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2.
West Indian med. j ; 47(2): 72, Jun. 1998.
Artigo em Inglês | MedCarib | ID: med-1797

RESUMO

We report the case of a 48 year old man presented with a 4 month history of vomiting and weight loss. Barium studies and upper gastrointestinal endoscopy demonstrated anteriomesenteric duodenal occlusion. We discuss the possible aetiology and significance of his investigation findings and subsequent management.(AU)


Assuntos
Adulto , Relatos de Casos , Humanos , Masculino , Síndrome da Artéria Mesentérica Superior/terapia , Síndrome da Artéria Mesentérica Superior/diagnóstico , Estrongiloidíase/complicações , Tiabendazol/uso terapêutico , Trinidad e Tobago
4.
Am J Trop Med Hyg ; 55(5): 474-6, Nov. 1996.
Artigo em Inglês | MedCarib | ID: med-2385

RESUMO

The enzyme-linked immunosorbant assay was used to investigate long term changes in serum immunoglobulin G1 (IgG1), IgG4, IgE, and IgA against Strongyloides stercoralis phosphate-buffered saline-soluble filariform larval antigens in eight Jamaican patients treated with ivermectin. Patients were followed for periods of between 170 and 542 days. Based on repeated formalin-ether concentration and agar plate culture, all patients were found to be uninfected up to 18 months following chemotherapy. Generally, all antibody isotype levels decreased following treatment, although there was considerable heterogeneity among patients. In a single patient with hyperinfection, the decrease in IgG4 was marginal and may represent a treatment failure. Reduction in serum antibody isotype responses to S. stercoralis following treatment may be used to assess the effectiveness of ivermectin in treating endemic strongyloides (AU)


Assuntos
21003 , Humanos , Anti-Helmínticos/uso terapêutico , Anticorpos Anti-Helmínticos/análise , Ivermectina/uso terapêutico , Strongyloides stercoralis/efeitos dos fármacos , Strongyloides stercoralis/imunologia , Estrongiloidíase/tratamento farmacológico , Estrongiloidíase/epidemiologia , Estrongiloidíase/imunologia , Imunoglobulina A/análise , Imunoglobulina E/análise , Imunoglobulina G/análise , Fatores de Tempo
5.
West Indian med. j ; 44(Suppl. 3): 10-1, Nov. 1995.
Artigo em Inglês | MedCarib | ID: med-5086

RESUMO

Infections with Strongyloides stercoralis are often refractory to thiabendazole therapy in certain patients. Ivermectin is being used increasingly for treatment of uncomplicated infections; however, possible immunopathological changes associated with drug-induced release of antigens as observed with use of the drug in filariasis has not been studied in strongyloidiasis. In this study we used the enzyme linked immunosorbant assay (ELISA) technique to examine the profiles of S. stercoralis-specific IgG4, IgE and IgA against saline soluble filariform extracts in 8 patients treated for the parasite. All patients were found to be negative for the parasite by stool examination following treatment. Isotype levels fell in concert following treatment although there was considerable heterogeneity among patients. Levels remained low following treatment response but were still measurable for up to eighteen months post-treatment. There appeared to be no rapid release of parasite antigens following treatment. One patient exhibited a transient increase in levels of IgA after which there was a decline in this and all other isotypes. The single patient with proven chronic infection and a history of gastrointestinal symptoms exhibited almost ablated IgG1, IgE and IgA responses prior to treatment but had a significant IgG4 response which remained high following treatment. The reduction in antibody levels post-treatment may be used as confirmation of parasitological cure. The study showed that there was no rapid release of S. stercoralis antigens as seen in filarial infections and that Ivermectin is safe and effective against the parasite (AU)


Assuntos
Humanos , Strongyloides stercoralis/efeitos dos fármacos , Ivermectina/uso terapêutico , Estrongiloidíase/tratamento farmacológico , Ensaio de Imunoadsorção Enzimática/estatística & dados numéricos
6.
Parasitology ; 110(Pt. 1): 97-102, Jan. 1995.
Artigo em Inglês | MedCarib | ID: med-2097

