Submicroscopic Plasmodium infection during pregnancy is associated with reduced antibody levels to tetanus toxoid.

Submicroscopic Plasmodium infections in pregnancy are common in endemic areas, and it is important to understand the impact of these low-level infections. Asymptomatic, chronic infections are advantageous for parasite persistence, particularly in areas where the optimal eco-epidemiological conditions for parasite transmission fluctuate. In chronic infections, the persistence of the antigenic stimulus changes the expression of immune mediators and promotes constant immune regulation, including increases in regulatory T cell populations. These alterations of the immune system could compromise the response to routine vaccination. This study aimed to evaluate the effect of submicroscopic plasmodial infection with P. falciparum and P. vivax during pregnancy on the immune response to the tetanus toxoid vaccine in Colombian women. Expression of different cytokines and mediators of immune regulation and levels of anti-tetanus toxoid (TT) immunoglobulin (Ig)G were quantified in pregnant women with and without submicroscopic plasmodial infection. The anti-TT IgG levels were significantly lower in the infected group compared with the uninfected group. The expression of interferon (IFN)-γ, tumour necrosis factor (TNF) and forkhead box protein 3 (FoxP3) was significantly higher in the infected group, while the expression of cytotoxic T lymphocyte antigen 4 (CTLA-4) and transforming growth factor (TGF)-ß was lower in the group of infected. In conclusion, submicroscopic Plasmodium infection altered the development of the immune response to the TT vaccine in Colombian pregnant women. The impact of Plasmodium infections on the immune regulatory pathways warrants further exploration.

Evolución temporal de las plaquetas y los anticuerpos antiplaquetarios en pacientes de área endémica con malaria no complicada / Temporal evolution of platelets and anti-platelets antibodies in patients of endemic area with non complicated malaria

Objetivo: evaluar plaquetas y anticuerpos antiplaquetarios IgG Ac-Pl (medidos por citometría de flujo) en pacientes de Turbo (Antioquia, Colombia) con paludismo no complicado. Metodología: estudio descriptivo, prospectivo y longitudinal de 45 pacientes (14-67 años). Treinta enfermos se siguieron 7 días. Resultados: A) Pretratamiento: hubo trombocitopenia malárica (TM) en 71% y Ac-Pl en 33%, con asociación significativa entre TM y Ac-Pl. La TM no se asocia con zona de residencia, haber tenido malaria en último año ni especie actual de Plasmodium, pero si con sexo (hombres) (p = 0,02078195), pero la concentración de Ac-Pl es similar en hombres y mujeres. Igualmente, la cantidad de plaquetas es estadísticamente igual entre los valores de las variables anteriores. La presencia de Ac-Pl no se relacionó con las anteriores variables. Hay baja e inversa correlación lineal entre plaquetas y Ac-Pl (r = -0,342 (p = 0,02310). B) Durante el seguimiento, la regresión lineal múltiple entre plaquetas y edad, años de residencia, número de episodios de malaria en el último año, parasitemia (expresada logarítmicamente) y concentración de Ac-Pl demostró que ningún coeficiente es significativo y la máxima explicación lograda (17%) la dan la parasitemia y los Ac-Pl. El mismo análisis entre Ac-Pl y edad, años de residencia en la zona, número de episodios de malaria en el último año, parasitemia (expresada logarítmicamente) demostró que las tres primeras explican 38% de los cambios en Ac-Pl, mientras que los episodios de malaria y el tiempo de residencia en la zona explican el 28%

Aim: To evaluate the number of platelets and the title of anti-platelet antibodies IgG Ac-PI (by flow cytometry) in patients with non-complicated malaria. Methods: Descriptive, prospective and longitudinal study from 45 patients (aged among 14-67). Thirty patients were followed during 7 days. Results: A) Pretreatment: it was found malarial thrombocytopenia (MT) in 71 % and significant association between MT and Ac-PI in 33 %. MT was not associated to residence zone, to have had malaria in the last year and Plasmodium species but sex associated (males, p= 0,02078195), although, the Ac-PI titers of male and female was similar. Correspondingly, the number of platelets was statistically similar to the values of above variables. There was a low and an inverse lineal correlation between platelets and titres of Ac-P1 (r= -0,342 (p= 0,02310)). B) During the following, multiple linear regression among platelets, age, years of residence in the zone, number of malaria episodes in the last year, parasitaemia (logarithmically expressed) and Ac-P1 titers showed no significant coefficient and the maximum explanation achieved (17%) was parasitaemia and Ac-P1 titers. Similar analysis among Ac-P1 and age, years of residence in the zone number of malaria episodes in the last year, parasitaemia (logarithmically expressed) showed that the first three explain 38 % of the changes in Ac-P1, whereas malaria episodes and years of residence in the zone explain 28%

