Identification of medically and forensically relevant flies using a decision treelearning method

Blow flies, flesh flies, and house flies can provide excellent evidence for forensic entomologists and are also essential to the fields of public health, medicine, and animal health. In all questions, the correct identification of fly species is an important initial step. The usual methods based on morphology or even molecular approaches can reach their limits here, especially when dealing with larger numbers of specimens. Since machine learning already plays a major role in many areas of daily life, such as education, business, industry, science, and medicine, applications for the classification of insects have been reported. Here, we applied the decision tree method with wing morphometric data to construct a model for discriminating flies of three families [Calliphoridae, Sarcophagidae, Muscidae] and seven species [Chrysomya megacephala (Fabricius), Chrysomya rufifacies (Macquart), Chrysomya (Ceylonomyia) nigripes Aubertin, Lucilia cuprina (Wiedemann), Hemipyrellia ligurriens (Wiedemann), Musca domestica Linneaus, and Parasarcophaga (Liosarcophaga) dux Thomson]. One hundred percent overall accuracy was obtained at a family level, followed by 83.33% at a species level. The results of this study suggest that non-experts might utilize this identification tool. However, more species and also samples per specimens should be studied to create a model that can be applied to the different fly species in Thailand.

First report of canine cutaneous myiasis caused by Chrysomya bezziana Villeneuve (Diptera: Calliphoridae) in Thailand

Although myiasis caused by the blow fly, Chrysomya bezziana Villeneuve (Diptera: Calliphoridae), has been reported in Thailand, all of the cases were human. This study described three cutaneous myiasis cases caused by C. bezziana in dogs in Chiang Mai province, northern Thailand. The removal of fly larvae together with specific treatment to cure all cases in this study was represented.

Orbital ophthalmomyiasis caused by Chrysomya bezziana in Thailand

Orbital ophthalmomyiasis occurs infrequently in Thailand. Herein, we report a case in Chiang Mai, Thailand, of orbital ophthalmomyiasis due to larvae of the blow fly Chrysomya bezziana (Diptera: Calliphoridae). A 94-year-old woman was admitted to Maharaj Nakorn Chiang Mai Hospital, Chiang Mai, Thailand, with a swollen and ulcerated right upper eyelid. The lesion in the eyelid had multiple holes around the ulcer site; bleeding was accompanied by pus and necrotic tissue - the site was filled with dipteran larvae. Eleven larvae were removed from the patient, of which five were killed for microscopic examination and six were reared in the laboratory under ambient temperature and natural relative humidity until they metamorphose into adult. Five third instars and one adult were morphologically identified as C. bezziana. The predisposing factors were probably chronic immobility, inability of the patient to perform daily activities, and presumably neglected and/or poor personal hygiene. To our knowledge, this case represents the first reported case of orbital ophthalmomyiasis caused by C. bezziana in Thailand.

Three Sarcophagid species (Diptera: Sarcophagidae) newly recorded in Thailand

This study contributed new records of three flesh fly species (Diptera: Sarcophagidae) to the fauna of Thailand - Miltogramma tibita Chao & Zhang (subfamily Miltogrammatinae), Myorhina situliformis (Zhong, Wu & Fan, 1982), and Iranihindia martellata (Senior-White, 1924) (subfamily Sarcophaginae). Collections of these species were performed using a sweep net and one-day old beef offal as bait. Miltogramma tibita differs from other known Miltogramma by having a fine long seta on the dorsal surface of tarsomeres 2-4. With this new record, the number of species belonging to the genus Miltogramma known from Thailand has increased to three which includes Miltogramma angustifrons (Townsend, 1933) and Miltogramma iberica Villeneuve, 1912. The new record of My. situliformis makes a total of three species for Myorhina and these include Myorhina otiophalla (Fan & Chen, 1981) and Myorhina caudagalli (Böttcher, 1912). Regarding Iranihindia, the recording of I. martellata makes a total of two species, the other being Iranihindia martellatoides (Baranov, 1931). This study provides a revised key of each genus where these newly recorded species were recorded, with their re-descriptions, illustrations, photographs, and scanning electron micrographs focusing on the male genitalia. The findings of these newly recorded species means that a total of 86 species of flesh flies have been recorded from Thailand.

Ontogenensis and developmental rate of the blow fly, Hypopygiopsis tumrasvini Kurahashi (Diptera: Calliphoridae)

Blow flies of the genus Hypopygiopsis are considered forensically important. In Thailand, four Hypopygiopsis species coexist, i.e., Hypopygiopsis fumipennis, Hypopygiopsis infumata, Hypopygiopsis violacea and Hypopygiopsis tumrasvini. In this study, the ontogeny and developmental rate of H. tumrasvini eggs, larvae and pupae were determined in the laboratory chamber reared at 25.0 ± 2.0°C and 80.0 ± 5.0% RH. Larvae emerged from eggs 10-12 h after deposition. Mean length of the first, second, third (feeding phase), third (post-feeding phase) instars and puparia were 3.5 ± 1.1, 7.2 ± 1.1, 13.5 ± 1.8, 12.5 ± 0.5 and 9.0 ± 0.7 mm, respectively. The median development time for first, second, third instar (feeding phase), third instar (post-feeding phase) and pupariation period was 8 h, 10 h, 34 h, 22 d and 9-10 d, respectively. Developmental curve of the larval length indicated the rapid progression from 0 until 40 h from the first instar until the feeding third instar. Video recording of pupariation revealed the development of pupal respiratory horn beneath the larval integument at 27.0 h; whereas it protruded through the orifice of the integument at 27.5 h.

