Anti-Trichinella IgG in ethnic minorities living in Trichinella-endemic areas in northwest Vietnam: study of the predictive value of selected clinical signs and symptoms for the diagnosis of trichinellosis.

The objective of this study was to assess the presence of anti-Trichinella IgG in the serum of persons from ethnic minorities from northwest Vietnam with clinical signs and symptoms that are compatible with trichinellosis. A total of 645 persons were enrolled, of which 200 people lived in two villages where outbreaks of human trichinellosis had been documented in 2004 and 2008, and 445 people who were hospitalized in the Dien Bien and Son La provincial hospitals without a definitive diagnosis. Presence of anti-Trichinella IgG was demonstrated in serum samples by a standardized Enzyme-linked Immunosorbant Assay (ELISA); positive serum samples were subjected to Western blot (WB) for confirmation. Seven (3.5%; 95% CI: 1.4-7.1) persons from the villages and seven (1.6%; 95% CI: 0.6-3.2) hospitalized patients, tested positive by both ELISA and WB. Fever (N=13), eosinophilia (N=12), myalgia (N=9), facial edema (N=9) and leukocytosis (N=8) were the most common clinical signs and symptoms in the serologically positive persons. The concomitant occurrence of facial edema and myalgia among the enrolled persons from the villages, accounted for 75% of the positive predictive value (PPV) and 99.5% of the negative predictive value (NPV), suggesting that they could be used for suspecting trichinellosis when serology is not available. The high prevalence (1.6-3.5%) of anti-Trichinella IgG in persons from Vietnamese provinces where Trichinella spiralis is circulating in pigs strongly supports the need to develop control programs to eliminate the infection from pigs and for consumers' education and protection.

Validation of a latex agglutination test for the detection of Trichinella infections in pigs.

An antigen detection kit (Trichin-L), based on latex agglutination and developed by the Bio-Rad company was validated at five European laboratories. The validation parameters included specificity, sensitivity, robustness and reproducibility. Specificity was evaluated by testing parasite antigens from five non-Trichinella parasites in addition to the Trichinella genus. To evaluate sensitivity, 10 pork samples spiked with 1, 3, 6 or 15 Trichinella larvae were tested in each laboratory. To evaluate the robustness of the test, the solubilized antigens were maintained at room temperature and tested at different times. Reproducibility was assessed in each laboratory using 40, 100g minced pork samples, each spiked with Trichinella spiralis. The use of larval homogenates obtained from the Trichin-L kit as a template for parasite identification at the species level by a multiplex PCR, was also evaluated. The results showed a high specificity and sensitivity where solubilized antigens maintained their stability and reactivity for up to three days. Reproducibility was high, as similar results were obtained in the five laboratories. The larval homogenates obtained using the Trichin-L kit were successfully used in multiplex PCRs to identify Trichinella species.

Intersectoral collaboration between the medical and veterinary professions in low-resource societies: The role of research and training institutions.

BACKGROUND: Neglected zoonoses continue to significantly affect human health in low-resource countries. A symposium was organised in Antwerp, Belgium, on 5 November 2010 to evaluate how intersectoral collaboration among educational and research institutions could improve the situation. RESULTS: Brucellosis and echinococcosis were presented as models for intersectoral collaboration. Low-resource societies face evident knowledge gaps on disease distribution, transmission within and across species and impact on human and animal health, precluding the development of integrated control strategies. RECOMMENDATIONS: While veterinarians have been the main driver of the One Health initiative, the medical profession does not seem to be fully aware of how veterinary science can contribute to human public health. It was postulated that transdisciplinarity could help fill knowledge gaps and that encouraging such transdisciplinarity should start with undergraduate students. Furthermore, intersectoral collaboration on zoonoses should not ignore the social sciences (e.g. assessment of indigenous knowledge and perception; participatory surveillance), which can contribute to a better understanding of the transmission of diseases and improve communities' participation in disease control activities.