Text Message Intervention for Latino Adults to Improve Diabetes Outcomes.

Introduction: Determine the effectiveness of a diabetes text message intervention to improve diabetes outcomes in Latino adults at a free clinic in the southeastern United States. Methods: A pre-post, one-group design was used with a convenience sample (n = 24) of Latino adults with type 2 diabetes and A1C ≥ 7 who consented to participate. Over 8 weeks, participants were sent 23 educational and motivational text messages that were based on the American Association of Diabetes Educators (AADE) 7 self-care tasks and the American Diabetes Association (ADA) Standards of Medical Care in Diabetes Mellitus (DM). Diabetes knowledge, self-efficacy, self-care, and A1C were measured. Results: Diabetes knowledge, self-efficacy, self-care, and A1C improved after 8 weeks. Statistically significant results (p < .05) were seen in two of the four evaluation instruments administered (Spoken Knowledge in Low Literacy in Diabetes Scale [SKILLD], p = .001, Diabetes Self-Efficacy Scale [DSES], p = .000). A1C improvements were significant (0.86 or 10 mmol/mol) from the pre-intervention (M = 9.06 [76 mmol/mol], SD = 1.49) to the post-intervention (M = 8.20 [66 mmol/mol], SD = 1.27, t [23] = 3.02, p = .006). Conclusion: Personalized communication, education, and follow-up via text messages improved diabetes knowledge, self-efficacy, self-care, and A1C among pilot project participants. Text messages are a useful tool for diabetes management.

Pathologic lesions in chimpanzees (Pan trogylodytes schweinfurthii) from Gombe National Park, Tanzania, 2004-2010.

During a population decline or disease outbreak, the true risk of specific diseases to a wild population is often difficult to determine because of a lack of baseline disease information. To better understand the risk of disease in an endangered and scientifically important population of chimpanzees (Pan trogylodytes schweinfurthii), a health monitoring program was initiated in Gombe National Park, Tanzania. As part of this health monitoring program, comprehensive necropsies with histopathology were conducted on chimpanzees (n = 11; 5 male, 6 female), ranging in age from fetal to 44 yr, that were found dead between August 2004 and January 2010. In contrast to previous reports, respiratory disease was not noted as a cause of morbidity or mortality. Trauma was the most common cause of death in these 11 chimpanzees. All of the chimpanzees greater than 1 yr of age had intestinal and mesenteric parasitic granulomas associated with true strongyles consistent with Oesophagostomum spp. The relative numbers of granulomas increased with age and, in some cases, may have been a cause of weight loss and diarrhea. Simian immunodeficiency virus (SIV)cpz infection was documented in four deceased apes, all of whom exhibited varying amounts of lymphoid depletion including two females with marked CD4+ T cell loss consistent with endstage SIVmac or human immunodeficiency virus infections. Myocardial megalokaryosis was common in chimpanzees greater than 1 mo of age; yet myocardial interstitial fibrosis, a common lesion in captive chimpanzees, was uncommon and only noted in two aged chimpanzees. These findings provide important information on causes of morbidity and mortality in wild chimpanzees, information that can be used to interpret findings during population declines and lead to better management of this population in the context of disease risk.

Risk factors associated with failure of heartworm prophylaxis among members of a national hunting dog club.

OBJECTIVE: To identify practices associated with failure of heartworm prophylaxis among dog and kennel owners and dog trainers. DESIGN: Online survey and mail-in questionnaire. Sample-708 members of a national hunting dog club. PROCEDURES: Heartworm prevention practices used by respondents that reported failure of prophylaxis were compared with practices used by respondents that reported success. RESULTS: Univariate analyses indicated failure of heartworm prophylaxis was inversely related to the number of dogs under a respondent's care. Year-round prophylactic practice was not significantly associated with reduced odds of failure, and efforts to control exposure to mosquitoes were similar among the comparison groups. Respondents reporting prophylaxis failure were more likely to test for heartworm infection ≥ 1 time/y, compared with those reporting success. In a multivariable analysis, residence south of the Virginia-North Carolina state line (ie, the 37th geographic parallel), testing for heartworm infection < once a year when the test was administered prior to April 1, and keeping dogs outdoors for longer periods at dusk, at dawn, or after dark were associated with increased odds of prophylaxis failure. CONCLUSIONS AND CLINICAL RELEVANCE: Veterinarians should stress the importance of annual heartworm testing 6 to 7 months after the last possible date of exposure to heartworm, regardless of whether a dog receives prophylactic treatment year-round. Reducing the number of hours dogs spend outdoors at dusk, at dawn, or after dark may reduce the odds of heartworm disease even when dogs are given preventive treatment.

