Impact of health education on knowledge and prevention behavior for congenital toxoplasmosis: the experience in Poznan, Poland.

In 1991-1997 educational activities were undertaken in the Poznan region of Poland to promote health education for the prevention of toxoplasmosis. The effect of education was measured in 2710 pregnant women by a questionnaire survey. Knowledge of toxoplasmosis and its prevention was almost doubled within 4 years. Similarly, the proportion of women having antenatal serological tests for toxoplasmosis significantly increased. In the examined population the knowledge of how Toxoplasma gondii is transmitted/acquired was better than the knowledge of individual risk factors for congenital toxoplasmosis. Correct hygienic behaviors in pregnancy were often practised by women who lacked good knowledge of toxoplasmosis. The experience from this study suggests the possible effectiveness of including prevention of toxoplasmosis into the whole package of preventing infectious diseases in pregnancy and into healthy lifestyle promotion. Health educational activities need to be realized by modern promotional technologies in addition to making available traditional written educational texts. There is a considerable role of medical services in promotion of a hygienic behavior in pregnant women preventing congenital toxoplasmosis in their offspring. Health education should be especially tailored to the population of pregnant women below the age of 21.

Intraspecific variability among NADH dehydrogenase subunit 1 sequences of Taenia hydatigena.

This paper describes intraspecific variability of the partial sequences of the mitochondrial ND1 gene among isolates of Taenia hydatigena from pigs in Poland, Ukraine and Wales. The differences between studied isolates ranged from 0.4 to 5.5%, which exceeds the variability within the same fragment between the different genetic variants of Echinococcus multilocularis and is comparable with the variability between the most closely related strains (G5/G6/G7) of E. granulosus. The biggest difference (5.5%) was found between the geographically most distant Ukrainian and Welsh samples of T. hydatigena while the samples collected from the neighbouring locations in Poland, were most similar to each other.

Toxocariasis in humans: clinical expression and treatment dilemma.

A new scheme of clarifying clinical forms of toxocariasis is proposed to include: (i) systemic forms: classical VLM and incomplete VLM; (ii) compartmentalized forms: ocular and neurological toxocariasis; (iii) covert toxocariasis; and (iv) asymptomatic toxocariasis. The following markers are helpful in defining clinical forms namely, patient characteristics and history, clinical symptoms and signs, positive serology, eosinophilia and increased levels of IgE. Amongst the available drugs albendazole is the most commonly used, although other benzimidazole compounds have a similar efficacy. The recommended dose of albendazole is 15 mg kg(-1) body weight daily for 5 days and in some cases with VLM syndrome the treatment needs to be repeated. An evaluation of treatment efficacy can be made by observing a rise in eosinophilia within a week followed by any improvement in clinical symptoms and signs, lower eosinophilia and serological tests taken over a period of at least 4 weeks. In addition to clinical rationales for the specific treatment of VLM and OLM, preventive treatment needs to be considered bearing in mind the increasing risk of larvae localizing in the brain during the course of an infection. To reduce migration of Toxocara larvae a single course of albendazole is suggested in cases where eosinophilia and serology are at least moderately positive.

Neonatal screening for congenital toxoplasmosis in the Poznan region of Poland by analysis of Toxoplasma gondii-specific IgM antibodies eluted from filter paper blood spots.

