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[Single dose mebendazole for the treatment of Trichuris trichiura and Necator americanus in chemotherapeutic control campaigns in the communities].

A study of intestinal parasitism is made in "Argelia Libre" community, Isle of Youth, by means of four coproparasitologic techniques: Kato Kratz, Ritchie, Direct, and Willis. Patients with geohelminths are divided into two groups of treatment: Group A, treated with 500 mg mebendazole in single doses and group B, treated with the classical scheme of 100 mg every 12 hours for three days. Results of treatment are expressed in terms of cure rates and percentage of egg-count reduction. When comparing schemes A and B, no significant differences are found (p less than 0.05). Due to its lower cost and easier administration, the single dosage scheme is recommended for massive chemotherapy of geohelminthiasis in the community.

Adolescent↗

Hookworm infection and anemia in adult women in rural Chiapas, Mexico.

OBJECTIVE: To describe associations between anemia and hookworm (Necator americanus) infection in hospitalized women in rural Chiapas, Mexico. MATERIAL AND METHODS: We retrospectively reviewed the hospital records of 68 anemic women (defined as having a hemoglobin level < 10 mg/dl) or with intestinal parasitism, identified through hospital discharge and transfusion records for the calendar year 1999. The medical charts of 86 cases were located, 18 of which were not confirmed as anemia cases. The hospital is located in Altamirano, Chiapas. Characteristics of subjects were compared using Student's t-test (for continuous variables) and the chi 2 test (for categorical variables). A p-value < or = 0.01 was used for statistical significance. Chart review and data analysis took place during the year 2000. RESULTS: Fifty percent of women who had stool examinations were infected with N. americanus. Necator often coexisted with other potential causes of anemia, such as pregnancy and hemorrhage. Hemoglobin levels in hookworm-infected women (mean 4.1 g/dl) were significantly lower than in uninfected women (mean 7.0 gm/dl), and Necator prevalence was significantly higher in the anemic women (50%) than in the overall hospital population (1.9%). CONCLUSIONS: Anemic women should be offered stool testing where Necator is present, and should be considered for antihelminthic treatment even if pregnant. Further investigation is recommended among women in Chiapas, and probably elsewhere in Mexico. The English version of this paper is available too at: http://www.insp.mx/salud/index.html.

Adult↗

Hypersensitivity to some nematode antigens.

Immediate and delayed skin reactions to antigens derived from Ascaris suum, Necator americanus, and Toxocara canis are described in three subjects and related to eosinophil counts and serum IgE levels. One, who had laboratory contact with ascarides but no known infection, gave positive immediate reactions to all three antigens. Another, following repeated experimental infection with necator, gave positive immediate reactions to all three antigens and a delayed reaction to necator alone. The third, following a single recent infection with necator, gave no immediate or delayed reaction.

Antigens↗

A comparison of post-mortem analysis of helminths with faecal egg counts.

Intestinal helminth infections are very common amongst residents of the Colombo area. Most common by post-mortem examination of 104 cases of sudden death were Trichuris trichiura (97.1%), Necator americanus (88.5%), Enterobius vermicularis (77.9%) and Ascaris lumbricoides (40.4%). Trematode and cestode infections were not encountered except a single case of H. diminuta infection. A comparison of the results obtained by the direct smear method for examining stools missed cases harbouring gravid females of up to 3 Ascaris lumbricoides, 29 Trichuris trichiura and 66 Necator americanus. The direct smear revealed all the helminths present except threadworms in only 30% of the cases. The correlation between worm loads calculated from ova counts and actual numbers harboured was fairly close in 19 out of 35 cases for Ascaris and 37 out of 78 cases for Necator americanus. Highly erroneous results were obtained in many instances when worm loads were calculated from the results of ova counts.

Adolescent↗

Cysteine conjugate beta-lyase activity in three species of parasitic helminth.

Living organisms employ a variety of metabolic pathways when detoxifying xenobiotic compounds, including the formation of cysteine S-conjugates via glutathione conjugation. However, cysteine conjugate beta-lyase (CCBL) catalysed beta-cleavage, of certain cysteine conjugates, is known to cause cytotoxicity. This study represents the first investigation into the expression of CCBL and other associated enzymes in helminth species. A survey of the three major groups of parasitic helminths [cestodes (Moniezia expansa), digeneans (Fasciola hepatica) and nematodes (Necator americanus, Heligmosomoides polygyrus)] has been made. The presence of CCBL enzymes within Moniezia expansa, Necator americanus and Heligmosomoides polygyrus has been established. Each species was screened for gamma-glutamyl transpeptidase activity and transaminase activity towards L-aspartate, L-alanine, L-albizziin and L-phenylalanine. Aspartate and alanine aminotransferase activity were detected in all four species tested. Gamma-glutamyl transpeptidase activity was only detected in Moniezia expansa and Necator americanus.

Alanine↗

The mutagenicity of some edible mushrooms in the Ames test.