Survey of heartworm prevention practices among members of a national hunting dog club.

Surveillance data indicate that failures have been reported for virtually all heartworm prevention product categories. Resistance of third and fourth stage larvae of Dirofilaria immitis to macrocyclic lactones, lack of compliance, other unknown factors, or a combination of these reasons may be the cause of failure. A survey of members of a national hunting dog club was conducted to identify practices used to prevent canine heartworm infections. Questionnaires were completed by 708 dog owners. Year-round administration of heartworm preventive medication was reported by 208 (88%) respondents residing north of the 37th parallel. Dosing was based on the estimated weight of the dog by 54 (7%) respondents, 389 (55%) did not record the date prophylaxis was administered, and 89 (13%) observed the dogs spit out pills. Heartworm testing at least once per year was done by 556 (79%) respondents and test dates were spread throughout the year. Only 448 (64%) respondents tested newly acquired dogs for heartworm. These findings suggest that veterinarians should place a greater emphasis on the frequency and timing of heartworm diagnostic tests, the importance of weighing dogs, duration of administration, recording the date monthly heartworm prophylaxis is given, and observing dogs to ensure that oral medication is retained.

Prevalence of antibody to Toxoplasma gondii and Trichinella spp. in feral pigs (Sus scrofa) of eastern North Carolina.

Feral pigs (Sus scrofa) survive in many climates, reproduce year-round, and are dietary generalists. In the United States, the size and range of the feral pig population has expanded, resulting in greater interaction with humans and domestic swine and increased potential for disease transmission. We conducted a serosurvey in feral pigs from eastern North Carolina to determine exposure to the zoonotic parasites, Toxoplasma gondii and Trichinella spp. Between September 2007 and March 2009, blood serum was collected from 83 feral pigs harvested at Howell Woods Environmental Learning Center, Four Oaks, North Carolina, USA. We used a modified agglutination test to test for T. gondii antibodies and an enzyme-linked immunosorbent assay to test for Trichinella spp. antibodies. The prevalences of antibodies to T. gondii and Trichinella spp. were 27.7% and 13.3%, respectively and 4% (n=3) had antibodies to both agents. We detected an increased risk of T. gondii antibodies with age, whereas the risk of exposure to T. gondii across years and between sexes was similar. In eastern North Carolina, feral pigs have been exposed to T. gondii and Trichinella spp. and may pose a health risk to domestic swine and humans.

Attributes, knowledge, beliefs, and behaviors relating to prevention of heartworm in dogs among members of a national hunting dog club.

The Food and Drug Administration Center for Veterinary Medicine (FDA/CVM) has cited an increasing number of reports of failure of heartworm prophylaxis in dogs. Failures may be due to resistance of L(3)-L(4) stage Dirofilaria immitis to the macrocyclic lactone class of compounds used for prophylaxis, lack of compliance with and understanding of administration of prophylactics, individual differences in drug absorption or metabolism, or a combination of these factors. Using the latest scientific information, the American Heartworm Society (AHS) and Companion Animal Parasite Council (CAPC) have developed guidelines for the diagnosis, prevention, and treatment of heartworm infection in dogs. This study summarizes the knowledge, beliefs, and behaviors relating to prevention of heartworm among members of a national hunting dog club, visitors to the club website, and attendees at club-sponsored events. These factors can have a direct effect on the success of heartworm prophylaxis. Results suggest that the dog owners lack confidence in the accuracy of the heartworm test to identify infection, the efficacy of products sold for prevention of heartworm, and the effectiveness of treatment to eliminate adult heartworms from infected dogs. Knowledge about when to begin heartworm preventive medication in a new puppy and the timing of heartworm tests was also lacking among a substantial number of respondents. In order to increase acceptance of prophylaxis and reduce the likelihood of a false conclusion of prophylactic failure, education of dog owners should focus on the need for an appropriately timed annual heartworm test and the importance of administering the last dose of monthly heartworm preventative after the last possible day of potential transmission.