The blow fly, Chrysomya megacephala, and the house fly, Musca domestica, as mechanical vectors of pathogenic bacteria in Northeast Thailand

The Oriental latrine fly, Chrysomya megacephala (Fabricius) (Diptera: Calliphoridae) and the house fly, Musca domestica L., (Diptera: Muscidae) are synanthropic flies which are adapted to live in close association with human habitations, thereby making them likely mechanical vectors of several pathogens to humans. There were two main aims of this study. The first aim was to determine the prevalence of these two fly species from five types of human habitations including: fresh-food markets, garbage piles, restaurants, school cafeterias and paddy fields, in the Muang Ubon Ratchathani and Warinchamrap districts of Ubon Ratchathani province of Northeast Thailand. Flies collection were conducted monthly from September 2010-October 2011 using a reconstructable funnel trap, containing 1 day-tainted beef offal as bait. A total of 7 750 flies (6 401 C. megacephala and 1 349 M.domestica) were collected. The second aim was to examine the potential of these flies to carry pathogenic bacteria. Bacteria were isolated from 994 individual flies collected using a sweep net (555 C. megacephala and 439 M. domestica). A total of 15 bacterial genera were isolated from the external surfaces, comprising ten genera of gram-negative bacteria and five gram-positive bacteria. The most common bacteria isolated from both species were coagulase-negative staphylococci, followed by Streptococcus group D non-enterococci. Human pathogenic enteric bacteria isolated were Salmonella sp., Shigella sp., Escherichia coli O157:H7, Salmonella typhi, Bacillus sp., and Enterococcus sp., of which S. typhi is the first report of isolation from these fly species. Other human pathogens included Staphylococcus aureus and Pseudomonas aeruginosa. Not only were the number of C. megacephala positive for bacteria significantly higher than for M. domestica, but they were also carrying ~11-12 times greater bacterial load than M. domestica. These data suggest that both fly species should be considered potential mechanical vectors of bacterial pathogens associated with human habitations year-round in this region of Northeast Thailand.

Morphology of puparia of flesh flies in Thailand

Puparia of five flesh fly species were investigated for forensic study. Boettcherisca nathani (Lopes, 1961), Boettcherisca peregrina (Robineau-Desvoidy, 1830), Lioproctia pattoni (Senior-White, 1924), Liopygia ruficornis (Fabricius, 1794) and Parasarcophaga (Liosarcophaga) dux (Thomson, 1869) were examined with a scanning electron microscopy (SEM). Differences between species were found in the number and arrangement of papillae in the anterior spiracle, the shape of intersegmental spines between the prothorax and mesothorax and the pattern of spiracular tufts at the posterior spiracle. The anterior spiracle of B. nathani had two rows, comprising 21-27 papillae; while those of B. peregrina and L. pattoni had one or two irregular rows with 24-26 and 20-28 papillae, respectively. Anterior spiracle of L. ruficornis and P. dux had one row of 10-15 papillae. Intersegmental spines between the prothorax and mesothorax and pattern of spiracular tufts at the posterior spiracle are morphologically different. L. ruficornis and P. dux puparia are similar, but the position of the interslit plate between the inner and middle spiracular slits was found to be an important attribute to separate both species. Morphometric analysis on the length and width of puparia of these species revealed statistically different among them. The key for identifying puparia of forensically important flesh flies has been provided.

Parasarcophaga (Liopygia) ruficornis (Diptera:Sarcophagidae): a flesh fly species of medical importance

Parasarcophaga (Liopygia) ruficornis is a well-known flesh fly species of medical importance, both as a myiasis-producing agent and fly seen in a forensic entomology context. This study performed a comprehensive literature review of this fly species, dealing with morphology, bionomics and medical involvement. Important characteristics used to identify P. ruficornis have been provided for both its third instar and adult for identification purpose in the future.

Morphology and identification of fly eggs: application in forensic entomology

Fly eggs found in corpses can be used as entomological evidence in forensic investigation. This study aims to investigate the morphology of forensically important fly eggs. Eggs of Chrysomya rufifacies, Chrysomya megacephala, Chrysomya pinguis, Chrysomya nigripes, Hypopygiopsis tumrasvini, Lucilia cuprina, Lucilia porphyrina and Musca domestica were examined using 1% potassium permanganate solution for 1 min. Morphometric analysis revealed that the mean length of Hy. tumrasvini (1.63 mm) and C. pinguis (1.65 mm) eggs was the longest, followed by that of L. porphyrina (1.45 mm), C. rufifacies (1.34 mm). The egg length, width of median area and darkness staining of hatching pleats were distinctive features. Four categories of median area were proposed, based on width; (1) distinctly wide (Megaselia scalaris, Synthesiomyia nudiseta); (2) wide (C. nigripes, M. domestica); (3) slightly widening (Hy. tumrasvini, L. cuprina, L. porphyrina); and (4) narrow (C. rufifacies, C. albiceps, C. megacephala, C. pinguis). Four species were examined using SEM, i.e., C. megacephala, C. pinguis, Hy. tumrasvini and L. porphyrina. The eggs of C. megacephala demonstrated swollen hatching pleats. Inside, the hexagon of the chorion appeared as a sponging bumpy feature. The egg of C. pinguis was similar to C. megacephala, except for the sponging bumpy feature on the outer surface of the hatching pleats. Regarding Hy. tumrasvini and L. porphyrina, their island structure was apparent at the inner surface of the upright hatching pleats. The key for identifying these eggs together with other reported species in Thailand has been updated.

Observations of the third instar larva and puparium of Chrysomya bezziana (Diptera: Calliphoridae)

Observations on the ultrastructure of the third instar larva and puparium of the Old World screw-worm fly, Chrysomya bezziana, are presented utilizing both light microscopy (LM) and scanning electron microscopy (SEM). Results of this study indicate that the shape of the intersegmental spines between the pro- and mesothorax markedly differ from other blow fly species (Chrysomya megacephala, Chrysomya rufifacies, Chrysomya nigripes, Lucilia cuprina) in being broad-based with sharp recurved tips. Other characters such as the posterior spiracles, number of papillae on the anterior spiracles, oral grooves, and posterior spiracular hairs also differ. The strong and robust mouthhooks may explain the ability of larvae to penetrate deeply into human tissues. Perforated sieve plates covered with antler-like projections were observed within the anterior spiracles of the puparium of C. bezziana. The posterior spiracular discs each bear three spiracular slits with approximately 2-microm wide openings that were viewed either open or closed by a membrane underneath. This study expands our knowledge of the fine details of the external morphology of both the third instar larva and puparium of C. bezziana, which is an obligatory myiasis-producing species in many regions. A key to differentiate the third instar of C. bezziana from other blow flies in Thailand is given.

