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Nippostrongylus (Nematoda) in protein-malnourished rats: host mortality, morbidity and rehabilitation.

The synergistic relationship between host nutrition and the effects of Nippostrongylus was investigated experimentally in rats fed a diet containing 1% (w/w) protein. Rats were infected with 10 doses of N. brasiliensis varying from 0.35 to 99 larvae/g and their daily food intake and weekly body mass were compared with those uninfected rats fed the same diet for a period of 9 weeks. The deterioration of the uninfected rats observed as a result of protein-energy malnutrition was found to be accelerated in a dose-dependent manner in the rats infected with N. brasiliensis. Analysis of food intake and body mass measurements demonstrated that this acceleration was related to a decrease in food intake and indicated a likely alteration in nutrient utilization, both of which were established by the end of the first week of the infection. Remission from the combined effects of malnutrition and infection was achieved by offering the rats a high-protein diet (20% w/w), whereupon rehabilitation was found to be complete within a period of 9 days. The implications of the results and the possible mechanisms involved in their generation are discussed in relation to the frequent coexistence of helminthiasis and malnutrition.

Animals↗

Human Toxocara infection of the central nervous system and neurological disorders: a case-control study.

Infection with Toxocara canis is a common world-wide human helminthiasis, which rarely elicits central nervous system (CNS) impairment. A case-control study to investigate this discrepancy was carried out, in which the cases were 27 adult neurological inpatients for whom a definite aetiological diagnosis was lacking, and for whom positive immunodiagnosis of toxocariasis had been obtained, both in cerebrospinal fluid (CSF) and in serum. Two control groups were used. Controls were adult inpatients with other neurological diseases who had no evidence of T. canis infection of the CNS. Multivariate logistic regression analysis did not reveal any positive relation between case status and clinical signs. A significant association was observed between case status and an elevated CSF cell count. Rural residence, ownership of dogs, and dementia were shown to be risk factors for toxocaral infection of CNS. These results suggest that migration of T. canis larvae in the human brain does not frequently induce a recognizable neurological syndrome but is correlated with the association of several risk factors including exposure to dogs, a status possibly responsible for repeated low-dose infections.

Analysis of Variance↗

Strategic control of gastrointestinal nematodes in dairy calves in Florestal, Minas Gerais, Brazil.

Following epidemiological studies of gastrointestinal helminthiasis in dairy cattle in Florestal County, Minas Gerais, 80 Swiss and crossbred Zebu x Holstein calves, 8-10-months old, were selected to test the efficacy of three treatment protocols using ivermectin for helminth control. The calves were treated in Brachiaria grass paddocks, naturally infected with Haemonchus, Cooperia, Oesophagostomum and Trichostrongylus species, and then divided into four groups of 20 animals each: group 1 was treated with 200 microg/kg body weight ivermectin in April (at the end of the rainy season) and October (beginning of the rainy season); group 2 was treated in April, August (middle of the dry season) and October; group 3 was treated in April, August, October and December (middle of the rainy season); and group 4 was left untreated as a control. The treatments effectively eliminated the worm burden only in groups 2 and 3 (p < 0.05), although the calves continued to excrete Cooperia eggs after each treatment with ivermectin.

Animals↗

Eosinophil cationic protein as a possible marker of active human Toxocara infection.

BACKGROUND: Human toxocariasis is a common, worldwide helminthozoonosis that may elicit syndromes including various allergy symptoms. The diagnosis relies upon specific serology. However, this parasitosis is often self-limiting, and many subjects have residual antibodies, thus making differential diagnosis quite difficult when blood eosinophilia, a commonly accepted criterion of active helminthiasis due to tissue-dwelling parasites, is lacking. METHODS AND RESULTS: We present a patient with chronic irritant cough displaying negative allergologic screening, normal blood eosinophilia, but positive toxocariasis immunodiagnosis. Therefore, this case presented the fortuitous association of an unexplained allergic picture with residual anti-Toxocara antibodies. In an attempt to distinguish between active and past toxocaral infection, the subject's level of eosinophil cationic protein (ECP) was assessed and then compared to those of four control groups, namely, healthy volunteers, subjects presenting anti-Toxocara residual antibodies, patients with various helminthiases, and patients with active toxocaral disease. Since the patient's ECP level was found to be sharply elevated, we hypothesized that viable Toxocara larvae were still present in the tissues, and the patient was given anthelmintic therapy. At the control checkup, the cough had waned and the ECP level had decreased to below the mean value observed in both healthy subjects and in subjects with past toxocaral infections. CONCLUSIONS: These data suggest, first, that patients presenting unexplained allergic syndromes should be checked for helminthiases, even if blood eosinophilia is lacking, and, second, in such subjects displaying positive toxocariasis immunodiagnosis, ECP assessment would be a useful marker to distinguish between active and past toxocaral disease.