RESUMO

The epidemiology of Strongyloides stercoralis was studied in families of clinical (reference) cases and their neighbours at endemic foci in Jamaica. Thirteen foci were studied based on the place of residence of a reference case. For each household of a reference case, the 4 most proximal neighbourhood households (spatial controls) were included in the study. Out of 312 persons contacted 244 were followed up using questionaires, stool examimation and serology. Prevalence of infection based on based on stool examination was 3.5 percent and on ELISA 24.2 percent. Prevalence increased with age but was not related to gender. Reference cases were significantly older than the general study population. The prevalence of infection based on both serology and stool examination was significantly higher in referecne than in neighbouring households (the reference cases, themselves, were not included in the analysis). Furthermore, prevalence of infection was highest among persons who shared a bedroom with a reference case and decreased significantly with increasing spatial separation. This is indicative of close contact transmission which has not been previously shown for a geohelminth, but which is common among microparasites.(AU)


Assuntos
Adolescente , Adulto , Criança , Pré-Escolar , Lactente , Pessoa de Meia-Idade , Habitação , Strongyloides stercoralis/isolamento & purificação , Estrongiloidíase/epidemiologia , Distribuição por Idade , Análise por Conglomerados , Ensaio de Imunoadsorção Enzimática , Jamaica/epidemiologia , Prevalência , Distribuição por Sexo , Estatística , Estrongiloidíase/diagnóstico
8.
Exp Parasitol ; 79(2): 99-105, Sept. 1994.
Artigo em Inglês | MedCarib | ID: med-2119

RESUMO

Forty-one-, 31-, and 28-kDa proteins of strongyloides stercoralis filariform larvae have previously been demonstrated to be sensitively and specifically recognized by serum IgG in individuals with strongyloidiasis. Characteristics of these proteins, their immunodominant epitopes, and reactive antibodies are described here. The proteins are soluble is aqueous as well as detergent extracts. The immunodominant epitopes are present in S. stercoralis but not in S. cebus or S. ratti. Epitopes on the three proteins are not shared, as determined by cross-absorption of serum with each of the size components on nitrocellulose. In most sera from strongyloidiasis patients there was reactivity to each of the proteins by IgG1 and IgG4, but reactivity by IgG2 or IgG3 was detectable only in a minority. A rabbit antiserum raised to a 41-kDa size fraction of S. stercoralis larvae reacted against a doublet of 41-kDa which was distinct from the immunodiagnostic 41-kDa protein.(AU)


Assuntos
Anticorpos Anti-Helmínticos/biossíntese , Anticorpos Anti-Helmínticos/diagnóstico , Epitopos Imunodominantes/análise , Strongyloides stercoralis/imunologia , Estrongiloidíase/diagnóstico , Anticorpos Anti-Helmínticos/sangue , Anticorpos Anti-Helmínticos/imunologia , Western Blotting , Eletroforese em Gel de Poliacrilamida , Imunoglobulina G/biossíntese , Imunoglobulina G/sangue , Soros Imunes/imunologia , Epitopos Imunodominantes/química , Epitopos Imunodominantes/imunologia , Larva/imunologia , Peso Molecular , Onchocerca/imunologia , Coelhos , Solubilidade , Especificidade da Espécie , Strongyloides ratti/imunologia , Estrongiloidíase/imunologia
9.
Am J Trop Med Hyg ; 51(2): 175-9, Aug. 1994.
Artigo em Inglês | MedCarib | ID: med-2098

RESUMO

Recently described enzyme-linked immunosorbent assay (ELISA) and immunoblot methods for the detection of serum IgG against Strongyloides stercoralis larval antigens were prospectively evaluated for the diagnosis of endemic strongyloidiasis. A modification of the ELISA involved preincubation of sera with Onchocerca gutturosa phosphate-buffered saline-soluble extract to remove cross-reactivity with other helminths. The sensitivity of the ELISA increased from 80 percent and 85 percent following preincubation. Similarly, there was an increase in specifity from 94 percent to 97 percent. The IgG recognition of 41-, 31-, and 28-kD filariform larval components showed sensitivities of 100 percent, 85 percent and 65 percent, respectively. Both the ELISA following incubation of sera with O. gutturosa extract and serum IgG reactivity to a 41-kD larval component using immunoblotting are sensitive and specific techniques for diagnosing endemic strongyloidiasis.(AU)


