Baseline patterns of infection in regions of Benin, Malawi and India seeking to interrupt transmission of soil transmitted helminths (STH) in the DeWorm3 trial.

Global efforts to control morbidity associated with soil-transmitted helminth infections (STH) have focused largely on the targeted treatment of high-risk groups, including children and pregnant women. However, it is not clear when such programs can be discontinued and there are concerns about the sustainability of current STH control programs. The DeWorm3 project is a large multi-country community cluster randomized trial in Benin, India and Malawi designed to determine the feasibility of interrupting the transmission of STH using community-wide delivery of mass drug administration (MDA) with anthelmintics over multiple rounds. Here, we present baseline data and estimate key epidemiological parameters important in determining the likelihood of transmission interruption in the DeWorm3 trial. A baseline census was conducted in October-December 2017 in India, November-December 2017 in Malawi and in January-February 2018 in Benin. The baseline census enumerated all members of each household and collected demographic data and information on occupation, assets, and access to water, sanitation and hygiene (WASH). Each study site was divided into 40 clusters of at least 1,650 individuals per cluster. Clusters were randomized to receive twice yearly community-wide MDA with albendazole (GSK) targeting eligible individuals of all ages (20 clusters), or to receive the standard-of-care deworming program targeting children provided in each country. In each site, a randomly selected group of 150 individuals per cluster (6,000 total per site) was selected from the baseline census using stratified random sampling, and each individual provided a single stool sample for analysis of STH infection using the Kato-Katz technique. Study site, household and individual characteristics were summarized as appropriate. We estimated key epidemiological parameters including the force of infection and the degree of parasite aggregation within the population. The DeWorm3 sites range in population from 94,969 to 140,932. The population age distribution varied significantly by site, with the highest proportion of infants and young children in Malawi and the highest proportion of adults in India. The baseline age- and cluster-weighted prevalence, as measured by Kato-Katz, varied across sites and by species, Baseline hookworm prevalence in India was 21.4% (95% CI: 20.4-22.4%), while prevalence of Ascaris and Trichuris by Kato-Katz was low (0.1% and 0.3% overall). In Malawi, the overall age- and cluster-weighted STH prevalence was 7.7% (95% CI: 7.1-8.4%) predominantly driven by hookworm infections (7.4%) while Ascaris (0.1%) and Trichuris (0.3%) infections were rare. In Benin, the overall age- and cluster-weighted prevalence was significantly lower (5.6%, 95% CI: 5.1-6.2%) and Ascaris (2.0%, 95% CI: 1.6-2.3%) was more common than in other sites. Ascaris infections were more likely to be moderate- or heavy-intensity (43.7%, unweighted) compared to hookworm (5.0%). The force of infection for hookworm was highest in adults in India and Malawi but appeared relatively stable across age groups in Benin. These data demonstrate the significant variability between the sites in terms of demography, socio-economic status and environmental characteristics. In addition, the baseline prevalence and intensity data from DeWorm3 suggest that each site has unique epidemiologic characteristics that will be critical in determining correlates of achieving STH transmission interruption in the DeWorm3 trial. Trial registration: The trial was registered at ClinicalTrials.gov (NCT03014167).

The impact of community-wide, mass drug administration on aggregation of soil-transmitted helminth infection in human host populations.

BACKGROUND: Soil-transmitted helminths (STH) are intestinal parasites estimated to infect over 1.5 billion people. Current treatment programmes are aimed at morbidity control through school-based deworming programmes (targeting school-aged children, SAC) and treating women of reproductive age (WRA), as these two groups are believed to record the highest morbidity. More recently, however, the potential for interrupting transmission by treating entire communities has been receiving greater emphasis and the feasibility of such programmes are now under investigation in randomised clinical trials through the Bill & Melinda Gates Foundation funded DeWorm3 studies. Helminth parasites are known to be highly aggregated within human populations, with a small minority of individuals harbouring most worms. Empirical evidence from the TUMIKIA project in Kenya suggests that aggregation may increase significantly after anthelminthic treatment. METHODS: A stochastic, age-structured, individual-based simulation model of parasite transmission is employed to better understand the factors that might induce this pattern. A simple probabilistic model based on compounded negative binomial distributions caused by age-dependencies in both treatment coverage and exposure to infection is also employed to further this understanding. RESULTS: Both approaches confirm helminth aggregation is likely to increase post-mass drug administration as measured by a decrease in the value of the negative binomial aggregation parameter, k. Simple analytical models of distribution compounding describe the observed patterns well. CONCLUSIONS: The helminth aggregation that was observed in the field was replicated with our stochastic individual-based model. Further work is required to generalise the probabilistic model to take account of the respective sensitivities of different diagnostics on the presence or absence of infection.