Ultrastructure of adhesive device in fly in families calliphoridae, muscidae and sarcophagidae, and their implication as mechanical carriers of pathogens

The ultrastructure of adhesive device or the pulvilli, pad-like structure between the tarsal claws of the legs, is presented in the blowfly (Calliphoridae), housefly and relatives (Muscidae), and flesh fly (Sarcophagidae) through scanning electron microscopy. The blowfly species were Chrysomya chani, Chrysomya nigripes, Chrysomya pinguis, and Chrysomya villeneuvi; while those of the housefly and relatives were Musca domestica and Hydrotaea chalcogaster, respectively. Fresh fly species included Boettcherisca peregrina and Liosarcophaga dux. Numerous tenent setae were observed on the ventral side of the pulvilli. Two features of the tip of the tenent setae were found as a spatula-like (in C. chani, C. pinguis, C. nigripes, M. domestica, H. chalcogaster, B. peregrina, and L. dux) and spoon-like tip (in C. villeneuvi). Transmission electron microscopy of the tenent setae in M. domestica revealed the electron-lucent centrally located, suggesting an adhesive substance. These results provided anatomical information that allow us to not only understand the successful attachment of flies to smooth surfaces but also clarify their role as a mechanical carrier of microorganisms.

Surface ultrastructure of the puparia of the blow fly, Lucilia cuprina (Diptera: Calliphoridae), and flesh fly, Liosarcophaga dux (Diptera: Sarcophagidae)

Surface ultrastructure of the puparia of the blow fly, Lucilia cuprina, and flesh fly, Liosarcophaga dux, are presented utilizing scanning electron microscopy (SEM). Emphasis was focused on characteristic features of the puparia that could be used for differentiation from other forensically important fly species. The puparium of L. cuprina typically measures 6.2+/-0.2 mm in length and 2.3+/-0.1 mm in width. Each anterior spiracle contains a single row of 5-7 papillae. The intersegmental spines between the prothorax and mesothorax are triangular with constricted tips. A clustered bubble membrane, comprising about 30 mammillate structures, is positioned dorsolaterally on each side of the first abdominal segment in young puparia but is replaced by short, tubular respiratory horns in aged puparia. The posterior end of the puparium is broadly truncate and bears a pair of medially positioned posterior spiracles that each contains three straight spiracular slits. The puparium of L. dux is larger in comparison to L. cuprina and typically measures 9.9+/-0.3 mm in length and 3.8+/-0.2 mm in width. An anterior spiracle of this species contains 14-17 papillae. The intersegmental spines between the prothorax and mesothorax are broad and triangular. A convoluted structure of unknown function was observed at the dorsolateral edge of segments 5-11. In L. dux, the caudal segment of the puparium is slightly tapered and abruptly truncated and contains a pair of posterior spiracles that are located within a deep concavity in the terminal end. Each posterior spiracular disc appears D-shaped, with a pronounced medial projection and three vertically oriented long, narrow spiracular slits. The anatomical features presented herein may be useful for identification of fly puparia of these two species in future forensic entomological investigations.

Isolation and in vitro antimalarial activity of hexane extract from Thai Picrasma javanica B1 stembark

The in vitro antimalarial activities against Plasmodium falciparum K1 of four extracts from the stembark of Picrasma javanica B1; ie water, methanol, chloroform and hexane extracts were studied using a modification of the [3H]hypoxanthine incorporation method. It was found that the hexane extract showed in vitro antimalarial activity with IC50 of 3.3 microg/ml. The extract was further fractionated using quick column chromatography, resulting in ten fractions. Fraction V was the most effective against P. falciparum K1 with IC50 of 4.4 microg/ml. Further isolation of fraction V using a column chromatographic technique provided six fractions. According to 1H- and 13C-NMR spectra, it could be concluded that the major compound in fraction V-3 was beta-sitosterol. Unfortunately, the antimalarial activity of beta-sitosterol could not be determined because of its low solubility in DMSO. However, fractions V-2 and V-4 still showed in vitro antimalarial activities with IC50 of 2.8 and 3.4 microg/ml, respectively. The further fractionation of these two active fractions could lead to promising candidates as antimalarial agents.

In vitro development of Haplorchis taichui (Trematoda: Heterophyidae)

Newly excysted metacercariae of Haplorchis taichui were cultured in a candle jar set at 37 degrees C. Both monophasic culture media [0.85% NaCl, RPMI 1640, RPMI 1640+10% fetal calf serum (FCS)] and diphasic culture media [RPMI 1640 + egg yolk agar, RPMI 1640 + 5%, 10% or 15% blood in blood agar (BA), RMPI 1640 + 5%, 10% and 15% FCS with 5% blood in BA] were used in vitro. Parasites survived for only 1 day in 0.85% NaCl without any development. In RPMI 1640 with egg yolk agar and RMPI 1640 + 5%, 10% FCS, the parasite survived for 3-5 days. In contrast, worms survived for 12-14 days in RPMI 1640 with blood agar without any change in result in a different concentration of blood in BA. The ovary and testes were observed after 3 days incubation in this media. Nevertheless, only 1 parasite in RPMI 1640 with 15% blood in BA had vitellaria and eggs at day 6. RPMI 1640 with blood agar can be used as short-term maintenance for the in vitro culture of H. taichui. However, further studies are needed.

Experimental infection of Gnathostoma spinigerum larvae in prawns and tadpoles

Naturally captured Lanchester's freshwater prawns (Macrobrachium lanchesteri) and farm-bred Rana regulosa tadpoles were assessed for their capability of being the first or second intermediate hosts of Gnathostoma spinigerum. Seventy specimens from each animal group were randomized into a control group and investigated for larvae of G. spinigerum by pressing them between two pieces of glass and examination under stereomicroscope. No Gnathostoma larvae were found in the entire control group. Another 120 specimens of each animal were used in two treatment groups; 60 being exposed to the first-stage larvae, G. spinigerum, and 60 exposed to cyclops containing the third-stage larvae for 7 days. No larvae of G. spinigerum were found in the prawns of both treatment groups that resembled tadpoles exposed to the first-stage larvae. In contrast, 18.3% of tadpoles, which were exposed to cyclops containing third-stage larvae, were infected. Lanchester's freshwater prawns cannot serve as intermediate host of G. spinigerum, while R. regulosa can serve as the second intermediate host.