Assuntos
Anticorpos Anti-Helmínticos/sangue , Ensaio de Imunoadsorção Enzimática , Immunoblotting , Strongyloides stercoralis/imunologia , Estrongiloidíase/diagnóstico , Antígenos de Helmintos/imunologia , Reações Cruzadas , Estudos de Avaliação , Reações Falso-Positivas , Fezes/parasitologia , Imunoglobulina G/sangue , Larva/imunologia , Onchocerca/imunologia , Estudos Prospectivos , Sensibilidade e Especificidade
10.
West Indian med. j ; 43(suppl.1): 20, Apr. 1994.
Artigo em Inglês | MedCarib | ID: med-5421

RESUMO

Strongyloides sterocalis infections were examined in families of clinical cases and also in those of their most proximal neighbours. Thirteen clinical cases in Kingston, Jamaica led to the identification of thirteen endemic foci. In addition to the clinical cases, 299 persons were contacted using questionnaires, stool examination and serology. Two hundred and thirty-one persons were fully compliant. The stool prevalence of S.sterocalis was 3.5 percent, while that based on ELISA was 24.2 percent (not including the 13 clinical cases). Both estimates of infection prevalence were significantly higher in the households of the clinical cases compared with the neighbours. The clinical cases were significantly older than the general study population. Furthermore, prevalence was highest among persons who shared a bedroom with a clinical case and decreased with spatial separation. These data strongly suggest that human strongyloides is a close-contact infection. This is likely to be facilitated by the direct phase of the parasite's life cycle and has significant implications for control of infections in endemic areas (AU)_


Assuntos
Humanos , Strongyloides stercoralis , Estrongiloidíase/transmissão , Jamaica
11.
J Infect Dis ; 169(3): 692-6, Mar. 1994.
Artigo em Inglês | MedCarib | ID: med-8124

RESUMO

Epidemilogic investigations of Strongyloides stercoralis and human T lymphotropic virus type I (HTLV-I) infections were conducted. Of 312 persons contacted, 209 (67 percent) provided blood and stool samples. Prevalences of S. stercoralis and HTLV-I antibodies were 26.8 percent and 8.1 percent (n = 198), respectively, and S. stercoralis larvae were detected in 4 percent. HTLV-I antibodies were significantly more common in persons positive for S. stercoralis larvae (10 [58.8 percent] of 17) compared with seropositive larvae-negative (4 [8.9 percent] of 45) or seronegative persons (9 [6.2 percent] of145) (P< .002). IgE levels increased with age in S. stercoralis-seropositive persons who were HTLV-I negative (P, .))2). However, there was an age-related depression of serum IgE in HTLV-I-positive persons (P < .003) that was sufficient to annul the IgE level-raising effect of S stercoralis seropositivity. The data provide evidence that HTLV-I infection is associated with increased frequency of larvae in the stool of S. stercoralis-infected persons and suggest that the mechanism may involve suppression of the IgE response (AU)


Assuntos
Humanos , 21003 , Masculino , Feminino , Infecções por HTLV-I/epidemiologia , Strongyloides , Estrongiloidíase/epidemiologia , Infecções por HTLV-I/complicações , Infecções por HTLV-I/imunologia , Jamaica/epidemiologia , Prevalência , Estrongiloidíase/complicações , Estrongiloidíase/imunologia
12.
J Infect Dis ; 168(3): 784-7, Sept. 1993.
Artigo em Inglês | MedCarib | ID: med-2120

RESUMO

Proteins from a deoxycholate-soluble extract of Strongyloides stercoralis infective larvae were separated by SDS-PAGE, blotting onto nitrocellulose paper, and reacted with sera from individuals with confirmed S. stercoralis infections (n = 100), suspectedS. stercoralis infections in whom no larvae could be detected (n = 27), and other nematode infections (40 with Wuchereria bancrofti, 20 with Onchocerca volvulus, 20 with Necator americanus, and 20 with mixed Ascaris lumbricoides and Trichuris trichiura infections). Immunodominant proteins of approximately 41, 31, and 28 kDa were recongnized by IgG in 91 percent, 88 percent and 90 percent respectively, of sera from those with confirmed strongyloidiasis; in 100 percent, 100 percent, and 93 percent of sera from those with suspected strongyloidiasis; and in 9 percent, 12 percent and 14 percent of sera from those infected with other nematodes. IgG reactivity to each of these proteins was a more specific means of immunodiagnosis than the currently use indirect ELISA; the methods were equally sensitive.(AU)