The mutagenic activity of five wild and two cultivated species of edible mushrooms was studied in the Ames Salmonella/microsome test system. The wild mushrooms tested were four species of the genus Lactarius (L. necator, L. torminosus, L. helvus and L. rufus) and bolete (Boletus edulis). The cultivated species were champignon (Agaricus bisporus) and shiitake (Lentinus edodes). All the mushrooms were mutagenic to tester strains sensitive to base-pair substitution mutagens, and L. necator, L. rufus and B. edulis also had some frameshift activity. Metabolic activation was not required and the mutagenic activity could be detected even in boiled mushroom extracts. After fractionation with organic solvents (ethanol followed by diethyl ether) the activity was recovered in the ether phase as well as the aqueous phase in the case of L. necator, but remained in the aqueous phase of the A. bisporus and Lentinus edodes extracts.

Basidiomycota↗

Chlorophenol hydroxylases encoded by plasmid pJP4 differentially contribute to chlorophenoxyacetic acid degradation.

Phenoxyalkanoic compounds are used worldwide as herbicides. Cupriavidus necator JMP134(pJP4) catabolizes 2,4-dichlorophenoxyacetate (2,4-D) and 4-chloro-2-methylphenoxyacetate (MCPA), using tfd functions carried on plasmid pJP4. TfdA cleaves the ether bonds of these herbicides to produce 2,4-dichlorophenol (2,4-DCP) and 4-chloro-2-methylphenol (MCP), respectively. These intermediates can be degraded by two chlorophenol hydroxylases encoded by the tfdB(I) and tfdB(II) genes to produce the respective chlorocatechols. We studied the specific contribution of each of the TfdB enzymes to the 2,4-D/MCPA degradation pathway. To accomplish this, the tfdB(I) and tfdB(II) genes were independently inactivated, and growth on each chlorophenoxyacetate and total chlorophenol hydroxylase activity were measured for the mutant strains. The phenotype of these mutants shows that both TfdB enzymes are used for growth on 2,4-D or MCPA but that TfdB(I) contributes to a significantly higher extent than TfdB(II). Both enzymes showed similar specificity profiles, with 2,4-DCP, MCP, and 4-chlorophenol being the best substrates. An accumulation of chlorophenol was found to inhibit chlorophenoxyacetate degradation, and inactivation of the tfdB genes enhanced the toxic effect of 2,4-DCP on C. necator cells. Furthermore, increased chlorophenol production by overexpression of TfdA also had a negative effect on 2,4-D degradation by C. necator JMP134 and by a different host, Burkholderia xenovorans LB400, harboring plasmid pJP4. The results of this work indicate that codification and expression of the two tfdB genes in pJP4 are important to avoid toxic accumulations of chlorophenols during phenoxyacetic acid degradation and that a balance between chlorophenol-producing and chlorophenol-consuming reactions is necessary for growth on these compounds.

2,4-Dichlorophenoxyacetic Acid↗

Molecular and population analyses of a recombination event in the catabolic plasmid pJP4.

Cupriavidus necator JMP134(pJP4) harbors a catabolic plasmid, pJP4, which confers the ability to grow on chloroaromatic compounds. Repeated growth on 3-chlorobenzoate (3-CB) results in selection of a recombinant strain, which degrades 3-CB better but no longer grows on 2,4-dichlorophenoxyacetate (2,4-D). We have previously proposed that this phenotype is due to a double homologous recombination event between inverted repeats of the multicopies of this plasmid within the cell. One recombinant form of this plasmid (pJP4-F3) explains this phenotype, since it harbors two copies of the chlorocatechol degradation tfd gene clusters, which are essential to grow on 3-CB, but has lost the tfdA gene, encoding the first step in degradation of 2,4-D. The other recombinant plasmid (pJP4-FM) should harbor two copies of the tfdA gene but no copies of the tfd gene clusters. A molecular analysis using a multiplex PCR approach to distinguish the wild-type plasmid pJP4 from its two recombinant forms, was carried out. Expected PCR products confirming this recombination model were found and sequenced. Few recombinant plasmid forms in cultures grown in several carbon sources were detected. Kinetic studies indicated that cells containing the recombinant plasmid pJP4-FM were not selectable by sole carbon source growth pressure, whereas those cells harboring recombinant plasmid pJP4-F3 were selected upon growth on 3-CB. After 12 days of repeated growth on 3-CB, the complete plasmid population in C. necator JMP134 apparently corresponds to this form. However, wild-type plasmid forms could be recovered after growing this culture on 2,4-D, indicating that different plasmid forms can be found in C. necator JMP134 at the population level.

2,4-Dichlorophenoxyacetic Acid↗

Comparison of albendazole and levamisole chemotherapy on prevalence and intensity of common soil-transmitted helminth infections in school children, Sierra Leone.

A comparison of two studies performed in Sierra Leone on the effect of anthelmintic, chemotherapy, levamisole, albendazole or a placebo in children aged 6 to 10 years on the prevalence and intensity of common soil transmitted helminths (S-THs) infections is presented. In total 501 children were screened, and 394 successfully follow-up. At baseline their overall prevalence and intensity (epg) of Ascaris, Necator and Trichuris were 34% (2,877), 22% (284) and 39% (266) respectively. At baseline there was no significant difference in the intensity of S-THs infections in the different treatment groups but the prevalence of Necator was significantly higher in the levamisole than the albendazole group (p < 0.05). At follow-up both albendazole and levamisole significantly reduced prevalence and intensity of Ascaris and Trichuris. Only albendazole significantly reduced those of Necator. The placebo group had no significant change in prevalence but a significant increase in intensity of all S-THs.

