Tropical_Health RSS : Gourt

Rapid Molecular Detection of Opisthorchis viverrini in Human Fecal Samples by Real-Time Polymerase Chain Reaction.

Rapid Molecular Detection of Opisthorchis viverrini in Human Fecal Samples by Real-Time Polymerase Chain Reaction. Am J Trop Med Hyg. 2009 Nov;81(5):917-20 Authors: Intapan PM, Thanchomnang T, Lulitanond V, Pongsaskulchoti P, Maleewong W Real-time fluorescence resonance energy transfer (FRET) polymerase chain reaction (PCR) supplemented with melting curve analysis is a highly sensitive and fast method offering a high throughput. We report the development of a real-time FRET PCR for molecular detection of Opisthorchis viverrini in human fecal samples. The diagnostic sensitivity, specificity, accuracy, and positive and negative predictive values of this method were 97.5%, 100%, 98.9%, 100%, and 98.2%, respectively. The sensitivity was not significantly different from that of the quantified formalin-ethyl acetate concentration technique, the gold standard (P > 0.05). The procedure has potential for diagnosis of human opisthorchiasis in disease-endemic areas, for large epidemiologic investigations involving at risk populations, and monitoring eradication programs of the liver fluke, which causes hepatobiliary diseases and induces cholangiocarcinoma. PMID: 19861632 [PubMed - in process]

Immunologic profiles of persons recruited for a randomized, placebo-controlled clinical trial of hookworm infection.

Immunologic profiles of persons recruited for a randomized, placebo-controlled clinical trial of hookworm infection. Am J Trop Med Hyg. 2009 Nov;81(5):911-6 Authors: Blount D, Hooi D, Feary J, Venn A, Telford G, Brown A, Britton J, Pritchard D Data from epidemiologic studies suggest that hookworm infections, in establishing an immunologic phenotype conducive to parasite survival, may protect against the development of allergic disease. We describe immunologic findings from a clinical study designed to investigate the safety of iatrogenic hookworm infection in participants with allergic rhinitis. The low, relatively safe level of hookworm infection used in this study was immunogenic, inducing eosinophilia and a significant specific IgG response. Importantly, no potentiation of IgE responses to the environmental allergens to which the participants were sensitized was seen. However, no evidence of systemic immune regulation was seen in infected participants. This finding may indicate that the level of infection or the frequency of infection may have to be altered in future trials to induce a therapeutically conducive immunologic phenotype. PMID: 19861631 [PubMed - in process]

Prevalence of Leptospira spp. in Urban Rodents from a Groceries Trade Center of Medellin, Colombia.

Prevalence of Leptospira spp. in Urban Rodents from a Groceries Trade Center of Medellin, Colombia. Am J Trop Med Hyg. 2009 Nov;81(5):906-10 Authors: Agudelo-Flórez P, Londoño AF, Quiroz VH, Angel JC, Moreno N, Loaiza ET, Muñoz LF, Rodas JD Leptospirosis is a widely distributed zoonosis, and rats are its most common source of infection. Our goal was to determine the frequency for Leptospira infection in rodents in a farmers market in the city of Medellin. We performed a descriptive transversal study sampling 254 rodents. Rodents were bled and killed, and kidneys samples were taken. Supernatants of macerated kidneys were cultured on Fletcher medium. Microagglutination tests (MATs) with 11 serovars were also carried out in rat serum, and a polymerase chain reaction (PCR) specific for pathogenic species was used to test each bacterial culture. All animals were identified as Rattus norvegicus; 25% and 20% were positive by MAT and culture, respectively. PCR tests of 12 isolates were positive for pathogenic serovars, and 4 of them were confirmed as L. interrogans by sequencing. These data show the role of this natural carrier and shedder of pathogenic leptospires in the epidemiology of urban leptospirosis in Colombia. PMID: 19861630 [PubMed - in process]

Micro-Positron Emission Tomography in the Evaluation of Trypanosoma cruzi-Induced Heart Disease: Comparison with Other Modalities.

Micro-Positron Emission Tomography in the Evaluation of Trypanosoma cruzi-Induced Heart Disease: Comparison with Other Modalities. Am J Trop Med Hyg. 2009 Nov;81(5):900-5 Authors: Prado CM, Fine EJ, Koba W, Zhao D, Rossi MA, Tanowitz HB, Jelicks LA Noninvasive assessment of cardiac structure and function is essential to understand the natural course of murine infection with Trypanosoma cruzi. Magnetic resonance imaging (MRI) and echocardiography have been used to monitor anatomy and function; positron emission tomography (PET) is ideal for monitoring metabolic events in the myocardium. Mice infected with T. cruzi (Brazil strain) were imaged 15-100 days post infection (dpi). Quantitative (18)F-FDG microPET imaging, MRI and echocardiography were performed and compared. Tracer ((18)F-FDG) uptake was significantly higher in infected mice at all days of infection, from 15 to 100 dpi. Dilatation of the right ventricular chamber was observed by MRI from 30 to 100 dpi in infected mice. Echocardiography revealed significantly reduced ejection fraction by 60 dpi. Combination of these three complementary imaging modalities makes it possible to noninvasively quantify cardiovascular function, morphology, and metabolism from the earliest days of infection through the chronic phase. PMID: 19861629 [PubMed - in process]

Long-Term Relapse Risk of Multibacillary Leprosy after Completion of 2 Years of Multiple Drug Therapy (WHO-MDT) in Cebu, Philippines.

Long-Term Relapse Risk of Multibacillary Leprosy after Completion of 2 Years of Multiple Drug Therapy (WHO-MDT) in Cebu, Philippines. Am J Trop Med Hyg. 2009 Nov;81(5):895-9 Authors: Balagon MF, Cellona RV, Cruz ED, Burgos JA, Abalos RM, Walsh GP, Saunderson PR, Walsh DS From 1987 to 1994, we enrolled 500 subjects completing 2-year WHO multiple drug therapy (MDT) for multibacillary leprosy in a prospective relapse study. Relapse was defined as new skin lesions and an increase in the bacterial index (BI) >/= 2+ (>/= 100x) at any single slit-skin smear site. At the study end in 2006, follow-up was 6,401 subject-years, a mean of 12.8 years/subject. We observed 23 relapses, 6-16 years after MDT (mean, 10.5 years; 95% confidence interval [CI], 9.2-11.8), peaking in Years 11-12 (> 1%/year). The cumulative risk was 6.6% (95% CI, 5.0-8.2%). In a subset of 181 subjects with pre-MDT average BI >/= 4+, 11 relapses occurred (cumulative risk, 10.1%). In mouse footpad assays, Mycobacterium leprae from relapsed subjects were rifampin and clofazimine sensitive. Taken together, the data suggest relapses are related to activation of dormant organisms (persisters) not killed by MDT rather than new infection. PMID: 19861628 [PubMed - in process]

Persistence of Mycobacterium ulcerans Disease (Buruli Ulcer) in the Historical Focus of Kasongo Territory, the Democratic Republic of Congo.

Persistence of Mycobacterium ulcerans Disease (Buruli Ulcer) in the Historical Focus of Kasongo Territory, the Democratic Republic of Congo. Am J Trop Med Hyg. 2009 Nov;81(5):888-894 Authors: Suykerbuyk P, Wambacq J, Phanzu DM, Haruna H, Nakazawa Y, Ooms K, Kamango K, Stragier P, Singa JN, Ekwanzala F, De Herdt E, De Maeyer P, Kestens L, Portaels F Fifty years after the last report of Mycobacterium ulcerans infections (Buruli ulcer [BU]) in Kasongo Territory, Maniema Province, Democratic Republic of Congo (DRC), we conducted a small-scale cross-sectional survey to assess if this historical BU focus was still active and if so to explore the disease epidemiology. Seventy-five active and inactive BU cases were identified on clinical grounds of which two of 28 BU active cases were laboratory confirmed. We used a modified BU02 form to reconstruct the local disease dynamics and we believe that the horrific conflict in eastern DRC and exceptional flooding were the most likely causes of the re-emergence of the disease. There is a need in the DRC to decentralize and integrate surveillance and control activities at local level to increase the effectiveness of patient management. PMID: 19861627 [PubMed - as supplied by publisher]

Household characteristics associated with handwashing with soap in rural bangladesh.

Household characteristics associated with handwashing with soap in rural bangladesh. Am J Trop Med Hyg. 2009 Nov;81(5):882-7 Authors: Luby SP, Halder AK, Tronchet C, Akhter S, Bhuiya A, Johnston RB Handwashing with soap prevents diarrhea and respiratory disease, but it is rarely practiced in high-need settings. Among 100 randomly selected villages in rural Bangladesh, field workers enrolled 10 households per village and observed and recorded household activities for 5 hours. Field workers observed 761 handwashing opportunities among household members in 527 households who had just defecated or who cleaned a child's anus who had defecated. In the final multivariate analysis, having water available at the place to wash hands after toileting (odds ratio = 2.2, 95% confidence interval 1.3, 4.0) and having soap available at the place to wash hands after toileting (odds ratio = 2.1, 95% confidence interval 1.3, 3.4) were associated with washing both hands with soap after fecal contact. Interventions that improve the presence of water and soap at the designated place to wash hands would be expected to improve handwashing behavior and health. PMID: 19861626 [PubMed - in process]

Population seroprevalence of hepatitis e virus antibodies in rural bangladesh.

Population seroprevalence of hepatitis e virus antibodies in rural bangladesh. Am J Trop Med Hyg. 2009 Nov;81(5):875-81 Authors: Labrique AB, Zaman K, Hossain Z, Saha P, Yunus M, Hossain A, Ticehurst J, Nelson KE Hepatitis E virus (HEV) causes a substantial burden of sporadic and epidemic disease worldwide. HEV infections result in serious morbidity and mortality, especially among pregnant women, and have significant economic costs. Few population-based studies have characterized the epidemiology of HEV. A rural Bangladeshi population was studied to determine the age- and gender- specific population seroprevalence of antibodies to HEV. Of 1,134 specimens tested from a representative, random population sample, 255 (22.5%) were anti-HEV IgG seropositive. Seroprevalence was lower among women (19.7%) than among men (25.8%). We found anti-HBc (hepatitis B core) in 380 of 1080(35.2%) tested, anti-HCV (hepatitis C) in 14 of 917(1.5%) tested, and anti-HAV (hepatitis A) in 116 of 124(93.5%) tested individuals. Our data suggest that viral hepatitis, especially HEV, remains an under-recognized and significant public health problem in rural Bangladeshi populations, warranting further attention. PMID: 19861625 [PubMed - in process]

Coverage of and Influences on Timely Administration of Hepatitis B Vaccine Birth Dose in Remote Rural Areas of the People's Republic of China.