Assuntos
Anticorpos Anti-Helmínticos/sangue , Antígenos de Helmintos/imunologia , Imunoglobulina G/sangue , Strongyloides stercoralis/imunologia , Estrongiloidíase/diagnóstico , Western Blotting , Reações Cruzadas , Ensaio de Imunoadsorção Enzimática , Larva/imunologia , Sensibilidade e Especificidade
13.
West Indian med. j ; 42(Suppl. 1): 50, Apr. 1993.
Artigo em Inglês | MedCarib | ID: med-5107

RESUMO

Strongyloides stercoralis is the most serious intestinal nematode infecting humans in the Caribbean. The parasite is, however, difficult to diagnose using standard laboratory techniques, especially in sub-clinical cases. An ELISA, using PBS extracts of filariform larvae as antigen, and a Western Blot method were evaluated in the Jamaican community. Sensitivity and specificity of the ELISA were 73 per cent and 93 per cent (n=135) respectively. Pre-incubation of sera with Onchocerca gutterosa (Filariata) antigen increased sensitivity and specificity of the ELISA to 82 per cent and 97 per cent, respectively. Similarly, The Western Blot which was based on IgG recognition of proteins of 41kD and one of 31kD or 28kD detected 82 per cent of infected individuals and 97 per cent of true negatives. There was no notable cross-reactivity by either ELISA or Western Blot with Ascaris, Trichuris or hookworm, also common to the Region. ELISA proved to be a sensitive and specific test for diagnosing S. stercoralis infection in Jamaica. Western Blotting had no significant merits over those of ELISA although it confirmed the presence of 3 immunodominant bands which may play a role in future immunodiagnosis. Furthermore, it adds to the battery of sensitive serological tests available to clinicians who have to decide on the infection status of potential S. stercoralis patients who are about to receive immuno-suppressive therapy (AU)


Assuntos
Humanos , Estrongiloidíase/diagnóstico , Ensaio de Imunoadsorção Enzimática , Western Blotting
14.
West Indian med. j ; 42(Suppl. 1): 32, Apr. 1993.
Artigo em Inglês | MedCarib | ID: med-5141

RESUMO

Epidemiological associations of Strongyloides stercoralis and Human T-Lymphotropic Virus Type-1 (HTLV-1) were investigated at eleven (11) foci endemic for strongyloidiasis in Jamaica. Each focus was identified on the basis of residency of a parasitologically-proved case of strongyloidiasis who presented at the University Hospital. Three hundred and twelve (312) persons were contacted, and blood and stool samples were collected for HTLV-1 and S. stercoralis serology and S. stercoralis coproculture, respectively. Overall compliance was 66.6 per cent. The prevalence of S. stercoralis in the pooled foci was 8.2 per cent including and 4.0 per cent excluding the hospital presenters, and for HTLV-1 it was 11.1 per cent and 8.1 per cent. Seroprevalence of S. stercoralis infection was 30 per cent and 26.8 per cent with and without the clinical cases, respectively. The prevalence of each infection was correlated with the age of the host (Spearman Rank Correlation, p<0.001). HTLV-1 was clustered in S. stercoralis larval shedders (58.8 per cent, n=17) compared with non-shedders (8.9 per cent, n=45) (Fisher's exact test, p<0.001), but particularly so among clinical cases 7 of whom (n=9) had HTLV-1 antibodies. The association was explained on the basis of age-related total serum IgE levels in HTLV-1/S. stercoralis infection cases. Individuals uninfected by S. stercoralis displayed a tendency for decreased IgE levels with age. This especially so in HTLV-1 carriers (ANCOVA: age * HTLV-1 interaction term t = 3.176, p<0.002). In marked contrast, S. stercoralis seropositive individuals had significantly elevated IgE titres in older persons compared with seronegative controls (ANCOVA: age * S. stercoralis interaction term t = 3.733, p<0.001). In persons seropositive for both HTLV-1 and S. stercoralis, however, the elevation of IgE levels previously observed in S. stercoralis positive individuals was completely subsumed by the negative influence of HTLV-1. It is suggested that impairment of host immunity by HTLV-1, and/or S. stercoralis in the presence of HTLV-1, exacerbates strongyloidiasis resulting in increased frequency of both larval shedding and parasite disease. Effect of S. stercoralis (S) and HTLV-1 (H) infection status on the host age/serum IgE association. This figure is designed to illustrate general trends; ungrouped data were used in statistical analyses (AU)


