Volume 90, Issue 2, February 2014
The American Journal of Tropical Medicine and Hygiene - Volume 90, Issue 2, February 2014
Impact of Ramadan on Clinical and Microbiologic Parameters of Patients Seen at a Diarrheal Hospital in Urban Dhaka, Bangladesh, 1996–2012
Daniel T. Leung, Sumon K. Das, M. A. Malek, Firdausi Qadri, A. S. G. Faruque and Edward T. Ryan
Pages: 294–298
https://doi.org/10.4269/ajtmh.13-0513
Ramadan is a month in the Islamic calendar when Muslims fast during daylight hours. We used data from the surveillance system of the International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka Hospital in Dhaka, Bangladesh, a predominantly Muslim country, to compare the etiology and clinical presentation of patients who presented with diarrhea during Ramadan to that of control periods, defined as the 30 days immediately before Ramadan. The proportion of infecting pathogens was largely the same, although Shigella spp. were less likely to be identified during Ramadan. Clinical presentations during Ramadan among adult Muslim diarrheal patients were also comparable to those admitted during control periods. A subgroup of cholera patients who presented after sunset during Ramadan had a shorter duration of diarrhea and higher prevalence of severe thirst, drowsiness, and severe dehydration. Our findings suggest that Ramadan has few effects on the profile of enteric pathogens and clinical features of adults seeking medical care for diarrhea.
Soil-Transmitted Helminth Infection and Nutritional Status Among Urban Slum Children in Kenya
Parminder S. Suchdev, Stephanie M. Davis, Monina Bartoces, Laird J. Ruth, Caitlin M. Worrell, Henry Kanyi, Kennedy Odero, Ryan E. Wiegand, Sammy M. Njenga, Joel M. Montgomery and LeAnne M. Fox
To evaluate the nutritional impact of soil-transmitted helminth (STH) infection, we conducted a cross-sectional survey of 205 pre-school (PSC) and 487 school-aged children (SAC) randomly selected from the surveillance registry of the Centers for Disease Control and Prevention of the Kibera slum in Kenya. Hemoglobin, iron deficiency (ID), vitamin A deficiency (VAD), inflammation, malaria, anthropometry, and STH ova were measured. Poisson regression models evaluated associations between STH and malnutrition outcomes and controlled for confounders. Approximately 40% of PSC and SAC had STH infection, primarily Ascaris and Trichuris; 2.9% of PSC and 1.1% of SAC had high-intensity infection. Malnutrition prevalence among PSC and SAC was anemia (38.3% and 14.0%, respectively), ID (23.0% and 5.0%, respectively), VAD (16.9% and 4.5%, respectively), and stunting (29.7% and 16.9%, respectively). In multivariate analysis, STH in PSC was associated with VAD (prevalence ratio [PR] = 2.2, 95% confidence interval = 1.1–4.6) and ID (PR = 3.3, 95% confidence interval = 1.6–6.6) but not anemia or stunting. No associations were significant in SAC. Integrated deworming and micronutrient supplementation strategies should be evaluated in this population.
A Loop-Mediated Isothermal Amplification (LAMP) Assay for Strongyloides stercoralis in Stool That Uses a Visual Detection Method with SYTO-82 Fluorescent Dye
Matthew R. Watts, Gregory James, Yasmin Sultana, Andrew N. Ginn, Alexander C. Outhred, Fanrong Kong, Jaco J. Verweij, Jonathan R. Iredell, Sharon C-A. Chen and Rogan Lee
An assay to detect Strongyloides stercoralis in stool specimens was developed using the loop-mediated isothermal amplification (LAMP) method. Primers were based on the 28S ribosomal subunit gene. The reaction conditions were optimized and SYTO-82 fluorescent dye was used to allow real-time and visual detection of the product. The product identity was confirmed with restriction enzyme digestion, cloning, and sequence analysis. The assay was specific when tested against DNA from bacteria, fungi and parasites, and 30 normal stool samples. Analytical sensitivity was to < 10 copies of target sequence in a plasmid and up to a 10−2 dilution of DNA extracted from a Strongyloides ratti larva spiked into stool. Sensitivity was increased when further dilutions were made in water, indicative of reduced reaction inhibition. Twenty-seven of 28 stool samples microscopy and polymerase chain reaction positive for S. stercoralis were positive with the LAMP method. On the basis of these findings, the assay warrants further clinical validation.