Coverage of and Influences on Timely Administration of Hepatitis B Vaccine Birth Dose in Remote Rural Areas of the People's Republic of China. Am J Trop Med Hyg. 2009 Nov;81(5):869-74 Authors: Zhou Y, Wang H, Zheng J, Zhu X, Xia W, Hipgrave DB A survey was conducted in 2006 to assess the coverage and timeliness of the birth dose of hepatitis B vaccine (HepB(1)) and related influences among children in rural areas of Guangxi, Guizhou, Tibet, and Shaanxi provinces, People's Republic of China. A total of 3,390 children born in 2004 were surveyed in four counties in each province, where a project to strengthen routine immunization is being implemented by the China Ministry of Health, supported by the United National Children's Fund. Two-stage stratified cluster sampling was undertaken to select those surveyed. A questionnaire was administered to parents or guardians and vaccination records were assessed. HepB(1) administration was timely for 31.6% of the sample. Timeliness of HepB(1) for children delivered at home (13%) was lower than for children born at county-level or higher facilities (54%) (odds ratio [OR] = 6.52, (95% confidence interval [CI] = 5.29-8.04, P < 10 (-3)), at township hospitals (49%, OR = 7.14, 95% CI = 5.68-8.98, P < 10 (-3)), or private clinics (59%, OR = 5.64, 95% CI = 3.68-8.64, P < 10 (-3)). Children of Tibetan (24.8%, OR = 0.16, 95% CI = 0.12-0.21, P < 10 (-4)), Zhuang (27.8%, OR = 0.73, 95% CI = 0.57-0.94, P < 0.02) or Meng, Miao, and Hui ethnicity (14.2%, OR = 0.36, 95% CI = 0.29-0.45, P < 10 (-4)) were less likely than children of Han ethnicity (33.2%) to have received a timely birth dose. Children lacking vaccination registration cards (OR = 0.64, 95% CI = 0.51-0.80, P < 10 (-4)) and children whose parents or guardians did not know the importance of timely HepB immunization (OR = 0.62, 95% CI = 0.46-0.84, P < 10 (-2)) were also less likely to have received a timely birth dose. Parental knowledge and prioritization of birth-dosing was low among children who did not receive it. The timeliness of HepB(1) should improve with increasing rates of hospital delivery, training of birth attendants, increasing staff and community awareness of the importance of the birth dose, and by focusing on vulnerable groups. PMID: 19861624 [PubMed - in process]

Chikungunya virus isolated from a returnee to Japan from sri lanka: isolation of two sub-strains with different characteristics.

Chikungunya virus isolated from a returnee to Japan from sri lanka: isolation of two sub-strains with different characteristics. Am J Trop Med Hyg. 2009 Nov;81(5):865-8 Authors: Lim CK, Nishibori T, Watanabe K, Ito M, Kotaki A, Tanaka K, Kurane I, Takasaki T A large-scale epidemic of chikungunya (CHIK) fever occurred in several Indian Ocean islands in 2004 and spread to India and Sri Lanka. In December 2006, a returnee to Japan from Sri Lanka developed an acute febrile illness. The patient was confirmed to have CHIK fever after reverse transcription-polymerase chain reaction, and specific IgM and IgG detection. CHIK virus was isolated from the serum specimen collected at the acute stage. The isolated virus developed two different sizes of plaques. Two sub-strains with different genetic and biological characteristics were obtained by plaque purification from one isolate. The entire genome was sequenced and phylogenetic analysis of the E1 genome showed that the sub-strains were of the Central/East African genotype, and were closely related to recent isolates in India. This is the first report of CHIK virus genome sequences isolated from a patient infected in Sri Lanka. PMID: 19861623 [PubMed - in process]

Phylogeny of Triatoma sherlocki (Hemiptera: Reduviidae: Triatominae) Inferred from Two Mitochondrial Genes Suggests Its Location Within the Triatoma brasiliensis Complex.

Phylogeny of Triatoma sherlocki (Hemiptera: Reduviidae: Triatominae) Inferred from Two Mitochondrial Genes Suggests Its Location Within the Triatoma brasiliensis Complex. Am J Trop Med Hyg. 2009 Nov;81(5):858-864 Authors: Mendonça VJ, da Silva MT, de Araújo RF, Júnior JM, Júnior MB, Almeida CE, Costa J, Graminha MA, Cicarelli RM, da Rosa JA The phylogenetic position of Triatoma sherlocki within triatomines group was inferred by analyzing mtDNA fragments of Cyt B and 16S ribosomal RNA by using maximum parsimony and Bayesian analysis. Despite being differentiated from members of the T. brasiliensis complex on morphologic grounds, molecular phylogenetic analysis suggests T. sherlocki is a member of this complex; moreover, it was placed as a sister species of T. melanica. These suggestions were supported by robust credibility rates. Hence, we show evidence for the paraphyletic group of the "Triatoma brasiliensis complex," which should be composed of T. brasiliensis brasiliensis, T. brasiliensis macromelasoma, T. juazeirensis, T. melanica, and T. sherlocki. PMID: 19861622 [PubMed - as supplied by publisher]

Blood Sources of Mosquitoes Collected from Urban and Peri-Urban Environments in Eastern Australia with Species-Specific Molecular Analysis of Avian Blood Meals.

Blood Sources of Mosquitoes Collected from Urban and Peri-Urban Environments in Eastern Australia with Species-Specific Molecular Analysis of Avian Blood Meals. Am J Trop Med Hyg. 2009 Nov;81(5):849-857 Authors: Jansen CC, Webb CE, Graham GC, Craig SB, Zborowski P, Ritchie SA, Russell RC, van den Hurk AF To identify the hosts of mosquitoes collected from urban and peri-urban habitats in eastern Australia, 1,180 blood fed mosquitoes representing 15 species were analyzed by enzyme-linked immunosorbent assay and molecular techniques. Four common and epidemiologically important species could be classified according to their host-feeding patterns: Aedes aegypti was anthropophilic, Ae. vigilax was mammalophilic, Culex quinquefasciatus was ornithophilic, and Cx. annulirostris was opportunistic, readily feeding on birds and mammals. Mitochondrial cytochrome b DNA sequence data showed that more than 75% of avian blood meals identified from Cx. annulirostris collected from Brisbane, Newcastle, and Sydney originated from ducks (Order Anseriformes, Family Anatidae). More than 75% of avian blood meals from Cx. quinquefasciatus from Cairns belonged to one of three Passerine species, namely Sphecotheres vieilloti (figbird), Sturnus tristis (common myna), and Philemon buceroides (helmeted friarbird). This study demonstrates associations between vectors in Australia and vertebrate hosts of endemic and exotic arboviruses. PMID: 19861621 [PubMed - as supplied by publisher]

Effects of Latitude and Longitude on the Population Structure of Culex pipiens s.l., Vectors of West Nile Virus in North America.

Effects of Latitude and Longitude on the Population Structure of Culex pipiens s.l., Vectors of West Nile Virus in North America. Am J Trop Med Hyg. 2009 Nov;81(5):842-848 Authors: Edillo F, Kiszewski A, Manjourides J, Pagano M, Hutchinson M, Kyle A, Arias J, Gaines D, Lampman R, Novak R, Foppa I, Lubelcyzk C, Smith R, Moncayo A, Spielman A, We assessed the structure and latitudinal selection that might result in sensitivities to critical day-lengths that trigger diapause between Culex pipiens populations distributed along North-South and East-West axes in eastern North America. Strong population structure between Cx. p. pipiens and Cx. p. quinquefasciatus existed. Among Cx. p. pipiens, a 100-km increase in the latitudinal change resulted in an increased square root of F(ST) by 0.002. A 100-km increase in the longitudinal change caused an increased square root of F(ST) by 0.035. A lack of latitudinal influence on the structure between Cx. p. pipiens populations suggests a uniform signal using the 12 microsatellite markers, which might increase the risk of West Nile virus (WNV) transmission toward northern areas because of longer breeding season, extend host-seeking period, and larger population size. Northern Cx. p. pipiens may have undergone additional generations before diapause is triggered, magnifying population size when WNV amplification is peaking. PMID: 19861620 [PubMed - as supplied by publisher]

Phase 1 Trial of the Dengue Virus Type 4 Vaccine Candidate rDEN4{Delta}30-4995 in Healthy Adult Volunteers.

Phase 1 Trial of the Dengue Virus Type 4 Vaccine Candidate rDEN4{Delta}30-4995 in Healthy Adult Volunteers. Am J Trop Med Hyg. 2009 Nov;81(5):834-841 Authors: Wright PF, Durbin AP, Whitehead SS, Ikizler MR, Henderson S, Blaney JE, Thumar B, Ankrah S, Rock MT, McKinney BA, Murphy BR, Schmidt AC rDEN4Delta30-4995 is a live attenuated dengue virus type 4 (DENV4) vaccine candidate specifically designed as a further attenuated derivative of the rDEN4Delta30 parent virus. In a previous study, 5 of 20 vaccinees who received 10(5) plaque-forming units (PFU) of rDEN4Delta30 developed a transient elevation of the serum alanine aminotransferase (ALT) level and an asymptomatic maculopapular rash developed in 10 of 20. In the current study, 28 healthy adult volunteers were randomized to receive 10(5) PFU of rDEN4Delta30-4995 (20) or placebo (8) as a single subcutaneous injection. The vaccine was safe, well-tolerated, and immunogenic. An asymptomatic generalized maculopapular rash and elevations in ALT levels were observed in 10% of the rDEN4Delta30-4995 vaccinees. None of the rDEN4Delta30-4995 vaccinees became viremic, yet 95% developed a four-fold or greater increase in neutralizing antibody titers. Thus, rDEN4Delta30-4995 was demonstrated to be safe, highly attenuated, and immunogenic. However, an asymptomatic localized erythematous rash at the injection site was seen in 17/20 rDEN4Delta30-4995 vaccinees. Therefore, alternative DENV4 vaccine strains were selected for further clinical development. PMID: 19861619 [PubMed - as supplied by publisher]

Dengue Plaque Reduction Neutralization Test (PRNT) in Primary and Secondary Dengue Virus Infections: How Alterations in Assay Conditions Impact Performance.

Dengue Plaque Reduction Neutralization Test (PRNT) in Primary and Secondary Dengue Virus Infections: How Alterations in Assay Conditions Impact Performance. Am J Trop Med Hyg. 2009 Nov;81(5):825-833 Authors: Thomas SJ, Nisalak A, Anderson KB, Libraty DH, Kalayanarooj S, Vaughn DW, Putnak R, Gibbons RV, Jarman R, Endy TP Dengue virus (DENV) infection is a worsening global health problem. The plaque reduction neutralization test (PRNT) is currently considered to be the "gold standard" to characterize and quantify circulating levels of anti-DENV neutralizing antibody (NAb). Many variations of the PRNT are currently in use and neither the assay nor its performance conditions have been standardized or harmonized between laboratories. We used a well-characterized panel of acute and late convalescent follow-up sera samples from children experiencing primary and secondary DENV infections to evaluate the performance of the dengue PRNT under a variety of testing conditions. Investigators varied cell type, control virus passage, and the use of complement across multiple assay runs of the same sample panel. Our findings indicate wide variation in PRNT titer results in response to varied testing conditions. PMID: 19861618 [PubMed - as supplied by publisher]

Translational regulation by the 3' untranslated region of the dengue type 2 virus genome.

