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PubMed1993

Involvement of a community in schistosomiasis control: a Kenyan experience.

This paper illustrates how community participation was achieved in a study that was carried out between 1983-1988 whose general objective was to reduce the transmission of schistosomiasis in a rice irrigation scheme in Kenya. A community of 2,219 people was mobilized through health education, to effect changes in behaviour regarding water contact, water use and faecal disposal. Health education, alternative water sources, latrines and mass chemotherapy with praziquantel were the schistosomiasis control strategies utilized in this study. By the end of 2 years, the canals were cleared of their thick vegetation, water, sanitation, bathing and washing facilities were constructed, water contact with infective waters was reduced, faecal contamination of water was reduced, the people's knowledge on schistosomiasis increased and the rate and intensity of schistosomiasis infection was reduced. The study demonstrated that it is possible to fully involve the community in disease control efforts.

Adult↗
PubMed1993

Perception of a schistosomiasis control project in rural Kenya by the beneficiaries.

A schistosomiasis control project was implemented in Mwea Rice Irrigation Scheme in Central Kenya between late 1983 and December 1988 by Kenya Medical Research Institute scientists in collaboration with the National Irrigation Board. The aim of the project was to control schistosomiasis through provision of alternative water sources, bath and laundry units, latrines, chemotherapy and health education. The community participated fully. Five years later in December 1988, 203 household heads were interviewed on their perception of the control project in terms of purpose, project ownership and management, benefits, continuity and their knowledge of schistosomiasis transmission cycle. 61% of the respondents were females and 39% males. 92% of them said that the purpose for the project was to treat, control and prevent bilharzia from spreading, and to promote good health. Slightly over 50% said that the project belonged to them but that they would have liked to be more involved in its management. 74% said that they are able to save time because the facilities are now nearer to them; whilst 79% felt that they were saving money because they did not have to buy drugs since they felt healthier. 99% said that they thought that bilharzia has been controlled, and 82% said that their children looked healthier. 95% said that they could see the project surviving for a long time period suggesting that it was self sustaining and they were willing to start a maintenance of facilities fund. Overall, the community appreciated the social, economic and health benefits derived from the control project.

Communicable Disease Control↗
PubMed1991

The effect of insecticide-treated bed nets on mortality of Gambian children.

Insecticide treatment of bed nets ("mosquito nets") may be a cheap and acceptable method of reducing the morbidity and mortality caused by malaria. In a rural area of The Gambia, bed nets in villages participating in a primary health-care (PHC) scheme were treated with permethrin at the beginning of the malaria transmission season. Additionally, children aged 6 months to 5 years were randomised to receive weekly either chemoprophylaxis with maloprim or a placebo throughout the malaria transmission season. We measured mortality in children in PHC villages before and after the interventions described, and compared this with mortality in villages where no interventions occurred (non-PHC villages). About 92% of children in PHC villages slept under insecticide-treated bed nets. In the year before intervention, mortality in children aged 1-4 years was lower in non-PHC villages. After intervention, the overall mortality and mortality attributable to malaria of children aged 1-4 in the intervention villages was 37% and 30%, respectively, of that in the non-PHC villages. Among children who slept under treated nets, we found no evidence of an additional benefit of chemoprophylaxis in preventing deaths. Insecticide-treated bed nets are simple to introduce and can reduce mortality from malaria.

Antimalarials↗
PubMed1997

An examination of current control strategies for Asian schistosomiasis in the Dongting lake region of China. II. A five year follow-up survey on Qingshan island.

In 1995-1996 we conducted an epidemiological survey in two communities (1656 individuals) on Qingshan island, Hunan province P.R. China, in order to determine the efficacy of current control strategies since their upgrading in 1991. In 1996, the overall prevalence for Schistosoma japonicum, Ascaris lumbricoides, Ancylostoma duodenale, and Trichuris trichiura had decreased moderately since 1991. The age-specific prevalence for S. japonicum for each of the representative age groups decreased slightly, but there was a significant reduction in these prevalences for the 5-9 (P < 0.01), 55-59 (P < 0.05) and the over 60 (P < 0.01) age groups. The 1996 intensities of infection for schistosomiasis were higher for all the age categories except for those aged 0-4 and 25-29 years of age. When the study population was further classified according to the percent uninfected, lightly infected (8-100 eggs/g (epg)), moderately infected (101-400 epg) and heavily infected (> 400 epg) for S. japonicum, there were fewer (5.6%) people infected in 1996 but the proportions of moderately (21.3 vs. 15.5%) and heavily (7.6 vs. 2.3%) infected individuals were higher than those observed in 1991. The reported cases of weakness and hepatomegaly (MSL > or = 3) were significantly lower (P < 0.01) in 1996 for both uninfected and infected (all intensities) individuals. General episodes of diarrhoea were also significantly lower in 1996 for those lightly (P < 0.05) and heavily (P < 0.01) infected. Likewise, the occurrence of splenomegaly (Hackett's > or = 2) was significantly lower among uninfected (P < 0.01) and heavily infected (P < 0.05) patients. In summary, although significant progress has been made in controlling schistosomiasis and other helminth infections in this highly endemic focus for schistosomiasis, there is still room for improvement. Chemotherapy for bovines and humans, mollusciding for Oncomelania control and health education should be initiated and upgraded if the health and well being of these island communities is to further improve.