[Intestinal parasites in schoolchildren, public health problem. Intervention from the National Integrated Health System of Uruguay]. / Enteroparasitosis en escolares, problema de salud pública. Intervención desde el Sistema Nacional Integrado de Salud de Uruguay.

OBJECTIVES: To generate a model of intervention, from the National Integrated Health System (NIHS, Uruguay), with school facilitators of health, web resources and approach from the schools to the community. MATERIALS AND METHODS: Descriptive cross-sectional study of population base using a random sampling, non-clustered, during the months of April and December 2016. This was based in the model of schoolchildren health promoters, the use of web resources and community approach with the school as the centre of actions. RESULTS: The prevalence of parasites was 14% for Giardiasis (6,5 and 22%) (IC95%: 11-17) and 26% for Oxiurosis (IC95%: 22-30) (20 and 44%). Soil transmitted helminthiases were geo-referenced: we found 45 clusters, mainly in slums without basic services. CONCLUSIONS: These worrying results show that there are regions in Montevideo (Uruguay) with high levels of faecal home and environmental contamination. Community approaches with prevention activities from NIHS may have a positive impact on these vulnerable populations.

OBJETIVOS: Generar un modelo de intervención en promoción de salud, desde el Sistema Nacional Integrado de Salud (SNIS) de Uruguay, con promotores escolares de salud, recursos web y abordaje desde los centros educativos a la comunidad. MATERIALES Y MÉTODOS: Estudio descriptivo transversal, de base poblacional, mediante un muestreo aleatorio, no agrupado, durante los meses de abril y diciembre de 2016. Se llevó a cabo una capacitación para escolares en promoción de salud, encuesta poblacional, herramientas web, exámenes parasitológicos y georreferenciación. RESULTADOS: Se observaron prevalencias de giardiasis, del 14% (IC95%: 11-17) (6,5 a 22%); y oxiurosis 26% (IC95: 22-30) (20 a 44%). Se visualizaron 45 conglomerados de geohelmintiasis (HTS), la mayoría en zonas con asentamientos poblacionales carentes de servicios básicos. CONCLUSIONES: La existencia de sectores poblacionales vulnerables con índices de contaminación fecal intradomiciliaria y ambientales hace necesario que el SNIS realice de forma sistemática actividades de promoción de salud que puedan aportar datos relevantes para intervenciones gubernamentales intersectoriales y para mejorar la salud de estos sectores desprotegidos.

Current anthelmintic treatment is not always effective at controlling strongylid infections in German alpaca herds.

BACKGROUND: Endoparasites are considered a major health problem of South American camelids as shown in a recent survey among German and Austrian camelid owners. Although prophylactic and therapeutic measures such as application of anthelmintics are commonly used, treatment efficacy is usually not assessed. Owners have expressed significant concerns regarding the effect of antiparasitic therapy, so this study aimed to evaluate the outcome of anthelmintic treatment in German alpaca herds with different drugs. RESULTS: Overall, 617 samples from 538 clinically healthy alpacas > 1 year-old from 27 farms (n = 11-157 animals/herd) were examined. The most common parasites detected by flotation were Eimeria spp. (75.1%) followed by strongylids (55.0%), Nematodirus spp. (19.3%), cestodes (3.1%) and Trichuris (2.7%). After initial coproscopical examination by flotation and strongylid egg quantification by the McMaster technique, positive animals excreting at least 150 eggs per gram of faeces were included in a faecal egg count reduction test (FECRT) using fenbendazole (n = 71 samples), moxidectin (n = 71) or monepantel (n = 66). Pre-treatment larval cultures (n = 23 positive pooled farm samples) revealed Haemonchus (87% of the farms), Cooperia (43.5%), Trichostrongylus (21.7%), Ostertagia (13.0%), Nematodirus and Oesophagostomum (4.3% each). Fenbendazole treatment reduced egg excretion by 45%, moxidectin by 91% and monepantel by 96%. On the farm level, 13/18 farms that used fenbendazole, 6/6 farms that used moxidectin and 2/5 farms that used monepantel had individual FECR values < 90% (fenbendazole) or < 95% (moxidectin, monepantel). Haemonchus and Cooperia were overrepresented on the farms with reduced treatment efficacy. CONCLUSIONS: Gastrointestinal strongylids are common in German alpacas and fenbendazole in particular was not sufficiently effective to reduce strongylid egg excretion. Although the FECRT could not unambiguously determine anthelmintic resistance in the present study, the finding that small ruminant strongylids, especially Haemonchus, are common in alpacas indicates that determination of effective anthelmintic doses, monitoring of efficacy and adapted (selective) treatment regimens must be implemented as part of sustainable deworming practices in this species in accordance with recommendations for ruminants.