In vitro excystation of Haplorchis taichui (Trematoda: Heterophyidae)

The effects of trypsin, bile extract, temperature and acid-based condition for the in vitro excystation of Haplorchis taichui metacercariae were studied. At 37 degrees C, approximately half the number of metacercariae excysted when exposed to 1% trypsin for 15 minutes with no more excystation found beyond this time. Increasing trypsin concentration seemed to reduce the excystation rate while bile extract was, however, unlikely to be an absolute requirement. A temperature of 37 degrees-41 degrees C yielded a similar excystation result in combination with 1% trypsin; however, less excystation occurred at a lower temperature of 35 degrees C. The acid-based environment of pH 8 gave the best excystation result in association with 1% trypsin at a temperature of 39 degrees C. Higher and lower basicity produced a smaller excystation rate. An environmental condition of 1% trypsin at pH 8 and a temperature of between 37 degrees-41 degrees C was recommended for the in vitro excystation of H. taichui metacercariae. The relatively broad temperature and pH range condition for the excystation of H. taichui corresponded with various definitive hosts that were infected naturally by this fluke.

Prevalence of Opisthorchis viverrini infection among villagers harboring Opisthorchis-like eggs

The precise occurrence of Opisthochis viverrini infection in humans, who were positive for Opisthorchis-like eggs in a stool examination, was determined using the potassium permanganate staining method. In the 68 specimens examined, there were more individual O. viverrini eggs (38.24%) than singular Haplorchis taichui eggs (29.41%). One-fourth of the total specimens contained a mixed infection of O. viverrini and H. taichi eggs. The median ratio of O. viverrini: H. taichui eggs in mixed infection cases was 2.29 (min = 1, max = 17.5). It is suggested that chemotherapy with praziquentel treatment should be given to patients who are positive for O. viverrini-like eggs.

Development of Haplorchis taichui (Trematoda: Heterophyidae) in Mus musculus mice

The development of Haplorchis taichui was studied in sixteen mice, Mus musculus. Metacercarial cysts of H. taichui were obtained from the freshwater fish, Thynnichthys thynnoides, collected in Chiang Mai Province, north Thailand. Approximately 200 active metacercariae were orally introduced into each mouse. Two mice were randomly sacrificed and necropsied daily from day 2-9 postinfection (pi). Two peaks of increment in the length and width of worms were found at day 3 and 7 pi. H. taichui was rapid in maturation, similar to other minute intestinal flukes. Rudimentary sex organs were found at day 2 pi. Spermatozoa in a seminal receptacle, vitellaria and eggs were seen as early as 3 days pi. The number of eggs increased daily to approximately 50-60 eggs thereafter. Mice can serve as a suitable experimental definitive host for harvesting adult H. taichui, especially in 1-week pi.

Intensity of trematode metacercariae in cyprinoid fish in Chiang Mal Province, northern Thailand

The intensity of infection of trematode metacercariae was determined in five species of cyprinoid fish collected from Mae Ngud reservoir, Chiang Mai Province. These species were Thynnichthys thynnoides, Puntioplites proctozysron, Hampala macrolepidota, Puntius leiacanthus and Puntius gonionotus. T. thynnoides contained the highest number (83.0%) of metacercariae, whereas P. gonionotus had the fewest (0.19%). The caudal fin was the area of highest infection of metacercariae (49.39%), with the anal fin having the fewest (5.93%). Most metacercariae was isolated from Haplorchis taichui (63.27%), with an intensity variation of 0.3-165.2 metacercariae/fish.

Surface ultrastructure of the third-instar larvae of Hydrotaea spinigera Stein (Diptera: Muscidae), a fly species of forensic importance

The surface ultrastructure of third-instar larvae of Hydrotaea (= Ophyra) spinigera Stein was observed with scanning electron microscopy. The number of papillae in each anterior spiracle ranges from 5-7. Abdominal segments 4-12 possess ventral welts. Each posterior spiracular disc bears 3 nearly straight slits, with the lower and middle slits closer together than the middle and upper slits. Although the larvae of H. spinigera are generally similar to two other closely-related species in Thailand, Hydrotaea (= Ophyra) leucostoma (Wiedemann) and Hydrotaea (= Ophyra) chalcogaster (Wiedemann), some of the morphological features can help in differentiating these species, thus allowing more accurate identification of species of fly larvae in forensic investigation.

Polygamy: the possibly significant behavior of Aedes aegypti and Aedes albopictus in relation to the efficient transmission of dengue virus

The polygamous behavior of male Aedes aegypti (L.) and Ae. albopictus (Skuse) was investigated by co-habiting a newly-emerged male and females in a 30 cm3 cage (1 male: 20 females) for up to 5 consecutive days. As determined by insemination rates, the results indicated that one Ae. aegypti and Ae. albopictus male could successfully mate with 1.10 (0-4), 4.10 (1-8), 5.40 (4-8), 5.10 (2-8), 5.15 (3-9) and 0.20 (0-3), 1.70 (0-3), 2.35 (1-4), 2.30 (0-4), 2.35 (1-4) Ae. aegypti and Ae. albopictus females, respectively on day 1,2,3,4 and 5 consecutively. The possibly significant role of their polygamy in relation to dengue virus transmission is discussed.

Chrysomya rufifacies (Macquart) as a forensically-important fly species in Thailand: a case report

The first documented use of the larvae of the hairy maggot blow fly, Chrysomya rufifacies, for estimating the postmortem interval (PMI) of a decomposing human corpse in Thailand is reported. A honeycomb-like wound observed on one leg of the corpse was infested with numerous third-stage C. rufifacies larvae. Based on the pupae and larvae present in accordance with the ambient temperature previously recorded, six days postmortem was estimated for a corpse at the time of its discovery and investigation. Since adult C. rufifacies specimens have been collected in many parts of both urban and mountainous areas in Thailand, more biological information about this blowfly species is needed to increase the accuracy of forensic investigations where the fly is present.

