquid nitrogen were centrifuged at high speed and the resulting deposit examined by the DFA technique. By this means, 32 negative results were confirmed for specimens from 10 chlamydia-negative patients with pelvic inflammatory disease or with high chlamydial antibody titres, and 26 negative results were confirmed for 19 patients who were positive at other sites. In addition, three chlamydia-positive and six chlamydia-negative results were obtained for sites where the original smear for DFA testing had been inadequate (few epithelial cells) and six specimens that were negative originally were found to be positive. Thus, of 73 specimens that were either inadequate or negative by DFA testing originally, 9 (12%) were positive by DFA testing after centrifugation.
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Affiliation(s)
- B Thomas
- Division of Sexually Transmitted Diseases, Clinical Research Centre, Harrow, Middlesex, UK
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Stacey C, Munday P, Thomas B, Gilchrist C, Taylor-Robinson D, Beard R. Chlamydia trachomatis in the fallopian tubes of women without laparoscopic evidence of salpingitis. Int J Gynaecol Obstet 1991. [DOI: 10.1016/0020-7292(91)90324-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Abstract
Two methods of simplifying the procedure for examining urine samples for Chlamydia trachomatis were investigated. When 73 urine samples from 56 men with acute non-gonococcal urethritis were examined by direct immunofluorescence (MicroTrak), centrifuging 1 ml volumes of urine at 13,000 rpm for five minutes was at least as efficient for detecting C trachomatis as centrifuging larger volumes at 3000 rpm for 30 minutes. Furthermore, examination of urine produced during a visit to a sexually transmitted disease clinic was at least as efficient as examination of early morning urine for detecting C trachomatis by MicroTrak, or by an enzyme immunoassay (IDEIA). Both modifications have practical advantages and should encourage the use of urine samples for diagnosing chlamydial infections in men.
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Affiliation(s)
- B J Thomas
- Division of Sexually Transmitted Diseases, Clinical Research Centre, Harrow, Middlesex
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Hay PE, Thomas BJ, Gilchrist C, Palmer HM, Gilroy CB, Taylor-Robinson D. The value of urine samples from men with non-gonococcal urethritis for the detection of Chlamydia trachomatis. Genitourin Med 1991; 67:124-8. [PMID: 2032705 PMCID: PMC1194646 DOI: 10.1136/sti.67.2.124] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Chlamydia trachomatis was sought at first and subsequent clinic visits in urethral swabs and urines from 112 heterosexual men with acute non-gonococcal urethritis (NGU). In comparison with a urethral swab tested by Micro Trak (MT), a urine deposit tested in the same way was 90% as sensitive. Examining a urine deposit by the enzyme immunoassay IDEIA was a little less sensitive (89%) than examining a similar deposit by MT, and was less sensitive (82%) than examining a urethral swab by MT. The results of testing urines were little influenced by collecting them either before or after swabbing the urethra, and there was evidence that examining all of a urine sample by IDEIA would have increased sensitivity. Overall, 55 (49%) of the men were diagnosed as C trachomatis-positive based on the results of testing both a urethral swab and a urine sample. Furthermore, a small numbers of chlamydiae were detected by examining urine by MT and, to a lesser extent, by IDEIA, so that there is no reason why this non-invasive approach should not be successful in men other than those with acute NGU.