Paleomedicine and the use of plant secondary compounds in the Paleolithic and Early Neolithic.

Reconstructing plant use before domestication is challenging due to a lack of evidence. Yet, on the small number of sites with assemblages, the wide range of different plant species cannot be explained simply in terms of nutrition. Assemblages from the Lower Paleolithic to the Early Neolithic were examined to investigate the relative edible and medicinal properties of the plants. The assemblages contain a mixture of edible species, plants that are both edible and medicinal, and plants with only medicinal properties. The proportion of medicinal plants at all sites is well above the natural average and increases over time. Mechanisms for preventing intestinal parasitic infections are common among animals and together with chimpanzees' preventative and curative self-medication practices suggest an evolutionary context for this behavior. A broad-spectrum approach to plant collection is likely to have been in place throughout the Paleolithic driven, in part, by the need for medicinal compounds.

Potential self-medication using millipede secretions in red-fronted lemurs: combining anointment and ingestion for a joint action against gastrointestinal parasites?

Self-anointing, referring to the behaviour of rubbing a material object or foreign substance over different parts of the body, has been observed in several vertebrate species, including primates. Several functions, such as detoxifying a rich food source, social communication and protection against ectoparasites, have been proposed to explain this behaviour. Here, we report observations of six wild red-fronted lemurs (Eulemur rufifrons) of both sexes and different age classes anointing their perianal-genital areas and tails with chewed millipedes. Several individuals also ingested millipedes after prolonged chewing. In light of the features of the observed interactions with millipedes, and the nature and potential metabolic pathways of the released chemicals, we suggest a potential self-medicative function. Specifically, we propose that anointing combined with the ingestion of millipedes' benzoquinone secretions by red-fronted lemurs may act in a complementary fashion against gastrointestinal parasite infections, and more specifically Oxyuridae nematodes, providing both prophylactic and therapeutic effects.

The use of Lespedeza cuneata for natural control of gastrointestinal nematodes in Merino sheep.

Lespedeza cuneata (poorman's lucerne; sericea lespedeza), a tannin-rich perennial legume, was offered as hay to dry Merino ewes in a confined feeding experiment to evaluate the effect on the level of gastrointestinal parasite infection in sheep. Medicago sativa (a low tannin containing perennial legume) was used as the control treatment. Parameters faecal egg count (FEC), FAMACHA© scores and rectal temperatures were used. FECs were substantially lower (p = 0.05) in the Lespedeza group after 35 days, together with a trend of higher rectal temperatures, compared with the Medicago group. Although non-significant (p > 0.05), the higher rectal temperatures suggested a lower level of anaemia in the sheep on the Lespedeza ration and, therefore, a lower parasite-worm burden. However, FAMACHA

The Role of Child Health Days in the Attainment of Global Deworming Coverage Targets among Preschool-Age Children.

BACKGROUND: Global deworming programs aim to reach 75% of at-risk preschool-age children (pre-SAC) by 2020. The 2013 global pre-SAC deworming coverage initially published by the World Health Organization (WHO) was 23.9%, but this estimate inadequately captured deworming delivered through Child Health Day (CHD) platforms. OBJECTIVE: To update global and regional coverage estimates of pre-SAC deworming in 2013 by supplementing data from the WHO Preventive Chemotherapy and Transmission Control (PCT) databank with national CHD data. METHODS: UNICEF country offices (n = 82) were mailed a questionnaire in July 2014 to report on official national biannual CHD deworming coverage as part of the global vitamin A supplementation coverage reporting mechanism. Coverage data obtained were validated and considered for inclusion in the PCT databank in a collaboration between UNICEF and WHO. Descriptive statistical analyses were conducted to update the number of pre-SAC reached and the number of treatments delivered. RESULTS: Of the 47 countries that responded to the UNICEF pre-SAC deworming questionnaire, 73 data points from 39 countries were considered for inclusion into the WHO PCT databank. Of these, 21 new data points were from 12 countries were newly integrated into the WHO database. With this integration, deworming coverage among pre-SAC increased to 49.1%, representing an increase in the number of children reached and treatments administered from 63.7 million to 130.7 million and 94.7 million to 234.8 million, respectively. The updated databank comprised 98 mass deworming activities conducted in 55 countries, in which 80.4% of the global pre-SAC population requiring deworming reside. In all, 57 countries requiring deworming were not yet represented in the database. CONCLUSIONS: With the inclusion of CHD data, global deworming programs are on track to achieving global pre-SAC coverage targets. However, further efforts are needed to improve pre-SAC coverage reporting as well as to sustain and expand deworming delivery through CHDs and other platforms.