Animals↗

Relationship between interleukin-5 production and variations in eosinophil counts during HIV infection in West Africa: influence of Mycobacterium tuberculosis infection.

Eosinophils are important effectors of the non-specific immune response and we studied whether perturbations in the production of the type 2 cytokine, interleukin-5 (IL-5), could account for the variations in eosinophil counts observed in human immunodeficiency virus (HIV) infection. HIV-infected patients without helminthiasis were investigated in a cross-sectional study in West Africa. Eosinophil counts were significantly higher in CDC-B patients than in controls, but were dramatically decreased at the CDC-C stage. Phorbol 12-myristate 13-acetate (PMA)+ ionomycin-induced IL-5 production by peripheral blood mononuclear cells (PBMC) was decreased from the A stage of the disease, and significant correlations were observed between IL-5 production and eosinophil counts in tuberculosis (TB)-negative HIV-1-positive, TB-positive HIV-1-positive and TB-positive HIV-negative patient groups. Nevertheless, the production of IL-5 was not decreased in HIV-positive patients with TB, in contrast to HIV-positive patients without TB presenting with the same ranges of CD4+ counts. Our data suggest that, during HIV infection, the impairment in IL-5 production is one of the factors associated with the 'paradoxal' eosinopenia observed in tropical areas, but that IL-5 production during active TB is compensated by cellular subsets, yet to be identified.

Acquired Immunodeficiency Syndrome↗

The health and nutritional status of school children in two rural communities in Sri Lanka.

There is growing evidence of considerable burden of morbidity and mortality due to infectious diseases and undernutrition in school children. This study describes the nutritional status and parasitic infections of school children in two areas of rural Sri Lanka. All children in four primary schools in the Moneragala district of Sri Lanka were included in the study. The height and weight of children were measured and anthropometric indices calculated. Stool and blood samples were examined for evidence of intestinal helminthiasis, malaria and anaemia. A greater proportion of boys than girls were underweight, wasted and stunted. Over 80% of the children were anaemic but did not apparently have iron deficiency anaemia according to their blood picture. The prevalence of parasitic infections such as hookworm and Plasmodium spp that may contribute to anaemia was low.

Body Weight↗

[Interactions of 2 associated parasitoses in the rat: Plasmodium berghei and Strongyloides ratti].

When Plasmodium berghei and Strongyloides ratti are associated, each one of these parasites can modify development of the other one. This repercussion is subordinated to the respective periods of contamination and strength of influential parasitism. It lies in an inhibition of Protozoosis or intensification of helminthiasis. When severe, palustral infection releases two hypercosticosteronemy phases; the more important one is situated at the peak of the parasitemia. These hypercorticosteronemiae reactions to a severe malaria enable the interpretation of the variations of an associateds trongyloïdiasis. They may be regarded as one of the inducer elements of immunological depression which takes place in the course of malaria in rodents.

Animals↗

[Epidemiology of alveolar echinococcosis in France. 1. Intestinal helminths in the red fox (Vulpes vulpes L.) from Haute-Savoie].

In the course of an epidemiological survey concerning the alveolar echinococcosis and its causative agent, Echinococcus multilocularis, the autopsies of 150 wild red foxes captured in the department of the Haute-Savoie between December 1983 and August 1988 disclosed 139 cases of intestinal helminthiasis with cestodes and nematodes; no trematode was found. Multiple infections were frequent. The cestoda recorded consist of the following species: Taenia crassiceps: 44 cases (29%); Echinococcus multilocularis: 34 cases (23%); Taenia polyacantha: 22 cases (14%); Mesocestoides litteratus: 7 cases (4.6%); Amoebotaenia paradoxa: 1 case (0.6%). The Nematoda concerned are: Uncinaria stenocephala: 79 cases (52%); Toxocara canis: 67 cases (44%); Toxascaris leonina: 16 cases (10%); Trichuris vulpis: 12 cases (8%); Pterygodermatites affinis: 8 cases (5%); Trichostrongyloidea sp.: 5 cases (3%). The animals were not examined for Trichinella spiralis. The results are compared with those observed anteriorly in the province of Auvergne (France).

Animals↗

Parasitism in young animals.

Pulmonary and gastrointestinal helminthiasis in young ruminants is usually followed by the development of immunity and lifelong freedom from disease. However, the recent advent of very effective systems of anthelmintic prophylaxis during the first year of life poses questions about the degree of immunity which animals might be expected to possess in later life. Aspects of this are discussed and, since bovine dictyocauliasis is potentially the most serious, the possibility of immunisation of older cattle, rather than calves, is suggested.

