Anopheles gambiae s.s. resistance to pyrethroids and DDT in semi-urban and rural areas of the Moyen-Ogooué Province, Gabon.

BACKGROUND: Pyrethroids are the main insecticides used in vector control for malaria. However, their extensive use in the impregnation of long-lasting insecticidal nets (LLINs) and indoor residual spraying has led to the development of resistance, threatening its success as a tool for malaria control. Baseline data prior to large scale distribution of LLINs are important for the implementation of efficient strategies. However, no data on the susceptibility of malaria vectors is available in the Moyen-Ogooué Province in Gabon. The aim of this study was to assess the susceptibility to pyrethroids and organochlorides of malaria vectors from a semi-urban and rural areas of the province and to determine the frequency of insecticide resistance genes. METHODS: Larvae were collected from breeding sites in Lambaréné and Zilé and reared to adults. Three to five-day old female Anopheles gambiae sensu lato mosquitoes were used in cone tube assays following the WHO susceptibility tests protocol for adult mosquitoes. A subsample was molecularly identified using the SINE200 protocol and the frequency of Vgsc-1014 F and - 1014 S mutations were determined. RESULTS: Anopheles gambiae sensu stricto (s.s.) was the sole species present in both Lambaréné and Zilé. Mosquito populations from the two areas were resistant to pyrethroids and organochlorides. Resistance was more pronounced for permethrin and DDT with mortality lower than 7% for both insecticides in the two study areas. Mosquitoes were statistically more resistant (P < 0.0001) to deltamethrin in Lambaréné (51%) compared to Zilé (76%). All the mosquitoes tested were heterozygous or homozygous for the knockdown resistance (Kdr) mutations Vgsc-L1014F and Vgsc-L1014S with a higher proportion of Vgsc-L1014F homozygous in Lambaréné (76.7%) compared to Zilé (57.1%). CONCLUSION: This study provides evidence of widespread resistance to pyrethroids in An. gambiae s.s., the main malaria vector in the Moyen-Ogooué Province. Further investigation of the mechanisms underlining the resistance of An. gambiae s.s. to pyrethroids is needed to implement appropriate insecticide resistance management strategies.

Implementation of less-invasive surfactant administration in a Canadian neonatal intensive care unit.

BACKGROUND: Less-invasive surfactant administration (LISA) is a recent technique used extensively in Europe but rarely used in North America. The aim of this study was to describe our experience following LISA implementation using poractant in a Canadian neonatal intensive care (NICU). METHODS: A retrospective analysis was conducted from June 2017 to April 2021 of LISA procedures in preterm infants. Data were collected on patient characteristics, outcomes following LISA, laryngoscopy, and adverse events. The primary outcome was the rate of successful LISA procedures. SETTING: Level IIIa academic NICU. RESULTS: LISA was successful in 93 of 101 infants (92%). Median gestational age was 30.9 weeks (interquartile range [IQR]: 29.4-33.0). All infants received atropine and fentanyl premedication. Eight LISA procedures were unsuccessful: five because of thoracic rigidity and three because of inability to expose the vocal cords. In the 93 successful procedures, a second dose of surfactant was needed for 15 of 93 infants (16.1%), either by repeated LISA (7/15; 7.5%) or by endotracheal intubation (8/15; 8.6%). In 63.4% of successful procedures, one laryngoscopy attempt was made. The median duration of laryngoscopy attempts was 60 s (IQR: 52-110). Two types of catheters were used: the multi-access catheter (MAC) or the Angiocath in 67% and 33% of procedures, respectively. One infant had bradycardia and 30.6% had profound desaturation of <75%. CONCLUSION: LISA with poractant alfa was implemented in a Canadian NICU with a high degree of procedural success. Fentanyl may lead to more adverse events with a risk of interrupting LISA and may not be the ideal agent for this procedure. These results may encourage wider dissemination of LISA in North America.

Viral metagenomics reveals the presence of novel Zika virus variants in Aedes mosquitoes from Barbados.

