Effect of Helicobacter pylori and Helminth Coinfection on the Immune Response to Mycobacterium tuberculosis.

Tuberculosis remains one of the main causes of morbidity and mortality worldwide despite decades of efforts to eradicate the disease. Although the immune response controls the infection in most infected individuals (90%), the ability of the bacterium to persist throughout the host's life leads to a risk of reactivation. Underlying conditions including human immunodeficiency virus (HIV) infection, organ transplantation, and immunosuppressive therapies are considered risk factors for progression to active disease. However, many individuals infected with Mycobacterium tuberculosis may develop clinical disease in the absence of underlying immunosuppression. It is also possible that unknown conditions may drive the progression to disease. The human microbiota can be an important modulator of the immune system; it can not only trigger inflammatory disorders, but also drive the response to other infectious diseases. In developing countries, chronic mucosal infections with Helicobacter pylori and helminths may be particularly important, as these infections frequently coexist throughout the host's life. However, little is known about the interactions of these pathogens with the immune system and their effects on M. tuberculosis clinical disease, if any. In this review, we discuss the potential effects of H. pylori and helminth co-infections on the immune response to M. tuberculosis. This may contribute to our understanding of host-pathogen interactions and in designing new strategies for the prevention and control of tuberculosis.

Detection of pathogenic Leptospira in ornamental water fountains from urban sites in Cali, Colombia.

Leptospirosis is a disease endemic to both rural and urban areas of tropical countries and resource-poor communities. Little information is available on the presence of Leptospira spp. in urban water sources. A study was conducted to detect pathogenic Leptospira in ornamental water fountains in Cali, Colombia. Twenty-seven water fountains were tested for pathogenic Leptospira using a multiplex PCR assay targeting the secY and the flaB genes. Pathogenic Leptospira was confirmed in 11 (41%) ornamental water fountains. Plazas, building exteriors, and sidewalks presented the highest proportion (67%) of pathogenic Leptospira-positive water fountains. Urban ornamental water fountains might be sources of pathogenic Leptospira and might pose a risk to humans who come into close contact, although relevance from a public health perspective is yet to be established.

Seroprevalence and factors associated with Leptospira infection in an urban district of Cali, Colombia.

Few studies have addressed Leptospira seroprevalence and risk factors in urban populations in Colombia. This study aimed to determine seroprevalence and factors associated with Leptospira infection in inhabitants of an urban district of Cali, Colombia. We collected sociodemographic and environmental data, as well as blood samples, from 353 subjects selected through a multistage cluster sampling design. We performed microagglutination test for the eight main Leptospira serogroups circulating in the region, considering a cut-off titer of ≥ 1:100. Most participants were female (226, 64.8%), with mean age 41.4 years, and 89 (32.6%) lived in low-low socioeconomic stratum (SES-1). Overall seroprevalence was 12.2% (95%CI: 10.3%-14.4%). Factors associated with Leptospira infection were SES 1, older age, single marital status, ethnic groups (Afro-Colombian and white/mestizo), school students, absence of toilet, barefoot walking, travel outside Cali in the previous month, and absence of skin and mucous-membrane lesions in the previous month. Our study suggests domestic and peridomiciliary transmission of Leptospira likely related to activities of daily living and inadequate environmental conditions. SES-1 is a major factor associated with Leptospira infection (adjusted OR = 4.08; 95%CI: 2.54-6.53; p < 0.001), suggesting that social and environmental conditions are key elements for endemicity of Leptospira infection in the study area. Epidemiological surveillance, improvement of environmental and sanitary conditions in various SES-1 areas, and community educational campaigns are recommended.