OBJECTIVES: The aims of the study were to determine the prevalence of congenital toxoplasmosis at birth in the Poznan region of Poland, the value of the serologic examination of filter paper blood specimens collected from newborns for the diagnosis of congenital Toxoplasma infection and the duration of anti-Toxoplasma-specific IgM antibodies in infants' sera. MATERIALS AND METHODS: All neonates born in the maternity wards of the University Hospital of Gynaecology and Obstetrics in Poznan and in 10 selected obstetrics wards in the district hospitals were included. Blood samples were collected on filter paper cards, between the first and sixth day of life, screened for anti-Toxoplasma-specific IgM antibodies by an immunocapture enzyme-linked immunosorbent assay and if positive further analyzed for specific IgG and IgA antibodies. RESULTS: Between June, 1996, and October, 1998, filter paper samples from 27,516 liveborn infants were tested, which constituted approximately 75% of all births and 83% of liveborn neonates from the Poznan region. Anti-T. gondii-specific IgM antibodies were found in 13 newborns, equivalent to a prevalence of Toxoplasma-specific IgM in newborns of 1 per 2,117 liveborn children (0.47 per 1,000) or 1 per 870 children (1.15 per 1,000) born to seronegative women at risk of primary T. gondii infection during pregnancy. We identified two congenitally infected infants who were IgM-negative at birth, had a classic triad of clinical symptoms during the first year of life and had high levels of specific IgG. The birth prevalence of congenital toxoplasmosis in the Poznan region was at least 1 per 1,834 live births (0.55 per 1,000) or 1 per 754 live neonates born to seronegative women (1.33 per 1,000). The sensitivity of the IgM assay on eluate from filter paper was not more than 86.7%, and the mean duration of IgM detectable by enzyme-linked immunosorbent assay in serum samples was the first 4.8 weeks of life. CONCLUSION: In Poland the screening for congenital toxoplasmosis detecting one case per each 2,000 live births could be considered for inclusion in existing national neonatal screening programs for phenylketonuria and congenital hypothyroidism.

Differential serodiagnosis for cystic and alveolar echinococcosis using fractions of Echinococcus granulosus cyst fluid (antigen B) and E. multilocularis protoscolex (EM18).

Echinococcus granulosus cyst fluid and E. multilocularis protoscolex extract were fractionated by a single step of preparative isoelectric focusing, resulting in an antigen B-rich fraction (8-kD) and an Em18-rich fraction, respectively. The usefulness of both fractions for differential serodiagnosis of cystic (CE) and alveolar (AE) echinococcosis was evaluated by a large-scale immunoblot analysis on a battery of 354 serum samples. These included 66 from AE patients originating from four different endemic areas, 173 from CE patients originating from seven different endemic areas, 71 from patients with other parasitic diseases, 15 from patients with hepatomas, and 29 from healthy individuals. In an immunoblot with the antigen B-rich fraction, 92% (158 of 173) of the CE sera as well as 79% (52 of 66) of the AE sera reacted with the 8-kD subunit. No cross-reactivity occurred with any sera from patients with cysticercosis, other parasitic diseases, or with hepatomas, or from healthy controls. In an immunoblot with the Em18-rich fraction, all but two sera from AE patients (64 of 66, 97%) recognized Em18, and only nine of 34 CE sera from China reacted with it. All other (139) CE sera from six other countries were negative as were all (115) other non-echinococcosis sera. These findings indicate that antigen B (8-kD) is not species-specific for E. granulosus but is genus-specific for Echinococcus, and that the Em18 antigen is a reliable serologic marker for species-specific differentiation of AE from CE.

[Echinococcosis in humans in Poland and in the world. An introduction to the session on echinococcosis]. / Bablowica u ludzi w swiecie i w Polsce wprowadzenie do sesji nt echinokokozy.

The activities of Associacion International de Hidatidologia, Informal WHO Working Groups on Research in Echinocooccosis and Japanese parasitologists group in Hokkaido are summarized. Progress in studying both cystic and alveolar echinococcoses in Poland is reviewed. In the last five years at the University of Medical Sciences in Poznan Poland echinococcosis was a subject of three MD thesis and habilitation for docent degree.

[Up-dated progress in diagnosis and treatment of echinococcosis]. / Aktualne zasady rozpoznawania i leczenia bablowicy.

