A comparison of metronidazole and single-dose ornidazole for the treatment of dientamoebiasis.

Recent reports of the pathogenic potential of Dientamoeba fragilis have underlined the need for an effective treatment against this colon-dwelling protozoan. Metronidazole is a well-known and commonly used anti-protozoal agent, but another 5-nitroimidazole derivative, ornidazole, may be preferable, where available, because of its longer half-life and fewer side-effects. This study compared the efficacies of metronidazole and ornidazole in a group of 112 patients with dientamoebiasis. Patients were randomised into two treatment groups: group 1 (n = 56) received metronidazole for 5 days, 20 mg/kg/day for children and 1.5 g/day for adults, in three oral doses, while group 2 (n = 56) received a single oral dose of ornidazole, 30 mg/kg for children and 2 g for adults. Stool samples were examined on the seventh and 14th days after treatment, and clinical symptoms were recorded to evaluate the efficacy of treatment. A statistically significant difference was recorded between the efficacies of ornidazole and metronidazole, both parasitologically (92.9% vs. 69.6%, p 0.001) and clinically (96.4% vs. 76.8%, p 0.001). Patients in the metronidazole group reported more side-effects than patients in the ornidazole group, none of whom required termination of treatment. These results suggest that single-dose ornidazole may be an important alternative agent for the treatment of dientamoebiasis.

Two novel serum-free media for the culture of Trichomonas vaginalis.

Definitive diagnosis of Trichomonas vaginalis, one of the common causes of sexually transmitted diseases in Turkey, relies on the microscopic examination of both fresh preparations and culture material of genital secretions and urine. The aim of this study was to compare the diagnostic efficacies of two culture media, serum-free TB1 and TB2, including iron and vitamin B12, respectively, with the well-known medium, TYM. Growth rate reached peak levels 48 h in TYM and 72 h in both TB1 and TB2 after inoculation. The highest amount of viable trophozoites has been obtained from TB1, almost equal to TYM but significantly higher than TB2. Fresh preparations obtained from the vaginal secretions of 119 patients have been examined and vaginal samples have been inoculated in TB1, TB2, and TYM. Viable T. vaginalis trophozoites have been detected in ten (8.4%) of fresh preparations and 11 (9.9%) of each medium. It is concluded that serum-free TB1 medium could be used effectively in both the isolation and maintenance of T. vaginalis culture in vitro.

Is there an association between clinical symptoms and intestinal parasitic infections?

Intestinal parasitic infections are major causes of childhood diseases in rural regions. The significant causes of this problem are the insufficient resources to improve the infrastructure in these regions and inadequate health services in both the diagnosis and treatment of diseases. The aim of this study was to assess the association between intestinal parasitic infections and clinical symptoms of infected children. Cellophane tape and stool samples of 100 children, aged between 7-10 years, from two villages of Manisa city, were examined for intestinal parasites and their symptoms were recorded. Although some symptoms, such as abdominal pain, anorexia and fatigue were found to be common in infected children, no significant relationship was found between symptoms and intestinal parasitic infections.

Evaluation of three new culture media for the cultivation and isolation of Leishmania parasites.

The aim of this study was to establish novel culture media for Leishmania parasites with a potential of obtaining high amounts of promastigotes with long-term viability, and consisting of ingredients that were available in microbiology or parasitology laboratories. Other features of these media included no requirement for blood, FCS (Fetal calf serum) or erythrocyte lysate, inexpensiveness and easiness in preparation. In addition, aspiration samples obtained from cutaneous leishmaniasis (CL) suspected patients were cultivated in these media. Three culture media were prepared; trypticase beef extract hemoglobine (TBH) medium, including trypticase, beef extract and yeast extract as the protein source, glucose as the carbohydrate source, FeNH4 and bovine hemoglobine; Peptone-Yeast extract medium (PY), found to be effective in our previous studies for cultuvation of on Leishmania parasites, with bovine hemoglobine (PYH) and Brain Heart medium, containing bovine hemoglobine (BKH). The number of promastigotes were the highest on day 8 and 13 in RPMI 1640 and BKH medium, respectively. In TBH and PYH, the peak level of reproduction was between day 16 and 19, and it was found to be higher in TBH medium after the day 20. The number of promastigotes were found to be close in BKH, TBH and RPMI-1640 media and lower in PYH medium. Examination of the cultivation of the aqueous lesion specimens of the 10 CL-suspected cases in media revealed reproduction in 9 flasks of RPMI-1640 containing 10% FCS, 7 TBH, 6 BKH and 4 PYH. The differences between the culture media were not found to be statistically significant. These results suggested that, three liquid culture media, assessed in this study, with no requirement for FCS or erythrocyte lysate, were effective in the reproduction of promastigotes, and could be used effectively in the patient isolation and field studies, as well.

Cutaneous leishmaniasis infection in Balb/c mice using a Leishmania tropica strain isolated from Turkey.

