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[Cysticercosis in the Czech Republic].

The authors report 10 cases of cysticercosis registered by the National Reference Laboratory for tissue helminthiasis. Six Czech citizens and four foreigners contracted the disease. Four of 6 Czech citizens were contaminated abroad. Six patients suffered from nervous manifestations of cysticercosis, 2 from muscular or subcutaneous cysticercosis and 2 patients had an asymptomatic course of the infection. The prerequisite of successful treatment with new anthelmintics is early diagnostics.

Adult↗

Serologic validation of HIV infection in a tropical area.

We have defined human immunodeficiency virus type 1 (HIV-1) serologic reactivity in Brazilians living in an area endemic for tropical diseases. Enzyme-linked immunosorbent assay (ELISA) and Western blot (WB) analyses were performed on 342 patients with diseases including Chagas' disease, schistosomiasis, typhoid fever, helminthiasis, and cutaneous and visceral leishmaniasis. Nine percent of the visceral leishmaniasis patients' sera reacted in the HIV-1 ELISA but all were WB negative. All other sera from these patients were HIV negative. A total of 224 HIV-1 ELISA repeatedly positive sera also were HIV-1 WB tested. They were drawn from a total population of 19,230 individuals, including AIDS patients, blood donors, homosexual men, intravenous drug users, pregnant women, individuals with hemophiliac, and tuberculosis and sexually transmitted disease patients. The WB results were analyzed using five different interpretive criteria for WB positivity. The Centers for Disease Control (CDC) and the World Health Organization (WHO) criteria were the most sensitive and specific for identifying HIV-1-infected individuals. The WB pattern was similar to that seen in the United States. Envelope (ENV) protein antibodies were highly predictive of HIV-1 infection; none of the AIDS patients lacked ENV protein reactivity. We conclude that among the tropical diseases studied, only visceral leishmaniasis is associated with false-positive HIV-1 ELISA tests. Current CDC and WHO criteria for interpretation of HIV-1 WB tests are appropriate for Brazil.

Acquired Immunodeficiency Syndrome↗

Possible relationship between allergic disease and infection by Giardia lamblia.

In order to better understand the possible relationship between allergic reactivity and infection with G. lamblia, specific IgE responses and skin test reactivity were evaluated in allergic or nonallergic Venezuelan children, with or without G. lamblia infection. Two groups of children were studied: one from our Allergy Clinic and the other from a slum area of Caracas. The total serum IgE levels in children from the slum area were significantly higher in those with intestinal helminthic parasites and giardiasis, compared with those with helminthiasis only (P < .001). In atopic children with giardiasis we also found an enhanced IgE antibody response to common environmental allergens (P < .05). As G. lamblia produces intestinal mucosal damage, we also studied the reactivity to cow milk and found that 22% of the children belonging to the low socioeconomic level demonstrated the presence of significant levels of specific IgE against this antigen. Of these milk-positive subjects, 40% were infected by G. lamblia in contrast to only 21% of the milk-negative children (P < .05). These results suggest that children with giardiasis may be exposed to greater amounts of intestinally absorbed antigens. We also studied the specific allergic response to G. lamblia, and found that in an unselected group of children of low socioeconomic level, 25% had positive skin tests, as did 50% of persons with symptomatic giardiasis. The presence of serum anti-Giardia IgE was also demonstrated in 22% of patients with giardiasis.

Animals↗

[Is human Dirofilaria (Nochtiella) repens parasitosis mor frequent than it appears on the Mediterranean coast?].

Some observations of human parasitism by Dirofilaria (Nochtiella) repens are frequently enough reported but they are also individually reported by different authors. Nïmes's geographical situation makes of it a privileged observatory for this helminthiasis. The worm's maturity varies depending on the subjects: the sensitivity of those and the clinical reactions are of a large variety. The ones that seem to be constant are the parasit's migrations in the different territories during a lot of months. It is the case in the observation reported here; in another article, we have shown the possibility of an intraperitoneal migration which discovery can be only of an extreme fate. Next to some noisy manifestations, other cases stayed quiet advise the adaptation of some autochtones submissed to iteratif infestations.

Adult↗

Causes of calf mortality in Kabete area of Kenya.

A total of 345 calf carcases of mainly dairy breeds from the farms around Kabete area were examined at the post-mortem facility in the Department of Veterinary Pathology and Microbiology, University of Nairobi, over a 10-year period (1980-1989). About 46.8% of the total deaths took place within the first 2 months, 31.8% of them in the first month and 13.3% in the first 2 weeks. In 23 cases (6.7%) no specific cause of death was determined. The major causes of death were diseases of the alimentary tract (31.3%)--mainly gastroenteritis (76/108) due to colibacillosis, salmonellosis, coccidiosis and helminthiasis, and bloat (20/108). The other major causes of death were diseases of the respiratory tract (16.8%)--mainly pneumonia (42/58), and tick-borne diseases (13.3%)--mainly east coast fever (ECF) (37/46). The alimentary and respiratory diseases were most common in the 1-30 d age group. The other causes of death occurred in the following frequencies: musculoskeletal system (7.0%), septicaemia (6.7%), malnutrition (6.1%), cardiovascular system (3.7%), nervous system (3.2%), liver (2.6%) and poisoning (2.6%).

