Seroprevalence of human cystic echinococcosis: A study from a tertiary care center of North India.

Present study retrospectively analysed the serological data of patients suspected of cystic echinococcosis (CE) attending the outpatient clinics or admitted in our hospital. An enzyme-linked immunoassay was used to analyse anti-CE antibodies in serum samples of 3680 patients. Microscopy of aspirated cystic fluid was performed on 170 cases only. CE seropositive cases were 595 (16.2%), of which 293 (49.2%) were males and 302 (50.8%) were females. A higher percentage of seropositivity was found in adults within age range of 21-40 years of age. There has been a decrease in seropositivity in the study years (2016-2021) in comparison to previous years (1999-2015).

Utilizing larvicidal and pupicidal efficacy of Eucalyptus and neem oil against Aedes mosquito: An approach for mosquito control.

BACKGROUND AND OBJECTIVES: Plant-based products can provide safe and biodegradable mosquito control agents. The essential oils have a strong odor due to complex secondary metabolites and exhibit lower density than that of water, which renders them suitable to form a thin layer above the water surface. The present study was designed to evaluate the larvicidal, pupicidal activity of Eucalyptus and neem oils against Aedes aegypti and Aedes albopictus. MATERIALS AND METHODS: We evaluated the activity of commercially available Eucalyptus (Eucalyptus globulus) and neem (Azadirachta indica) oils against larvae and pupae of A. aegypti and A. albopictus for their larvicidal and pupicidal activity, stability in different water types, dependence on volume and surface area of the water body, and residual efficacy. RESULTS: Eucalyptus oil was found to be more effective against larvae and pupae at lower concentrations, i.e., concentration at which 50% is observed (LC50) for larvae and pupae was 93.3 and 144.5 parts per million (ppm) and concentration at which 90% is observed (LC90) was 707.9 and 741.3 ppm, respectively, while for neem oil, LC50 for larvae and pupae was 7852 and 19,054 ppm and LC90 was 10,092 and 19,952 ppm, respectively. The efficacy of Eucalyptus oil depended on surface area rather than volume of water, and the residual efficacy of Eucalyptus oil was up to 8 days. CONCLUSIONS: Eucalyptus oil was more effective against mosquito larvae at lower concentration as compared to neem oil. It can, therefore, be utilized in the community in artificial and small temporary water bodies as an eco-friendly vector control measure in the era of increasing resistance to chemical insecticides.

Seroprevalence of human cystic echinococcosis from North India (2004-2015).

CONTEXT: Cystic echinococcosis (CE) caused by Echinococcus granulosus is a disease of a significant burden in India. The World Health Organization recommends the use of hospital data for population surveillance to measure the prevalence of CE. AIM: The aim of this study was to estimate the seroprevalence of CE and to compare with previous prevalence rates to estimate the changing pattern in seroprevalence of CE. MATERIALS AND METHODS: A retrospective analysis of laboratory data of 3929 clinically and/or radiologically suspected cases of CE was carried out for 12 years from 2004 to 2015 and compared to the previous data from 1984 to 2003. The seroprevalence of anti-hydatid immunoglobulin G (IgG) was assessed by enzyme-linked immune sorbent assay. Casoni's intradermal skin test and microscopy on aspirated hydatid cyst fluid were also done. The statistical significance was assessed using Chi-square test and Fisher's t-test. RESULTS: Of the 3929 samples, 1124 (28.6%) were positive for specific anti-hydatid IgG antibody response, while of the 121 tested by Casoni's test, 56 (46.3%) were positive. The seropositivity of CE over the period of 12 years is rising. As compared to our previous data from 1984 to 2003, an overall significant increase in seropositivity was observed during 2004-2015 (28.6% vs. 15.0% in 1984-2003, P < 0.0001). CONCLUSIONS: This study emphasizes the necessity of continuous surveillance and integrated control measures to prevent CE in humans and livestock across the country.