BACKGROUND: The Zika virus (ZIKV) epidemic of 2015/2016 spread throughout numerous countries. It emerged in mainland Latin America and spread to neighboring islands, including the Caribbean island of Barbados. Recent studies have indicated that the virus must have already been circulating in local mosquito populations in Brazil for almost 2 years before it was identified by the World Health Organization in 2015. Metagenomic detection assays have the potential to detect emerging pathogens without prior knowledge of their genomic nucleic acid sequence. Yet their applicability as vector surveillance tools has been widely limited by the complexity of DNA populations from field-collected mosquito preparations. The aim of this study was to investigate local vector biology and characterize metagenomic arbovirus diversity in Aedes mosquitoes during the ongoing 2015/2016 ZIKV epidemic. METHODS: We performed a short-term vector screening study on the island of Barbados during the ongoing 2015/2016 ZIKV epidemic, where we sampled local Aedes mosquitoes. We reanalyzed mosquito viral microbiome data derived from standard Illumina MiSeq sequencing to detect arbovirus sequences. Additionally, we employed deep sequencing techniques (Illumina HiSeq) and designed a novel bait capture enrichment assay to increase sequencing efficiency for arbovirus sequences from complex DNA samples. RESULTS: We found that Aedes aegypti seemed to be the most likely vector of ZIKV, although it prevailed at a low density during the observed time period. The number of detected viruses increased with sequencing depth. Arbovirus sequence enrichment of metagenomic DNA preparations allowed the detection of arbovirus sequences of two different ZIKV genotypes, including a novel one. To our knowledge, this is the first report of the S3116W mutation in the NS5 gene region of ZIKV polyprotein. CONCLUSIONS: The metagenomic arbovirus detection approach presented here may serve as a useful tool for the identification of epidemic-causing arboviruses with the additional benefit of enabling the collection of phylogenetic information on the source. Apart from detecting more than 88 viruses using this approach, we also found evidence of novel ZIKV variants circulating in the local mosquito population during the observed time period.

Prevalence, molecular characteristics and antimicrobial susceptibility patterns of MRSA in hospitalized and nonhospitalized patients in Barbados.

The epidemiology and clonality of methicillin-resistant Staphylococcus aureus (MRSA) has not been investigated, as not much research or surveillance has been undertaken to identify and characterize the circulating MRSA strains in Barbados. Prevalence rates, molecular characteristics and antimicrobial susceptibility pattern of MRSA infections in hospitalized and nonhospitalized patients were investigated. A total of 293 isolates were included in the study, with 100 from the hospital and 193 from the public health laboratory. Isolates were collected over a period of 1 (2015-2016) and 3 years (2013-2016) respectively. MRSA was identified using standard microbiologic techniques and was further analysed by multiplex PCR for the presence of the spa, mec gene complex typing and PVL genes (lukS-PV and lukF-PV). A prevalence rate of 19.7% was calculated for those hospitalized. All hospital isolates were sensitive to vancomycin, rifampin, linezolid and cotrimoxazole (trimethoprim/sulfamethoxazole), whilst 82% were sensitive to clindamycin. The PVL gene was detected in 76% of hospital isolates. In the community isolates, resistance was observed in erythromycin (100%), ciprofloxacin (97.4%), clindamycin (13%) and cotrimoxazole (5.7%). There was no resistance to vancomycin. The PVL gene was detected in 97.9% of the isolates, the mecA gene in only 2.1% and the mecC gene in 0%. Most MRSA isolates were community acquired in both settings, and the antimicrobial susceptibility profile was similar, suggesting transmission of community-associated MRSA into the hospital environment. Further harmonization of antimicrobial policy for the treatment of MRSA (and by extension other pathogens) should be implemented to quell ongoing transmission. We found that 93.4% of MRSA in Barbados treated in the primary healthcare system were sensitive to cotrimoxazole. By typing MRSA isolates and drawing interferences on transmission on the basis of genetic relatedness, transmission pathways may be tracked. Further studies must be performed for this high level of comprehensiveness so that with the surveillance of MRSA, effective strategies may be developed to prevent or limit transmission.

Long-term epidemiological dynamics of dengue in Barbados - one of the English-speaking Caribbean countries.