Translational regulation by the 3' untranslated region of the dengue type 2 virus genome. Am J Trop Med Hyg. 2009 Nov;81(5):817-24 Authors: Wei Y, Qin C, Jiang T, Li X, Zhao H, Liu Z, Deng Y, Liu R, Chen S, Yu M, Qin E The role of the 3'untranslated region (UTR) of the dengue virus (DENV) genome during viral translation remains to be elucidated. We assessed the contribution of well-defined RNA elements in the 3'UTR of DENV-2 to viral translation using a virus-induced reporting gene system and deoxyribozymes (DRzs) targeting the 3'UTR of the DENV-2 genome. Results show that mRNAs carrying a deletion of repeated conserved sequence (RCS2)-CS2 are translated less efficiently than wild type mRNAs. However, mRNAs with a deletion of CS1-stem loop (SL) are translated more efficiently. Thus, CS1-SL and RCS2-CS2 may have different effects on translational regulation. Additionally, the translation-suppressing effect of CS1-SL or the SL element is further confirmed in DENV-2-infected cells using DRzs. Mutagenesis studies show that, rather than the secondary structure, nucleotides 10663-10677 and 10709-10723 are responsible for translational suppression of SL. Overall, our results demonstrate that sequences and elements within the DENV-2 3'UTR regulate viral translation. PMID: 19861617 [PubMed - in process]

Prevalence and genetic heterogeneity of bartonella strains cultured from rodents from 17 provinces in Thailand.

Prevalence and genetic heterogeneity of bartonella strains cultured from rodents from 17 provinces in Thailand. Am J Trop Med Hyg. 2009 Nov;81(5):811-6 Authors: Bai Y, Kosoy MY, Lerdthusnee K, Peruski LF, Richardson JH To study the distribution and diversity of Bartonella in rodents from Thailand, 330 rodents belonging to 13 species were tested. The majority (80.6%) of rodents examined belonged to the genus Rattus. Bartonellae were cultured from 41.5% of the rodents with a wide range of prevalence by host species and regions. Sequencing of gltA revealed diverse Bartonella strains. Bartonellae from Rattus spp. belonged to 23 variants and clustered with Bartonella coopersplainensis, Bartonella elizabethae, Bartonella phoceensis, Bartonella rattimassiliensis, Bartonella tribocorum, and an unknown geno-group. Bartonellae from Bandicota spp. belonged to six variants and clustered with B. coopersplainensis, B. rattimassilliensis, and B. tribocorum. Three variants from Mus spp. clustered with B. coopersplainensis or B. rattimassilliensis. The only isolate from a Berylmys berdmorei fell into the B. tribocorum group. The observations highlight the need to study these agents for their role in human febrile illnesses of unknown etiology in Thailand and elsewhere in Asia. PMID: 19861616 [PubMed - in process]

Interleukin-1 Beta Single-Nucleotide Polymorphism's C Allele is Associated with Elevated Risk of Gastric Cancer in Helicobacter pylori-Infected Peruvians.

Interleukin-1 Beta Single-Nucleotide Polymorphism's C Allele is Associated with Elevated Risk of Gastric Cancer in Helicobacter pylori-Infected Peruvians. Am J Trop Med Hyg. 2009 Nov;81(5):804-810 Authors: Gehmert S, Velapatiño B, Herrera P, Balqui J, Santivañez L, Cok J, Vargas G, Combe J, Passaro DJ, Wen S, Meyer F, Berg DE, Gilman RH Particular alleles of the interleukin-1B (IL-1B) gene have been correlated with increased risk of atrophic gastritis and gastric cancer in the populations of East Asia and Europe. No such data exist from Peru, a developing country with a population genotypically different from others studied and with a high prevalence of Helicobacter pylori infection and gastric cancer. We conducted a case-control study comparing 334 hospitalized patients with atrophic gastritis or gastric cancer with 158 nonatrophic gastritis patients (controls). Conditional logistic regression analysis revealed that an increased risk of atrophic gastritis (odds ratio, 5.60) and gastric cancer (odds ratio, 2.36) was associated with the IL-1B-511 C allele. Our study is the first to establish this allele as a risk for these conditions. Given the high prevalence of H. pylori and recurrence rate after treatment, IL-1B-511 single-nucleotide polymorphism analysis may identify those individuals who would benefit most from robust H. pylori eradication efforts in Peru. PMID: 19861615 [PubMed - as supplied by publisher]

Geographic Distribution and Prevalence of Schistosomiasis and Soil-Transmitted Helminths among Schoolchildren in Mozambique.

Geographic Distribution and Prevalence of Schistosomiasis and Soil-Transmitted Helminths among Schoolchildren in Mozambique. Am J Trop Med Hyg. 2009 Nov;81(5):799-803 Authors: Augusto G, Nalá R, Casmo V, Sabonete A, Mapaco L, Monteiro J Schistosomiasis and soil-transmitted helminths (STHs) are most prevalent in developing countries. In Mozambique, the first and only national survey of the distribution and prevalence of schistosomiasis and STHs was conducted in 1952 and 1957. Only occasional surveys in restricted areas have been conducted since the 1950s. The objective of our survey was to update information on the geographic distribution and prevalence of schistosomiasis and STHs in this country. During August 2005-June 2007, the Schistosomiasis and STH Laboratory of National Institutes of Health of the Ministry of Health undertook an epidemiologic survey among schoolchildren. A total of 83,331 persons attending primary schools were sampled. The mean age was 11.36 years (range: 7-22 years). Stool and urine samples were collected and examined by using Kato-Katz and filtration and Ritchie and Willis techniques. Results indicate a widespread occurrence of Schistosoma haematobium (overall prevalence = 47.0%) and STHs (prevalence = 53.5%). Prevalence varied dramatically across the country, with the highest prevalence in districts in northern provinces (Cabo Delgado, Niassa, Nampula, and Zambezia) and in certain provincial capital cities. Districts in the southern region of the country were less affected. Schistosoma mansoni was less common, with prevalence of 1%. We conclude that schistosomiasis and STHs are widely distributed in Mozambique and confirm the need for a national helminth control program. PMID: 19861614 [PubMed - in process]

Integrating NTD Mapping Protocols: Can Surveys for Trachoma and Urinary Schistosomiasis Be Done Simultaneously?

Integrating NTD Mapping Protocols: Can Surveys for Trachoma and Urinary Schistosomiasis Be Done Simultaneously? Am J Trop Med Hyg. 2009 Nov;81(5):793-8 Authors: King JD, Eigege A, Richards F, Jip N, Umaru J, Deming M, Miri E, McFarland D, Emerson PM We determined whether the school-based "disease mapping" methodology used to assess urinary schistosomiasis (SCH) is useful for determining trachoma interventions and whether the district-based approach recommended for trachoma is useful for SCH control programs. We conducted two separate integrated surveys in eight districts of central Nigeria: school based and district based. A total of 17,189 children were examined for trachoma and 16,238 children were examined for hematuria from 363 schools and 2,149 households. School surveys identified 67 communities warranting praziquantel drug treatment of SCH and 142 trachoma-endemic communities warranting trachoma control activities. In district-level estimates, we identified 24 communities for praziquantel treatment and 0 for trachoma intervention. Integrating trachoma into SCH school-based surveys, and SCH into trachoma surveys, was quick and easy, but in this setting, school-based surveys were more useful for identifying communities where intervention is warranted. PMID: 19861613 [PubMed - in process]

Spatial distribution of female genital mutilation in Nigeria.

Spatial distribution of female genital mutilation in Nigeria. Am J Trop Med Hyg. 2009 Nov;81(5):784-92 Authors: Kandala NB, Nwakeze N, Kandala SN The harmful effects of female genital mutilation (FGM) on women are recognized worldwide. Although it is practiced by persons of all socioeconomic backgrounds, there are differences within countries and between communities. The aim of this study was to use the 2003 Nigeria Demographic and Health Survey data to determine the spatial distribution of the prevalence of FGM and associated risk factors. Data were available for 7,620 women; 1,673 (22.0%) interviewed had had FGM and 2,168 women had living children, of whom 485 (22.4%) daughters had undergone FGM. Unmarried women were more likely to report a lower prevalence of FGM. Modernization (education and high socioeconomic status) had minimal impact on the likelihood of FGM, but education plays an important role in the mother's decision not to circumcise her daughter. It follows from these findings that community factors have a large effect on FGM, with individual factors having little effect on the distribution of FGM. PMID: 19861612 [PubMed - in process]

A simplified, low-cost method for polarized light microscopy.

A simplified, low-cost method for polarized light microscopy. Am J Trop Med Hyg. 2009 Nov;81(5):782-3 Authors: Maude RJ, Buapetch W, Silamut K Malaria pigment is an intracellular inclusion body that appears in blood and tissue specimens on microscopic examination and can help in establishing the diagnosis of malaria. In simple light microscopy, it can be difficult to discern from cellular background and artifacts. It has long been known that if polarized light microscopy is used, malaria pigment can be much easier to distinguish. However, this technique is rarely used because of the need for a relatively costly polarization microscope. We describe a simple and economical technique to convert any standard light microscope suitable for examination of malaria films into a polarization microscope. PMID: 19861611 [PubMed - in process]

Influence of tropical climate conditions on the quality of antihypertensive drugs from rwandan pharmacies.

Influence of tropical climate conditions on the quality of antihypertensive drugs from rwandan pharmacies. Am J Trop Med Hyg. 2009 Nov;81(5):776-81 Authors: Twagirumukiza M, Cosijns A, Pringels E, Remon JP, Vervaet C, Van Bortel L The objective of this study was to assess the quality of antihypertensive drugs and to investigate the influence of tropical storage conditions. Drug content and in vitro dissolution tests were performed on 10 test formulations (from Rwanda) and 6 reference formulations (from Belgium or France) after purchase and after 6-month storage under long-term (25 +/- 2 degrees C and 60 +/- 5% relative humidity [RH]) and accelerated (40 +/- 2 degrees C and 75 +/- 5% RH) testing conditions. Twenty percent of test formulations were of substandard content at the time of purchase. After 6 months at accelerated testing conditions, 7 of 10 test formulations were substandard in content and 8 were substandard for the combined criteria of drug content and dissolution, whereas no reference drug became substandard. This study shows that, apart from some drugs being already substandard from purchase, accelerated testing conditions (simulating tropical climate) have deleterious effects on the majority of antihypertensive drug formulations found in the Rwandan market. PMID: 19861610 [PubMed - in process]

Seasonal Pattern of Pneumonia Mortality among Under-Five Children in Nairobi's Informal Settlements.

