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Background: It is hypothesized that schistosomiasis and intestinal parasites increase susceptibility to HIV-1 infection and enhance AIDS progression by immunomodulation. This study aims to compare the prevalence and risk factors for schistosomiasis and intestinal parasites in HIV-1 infected and uninfected persons and to evaluate the association between HIV-1 induced immunosuppression and risk factors for parasite infection. Methods: This was a cross-sectional study conducted at Boane Health Center in Boane village, Maputo Province from April to June 2017 in 280 patients aged over 5 years. From each of 140 HIV-1 infected or 140 HIV-1 uninfected persons, demographic and clinical data were collected as well as one stool and urine sample for parasitological analysis. All stool samples were processed using direct wet mount and Ritchie method for detection of common parasites, and modified Ziehl-Neelsen staining techniques to identify Cryptosporidium spp., Cystoisospora belli and Cyclospora spp. oocysts from children stools. The urine was sedimented and analyzed for S. haematobium eggs detection. Results: The overall prevalence of parasitism in the study population was 46.8% (131/280). Fifty six percent of the HIV-1 infected persons (78/140) were infected by at least one parasite compared to 38% (53/140 of the HIV-1 uninfected persons (odds ratio [OR] 2.0, 95% confidence interval [CI] 1.2-3.3).Further, HIV-1 infected persons were more likely to be infected by S. mansoni (OR 5.6, 95% CI 1.8-15.8) when compared to HIV-1 uninfected person and HIV-1 infected women were more likely to be infected by S. mansoni (OR 6.7 CI 95% 1.8-22.8%) when compared to HIV-1 uninfected women (p< 0.001). HIV-1 serostatus (OR 7.0, 95% CI 1.5-31.2). Multivariate logistic regression revealed that HIV-1 infected status (OR=1.813575), the use of river or lake as water sources either for drinking (OR=7.289245) or domestic chores (OR=9.16205) were significant risk factor for parasitic infection. Partcipants with secondary and higher school (OR=0.379) were less likely to have a parasitic infection compared with primary school or illiterate participants. Conclusions: It is possible that the a high prevalence of schistosomiais and intestinal parasites in this region plays an important role on the transmission and pathogenesis of HIV.
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INTRODUCTION: Leptospirosis is a neglected zoonotic disease caused by a bacteria of the genus Leptospira. In Africa it is frequently mistaken for frequently occurring conditions such as malaria. The aim of this study was to identify rodent species involved in the transmission of the disease, the prevalence of pathogenic Leptospira spp. in selected rodent species and risk factors for human leptospirosis. MATERIAL AND METHODS: We conducted a descriptive and exploratory epidemiological and molecular study in Mozambique Island city in 2015. Six neighborhoods, comprising 30 households each were randomly selected. People from the selected 180 households were interviewed regarding their awareness of the disease, the presence of rodents in their houses, chemicals used to eliminate them, sewage disposal, water supply system, and other key issues related to the disease. In each neighborhood we trapped 10 rodents for morphometric study to identify their species and for molecular isolation of Leptospira DNA. We extracted kidneys from 57/60 of rodents trapped, and performed nested polymerase chain reaction targeting rrs 16S ribosomal DNA and lipL32 genes for identification of Leptospira genus and pathogenic Leptospira spp. respectively. RESULTS: Of the 180 participants 92 (51%) reported having heard of leptospirosis; 107 (59%) have had the disease; 151 (83%) reported the existence of rats in their house; 100 (56%) had latrines; 118 (66%) used chemicals to kill the rats; 102 (57%) used well water and 114 (63%) used trash containers. The most prevalent rodent species captured was Rattus norvegicus 36/60 (60%), followed by Rattus rattus 19/60 (31.67%) and Mus musculus 3/60 (5%). rrs 16S ribosomal DNA was identified in 20/57 (35.%) rodents. Out these two were positive for lipL32 gene, giving an overall pathogenic Leptospira infection of 3.5% (2/57). The rodent species identified as carriers of pathogenic Leptospira were Rattus norvegicus (1) and R. rattus (1). CONCLUSION: This is the first study in Mozambique to identify the presence of pathogenic species of Leptospira using molecular tools. Leptospirosis risk factors in Mozambique Island city are rodent's infestation, limited disease awareness, lack of access to clean water, insufficient resources for waste collection, greater clustering of households, poor sanitation environment and degradation of living conditions. Pathogenic Leptospira spp. are present in the area studied and at least two species of rodents, the R. rattus and R. norvegi-cus are potentially involved in the transmission of the causal agents of the disease.