Age Factors↗

Endoscopic removal of Ascaris lumbricoides from the biliary tract as emergency treatment for acute suppurative cholangitis.

Ascariasis is the most common intestinal helminthiasis worldwide. Heavily infected individuals are prone to develop bowel obstruction or perforation as well as biliary disease. Nevertheless, the presence of roundworms in the biliary tree outside endemic areas is very uncommon. The migration of these worms to the biliary system can cause biliary colic, pancreatitis, or even acute suppurative cholangitis with hepatic abscesses and septicemia. We report here on 2 infants with 14 and 15 months and a 9-year-old boy who suffered from massive biliary ascariasis and who presented with acute suppurative cholangitis. All cases were successfully treated by endoscopic retrograde cholangiopancreatography with worm extraction and adjuvant medical therapy. Physicians should be aware of ascariasis in patients with pancreatobiliary symptoms who have traveled to endemic areas or in immigrants from these areas.

Animals↗

[Diagnosis of and anthelminthic therapy for enterobius vermicularis infections during pregnancy: review of the literature and case report].

Intestinal infection due to the pinworm Enterobius vermicularis is the most prevalent helminthiasis in Europe and North America. Humans are the only known reservoir and young children are most often affected. The disease is highly contagious and is transmitted via the faecal-oral route. Insufficient hand hygiene, contaminated bed linens and clothes may play a role in transmission. Clinical symptoms often encompass severe nocturnal anal pruritus, when female worms deposit an abundance of eggs in the perianal region. The infection is diagnosed by applying an adhesive tape on the perianal region, followed by microscopic examination. Serious complications, such as extraintestinal infections, occur only rarely. Infections of the female genital tract and the peritoneum are described in the literature, also in pregnant women. We describe a case of a pregnant patient in the 33 (rd) week of gestation with intense anal pruritus in whom an enteral pinworm infection was diagnosed. The patient was successfully treated with mebendazole, an anthelminthic agent. Analysis of the data currently available for the administration of mebendazole during pregnancy did not show an elevated rate of congenital anomalies. However, further studies still have to be performed.

Adult↗

Epidemiology of alveolar echinococcosis in southern Cantal, Auvergne region, France.

Alveolar echinococcosis (AE) is a helminth zoonosis which is encountered only in the northern hemisphere. In central France, the Auvergne region represents the most western and southern extension of this helminthiasis. In 1999, a human case of AE was diagnosed in the southern part of the Cantal department, where AE was supposed absent, and an epidemiological survey was subsequently carried out. The transmission of the zoonosis in the sylvatic and peridomestic definitive hosts was studied, as well as that in the rodent and human intermediate hosts. Eleven red foxes (Vulpes vulpes) were shot, and 50 fox faecal deposits were collected. Twelve farm dogs had their faeces taken by rectal touch, and four were checked after arecoline purgation. Optical detection of Echinococcus multilocularis worms was achieved on fox intestines after scraping, and also on dog stools after arecoline therapy. Coproantigen ELISA assay was performed for the 11 scraping products, for the 50 fox faeces, and for the 12 dog faecal samples. No adult AE agent was observed by microscopy, and the ELISA assay yielded positive results in one of 11 fox intestines, one of 50 fox faeces, and 2 of 12 dog faecal samples. Twenty-five small mammals were trapped, of which 19 were Arvicola terrestris water voles. One rodent liver exhibited a hepatic lesion consistent with AE. An epidemiological questionnaire was completed in 85 human volunteers, who were also serologically tested for AE. Only one (the case's husband) exhibited a Western-blotting pattern indicative of a low-grade AE infection. The results of this preliminary study suggested a slow AE extension to the south of Cantal department from the northern focus.

Aged↗

Cytokine-mediated regulation of intestinal helminth infections: the Trichuris muris model.

The Trichuris muris-mouse model of intestinal helminth infection provides a convenient system to examine the immune mechanisms operating during acute and chronic infection. Particular subsets of helper T lymphocytes (CD4+Th cells) play an important role in regulating infection via the secretion of distinct groups of cytokines. Reciprocal activation of Th cell subsets is associated with either expulsion of the parasites from the intestine (Th2 cells) or chronic infection (Th1 cells). In vivo neutralization experiments using anti-cytokine monoclonal antibodies show that critical cytokines are involved, with interferon-gamma playing an important role in the establishment of chronic trichuriasis and interleukin-4 in expulsion of the parasite from the gut. This model has provided clear evidence of a crucial role for distinct cytokines in mediating host protection against intestinal helminth infection and that manipulation of the immune response through the Th cell-cytokine axis can benefit either the host or the parasite. As such, the T. muris model is poised to generate important new data relevant not only to intestinal helminthiasis but to the wider field of parasite immunity and infection in general.