Albendazole↗

Assessment of the effectiveness of primary health care interventions in the control of three intestinal nematode infections in rural communities.

In a 30 months' longitudinal study, primary health care intervention was effective in reducing the prevalence of three common intestinal nematode infections (Ascaris lumbricoides, Trichuris trichiura and Necator americanus) in three communities. This was achieved by training school leavers and auxiliary aides as microscopists, health inspectors and field assistants and deploying them to provide screening, surveillance, environmental sanitation, and mass-expulsion chemotherapy (MEC). Post-control surveillance confirmed that the prevalence of these infections had been greatly reduced. The prevalence of Ascaris lumbricoides had declined from 49.3% (pre-intervention) to 10.5% (post-intervention). Hookworm had fallen from 31.4% (pre-intervention) to 4.1% (post-intervention) and whipworm from 40.7% (pre-intervention) to 6.5% (post-intervention). Overall percentage decreases of 78.7%, 86.9% and 84.0% were recorded for Ascaris lumbricoides, Necator americanus and Trichuris trichiura respectively. The initial decline in prevalence was due to the MEC campaign, but the improved sanitation and health education presumably reduced the reinfection rate. If the entire population participated, periodic repetition of the mass expulsion therapy campaign at appropriate intervals combined with continued attention to environmental hygiene and prolonged health education could bring these infections under control within a few years.

Animals↗

Observations on the feeding behaviour of parasitic third-stage hookworm larvae.

The feeding behaviour of parasitic 3rd-stage larvae (L3) of the hookworms Ancylostoma caninum, A. ceylanicum and Necator americanus was examined. Less than 11% of A. caninum L3 recovered from the small intestines of dogs infected orally were feeding at 4-48 h post-infection (p.i.), and none of the A. ceylanicum L3 recovered from the intestines of orally infected hamsters had resumed feeding. All L4 of both species recovered at 36 and 48 h p.i. had resumed feeding. On the other hand, approximately 16% of the A. ceylanicum L3 recovered from the skin of percutaneously infected hamsters at 18 h were feeding, and the percentage feeding increased to nearly 58% at 44 h p.i. Necator americanus L3 recovered from the skin of percutaneously infected neonatal hamsters resumed feeding at 6-12 h p.i. and reached 90-94% by 18 h. Feeding began to decline at 66 h, and reached 29% at 120 h p.i. This decrease was associated with the migration of larvae from the skin to the lungs. By 192 h p.i. over 95% of the larvae had reached the small intestine, and all had moulted to the L4. The results indicate that parasitic L3 resume feeding in the skin during percutaneous infections, and suggest that feeding by hookworm L3 correlates with the resumption of development.

Ancylostoma↗

Total and specific IgE (house dust mite and intestinal helminths) in asthmatics and controls from Gondar, Ethiopia.

BACKGROUND: The role, if any, of parasitosis in the development of asthma remains incompletely understood; both 'protective' and 'predictive' associations have been reported. We report a study which examined immunoglobulin (Ig) E responses to two common helminths in asthmatics living in Ethiopia. OBJECTIVE: To compare the frequencies of specific IgE antibodies to Ascaris and Necator species and to Der p 1 among 84 adult asthmatics and a referent group of nonasthmatics. METHODS: A case-control analysis. RESULTS: Total IgE levels were not different between the two groups. The presence of specific IgE to Der p 1 was strongly associated with asthma (P = 0.001). Raised levels of Ascaris-(P = 0.010) and Necator- (P = 0.001) specific IgE antibodies were more common among referents; there were no associations between specific IgE production to Der p 1 and either of the two parasites. CONCLUSION: These findings confirm the association between Der p 1 sensitization and asthma among urban, adult Ethiopians. While they also indicate a negative relationship with two indicators of helminth infestation it appears that this is not mediated through the immunological response to common aeroallergens.

Adolescent↗

The distribution of helminth infections along the coastal plain of Kwazulu-Natal province, South Africa.

The results of a previous study indicated that, in the province of KwaZulu-Natal, South Africa, Necator americanus and Strongyloides stercoralis were endemic to the coastal lowlands only. The prevalences of these helminths, as well as those of Trichuris trichiura and Ascaris lumbricoides, have now been investigated along a 1000-km-long transect through the coastal plain, at altitudes of < 300 m, from the Mozambique border (26 degrees 57'S) to the border with Eastern Cape province (30 degrees 53'S). Necator americanus was by far the most dominant hookworm species. Although prevalences of N. americanus and S. stercoralis infection decreased with increasing southerly latitude, those of T. trichiura and A. lumbricoides did not. Determinants of these distribution patterns are examined in terms of a suite of temperature- and rainfall-related variables.

Adolescent↗