Cystatin capture enzyme-linked immunosorbent assay for serodiagnosis of human clonorchiasis and profile of captured antigenic protein of Clonorchis sinensis

Enzyme-linked immunosorbent assay (ELISA) with crude extracts of adult Clonorchis sinensis has been reported to have a high degree of sensitivity with a moderate degree of specificity for the serodiagnosis of clonorchiasis. The cystatin capture ELISA was investigated for its usefulness for the serodiagnosis of human clonorchiasis. Cystatin bound specifically to cysteine proteinases in crude extracts of adult C. sinensis worms, and its binding capacity was not hindered competitively by the other proteinase inhibitors tested. The cystatin capture ELISA for clonorchiasis showed a higher degree of specificity than the conventional ELISA, which produced some cross-reactivities to sera from patients with cysticercosis, sparganosis, and opisthorchiasis. Immunoglobulin G antibodies to C. sinensis cysteine proteinases were produced in experimental rabbits at week 3, and their levels increased rapidly and remained at a plateau after 8 weeks of infection. Of the proteins from the C. sinensis crude extract captured with cystatin, seven proteins were reactive with the serum from patients with clonorchiasis. The cystatin capture ELISA is indicated to be a sensitive and highly specific immunodiagnostic assay for serodiagnosis of human clonorchiasis.

Mechanical carrier of bacterial enteric pathogens by Chrysomya megacephala (Diptera: Calliphoridae) in Chiang Mai, Thailand

Chrysomya megacephala was studied regarding its mechanically bacterial carrier in urban areas of Chiang Mai, northern Thailand. Fifty-six adult flies were randomly collected using sweep insect net during April-May, 1999 from 3 fresh food markets and examined for bacteriological isolation. Among them, 49 flies (87.5%) were bacterial carriers. The total 22 bacterial species and 8 groups were isolated. Three species previously reported as the bacterial enteric pathogens causing diarrheal disease were isolated from 5 flies, ie Aeromonas hydrophila, Edwardsiella tarda and Vibrio cholerae non-01, with their prevalence rates in flies being 3.579, 1.79% and 3.57%, respectively. Five possible bacteria enteric pathogens, ie Aermononas sobria, Citrobacter freundii, Escherichia coli, Providencia alcalifaciens and Pseudomonas aeruginosa, were isolated from 21 flies with the prevalence rates in flies being 5.34%, 3.57%, 26.79%, 7.14% and 1.79%, respectively. The bacterial load isolated from all 3 pathogenic species was entirely found more than 10 colony per fly, indicating the high chance for disease transmission via this fly species. C. megacephala may play the possible and/or important role of bacterial enteric pathogens transmission, thereby promoting the public health personnel for sanitation improvement in fresh food markets and fly control management in these particular areas.

The first documented forensic entomology case in Thailand

The forensic entomology case described herein is the first such case documented in Thailand. A mummified corpse of a 32-yr-old man was discovered in a forested habitat, with the larvae of six species of flies (Diptera) found in association with the corpse at the time of its discovery, i.e., those of Hydrotaea (=Ophyra) spinigera Stein (family Muscidae), Piophila casei (L.) (family Piophilidae), Megaselia scalaris (Loew) (family Phoridae), Sagus sp. (family Stratiomyidae), and larvae of two unidenitified flesh fly species (family Sarcophagidae). The presence and age of the larval specimens of P. casei, M. scalaris, and H. spinigera gave entomological evidence that the postmortem interval for the corpse was 3-6 mo. This report also documets some of the forensically important fly species that occur in Thailand.

Scanning electron microscopy of the third-instar Piophila casei (Diptera: Piophilidae), a fly species of forensic importance

The morphology of third-instar Piophila casei (L.) is described by means of scanning electron microscopy. Features of the anterior cephalic region and creeping welts that are used in larval skipping and creeping, respectively, are highlighted. Morphological features classically used for larval identification are also illustrated.

Scanning electron microscopy of Aedes lineatopennis (Diptera: Culicidae) eggs

The eggs of Aedes lineatopennis (Ludlow) are described by means of a scanning electron microscopy. The Ae. lineatopennis egg has a rather boat-shaped, fragmented micropylar collar, and membrane-like wall enclosing many tubercles of exochorionic sculpture.

Surface ultrastructure of excysted metacercariae of Haplorchis taichui (Trematoda: Heterophyidae)

The morphology of newly excysted juvenile Haplorchis taichui was studied using a light and a scanning electron microscope (SEM). The reproductive organs were well developed. The whole body surface was covered with numerous transverse rows of scale-like spines, which had 3-11 points at the tip. The spines on the dorsal were similar with those on the ventral surfaces in shape, size and number of points. The spines in anterior were digitated into 10-11 points, then 8-9 points and 7 points. The presence of 3 points in each spine was observed in the area adjacent to the excretory pore. Two types of sensory papillae existed throughout the body: type I, ciliated knob-like swellings and type II, round swellings of the tegument. The rapid maturation of H. taichui results from the development of both internal and external organs during the newly excysted stage.

Successful eradication of Ascaris lumbricoides and hookworm infection after three repeated doses of albendazole

Three repeated orally doses of albendazole 400 mg in 6 weekly intervals were evaluated in Thai hill-tribe students who had at least one kind of soil-transmitted helminths (i.e. Ascaris lumbricoides, hookworm and Trichuris trichiura). Stool examination and parasite egg count were performed using Beaver's standard direct smear method and Kato-Katz's cellophane thick smear method prior to treatment and then 1 month after the first, second and third dose of drug administrations. A single dose of albendazole was very effective against A. lumbricoides and hookworm infections, with cure rates of 98.68 per cent and 92.16 per cent, respectively. The second and third dosages eradicated A. lumbricoides and hookworm infections, respectively. Conversely, the first to third cure rates for T. trichiura infection were relatively low, being 37.76-58.16 per cent. Three repeated doses of albendazole proved to be beneficial in eradication of A. lumbricoides and hookworm infections, and decreased the prevalence of T. trichiura infected cases. For eradication of T. trichiura infection, further regimen and period of drug administration is required.

Lack of efficacy of quinine and artemether against advanced third-stage larvae of Gnathostoma spinigerum in vitro

The efficacy of quinine and artemether--the effective blood schizontocide in malarial treatment--has been in vitro tested with the advanced third-stage larvae of Gnathostoma spinigerum. All larvae were collected from freshwater eel (Fluta alba) and exposed to the culture medium, each containing either quinine dihydrochloride or artemether at a final concentration of 20 microg/ml and 0.5 microg/ml, respectively for 21 consecutive days. Larval motility was assessed daily and the topographical changes were assessed using scanning electron microscope after 21-days of drug exposure. All worms moved actively for 21 days of study period and no change in surface ultrastructure was observed. Quinine and artemether at these concentrations have no effect on movement and topographical changes on the advanced third-stage larvae of this parasite.