Seasonal Pattern of Pneumonia Mortality among Under-Five Children in Nairobi's Informal Settlements. Am J Trop Med Hyg. 2009 Nov;81(5):770-5 Authors: Ye Y, Zulu E, Mutisya M, Orindi B, Emina J, Kyobutungi C Using longitudinal data from the Nairobi Urban and Demographic Surveillance System (NUHDSS), we examined the seasonal pattern of pneumonia mortality among under-five children living in Nairobi's slums. We included 17,787 under-five children resident in the NUHDSS from January 1, 2003 to December 31, 2005 in the analysis. Four hundred thirty-six deaths were observed and cause of death was ascertained by verbal autopsy for 377 of these deaths. Using Poisson regression, we modeled the quarterly mortality risk for pneumonia. The overall person-years (PYs) were 21,804 giving a mortality rate of 20.1 per 1,000 PYs in the study population. Pneumonia was the leading cause of death contributing 25.7% of the total deaths. Pneumonia mortality was highest in the second quarter (risk ratio [RR] = 2.3, confidence interval [CI]: 1.2-4.2 compared with the fourth quarter). The study provides evidence that pneumonia-related mortality among under-fives in Nairobi's slums is higher from April to June corresponding to the rainy season and the beginning of the cold season. PMID: 19861609 [PubMed - in process]

Budd-Chiari syndrome as a vascular complication of amebic liver abscess.

Budd-Chiari syndrome as a vascular complication of amebic liver abscess. Am J Trop Med Hyg. 2009 Nov;81(5):768-9 Authors: Méchaï F, Aoun O, Ficko C, Barruet R, Imbert P, Rapp C Amebiasis remains a major public health issue in most of the world. Amebic liver abscess is the most common extraintestinal manifestation. A complication such as venous obstruction associated with amebiais is rare. We report a thrombosis in hepatic veins associated with amebic hepatic abscess in a traveler. PMID: 19861608 [PubMed - in process]

Absence of asymptomatic malaria infections in previously high endemic areas of sri lanka.

Absence of asymptomatic malaria infections in previously high endemic areas of sri lanka. Am J Trop Med Hyg. 2009 Nov;81(5):763-7 Authors: Fernando SD, Abeyasinghe RR, Galappaththy GN, Rajapaksa LC As the goal of malaria elimination from Sri Lanka is currently being pursued, this study was planned to determine the prevalence of asymptomatic malaria infections. Five health areas in Trincomalee and Kurunegala districts that reported high prevalence in the recent past were purposively selected. The smallest administrative units (GN divisions) having high malaria risk within each area were identified. From these divisions, 20% of the population was randomly selected for blood smear examination and in a 50% sub-sample polymerase chain reaction (PCR) assay was performed. A population of 3,730 from 13 GN divisions was sampled. Thick and thin Giemsa-stained blood smears were negative for malaria parasites. The PCR carried out in 50% of the study sample was also negative for malaria parasites. The findings illustrate the absence of asymptomatic carriers in previously high transmission areas and it appears that achieving malaria elimination in Sri Lanka by 2015 is feasible. PMID: 19861607 [PubMed - in process]

Histopathology of Fatal Respiratory Distress Caused by Plasmodium vivax Malaria.

Histopathology of Fatal Respiratory Distress Caused by Plasmodium vivax Malaria. Am J Trop Med Hyg. 2009 Nov;81(5):758-762 Authors: Valecha N, Pinto RG, Turner GD, Kumar A, Rodrigues S, Dubhashi NG, Rodrigues E, Banaulikar SS, Singh R, Dash AP, Baird JK An otherwise healthy 20-year-old woman in Goa, India, received antibiotics after a diagnosis of upper respiratory tract infection. One week later, vivax malaria was diagnosed at a health center, but the patient developed respiratory distress and lost consciousness. She arrived at emergency department in shock, breathless, and comatose. She died within minutes. Two independent laboratories later confirmed Plasmodium vivax by microscopy (140,000/muL) and by nested and real-time polymerase chain reaction methods. Post-mortem examination showed congestion of alveolar capillaries by heavy monocytic infiltrates, along with diffuse damage to alveolar membranes consistent with acute respiratory distress syndrome. Parasites seen in lung tissue were roughly proportionate to both peripheral hyperparasitemia and those seen in other organs without lesions. In this patient, vivax malaria caused a rapidly fatal respiratory distress. PMID: 19861606 [PubMed - as supplied by publisher]

Malaria diagnosis by a polymerase chain reaction-based assay using a pooling strategy.

Malaria diagnosis by a polymerase chain reaction-based assay using a pooling strategy. Am J Trop Med Hyg. 2009 Nov;81(5):754-7 Authors: Bharti AR, Letendre SL, Patra KP, Vinetz JM, Smith DM Pooling clinical specimens reduces the number of assays needed when screening for infectious diseases. Polymerase chain reaction (PCR)-based assays are the most sensitive tests to diagnose malaria, but its high cost limits its use. We adapted a pooling platform that could reduce the number of assays needed to detect malaria infection. To evaluate this platform, two sets of 100 serum samples, with 1% and 5% malaria prevalence, were tested. DNA, extracted from pooled samples, was amplified by malaria-specific PCR. Additional validation was performed by determining the level of PCR detection based on 1:10 and 1:100 dilution. The platform correctly detected all malaria samples in the two test matrices. The use of stored serum samples also has important implications for studies investigating malaria prevalence rates retrospectively. Field studies, using serum and whole blood specimens, are needed to validate this technique for the adaptation of these methods for clinical utility. PMID: 19861605 [PubMed - in process]

Sex affects the steady-state pharmacokinetics of primaquine but not doxycycline in healthy subjects.

Sex affects the steady-state pharmacokinetics of primaquine but not doxycycline in healthy subjects. Am J Trop Med Hyg. 2009 Nov;81(5):747-53 Authors: Binh VQ, Chinh NT, Thanh NX, Cuong BT, Quang NN, Dai B, Travers T, Edstein MD We evaluated whether sex affects the steady-state pharmacokinetics of the antimalarial drugs, primaquine and doxycycline, in healthy subjects. Seventeen male and 17 female healthy Vietnamese subjects were administered 30 mg (base) of primaquine daily for 14 days. After a 2-week washout period, 14 male and 14 female subjects were administered 100 mg (base) of doxycycline daily for 14 days. Women had significantly higher median values of C(max) (212 versus 122 ng/mL, P< 0.001) and AUC(0-24) (1,909 versus 917 ng . h/mL, P < 0.001) of primaquine compared with men. Other than a longer t(max) in women, no sex-related differences were seen in the pharmacokinetics of doxycycline. The primaquine pharmacokinetic data suggest that women have increased exposure to primaquine, which may put them at increased risk for toxicity when administered the same maintenance dose as men. The similar pharmacokinetics of doxycycline between the two sexes justifies the same maintenance dose. PMID: 19861604 [PubMed - in process]

Successful Sporozoite Challenge Model in Human Volunteers with Plasmodium vivax Strain Derived from Human Donors.

Successful Sporozoite Challenge Model in Human Volunteers with Plasmodium vivax Strain Derived from Human Donors. Am J Trop Med Hyg. 2009 Nov;81(5):740-746 Authors: Herrera S, Fernández O, Manzano MR, Murrain B, Vergara J, Blanco P, Palacios R, Vélez JD, Epstein JE, Chen-Mok M, Reed ZH, Arévalo-Herrera M Successful establishment of a Plasmodium vivax sporozoite challenge model in humans is described. Eighteen healthy adult, malaria-naïve volunteers were randomly allocated to Groups A-C and exposed to 3 +/- 1, 6 +/- 1, and 9 +/- 1 bites of Anopheles albimanus mosquitoes infected with P. vivax, respectively. Seventeen volunteers developed signs and symptoms consistent with malaria, and geometric mean prepatent periods of 11.1 days (9.3-11) for Group A; 10.8 days (9.8-11.9) for Group B; and 10.6 days (8.7-12.4) for Group C, with no statistically significant difference among groups (Kruskal-Wallis, P = 0.70). One volunteer exposed to eight mosquito bites did not develop a parasitemia. No differences in parasite density were observed and all individuals successfully recovered after anti-malarial treatment. None of the volunteers developed parasite relapses within an 18-month follow-up. In conclusion, malaria-naive volunteers can be safely and reproducibly infected with bites of 2-10 An. albimanus mosquitoes carrying P. vivax sporozoites. This challenge method is suitable for vaccine and anti-malarial drug testing. PMID: 19861603 [PubMed - as supplied by publisher]

African tick bite Fever in a taiwanese traveler returning from South Africa: molecular and serologic studies.

African tick bite Fever in a taiwanese traveler returning from South Africa: molecular and serologic studies. Am J Trop Med Hyg. 2009 Nov;81(5):735-9 Authors: Tsai KH, Lu HY, Huang JH, Fournier PE, Mediannikov O, Raoult D, Shu PY We report the first imported case of African tick bite fever (ATBF) in a patient from Taiwan who returned from a 10-day trip to South Africa. Diagnosis was confirmed by polymerase chain reaction (PCR) from eschar biopsies. Portions of rickettsial ompA (491 bp) and ompB (273 bp) genes were amplified and subsequent sequencing of PCR product showed its 100% identity with R. africae. Microimmunofluorescence (MIF) assay of patient's serum on Days 14 and 46 after the onset of illness revealed IgG seroconversion when tested with spotted fever group (SFG) rickettsiae antigens, including R. africae. The patient clinically improved on the third day of 14-day treatment with a combination of ciprofloxacin and minocycline. Based on the patient's travel history and chronology of clinical symptoms, we strongly suspect that the tick-biting event occurred in Kruger National Park. PMID: 19861602 [PubMed - in process]

Tache noire in african tick bite Fever.

Tache noire in african tick bite Fever. Am J Trop Med Hyg. 2009 Nov;81(5):733-4 Authors: Tappe D, Dobler G, Stich A PMID: 19861601 [PubMed - in process]

Syndromic approach to treatment of snake bite in Sri Lanka based on results of a prospective national hospital-based survey of patients envenomed by identified snakes.

Related Articles Syndromic approach to treatment of snake bite in Sri Lanka based on results of a prospective national hospital-based survey of patients envenomed by identified snakes. Am J Trop Med Hyg. 2009 Oct;81(4):725-31 Authors: Ariaratnam CA, Sheriff MH, Arambepola C, Theakston RD, Warrell DA Of 860 snakes brought to 10 hospitals in Sri Lanka with the patients they had bitten, 762 (89%) were venomous. Russell's vipers (Daboia russelii) and hump-nosed pit vipers (Hypnale hypnale) were the most numerous and H. hypnale was the most widely distributed. Fifty-one (6%) were misidentified by hospital staff, causing inappropriate antivenom treatment of 13 patients. Distinctive clinical syndromes were identified to aid species diagnosis in most cases of snake bite in Sri Lanka where the biting species is unknown. Diagnostic sensitivities and specificities of these syndromes for envenoming were 78% and 96% by Naja naja, 66% and 100% by Bungarus caeruleus, 14% and 100% by Daboia russelii, and 10% and 97% by Hypnale hypnale, respectively. Although only polyspecific antivenoms are used in Sri Lanka, species diagnosis remains important to anticipate life-threatening complications such as local necrosis, hemorrhage and renal and respiratory failure and to identify likely victims of envenoming by H. hypnale who will not benefit from existing antivenoms. The technique of hospital-based collection, labeling and preservation of dead snakes brought by bitten patients is recommended for rapid assessment of a country's medically-important herpetofauna. PMID: 19815895 [PubMed - indexed for MEDLINE]

Flea diversity and infestation prevalence on rodents in a plague-endemic region of Uganda.