Assuntos
Humanos , Infecções por HTLV-I/complicações , Estrongiloidíase/complicações , Jamaica , Fatores Etários
15.
West Indian med. j ; 39(4): 213-17, Dec. 1990.
Artigo em Inglês | MedCarib | ID: med-14269

RESUMO

In vitro bioassay of (a) aqueous methanol extracts (AME) of the green leaves of mimosa (Mimosa pudica), love weed (Cuscuta americana), vervine (Stachytarpheta jamaicensis), chicken weed (Salvia serotina) and breadfruit (Artocarpus altilis); (b) methanol-water fraction (MWF) of breadfruit leaves, and (c) commercially available drugs albendazole, thiabendazole and levamisole were assayed for nematode inactivating potential, using filariform larvae of Strongyloides stercoralis. Test larvae were obtained from a 10-day-old charcoal coproculture. Bioassays were conducted in Locke's solution, using 100 larvae in each of three replicates. Inactivation was recorded microscopically at 1, 2, 6 and 12 hours, then every 24 hours up to 5 days' incubation. It(50) (time for inactivation of 50 percent of larvae) values read: levamisole and mimosa extract < 1 hour; love weed extract, approximately 2 hours; breadfruit (MWF), 9.5 hours; chicken weed, 20 hours; albendazole, 35 hours; breadfruit (AME), 49 hours; thiabendazole, 74 hours and vervine extract, 81.5 hours. It(95) values followed a similar trend, and were approximately double the It(50) measures. A potential role for locally available natural products in the treatment of strongyloidiasis is highlighted (AU)


Assuntos
Humanos , 21003 , Plantas Medicinais , Strongyloides/efeitos dos fármacos , Anti-Helmínticos , Strongyloides/efeitos dos fármacos , Extratos Vegetais , Estrongiloidíase/tratamento farmacológico , Larva/efeitos dos fármacos , Jamaica , Bioensaio , Fezes/parasitologia
16.
West Indian med. j ; 39(suppl. 1): 35-6, April 1990.
Artigo em Inglês | MedCarib | ID: med-5284

RESUMO

In Japan, a positive association exists between the presence of serum antibodies to HTLV-1 and S. stercoralis. Also, it has been shown in Jamaica that coincidental HTLV-I infection may influence the outcome of treatment of S. stercoralis, or even underlie development of severe strongyloidiasis in some persons. However, the relationship between HTLV-I and S. stercoralis remains unclear. This paper highlights a hitherto unreported association between the occurrence of serum antibodies to HTLV-I, to S. stercoralis, and total serum IgE and strongyloidiasis in a Jamaican community. Blood and stool samples were collected from 67 persons from 6 geographical locations in Kingston. Sera were analysed for antibodies to S. stercoralis and HTLV-I, while stool samples were subjected to charcoal coproculture. As in Japan, individuals serologically positive for S. stercoralis tended to be infected more often with HTLV-I (33 per cent) than seronegative individuals (15 per cent), but the difference was not significant (two-tailed Fisher's exact test; P = 0.15). However, parasitologically-proved strongyloidiasis and HTLV-I seroconversion were strongly associated; while occurrence of HTLV-I was 67 per cent in individuals whose stool contained S. stercoralis larvae, it was only 15 per cent in their parasitologically negative counterparts (two-tailed Fisher's exact test; P = 0.01). Analyses strongly suggest that serological status for S. stercoralis HTLV-I affect IgE titres interaction term, F = 3.54; P = 0.06). IgE titres were lower in HTLV-I seropositive than seronegative individuals in both groups with and without S. stercoralis antibodies (HTLV-I main effect, F = 11.13; P = 0.002), but more strongly so in the former group (Table). S. stercoralis infection appeared to elevate reagin levels in some individuals in the HTLV-I negative group (n=13) (one-way ANOVA, F = 2.09; P - 0.15). In contrast, however, serum IgE titres were depressed in the group (n-5) with HTLV-I and concomitant S. stercoralis infection to levels perhaps even lower than those seen in HTLV-I individuals who did not have S. stercoralis (one-way ANOVA, F = 2.39; p = 0.15). Thus, it appears that HTLV-I and S. stercoralis operate synergistically to effect a significant reduction in IgE serum antibodies in infected individuals. If expressed at the level of the intestinal mucosa, this may permit increased rates of autoinfection of the parasite and result in correspondingly greater worm loads and patient morbidity. Lower levels of IgE antibodies against S. stercoralis are known to be associated with disseminated disease (AU)


