Search PubMed⌕ Search

Biomedical subjects

E Ruiz-Tiben

Publications and source records attributed to E Ruiz-Tiben.

32 records · Page 2Linked to original sources

Survival of Schistosoma mansoni in the human host: estimates from a community-based prospective study in Puerto Rico.

Changes over time in the prevalence and intensity of Schistosoma mansoni infection were measured by serial quantitative stool examinations using the modified Ritchie concentration technique in a 9-year prospective study of an endemic Puerto Rican community with a population of about 1,000 persons. The complete interruption of transmission was achieved by snail control during the 2nd year of the study, in February 1973. Annual stool specimens were obtained from all willing community residents. In addition, from 27 of these residents 10 consecutive stools were collected in each of 3 years: 1973, 1976, 1977. After a chemotherapy campaign with oxamniquine in 1980, only eight of these 27 persons remained untreated. Ten consecutive stools were collected from seven of these untreated individuals in 1981. We calculated the rate of decline (beta) in geometric mean egg count in the cohort of 27 over 5 years and in the subcohort of seven over 9 years. Similarly, beta was calculated from the change in the single annual stool counts in 528 persons providing data for all of the first 6 years of the study. Estimates of the average life-span (-1/beta, in a model assuming constant rate of death) of the adult S. mansoni with 95% confidence intervals are for the cohort of 27, 5.5 years (4.0 to 9.1), for the cohort of seven, 37 years (8.0 to infinity), and and for the cohort of 528, 35 years (16 to infinity).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

The planning of a community health model project in an area in Egypt (El Qalyub) with concomitant occurrence of S. mansoni and S. haematobium.

In addition to knowing about the tolerance, efficacy, and safety of a new antischistosomal agent, public health authorities also have a critical need to know the degree to which population-based chemotherapeutic programmes can potentially reduce disease transmission and morbidity. Rational nationwide planning on a cost-effective basis is impossible without such information. Thus the Qalyub Project, a major collaborative research effort by the Egyptian Ministry of Health, the US Center for Disease Control and Tulane University, has undertaken to measure the impact of alternate control strategies in 8 study villages in a region where Schistosoma mansoni (over 50% prevalence) and S. haematobium (approximately 30%) are coendemic. Selected population chemotherapy with 2-cyclohexylcarbonyl-1,2,3,6,7,11b-hexahydro-4H-pyrazino[2,1-a] isoquinolin-4-one (praziquantel, EMBAY 8440, Biltricide) alone and in combination with snail control, is being evaluated in terms of cost and impact on transmission as measured by changes in precontrol levels of incidence (of new infections) and infection rates in natural and sentinel populations of the snail intermediate hosts. The methodology of such a community-based study requires meticulous and standardized collection of clinical, parasitologic, malacologic, and behavioral data over a period of years, and is described in detail in this paper. The outcome of the research in progress will have considerable significance for planning future schistosomiasis control effects in Egypt and elsewhere.

Adolescent↗

The Boqueron Project after 5 years: a prospective community-based study of infection with Schistosoma mansoni in Puerto Rico.

The Boqueron Schistosomiasis Project is a prospective community-based study of Schistosoma mansoni infection after the interruption of transmission by nonchemotherapeutic control measures. The study methods and the parasitologic results of the first five annual stool surveys are described in this report. In the first year, 1972, among 904 inhabitants (88% of the total population) the prevalence of infection was 40%, and the geometric mean intensity of infection among positives was 16.1 eggs per gram (epg). Snail control was begun in early 1973 with molluscicides and habitat modification. Intensive monitoring every 2 weeks revealed only 63 noninfected Biomphalaria glabrata in the community during the subsequent 4 years. The incidence of new infectins among people negative in all previous surveys dropped from 17% in 1972 to 1% in 1974 and has remained negligible since then. Among young children and newborn, only four new infections (all less than 5 epg) were found after the first control year. Despite this low rate of transmission, prevalence only decreased from 37% to 34%, and the population geometric mean fecal egg output has not substantially changed in a cohort of 528 individuals examined in each of the six annual surveys. Possible reasons for the minimal change in parasitologic status are discussed and include water contact behavior outside the community and changes in laboratory techniques. Data from the first 5 years of the study suggest that in a population where mean intensity of infection with S. mansoni is low, further decreases in prevalence and intensity of infection occur slowly. The implications for control programs based on nonchemotherapeutic measures are discussed.

Adolescent↗

Assessment of schistosomiasis in the Dominican Republic.

Active transmission of intestinal schistosomiasis is currently limited to the southeastern part of the Dominican Republic. A population-based stool survey in 1980 detected 4 asymptomatic individuals among 114 selected at random in 2 towns and a rural community in El Seibo Province. The distribution of the transmitting snail, Biomphalaria glabrata, considerably exceeds that of Schistosoma mansoni, extending to the National District and capital city of Santo Domingo and well into certain central valley provinces. There is evidence that transmission sites have shifted during the past three decades because of urban development, molluscicidal activities and, perhaps, introduction of competing mollusks. In spite of intermittent control activities, the combination of domestic and recreational use of streams with consequent fecal contamination, and the extended distribution of B. glabrata indicates that the potential for new transmission foci is as great today as it was 10 years ago. This potential transmission of S. mansoni is a continuing threat to public health in the Dominican Republic.

Adolescent↗

The efficacy of oxamniquine in acute schistosomiasis: a clinical analysis of 28 treated patients.

During the summer of 1980, acute Manson's Schistosomiasis occurred in 28 pediatric patients, swimming in two ponds with no watershed connections between them, in the rural area of Juncos and Cidra, Puerto Rico. Clinical and immunological events were studied and Oxamniquine (Vansil, Pfizer) was administered to all of them and followed closely for 3 years. Fever and general malaise recorded in 93% of the patients, diarrhea and abdominal pain in 68% and urticaria or facial edema in 64%. Hepato and/or splenomegaly was recorded in 71% of them. Twenty seven of the patients had evidence of immunoserological activity against adult schistosomal antigens (GASP and PSAP). Two patients had intense immunologic activity, even before the recovering of fresh Schistosoma mansoni eggs in their stool. This was a response to GASP and PSAP antigens. When they started passing fresh eggs of schistosoma and COP (Circumoval Precipitation Test) turned positive, their clinical status worsened and antibodies to GASP antigen increased two fold. The oviposition phase elicited a strong antibody and immunological reaction with significant eosinophilia and cross reaction was observed between adult schistosomal and egg shell antigens. Severe clinical manifestations were seen in spite of low egg excretion. Oxamniquine was effective in obtaining a coprological cure and in altering the immunologic response as compared with other untreated groups in literature.

Acute Disease↗