Using the dengue surveillance program, we prospectively collected data on all the suspected and confirmed cases of dengue in Barbados from 2006 to 2015. Data were analysed for demographic, seasonal and temporal dynamics of this disease in this country. The overall mean annual incidence rate of suspected and confirmed dengue over the study period was 0.49% (range 0.15%-0.99%) and 0.16% (range 0.05%-0.48%), respectively. There was a significant correlation between the mean monthly number of confirmed cases, the mean monthly rainfall and the mean monthly relative humidity percentage. Dengue in this population is predominantly an infection affecting children and young adults. The median age of the patients with both, suspected and confirmed dengue was 25 years and the highest proportion of cases was seen in the age group 0-15 years. The annual incidence rates of both the suspected and the confirmed cases showed an upward trend during the study period and this upward trend was more pronounced among children.

Effects of boiling and roasting on proximate composition, lipid oxidation, fatty acid profile and mineral content of two sesame varieties commercialized and consumed in Far-North Region of Cameroon.

The aim of this study was to determine the effect of boiling and roasting on the proximate, lipid oxidation, fatty acid profile and mineral content of two sesame seeds varieties. The proximate composition was significantly affected (P<0.05) during treatments. The minerals of seeds roasting at 120°C for 10min were significantly decreased. The free fatty acids content of sesame oil after processing was significantly increased (P<0.05). Iodine and peroxide value were also affected by processing. Totox and p-Anisidine values were significantly increased during processing. The fatty acids composition a little modified during processing, and roasting at 180°C for 10min mostly affected the polyunsaturated fatty acids for all sesame varieties. C16:0, C18:0, C18:1 and C18:2 were quantitatively the most important fatty acids in sesame oil. Boiling appeared to be the best processing method for cooking the two sesame varieties concerning oxidative stability and fatty acid profile.

Are short (blue) wavelengths necessary for light treatment of seasonal affective disorder?

Despite widely published speculation regarding a potential potency advantage of short-wavelength (blue-appearing) light for Seasonal Affective Disorder (SAD) treatment, there have been few systematic studies. Those comparing short-wavelength to broad-wavelength (white) light under actual clinical conditions suggest equivalent effectiveness. This multicenter, parallel-group design trial was undertaken to compare the effects of light therapy on SAD using blue (~465 nm) versus blue-free (595-612 nm) LED lights. Fifty-six medication-free subjects aged 21-64 years who met DSM-IV-TR criteria for recurrent major depression with winter-type seasonal pattern were enrolled in this blinded study at five participating centers between January and March 2012. Thirty-five subjects met the criteria for randomization to 30 min of either blue (~465 nm) or blue-free (595-612 nm) daily morning light therapy. Twenty-nine subjects completed the study; three subjects withdrew due to treatment-related adverse events, including migraines, and three withdrew for non-study-related reasons. The primary effectiveness variable was depression score (SIGH-ADS) after six weeks of daily light treatment. Secondary effectiveness variables included quality-of-life (QoL) and suicidality ratings. Using an intent-to-treat analysis, mean depression scores were different at baseline for the blue group (29 ± 5 versus 26 ± 5, p = 0.05 blue versus blue-free, respectively), and the initial score was used as a covariate. Baseline scores were not significantly different between treatment groups among those who completed the study, and no significant differences in depression scores were observed after 6 weeks (mean ± SD scores at 6 weeks: 5.6 ± 6.1 versus 4.5 ± 5.3, p = 0.74, blue versus blue-free, respectively). In addition, the proportion of subjects who met remission criteria, defined as a depression score ≤8, was not significantly different between the two groups (p = 0.41); among the 29 subjects who completed the study, 76% of subjects experienced remission by the end of the trial, which coincided with the beginning of spring. The QoL and suicidality ratings were also significantly improved from pre- to post-treatment, with no significant difference between treatments. No subject experienced worsening or non-improved symptoms over the 6-week trial. The main finding of this study is that subjects treated with blue light did not improve more than subjects treated with blue-free light; both showed substantial improvement on multiple measures. Failure to find differences may have resulted from methodological constraints, including a small sample size. Recruitment began mid-winter during an unusually mild season, and the trial was terminated earlier than planned by the study sponsor due to a failure to detect a difference. However, if confirmed in a larger randomized sample, these results suggest that blue wavelengths are not necessary for successful SAD treatment.

Epidemiological Trend and Clinical Observations among Children and Adults with Dengue in Barbados.