Diagnostic proces and choice of optimal management of cystic echinococcosis have to be related to the natural history of the parasite. The early and the late stages of invasion require a careful differential diagnosis with non-parasitic diseases. These are also the stages that many not require surgery. Chemotherapy, PAIR and "wait and observe approach" are alternative ways of cystic echinococcosis management. Em-18 WB test has a good diagnostic value in alveolar echinococcosis. Management of alveolar echinococcosis is based on radical surgery, prolonged chemotherapy and long-term observation.

[The application of aerodynamic method for the evaluation of the efficiency of the vocal, articulation and respiratory organs during singing and playing wind instruments]. / Zastosowanie metody aerodynamicznej do oceny wydolnosci narzadu glosowego, artykulacyjnego i oddechowego w czasie spiewu oraz gry na instrumentach detych.

This paper discusses the application of the aerodynamic method for the estimation of the efficiency of the vocal articulation and respiratory organ during singing and playing wind instruments. An evaluation of the vocal and respiratory organ was carried out on the basis of an analysis and correlation between the following parameters: PV--phonation volume, MPT--maximum phonation/playing time, SP--subglottal/blowing pressure, MFR--mean flow rate, GR--glottal resistance, EP--expiratory power, W--work. Volume and airflow was measured by a pneumotachometr with an electronic spirometer. The application of a plethysmographic booth made it possible to carry out non-invasive, indirect measurements of the subglottal and blowing pressure. Changes of pressure during singing and playing were recorded in the form of an aerodynamogram curve. This curve was used to determine the maximum duration of sound. Other quantities were derived from a mathematical analysis.

[A study of the phenomenon of voice intonation: analysis, usage and diagnosis]. / Badanie zjawiska intonacji glosu--analiza, zastosowanie w diagnostyce.

The aim of this work was to study the average rise time (RT) and average flow rate (MRT) in utterance. Data were collected from 48 singers and 44 patients. The group of patients included cases of modulus vocale, polypus laryngis, paresis bilateralis, hemiparesis, and CA laryngis. Various characteristics of utterance were recorded synchronously: the frequency and intensity of the fundamental laryngeal tone were measured with a laryngophone, a microphone was used to monitor acoustic radiation from the mouth, and a pneumotrachometer was applied for the measurement of flow rate. The data were stored and analysed with the use of a computer. Results show that the analysis carried out in the study describes the distinctive characteristics of normal and pathologic utterance. The main findings are as follows: a) rise time (RT) decreases with increasing loudness and pitch of the sound and is also shorter in staccato than inlegato sounds; b) during the initial transient of staccato sounds, the average flow rate in the glottis increases with intensity and pitch of the sound; c) pre-fonation time (TPP) and air volume do not differentiate normal and pathologic utterance; d) in cases of voice pathology, the analysis of utterance described in this study can be used for the evaluation of therapy and rehabilitation.

Molecular genetic analysis of human cystic hydatid cases from Poland: identification of a new genotypic group (G9) of Echinococcus granulosus.

We have used nuclear (ribosomal ITS1) and mitochondrial (ND1) sequences to characterize human and pig isolates of Echinococcus granulosus collected by fine needle aspiration biopsy (FNAB) in Poland. The data indicate clearly that the Polish patients were not infected with the common sheep strain (G1 genotype) of E. granulosus, normally associated with human cystic hydatid infection. Instead, the hydatid parasite infecting the Polish patients shares very similar ND1 sequence with the previously characterized pig (G7) genotype but it also exhibits some clear differences. In particular, E. granulosus DNA from the Polish patients amplified a single ITS1 fragment in PCR and distinct ITS1-RFLP patterns were obtained after restriction digestion. The form of hydatid isolated from the Polish patients appears, therefore, to represent a distinct, previously undescribed genotype (designated G9) of E. granulosus.

[Aeroacoustic and pneumotachometric studies in the evaluation of vicarious voice in laryngectomy patients]. / Badania aeroakustyczne i pneumotachometryczne w ocenie mowy zastepczej u chorych po laryngektomii.