Recurrent Streptococcus bovis Meningitis in Strongyloides stercoralis Hyperinfection after Kidney Transplantation: The Dilemma in a Non-Endemic Area
Taqi T. Khan, Fatehi Elzein, Abdullah Fiaar and Faheem Akhtar
Cutaneous Emergence of Eustrongylides in Two Persons from South Sudan
Mark L. Eberhard and Ernesto Ruiz-Tiben
Two large, living worms were collected as they emerged from the lower limb of each of two persons in South Sudan. The worms were observed by staff of the South Sudan Guinea Worm Eradication Program during surveillance activities in communities at-risk for cases of Guinea worm disease (dracunculiasis). The worms measured 7 and 8 cm in length and were identified as fourth-stage larvae of Eustrongylides. This is the first report of such worms emerging from the skin; all five previous reports of human infection involved surgical removal of worms from the peritoneal cavity.
Calcified Neurocysticercus, Perilesional Edema, and Histologic Inflammation
Theodore E. Nash, Luther A. Bartelt, Poonum S. Korpe, Beatriz Lopes and Eric R. Houpt
Here, we present the second report of the histopathology of a Taenia solium calcification giving rise to perilesional edema. This has important implications, because if perilesional edema lesions are inflammatory in character, immunosuppressive or anti-inflammatory medications, not just antiepileptic drugs alone, may be useful to prevent or treat recurring episodes in such patients.
Assessment of Quality of Life as a Tool for Measuring Morbidity Due to Schistosoma mansoni Infection and the Impact of Treatment
Kimberly Y. Won, Bernard Abudho, Anna J. Blackstock, Susan P. Montgomery, Erin D. Kennedy, Bobbie Person, Pauline N. M. Mwinzi, Elizabeth A. Ochola, Karen T. Foo, Allen W. Hightower, Diana M. S. Karanja and W. Evan Secor
Recently, health measurements have broadened to include the assessment of quality of life (QOL). This study was conducted to assess whether the short form of the World Health Organization (WHO) QOL questionnaire (WHOQOL-BREF) was an effective tool for measuring morbidity due to Schistosoma mansoni infection and whether it could detect an impact of treatment with praziquantel. A total of 724 adults 18–85 years of age were enrolled. At baseline, S. mansoni prevalence was 73.2% by stool examination and 75.4% by circulating cathodic antigen, and there was no association between infection status and WHOQOL-BREF scores. Six months after treatment, S. mansoni prevalence was lower and the proportion of persons with higher WHOQOL-BREF scores significantly increased among persons who were infected at baseline. However, a similar increase was observed in persons not infected at baseline. In areas of high prevalence, the WHOQOL-BREF may not be able to detect the benefits of schistosomiasis control programs.
Coinfection with Plasmodium falciparum and Schistosoma haematobium: Additional Evidence of the Protective Effect of Schistosomiasis on Malaria in Senegalese Children
Magali Lemaitre, Laurence Watier, Valérie Briand, André Garcia, Jean Yves Le Hesran and Michel Cot
Parasitic infections are associated with high morbidity and mortality in developing countries. Several studies focused on the influence of helminth infections on malaria but the nature of the biological interaction is under debate. Our objective was to undertake a study to explore the influence of the measure of excreted egg load caused by Schistosoma haematobium on Plasmodium falciparum parasite densities. Ten measures of malaria parasite density and two measures of schistosomiasis egg urinary excretion over a 2-year follow-up period on 178 Senegalese children were considered. A linear mixed-effect model was developed to take data dependence into account. This work showed that children with a light S. haematobium infection (1–9 eggs/mL of urine) presented lower P. falciparum parasite densities than children not infected by S. haematobium (P < 0.04). Possible changes caused by parasite coinfections should be considered in the anti-helminth treatment of children and in malaria vaccination development.
Absence of an Association Between Plasmodium falciparum Infection and Post-Ivermectin Loa-Related Non-Neurologic Serious Adverse Events
Joël Fokom-Domgue, Sébastien D. Pion, Raceline Gounoue, Julie Akame, Patrick Nguipdop-Djomo, Nana A. Y. Twum-Danso, Björn Thylefors, Michel Boussinesq and Joseph Kamgno
Although ivermectin treatment can induce serious adverse events (SAEs) in individuals harboring high Loa loa microfilaremia (mf), not all patients with high mf levels develop such reactions, suggesting that cofactors may be involved. A study was conducted in Cameroon to investigate the possible role of Plasmodium coinfection at the time of ivermectin treatment in the development of SAEs. Before their first ivermectin treatment, thick smears were obtained from 4,175 individuals to determine the burden of Plasmodium sp., L. loa, and Mansonella perstans. After treatment, 18 (4.3 per 1,000) patients developed a non-neurologic SAE. Logistic regression analysis, adjusting for age, sex, P. falciparum infection, and M. perstans infection intensities, confirmed that L. loa mf was the main risk factor for SAEs. We found no evidence that coinfection with P. falciparum at the time of ivermectin treatment was associated with the occurrence of Loa-related SAEs in this population.