Age Factors↗

Ascaris and Trichuris do not contribute to growth retardation in primary school children.

To access the effectiveness of the treatment of soil-transmitted helminthiasis (STH) on the growth of primary school children, 353 children were block stratified to receive either mebendazole plus pyrantel oxantel pamoate every three months or a placebo. The children were followed for two years with 89% completing the trial. Follow-up stools indicated that the treatment was efficacious for ascariasis and trichuriasis. There was virtually no hookworm infection. The children were malnourished as measured by the number below -2 SD of height and weight standards. There was no difference in height or weight between the treatment and control groups by sex initially or at the end of two years of follow-up. The treatment of Ascaris and Trichuris had no effect on growth parameters. The effect of STH on growth may be mediated through hookworm infections.

Ascariasis↗

Gongylonematiasis in the common marmoset (Callithrix jacchus).

Two cases of gongylonematiasis in common marmosets of two research facilities in Germany are reported. The helminthiasis was transmitted from colony A to colony B by one infected female and within colony B by cockroaches (Blatella germanica). Four of 40 cockroaches examined in colony B were infected with rhabditiform larvae. Clinical signs of disease in the infected animals consisted of intense itching and scratching of the edematous and slightly hyperemic perioral tissues. Histologically the adult helminths lodged predominantly in the mucous membranes of the upper and lower lips; they were less frequently present in the labial cutaneous parts or in the tongue and could not be seen in the esophageal wall, bronchi, or abdominal organs. The helminthic infection probably caused minor to moderate mixed inflammatory infiltrates of the periesophageal connective tissues and intense inflammation of the deep lingual muscular tissues. Lesions of the mucosal membranes of the lips and tongue had predominant accumulations of neutrophilic granulocytes, lymphocytes, and mostly degranulated mast cells with only a few eosinophilic granulocytes. In the cutaneous part of the lips multifocal microabscesses were considered to be secondary lesions from the intense scratching.

Animals↗

[The primary and secondary prevention of enterobiasis today].

The paper provides evidence for dividing the prevention of enterobiasis, which is the major human helminthiasis in Russia, into social and medical ones. It proposes to implement 4 directions of medical prophylaxis: behavioral, sanitary and hygienic, functional and biological, and therapeutic and health-improving actions. The paper also characterizes measures underlying each of them.

Anthelmintics↗

Infectious diseases in the 21st century.

Infecto-contagious diseases in the twenty-first century with respect to precedent will see themselves deprived of smallpox, dracunculiasis and very probably of paralyzing poliomyelitis. Vaccination-preventable diseases, such as measles, whooping cough, diphtheria, tetanus, rabies, some forms of meningitis, yellow fever and episodes of disseminated tuberculosis will greatly diminish in their rates of morbi-lethality; the elimination of some, and the eradication of measles, are expected. Other diseases such as diarrhea (including cholera), geo-helminthiasis, some severe respiratory tract infections and the majority of vector-transmitted infectious diseases will decrease due to improvements in potable water services, drainage, sanitary food control, living quarters, and individual and community anti-vector action. Leprosy, onchocerciasis and several parasitoses will be controlled by the available antimicrobial drugs. Infectious diseases will continue to be an important health problem due to: Reduction in the immunocompetence resulting from the aging of the population, chemotherapies necessary for neoplasms, and autoimmune pathology and the survival of persons with primary immunodeficiencies; lifestyles prone to infectious pathology, such as mega-city urbanization, children in day care centers, industrialized foods, intravenous drug addiction, sexual liberation, global commerce, and tourism; antibiotic-multiresistant microbial flora; environmental disturbances as a result of global warming, deforestation, the settling of virgin areas, dams, the large-scale use of pesticides, fertilizers and antimicrobials, and natural/social disasters generators of poverty, violence and deprivation will result in emergence or re-emergence of infectious diseases already controlled in the past.

Communicable Disease Control↗

The evaluation of the 29 and 31 kDa antigens in female Angiostrongylus cantonensis for serodiagnosis of human angiostrongyliasis.

The objective of this study was to evaluate the crude somatic extract of female Angiostrongylus cantonensis by ELISA and to evaluate the 29 kDa and the 31 kDa components of female worm by EITB for serodiagnosis of human angiostrongyliasis. Using ELISA, cross reaction occurred among all sera tested except capillariasis. The sensitivity, specificity, positive and negative predictive values of ELISA were found to be 100%, 66.8%, 27.1% and 100% respectively. Using EITB, The 29 kDa component cross-reacted with most of the heterologous sera while the 31 kDa component was recognized by 69.2% (18/26) sera from angiostrongyliasis patients, cross-reacted only with trichinellosis, trichuriasis and opisthorchiasis sera. This component may possibly used as reliable agents for angiostrongyliasis out of other tissue infected helminthiasis. The sensitivity, specificity, positive and negative predictive values of EITB for the 31.0 kDa component were 69.2%, 82.4%, 46.2% and 92.5% respectively.