Assuntos
Humanos , Estrongiloidíase/imunologia , Infecções por HTLV-I/complicações , Infecções por HTLV-I/imunologia , Jamaica , Anticorpos Anti-HTLV-I
17.
Am J Hum Biol ; 2: 429-38, 1990.
Artigo em Inglês | MedCarib | ID: med-15701

RESUMO

Human T-cell lymphotropic virus type I (HTLV-I), the first human retrovirus to be isolated, is the cause of endemic tropical spastic paraparesis (TSP). Originally, this chronic neurological disorder was described as a disease seen among blacks of low socioeconomic status living in tropical countries, and thus for many decades TSP remained a little known curiousty outside the endemic regions. The link between HTLV-I infection and TSP was made fortuitously, when antibodies to HTLV-I were found in serum and cerebrospinal fluid of TSP patients in Jamaica, Colombia, and Martinique. Soon thereafter a similar disorder, designated HTLV-I associated myelopathy (HAM), was reported from southern Japan. This broadened the geographic and ethnic boundaries of this chronic myelopathy and the disease has now been reported in multiple ethnic groups from more than 40 countries, in both tropical and temperate regions. The name TSP/HAM is now used to include all patients (regardless of race or country of origin) who have HTLV-I-positive endemic TSP or HAM. (AU)


Assuntos
Humanos , Infecções por HTLV-I/etiologia , Paraparesia Espástica Tropical/etiologia , Vírus Linfotrópico T Tipo 1 Humano/patogenicidade , Clima Tropical , Jamaica , Infecções por HTLV-I/complicações , Infecções por HTLV-I/epidemiologia , Paraparesia Espástica Tropical/complicações , Paraparesia Espástica Tropical/epidemiologia , Japão , Estrongiloidíase/complicações
18.
West Indian med. j ; 38(Suppl. 1): 36, April 1989.
Artigo em Inglês | MedCarib | ID: med-5680

RESUMO

It is uncertain whether HTLV-I infection and Strongyloidiasis are related other than by chance. A consecutive series of Jamaican patients and controls have been analysed retrospectively for anti-Strongyloides and HTLV-1 antibodies to determine whether either influences the outcome of anti-helminthic therapy. Twenty-seven Jamaicans (16 M, 11F) mean age 50.2 years (range 16-85), who were found to have Strongyloides stercoralis infection were studied at the University Hospital of the West Indies. At the same time, a parasite-negative group of 13 patients (6M, 7F) of mean age 37.6 years, (range 23-53), with minor or no gastrointestinal disease served as controls. Pretreatment blood samples were taken from the Strongyloides group and controls. Serum was subsequently tested for IgG antibodies to filariform Strongyloides stercoralis larval antigens by ELISA and to HTLV-1 by ELISA and Western Blot. Outcome of the treatment of Strongyloidiasis with thiabendazole (25 -mg/kg b.d. orally for 10 days was determined at 2 months. Strongyloides reciprocal antibody titre was considerably higher in patients than controls, mean 870 vs 167; median 1,024 vs 8 (p<0.001). The sensitivity of the antibody test was 93 percent, but the specificity was 69 percent at best. There was no correlation with the anti-Strongyloides antibody titre and outcome with anti-helminthic therapy. HTLV-1 antibodies were found only in the Strongyloides patients, 12 of 27 (44 percent); antibody titres were high and positive with both test used: only one patient was known beforehand to have a disease associated with HTLV-1 infection. Of those 12 with HTLV-1 antibodies, 3 (25 percent) were cured, 7 still had the infection at 2 months, a further 2 had died or defaulted from follow-up. Of the 15 patients without HTLV-1 antibodies, 9 (60 percent) were cured, 3 still had the infection and 3 had died or defaulted. By chi-square analysis, the difference is significant whether one includes all the deaths and defaulters on an intention-to-treat basis or just those who were available at 2 months post-therapy. However, since none of the deaths were related to Stongyloidiasis or HTLV-1 injection, it is probably justifiable to exclude the deaths from the computation. These results show that the association of Strongyloidiasis and HTLV-1 is more than chance clustering. Not only is the prevalence of HTLV-1 antibodies far higher in the patients with Strongyloidiasis than in the normal Jamaican population, but that concurrent asymptomatic HTLV-1 infection interferes with anti-helminthic treatment (AU)