Serosurveillance to Monitor Onchocerciasis Elimination: The Ugandan Experience
David Oguttu, Edson Byamukama, Charles R. Katholi, Peace Habomugisha, Christine Nahabwe, Monica Ngabirano, Hassan K. Hassan, Thomson Lakwo, Moses Katabarwa, Frank O. Richards and Thomas R. Unnasch
Uganda is the only African country whose onchocerciasis elimination program uses a two-pronged approach of vector control and mass drug distribution. The Ugandan program relies heavily upon the use of serosurveys of children to monitor progress toward elimination. The program has tested over 39,000 individuals from 11 foci for Onchocerca volvulus exposure, using the Ov16 ELISA test. The data show that the Ov16 ELISA is a useful operational tool to monitor onchocerciasis transmission interruption in Africa at the World Health Organization (WHO) recommended threshold of < 0.1% in children. The Ugandan experience has also resulted in a re-examination of the statistical methods used to estimate the boundary of the upper 95% confidence interval for the WHO prevalence threshold when all samples tested are negative. This has resulted in the development of Bayesian and hypergeometric statistical methods that reduce the number of individuals who must be tested to meet the WHO criterion.
Glycoprotein 60 Diversity in Cryptosporidium parvum Causing Human and Cattle Cryptosporidiosis in the Rural Region of Northern Tunisia
Ikram Rahmouni, Rym Essid, Karim Aoun and Aïda Bouratbine
The zoonotic potential of Cryptosporidium parvum was studied in an extensive cattle farming region of northern Tunisia. Seventy fecal samples from pre-weaning calves and 403 fecal samples from children were examined by microscopy after modified Ziehl–Neelsen (MZN) staining. Positive Cryptosporidium specimens were identified at a species level using an 18S rRNA nested polymerase chain reaction (PCR) followed by an Restriction Fragment Length Polymorphism (RFLP) analysis. C. parvum isolates were subgenotyped by sequence analysis of the glycoprotein 60 (gp60) gene. Among calf samples, 14 samples were positive by MZN method. C. parvum was identified in all cases. Twelve parvum isolates (85.7%) belonged to family subtype IIa. Subtype IIaA15G2R1 was more prevalent (50%). Two C. parvum isolates corresponded to the IIdA16G1 subtype. Seven human samples were positive by MZN method. C. parvum and C. meleagridis were identified in four and three cases, respectively. Intraspecific characterization of C. parvum identified two subtypes, the IIaA15G2R1 and the IIdA16G1, also found in calves.
Cyclospora cayetanensis: This Emerging Protozoan Pathogen in Mexico
José T. Sánchez-Vega, Héctor A. Cabrera-Fuentes, Addi J. Romero-Olmedo, José L. Ortiz-Frías, Flura Sokolina and Guillermo Barreto
A Mexican airline pilot had clinical manifestations of illness after a five-day stay in Lima, Peru. Six months later in Mexico, he was given a diagnosis of infection with Cyclospora cayetanensis by using coproparasitoscopic serial tests. He was treated twice with nitazoxadine successfully.
Molecular Mechanisms of In vitro Betulin-Induced Apoptosis of Leishmania donovani
Prakash Saudagar and Vikash Kumar Dubey
Although leishmanial infections of humans occur globally, the major health impact lies in developing nations, thus, leishmaniases remain "neglected" diseases for new drugs development. Multidrug resistance has been documented in most countries where leishmaniases is endemic. Betulin is a widely available and affordable natural product exerting leishmanicidal activity at micromolar concentration. In this study, the molecular mechanisms of death that contribute to the anti-leishmanial activity of betulin are investigated. In promastigotes, betulin stimulated reactive oxygen species generation at micromolar concentrations in Leishmania. Apoptosis was observed in betulin-treated promastigotes using flow cytometric analysis of treated cells stained with annexin V-FITC and propidium iodide. Furthermore, betulin treatment of promastigotes led to mitochondrial membrane damage, activation of caspase-like proteases, and DNA fragmentation in Leishmania donovani promastigotes. Betulin treatment of amastigotes cultured within macrophages, resulted in a reduced number of amastigotes, with no substantive cytotoxic damage to the host macrophage cells at leishmanicidal drug concentrations.
Sarcocystis nesbitti Infection in Human Skeletal Muscle: Possible Transmission from Snakes
Yee Ling Lau, Phooi Yee Chang, Chong Tin Tan, Mun Yik Fong, Rohela Mahmud and Kum Thong Wong
Sarcocystis nesbitti is an intracellular protozoan parasite found as sarcocysts within muscle fibers of intermediate hosts (monkey and baboon). The definitive host is suspected to be the snake. We report two cases from a larger cohort of 89 patients who had fever, headache, and generalized myalgia after a trip to Pangkor Island, Malaysia. Sarcocysts were detected in skeletal muscle biopsy specimens by light and electron microscopy from these two patients. DNA sequencing based on the 18S ribosomal DNA region identified the Sarcocystis species as S. nesbitti. We also identified S. nesbitti sequences in the stools of a snake (Naja naja). Phylogenetic analysis showed that these sequences form a cluster with most of the other known Sarcocystis species for which the snake is a definitive host. We believe these two patients were likely to have symptomatic acute muscular sarcocystosis after S. nesbitti infection that may have originated from snakes.