Adolescent↗
PubMed1985

Efficacy of morantel tartrate in a sustained release bolus on the control of subclinical gastrointestinal parasitism in first-year grazing dairy replacements.

Thirty-four heifers (24 Holstein, 8 Ayrshire, 2 Jersey) and 12 Holstein steer calves were grouped into 23 blocks of 2 animals each according to breed, sex, and body weight. Animals in each block were randomly assigned to control or treated groups. The treated group received an anthelmintic bolus containing morantel tartrate before they were permitted access to pasture. A 2.6 ha pasture was divided in half with a double fence; the resulting two pastures had separate feed and water troughs. Steer calves were slaughtered upon termination of the trial to ascertain gastrointestinal parasite burdens. Two worm-free tracer calves were placed on each pasture every 2 mo and slaughtered after 4 wk of grazing to determine parasite infectivity of pastures. Herbage samples were obtained monthly and analyzed for infective larvae. The trial was conducted for 141 d during the grazing season. Treatment resulted in 90% reduction in infective larvae on pasture, 74% reduction in fecal worm-eggs, 91% reduction in adult worm burdens, and a trend toward reduced worm burdens in tracer calves by 52%. An overall average daily gain of .68 and .88 kg was obtained for control and treated animals. Reproductive data for the heifers remaining in the herd from the trial showed that treatment resulted in 44 less days to first breeding.

Animals↗
PubMed1999

Mice immunised with synthetic peptide from N-terminal conserved region of merozoite surface antigen-2 of human malaria parasite Plasmodium falciparum can control infection induced by Plasmodium yoelii yoelii 265BY strain.

Synthetic peptides representing conserved MSA-2 sequences are being considered as a possible component of a blood stage malaria vaccine. Antibody response towards the entire N-terminal conserved region of MSA-2 and its constituent B-epitope SNTFINNA following immunisation of BALB/c and C57BL/6 mice with different peptide constructs was assessed by ELISA and immunofluorescence antibody test (IFAT). Co-linear synthesis of SNTFINNA-epitope in tandem with the entire N-terminal conserved region peptide (P23) made this construct, namely P8.P23, to be highly immunogenic in both mouse strains, with the antibody response to the SNTFINNA epitope comparable to that following tetanus toxoid protein conjugate immunisation. The antibodies raised specifically recognised the schizont stages of Plasmodium falciparum and Plasmodium yoelii. There was no protection observed upon challenge of immunised BALB/c and C57BL/6 mice with the highly lethal Plasmodium yoelii nigeriensis strain. On the contrary, BALB/c mice immunised with P8.P23 construct were able to resist blood stage infection induced by Plasmodium yoelii yoelii 265BY parasites, while animals inoculated with P23 did not control infection. Affinity purified rabbit anti-SNTFINNA IgG showed more than 60% inhibition of merozoite invasion of fresh erythrocytes in in vitro P. falciparum culture. The low prevalence of antibody response to SNTFINNA-epitope, tested in a dot-blot assay, was observed in sera of 80 individuals living in malaria endemic area in a India; the phenomenon may point out the cryptic character of epitopes residing at the N-terminal conserved region of MSA-2.

Animals↗
PubMed1997

Drug resistance among malaria and other parasites.

Recent decades have witnessed the emergence and spread of parasites resistant to standard drug therapies, particularly malaria. Chloroquine-resistant Plasmodium falciparum has now spread to most malarial areas, and resistance to other antimalarial drugs, including mefloquine and sulfadoxine-pyrimethamine, have become significant problems in some parts of Southeast Asia and South America. Chloroquine-resistant P. vivax is well established in Papua New Guinea and Indonesia and has been reported in other areas. Trichomonas and Giardia infections resistant to metronidazole have also been documented. This article reviews the current status of drug resistance among parasites, particularly malaria, and offers strategies for managing patients with these infections.