Related Articles Flea diversity and infestation prevalence on rodents in a plague-endemic region of Uganda. Am J Trop Med Hyg. 2009 Oct;81(4):718-24 Authors: Amatre G, Babi N, Enscore RE, Ogen-Odoi A, Atiku LA, Akol A, Gage KL, Eisen RJ In Uganda, the West Nile region is the primary epidemiologic focus for plague. The aims of this study were to 1) describe flea-host associations within a plague-endemic region of Uganda, 2) compare flea loads between villages with or without a history of reported human plague cases and between sampling periods, and 3) determine vector loads on small mammal hosts in domestic, peridomestic, and sylvatic settings. We report that the roof rat, Rattus rattus, is the most common rodent collected in human dwellings in each of the 10 villages within the two districts sampled. These rats were commonly infested with efficient Y. pestis vectors, Xenopsylla cheopis and X. brasiliensis in Arua and Nebbi districts, respectively. In peridomestic and sylvatic areas in both districts, the Nile rat, Arvicanthus niloticus, was the most abundant rodent and hosted the highest diversity of flea species. When significant temporal differences in flea loads were detected, they were typically lower during the dry month of January. We did not detect any significant differences in small mammal abundance or flea loads between villages with our without a history of human plague, indicating that conditions during inter-epizootic periods are similar between these areas. Future studies are needed to determine whether flea abundance or species composition changes during epizootics when humans are most at risk of exposure. PMID: 19815894 [PubMed - indexed for MEDLINE]

Spatial variation of Yersinia pestis from Yunnan Province of China.

Related Articles Spatial variation of Yersinia pestis from Yunnan Province of China. Am J Trop Med Hyg. 2009 Oct;81(4):714-7 Authors: Zhang Z, Hai R, Song Z, Xia L, Liang Y, Cai H, Liang Y, Shen X, Zhang E, Xu J, Yu D, Yu XJ Yunnan Province of China is considered the site of origin for modern plague. We analyzed the genotypes of eight Yersinia pestis strains isolated from three counties in Yunnan Province by pulse field gel electrophoresis (PFGE). PFGE showed that strains isolated from the same site were identical regardless of hosts or year of isolation. However, Y. pestis strains isolated from geographically distinct loci were genetically divergent. Whole genome sequences of two strains from two foci in Yunnan showed that the genetic variation of Y. pestis strains was caused by genome rearrangement. We concluded that Y. pestis strains in each epidemic focus in Yunnan were a clonal population and selected by host environments. The genomic variability of the Y. pestis strains from different foci were caused by genome rearrangement, which may provide a positive selective advantage for Y. pestis to adapt to its host environments. PMID: 19815893 [PubMed - indexed for MEDLINE]

Intra-cystic drug concentration of albendazole sulphoxide in patients with Echinococcus granulosus cysts.

Related Articles Intra-cystic drug concentration of albendazole sulphoxide in patients with Echinococcus granulosus cysts. Am J Trop Med Hyg. 2009 Oct;81(4):712-3 Authors: Capan M, Keltner S, Thalhammer F, Winkler S, Jäger W, Zeitlinger M, Ramharter M Albendazole therapy--alone or in combination with surgery--remains the standard of care for human echinococcosis depending on the stage of disease. However, only limited data are available on target site concentrations in liver cysts and data for non-liver cysts are lacking. We report on intra-cystic concentrations of the biologically active metabolite albendazole sulphoxide in non-liver cysts indicating a relative intra-cystic drug concentration of 48-156% compared with plasma levels. These data are evidence for a satisfactory penetration of albendazole sulphoxide into Echinococcus cysts localized in other organs than the liver and underline the usefulness of albendazole therapy for this indication. PMID: 19815892 [PubMed - indexed for MEDLINE]

Macrofilaricidal activity and amelioration of lymphatic pathology in bancroftian filariasis after 3 weeks of doxycycline followed by single-dose diethylcarbamazine.

Related Articles Macrofilaricidal activity and amelioration of lymphatic pathology in bancroftian filariasis after 3 weeks of doxycycline followed by single-dose diethylcarbamazine. Am J Trop Med Hyg. 2009 Oct;81(4):702-11 Authors: Mand S, Pfarr K, Sahoo PK, Satapathy AK, Specht S, Klarmann U, Debrah AY, Ravindran B, Hoerauf A In a placebo controlled trial, the effects of 21- and 10-day doxycycline treatments (200 mg/day) followed by single dose diethylcarbamazine (administered 4 months post treatment) on depletion of Wolbachia endobacteria from Wuchereria bancrofti, filaricidal activity, and amerlioration of scrotal lymph vessel dilation were studied in 57 men from Orissa, India. The 21-day doxycycline course reduced Wolbachia in W. bancrofti by 94% before diethylcarbamazine administration. After 12 months, all patients with this treatment were amicrofilaremic and different from the 10-day doxycycline (42.9%) and placebo (37.5%) groups, and significantly fewer were positive for scrotal worm nests (6.7%) compared with 10-day doxycycline (60%) and placebo (66.7%). Average scrotal lymph vessel diameters were reduced from 0.7 cm pre-treatment to 0.02 cm in patients after 21 days of treatment, while no significant changes were seen in the other groups. This latter feature confirms the beneficial effects of doxycycline on lymphatic dilation and thus adds to the existing evidence that doxycycline, in addition to being macrofilaricidal, may be used to prevent or reverse lymphatic pathology. PMID: 19815891 [PubMed - indexed for MEDLINE]

Clinical factors predictive of encephalitis caused by Angiostrongylus cantonensis.

Related Articles Clinical factors predictive of encephalitis caused by Angiostrongylus cantonensis. Am J Trop Med Hyg. 2009 Oct;81(4):698-701 Authors: Sawanyawisuth K, Takahashi K, Hoshuyama T, Sawanyawisuth K, Senthong V, Limpawattana P, Intapan PM, Wilson D, Tiamkao S, Jitpimolmard S, Chotmongkol V Angiostrongylus cantonensis is mainly caused eosinophilic meningitis in humans, whereas a minority of patients develop encephalitic angiostrongyliasis (EA). EA is an extremely fatal condition, and the clinical factors predictive of EA have never been reported. A comparison study was conducted in a hospital situated in an endemic area of Thailand. We enrolled 14 and 80 angiostrongyliasis patients who developed encephalitis and meningitis, respectively. Logistic regression analysis was used to assess the clinical variables predictive of encephalitis. Age (adjusted odds ratio [OR], 1.22; 95% confidence interval [CI], 1.05-1.42), duration of headache (adjusted OR, 1.26; 95% CI, 1.03-1.55), and fever > 38.0 degrees C (adjusted OR, 37.05; 95% CI, 1.59-862.35) were identified as statistically significant factors for EA prediction. Elderly patients with angiostrongyliasis experiencing fever and prolonged headaches were at the highest risk of developing EA. PMID: 19815890 [PubMed - indexed for MEDLINE]

The microscopic agglutination test (MAT) is an unreliable predictor of infecting Leptospira serovar in Thailand.

Related Articles The microscopic agglutination test (MAT) is an unreliable predictor of infecting Leptospira serovar in Thailand. Am J Trop Med Hyg. 2009 Oct;81(4):695-7 Authors: Smythe LD, Wuthiekanun V, Chierakul W, Suputtamongkol Y, Tiengrim S, Dohnt MF, Symonds ML, Slack AT, Apiwattanaporn A, Chueasuwanchai S, Day NP, Peacock SJ A prospective study in Thailand identified 106 patients with culture-proven leptospirosis. The accuracy of the microscopic agglutination test (MAT) in predicting the infecting serovar was evaluated in 78/106 (74%) patients with a diagnostic titer. MAT correctly determined the infecting serovar in 26 cases (33%), indicating that this assay is a poor predictor of infecting serovar in our setting. PMID: 19815889 [PubMed - indexed for MEDLINE]

Seroprevalence of Q fever in the United States, 2003-2004.

Related Articles Seroprevalence of Q fever in the United States, 2003-2004. Am J Trop Med Hyg. 2009 Oct;81(4):691-4 Authors: Anderson AD, Kruszon-Moran D, Loftis AD, McQuillan G, Nicholson WL, Priestley RA, Candee AJ, Patterson NE, Massung RF We performed serum testing for IgG antibodies against Coxiella burnetii (phase I and phase II) and analyzed questionnaire data from 4,437 adults > or = 20 years of age who participated in the National Health and Nutrition Examination Survey 2003-2004 survey cycle. National Q fever seroprevalence was determined by enzyme-linked immunosorbent assay and confirmed by using immunofluorescent antibody testing. Overall seroprevalence for Coxiella burnetii was 3.1% (95% confidence interval [CI] = 2.1-4.3%) among 4,437 adults > or = 20 years of age. Coxiella burnetii age-adjusted antibody prevalence was higher for men than for women (3.8%, 95% CI = 2.7-5.2% versus 2.5%, 95% CI = 1.5-3.7%, respectively, P < 0.05). Mexican Americans had a significantly higher antibody prevalence (7.4%, 95% CI = 6.6-8.3%) than either non-Hispanic whites (2.8%, 95% CI = 1.7-4.3%) or non-Hispanic blacks (1.3%, 95% CI = 0.6-2.5%) (P < 0.001). Multivariate analysis showed that the risk for Q fever antibody positivity increased with age and was higher among persons who were foreign-born, male, and living in poverty. These findings indicate that the national seroprevalence of Q fever in the United States is higher than expected on the basis of case numbers reported to the Centers for Disease Control and Prevention from state health departments. Potential differences in risk for exposure by race/ethnicity warrant further study. PMID: 19815888 [PubMed - indexed for MEDLINE]

Comparative efficacy of BioUD to other commercially available arthropod repellents against the ticks Amblyomma americanum and Dermacentor variabilis on cotton cloth.

Related Articles Comparative efficacy of BioUD to other commercially available arthropod repellents against the ticks Amblyomma americanum and Dermacentor variabilis on cotton cloth. Am J Trop Med Hyg. 2009 Oct;81(4):685-90 Authors: Bissinger BW, Zhu J, Apperson CS, Sonenshine DE, Watson DW, Roe RM BioUD is an arthropod repellent that contains the active ingredient 2-undecanone originally derived from wild tomato plants. Repellency of BioUD was compared with five commercially available arthropod repellents against the ticks Amblyomma americanum (L.) and Dermacentor variabilis Say in two-choice bioassays on treated versus untreated cotton cheesecloth. Overall mean percentage repellency against both species was greatest for and did not differ significantly between BioUD (7.75% 2-undecanone) and products containing 98.1% DEET, 19.6% IR3535, and 30% oil of lemon eucalyptus. Products containing 5% and 15% Picaridin and 0.5% permethrin were also repellent compared with untreated controls but to a lesser degree than BioUD. The four most active repellents at the same concentrations used before were directly compared in head-to-head bioassays on cotton cheesecloth. BioUD provided significantly greater overall mean percentage repellency than IR3535 for A. americanum and D. variabilis. BioUD was significantly more repellent than oil of lemon eucalyptus for A. americanum but did not differ significantly in repellency against D. variabilis. No statistically significant difference in overall mean percentage repellency was found between BioUD and DEET for A. americanum or D. variabilis. In a 7-week time course bioassay, BioUD applied to cotton cheesecloth and held at room temperature provided 5 weeks of > 90% repellency against A. americanum. PMID: 19815887 [PubMed - indexed for MEDLINE]

Development of field-based real-time reverse transcription-polymerase chain reaction assays for detection of Chikungunya and O'nyong-nyong viruses in mosquitoes.