Seroprevalence and factors associated with Leptospira infection in an urban district of Cali, Colombia / Seroprevalencia y factores asociados a la infección por Leptospira en un distrito urbano de Cali, Colombia / Soroprevalência da infecção por Leptospira e fatores associados em um distrito urbano de Cali, Colômbia

Few studies have addressed Leptospira seroprevalence and risk factors in urban populations in Colombia. This study aimed to determine seroprevalence and factors associated with Leptospira infection in inhabitants of an urban district of Cali, Colombia. We collected sociodemographic and environmental data, as well as blood samples, from 353 subjects selected through a multistage cluster sampling design. We performed microagglutination test for the eight main Leptospira serogroups circulating in the region, considering a cut-off titer of ≥ 1:100. Most participants were female (226, 64.8%), with mean age 41.4 years, and 89 (32.6%) lived in low-low socioeconomic stratum (SES-1). Overall seroprevalence was 12.2% (95%CI: 10.3%-14.4%). Factors associated with Leptospira infection were SES 1, older age, single marital status, ethnic groups (Afro-Colombian and white/mestizo), school students, absence of toilet, barefoot walking, travel outside Cali in the previous month, and absence of skin and mucous-membrane lesions in the previous month. Our study suggests domestic and peridomiciliary transmission of Leptospira likely related to activities of daily living and inadequate environmental conditions. SES-1 is a major factor associated with Leptospira infection (adjusted OR = 4.08; 95%CI: 2.54-6.53; p < 0.001), suggesting that social and environmental conditions are key elements for endemicity of Leptospira infection in the study area. Epidemiological surveillance, improvement of environmental and sanitary conditions in various SES-1 areas, and community educational campaigns are recommended.

Pocos estudios se han centrado en la seroprevalencia por Leptospira y sus factores de riesgo en poblaciones urbanas de Colombia. Este estudio tuvo como meta determinar la seroprevalencia y los factores asociados a la infección por Leptospira en una población residente de un distrito urbano de Cali, Colombia. Recogimos datos sociodemográficos y ambientales, así como muestras de sangre, de 353 sujetos seleccionados a través de un diseño de muestreo por conglomerados en etapas múltiples. Se realizó un test de microaglutinación para los ocho serogrupos principales de Leptospira circulando en la región, considerando una zona corte de ≥ 1:100. La mayoría de los participantes fueron mujeres (226, un 64,8%), con un promedio de edad de 41,4 años, con 89 (32,6%) que vivían en condiciones socioeconómicas bajas o muy bajas (SES-1). La seroprevalencia global fue de un 12,2% (IC95%: 10,3%-14,4%). Los factores asociados con la infección por Leptospira fueron SES-1, edad más avanzada, estado civil soltera, grupo étnico (afrocolombiano y blanco/mestizo), estudiantes escolares, ausencia de baño, caminar descalzo, viajar fuera de Cali durante el mes previo al estudio, y ausencia de lesiones en la piel y membranas mucosas durante el mes previo al mismo. Nuestro estudio sugiere que la trasmisión doméstica y peridomiciliaria de la Leptospira está vinculada a actividades de la vida diaria y a condiciones ambientales inadecuadas. SES-1 es un factor importante, asociado a la infección por Leptospira (OR ajustada = 4,08; IC95%: 2,54-6,53; p < 0,001), sugiriendo que las condiciones sociales y ambientales son elementos clave para la endemicidad de la infección por Leptospira en el área de estudio. Se recomienda vigilancia epidemiológica, mejora de las condiciones ambientales y sanitarias en varias áreas SES-1, así como campañas educacionales dirigidas a la comunidad.

Poucos estudos trataram da soroprevalência para Leptospira e fatores de risco em populações urbanas da Colômbia. Este estudo teve como objetivo determinar a soroprevalência e fatores associados com a infecção por Leptospira nos habitantes de um distrito urbano de Cali, Colômbia. Os autores coletaram dados sociodemográficos e ambientais, além de amostras de sangue, de 353 indivíduos selecionados através de uma amostragem de aglomerados em múltiplas fases. Foi realizado o teste de microaglutinação para os oitos principais grupos sorológicos da Leptospira circulantes na região, considerando um título de ≥ 1:100. A maioria dos participantes era do sexo feminino (226, 64,8%), com média de idade de 41,4 anos; 89 (32,6%) pertenciam ao estrato socioeconômico mais baixo (SES-1). A soroprevalência global era 12,2% (IC95%: 10,3%-14,4%). Os fatores associados à infecção por Leptospira eram SES-1, idade, estado civil solteiro, grupo étnico (afro-colombiano e branco/mestiço), estudantes, ausência de privada no domicílio, andar descalço, viagem fora de Cali no mês anterior e ausência de lesões mucocutâneas no mês anterior. O estudo sugere a transmissão domiciliar e peridomiciliar da Leptospira, provavelmente associada a atividades cotidianas e condições ambientais adversas. SES-1 é um fator importante associado à infecção com Leptospira (OR ajustado = 4,08; IC95%: 2,54-6,53; p < 0,001), indicando que as condições sociais e ambientais são elementos importantes na endemicidade da leptospirose na área do estudo. Recomendamos a vigilância epidemiológica, melhora das condições ambientais e sanitárias em diversas áreas SES-1 e campanhas educativas comunitárias.