Angiostrongylus cantonensis↗

[Diagnosis of human neurocysticercosis by ELISA-IgG using a purified antigen].

An analysis of immunodiagnosis data for human neurocysticercosis (NC) by ELISA-IgG, complement fixation test (CFT) and indirect hemagglutination test (IHAT) in 67 serum samples and 54 cerebrospinal fluids (CSF) from confirmed cases of different hospitals from the Metropolitan Area of Santiago, Chile, was performed. The cut-off value was determined by using serum samples from 60 apparently healthy persons, whose absorbance values were the mean plus three standard deviations. The sensitivity of ELISA was 97.0% and 100% for serum samples and CSF respectively. This assay was considered of statistical significance (p < 0.05) when it was compared with CFT. Specificity was established by testing a purified antigen over 109 different helminthiasis serum samples, 185 neurological affections other than NC and 60 control samples. A 98.3% of global specificity was found. The use of ELISA-IgG and a purified antigen in the approach of immune diagnosis of NC is considered a useful assay, particularly if it is performed on paired serum/CSF samples.

Animals↗

[A clinical and biological study of parasitic and fungal diarrhea in immunosuppressed patients in an urban and suburban area of Yaoundé].

We studied 66 cases of intestinal mycosis and parasitosis in patients infected with the human immunodeficiency virus with chronic diarrhea. All subjects were from the Yaounde urban area and were followed between February and December 1996. They were recruited from 3 hospitals in the center of Yaounde and were aged between 2 and 52 years. There was weight loss in 80.3% and severe dehydration in 72.3% of cases. Feces consisted mostly of watery stools similar to those of cholera patients (50% of cases) and loose stools (43.9% of cases). Parasitic agents were detected in 31.8% and fungal agents in 80.5% of cases. The opportunistic Protozoans detected included Cryptosporidium parvum (15.8%), microsporidia (8.8%) and Isospora belli (3.5%). Six cases of helminthiasis were also identified. Candida albicans was the most common opportunistic mycosis agent (39.1%). Other fungal species detected included Geotrichum candidum, Candida pseudotropicalis and Trichosporon sp. but all of these were less common.

AIDS-Related Opportunistic Infections↗

[Wilson's disease ("hepatic form") in a region endemic for schistosomiasis mansoni: clinical presentation of 25 patients].

Brazil has a young population and areas of endemic mansoni schistosomiasis where Wilson's disease might be easily misdiagnosed in patients erroneously classified as having either the hepatosplenic or the hepatointestinal form of the helminthiasis. Twenty five patients with the "hepatic form" of Wilson's disease (14 males and 11 females) were investigated in Belo Horizonte, MG; the mean age was 13.7 years (3 to 22). Nineteen had hepatomegaly (76%) and nine splenomegaly (36%). Twenty two (88%) had cirrhosis. The Kaiser-Fleisher ring was detected in fifteen (60%). Four (16%) had clear neurological abnormalities. Eleven (44%) had ascitis and/or jaundice. Ninety one point three per cent and 92% had low ceruloplasmin and copper serum levels respectively. Eighty four point two per cent showed an increased 24 hours urinary copper excretion; seven patients in whom hepatic copper was determined had increased values. Six out of nine had at least a ten fold increase in 24 hours urinary copper excretion following penicillamine use ("penicillamine test"). Three out of 19 patients (15.8%) had mansoni schistosoma ova in stools examination, a common prevalence in our population. Their biopsies showed inactive cirrhosis without schistosomiasis-associated alterations. At least fourteen patients (56%) could be misdiagnosed as having hepatointestinal or hepatosplenic schistosomisis when in fact they suffered from Wilson's disease with or without asymptomatic intestinal schistosomiasis, losing the chance of an early treatment. The follow-up time of 22 patients was 52 months (1 to 96); eight (36.3%) died, four from bleeding esphageal varices, three from terminal hepatic failure and one from fulminant liver failure. The majority of the patients, including those who died, had abandomned the use of penicillamine or had taken it irregularly, due mainly to its highly expensive cost. A 17 year old patient underwent a successful liver transplant in 1989.

Adolescent↗

Threshold quantities for helminth infections.

For parasites with a clearly defined life-cycle we give threshold quantities that determine the stability of the parasite-free steady state for autonomous and periodic deterministic systems formulated in terms of mean parasite burdens. We discuss the biological interpretations of the quantities, how to deal with heterogeneity in both parasite and host populations, how to incorporate the effects of periodic discontinuities, and the relation of the threshold quantities to the basic reproduction ratio Ro. Examples from the literature are given. The analysis of the periodic case extends easily to 'micro-parasitic' systems.

Animals↗