Musca domestica as a mechanical carrier of bacteria in Chiang Mai, north Thailand

The common house fly, Musca domestica L., was assessed for its potential as a mechanical carrier of bacteria in urban areas of Chiang Mai province, north Thailand. Sixty-one specimens (61.0%) were found to carry bacteria, with each harboring 1-5 bacteria. No significant difference between the sex of flies for carrying bacteria was found. A total of 21 bacteria was isolated, of which the most common was coagulase negative staphylococci (n = 38), followed by Viridans streptococci (n = 9). The highest bacterial load for all bacteria isolated was 10(3)-10(4) (67%), followed by > 10(4) (26%) colonies per fly. It is recommended that fly control management measures, including sanitation improvement, should be implemented.

Scanning electron microscopic observations on advanced third-stage larva of Gnathostoma spinigerum after in vitro exposure to albendazole sulphoxide

Gnathostomiasis is the parasitic disease caused by the migration of an advanced third-stage larva of Gnathostoma spinigerum. To date, albendazole is claimed to be the effective drug in preventing the reoccurrence of migratory swelling in patients. After being exposed to 1 and 2 micrograms/ml albendazole sulphoxide (AlbSO) in vitro, the parasites moved deteriorately, however, no dead larva was found even exposed to these concentrations for 21 consecutive days. The topographical alterations after 21 days of albendazole sulphoxide exposure are described using a scanning electron microscope. The marked changes in surface morphology were observed in both neck and body regions. The tegumental surface on the neck region was swollen and covered with fuzzy materials, whereas, the spines on the posterior region of the body were dislodged. These changes would probably lead to reduction of intermittent cutaneous migratory swelling in human gnathostomiasis patients.

Movability of advanced third-stage larva of Gnathostoma spinigerum exposed to albendazole sulphoxide in vitro

Movability of advanced third-stage larvae of Gnathostoma spinigerum exposed to albendazole sulphoxide (AlbSO), the active metabolite of albendazole, was determined in vitro. Larvae in control groups moved actively with the whole body for all 21 days of the study period. In larvae treated with AlbSO 1 microg/ml, the movement was significantly reduced after 11 days exposed to the drug and to be only a part of body on the 15th-21st days. In larvae treated with AlbSO 2 microg/ml, the movement was initiated in decreasing after 9th days and to be only a part of body on the 12th-17th days. Finally, worms were immobile but not dead on the 20th-21st days. Although there was no larvae died at 21st days exposed to AlbSO in both concentrations; but all worms were sluggish and may die later. These lethargic worms may not be able to migrate in patients and leading to cure. Albendazole may not be benefit for acute symptom clearance; however, it can prevent the recurrent migratory swelling after the treatment of 21 day-course.

Prevalence of trematode metacercariae in cyprinoid fish of Ban Pao district, Chiang Mai Province, northern Thailand

The prevalence of trematode metacercariae in natural cyprinoid fish was carried out in Ban Pao district, Chiang Mai Province, northern Thailand. Fish were collected from both man-made water reservoirs and natural sources during July 1996-May 1997. Nine species of cyprinoid fish harbored the metacercariae of Opisthorchis viverrini and small intestinal flukes of the family Heterophyidae, ie Haplorchis taichui, H. pumilio and Centrocestus spp. Metacercariae of H. taichui were found approximately 384 times more than O. viverrini. Among the fish collected, Puntius leiacanthus contained the highest number of metacercariae of H. taichui (182 metacercariae/fish) whereas P. orphoides contained the highest number of metacercariae of O. viverrini (1.4 metacercariae/fish). Metacercariae of H. taichui found in this area were year-round, with the highest and lowest incidence rates being in winter and rainy season, respectively. The difference between H. taichui and O. viverrini with respect to their prevalences are discussed.

Potassium permanganate staining for differentiation the surface morphology of Opisthorchis viverrini, Haplorchis taichui and Phaneropsolus bonnei eggs

Potassium permanganate staining method was developed for differentiation Opisthorchis viverrini, Haplorchis taichui and Phaneropsolus bonnei eggs. The surfaces of O. viverrini, H. taichui and P. bonnei eggs stained permanently and temporarily were similar in appearance even the staining procedures were varied both in concentration and time. Determined under light microscope set at 400x, all of these eggs were oval-shaped, operculated at one pole and indistinct small knob at posterior end. O. viverrini eggs showed the distinct musk-melon-like prominent ridges on the surface. Haplorchis taichui eggs had a light striae pattern while P. bonnei eggs had a smooth egg shell. Length of these trematode eggs were significant different (chi2 test, p < 0.05). Mean +/- SD of O. viverrini, H. taichui and P. bonnei eggs were 26.34 +/- 1.65 microm, 29.03 +/- 1.48 microm and 23.00 +/- 1.49 microm, respectively. Regarding of their width, the mean +/- SD of O. viverrini, H. taichui and P. bonnei eggs were 15.54 +/- 0.69 microm. 14.94 +/- 0.91 microm and 12.25 +/- 1.02 microm, respectively. The means of width of O. viverrini and H. taichui eggs were not significantly different (chi2 test, p > 0.05), however, they were significantly different from those of P. bonnei (chi2 test, p < 0.05). Temporary staining using 1% w/v concentration and only 1 minute of time is useful in the mass fecal examination survey for the prevalence and intensity of truly Opisthorchis infection.

Organophosphate and pyrethroid susceptibilities of Culex salinarius adults from Texas and New Jersey

Susceptibilities of adults from newly established colonies of Culex salinarius from New Jersey and Texas to commonly used mosquito adulticides were assessed using the insecticide-coated vial bioassay technique. Females from both colonies were similar in their susceptibilities to naled, chlorpyrifos, resmethrin, and permethrin. However, females from the New Jersey colony (established from collections made in Cape May County, NJ) were found to be 9 times more tolerant to malathion than were those from the Texas colony (established from collections made in Chambers County, TX), with median lethal concentration values for malathion tested against these 2 colonies of 0.70 and 0.08 microgram malathion/vial, respectively. The differences between these 2 colonies with respect to their tolerances to malathion may be a product of the age of each colony at the time assessments were made and/or the degree to which the parent stock used to start each colony was previously exposed to malathion in the field.