Fetal and Neonatal Health Consequences of Vertically Transmitted Hepatitis E Virus Infection
Lisa J. Krain, Jessica E. Atwell, Kenrad E. Nelson and Alain B. Labrique
Hepatitis E virus (HEV) infections lead to tens of thousands of deaths annually, mostly in developing countries. Hepatitis E poses a significant threat to the health of expectant mothers, a well-noted epidemiologic feature of the disease, but the contribution of vertically transmitted HEV infection to fetal and neonatal morbidity and mortality has received limited attention. Evidence assembled to date suggests that mother-to-child HEV transmission may be frequent and deleterious to the fetus and newborn in pregnancies affected by hepatitis E. Additional work is required to resolve key questions. (1) What risks do subclinical maternal HEV infections and infections early in pregnancy pose to fetal health and development? (2) Does vertical transmission occur during labor and/or breastfeeding and contribute appreciably to neonatal morbidity and mortality? (3) How do treatment decisions for severely ill mothers affect fetal and neonatal outcomes? (4) Can maternal vaccination effectively prevent vertical transmission of HEV?
Effects of Vivax Malaria Acquired Before 20 Weeks of Pregnancy on Subsequent Changes in Fetal Growth
Amantino C. Machado Filho, Elenice P. da Costa, Emely P. da Costa, Iracema S. Reis, Emanoela A. C. Fernandes, Bernardo V. Paim and Flor E. Martinez-Espinosa
The resistance index (RI), pulsatility index (PI), fetal biometry, fetal heart rate (FHR), placental thickness, and hemoglobin levels were compared in 30 Plasmodium vivax-infected women between 14 and 20 weeks of pregnancy and a control group. Evaluations were performed at the moment of the malaria diagnosis and 26 weeks of pregnancy. The malaria group had lower levels of hemoglobin and greater placental thickness in both assessments, higher FHR in the first evaluation, and lower values on fetal biometry in the second assessment. There were no differences when comparing RI and PI on umbilical arteries between the two groups. Birth weight and height were lower in newborns in the malaria group than the control group. The results suggest that P. vivax infections at an earlier gestational age do not affect umbilical arteries blood flow but do affect fetal biometry in the second trimester of pregnancy and at birth.
Evidence of a Major Reservoir of Non-Malarial Febrile Diseases in Malaria-Endemic Regions of Bangladesh
Paul Swoboda, Hans-Peter Fuehrer, Benedikt Ley, Peter Starzengruber, Kamala Ley-Thriemer, Mariella Jung, Julia Matt, Markus A. Fally, Milena K. S. Mueller, Johannes A. B. Reismann, Rashidul Haque, Wasif A. Khan and Harald Noedl
In malaria-endemic regions any febrile case is likely to be classified as malaria based on presumptive diagnosis largely caused by a lack of diagnostic resources. A district-wide prevalence study assessing etiologies of fever in 659 patients recruited in rural and semi-urban areas of Bandarban district in southeastern Bangladesh revealed high proportions of seropositivity for selected infectious diseases (leptospirosis, typhoid fever) potentially being misdiagnosed as malaria because of similarities in the clinical presentation. In an area with point prevalences of more than 40% for malaria among fever cases, even higher seroprevalence rates of leptospirosis and typhoid fever provide evidence of a major persistent reservoir of these pathogens.
Melioidosis Requires Better Data Sharing for Improved Diagnosis and Management in the Mekong Region
Blandine Rammaert, Sophie Goyet and Arnaud Tarantola
https://doi.org/10.4269/ajtmh.13-0657a
Paragonimiasis as an Important Alternative Misdiagnosed Disease for Suspected Acid-fast Bacilli Sputum Smear–Negative Tuberculosis
Hubert Barennes, Günther Slesak, Yves Buisson and Peter Odermatt
In Response
Pornpan Suntornsut, Gumphol Wongsuvan, Vanaporn Wuthiekanun, Kriangsak Kasemsupat, Yaowaruk Jutrakul, Nicholas P.J. Day, Sharon J. Peacock and Direk Limmathurotsakul
https://doi.org/10.4269/ajtmh.13-0657b
< Prev | 1 2 3 | Next >
Volume 104 (2021)
Volume 95 ([2016, 2017])
Volume s1-31 (1951)
Volume s1-9 (1929)
Tweets by @ASTMH
Tweets by @AJTMH
http://instance.metastore.ingenta.com/content/journals/14761645/90/2
BROWSE_VIEW_TOC