OBJECTIVE: To describe the epidemiological characteristics and the clinical manifestations of the confirmed dengue cases over a ten-year period in Barbados, one of the English-speaking Caribbean countries. METHODS: All the cases of confirmed dengue from 2000 to 2009 were retrospectively studied. Long-term trends in incidence rate, demographic characteristics such as age, gender and seasonal distribution; clinical manifestations, immunological characteristics, need for hospitalization and mortality were studied. RESULTS: There were 3413 confirmed cases of dengue including 778 (22.8%) children and 2635 (77.2%) adults. The mean annual incidence rate of dengue was 1.36/1000 population. The median age of the persons with confirmed dengue was 27 years. The largest number of cases was seen in the 11 to 16-year age group. Hospitalization was required in 13.1% of dengue cases; 72.5% and 84% of all dengue were secondary infections among the children and adults, respectively. Dengue haemorrhagic fever accounted for 2.2% and 6% of all confirmed dengue among children and adults, respectively. The overall case fatality rate in this study was 0.35%. CONCLUSIONS: Dengue is a significant health problem primarily in adolescents and young adults. It is characterized by less severe cases and lower mortality rate.

Antiproliferative activities of Fagara xanthoxyloides and Pseudocedrela kotschyi against prostate cancer cell lines.

BACKGROUND/AIM: Roots of Fagara zanthoxyloides and Pseudocedrela kotchyii are used as chewing sticks and as medicinal remedies for diarrhea, cough and fever in West Africa. Extracts of the two plants also possess anti-bacterial, anti-fungal and anti-malarial activities. The aim of the present study was to determine the effects of such extracts on the growth, proliferation and induction of apoptosis in four prostate cancer cell lines. Materials and Methods. Androgen-independent PC3 and DU-145 and androgen-dependent LNCaP and CWR-22 prostate cancer cell lines were cultured for five days with different concentrations of the extracts and examined for growth inhibition and evidence of apoptosis. RESULTS: Irrespective of their androgen dependence, all four cancer cell lines exhibited a dose-dependent decrease in cell proliferation and viability by the 3-[4,5-dimethylthiazol-2yl]-2,5-diphenyltetrazolium bromide (MTT) assay and in induction of apoptosis. The results also show that LNCap cells were the most sensitive to the two extracts, with highest inhibition at day 3 and exhibiting the highest rate of apoptosis. Conclusion. These observations suggest that F. zanthoxyloides and P. kotchyii could serve as potential chemopreventive agents in the treatment of prostate cancer.

Impact of short-time urine freezing on the sensitivity of an established Schistosoma real-time PCR assay.

Urogenital schistosomiaisis is a serious public health problem in sub-Saharan Africa. In this study, we have updated an established real-time polymerase chain reaction (PCR) routinely used in our laboratory. Schistosoma genus-specific real-time PCR was performed on DNA isolated from 85 urine samples and pellets obtained after centrifugation without and after frozen storage. The results revealed that concentration by centrifugation of the urine samples and freezing of the samples before extracting DNA improves the sensitivity of the PCR.

A quality control program within a clinical trial Consortium for PCR protocols to detect Plasmodium species.

Malaria parasite infections that are only detectable by molecular methods are highly prevalent and represent a potential transmission reservoir. The methods used to detect these infections are not standardized, and their operating characteristics are often unknown. We designed a proficiency panel of Plasmodium spp. in order to compare the accuracy of parasite detection of molecular protocols used by labs in a clinical trial consortium. Ten dried blood spots (DBSs) were assembled that contained P. falciparum, P. vivax, P. malariae, and P. ovale; DBSs contained either a single species or a species mixed with P. falciparum. DBS panels were tested in 9 participating laboratories in a masked fashion. Of 90 tests, 68 (75.6%) were correct; there were 20 false-negative results and 2 false positives. The detection rate was 77.8% (49/63) for P. falciparum, 91.7% (11/12) for P. vivax, 83.3% (10/12) for P. malariae, and 70% (7/10) for P. ovale. Most false-negative P. falciparum results were from samples with an estimated ≤ 5 parasites per µl of blood. Between labs, accuracy ranged from 100% to 50%. In one lab, the inability to detect species in mixed-species infections prompted a redesign and improvement of the assay. Most PCR-based protocols were able to detect P. falciparum and P. vivax at higher densities, but these assays may not reliably detect parasites in samples with low P. falciparum densities. Accordingly, formal quality assurance for PCR should be employed whenever this method is used for diagnosis or surveillance. Such efforts will be important if PCR is to be widely employed to assist malaria elimination efforts.