Nivel de conocimiento sobre las medidas de prevención de parasitosis por las madres que acuden al Puesto de Salud “Las Flores”, Santiago de Surco, Lima / Level of knowledge about prevention of parasitic infections in mothers who come to the health post “Las Flores”, Santiago de Surco, Lima

Objetivo: determinar el nivel de conocimiento de las medidas de prevención sobre parasitosis en las madres que acuden al Puesto de Salud “Las Flores” de Santiago de Surco, Lima. Material y Métodos: estudio de tipo descriptivo y transversal que incluyó a 100 madres de familia que reciben atención de manera regular en el Puesto de Salud “Las Flores” del Distrito de Santiago de Surco (Lima-Perú). Se consignó la edad, el lugar de nacimiento, el grado de instrucción, la ocupación y el nivel de conocimiento sobre medidas de prevención de parasitosis de las madres de familia. Resultados: 40% de las madres tuvo un nivel de conocimiento bueno, 38% un nivel de conocimiento regular, 12% un nivel de conocimiento malo y 10% un nivel de conocimiento muy bueno. Ninguna tuvo un nivel de conocimiento muy malo. Conclusión: En la población en estudio, la mitad de las madres de familia presentaron un nivel de conocimiento insuficiente del tema. Existió asociación estadística significativa entre el grado de instrucción y el nivel de conocimiento de las madres de familia.

Objective: determine the level of knowledge of preventive measures for parasitosis in mothers attending the Health Post “Las Flores” Santiago de Surco, Lima. Material and Methods: descriptive and transversal study involving 100 mothers receiving care on a regular basis in the Health Post “Las Flores” District of Santiago de Surco (Lima- Peru). Age, place of birth, level of education, occupation and level of knowledge on prevention of parasitosis of the mothers was recorded. Results: 40 % of mothers had a good level of knowledge, 38 % regular knowledge level , a level of 12 % poor knowledge level and 10 % very good knowledge. None had a very poor level of knowledge. Conclusion: in the study population , half of the mothers had an insufficient level of knowledge on the subject. There was statistically significant association between level of education and the level of knowledge of mothers.

High frequency of leaf swallowing and its relationship to intestinal parasite expulsion in "village" chimpanzees at Bulindi, Uganda.

Self-medication by great apes to control intestinal parasite infections has been documented at sites across Africa. Chimpanzees (Pan troglodytes) swallow the leaves of certain plant species whole, without chewing. Previous studies demonstrated a relationship between chimpanzee leaf swallowing and expulsion of nematode worms (Oesophagostomum sp.) and tapeworms (Bertiella sp.) in dung. We investigated the relationship between leaf swallowing and parasite expulsion in chimpanzees inhabiting a fragmented forest-farm mosaic at Bulindi, Uganda. During 13 months whole undigested leaves occurred in chimpanzee dung at a considerably higher frequency (10.4% of dungs) than at other sites (0.4-4.0%). Leaf swallowing occurred year-round and showed no pronounced seasonality. Chimpanzees egested adults of multiple species of Oesophagostomum (including O. stephanostomum) and proglottids of two tapeworms-Bertiella sp. and probably Raillietina sp. The latter may not be a true infection, but the byproduct of predation on domestic fowl. Compared to previous studies, the co-occurrence of whole leaves and parasites in chimpanzee dung was low. Whereas the presence of leaves in dung increased the probability of adult nematode expulsion, no association between leaf swallowing and the shedding of tapeworm proglottids was apparent. Anthropogenic habitat changes have been linked to alterations in host-parasite interactions. At Bulindi, deforestation for agriculture has increased contact between apes and people. Elevated levels of leaf swallowing could indicate these chimpanzees are especially vulnerable to parasite infections, possibly due to environmental changes and/or increased stress levels arising from a high frequency of contact with humans. Frequent self-medication by chimpanzees in a high-risk environment could be a generalized adaptation to multiple parasite infections that respond differently to the behavior. Future parasitological surveys of apes and humans at Bulindi are needed for chimpanzee health monitoring and management, and to investigate the potential for disease transmission among apes, people, and domestic animals.