Pharmacokinetics of intramuscular artemether in patients with severe falciparum malaria with or without acute renal failure

AIMS

The pharmacokinetics of intramuscular artemether and its major plasma metabolite-dihydroartemisinin, were investigated in patients with severe manifestations of falciparum malaria.

METHODS

Six severe falciparum malaria patients with acute renal failure (ARF) and 11 without ARF were recruited into the study. They were treated with intramuscular artemether at a loading dose of 160 mg, followed by daily doses of 80 mg for another 6 days (total dose 640 mg).

RESULTS

Patients with and without ARF showed a good initial response to treatment; the parasite and fever clearance times were 66(30-164) and 76(36-140) h [median(range)], respectively. None had reappearance of parasitaemia in their peripheral blood smear within 7 days of initiation of treatment. In comatose patients, the time to recovery of consciousness was 51.6(22-144) h. Artemether was detected in plasma as early as 1 h after a 160 mg dose, and declined to undetectable levels within 24 h in most cases. Patients with ARF had significantly higher Cmax [2.38(1.89-3.95) vs 1.56(1.05-3.38) ng ml(-1) mg(-1) dose], AUC [35.4(22-52.9) vs 25.2(13.4-52.9) ng ml(-1) h mg(-1) dose], and lower Vz/F [5.45(3.2-6.9) vs 8.6(4.2-12.3) l kg(-1)] and CL/F [7.4(5.4-13.8) vs 19.1(8.5-25.1) ml min(-1) kg(-1)] when compared with those without ARF. In addition, t1/2,z was significantly longer in ARF patients [7.0(5.5-10.0) vs 5.7(4.2-6.6) h]. The pharmacokinetics of dihydroartemisinin in the two groups of patients were comparable.

CONCLUSIONS

ARF significantly modified the pharmacokinetics of intramuscular artemether. The changes could be attributed to either improved absorption/bioavailability, a reduction of systemic clearance, or a change in plasma protein binding of the drug.

Effect of artemether on electrocardiogram in severe falciparum malaria

The effect of intramuscular artemether (intramuscular loading dose of 160 mg, followed by 80 mg daily for another 6 doses), in comparison with that of quinine (intravenous infusion of loading dose of 20 mg/kg, followed by 10 mg/kg q 8 hourly for 7 days), on the electrocardiograph of severe falciparum malaria patients were investigated in 102 Thai patients (92 males, 10 females) admitted to Pra Pokklao Hospital, Chantaburi, southeast of Thailand. Fifty patients (19 with quinine and 31 with artemether) were eligible for ECG analysis. Hypotension was found significantly more common in the quinine group (13 vs 2 cases). Thirteen, 5 and 1 patients with quinine treatment, respectively, had tachycardia, non-specific T-wave change and QTc prolongation. No significant dysrhythmia was found despite high plasma quinine concentrations. Five patients died; their ECGs were not significantly different from those who survived. In the group with intramuscular artemether, 17 cases had tachycardia prior to artemether treatment. QTc prolongation and non-specific T-wave change were found in 2 and 6 cases. One patient had RBBB and second degree AV-block on Day 1, but returned to normal on Day 2. No other dysrhythmia or other significant changes in ECG tracing which would suggest any effect of artemether on cardiovascular system were observed.

Plasma quinine concentrations in falciparum malaria with acute renal failure

Plasma quinine (Qn) monitoring was performed in 32 patients with severe falciparum malaria (10 with acute renal failure (ARF) and 22 with other severe manifestations) who were treated with the standard regimen of 10 mg/kg body weight Qn dihydrochloride, with a loading dose of 20 mg/kg body weight. Median plasma Qn concentrations prior to the first dose on each day were approximately 10-30% higher in ARF patients than in non-ARF patients during acute infection. Seven patients underwent haemodialysis; 2 died after 2 cycles. There were no significant changes in plasma Qn concentrations in patients with ARF during haemodialysis. No Qn was detectable in haemodialysate fluids. This suggests that dosage adjustment of Qn during haemodialysis is unnecessary. Cardiotoxity of Qn must be of concern in malaria patients with ARF after 3 days of Qn therapy, and ECG monitoring during Qn infusion is recommended in all severe malaria patients with persistent ARF. If there is any arrhythmia, the infusion should be discontinued. However, in some hospitals where ECG facilities are not available, reduction in Qn dosage in persistent ARF patients should be considered after the third day of therapy. The appropriate dosage reduction should be further studied. Monitoring of total plasma Qn concentrations (which has been used routinely) is of no value for predicting the cardiotoxicity in ARF patients; monitoring of free Qn would be more appropriate. However, ECG seems to be the practical procedure to monitor cardiotoxicity of Qn. It may be possible to use the QTc interval to estimate the Qn concentration in severe malaria patients without ARF, but not in patients with persistent ARF.

Pharmacokinetics of quinine in patients with chronic renal failure

METHODS. We investigated the pharmacokinetics of quinine (Qn) following administration of a single oral dose of 600 mg Qn sulphate in six male Thai patients with a moderate degree of chronic renal failure (CRF), and six male Thai subjects with normal renal function. RESULTS. The drug was well tolerated in both groups of subjects; no major adverse reactions were observed. A marked alteration in the pharmacokinetics of Qn was found in patients with CRF compared to healthy subjects; there were six significant changes in the pharmacokinetic parameters. Absorption was delayed, but increased in CRF (tmax 4.5 vs 1.6 h, Cmax 6.17 vs 3.45 micrograms.ml-1). Total clearance was significantly reduced (0.94 vs 2.84 ml.min-1.kg-1, whereas Vz/f remained unchanged (1.82 vs 2.78 l. kg-1). This resulted in the increased values of AUC and prolongation of the t1/2z and MRT in the patients (AUC 181.5 vs 61.8 micrograms.min-1.ml-1, t1/2z 26 vs 9.7 h, MRT 36.4 vs 11.3 h). Median concentrations of plasma unbound fraction of Qn collected at 4 h after drug administration in patients and healthy subjects were 7.3 vs 9.8%, respectively.