Randomized, controlled, assessor-blind clinical trial to assess the efficacy of single- versus repeated-dose albendazole to treat ascaris lumbricoides, trichuris trichiura, and hookworm infection.

In many regions where soil-transmitted helminth infections are endemic, single-dose albendazole is used in mass drug administration programs to control infections. There are little data on the efficacy of the standard single-dose administration compared to that of alternative regimens. We conducted a randomized, controlled, assessor-blinded clinical trial to determine the efficacies of standard and extended albendazole treatment against soil-transmitted helminth infection in Gabon. A total of 175 children were included. Adequate cure rates and egg reduction rates above 85% were found with a single dose of albendazole for Ascaris infection, 85% (95% confidence interval [CI], 73, 96) and 93.8% (CI, 87.6, 100), respectively, while two doses were necessary for hookworm infestation (92% [CI, 78, 100] and 92% [CI, 78, 100], respectively). However, while a 3-day regimen was not sufficient to cure Trichuris (cure rate, 83% [CI, 73, 93]), this regimen reduced the number of eggs up to 90.6% (CI, 83.1, 100). The rate ratios of two- and three-dose regimens compared to a single-dose treatment were 1.7 (CI, 1.1, 2.5) and 2.1 (CI, 1.5, 2.9) for Trichuris and 1.7 (CI, 1.0, 2.9) and 1.7 (CI, 1.0, 2.9) for hookworm. Albendazole was safe and well tolerated in all regimens. A single-dose albendazole treatment considerably reduces Ascaris infection but has only a moderate effect on hookworm and Trichuris infections. The single-dose option may still be the preferred regimen because it balances efficacy, safety, and compliance during mass drug administration, keeping in mind that asymptomatic low-level helminth carriage may also have beneficial effects. (This study has been registered at ClinicalTrials.gov under registration number NCT01192802.).

In vitro biological activities of seed essential oils from the Cameroonian spices Afrostyrax lepidophyllus MILDBR. and Scorodophloeus zenkeri HARMS rich in sulfur-containing compounds.

The chemical composition of the essential oils obtained from the seeds of bush onion (Afrostyrax lepidophyllus) and tropical garlic tree (Scorodophloeus zenkeri), plants used as spices in the traditional African cuisine, was determined by GC-FID and GC/MS analyses. Moreover, in vitro biological properties of the oils, namely, the cytotoxic, antioxidant, and antimicrobial activities, were investigated by the MTT, the DPPH(.) and ABTS(.+) scavenging, and the agar disc-diffusion methods, respectively. Both oils were composed mainly by S-containing compounds, accounting for 91.0-96.1% of the total oil compositions, which provided them the typical garlic- and onion-like odors of spices. The predominant compound in both oils, 2,4,5,7-tetrathiaoctane (1; 51.5-52.9%), was isolated by preparative TLC and structurally elucidated by (1) H- and (13) C-NMR data. The oils exhibited a strong inhibitory effect on the growth of human cancer cells, namely, T98G (human glioblastoma multiforme cell line), MDA-MB 231 (human breast adenocarcinoma cell line), A375 (human malignant melanoma cell line), and HCT116 (human colon carcinoma cell line) cells, and a good DPPH(.) - and ABTS(.+) -scavenging activity, while the antimicrobial effects were negligible. The volatile compositions of A. lepidophyllus and S. zenkeri oils supported their use as odorous spices. The significant inhibition activities detected make these oils worthy of further investigation as promising chemopreventive agents to be exploited in the African pharmaceutical market.

Volatile oil from striped African pepper (Xylopia parviflora, Annonaceae) possesses notable chemopreventive, anti-inflammatory and antimicrobial potential.