Related Articles Development of field-based real-time reverse transcription-polymerase chain reaction assays for detection of Chikungunya and O'nyong-nyong viruses in mosquitoes. Am J Trop Med Hyg. 2009 Oct;81(4):679-84 Authors: Smith DR, Lee JS, Jahrling J, Kulesh DA, Turell MJ, Groebner JL, O'Guinn ML Chikungunya (CHIK) and O'nyong-nyong (ONN) are important emerging arthropod-borne diseases. Molecular diagnosis of these two viruses in mosquitoes has not been evaluated, and the effects of extraneous mosquito tissue on assay performance have not been tested. Additionally, no real-time reverse transcription-polymerase chain reaction (RT-PCR) assay exists for detecting ONN virus (ONNV) RNA. We describe the development of sensitive and specific real-time RT-PCR assays for detecting CHIK and ONN viral RNA in mosquitoes, which have application for field use. In addition, we compared three methods for primer/probe design for assay development by evaluating their sensitivity and specificity. This comparison resulted in development of virus-specific assays that could detect less than one plaque-forming unit equivalent of each of the viruses in mosquitoes. The use of these assays will aid in arthropod-borne disease surveillance and in the control of the associated diseases. PMID: 19815886 [PubMed - indexed for MEDLINE]

Crimean-Congo hemorrhagic fever virus as a nosocomial pathogen in Iran.

Related Articles Crimean-Congo hemorrhagic fever virus as a nosocomial pathogen in Iran. Am J Trop Med Hyg. 2009 Oct;81(4):675-8 Authors: Mardani M, Keshtkar-Jahromi M, Ataie B, Adibi P Crimean-Congo hemorrhagic fever (CCHF) is a viral disease with several different modes of transmission. We describe the manifestations, outcome, and likely modes of transmission for three nosocomial cases. All three cases were healthcare workers (two men and one woman). They had fever, myalgia, and petechia. Disseminated intravascular coagulation resulted in the death occurred in the woman. Because this disease is manifested with non-specific influenza-like symptoms, diagnosis can be difficult. Data for these patients can be used to investigate airborne or sexual transmission of this virus, although neither route was substantiated for these patients. Use of universal precautions and early case detection are the most helpful strategy for preventing nosocomial transmission of CCHF. PMID: 19815885 [PubMed - indexed for MEDLINE]

Development of an Alamar Blue viability assay in 384-well format for high throughput whole cell screening of Trypanosoma brucei brucei bloodstream form strain 427.

Related Articles Development of an Alamar Blue viability assay in 384-well format for high throughput whole cell screening of Trypanosoma brucei brucei bloodstream form strain 427. Am J Trop Med Hyg. 2009 Oct;81(4):665-74 Authors: Sykes ML, Avery VM There is an urgent need for new compounds for the drug development pipeline for treatment of patients with African sleeping sickness. One approach for identifying such compounds is by high throughput screening (HTS) of compound collections. For time and cost considerations, there is a need for the development of an assay that uses at least 384-well formats. To our knowledge, there are currently no viability assays for whole cell screening of trypanosomes in the 384-well plate format. We have developed and optimized an Alamar Blue viability assay in a 384-well format for Trypanosoma brucei brucei bloodstream form strain 427 (BS427). The assay had a Z' > 0.5 and tolerated a final dimethyl-sulfoxide concentration of 0.42%. Drug sensitivity was compared with those reported from previously developed 96-well methods and was found to be comparable. The sensitivity and cost benefit of the Alamar Blue assay make it an excellent candidate for HTS application. PMID: 19815884 [PubMed - indexed for MEDLINE]

Clinical course of monoclonal and oligoclonal gammopathies in patients infected with Orientia tsutsugamushi.

Related Articles Clinical course of monoclonal and oligoclonal gammopathies in patients infected with Orientia tsutsugamushi. Am J Trop Med Hyg. 2009 Oct;81(4):660-4 Authors: Park DS, Cho JH, Lee JH, Lee KE Although we have encountered many cases of monoclonal gammopathies (MGs) or oligoclonal gammopathies (OGs) in patients with Orientia tsutsugamushi infections, the clinical course of MG/OG associated with these infections has rarely been reported. We serially monitored 18 cases of MG/OG that appeared in the acute phase or early convalescent phase of scrub typhus. All MGs/OGs associated with infection with O. tsutsugamushi disappeared 7-15 weeks after treatment with doxycycline. In three cases of scrub typhus, MGs/OGs appeared before seropositive conversion (presence of antibodies against O. tsutsugamushi) and disappeared before seronegative conversion. Understanding our cases may be helpful for relevant clinical counseling and making appropriate medical decisions to avoid unnecessary invasive or cost-intensive diagnostic procedures for MGs/OGs in scrub typhus, especially in disease-endemic areas. We also suggest that 2-4 months after antibiotic treatment might be the optimal follow-up time to observe the disappearance of MGs/OGs associated with O. tsutsugamushi infections. PMID: 19815883 [PubMed - indexed for MEDLINE]

Molecular epidemiology of Chagas disease in the wild transmission cycle: the evaluation in the sylvatic vector Mepraia spinolai from an endemic area of Chile.

Related Articles Molecular epidemiology of Chagas disease in the wild transmission cycle: the evaluation in the sylvatic vector Mepraia spinolai from an endemic area of Chile. Am J Trop Med Hyg. 2009 Oct;81(4):656-9 Authors: Coronado X, Rozas M, Botto-Mahan C, Ortíz S, Cattan PE, Solari A The sylvatic transmission cycle of Chagas disease in Chile is composed of wild mammals and insects of the genus Mepraia. We determined infection rates and Trypanosoma cruzi genotypes in Mepraia spinolai. We collected 227 insects from two ecologically contrasting areas to assess T. cruzi infection. Polymerase chain reaction (PCR)-amplified minicircle DNAs were characterized by Southern blot and hybridization tests with genotype-specific probes. Infection in insects from the more fertile area was almost 2-fold higher than in the poorer area. The genotype TCI was the most prevalent and other genotypes such as TCIIb, TCIId, and TCIIe were found at lower rates. The areas differed in their genotype distribution but not in their genotype diversity. We suggest that the difference in abundance and richness of mammals between the areas may be producing the detected infection levels in vectors. Our results are compared with those reported for mammals from the same area. PMID: 19815882 [PubMed - indexed for MEDLINE]

Feeding and defecation patterns of Rhodnius nasutus (Hemiptera; Reduviidae), a triatomine native to an area endemic for Chagas disease in the state of Ceará, Brazil.

Related Articles Feeding and defecation patterns of Rhodnius nasutus (Hemiptera; Reduviidae), a triatomine native to an area endemic for Chagas disease in the state of Ceará, Brazil. Am J Trop Med Hyg. 2009 Oct;81(4):651-5 Authors: Oliveira TG, Carvalho-Costa FA, Sarquis O, Lima MM The importance of Rhodnius nasutus in the transmission of Chagas disease in northeastern Brazil was investigated regarding feeding and defecation patterns of this triatomine under laboratory conditions. An average of 30 samples were studied for each instar, from fourth-instar nymphs onward. On average, 86.4% started feeding after less than 10 minutes. In terms of the duration of feeding, 53.3% of fourth instar nymphs, 81.9% of fifth-instar nymphs, 21.9% of males, and 36.7% of females fed for more than 15 minutes. In all groups, there were insects that defecated and urinated during feeding; adult males defecated the most and fourth instar nymphs defecated the least. The results demonstrate that R. nasutus may be considered an efficient T. cruzi vector because it avidly searches for a food source, has a lengthy feeding time with low probability of interruption during feeding, and achieves a high percentage of engorgement. PMID: 19815881 [PubMed - indexed for MEDLINE]

Effect of peridomestic environments on repeated infestation by preadult Aedes aegypti in urban premises in Nha Trang City, Vietnam.

Related Articles Effect of peridomestic environments on repeated infestation by preadult Aedes aegypti in urban premises in Nha Trang City, Vietnam. Am J Trop Med Hyg. 2009 Oct;81(4):645-50 Authors: Tsuzuki A, Vu TD, Higa Y, Nguyen TY, Takagi M To determine the effect of peridomestic environments on Aedes aegypti infestation in urban premises, we conducted two consecutive surveys in the hot-dry and cool-wet seasons. Most Ae. aegypti pupae (79%) were recovered from premises where preadult forms (larvae and/or pupae) had been detected in both surveys. Hence, repeated infestation appears to be a useful parameter to identify premises associated with a high potential risk of dengue transmission. Multivariate analysis revealed that not only the persistent presence of containers discarded outdoors, wells, large plastic buckets, jars, and concrete toilet basins in the premises (adjusted odds ratios [aORs] = 63.3, 23.3, 22.5, 6.6, and 5.6, respectively) but also the presence of six or more residents was significantly associated with repeated infestation (aOR = 6.1). Premises with six or more residents along with specific container types from which a large number of pupae were recovered should be targeted in dengue-control programs. PMID: 19815880 [PubMed - indexed for MEDLINE]

Hemostatic changes in Vietnamese children with mild dengue correlate with the severity of vascular leakage rather than bleeding.

Related Articles Hemostatic changes in Vietnamese children with mild dengue correlate with the severity of vascular leakage rather than bleeding. Am J Trop Med Hyg. 2009 Oct;81(4):638-44 Authors: Wills B, Tran VN, Nguyen TH, Truong TT, Tran TN, Nguyen MD, Tran VD, Nguyen VV, Dinh TT, Farrar J The mechanisms underlying the bleeding manifestations and coagulopathy associated with dengue remain unclear, in part because of the focus of much previous work on severe disease without an appropriate comparison group. We describe detailed clinical and laboratory profiles for a large group of children with dengue of all severities, and a group with similar non-dengue febrile illnesses, all followed prospectively from early presentation through to recovery. Among the dengue-infected patients but not the controls, thrombocytopenia, increased partial thromboplastin times and reduced fibrinogen concentrations were apparent from an early stage, and these abnormalities correlated strongly with the severity and timing of vascular leakage but not bleeding. There was little evidence of procoagulant activation. The findings do not support a primary diagnosis of disseminated intravascular coagulation to explain the intrinsic coagulopathy. An alternative biologically plausible hypothesis is discussed. PMID: 19815879 [PubMed - indexed for MEDLINE]

Statins fail to improve outcome in experimental cerebral malaria and potentiate Toll-like receptor-mediated cytokine production by murine macrophages.