Synanthropic Cockroaches (Blattidae: Periplaneta spp.) Harbor Pathogenic Leptospira in Colombia.

Leptospirosis cases in Colombia are typically linked to peridomestic rodents; however, empirical data suggest that Leptospira-infected patients with no apparent exposure to these reservoirs are common. Cockroaches (Periplaneta spp.) have equal or greater interaction with humans than rodents, yet their potential role as carriers of Leptospira has not been assessed. We determined if pathogenic Leptospira is harbored by Periplaneta spp. in Cali (Colombia) and the variables influencing this relationship. Fifty-nine cockroaches were captured from seven sites and DNA was extracted from the body surface and digestive tract for a multiplex polymerase chain reaction, targeting genes secY and flaB. Logistic regression models and proportion tests showed a higher likelihood for Leptospira to be isolated from body surfaces (P > 0.001) and from individuals inside houses (six times more likely). These findings are the first to demonstrate an association between Periplaneta spp. and Leptospira, suggesting the need to investigate the potential for cockroaches to serve as reservoirs or transport hosts for Leptospira.

Anti-leptospiral agglutinins in marmosets (Saguinus oedipus and Saguinus leucopus) from illegal trade / Aglutininas anti-leptospira en monos tití (Saguinus oedipus y Saguinus leucopus) de comercio ilegal

Objective. Determine the infection status with pathogenic Leptospira of one Saguinus oedipus and nine Saguinus leucopus at the Cali Zoo that had been confiscated in Colombia from illegal trade. Materials and methods. A full physical examination, blood work, urinalysis were conducted in all individuals during the reception health check-up, in addition to running the microagglutination test with a pool of 19 serovars, with a starting dilution of 1:50. Results. A high positive titer (≥1:3200) to Leptospira alexanderi serovar manhao in an asymptomatic S. oedipus was detected. All S. leucopus tested negative or less than 1:50. Conclusions. Captive locations have been documented to artificially enhance opportunities to come into contact with contaminated bodily fluids from peridomestic rodents. However, infectious diseases acquired during the illegal transport of wildlife to major metropolitan centers are rarely considered a wildlife conservation or public health threat. Infection with zoonotic pathogens should also be considered an additional threat to endangered wild primates involved in illegal trade, which could hamper reintroduction efforts or other population management procedures for primate species with restricted and fragmented distributions.

Objetivo. Determinar el estado de infección con Leptospira patógena en un Saguinus oedipus y nueve Saguinus leucopus en el Zoológico de Cali tras haber sido decomisados de tráfico ilegal en Colombia. Materiales y métodos. Se procedió a realizar un examen físico, cuadro hemático y bioquímica, urianálisis, y adicionalmente se realizó la prueba de microaglutinación con un pool de 19 serovares, en una dilución inicial de 1:50. Resultados. Se detectó una respuesta elevada en títulos (≥1:3200) a Leptospira alexanderi serovar manhao en un S. oedipus. Todos los S. leucopus resultaron negativos o con títulos menores de 1:50. Conclusiones. Se ha documentado que el cautiverio puede incrementar artificialmente las oportunidades para que los animales en encierros entren en contacto con fluidos corporales contaminados de roedores peridomésticos. Sin embargo, las enfermedades infecciosas adquiridas durante el transporte ilegal de la fauna silvestre a los principales centros metropolitanos son rara vez consideradas amenazas a la conservación de la fauna o para la salud pública. La infección con patógenos zoonóticos se debería también considerar como un riesgo adicional para primates en peligro de extinción involucrados en tráfico ilegal, lo que podría afectar esfuerzos de reintroducción u otras medidas de manejo de poblaciones de primates con distribuciones fragmentadas y restringidas.