Stage-specific antibody response against two larval stages of Brugia malayi in different clinical spectra of brugian filariasis.

CONTEXT: T-cell hypo-responsiveness in microfilaria (Mf) carriers against the microfilarial stage antigen of Brugia malayi has been described, but no study has been carried out to assess antibody dynamics against stage-specific antigens. AIM: The work was carried out with the aim to assess stage-specific antibody responses against L3 and microfilarial stage antigens in brugian filariasis in an endemic area. SETTING AND DESIGN: Patients with different clinical spectra of brugian filariasis were recruited to evaluate antibody responses to brugian antigens. SUBJECTS AND METHODS: Serum samples were collected from patients with different clinical spectra and antibody response was evaluated for total immunoglobulin G (IgG), IgG isotypes (IgG1, IgG2, IgG3, IgG4) and immunoglobulin E (IgE) response to L3 and microfilarial stage by enzyme-linked immunosorbent assay. STATISTICAL ANALYSIS: Paired t-test and one-way analysis of variance were carried out to analyze the data. RESULTS: L3 and microfilarial stage antigens showed almost similar antibody responses in adenolymphangitis (ADL) and chronic pathology (CP) patients, however, diminished antibody response was observed with Mf stage antigen, especially with microfilaraemia. ADL patients had minimum antibody levels of all isotypes except IgG2 on day 0 which showed an increase subsequently, indicating suppression of antibody response during filarial fever. CP patients showed increase in IgE and decrease in IgG4 antibodies on day 365 indicating that these differences may be due to recent conversion into CP. CONCLUSION: A prominent hyporesponsiveness in microfilaraemic individuals against microfilarial stage, but not against the L3 stage of the same parasite was observed, concluding stage-specificity in humoral immune response in brugian filariasis.

Circulating filarial antigen detection in brugian filariasis.

Human lymphatic filariasis (LF) is a major cause of disability globally. The success of global elimination programmes for LF depends upon effectiveness of tools for diagnosis and treatment. In this study on stage-specific antigen detection in brugian filariasis, L3, adult worm (AW) and microfilarial antigenaemia were detected in around 90-95% of microfilariae carriers (MF group), 50-70% of adenolymphangitis (ADL) patients, 10-25% of chronic pathology (CP) patients and 10-15% of endemic normal (EN) controls. The sensitivity of the circulating filarial antigen (CFA) detection in serum samples from MF group was up to 95%. In sera from ADL patients, unexpectedly, less antigen reactivity was observed. In CP group all the CFA positive individuals were from CP grade I and II only and none from grade III or IV, suggesting that with chronicity the AWs lose fecundity and start to disintegrate and die. Amongst EN subject, 10-15% had CFA indicating that few of them harbour filarial AWs, thus they might not be truly immune as has been conventionally believed. The specificity for antigen detection was 100% when tested with sera from various other protozoan and non-filarial helminthic infections.

Allele frequency of ABO blood group antigen and the risk of esophageal cancer.

BACKGROUND: ABO blood group and risk of squamous cell carcinoma of esophagus have been reported by many studies, but there is no discipline that had provided association with the genotype and gene frequency by population statics. METHODS: We conducted a case-control study on 480 patients with squamous cell carcinoma of the esophagus and 480 noncancer patients. ABO blood group was determined by presence of antigen with the help of monoclonal antibody. Chi-square test and odds ratio (OR) with 95% confidence intervals (CIs) were calculated by statistical methods, and gene frequencies were calculated by Hardy-Weinberg model. RESULTS: We observed significant associations between ABO genotype and squamous cell carcinoma of esophagus. OR (95% CIs) was 1.69 (1.31-2.19) for presence of B antigen allele relative to its absence (P < 0.0001); in female subgroup OR (95% CIs) observed at 1.84 (1.27-2.65) was statistically significant (P = 0.001). SCC of esophagus shows significant difference in comparison to general population; blood group B is found to be higher in incidence (P = 0.0001). Increased risk of cancer was observed with absence of Rh antigen (P = 0.0001). Relatively increased gene frequency of q[B] allele is observed more significantly in female cancer patients (P = 0.003). CONCLUSION: Statistically significant association between squamous cell carcinoma of the esophagus and ABO and Rh genotype is identified by this study. Sex and anatomical site of cancer also present with statistically significant relative association. However, larger randomised trials are required to establish the hypothesis.