Related Articles Statins fail to improve outcome in experimental cerebral malaria and potentiate Toll-like receptor-mediated cytokine production by murine macrophages. Am J Trop Med Hyg. 2009 Oct;81(4):631-7 Authors: Helmers AJ, Gowda DC, Kain KC, Liles WC Cerebral malaria is responsible for a large proportion of the estimated one million deaths caused by Plasmodium falciparum malaria annually. This disease is associated with excessive pro-inflammatory cytokine production resulting from dysregulated host responses to infection. On the basis of reports indicating potent activity against host-mediated inflammatory disorders such as sepsis, we examined the activity of statins (3-hydroxy-3-methylglutaryl-coenzyme A reductase inhibitors) on malaria-associated inflammation in vivo and in vitro. Simvastatin failed to improve survival or alter parasitemia in C57BL/6 mice infected with Plasmodium berghei ANKA, an experimental model of cerebral malaria. In vitro statin treatment potentiated production of tumor necrosis factor and interleukin-6 by murine peritoneal macrophages in response to P. falciparum glycosylphosphatidyl inositol, a Toll-like receptor 2 (TLR2) ligand. Statin treatment also potentiated pro-inflammatory cytokine production stimulated by a panel of TLR2 and TLR4 ligands. Our results indicate that statins fail to confer protection in experimental cerebral malaria and potentiate TLR-mediated pro-inflammatory cytokine production by primary murine macrophages. PMID: 19815878 [PubMed - indexed for MEDLINE]

Non-destructive determination of age and species of Anopheles gambiae s.l. using near-infrared spectroscopy.

Related Articles Non-destructive determination of age and species of Anopheles gambiae s.l. using near-infrared spectroscopy. Am J Trop Med Hyg. 2009 Oct;81(4):622-30 Authors: Mayagaya VS, Michel K, Benedict MQ, Killeen GF, Wirtz RA, Ferguson HM, Dowell FE Determining malaria vector species and age is crucial to measure malaria risk. Although different in ecology and susceptibility to control, the African malaria vectors Anopheles gambiae sensu stricto and An. arabiensis are morphologically similar and can be differentiated only by molecular techniques. Furthermore, few reliable methods exist to estimate the age of these vectors, which is a key predictor of malaria transmission intensity. We evaluated the use of near-infrared spectroscopy (NIRS) to determine vector species and age. This non-destructive technique predicted the species of field-collected mosquitoes with approximately 80% accuracy and predicted the species of laboratory-reared insects with almost 100% accuracy. The relative age of young or old females was predicted with approximately 80% accuracy, and young and old insects were predicted with > or = 90% accuracy. For applications where rapid assessment of the age structure and species composition of wild vector populations is needed, NIRS offers a valuable alternative to traditional methods. PMID: 19815877 [PubMed - indexed for MEDLINE]

Pharmacokinetic profiles of artesunate after single intravenous doses at 0.5, 1, 2, 4, and 8 mg/kg in healthy volunteers: a phase I study.

Related Articles Pharmacokinetic profiles of artesunate after single intravenous doses at 0.5, 1, 2, 4, and 8 mg/kg in healthy volunteers: a phase I study. Am J Trop Med Hyg. 2009 Oct;81(4):615-21 Authors: Li Q, Cantilena LR, Leary KJ, Saviolakis GA, Miller RS, Melendez V, Weina PJ The pharmacokinetics of good manufacturing process injection of artesunate (AS) were evaluated after single doses at 0.5, 1, 2, 4, and 8 mg/kg with a 2-minute infusion in 40 healthy subjects. Drug concentrations were analyzed by validated liquid chromatography and mass spectrometry system (LC-MS/MS) procedures. The drug was immediately converted to dihydroartemisinin (DHA), with elimination half-lives ranging 0.12-0.24 and 1.15-2.37 hours for AS and DHA, respectively. Pharmacokinetic model-dependent analysis is suitable for AS, whereas DHA fits both model-dependent and -independent methods. Although DHA concentration was superior to that of AS with a 1.12-1.87 ratio of area under the curve (AUC)(DHA/AS), peak concentration of AS was much higher than that of DHA, with a 2.80- to 4.51-fold ratio of peak concentration (C(max AS/DHA)). Therefore, AS effectiveness has been attributed not only to its rapid hydrolysis to DHA, but also to itself high initial C(max). PMID: 19815876 [PubMed - indexed for MEDLINE]

Assessing the impact of indoor residual spraying on malaria morbidity using a sentinel site surveillance system in Western Uganda.

Related Articles Assessing the impact of indoor residual spraying on malaria morbidity using a sentinel site surveillance system in Western Uganda. Am J Trop Med Hyg. 2009 Oct;81(4):611-4 Authors: Bukirwa H, Yau V, Kigozi R, Filler S, Quick L, Lugemwa M, Dissanayake G, Kamya M, Wabwire-Mangen F, Dorsey G A single round of indoor residual spraying (IRS) using lambda-cyhalothrin was implemented in a district of Uganda with moderate transmission intensity in 2007. Individual patient data were collected from one health facility within the district 8 months before and 16 months after IRS. There was a consistent decrease in the proportion of patients diagnosed with clinical malaria after IRS for patients < 5 and > 5 years of age (52% versus 26%, P < 0.001 and 36% versus 23%, P < 0.001, respectively). There was a large decrease in the proportion of positive blood smears in the first 4 months after IRS for patients < 5 (47% versus 14%, P < 0.001) and > 5 (26% versus 9%, P < 0.001) years of age, but this effect waned over the subsequent 12 months. IRS was effective in reducing malaria morbidity, but this was not sustained beyond 1 year for the proportion of blood smears read as positive. PMID: 19815875 [PubMed - indexed for MEDLINE]

Resurgence of Plasmodium vivax malaria in the Republic of Korea during 2006-2007.

Related Articles Resurgence of Plasmodium vivax malaria in the Republic of Korea during 2006-2007. Am J Trop Med Hyg. 2009 Oct;81(4):605-10 Authors: Jun G, Yeom JS, Hong JY, Shin EH, Chang KS, Yu JR, Oh S, Chung H, Park JW Plasmodium vivax malaria, which re-emerged in the Republic of Korea (ROK) in 1993, had decreased since 2001. However, case numbers began to increase again in 2005. The number of cases rose 54.0% in 2006, but the rate of increase slowed down in 2007. Among the total of 4,206 cases of P. vivax malaria during 2006-2007, 756 cases (18.0%) were ROK military personnel, 891 cases (21.2%) were veterans, and 2,559 cases (60.8%) were civilians. The rapid increase during this period was mostly contributed by the western part of the malaria-risk areas that is under the influence of adjacent North Korea. Local transmission cases in ROK have also increased gradually and the transmission period seemingly became longer. Chemoprophylaxis in the military should be re-assessed in view of chloroquine-resistance. Continuous surveillance and monitoring are warranted to prevent further expansion of P. vivax malaria caused by climate change in ROK. PMID: 19815874 [PubMed - indexed for MEDLINE]

Biological resistance of hydroxychloroquine for Plasmodium vivax malaria in the Republic of Korea.

Related Articles Biological resistance of hydroxychloroquine for Plasmodium vivax malaria in the Republic of Korea. Am J Trop Med Hyg. 2009 Oct;81(4):600-4 Authors: Lee SW, Lee M, Lee DD, Kim C, Kim YJ, Kim JY, Green MD, Klein TA, Kim HC, Nettey H, Ko DH, Kim H, Park I The Republic of Korea (ROK) Army instituted a vivax malaria chemoprophylaxis program (hydroxychloroquine [HCQ] 400 mg per week) in 1997 that was expanded to nearly 200,000 soldiers by 2007, raising concerns for the emergence of drug-resistant vivax malaria. Therefore, a study of whole blood HCQ concentrations for all malaria patients admitted to four ROK Army hospitals was conducted from June through September 2007. For all 142 vivax malaria patients enrolled, fevers returned to normal by Day 3 post-treatment and all thin blood films were negative for parasites by Day 7. Pre-treatment whole blood concentrations of HCQ for 14 patients were > 100 ng/mL. Eight of the patients were enrolled in the ROK Army chemoprophylaxis program that reported taking HCQ as directed, with the last pill taken > or = 4 days before diagnosis. Although there was no evidence of clinical resistance, chemoprophylaxis data indicates the biological resistance or tolerance to HCQ in ROK. PMID: 19815873 [PubMed - indexed for MEDLINE]

Severe imported malaria in adults: retrospective study of 20 cases.

Related Articles Severe imported malaria in adults: retrospective study of 20 cases. Am J Trop Med Hyg. 2009 Oct;81(4):595-9 Authors: González A, Nicolás JM, Muñoz J, Castro P, Mas J, Valls ME, Coma JR, Aibar J, Gascon J Severe imported malaria is an important problem in many countries in which this disease is not endemic. This retrospective study describes the characteristics of 20 adults with severe imported malaria admitted to our intensive care unit from 1991 through 2007. All episodes were caused by Plasmodium falciparum and all patients had returned from sub-Saharan Africa, except for one transfusion recipient. All persons were considered non-immune, and none had taken appropriate chemoprophylaxis. The median time between the initiation of symptoms and the diagnosis was seven days. Five patients died (mortality rate = 25%). A higher frequency of unrousable coma and acidosis and a higher median Apache II score at admission was noted in the persons who died. Mortality by severe malaria remains high despite high quality management, which highlights the importance of chemoprophylaxis and early diagnosis and treatment. PMID: 19815872 [PubMed - indexed for MEDLINE]

Adaptation of a Thai multidrug-resistant C2A clone of Plasmodium falciparum to Aotus monkeys and its preliminary in vivo antimalarial drug efficacy-resistance profile.

Related Articles Adaptation of a Thai multidrug-resistant C2A clone of Plasmodium falciparum to Aotus monkeys and its preliminary in vivo antimalarial drug efficacy-resistance profile. Am J Trop Med Hyg. 2009 Oct;81(4):587-94 Authors: Obaldía N, Milhous W, Kyle D A multidrug-resistant (MDR) clone of Plasmodium falciparum (C2A) from Thailand was adapted through serial passage to Aotus monkeys. During adaptation, the parasite showed resistance to a single 20 or 40 mg/kg oral dose of mefloquine (MQ). Infection was only cured when MQ was administered orally at 40 mg/kg once in combination with intravenous artesunic acid at 20 mg/kg for 3 days. Similarly, the parasite clone was found to be resistant to quinine, failing at 20 mg/kg orally for 5 days in combination with an experimental dihydrofolate reductase (DHFR) inhibitor (WR297608) at 10, 20, or 40 mg/kg orally for 3 days, and with atovaquone/proguanil at 25 mg/kg for 3 days. This new model will allow in vivo testing of new antimalarial compounds or their combinations against a currently circulating MDR P. falciparum strain. PMID: 19815871 [PubMed - indexed for MEDLINE]

Aspergillus flavus brain abscesses associated with hepatic amebiasis in a non-neutropenic man in Senegal.

Related Articles Aspergillus flavus brain abscesses associated with hepatic amebiasis in a non-neutropenic man in Senegal. Am J Trop Med Hyg. 2009 Oct;81(4):583-6 Authors: Brun S, Fekkar A, Busse A, Seilhean D, Lecsö M, Adler D, Prodanovic H, Mazier D, Datry A A non-neutropenic man living in Senegal was repatriated to France for liver amebic abscesses associated with brain abscesses presumed to be of amebic origin. Surprisingly, the post-mortem examinations of brain abscesses showed Aspergillus flavus. The route of infection by A. flavus in this particular context is discussed. PMID: 19815870 [PubMed - indexed for MEDLINE]

Sensitive, specific, and rapid detection of Leishmania donovani DNA by loop-mediated isothermal amplification.