Adult↗
PubMed1998

A stage-specific, parasite-induced, "window" of in vivo interferon-gamma production is associated with pathogenesis in Theileria annulata infection.

The tick-borne protozoan parasite Theileria annulata causes tropical theileriosis, a severe leukoproliferative disease of cattle, which naive susceptible animals fail to control. The parasite infects and transforms macrophages, developing in the local draining lymph node. IFN gamma has been shown to block parasite development in newly infected cells, and inhibits the growth of fully differentiated macroschizont stage-infected cells in vitro. However, the parasite has been found to specifically induce IFN gamma production by T cells and appears to flourish in the face of this T cell-derived response in vivo. Here we show that the production of IFN gamma in vivo is tightly controlled by the parasite. Induction of cytokine production by T cells is not initiated until the parasite has developed beyond the IFN gamma sensitive trophozoite stage. Cytokine production is kept high as infected macrophages develop, and IFN gamma appears to play an active role in maintaining the growth of these cells. Once the infection is fully established, IFN gamma is down regulated, avoiding potential inhibitory effects. Thus by controlling T cell IFN gamma production, the parasite induces a "window" of cytokine expression which promotes its own growth, but avoids potential inhibitory effects of the cytokine.

Animals↗
PubMedDate not supplied

Health education, public information, and communication in schistosomiasis control in Brazil: a brief retrospective and perspectives.

In recent years, the strategy for the control of schistosomiasis has placed increased emphasis on the role of health education, public information, and communication. This should, not only bring about specific changes in behavior aiming at disease prevention, but also stimulate participation of the community in health programs. Beyond this, it is desirable that both community members and researchers should seek better life conditions through a transformative social action. The present paper addresses these concerns; first, by critically reviewing some health education programs that were developed in Brazil, and, secondly, by analyzing and suggesting ways to improve this area.

Adolescent↗
PubMed1992

The mortality and fecundity of Haemonchus contortus in parasite-naive and parasite-exposed sheep following single experimental infections.

Parasite-exposed lambs and their parasite-naive controls were experimentally infected once only with 30,000 H. contortus larvae at 3, 9, 12, and 20 weeks following termination of a moderate immunizing infection of 30,000 H. contortus larvae. Previously exposed lambs, challenged at 3 weeks, had a significant reduction in the total H. contortus worm burden as compared to parasite-naive controls. No difference in the total H. contortus worm burden was found between parasite-exposed or parasite-naive lambs challenged at 9 weeks or thereafter. Female worms were found to be significantly smaller in lambs previously exposed to the parasite as compared to those found in parasite-naive lambs. The average parasite fecundity was 4700 eggs per female worm per day. Previous exposure of the lambs to the parasite had no effect on parasite fecundity. Various mathematical models were used to examine parasite fecundity. Parasite fecundity was found to increase in the initial post-challenge period reaching a constant value approximately 58 days after challenge infection. No density-dependent constraints on fecundity were observed.

Animals↗
PubMed2006

Co-agglutination test for cysticercus antigen detection in the serum for the diagnosis of cysticercosis.

The objective of the study was to develop the co-agglutination (Co-A) test, a rapid slide agglutination test for the diagnosis of cysticercosis. The present study included 21 cases of cysticercosis, which comprised seven cases of clinico-radiologically definite cases of neurocysticercosis (NCC) proven with either computed tomography (CT) scan or magnetic resonance imaging (MRI), eight cases of clinically strong NCC, six cases of extraneural cysticercosis in muscle and eye; 40 non-cysticercal parasitic infection controls; and 20 healthy controls. Hyperimmune cysticercus antiserum was raised in rabbits and was used to coat Staphylococcus aureus (Cowan strain-I) bearing protein A (SAPA) cells, and the Co-A was standardized to detect cysticercal antigen in the serum. Serum samples from 12 out of 21 (57%) cases of cysticercosis were positive for cysticercal antigen by the Co-A test. Of the 12 positive samples, eight were from cases of neurocysticercosis and four from cases of extra-neural cysticercosis. Serum samples from seven out of 40 non-cysticercal parasitic infection controls and serum samples from one out of 20 (5%) healthy controls showed a false-positive reaction for the antigen by the Co-A test. There was a statistically significant difference between the antigen detection rates among cysticercosis patients on one hand, and the patients with other parasitic diseases (P = 0.0014), and healthy controls (P=0.0003) on the other. The Co-A test appears to be a moderately sensitive and specific test for the diagnosis of cysticercosis.