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Affiliation(s)
- P E Hay
- Division of Sexually Transmitted Diseases, Clinical Research Centre, Harrow, Middlesex, UK
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Palmer HM, Gilroy CB, Thomas BJ, Hay PE, Gilchrist C, Taylor-Robinson D. Detection of Chlamydia trachomatis by the polymerase chain reaction in swabs and urine from men with non-gonococcal urethritis. J Clin Pathol 1991; 44:321-5. [PMID: 2030152 PMCID: PMC496909 DOI: 10.1136/jcp.44.4.321] [Citation(s) in RCA: 59] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
A polymerase chain reaction (PCR) was developed for Chlamydia trachomatis in which a 380 base pair DNA fragment was amplified. Amplification occurred with the DNA from the 15 serovars but not with that from other Chlamydia spp or with DNA from a variety of other organisms. Chlamydial DNA (10(-16) g) could be detected and the PCR seemed to be able to detect single organisms. Urethral swabs were obtained from 37 men with acute non-gonococcal urethritis (NGU), 18 (49%) of whom were positive for C trachomatis by MicroTrak. As a result of clinical re-examinations 65 urethral swabs were available for analysis by the PCR. In comparison with MicroTrak, PCR had a sensitivity of 95%, a specificity of 94%, a positive predictive value of 86% and a negative predictive value of 98%. The PCR was apparently less sensitive (82%) in tests on urine samples. Overall, however, values of sensitivity and specificity of the PCR compared favourably with those of MicroTrak. The PCR for C trachomatis is likely to be a valuable technique for research, but problems of DNA contamination suggest that it should not be recommended for routine diagnosis.
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Affiliation(s)
- H M Palmer
- Division of Sexually Transmitted Diseases, Clinical Research Centre, Harrow, Middlesex
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Abstract
23 women with lower abdominal pain and Chlamydia trachomatis in the cervix, urethra, or both sites were studied. Laparoscopy was done with sampling of the endometrium and fallopian tubes for detection of C trachomatis. 11 women had laparoscopic evidence of pelvic inflammatory disease (PID); C trachomatis was detected in the upper genital tract of 8, but not in the upper tract of 5 who had laparoscopy again after treatment. The organism was also found in the upper genital tract of 9 of the 12 women without laparoscopic evidence of PID. Most of the women with abdominal pain or tenderness had tubal or endometrial C trachomatis infection, although only half had laparoscopic evidence of salpingitis. This finding suggests that antibiotic treatment should be given as soon as chlamydial infection is detected in the cervix and that pain does not necessarily point to C trachomatis in the upper genital tract. Laparoscopy may miss important pathogens in the upper genital tract, unless the procedure is complemented with detailed microbiological investigation.
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Affiliation(s)
- C Stacey
- Department of Genitourinary Medicine, St Mary's Hospital, London
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Abstract
In tests on 375 genital tract specimens a commercially available enzyme immunoassay for Chlamydia trachomatis (IDEIA; Boots-Celltech) was found to have sensitivity values of 62% for men and 74% for women, and a specificity of 97% for both groups, relative to the results obtained by a fluorescence assay (Micro Trak; Syva). The positive predictive value and the negative predictive value of the immunoassay were 91% and 87%, respectively. Collection of samples for IDEIA in transport medium in plastic phials, as opposed to glass phials recommended by the manufacturer, had no effect on these values. Tests of the sensitivity of IDEIA using laboratory strains of C trachomatis showed that the assay detected chlamydial elementary bodies only at dilutions at least 10-fold lower than those at which they could be detected by Micro Trak. Tests of the specificity of the assay with microorganisms found in the genital tract, other than chlamydiae, showed that reactions occurred with a number of these. Testing three cervical swabs from the same patient, with the material taken into a single phial of transport medium, increased the sensitivity of IDEIA from 74% to 96%, without reducing the specificity which remained at 97%. It is concluded that this approach enchances the value of the test in a sexually transmitted disease clinic population and may do so in a population with a low prevalence of chlamydiae.
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Affiliation(s)
- B J Thomas
- Division of Sexually Transmitted Diseases, Clinical Research Centre, Harrow, Middlesex
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Jalil N, Gilchrist C, Taylor-Robinson D. Factors influencing the in-vitro sensitivity of Ureaplasma urealyticum to tetracyclines. J Antimicrob Chemother 1989; 23:341-5. [PMID: 2732118 DOI: 10.1093/jac/23.3.341] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
The sensitivity of 23 strains of Ureaplasma urealyticum to doxycycline was measured by a metabolism-inhibition technique. The minimal inhibitory concentrations were not influenced by using, as inocula in the tests, organisms either directly from the patient or after culture, providing that the numbers of organisms in the inocula were about the same in both. All the strains were sensitive to doxycycline but an apparent increase in the resistance of the cultured organisms occurred when the number, expressed as colour-changing units (ccu), in the inoculum was 10(5) or more/ml. Tests may be undertaken on cultured organisms of U. urealyticum but it is recommended that a standard inoculum of 10(3)-10(4) ccu/ml should be used.