Related Articles Sensitive, specific, and rapid detection of Leishmania donovani DNA by loop-mediated isothermal amplification. Am J Trop Med Hyg. 2009 Oct;81(4):578-82 Authors: Takagi H, Itoh M, Islam MZ, Razzaque A, Ekram AR, Hashighuchi Y, Noiri E, Kimura E We have applied a loop-mediated isothermal amplification (LAMP) technique to detect Leishmania donovani DNA. The LAMP technique detected 1 fg of L. donovani DNA, which was 10-fold more sensitive than a conventional polymerase chain reaction (PCR). All nested PCR-positive blood samples from visceral leishmaniasis patients were positive with the LAMP technique, and DNA samples from L. infantum, L. major, L. mexicana, L. tropica, L. braziliensis, Plasmodium falciparum, and healthy humans were negative with the LAMP technique. The advantages of the LAMP method are its shorter reaction time, a lack of requirement of sophisticated equipment, and visual judgment of positivity based on the turbidity of reaction mixture. Our LAMP technique can be a better alternative to a conventional PCR, especially under field conditions. PMID: 19815869 [PubMed - indexed for MEDLINE]

Vector incrimination of sand flies in the most important visceral leishmaniasis focus in Iran.

Related Articles Vector incrimination of sand flies in the most important visceral leishmaniasis focus in Iran. Am J Trop Med Hyg. 2009 Oct;81(4):572-7 Authors: Oshaghi MA, Ravasan NM, Javadian EA, Mohebali M, Hajjaran H, Zare Z, Mohtarami F, Rassi Y The prevalence, host preference, and rate of Leishmania spp. infection of sand fly species are important parameters for incrimination of parasite vectors. We applied polymerase chain reaction (PCR)-based and enzyme-linked immunosorbent assay (ELISA) methods to detect Leishmania spp. parasites and blood meals within individual sand flies in the most important visceral leishmaniasis (VL) focus in northwestern Iran. Leishmania spp. minicircles (kinetoplast DNA) were found in 14 (0.9%) of 1,569 female specimens. Sequence analysis of 650 basepairs of an internal transcribed spacer ribosomal DNA gene identified L. infantum/L. donovani in 12 specimens and L. adleri-like parasites in 2 specimens. Nine (64.3%) of 14 of the Leishmania spp.-positive sand flies were Phlebotomus perfeliewi transcaucasicus. Blood meal identification of host DNA within sand flies by PCR-based and ELISA methods showed that 30% and 28%, respectively, were positive for human blood. Results of this study showed that P. perfeliewi transcaucasicus is the most prevalent, infected, and anthropophagic sand fly and plays a major role in VL transmission in the region studied. PMID: 19815868 [PubMed - indexed for MEDLINE]

Molecular epidemiology of American tegumentary leishmaniasis in Panama.

Related Articles Molecular epidemiology of American tegumentary leishmaniasis in Panama. Am J Trop Med Hyg. 2009 Oct;81(4):565-71 Authors: Miranda A, Carrasco R, Paz H, Pascale JM, Samudio F, Saldaña A, Santamaría G, Mendoza Y, Calzada JE American tegumentary leishmaniasis is an increasing public health problem in Panama. This study describes the clinical characteristics and the molecular epidemiology of leishmaniasis in Panama over a 5-year period (2004-2008). Additionally, we applied a polymerase chain reaction (PCR)-restriction fragment length polymorphism (RFLP)-based assay to identify Leishmania species in clinical isolates, skin scrapings, and sandflies specimens. Whereas 60.3% of cases were detected with conventional parasitologic techniques (smear or in vitro culture), the PCR detected 72% positive patients. Our clinical-epidemiologic data corroborate the high incidence of L. (Viannia) panamensis and provide evidence of peridomestic and/or domestic transmission. Mucosal involvement was observed in 4.2% of the patients. The overall natural infection rate with Leishmania in 103 pools of sandflies was 0.46%. Lutzomyia gomezi and Lutzomya panamensis were the prevalent species incriminated as vectors at the capture sites in central Panama. This study contributes to a better knowledge of the current epidemiology of tegumentary leishmaniasis in Panama. PMID: 19815867 [PubMed - indexed for MEDLINE]

Tegumentary leishmaniasis as the cause of immune reconstitution inflammatory syndrome in a patient co-infected with human immunodeficiency virus and Leishmania guyanensis.

Related Articles Tegumentary leishmaniasis as the cause of immune reconstitution inflammatory syndrome in a patient co-infected with human immunodeficiency virus and Leishmania guyanensis. Am J Trop Med Hyg. 2009 Oct;81(4):559-64 Authors: Chrusciak-Talhari A, Ribeiro-Rodrigues R, Talhari C, Silva RM, Ferreira LC, Botileiro SF, Santos LO, Dietze R, Talhari S We report a case of immune reconstitution inflammatory syndrome (IRIS) in a 32-year-old man infected with human immunodeficiency virus and Leishmania guyanensis. Three months after initiation of highly active anti-retroviral therapy (HAART), the patient had disseminated cutaneous leishmaniasis and started anti-leishmanial therapy. The patient's leishmaniasis manifestations during HAART ranged form an anergic response (46 CD4+ T cells/microL) to a disseminated cutaneous leishmaniasis (112 CD4+ T cells/microL). Eight weeks later (168 CD4+ T cells/microL, skin biopsy specimens showed inflammatory infiltrates with no detectable amastigotes. The patient then became comatose. Prednisone therapy (60 mg/day) was initiated with a significant improvement within 48 hours. Three months later (CD4+ T cell count = 184 cell/microL), localized, classic, cutaneous leishmaniasis developed in the patient and anti-leishmanial treatment was re-introduced. On that occasion, frequency of T regulatory cells was 1.82% of all CD4+ cells. Our data suggest a pivotal role for CD4+ T cells in the onset of IRIS and lesion ulceration and their association with a low frequency of T regulatory cells. PMID: 19815866 [PubMed - indexed for MEDLINE]

Co-Infection of Leishmania (Viannia) braziliensis and HIV: report of a case of mucosal leishmaniasis in Cochabamba, Bolivia.

Related Articles Co-Infection of Leishmania (Viannia) braziliensis and HIV: report of a case of mucosal leishmaniasis in Cochabamba, Bolivia. Am J Trop Med Hyg. 2009 Oct;81(4):555-8 Authors: Torrico F, Parrado R, Castro R, Marquez CJ, Torrico MC, Solano M, Reithinger R, García AL We describe the first case of Leishmania/HIV co-infection reported in Bolivia. Initially hospitalized with a diagnosis of pneumonia and bronchitis, the patient had numerous cutaneous and mucosal lesions caused by Leishmania (Viannia) braziliensis. The patient was also diagnosed as severely immunocompromised because of HIV infection. PMID: 19815865 [PubMed - indexed for MEDLINE]

Vestibular-evoked myogenic potential (VEMP) in the evaluation of schistosomal myeloradiculopathy.

Related Articles Vestibular-evoked myogenic potential (VEMP) in the evaluation of schistosomal myeloradiculopathy. Am J Trop Med Hyg. 2009 Oct;81(4):551-4 Authors: Felipe L, Gonçalves DU, Tavares MC, Sousa-Pereira SR, Antunes CM, Lambertucci JR Schistosomal myeloradiculopathy (SMR) is the most severe and disabling form of schistosomiasis. The diagnosis is based on clinical, laboratory, and image data. Vestibular-evoked myogenic potential (VEMP) is a neurophysiologic test that assesses the vestibulospinal pathway through acoustic or galvanic stimuli. The aim of this study was to evaluate cervical spinal abnormalities in patients with SMR. Fifty-two subjects were evaluated, of whom 29 had SMR and 30 did not (normal control). Normal VEMP was observed in all volunteers without SMR. Abnormal VEMP was recorded in 34% of the group with SMR. After treatment, abnormal VEMP was found in 80% of those with persistent neurologic abnormalities. VEMP is a functional test, and the alteration may precede image abnormalities. This procedure may be useful for early diagnosis of schistosomal cervical spinal cord involvement. PMID: 19815864 [PubMed - indexed for MEDLINE]

Cervical schistosomiasis as a risk factor of cervical uterine dysplasia in a traveler.

Related Articles Cervical schistosomiasis as a risk factor of cervical uterine dysplasia in a traveler. Am J Trop Med Hyg. 2009 Oct;81(4):549-50 Authors: Dzeing-Ella A, Mechaï F, Consigny PH, Zerat L, Viard JP, Lecuit M, Lortholary O Female genital schistosomiasis (FGS) may be under-recognized in endemic areas as a cause of cervical dysplasia, neoplasia, infertility, and as a facilitator of the transmission of HIV. To the best of our knowledge, few cases of FGS mimicking neoplasia have been reported in travelers. We report a clinical case of a 34-year-old white woman who presented with a severe cervical dysplasia, without any features of human papilloma virus infection, 2 years after bathing in a waterfall, a source of schistosomiasis, in Mali. Schistosomes eggs were found on the conization. Management included conization and medical treatment, resulting in a full clinical and histologic recovery. FGS should be kept in mind as a possible cause of cervical dysplasia in endemic areas. Medical treatment with praziquantel improves this condition. PMID: 19815863 [PubMed - indexed for MEDLINE]

Peripheral rim enhancement in tuberculous mediastinal lymph nodes.

Related Articles Peripheral rim enhancement in tuberculous mediastinal lymph nodes. Am J Trop Med Hyg. 2009 Oct;81(4):548 Authors: Jayakrishnan B, Al-Rawas OA PMID: 19815862 [PubMed - indexed for MEDLINE]

Cerebral malaria: a new way forward with magnetic resonance imaging (MRI).

Related Articles Cerebral malaria: a new way forward with magnetic resonance imaging (MRI). Am J Trop Med Hyg. 2009 Oct;81(4):545-7 Authors: Looareesuwan S, Laothamatas J, Brown TR, Brittenham GM Magnetic resonance studies offer a new way through the impasse that now seems to block further progress in disentangling the pathogenesis and improving the treatment of cerebral malaria, a catastrophic neurologic complication of infection with Plasmodium falciparum. The underlying mechanisms responsible for coma in cerebral malaria are still unknown and the relative contributions of the microvascular sequestration of infected erythrocytes, the inflammatory response to P. falciparum, disordered hemostasis, and other factors remain controversial. For more than a century, neuropathologic studies have provided the basis for concepts of causation of cerebral malaria. Magnetic resonance techniques now offer non-invasive means of determining essential anatomic, metabolic, biochemical, and functional features of the brain in patients with cerebral malaria during life that could transform our understanding of the pathogenesis of cerebral malaria and lead to the development of new neuroprotective treatments. PMID: 19815861 [PubMed - indexed for MEDLINE]