The aim the study was showed some spirometric and aerodynamic parameters of the respiratory system and of vicarious voice at laryngectomized patients, which were performed in plethysmographic cabin and by using of pneumotachometer. Clinical material stated 20 laryngectomized men, aged 45-77 years, who were divided into two groups (by Pruszewicz): A-well or very well speaking and B-bad speaking. The obtained results showed that laryngectomized well or very well speaking made bigger work of the respiratory system during vicarious voice than bad speaking ones. The well and very well speaking patients used twice (in case of consonants) and three times (in case of vowels) the volume of oesophageal-throat's air greater than bad speaking patients. Aerodynamic examinations in plethysmographic cabin allows for monitoring of vicarious voice at laryngectomized after operation and qualification some of ones for voice prosthetization in the aim of voice amplification.

[Congenital toxoplasmosis in the Poznan region]. / Toksoplazmoza wrodzona w województwie poznanskim.

Among 3,734 women, hospitalized for giving birth, 58.9% had a positive Toxoplasma serological test (DA). No clinical expression of congenital toxoplasmosis was observed in 4,311 newborns; seven had a false positive ISAGA test with cord blood. Only 24% of the women were aware of congenital toxoplasmosis and only 3% were serologically examined before. Health education should be intensified and serological tests more commonly performed especially in the risk groups.

[Diagnostic value of specific Giardia fecal antigen tests]. / Wartosc diagnostyczna testów wykrywajacych swoiste antygeny Giardia.

Two commercial faecal antigen tests, based on Giardia specific antigens, were compared with traditional microscopical examination of faeces in 40 clinical patients, including 14 patients with a confirmed Giardia infection as well as in a survey among 96 children in four day care centers. The results obtained with these faecal antigen tests were not much better than by using traditional microscopy by a well trained parasitologist. Specific Giardia antigen (GSA 65) has been still detected in faeces up to day 4th after treatment of giardiasis, when microscopical examination of faeces was already for a few days negative. The Giardia antigen detection test was not very useful in examining the unconcentrated duodenal content.

Potential eradicability of taeniasis and cysticercosis.

PIP: Taeniasis and cysticercosis are, respectively, infections with the adult and larval stages of tapeworm parasites belonging to the genus Taenia. The World Health Organization (WHO) estimates that Taenia infections afflict approximately 50 million people annually and kill 50,000. One may assume all of these deaths to be the result of T. solium neurocysticercosis. Taenia infections also lead to the death of many cattle and swine, and resulting substantial economic losses. Swine and cattle serve as the intermediate hosts for the larval stage tapeworm parasites, while humans are the obligatory final stage hosts. Humans become infected with Taenia by ingesting raw or inadequately cooked meat of infected intermediate hosts. Mature tapeworms then produce eggs in the human hosts which are excreted and eventually consumed by animal hosts. The prevalence of Taenia is highest in the rural areas of Latin American, Asia, and Africa, but the parasites are vulnerable to eradication. More success has been had in thwarting the spread of T. solium than T. saginata. Sections briefly discuss the biology and transmission of Taenia; the medical and veterinary impacts; prevalence and distribution; the case for eradication; current strategies; remaining barriers; news tools and knowledge; and research and planning needs. Current strategies include long- and short-term interventions developed by the WHO and the Pan American Health Organization based upon the mass treatment of taeniasis in existing transmission foci.^ieng

Further evidence for the occurrence of a distinct strain of Echinococcus granulosus in European pigs.

The morphology, adult development and genetic characteristics of Echinococcus granulosus isolated from pigs in Poland were examined and compared with those of other recognised strains of E. granulosus. The isolates were characterised by their distinct morphology, rapid maturation and unique DNA hybridisation profiles. The form of E. granulosus that occurs in European pigs may therefore be a distinct strain that can be separated morphologically and genetically from other strains and that exhibits features of epidemiological significance, including a rapid rate of development in dogs and an apparent low infectivity to humans and domestic ungulates.