Preventive chemotherapy and the fight against neglected tropical diseases.

Preventive chemotherapy is the public health strategy recommended by the WHO against a set of neglected tropical diseases that includes four groups of helminth infections (lymphatic filariasis, onchocerciasis, schistosomiasis and soil-transmitted helminthiasis) and one chlamydial (trachoma) infection. This article presents the characteristics of preventive chemotherapy interventions directed against each disease targeted by this strategy and provides an update on the status of their implementation worldwide.

Diagnostics are central for a truly holistic approach against intestinal parasitic diseases.

This is a perspectives piece on the central role of diagnostics for a truly holistic approach against gastrointestinal (GI) parasitic diseases. This article was motivated by a recent review in the International Journal of Infectious Diseases, where Absar Alum and colleagues (September 2010) reviewed the global burden, key transmission pathways, current tools and strategies, and provided their vision of a holistic approach to control GI protozoan and helminthic infections in humans. We argue that, as the success of multiple rounds of national deworming campaigns are actualized in various parts of the world, diagnostics become vital to achieve successful elimination and to aid pharmacovigilance against emerging pathogen resistance to the limited deworming pharmacopoeia.

The global war against intestinal parasites--should we use a holistic approach?

Intestinal parasite infections have been known to compromise the quality of human life since prehistoric times. Throughout the ages, human civilizations have fought against parasitism, including intestinal parasites. During the second half of the last century, the focus of disease-combating efforts moved to other imminent public health issues, under the notion that the fight against infectious diseases had been won. However, the disease incidence data indicate that these diseases continue to wreak havoc on human productivity across the globe. Lately, chemotherapeutic intervention has been stressed for the control of intestinal parasitic infections. In this paper we evaluate the need for a holistic approach to address this issue and make recommendations for this cause.

Survey of iodine deficiency and intestinal parasitic infections in school-going children: Bie Province, Angola.

OBJECTIVE: To obtain baseline pre-intervention prevalence levels of iodine deficiency and parasitic and helminth infections in school-going children in Bie Province, Angola. DESIGN: A cross-sectional study conducted in randomly selected schools. The target population was children aged 6-10 years. SETTING: Bie Province, Angola. SUBJECTS: A total of 1029 children sampled, with 791 stool samples and 826 urine samples collected from twenty-four schools. RESULTS: Widespread severe and moderate deficiencies in iodine. Children in five schools were severely iodine deficient. All sampled schoolchildren were iodine deficient to a greater or lesser extent. In all, 80 % of all children across the twenty-four schools were infected with one or a combination of intestinal helminths and intestinal protozoa. CONCLUSIONS: These findings have serious implications for the cognitive development of Angolan children, as well as for Angola's development in terms of productivity and economic potential. It is strongly recommended that the provincial and national Ministries of Health, in collaboration with international health agencies, immediately plan and implement a strategy to provide sufficient iodine through iodised oil capsules and iodised salt to the iodine-deficient population. National coalitions need to be strengthened among the government, partners and salt producers. It is also recommended that all the children in schools be de-wormed for multiple helminth species at least twice a year.

Exploiting the effect of dietary supplementation of small ruminants on resilience and resistance against gastrointestinal nematodes.

This paper focuses on targeted nutritional supplementation as a means to reduce the requirement for chemotherapeutic control of gastrointestinal nematode infection of small ruminants and considers the limitations to practical application. Supplementary feeding, particularly with additional dietary protein, can assist resilience to infection during times when metabolic resources are being directed towards dealing with the pathophysiological effects of infection and away from production of meat, milk and fibre. Substantial experimental evidence from studies of both sheep and goats supports this hypothesis particularly in relation to young lambs and kids after weaning and in ewes around parturition. In addition, nutritional supplementation frequently increases resistance to infection, as indicated by decreased faecal worm egg counts and worm burdens. As a result, supplementation has the potential to reduce the requirement for anthelmintic treatment. Practical application of this knowledge can, however, be quite complex in many small ruminant production systems. In general, strategic supplementation should target those times when nutrient requirements are greatest and provide those nutrients which are deficient whether protein, energy, minerals or trace elements. Complexity arises when we consider that nutrient requirements will differ between localities for different species and breed of host, at different stages of growth and reproduction, with differing seasonal availability of forage, with different species of nematodes and different levels of established infections and exposure to infective stages. As a starting point, the provision of nutrients to optimize rumen function and animal performance in the particular production system should assist in maintaining resilience to nematode infection. Provision of nutrients in excess of this requirement, if economically feasible, may yield further benefits in some situations and reduce the need for alternative control measures for gastrointestinal nematode parasites.