Pharmacokinetics of quinine in chronic liver disease

The pharmacokinetics of quinine were investigated in a) six healthy male Thai subjects, and b) nine male Thai patients with a moderate degree of chronic liver disease, after a single oral dose of 600 mg quinine sulphate. tmax and t1/2.2 were significantly prolonged in patients (median [range] tmax 2 [1-5] vs 1.6 [0.8-2] h; t1/2,z 23.4 [17.4-41.7] vs 9.7 [7.8-17.2] h), and Vz/F was significantly larger (median [range] 4.21 [2.33-15.87] vs 2.78 [1.49-3.38] 1 kg-1). Median (range) concentration of the plasma unbound Qn fraction collected from the patients at 4 h after drug administration was 17 (8.4-17.8)% of total drug concentration.

Comparison of artemether and quinine in the treatment of severe falciparum malaria in south-east Thailand

One hundred and two Thai patients with severe falciparum malaria (92 males and 10 females) were allocated at random to receive either the standard regimen of quinine infusion (52 cases) or intramuscular artemether (50 cases). The patients in both groups had comparable admission clinical and laboratory data. Artemether gave a better survival rate (87.2% vs. 63.3%) and parasite clearance time (54 vs. 78 h) than quinine. Fever clearance times (79 h vs. 84 h) and time to recovery of consciousness (48 h in both groups) were comparable. Previous treatment with quinine or mefloquine had no influence on treatment outcome. The most common adverse effect in patients treated with quinine was tinnitus. Two patients had severe hearing impairment which resolved within 1 week after the end of treatment. Mild, transient pain was noted at the injection site of artemether but no abscess formed. QTc wave prolongation was seen in most patients receiving quinine; however, no arrhythmia was observed despite the high concentration of quinine in some patients who had received quinine before admission. Complications developed in 7 survivors in each treatment group. No patient in the artemether group had neurological sequelae after recovery of consciousness, but 2 in the quinine group had left facial palsy and one had a myasthenia gravis-like syndrome. No patient died with complications in he artemether group, but 7 died with pulmonary complications in the quinine group.

Electroencephalography in cerebral malaria

Electroencephalography (EEG) was performed in 13 male patients with cerebral malaria during the first 24 hours of admission, using a 10-channel, 10-20 system EEG machine (6 montages, 20 minute duration). The EEG patterns were of theta and delta waves from both sides of cerebral hemisphere suggesting diffused cortical dysfunction. No epileptic pattern was found in patients who had seizures prior to, or after admission. The initial EEG performed on the day of admission did not show any specific pattern attributable to any pathological condition. It was also unable to predict the prognosis of the 2 dead patients. However, one cerebral malaria patient with left hemiplegia was subsequently found to have right basal ganglia hemorrhage in CAT scan, high amplitude delta waves and theta waves in the tracings of the right hemisphere. The study suggests that a single EEG data on admission can hardly give enough information for prediction of the clinical course and outcome of cerebral malaria. Serial EEGs probably provide more useful information regarding the prognostic signs in this group of patients. Nevertheless, EEG could be useful to rule out some cerebral pathology such as space occupying lesions, epilepsy or any other causes of unconsciousness that could produce similar cerebral symptoms in malaria patients.

Pharmacokinetics of artemether after oral administration to healthy Thai males and patients with acute, uncomplicated falciparum malaria

1. The pharmacokinetics of artemether were investigated (a) in six healthy male Thai volunteers after single 200 mg oral doses and (b) in eight male Thai patients with acute uncomplicated falciparum malaria after an initial 200 mg oral dose followed by 100 mg at 12 h then 100 mg daily for 4 days. 2. In the healthy subjects, median (range) maximum plasma concentrations of artemether of 118 (112-127) ng ml-1 were reached at 3 (1-10) h. Thereafter, drug concentrations declined monoexponentially with a median (range) t1/2.z of 3.1 (1.0-9.6) h. The median (range) AUC and MRT values were 1.10 (0.33-4.44) micrograms ml-1 h and 8.3 (3.5-20.8) h. The median Cmax value of dihydroartemisinin, an active metabolite, was 379 (162-702) mg ml-1 at 6 (2-12) h. Its median AUC value was 6.6 (0.83-38.7) micrograms ml-1 h; the apparent t1/2.z was 10.6 (4.7-19.2) h and the median MRT value was 16.0 (5.0-41.0) h. 3. In the patients, a higher Cmax value of parent drug than those observed in healthy subjects (median and range of 231 (116-411) ng ml-1), was reached at 3 (1-3) h after the first dose. Steady state was reached after the third dose (24 h) and concentrations fluctuated over the range of 36-60 ng ml-1. The respective median (range) values of AUC and t1/2.z were 5.8 (3.76-12.9) micrograms ml-1 h and 4.2 (2.5-5.3) h.(ABSTRACT TRUNCATED AT 250 WORDS)

Preliminary report: a comparative clinical trial of artemether and quinine in severe falciparum malaria

Twenty-six patients with severe falciparum malaria were randomized to be treated with quinine or artemether. Twelve patients received quinine at the standard dose and fourteen patients received artemether intramuscularly at a total dose of 640 mg over 7 days. The patients were kept in the hospital for at least 7 days. Peripheral smear was performed 6-hourly until there was no parasitemia, then daily until discharged. Adverse effects were monitored through physical examination, laboratory findings and questionnaires. Laboratory examination was performed on admission, day 2, day 4 weekly until discharged. The patients in both groups were comparable in age, body weight, admission parasitemia, hemoglobin and white blood cell count. The survival rates were 93% and 58% in artemether and quinine groups, respectively (p = 0.052 at 95% confidence, using Fisher's exact test). The parasite and fever clearance times, and the time taken to gain consciousness in cerebral malaria patients were not significantly different between the two groups. Adverse effects in the quinine group consisted of dizziness and vertigo which were found in 4 patients. No adverse effects were noticed in the artemether group. This preliminary report suggests that artemether is a good alternative drug for severe falciparum malaria and seems to be better than quinine regarding survival rate and side effects. Confirmation of these findings in a larger study size is needed.