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INTRODUCTION: Increased evidence suggests intestinal parasite infections, one of the major causes of morbidity and mortality in sub-Saharan Africa, increase the acquisition and progression of AIDS. OBJECTIVE: The aim of this study was to determine the prevalence of HIV and intestinal parasite co-infections, the relationship to the degree of immunosuppression and the effect of antiretroviral treatment (ART) and trimethoprim-sulfamethoxazole (TS) on patients treated at 1° de Maio Health Centre in Maputo, Mozambique. METHODS: A cross sectional study was conducted from December 2015 to August 2016. A total of 517 stool samples from 371 (71.8%) HIV infected and 146 (28.2%) HIV uninfected patients were examined for the presence of parasites using direct wet mount, Ritchie and modified Ziehl Neelsen techniques. A subsample of 201 stools from HIV infected patients was processed for coproantigens for the detection of Cryptosporidium spp. RESULTS: Overall, 148 (28.6%) of the individuals were infected with at least one parasite. The prevalence of intestinal parasites was 98 (26.4%) and 50 (34.2%) in HIV infected and uninfected patients, respectively. This difference was not statistically significant. We identified 10 different parasites including (most frequently) Trichuris trichiura 67 (12.9%), Ascaris lumbricoides 27 (5.2%) and Entamoeba coli 40 (7.7%). Giardia intestinalis prevalence was significantly higher in HIV infected patients 12 (3.2%), p = 0.02. Parasitic intensity was higher in HIV infected patients than in HIV uninfected patients. Cryptosporidium spp. prevalence by coproantigen detection was 6% and was associated with degree of immune suppression. A CD4+ T-cell count of < 200 cells/µL was significantly associated with higher prevalence and intensity of parasitism, while ART and TS prophylaxis was associated with lower parasitic prevalence. CONCLUSIONS: Our study revealed that the prevalence and intensity of intestinal parasites in HIV infected patients was related to the degree of immune suppression as assessed by CD4+ cell count, while ART and TS seemed to reduce the parasitic infection.
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OBJECTIVE: To investigate a potential immunomodulatory effect of the 60-kd heat-shock protein (Hsp60) on experimental spontaneous Sjögren's syndrome (SS). METHODS: Seven-week-old nonobese diabetic (NOD) mice were immunized with eukaryotic Hsp60 or an Hsp60-derived peptide (amino acid residue [aa] 437-460). At 21 weeks of age, nondiabetic mice were investigated for salivary gland inflammation, exocrine function, and extraglandular disease manifestations. In addition, biomarker profiles comprising 87 analytes in serum and 75 in saliva were analyzed. RESULTS: In mice immunized with Hsp60 and aa 437-460, SS-related histopathologic features were significantly reduced compared with NOD controls. In addition, 50% of Hsp60-injected mice and 33% of aa 437-460-injected mice retained normal exocrine function. Both treatments induced similar changes in biomarker profiles. Notably, levels of circulating interferon-gamma-inducible 10-kd protein (IP-10) and eotaxin were decreased significantly after treatment. Anti-type 3 muscarinic acetylcholine receptor (anti-M3R) IgG1, interleukin-10, and leptin discriminated best between the different treatment groups. Successful prevention of hyposalivation was accompanied by quantitative alterations in 36 biomarkers, of which 19 mediators of inflammation declined to levels comparable with those found in BALB/c mice. Low secreted vascular endothelial growth factor A was the most accurate predictor of successful prevention of hyposalivation. Low salivary granulocyte chemotactic protein 2 was identified as the best predictor of normal secretory function across the strains. CONCLUSION: Immunization with Hsp60 and its peptide aa 437-460 led to inhibition of SS in NOD mice. Comprehensive analyses revealed specific biomarker signatures capable of predicting treatment group and treatment outcome. Molecules involved in inflammatory chemotaxis, neovascularization, and regulatory pathways caused the differences displayed by the biomarker profiles.