Improving resilience against natural gastrointestinal nematode infections in browsing kids during the dry season in tropical Mexico.

The objective was to determine the effect of supplementary feeding on the resilience and resistance of Criollo kids against natural gastrointestinal nematode (GIN) infections, when browsing native vegetation during the dry season in tropical Mexico. Thirty-three two-month-old Criollo kids, raised nematode free, were included at weaning in a 20-week trial. The kids were placed into four groups. Two groups of eight kids were offered 100g/day soybean and sorghum meal (26%:74% respectively fresh basis) (treated/supplemented (T-S) and infected/supplemented (I-S)). Two groups remained with no supplement for the duration of the trial (infected/non-supplemented (I-NS) (n=9) and treated/non-supplemented (T-NS) (n=8)). Kids in groups T-S and T-NS were drenched with 0.2mg of moxidectin/kg body weight orally (Cydectin, Fort Dodge) every 28 days. Groups I-S and I-NS were naturally infected with GIN. The animals browsed native vegetation for an average of 7h/day together with a herd of 120 naturally infected adult goats. Cumulative live weight gain (CLWG), packed cell volume (PCV), haemoglobin (Hb), total plasma protein and plasma albumin were recorded every 14 days as measurements of resilience. Resistance parameters (faecal egg counts (FEC) and peripheral eosinophil counts (PEC)) were also measured. Bulk faecal cultures were made for each group every 28 days. Every month a new pair of initially worm-free tracer kids assessed the infectivity of the vegetation browsed by the animals. Tracer kids and faecal cultures showed that kids faced low mixed infections (Haemonchus contortus, Trichostrongylus colubriformis and Oesophagostomum columbianum). Under conditions of scarce vegetation, such as those in the present study, supplemented groups (I-S and T-S) had higher growth rates compared to the non-supplemented groups independently of the control of GIN infection with anthelmintic (AH) treatment (P<0.001). Supplementary feeding did not affect FEC or PEC. In the absence of supplementation, lack of AH treatment may lead to outbreaks of clinical nematodosis. The supplementary feeding was economically feasible.

Modulation of jejunal contractions by extract of Carica papaya L. seeds.

Carica papaya L. (papaya) seed preparations are used in traditional medicine to expel intestinal worms in human and ruminants. In the present study, an ethanol extract of papaya seeds (EEPS; 0.1-6.4 mg/mL) caused concentration-dependent inhibition of jejunal contractions in contrast to corresponding concentrations of DMSO (solvent control). The inhibitory effect of EEPS on jejunal contractions was significantly irreversible. Previous studies have indicated that benzyl isothiocyanate (BITC) is the main bioactive compound responsible for the anthelmintic activity of papaya seeds. In the present study, standard BITC (0.01-0.64 mmol/L) also caused significant irreversible inhibition of jejunal contractions. Recovery of jejunal contractions after BITC-induced inhibition was weaker than recovery after EEPS-induced inhibition (BITC versus EEPS: 19 +/- 7% vs 38 +/- 13%). Cryosections of the jejunum showed marked morphological damage of the segments treated with BITC in contrast to DMSO-treated segments. EEPS-induced jejunal damage was, however, less marked. These results indicate that papaya seed extract and BITC, its principal bioactive constituent are capable of weakening the contractile capability of rabbit isolated jejunum. It is thus envisaged that at the toxic level that will be needed to kill and expel intestinal worms in vivo, BITC may also cause impairment of intestinal functions.

Impact of glutamine and Oasis hatchling supplement on growth performance, small intestinal morphology, and immune response of broilers vaccinated and challenged with Eimeria maxima.