[Temporal evolution of platelets and anti-platelet antibodies in patients of endemic area with non complicated malaria]. / Evolución temporal de las plaquetas y los anticuerpos antiplaquetarios en pacientes de área endémica con malaria no complicada.

AIM: To evaluate the number of platelets and the title of anti-platelet antibodies IgG Ac-PI (by flow cytometry) in patients with non-complicated malaria. METHODS: Descriptive, prospective and longitudinal study from 45 patients (aged among 14-67). Thirty patients were followed during 7 days. RESULTS: A) Pretreatment: it was found malarial thrombocytopenia (MT) in 71 % and significant association between MT and Ac-PI in 33 %. MT was not associated to residence zone, to have had malaria in the last year and Plasmodium species but sex associated (males, p= 0.02078195), although, the Ac-PI titers of male and female was similar. Correspondingly, the number of platelets was statistically similar to the values of above variables. There was a low and an inverse lineal correlation between platelets and titres of Ac-P1 (r= -0.342 (p= 0.02310)). B) During the following, multiple linear regression among platelets, age, years of residence in the zone, number of malaria episodes in the last year, parasitaemia (logarithmically expressed) and Ac-P1 titers showed no significant coefficient and the maximum explanation achieved (17%) was parasitaemia and Ac-P1 titers. Similar analysis among Ac-P1 and age, years of residence in the zone number of malaria episodes in the last year, parasitaemia (logarithmically expressed) showed that the first three explain 38 % of the changes in Ac-P1, whereas malaria episodes and years of residence in the zone explain 28%.

Seguridad alimentaria y nutricional en un espacio de riesgo para la malaria / Food and nutritional security in a risk area for malaria

To explore some relationships between alimentary and nutritional security (SAN) and nutritional status in an endemic malaria community, applying qualitative and quantitative methods simultaneously. The study was descriptive and prospective. The population were all farming Afro-American families who live in the basin of the river Valle (Bahía Solano. Chocó, Colombia) that derived the base of their feeding of the agriculture. The SAN was measured from the monthly availability of foods and was classified in adequate and inadequate according to the available monthly caloric balance percentage. We determined the risk of acute malnutrition (indicative P/T), chronic (T/E), global (P/E) and risk of thinness (BMI). We sought for malarian cases. The official data of illness were revised. We applied surveys to know the morbidity and knowledge, attitudes and practices in malaria infections, 29 per cent of homes had alimentary insecurity. There was protein deficit and iron of high availability, calcium and vitamin A in 100 per cent of families. In children under 6 years old, we found 31 per cent and 69 per cent, in same order, with low P/T and T/E, while in the 6-10 year old children had 14 per cent and 41 per cent, respectively. In adolescents (11 to 17 years old) the risk of thinness was 15 per cent and in adults 3 per cent. There was not association between alimentary available and family nutritional status. These results suggest subclinics deficiencies of micronutrients.

[Nutritional status and immunoglobulin and cytokine concentrations in children with malaria]. / Estado nutricional y niveles de inmunoglobulinas y citocinas en niños con malaria.