Neospora caninum and Toxoplasma gondii antibody prevalence in Alaska wildlife.

Free-ranging caribou and moose populations in some regions of Alaska undergo periodic declines in numbers. Caribou and moose are managed by the state as valuable resources for not only sustenance and subsistence, but also for cultural heritage. Incidence and prevalence of diseases that may impact herd health and recruitment from year to year are relevant to management decisions aimed to protect the long-term viability of these herds. Neospora caninum and Toxoplasma gondii are two apicomplexan parasites that can cause neurologic disease and abortions in their intermediate hosts and less frequently cause disease in their definitive hosts. The definitive hosts of N. caninum and T. gondii are canids and felids, respectively, and prevalence in the environment is in part dependent on maintenance of the life cycle through the definitive hosts. Serum samples from caribou (Rangifer tarandus, n=453), wolf (Canis lupus, n=324), moose (Alces alces, n=201), black-tailed deer (Odocoileus hemionus, n=55), coyote (Canis latrans, n=12), and fox (Vulpes vulpes, n=9) collected in Alaska were assayed for N. caninum- and T. gondii-reactive antibodies with an immunofluorescent antibody test (IFAT) and a modified agglutination test (MAT), respectively. Seroprevalence of N. caninum was greater in caribou (11.5%) than in wolves (9.0%), moose (0.5%), or black-tailed deer (0%). Seroprevalence of T. gondii was greater in wolves (17.8%) than in caribou (0.4%), moose (0%), or black-tailed deer (0%). Seroprevalence of N. caninum and T. gondii were 16.7% and 0.0% in coyotes and 0.0% and 12.5% in fox, but small sample sizes prevented further analysis. Antibodies to N. caninum in young caribou compared to adult caribou suggest that vertical transmission may be an important component of new infections in Alaskan caribou. The spatial distribution of antibody-positive individuals across Alaska may reflect differences in frequency of definitive hosts and alteration of predation patterns among regions.

Toxoplasma gondii: epidemiology, feline clinical aspects, and prevention.

Toxoplasma gondii is a parasite of birds and mammals. Cats are the only definitive host and thus the only source of infective oocysts, but other mammals and birds can develop tissue cysts. Although feline infections are typically asymptomatic, infection during human pregnancy can cause severe disease in the fetus. Cat owners can reduce their pets' exposure risk by keeping all cats indoors and not feeding them raw meat. Humans usually become infected through ingestion of oocyst-contaminated soil and water, tissue cysts in undercooked meat, or congenitally. Because of their fastidious nature, the passing of non-infective oocysts, and the short duration of oocyst shedding, direct contact with cats is not thought to be a primary risk for human infection.

Baylisascaris procyonis in raccoons (Procyon lotor) in eastern Tennessee.

Raccoon (Procyon lotor) carcasses (n=118) were collected from July through December 2007 throughout eastern Tennessee. Necropsies were performed, and Baylisascaris procyonis was collected from the gastrointestinal tract of infected carcasses. Prevalence rates were determined for the overall sample population, males and females, and adults and juveniles. The sample population had a B. procyonis prevalence of 12.7%. Males and females had a prevalence of 15% and 11%, respectively; prevalence in adults and juvenile was 13% and 12.6%, respectively. There were no significant differences in prevalence rates between the different groups. Baylisascaris procyonis is an ascarid infection of raccoons that can infect humans and over 100 species of other animals. The presence of infection in raccoons, paired with the expansion of human populations in eastern Tennessee, is likely to lead to increased interactions between humans and raccoons and therefore an increased risk of human and domestic animal exposure to B. procyonis.

Incidental isolation of Setaria equina microfilariae in preparations of equine peripheral blood mononuclear cells.