Seven hundred and twenty hatchling broilers were allotted to 12 treatment groups. Groups 1 and 2 were fasted for 48 h posthatch; groups 3 and 4 were fasted for 48 h followed by ad libitum access to a 1% glutamine (Gln) diet; groups 5 and 6 had ad libitum access to a common diet; groups 7 and 8 had access to a 1% Gln diet posthatch; groups 9 and 10 were fed regular Oasis hatchling supplement; and groups 11 and 12 were fed Oasis sprayed with 1% Gln for the first 48 h posthatch. The birds in treatment groups 2, 4, 6, 8, 10, 11, and 12 were vaccinated with Eimeria maxima posthatch, and all birds were orally challenged with high dose E. maxima on d 22. During the first 2 wk, birds in group 7 had the highest gain and feed efficiency among treatments (P < 0.01). Compared with birds in the nonGln groups, birds in the Gln group had higher gain, feed efficiency, and livability (P < 0.05). Among the Fast (groups 1 to 4), Feed (groups 5 to 8), and Oasis (groups 9 to 12) groups, birds in the Feed groups had the highest gain during d 0 to 21 (P < 0.01). During d 22 to 28, birds in the Fast groups had the lowest BW and livability (P < 0.01), and the nonvaccinated birds had lower gain and feed efficiency relative to vaccinated birds (P < 0.01). Birds in the Feed and Oasis groups had higher villus height (VH) of mid small intestine than Fast groups at d 2 and 7 (P < 0.05), and nonvaccinated birds had higher VH than vaccinated birds (P < 0.01) at d 7 after hatch. On d 14, there were differences in serum interferon-gamma (P < 0.05) levels among treatments. During d 22 to 28, vaccinated birds had lower lesion scores in the mid small intestine than nonvaccinated birds (P < 0.01), and birds in the Feed or Oasis groups had lower lesion scores compared with the Fast groups (P < 0.02). These results indicated the importance of immediate access to feed posthatch, the beneficial effects of feeding Oasis hatching supplement and Gln after hatch, as well as the necessity of the vaccination program against coccidiosis challenge.

Gastrointestinal nematode infection in sheep--a review of the alternatives to anthelmintics in parasite control.

Efforts to curb production losses caused by nematode parasitism in sheep have led to the development of a number of control methods to complement or replace anthelmintics. The need for alternative control measures stems from the emergence of anthelmintic-resistant parasitic nematodes with reports of multi-class resistance to these drugs now emerging. A number of these control methods such as predacious microfungi, protein supplementation, plant extracts in feed and vaccines have demonstrated potential to control infection but require development and examination under natural conditions. Breeding for natural resistance to nematode infection has already shown success in controlling the disease under natural conditions. Selection for resistance is currently based on fecal egg count measurements but identification of genetic indicators of resistance will provide a more efficient method of selection. Current quantitative trait loci for nematode resistance include the MHC genes, interferon gamma gene, IgE gene and microsatellites on chromosome 1, 5 and 6. This paper reviews the current alternatives to anthelmintics to control infection, with an emphasis on breeding for host resistance and identification of genetic indicators of resistance.

Common intestinal parasites.

Intestinal parasites cause significant morbidity and mortality. Diseases caused by Enterobius vermicularis, Giardia lamblia, Ancylostoma duodenale, Necator americanus, and Entamoeba histolytica occur in the United States. E. vermicularis, or pinworm, causes irritation and sleep disturbances. Diagnosis can be made using the "cellophane tape test." Treatment includes mebendazole and household sanitation. Giardia causes nausea, vomiting, malabsorption, diarrhea, and weight loss. Stool ova and parasite studies are diagnostic. Treatment includes metronidazole. Sewage treatment, proper handwashing, and consumption of bottled water can be preventive. A. duodenale and N. americanus are hookworms that cause blood loss, anemia, pica, and wasting. Finding eggs in the feces is diagnostic. Treatments include albendazole, mebendazole, pyrantel pamoate, iron supplementation, and blood transfusion. Preventive measures include wearing shoes and treating sewage. E. histolytica can cause intestinal ulcerations, bloody diarrhea, weight loss, fever, gastrointestinal obstruction, and peritonitis. Amebas can cause abscesses in the liver that may rupture into the pleural space, peritoneum, or pericardium. Stool and serologic assays, biopsy, barium studies, and liver imaging have diagnostic merit. Therapy includes luminal and tissue amebicides to attack both life-cycle stages. Metronidazole, chloroquine, and aspiration are treatments for liver abscess. Careful sanitation and use of peeled foods and bottled water are preventive.