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Idoso , Infecções por HTLV-I/complicações , Estrongiloidíase/complicações , Estrongiloidíase/tratamento farmacológico , Ensaio de Imunoadsorção Enzimática , Tiabendazol/administração & dosagem
19.
West Indian med. j ; 38(Suppl. 1): 28, April 1989.
Artigo em Inglês | MedCarib | ID: med-5693

RESUMO

The distribution of enteric parasites in the population is governed by a number of factors which may be both intrinsic and extrinsic in nature. While over-dispersion of intestinal helminths among indiciduals in the host population has recently attracted much interest, the spatial distribution of cases in the community has received comparatively little attention. The object of this study was to investigate the spatial distribution of cases of strongyloidiasis at Jamaican endemic foci, and to seek correlations between the presence of infection and socio-economic demographic and biomedical critieria. The home environments of 24 clinical cases of S. stercoralis infection were visited, and all the inhabitants requested to submit two consecutive stool samples for parasitological analyses. Duplicate, standard formol-ether concentration and Harada and Mori coproculture was used. Information on socio-economic isolation controls for the reference households (n=15) as well as the eleven control units (n=51). There were analysed for anti S. sterocoralis filariform IgG, using ELISA. The survey revealed at least one (and as many as three), additional case of strongyloidiasis in seven (19 percent) of the reference household; there were four instances of common infection among spouses, and an additional four among genectically related individuals in the same household. There was no parasitological evidence of infection among the inhabitants of the control units. However, serological investigations indicated no significant differences (Fisher's Exact Test) in the apparent level of exposure of individuals inhabiting the four reference households (25 percent) (index case excluded) and those occupying the control units (22 percent). Preliminary observations suggest a decline in the apparent level of exposure in the control households with increasing ambulatory distance from the reference dwelling. Presence of infection was not correlated with socio-economic index or host gender. Examination of the horizontal age-prevalence plot indicates no significant differences in infection prevalence between adults and children; the high levels of infection among the lower age groups is probably a function of the sensitvie diagnostic procedures utilized in this study. Current S. stercoralis infection appears to be familially distributed in the host community; identification of a single case of strongyloidiasis is likely to indicate the presence of a cluster of infected subclinical individuals at the same locus. Serological analyses suggest a high level of exposure to S. stercoralis in the host community, and sheds further light on the transmission of this potentially lethal parasitic infection (AU)


Assuntos
Humanos , Estrongiloidíase/epidemiologia , Jamaica/epidemiologia , Fatores Socioeconômicos , Parasitos
20.
J Trop Med Hyg ; 92(1): 41-5, Feb. 1989.
Artigo em Inglês | MedCarib | ID: med-3002

RESUMO

Arteriomesenteric occlusion of the distal duodenum may occur in clinical conditions which result in narrowing of the angle between the aorta and superior mesenteric artery. Two patients with arteriomesenteric duodenal occlusion associated with Strongyloides stercoralis infection are described. In one patient the mechanism of occlusion appeared to be significant weight loss and associated visceroptosis, while in the other patient increased diameter of superior mesenteric vessels was the major factor. Strongyloidiasis, a curable parasitic infection, should be considered in patients presenting with arteriomesenteric occlusion of the distal duodenum. (AU)


Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Feminino , Obstrução Duodenal , Oclusão Vascular Mesentérica , Estrongiloidíase/complicações , Strongyloides stercoralis , Perda de Peso , Obstrução Duodenal
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