Fruits of Xylopia parviflora, well known as striped African pepper, are sold in the Cameroonian markets as a flavouring ingredient to make traditional soups. The essential oil hydrodistilled from fruits was analysed for in vitro biological activities, namely cytotoxic, anti-inflammatory, antimicrobial and antioxidant, by MTT, nitric oxide inhibitory assay, agar disc diffusion method, and DPPH and ABTS assays. The essential oil composition, analysed by GC and GC-MS, was dominated by monoterpene hydrocarbons (50.0%) responsible for the pepper odour, such as ß-pinene (34.0%) and α-pinene (10.3%). The oil induced a strong inhibitory effect on tumour cells MDA-MB 231 and HCT116, with inhibition values close to those of cisplatin. A dose-dependent decrease in NO production was noted in RAW 264.7 macrophages treated with the oil, revealing a promising anti-inflammatory potential. The essential oil showed a measurable antimicrobial activity against all the species tested, while the radical scavenging activity was low.

Antioxidant, antiproliferative and antimicrobial activities of the volatile oil from the wild pepper Piper capense used in Cameroon as a culinary spice.

Wild pepper (Piper capense L.f., Piperaceae) is a spice traditionally used in western Cameroon to make soups called 'Nkui' and 'Nah poh'. In the present work, the essential oil hydrodistilled from fruits was analyzed by GC-FID and GC-MS, and for in vitro biological activities, namely cytotoxic, antioxidant and antimicrobial, by MTT, DPPH, ABTS and agar disc diffusion methods. The oil composition was dominated by monoterpene hydrocarbons (56.5%) responsible for the pepper odor, such as (beta-pinene (33.2%), sabinene (10.0%) and alpha-pinene (8.9%). The oil induced a concentration-dependent inhibitory effect on human tumor cells MDA-MB 231 (breast adenocarcinoma), A375 (malignant melanoma) and HCT116 (colon carcinoma), showing IC50 values of 26.3, 76.0 and 22.7 microg/ml, respectively. The oil showed total antioxidant activity with a Trolox equivalent antioxidant concentration (TEAC) value of 140 micromol/g. The essential oil of P. capense proved to be an effective scavenger of the ABTS+ radical, with an activity only about 30 times lower than that of Trolox. Moderate activity was observed against the Gram-positive species Staphylococcos aureus and Enterococcusfaecalis, and the yeast Candida albicans. The notable inhibition of some human tumor cells is worthy of further investigation to discover the possible mechanisms of action responsible for the observed cytotoxic effect of this essential oil.

CAG repeat expansion in Huntington disease determines age at onset in a fully dominant fashion.

OBJECTIVE: Age at onset of diagnostic motor manifestations in Huntington disease (HD) is strongly correlated with an expanded CAG trinucleotide repeat. The length of the normal CAG repeat allele has been reported also to influence age at onset, in interaction with the expanded allele. Due to profound implications for disease mechanism and modification, we tested whether the normal allele, interaction between the expanded and normal alleles, or presence of a second expanded allele affects age at onset of HD motor signs. METHODS: We modeled natural log-transformed age at onset as a function of CAG repeat lengths of expanded and normal alleles and their interaction by linear regression. RESULTS: An apparently significant effect of interaction on age at motor onset among 4,068 subjects was dependent on a single outlier data point. A rigorous statistical analysis with a well-behaved dataset that conformed to the fundamental assumptions of linear regression (e.g., constant variance and normally distributed error) revealed significance only for the expanded CAG repeat, with no effect of the normal CAG repeat. Ten subjects with 2 expanded alleles showed an age at motor onset consistent with the length of the larger expanded allele. CONCLUSIONS: Normal allele CAG length, interaction between expanded and normal alleles, and presence of a second expanded allele do not influence age at onset of motor manifestations, indicating that the rate of HD pathogenesis leading to motor diagnosis is determined by a completely dominant action of the longest expanded allele and as yet unidentified genetic or environmental factors.

Influence of diabetes on endothelial cell response during sepsis.