Agglutination Tests↗
PubMed1980

Study of Plasmodium falciparum resistance to 4-Aminoquinolines (Chloroquine) in Sabah, Malaysia.

The status of P. falciparum resistance to chloroquine in Sabah, Malaysia were not know until 1971-1972. Several in-vivo and on in-vivo studies were conducted from 971-1975, and the result showed 51% out of total 57 cases studied were resistant to chloroquine. The latest in-vitro study (collaborative with WHO) started in July 1978, to continue till 1980, to cover the whole State. The preliminary result shows 65 cases (85%) out of a total 76 successful tests are resistant to chloroquine. On the basis of this preliminary result, the radical treatment for P. falciparum infection was changed from chloroquine to Fansidar from June 1979 throughout the State.

Adolescent↗
PubMed1995

Influence of chemoprophylaxis on protective immunity to nematodes in cattle: a two-year study comparing four control strategies.

A two-year study was conducted in three sequential phases. Initially, four matched groups of nine calves grazing similar pastures were subjected to different chemoprophylactic control programmes while a fifth group acted as unprotected controls. After being housed in the autumn, three calves from each group and two parasite-naive controls were challenged experimentally with Ostertagia ostertagi, Cooperia oncophora and Dictyocaulus viviparus. Post mortem worm counts revealed gradations of protective immunity, with the field controls showing the highest level and the naive controls the lowest. In the second grazing season the remaining animals from each group were grazed together with parasitenaive controls on two fields. No further prophylactic treatments were given. One of the naive controls developed severe parasitic bronchitis but the signs in the other groups were milder and transient. It is concluded that the calves protected by chemoprophylaxis in their first grazing season developed marked resistance to gastrointestinal and pulmonary nematodes, but that their level of immunity was influenced by the effectiveness of the prophylactic strategy used.

Animals↗
PubMed2001

The potential of nematophagous fungi to control the free-living stages of nematode parasites of sheep: towards the development of a fungal controlled release device.

Studies showed that chlamydospores of the nematophagous fungus, Duddingtonia flagrans, are capable of surviving pressures of several tonnes when incorporated into matrices and pressed into tablets for the manufacture of prototype intraruminal controlled release devices (CRDs). They remain viable in this tabletted form for at least 9 months when stored at 4 degrees C. In vitro studies demonstrated that there was no effect on spore viability of prolonged exposure to either room or elevated temperature (40 degrees C) in air, or under an atmosphere of either of the major ruminal gases, carbon dioxide and methane. In vivo, studies showed that viable chlamydospores could be detected at the erosion surface of prototype CRDs recovered from the rumen and also in faeces of fistulated sheep, for up to 3 weeks after administration. Further studies have shown that chlamydospores released from such devices can substantially reduce the number of infective larvae that develop in cultures of faeces collected from sheep infected with the nematode parasite, Haemonchus contortus. This work demonstrates, in principle, that the deployment of chlamydospores of D. flagrans in intraruminal CRDs, is another possibility in the development of a range of methods for the biological control of parasites in livestock.

Animals↗
PubMed1993

A 13-year follow-up of treatment and snail control in an area endemic for Schistosoma mansoni in Brazil: incidence of infection and reinfection.

The incidences of Schistosoma mansoni infection and reinfection were investigated in an endemic area of Brazil (Peri-Peri, State of Minas Gerais) where chemotherapy and snail control had been used for 13 years (1974-87). Two cohorts were followed: the first consisted of 584 individuals with no evidence of infection at entry (infection cohort), and the second comprised 296 individuals who were treated and did not eliminate eggs 8-12 months afterwards (reinfection cohort). The incidence of infection (per 100 person-years) decreased from 7.5 in 1974-77 to 3.6 in 1986-87, and that of reinfection from 21.3 in 1974-77 to 3.7 in 1986-87. Calendar period, age at risk, and sex were independently associated with both infection and reinfection, while a heavy S. mansoni egg count prior to treatment (> or = 500 epg (eggs per gram of stools)) was independently associated with reinfection. The geometric mean number of eggs after treatment among those reinfected (47 epg) was approximately half that among those infected for the first time (81.5 epg). Age at risk had the greatest effect on both infection and reinfection. The rate ratios of infection and reinfection were 3 to 6 times higher among individuals younger than 20 years than among those aged > or = 25 years, even after adjusting for confounders. This suggests the existence of a strong protective effect with increased age (because of biological and/or environmental factors) for both infection and reinfection.

Adolescent↗