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Affiliation(s)
- N Jalil
- Division of Sexually Transmitted Diseases, Clinical Research Centre, Harrow, Middlesex, UK
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Abstract
Ureaplasma urealyticum organisms (ureaplasmas) were isolated from the urethra and epididymal aspirate of a man aged 24 who had acute right sided epididymitis. No other microorganisms were detected, and he had no chlamydial antibody response. A fourfold antibody response to the epididymal ureaplasma isolate was detected by two methods, however, and the patient responded clinically to doxycycline, to which the ureaplasmal isolates were susceptible in vitro. These findings suggest that U urealyticum had a causative role.
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Affiliation(s)
- N Jalil
- Jefferiss Research Wing of the Praed Street Clinic, St. Mary's Hospital, Paddington, London
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Botcherby M, Gilchrist C, Bremner J, Byrne MA, Harris JR, Taylor-Robinson D. Rapid diagnosis of genital herpes by detecting cells infected with virus in smears with fluorescent monoclonal antibodies. J Clin Pathol 1987; 40:687-9. [PMID: 3038967 PMCID: PMC1141064 DOI: 10.1136/jcp.40.6.687] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
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Denman AM, Fialkow PJ, Pelton BK, Salo AC, Appleford DJ, Gilchrist C. Lymphocyte abnormalities in Behçet's syndrome. Clin Exp Immunol 1980; 42:175-85. [PMID: 6161726 PMCID: PMC1537074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
In order to test indirectly the hypothesis that Behçet's syndrome is caused by a virus, lymphocytes from eighty-six patients were evaluated for two parameters consistent with persistent virus infection: chromosomal abnormalities and decreased ability to herpes simplex virus type I (HSV) to grow in lymphocyte cultures stimulated by PHA. Whereas HSV grew in lymphocytes cultured from all normal donors, replication was impaired in lymphocytes from 37% of the patients with Behçet's syndrome. This figure is increased to 57% if patients receiving steroids or cytotoxic drugs were excluded. Lymphocytes were scored as chromosomally abnormal from sixteen of the thirty-eight patients examined, compared with only one of seventeen normal controls. There was damage to specific chromosomes in four patients. The frequency with which chromosomal abnormalities were detected was significantly related to failure to replicate HSV and inversely related to concomitant steroid treatment. The findings are consistent with a viral aetiology for Behçet's syndrome but other explanations are not excluded.
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Fialkow PJ, Gilchrist C, Allison AC. Autoimmunity in chronic graft-versus-host disease. Clin Exp Immunol 1973; 13:479-86. [PMID: 4123818 PMCID: PMC1553729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
F1 mice with chronic GVH disease were studied to investigate the hypothesis that non-specific stimulation of helper T cells, such as might be seen in graft-versus-host (GVH) disease, results in autoantibody production. Antinuclear antibody (ANA) was detected significantly more frequently in F1 mice with GVH disease than in control animals. The antigenic specificities of the ANA indicate that it is of host origin and, since it reacts with syngeneic nuclei, it can be considered a true autoantibody. The pattern of development, intensity, prevalence and sex distribution of ANA reactions differed notably in experiments with A × CBA F1s compared to those with C57B1/6 × BALB/c F1s suggesting that these parameters of ANA formation are influenced significantly by the genotype of the animal with GVH disease.
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Gaugas JM, Chesterman FC, Hirsch MS, Rees RJ, Harvey JJ, Gilchrist C. Unexpected high incidence of tumours in thymectomized mice treated with anti-lymphocytic globulin and Mycobacterium leprae. Nature 1969; 221:1033-6. [PMID: 4304484 DOI: 10.1038/2211033a0] [Citation(s) in RCA: 38] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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