Animals↗

Patterns of health-care utilization and morbidity in a rural community near Lahore, Pakistan.

Patterns of health-care utilization and of morbidity were investigated in a demographically defined community: the 1400 inhabitants of a rural village near Lahore, Pakistan. The data collected, by semi-monthly clinic surveys from February 1982 to January 1983, showed that 42% of the study population sought health care during the year-long study period, between one and 10 (mean 2.1) times each. Females attended the clinics twice as often as males. The 1193 person-visits that were recorded at the field clinics yielded a total of 1354 cases of various diseases. The cumulative number of clinic-visits per person fitted a negative binomial distribution, indicating that health problems were concentrated in a small portion of the population. When the patients were classified according to the International Classification of Diseases, the most common disease category was that of the respiratory system (27.6%), followed by infectious and parasitic diseases (18.7%), diseases of the skin (13.7%) and those of the nervous system and sense organs (10.9%). Classification of the cases by single disease condition indicated that diarrhoea, helminthiasis, malaria, anaemia, conjunctivitis, bronchitis, coryza, pharyngitis, tonsillitis, dyspepsia and pyoderma were the most common diseases. In view of the fact that infectious diseases continue to be a major public health problem in rural Pakistan, the need for a sound health policy that is primarily focused on preventive medicine, especially health education, is apparent.

Adolescent↗

Aetiology and clinical features of acute childhood diarrhoea in an outpatient clinic in Vellore, India.

The aetiology of acute diarrhoea was investigated in 245 children less than 3 years old in a paediatric outpatient clinic in southern India. In 55% of the children organisms were found in the stools, and one quarter were infected with multiple organisms. Viruses, enteropathogenic E. coli, shigella and campylobacter species accounted for 75% of all isolates. Cholera and helminthiasis were rare, and no child had amoebiasis. Clinical findings were useful in the diagnosis of shigella and rotavirus infection only. Children with shigellosis had classical dysentery, and a greater number of stools; they were unlikely to be breast-fed, to be less than 6 months old, or to have watery stools. Rotavirus infections were characterized by vomiting. Only 20% of the 245 children had an infection which could be treated effectively with antimicrobials.

Campylobacter Infections↗

The effect of iron and protein deficiency on the development of acquired resistance to reinfection with Nippostrongylus brasiliensis in rats.

Iron and protein deficiency delays the immunological rejection of Nippostrongylus brasiliensis from the small intestine of rats undergoing a primary infection with the parasite. In the present study, iron and protein deficiency significantly reduced acquired resistance to reinfection with N. brasiliensis. Repletion of deficient animals with iron and protein restored their capacity to mount an effective immune response to a secondary infection with the parasite. These results suggest that chemotherapy of helminthiasis should be integrated with nutritional supplementation.

Animals↗

Strongyloides stercoralis: the first rodent model for uncomplicated and hyperinfective strongyloidiasis, the Mongolian gerbil (Meriones unguiculatus).

Strongyloidiasis is the most common endemic helminthiasis in several of the world's industrialized nations, yet relatively little is known about its basic biology and immunobiology because a practical rodent model for the investigation of this clinically important parasitism is lacking. This study reports such a model for use in the investigation of Strongyloides stercoralis infection. Normal male gerbils infected subcutaneously with 1000 infective filariform larvae harbored moderate numbers (83.6 +/- 27.6) of adult worms at 35 days after infection, and a low-grade infection persisted for at least 131 days mimicking the chronicity of human infections. Gerbils treated weekly with 2 mg of methylprednisolone acetate developed hyperinfective strongyloidiasis with up to 8000 autoinfective larvae occurring in these animals at postinfection day 21. Autoinfection never occurred in normal (untreated) gerbils.

Animals↗

Premenarchal vulvovaginitis.

The general subject of premenarchal vulvovaginitis has been reviewed. Vulvovaginal inflammations and infections in the premenarchal child are caused by a large number of etiologic agents. The symptoms, diagnosis, and treatment of the most common of these, namely, nonspecific infections, specific nongonorrheal infections, gonorrhea, protozoal infestations, helminthiasis, mycotic infections, and inflammations due to physical, chemical, and allergenic agents, have been discussed. Reference has been made not only to the older literature but also to some of the pertinent reports published during the last 10 years.

Bacterial Infections↗