Development and evaluation of multiplex PCR in rapid diagnosis of abdominal tuberculosis.

The clinical features of abdominal tuberculosis (TB) are non-specific and establishing a diagnosis remains a challenge. A delay in diagnosis is likely to increase the morbidity in these patients. We developed a multiplex polymerase chain reaction (PCR) using 16SrRNA, IS6110, and devR, and evaluated it in comparison with other conventional tests in clinical suspects of abdominal TB. A total of 183 patients with clinical suspicion of abdominal TB (96 patients with intestinal TB and 87 with peritoneal TB) were enrolled for the study. Endoscopic or intraoperative biopsies were collected from patients suspected of intestinal TB and ascitic fluid was collected from patients with a suspicion of peritoneal TB. Of the intestinal tuberculosis group, there were 40 confirmed cases and 56 controls, while of the peritoneal tuberculosis group there were 37 confirmed cases and 50 controls. Multiplex PCR showed a high sensitivity and specificity in both the intestinal TB and peritoneal TB groups. When combined with histopathology, multiplex PCR could detect 97.5% of all the cases in the intestinal tuberculosis group, while in combination adenosine deaminase levels (ADA) in cases of peritoneal tuberculosis it increased the specificity of diagnosis of peritoneal tuberculosis to 95%. In combination with histopathology in suspected intestinal TB cases, and ADA testing in suspected peritoneal TB cases, it can be used as a highly sensitive, specific, and rapid diagnostic tool with the ability to supplement the limitations of other diagnostic modalities.

Neurocysticercosis: A disease of neglect.

Neurocysticercosis (NCC) is a neglected tropical disease caused by larval forms of the parasite Taenia solium lodging in central nervous system (CNS). There is a huge morbidity and debilitation due to CNS manifestations of NCC in developing and underdeveloped regions of the globe, mainly Asian, African and Latin American countries. It is the cause of epilepsy in about 1% of the population of endemic countries and is the underlying etiology in about 15-50% persons with epilepsy, depending upon the geographical region. There is no perfect diagnostic method and the diagnosis relies on a combination of clinical, radio-imaging, immunologic and epidemiologic data. Treatment includes anti-parasitic treatment by cysticidal drugs and management of associated symptoms and complications. The disease is eradicable and control depends on an integrated and coordinated involvement of international bodies like the World Health Organization along with scientific institutions and political and administrative strata of the endemic countries to provide the essential tools such as adequate sanitation, live-stock management, health education and improved socio-economic conditions.

Cytomegalovirus glycoprotein B gene polymorphism and its association with clinical presentations in infants.

The clinical manifestations in cytomegalovirus infected-infants vary from asymptomatic illness to highly fatal cytomegalic inclusion disease. The influence of human cytomegalovirus (HCMV) strains on the outcome of HCMV disease is poorly explored. The present study was undertaken to explore the role of gB genotypes with clinical features in infants with clinically suspected HCMV disease. Urine samples of 71 infants (age < 1 year) with clinically suspected HCMV disease were subjected to amplification of glycoprotein B (gB) gene by polymerase chain reaction (PCR) followed by restriction fragment length polymorphism using RsaI and HinfI. HCMV DNA could be detected in 12 samples by gB gene PCR, 6 of which comprised of gB2, followed by gB1 in 5 samples and gB3 in 1 sample. Organomegaly was the most common finding (67%) followed by jaundice (50%), pneumonia (50%), seizures (42%), microcephaly (25%), low birth weight (25%) and rashes (17%). No particular genotype was significantly associated with specific clinical presentation or organ system involvement.