Leishmania tropica, which is endemic in Turkey, is the causative agent of cutaneous leishmaniasis. Leishmania tropica promastigotes (2 x 10(7)) isolated from a patient with dermal leishmaniasis and reproduced in NNN medium were inoculated subcutaneously into the footpads of 10 Balb/c mice. Cutaneous leishmaniasis developed on the footpads of 4 mice approximately 45 days later. Leishmania tropica amastigotes were observed in smear slides and then cultivated in NNN medium. Balb/c mice are a suitable laboratory model for this isolate of L. tropica and thus a source of amastigotes for studies on the immunology, chemotherapy, and pathogenicity of cutaneous leishmaniasis.

A new experimental in vitro culture medium for cultivation of Leishmania species.

A new liquid culture medium prepared with chemicals that can be obtained economically and commercially was tested in in vitro cultivation of Leishmania promastigotes to obtain a large number of organisms to use in serological studies. The number of Leishmania infantum and Leishmania tropica promastigotes taken from Novy-MacNeal-Nicolle (NNN) medium reached 1 x 10(7)/ml at the end of the 8th day in our new medium, though in NNN medium the number of organisms reached only 5 x 10(6)/ml. After 10 subsequent passages, the culture medium prepared was evaluated as being quite inexpensive, simple, and successful compared with other commercially available liquid culture media.

Incidence of Trichomonas vaginalis among women having vaginal discharge, in Manisa, Turkey.

Trichomoniasis characterise with a foamy yellowish odorous discharge, is an infection that causes superficial defects and necrotic ulcers in mucosa, and is spreadable with sexual contact. In T. vaginalis infection, the diagnosis can be made after the examination of saline wet mount preparations, stained smears preparation and cultivation of the vaginal discharge, the urine and the materials obtained from prostate secretion in males. In the present study, vaginal discharge samples obtained from 207 patients applied to Celal Bayar University, Medical Faculty Research Hospital, Manisa with vaginal discharge complaints were examined by utilising wet mount preparations, Giemsa staining method and CPLM cultivation method. In 27 of them (13.1%) T. vaginalis was detected by both saline wet mount preparation and Giemsa staining method. But as a result of the cultivation in CPLM media of the vaginal discharge materials collected from infected samples reproduction was observed in only 21 of them (10.2%). A treatment of Secnidazole by 2 gr. unique dose was applied to infected patients and their spouses and a complete recovery was followed up both microscopically and clinically.

PIP: The incidence of Trichomonas vaginalis was investigated in 207 women 18-45 years of age who presented to Celal Bayar University Hospital in Manisa, Turkey, with vaginal discharge. In 27 women (13.1%), T. vaginalis was detected by both direct microscopy of saline wet mount preparations and the microscopic examination of Giemsa stained smears. After cultivation of the vaginal discharge samples in CPLM media, T. vaginalis reproduction was seen in 21 samples (10.2%). All women with T. vaginalis as well as their spouses were treated with 2 g of Secnidazole and complete recovery was observed at follow-up 1 week after treatment ended.

Epidemiology, diagnosis and control of leishmaniasis in the Mediterranean region.

The leishmaniases are a widespread and medically important group of parasitic diseases, some of which pose a serious health threat in communities throughout the Mediterranean basin. In 1993, a joint, collaborative study of the Mediterranean leishmaniases was initiated by scientists from Israel, Turkey, Portugal and the Netherlands. The aim of this project was the development of a multi-component approach to the successful control of all forms of leishmaniasis, with special emphasis on the more severe, visceral leishmaniasis (VL). The need for highly sensitive and accurate new tools to facilitate diagnosis and epidemiological surveys of endemic areas and for studies on the immunology of VL in laboratory models (dogs and mice) was soon recognized. It is anticipated that the development of these tools and the associated technology will provide a better understanding of the disease and improve its control.

Cultivation of Leishmania sp. in nutrient broth.

Bone-marrow aspiration and biopsy material samples obtained from two patients, one diagnosed as visceral and other as cutaneous leishmaniasis, were inoculated in Novy, McNeal, Nicolle (NNN) medium and nutrient broth (NB), containing fetal calf serum (FCS), penicillin and streptomycine. Both media were incubated at 27 degrees C for 10 days and observed daily for L. infantum and L. major promastigotes. Promastigotes were observed in nutrient broth after the first day, while in NNN media after the second or third day of incubation, indicating the effectiveness of nutrient broth in early diagnosis of both forms of leishmaniasis.

Trichomoniasis in non-gonococcic urethritis among male patients.

Urethral discharge of 415 male patients, age 18-50, were examined for Trichomonas vaginalis by direct examination of fresh and Giemsa-stained slides and cultivation in CPLM media. In this study, 85 (20.7%) specimens out of 415, were found to be positive for trichomoniasis. Three groups consisting of 30, 29 and 26 patients each was treated with secnidazole, metronidazole and ornidazole respectively. In the follow up controls, all patients were found to be negative for trichomoniasis and all complaints were disappeared totally without a significant difference between all groups.