AIMS/HYPOTHESIS: Several endothelial pathways of cell adhesion, coagulation and vascular endothelial growth factor (VEGF) signalling are activated during sepsis. The objective of this analysis was to investigate the influence of diabetes on biomarkers of endothelial cell activation in sepsis. METHODS: This was a prospective observational cohort study of a convenience sample of adult patients (age ≥ 18 years) for whom infection was clinically suspected and who presented to an urban tertiary care emergency department between February 2005 and November 2008. We investigated the association of diabetes and sepsis with various endothelial activation biomarkers of cell adhesion (E-selectin, vascular cell adhesion molecule 1 [VCAM-1] and intercellular adhesion molecule 1 [ICAM-1]), coagulation (plasminogen activator inhibitor 1 [PAI-1]) and VEGF signalling (soluble fms-like tyrosine kinase-1 [sFLT-1]). RESULTS: A total of 207 patients (34% with sepsis, 32% with severe sepsis and 34% with septic shock) were studied, including 63 (30%) with diabetes. Compared with patients without diabetes, patients with diabetes had significantly increased E-selectin and sFLT-1 levels overall; this was most pronounced during septic shock in the stratified analysis. Multivariate models including age, sex, sepsis severity and other variables as potential covariates confirmed the association of diabetes with elevated circulating plasma levels of E-selectin (standardised ß 0.24, p < 0.001) and sFLT-1 (standardised ß 0.19, p < 0.01), but there was no significant association with VCAM-1, ICAM-1 or PAI-1. CONCLUSIONS/INTERPRETATION: During septic shock, patients with diabetes had higher levels of circulating biomarkers of endothelial cell adhesion (E-selectin) and VEGF signalling (sFLT-1). Future studies should address whether enhanced activation of the endothelium places patients with diabetes at increased risk for the development of sepsis and worsening morbidity and mortality.

Seroprevalence of toxoplasmosis, leptospirosis and brucellosis in sugarcane field-workers in Trinidad and Tobago.

Sugarcane field-workers, like rice field-workers, livestock farmers and abattoir workers are known to be occupationally exposed to zoonotic agents. The study determined the seroprevalence of immunoglobulins to Toxoplasma gondii (IgM), Leptospira spp (IgM) and Brucella abortus (IgG) in sugarcane field-workers across weighing stations in the island of Trinidad. In addition, the association of risk factors to infections by the three zoonoses was investigated. Blood samples were collected from consenting apparently healthy sugarcane field-workers across the island of Trinidad. Current/acute infection in individuals was determined in the sera of individuals using the enzyme immunoassay (EIA) for T gondii IgM antibodies, enzyme-linked immunosorbent assay (ELISA) for Leptospira spp IgM immunoglobulins and both buffered plate agglutination test (BPAT) and competitive ELISA for B abortus IgG antibodies. The seroprevalence of IgM immunoglobulins to T gondii was 15.7% (64 of 407) and to Leptospira spp was 0.7% (5 of 704) and the difference was statistically significant (p 0 < 0.05; chi2). All 704 samples tested for B abortus IgG immunoglobulins were negative. All risk factors (age, gender race and type of work done) were not statistically significantly (p > 0.05; chi2) associated with infections by T gondii and Leptospira spp. It was concluded that sugarcane field-workers in Trinidad were at high risk of acute toxoplasmosis and, to a lesser extent, to leptospirosis. The fact that the four risk factors studied were not significantly associated with T gondii and Leptospira spp infections suggests that they may not be important in the epidemiology of both diseases in the population studied.

Seroprevalence of toxoplasmosis, leptospirosis and brucellosis in sugarcane fieldworkers in Trinidad and Tobago / Seroprevalencia de la toxoplasmosis, la leptospirosis y la brucelosis en los trabajadores de las plantaciones de caña de azúcar en Trinidad y Tobago