In the course of a vaccine experiment on horses, microfilariae were observed in cultures of peripheral blood mononuclear cells (PBMCs) isolated from eleven of fifteen study horses. The microfilariae were clearly viable as evidenced by their vigorous movements in the cultures, thus indicating that they had survived the Ficoll gradient purification and the cryopreservation method used for retaining the PBMCs. The microfilariae were identified as Setaria equina, which is a vector-borne filarial nematode that causes a relatively benign infection of equids in which the adult worms reside in the peritoneal cavity. Although it is not possible to definitely state where the infections were acquired, the horses originated from Saskatchewan, Canada and spent a relatively short period of time in the United States prior to blood sampling. Therefore, it is likely that the infections occurred in Canada. Interestingly, assays conducted to determine levels of cytokine mRNA transcripts in the isolated PBMCs seemed to be largely unaltered by the presence of the microfilariae in the cell cultures. These findings demonstrate that a standard method used to purify and cryopreserve PBMCs from blood can result in the unintended co-isolation of worms from microfilaremic animals. Furthermore, the presence of the microfilariae did not appear to alter significantly the results of our immunologic assays, suggesting either that the nematode antigens were not recognized or that immunological tolerance may have developed in these horses. Although notable effects on the assays were not observed in this study, it seems possible that microfilarial contamination could represent a confounding variable for experiments examining cellular immunity.

Homocysteine and related B-vitamin status in coeliac disease: Effects of gluten exclusion and histological recovery.

OBJECTIVE: Hyperhomocysteinaemia is considered to be a risk factor for cardiovascular disease (particularly stroke) and has been implicated in recurrent miscarriage and osteoporotic fracture, recognized manifestations of coeliac disease (CD). The objective of this study was to compare plasma homocysteine levels and biomarker status of metabolically related B vitamins (folate, vitamin B(12), B(6) and riboflavin) in treated and untreated CD patients and healthy controls. MATERIAL AND METHODS: CD patients attending a clinic for either initial or follow-up biopsy (at least 12 months after commencing a gluten-free diet) were categorized into three groups: 1) newly diagnosed (untreated; n=35); 2) persistent villous atrophy (VA) at follow-up (n=24) or 3) recovered VA at follow-up (n=41). Blood samples were analysed for plasma homocysteine, serum and red cell folate and serum vitamin B(12) levels, and for plasma pyridoxal 5-phosphate (PLP, vitamin B(6)) and riboflavin (vitamin B(2)) status. RESULTS: Homocysteine concentrations were significantly higher (p=0.05) and red cell and serum folate significantly lower (p<0.001) in untreated patients compared with controls, while all three reached normal levels in recovered VA patients. Although untreated and persistent VA patients tended to have lower B(12) levels, these did not reach significance. There was no evidence of compromised B(6) or riboflavin status, even in untreated CD patients. Homocysteine concentrations were inversely associated with both serum (r=-0.421; p<0.001) and red cell (r=-0.459; p<0.001) folate and with serum vitamin B(12) (r=-0.353; p=0.001). CONCLUSIONS: Gluten exclusion in CD improves folate status and normalizes homocysteine concentrations. Reducing the risk of homocysteine-related disease may be another reason for aggressive diagnosis and treatment of CD.

Serologic survey of domestic felids in the Petén region of Guatemala.

Blood samples were analyzed from 30 domestic cats (Felis domesticus) from the Petén region of Guatemala to determine the seroprevalence of common pathogens that may pose a potential risk to native wild felids. Eight of the cats had been vaccinated previously; however, owners were unable to fully describe the type of vaccine and date of administration. In addition, blood samples were obtained from two captive margays (Leopardus wiedii). Samples were tested for antibodies to feline immunodeficiency virus, Dirofilaria immitis, feline panleukopenia virus, feline herpesvirus, feline coronavirus, canine distemper virus, and Toxoplasma gondii and for feline leukemia virus (FeLV) antigen. Fifty percent or more of the cats sampled were seropositive for feline herpesvirus (22 of 30), feline panleukopenia (15 of 30), and T. gondii (16 of 30). Five cats were positive for FeLV antigen. Both margays were seropositive for feline coronavirus and one was strongly seropositive to T. gondii. All animals were seronegative for D. immitis. This survey provides preliminary information about feline diseases endemic to the Petén region.

Presidential address 2002. Parasitology in the 21st century.