OBJECTIVES: To relate nutritional status and concentrations of immunoglobulins and cytokines in children with malaria from two areas with different risk of malaria transmission. METHODS: We performed a descriptive, cross-sectional study comparing children aged 4-11 years old from two areas with different risk of malaria transmission in Colombia. The sample consisted of 66 children from El Bagre and Zaragoza (high transmission area) and 62 children from Turbo (low transmission area). To determine the risk of undernutrition, height/weight, age/height and weight/age indexes were calculated, and serum concentrations of interleukin-10 (IL-10), tumor necrosis factor-alpha (TNF-alpha), total IgE and malaria-specific IgE were measured. RESULTS: In the high transmission area, concentrations of total and specific IgE and of TNF-alpha were significantly higher. In both areas, the values obtained for total IgE (84 %), specific-IgE (32 %), TNF-alpha (72 %) and IL-10 (84 %) were higher than standard values. Anthropometric indicators revealed acute undernutrition (wasting) in 33 %, chronic undernutrition (stunting) in 52 %, and global undernutrition in 56 % of the population. CONCLUSIONS: Malaria and protein-energy malnutrition were highly prevalent in both areas. In children from the low transmission area, stunting was significantly greater. In the high transmission area, the mean total IgE was twice that found in the low transmission area and no association with nutritional status was observed. Levels of specific IgE did not differ according to the species of Plasmodium infection.

Estado nutricional y niveles de inmunoglobulinas y citocinas en niños con malaria / Nutritional status and immunoglobulin and cytokine concentrations in children with malaria

Objetivos: Relacionar el estado nutricional y los niveles de inmunoglobulinas y citocinas en niños maláricos de dos zonas con diferente riesgo para malaria. Métodos: Mediante un estudio descriptivo transversal se compararon 2 grupos de niños entre 4-11 años de edad procedentes de dos zonas con diferente riesgo para malaria en Colombia: 66 niños de los municipios de El Bagre y Zaragoza (zona de mayor riesgo malárica) y 62 niños de Turbo (zona de menor riesgo). Se calcularon los índices peso/talla, talla/edad y peso/edad para establecer el riesgo de desnutrición y se midieron concentraciones séricas de interleucina 10 (IL-10), factor de necrosis tumoral alfa (TNF- ), inmunoglobulina E (IgE) total e IgE específica para malaria. Resultados: En la zona de mayor riesgo fueron significativamente mayores los niveles de IgE total, IgE específica, y TNF- .Ambas zonas presentaron niveles superiores a los establecidos por los estándares para IgE total (84 por ciento), IgE específica (32 por ciento), TNF- (72 por ciento) e IL-10 (84 por ciento). Los riesgos de desnutrición fueron: aguda, 33 por ciento; crónica, 52 por ciento, y global, 56 por ciento. Conclusiones: La malaria y la desnutrición coexisten con alta frecuencia en ambas zonas. En la zona de menor riesgo malárico hay significativamente más desnutrición crónica. El promedio de IgE total en la zona de mayor riesgo malárico es el doble del que existe en la zona de menor riesgo y no hay asociación con el estado nutricional. Los valores de IgE específica no difieren por especie de Plasmodium infectante (AU)

Antimalarial activity of neurolenin B and derivates of Eupatorium inulaefolium (Asteraceae).

Dried stems and leaves of Eupatorium inulaefolium (Austroeupatorium inulaefolium) (Asteraceae) were used to obtain four crude extracts (hexane, dichloromethane, methanol and ethanol). Two fractions were obtained from the hexane extract (S1 and S2) and three compounds (neurolenin B, lobatin A and lobatin B) from the dichloromethane extract. The ethanol, hexane, dichloromethane and methanol extracts, two fractions from the hexane extract (S1 and S2), and neurolenin B were evaluated in vitro against Plasmodium falciparum, FCB-2 strain. Two extracts (dichloromethane and methanol), the S2 fraction and neurolenin B showed statistically significant antiplasmodial activity.

[Onychomycosis due to Malassezia.]. / Onicomicosis por Malassezia.

The records of fifty patients presenting Malassezia spp. associated onychomycosis were compiled from two different mycology laboratories from Medellín, Colombia. Malassezia spp. was isolated by culture as the only etiological agent in 32% of the cases and associated to a yeast of the genus Candida in 30% of the cases. In 22% of the cases although Malassezia spp. was observed by direct examination, it was no isolated but others species were obtained. No etiological agent was isolated by culture in 16% of the cases. We found evidence of the Malassezia spp.- Candida relationship in 48% of the cases by either direct examination or by culture isolation. The level of detection of Malassezia spp. by culture isolation was of 62% as compared to the direct examination. Results showed similar patterns of distribution of epidemilogical factors for both entities: onychomycosis by Candida albicans and onychomycosis by Malassezia spp.