Sugarcane field-workers, like rice field-workers, livestock farmers and abattoir workers are known to be occupationally exposed to zoonotic agents. The study determined the seroprevalence of immunoglobulins to Toxoplasma gondii (IgM), Leptospira spp (IgM) and Brucella abortus (IgG) in sugarcane field-workers across weighing stations in the island of Trinidad. In addition, the association of risk factors to infections by the three zoonoses was investigated. Blood samples were collected from consenting apparently healthy sugarcane field-workers across the island of Trinidad. Current/acute infection in individuals was determined in the sera of individuals using the enzyme immunoassay (EIA) for T gondii IgM antibodies, enzyme-linked immunosorbent assay (ELISA) for Leptospira spp IgM immunoglobulins and both buffered plate agglutination test (BPAT) and competitive ELISA for B abortus IgG antibodies. The seroprevalence of IgM immunoglobulins to T gondii was 15.7% (64 of 407) and to Leptospira spp was 0.7% (5 of 704) and the difference was statistically significant (p 0 < 0.05; χ2). All 704 samples tested for B abortus IgG immunoglobulins were negative. All risk factors (age, gender, race and type of work done) were not statistically significantly (p > 0.05; χ2) associated with infections by T gondii and Leptospira spp. It was concluded that sugarcane field-workers in Trinidad were at high risk of acute toxoplasmosis and, to a lesser extent, to leptospirosis. The fact that the four risk factors studied were not significantly associated with T gondiiand Leptospira spp infections suggests that they may not be important in the epidemiology of both diseases in the population studied.

Se sabe que los trabajadores de las plantaciones de caña de azúcar - al igual que los trabajadores de los campos de arroz, la ganadería y los mataderos - se hallan expuestos a agentes zoonóticos debido a su ocupación. El estudio determinó la seroprevalencia de las inmunoglobulinas en relación con Toxoplasma gondii (IgM), Leptospira spp (IgM) y Brucella abortus (IgG) en los trabajadores cañeros a lo largo de las estaciones de pesaje en la isla de Trinidad. Además, se investigó la asociación de factores de riesgo de infecciones por las tres formas de zoonosis. Se obtuvieron muestras de sangre a lo largo de la isla de Trinidad, tomadas de trabajadores cañeros de apariencia saludable, que dieron su consentimiento. La infección aguda presente en los individuos, fue determinada en sus sueros mediante el inmunoensayo enzimático (IEE) para anticuerpos de T gondii IgM, el ensayo inmunosorbente vinculado a enzimas (ELISA) para inmunoglobulinas frente a Leptospira spp IgM, y la prueba de aglutinación tamponada en placa (BPAT) así como el ELISA competitivo para anticuerpos de B abortus IgG. Palabras claves: toxoplasmosis, leptospirosis, brucelosis, trabajadores cañeros, Trinidad. La seroprevalencia de inmunoglobulinas IgM para T gondii fue de 15,7% (64 de 407) en tanto que para la Leptospira spp fue 0,7% (5 de 704). La diferencia fue estadísticamente significativa (p 0 < 0.05; c²). Las 704 muestras sometidas a la prueba de inmunoglobulinas para B abortus IgG, fueron negativas. Los factores de riesgo (edad, género, raza y tipo de trabajo realizado) no estuvieron significativamente asociados (p > 0.05; c²) de manera estadística con las infecciones por T gondii y Leptospira spp Se llegó a la conclusión de que los trabajadores cañeros de Trinidad presentaban un alto riesgo de toxoplasmosis aguda y, en menor medida, de leptospirosis. El hecho de que los cuatro factores de riesgo estudiados no estaban significativamente asociadas con T gondiiy a infecciones de Leptospira spp, sugiere que puede que no sean importantes en la epidemiología de ambas enfermedades en la población estudiada.

An analysis of the subtypes of dengue fever infections in Barbados 2003-2007 by reverse transcriptase polymerase chain reaction.

BACKGROUND: To perform a retrospective analysis of patients with IgM antibodies to dengue fever infection to determine the serotypes present by molecular techniques. A representative sample (approximately 20%/per year) of patients diagnosed with dengue fever infection were selected based on the detection of IgM antibodies in the acute phase serum sample. RNA was extracted from each sample and reverse transcribed. Following this, the amplicons were electrophoresed and serotyped based on band sizes. RESULTS: This study consisted of 71 males and 101 females ranging in age from 0 - 50+ yrs giving a total of 172 persons with an average of 34.4 patients per year. Onset averaged 6.9 days ranging from 0-90 days. Common symptoms were as follows: fever (69%), headache (52%), arthralgia (36%), ocular pain (32%), emesis (15%) and lumbar pain (15%). All patients investigated with the exception of one, were infected with DENV-3. CONCLUSION: DENV-3 is currently circulating on the island and not DENV-1 or DENV-2 as in previous years. This has implications for the enhancement of clinical, laboratory and environmental surveillance systems.