During the past several weeks, I, like many of my predecessors, have read many speeches previously delivered at the annual meeting of the American Society of Parasitologists (ASP). These are wonderful, exciting papers, and I recommend them to you. The history of our Society and much of parasitological research and philosophy are contained in these speeches. An understanding of parasitology and specifically of the ASP in the 21st century necessitates an understanding of our roots. Just as proteomics, genomics, DNA, and Mendel are a continuum, so is our progression as a science and as a Society. This thought is not original with me. Several presidents have discussed this point in detail: Eloise Cram in 1956, "Stepping Stones in the History of the American Society of Parasitologists" (Cram, 1956); Martin Ulmer in 1978, "What's Past is Prologue" (Ulmer, 1978); Harry Hoogstraal in 1984, "ASP: Its Historic Role and Modern Opportunities" (Hoogstraal, 1985); and Mike Kemp in 1988, "Parasitology a Degenerate Discipline, Populated by Degenerate Scientists, Studying Degenerate Organisms?" (Kemp, 1989).

Prevalence of endoparasitic infection in children and its relation with cholera prevention efforts in Mexico.

OBJECTIVE: To investigate whether increased knowledge and use of public health measures promoted for cholera prevention is reflected in lower prevalence of parasitic infection in households in a community in the state of Tamaulipas, Mexico, that is close to the border with the United States of America. METHODS: Between 1994 and 1997, fecal samples from 438 children were collected through convenience sampling and then examined for helminth eggs/larvae and protozoan cysts as biologic indicators of household compliance with recommended cholera prevention measures. The suggested measures were to wash hands before meals and after defecation, to drink purified water, to wash fruits and vegetables, and to eat well-cooked food. In addition, information on the knowledge of and the use of cholera preventive measures was collected by interviews with adult informants in 252 households (186 of those households also provided a fecal sample for analysis). RESULTS: Parasitic infections occurred in 131 of the 438 children (30%), who resided in 79 of the 186 households (42%) that provided fecal samples. Giardia lamblia accounted for 12.5% of all infections. Infections with Hymenolepis nana, Ascaris lumbricoides, Trichuris trichiura, Enterobius vermicularis, Ancylostoma/Necator, Strongyloides stercoralis, Entamoeba coli, Entamoeba hartmanni, Entamoeba histolytica, Endolimax nana, and Iodamoeba bütschlii were also noted. Infected children were older and more often had an infected sibling. Households with three or more children were also more likely to have an infected child. The primary caregivers in the households where at least one child had a parasitic infection were distinguished by their inability to list at least three cholera prevention measures from memory. CONCLUSIONS: The 42% household prevalence of parasitic infection was relatively high and indicates that some residents of this community may not have fully embraced the public health education efforts promoted for prevention of cholera. The occurrence of nonpathogenic protozoan parasites such as Endolimax nana, Entamoeba coli, Entamoeba hartmanni, and I. bütschlii are important bioindicators for the persistence of unhygienic behaviors that increase the risk of cholera and other infectious diseases dependent on fecal-oral transmission. Information obtained by similar studies can be useful for monitoring compliance with community health and hygiene programs and may indicate the need to intensify educational efforts for the prevention of diarrhea associated with enteric pathogens that cannot be controlled by drugs alone.

Detection of Toxoplasma gondii IgG antibodies in juvenile great grey kangaroos, Macropus giganteus giganteus.

Serial IgG antibody titers to Toxoplasma gondii from three juvenile great grey kangaroos (Macropus giganteus giganteus) with clinical signs consistent with toxoplasmosis were compared with titers from three clinically normal juveniles of similar age. The modified agglutination test was used to measure antibodies to T. gondii. Results demonstrated declining antibody titers to T. gondii in five of six animals. Antibody titers were similar in animals with and without clinical signs. This was interpreted as an indication that maternal IgG antibodies to T. gondii were transferred to juveniles, presumably in milk, rather than an indication of clinical disease. Therefore, clinicians should interpret Toxoplasma serology results in juvenile macropods cautiously.

Prevalence of endoparasitic infection in children and its relation with cholera prevention efforts in Mexico

OBJECTIVE: To investigate whether increased knowledge and use of public health measures promoted for cholera prevention is reflected in lower prevalence of parasitic infection in households in a community in the state of Tamaulipas, Mexico, that is close to the border with the United States of America. METHODS: Between 1994 and 1997, fecal samples from 438 children were collected through convenience sampling and then examined for helminth eggs/larvae and protozoan cysts as biologic indicators of household compliance with recommended cholera prevention measures. The suggested measures were to wash hands before meals and after defecation, to drink purified water, to wash fruits and vegetables, and to eat well-cooked food. In addition, information on the knowledge of and the use of cholera preventive measures was collected by interviews with adult informants in 252 households (186 of those households also provided a fecal sample for analysis). RESULTS: Parasitic infections occurred in 131 of the 438 children (30 percent), who resided in 79 of the 186 households (42 percent) that provided fecal samples. Giardia lamblia accounted for 12.5 percent of all infections. Infections with Hymenolepis nana, Ascaris lumbricoides, Trichuris trichiura, Enterobius vermicularis, Ancylostoma/Necator, Strongyloides stercoralis, Entamoeba coli, Entamoeba hartmanni, Entamoeba histolytica, Endolimax nana, and Iodamoeba bütschlii were also noted. Infected children were older and more often had an infected sibling. Households with three or more children were also more likely to have an infected child. The primary caregivers in the households where at least one child had a parasitic infection were distinguished by their inability to list at least three cholera prevention measures from memory. CONCLUSIONS: The 42 percent household prevalence of parasitic infection was relatively high and indicates that some residents of this community may not have fully embraced the public health education efforts promoted for prevention of cholera. The occurrence of nonpathogenic protozoan parasites such as Endolimax nana, Entamoeba coli, Entamoeba hartmanni, and I. bütschlii are important bioindicators for the persistence of unhygienic behaviors that increase the risk of cholera and other infectious diseases dependent on fecal-oral transmission...

Increased prevalence of Brucella suis and pseudorabies virus antibodies in adults of an isolated feral swine population in coastal South Carolina.

Two hundred twenty seven adult (> 8 mo) feral swine (Sus scrofa) trapped from April through July 1999 at three locations on a coastal South Carolina (USA) peninsula with restricted ingress and egress were tested for Brucella suis and pseudorabies virus (PRV) antibodies. Approximately 44% of the animals tested positive for B. suis antibodies and 61% tested positive for antibodies to PRV. Previous surveys (1976 and 1992) of feral swine at the same location with similar methods indicated lower seroprevalences (28% and 18% for B. suis and 0% and 19% for PRV). We also found 39% of feral swine seropositive (n = 179) for Trichinella spiralis and 49% seropositive (n = 181) for Toxoplasma gondii. Results of repeated sampling demonstrated that seroprevalence to pathogens can increase with time in an isolated, unhunted population of feral swine suggesting an increased risk to local domestic livestock and potentially to human health.

Diagnosis and Treatment of Trichospirura leptostoma Infection in Common Marmosets (Callithrix jacchus).

Trichospirura leptostoma is a spirurid nematode that inhabits the pancreatic ducts of the common marmoset, Callithrix jacchus, and other New World primates. This parasite was diagnosed in members of this species at the Marmoset Research Center in Oak Ridge, Tennessee colony after their importation from multiple colonies outside the United States. Animals with few parasites in the pancreas had few tissue changes, whereas those with many parasites had moderate to severe fibrosis replacing exocrine tissue. Trichospirura leptostoma can cause chronic pancreatitis, resulting in subclinical to clinical pancreatic insufficiency and secondary malnutrition. Clinical signs of pancreatic insufficiency in affected marmosets included weight loss (despite good appetite) and increased fecal volume. Because earlier reports did not mention treatments, experimental therapeutic regimens were attempted to eliminate infections from the marmosets. In the clinical studies, different doses and treatment periods with ivermectin and fenbendazole were evaluated for therapeutic efficacy. Fenbendazole given daily at a dosage of 50 mg/kg of body weight by gavage for 14 days was the most effective treatment (PI 0.052). Control of the cockroach vector, as well as treatment of infected animals, is needed to prevent Trichospirura leptostoma-induced disease.