Esophageal length in children: Reference data and a novel predictive equation.

Minimal information exists on the length of the child's esophagus, namely the distance from the cricopharyngeus to the esophagogastric junction (EGJ). We aimed to investigate the relationship between esophageal length (EL) and the age, height, and weight of the child. Children undergoing upper gastrointestinal endoscopy between February 2019 and May 2021 at our institution were prospectively audited. Children with anatomical esophageal disorders were excluded. Endoscopic distances from the incisors to the cricopharyngeus and EGJ were obtained, and novel predictive equations derived to predict EL. Intra-observer agreement for endoscopic measurements showed an intra-class correlation coefficient of 0.99. A total of 290 children aged 0.4-17.3 years were included in the analysis; they were divided into a model development cohort (n = 261) and a model validation cohort (n = 29). Measured EL correlated best with height (r = 0.92) as compared to age (r = 0.90) or weight (r = 0.83). The optimal equation for predicting EL was 0.156 × height (cm) - 1.336 (adjusted R2  = 0.841); this had a success rate of 76% in the validation cohort. The optimal equation for predicting distance from incisors to EGJ was 0.199 × height (cm) + 6.470 (adjusted R2  = 0.889); this had a success rate of 69% in the validation cohort. This is the first study to report a predictive equation for estimating esophageal length in children. Accurate prediction of esophageal length may assist with clinical esophageal procedures in children such as nasogastric and pH probe placement.

Epigastric Hernias in Children: A Personal Series and Systematic Review of the Literature.

Epigastric hernias are relatively uncommon in children, and there is a paucity of literature on their incidence, presenting features, natural history, and surgical outcomes. A systematic review was conducted according to PRISMA guidelines. Articles describing the incidence, outcome, and interventions for pediatric epigastric hernias, both open and laparoscopic, were analyzed. Eight relevant articles published between 1975 and 2019 were included in the analysis. Of 81 children, 58% were females, 35% were symptomatic and 8% were multiple. All hernias contained preperitoneal fat only and were repaired using standard open surgery or laparoscopic techniques. No recurrences were recorded. In a personal series of 37 hernias in 36 children of median age 4 years, there were no recurrences; however, this series included two children with a recurrent or persistent epigastric hernia after surgery by others. Epigastric hernias in children are relatively uncommon. They typically contain only preperitoneal fat but more than a third are symptomatic. Standard open repair can be undertaken with minimal morbidity. Laparoscopic repair takes longer and provides a marginal cosmetic benefit.

Scoliosis after thoracotomy repair of esophageal atresia: a systematic review.

Standard surgical repair of esophageal atresia/tracheoesophageal fistula (EA/TEF) is via a right posterolateral thoracotomy. A recognized complication is the later development of scoliosis. The prevalence and pathogenesis of secondary scoliosis are poorly understood. We, therefore, conducted a systematic review on this topic. All English language articles reporting incidence, outcomes and/or interventions for scoliosis in children after EA repair via thoracotomy were identified. Fourteen relevant articles published between 1969 and 2019 reporting 1338 children were included in the analysis. The aggregate prevalence of scoliosis among 937 children without congenital vertebral anomalies was 13%, but this figure varied widely between studies. Severity of scoliosis was documented in 181 children; eight children had a Cobb angle > 40° and 10 had undergone spinal surgery. The spinal curvature in affected individuals was dominantly or exclusively convex to the left. In conclusion, the reported prevalence of scoliosis varies widely but on average affects about one in eight children after open repair of EA/TEF. Most cases are mild and do not require intervention. It is currently uncertain whether secondary scoliosis is preventable by using meticulous thoracotomy techniques or thoracoscopic repair.Level of evidence IV.

An investigation of the frequency of detection of fluoroquinolone residues in the muscle of broiler chickens sold at supermarkets and pluck shops in Trinidad

Objective: Fluoroquinolones are broad spectrum antimicrobials, used to treat a wide myriad of gastrointestinal, genitourinary and respiratory infections in both humans and animals. They are also used prophylactically in livestock including poultry and fish. this occurrence, coupled with the abuse of the drug due to extra-label and improper use, have led to concerns about both antimicrobial resistance to these drugs and the presence of their residues in veterinary products such as meat. Tremendous human health issues inclusive of antimicrobial resistance, anaphylactic reactions, carcinogenicity, mutagenicity, teratogenicity and the disruption of normal flora can occur due to the use and abuse of these antimicrobials. We hypothesized that fluoroquinolones residues are present in the meat of broiler chickens in Trinidad. Hence, our objectives were to detect the presence and concentrations of fluoroquinolone residues in broiler chickens sold at supermarkets and pluck shops in Trinidad. Design and Methodology: A total of 168 carcasses were sampled from supermarkets and pluck shops across Trinidad and Tobago, during July to August of 2018. The breast muscles were removed and subjected to first the extraction process then to the Ridascreen® Chinolone/Quinolones Enzyme Linked- Immunosorbent Assay (ELISA) to determine the presence and concentrations of fluoroquinolones in these samples. Results: Fluoroquinolone residues were detected at a frequency 14.3% (24/168), with concentrations ranging from 5.53-161.41µg/kg and 2.4% (4/168) of carcasses contained fluoroquinolones at levels higher than (100 µg/kg) that stipulated by the Codex Alimentarius. Conclusion: Fluoroquinolones are present in broiler chickens sold in Trinidad. Its presence, at times higher than the recommended levels, has serious public health implications.

A comparison of the efficacy of two commercial acaricides (fipronil and amitraz) with Azadirachta indica (neem) on the brown dog tick (Rhipicephalus sanguineus) from canines in Trinidad

Objective: Rhipicephalus sanguineus, the most common species of tick found on canines in Trinidad. It is a potential vector for potentially fatal zoonotic diseases such as borreliosis (Lyme disease), babesiosis, anaplasmosis and human granulocytic ehrlichiosis. Common acaricides used by pet owners such as fipronil and amitraz are often misused and abused as owners may fail to follow the manufacturers' instructions. The objectives of this study were to compare the efficacies of the commercial acaricides (fipronil and amitraz) to the herbal alternative, neem on brown dog ticks in Trinidad. Design and Methodology: The Larval Packet Test (LPT) was conducted in triplicate for each of three concentrations (high, recommended and low concentrations) of fipronil, amitraz, neem oil and neem leaf extract. STATA version 15 was used to perform a mixed effects Poisson regression analysis. Results: Both the commercial and herbal acaricides were effective in causing death of the larvae. Larvae were susceptible to amitraz and fipronil at all concentrations used, however they displayed variable resistance to the neem oil and neem leaf extract. Conclusions: The commercial preparations (amitraz and fipronil) proved to be more effective than neem oil and neem leaf extract, however the latter can be used as a herbal alternative to control R. sanguineus in Trinidad.

Estrus synchronization and expression of estrus behaviors during periovulatory period in doublesynch treated buffalypso (Bubalus bubalis) in Trinidad

Objectives: Experiment was conducted to investigate (a) the effect of the doublesynch protocol on pregnancy rate in buffalypso (b) the effectiveness of the doublesynch protocol for estrous synchronization and (c) to observe and record signs of estrous in buffalypso. Design and Methodology: In this study, eleven buffalypsoes (n=11) were administered Prostaglandin (PGF2α)on day 0, Gonadotropin-releasing hormone (GnRH) on day 2, a second PGF2α injection on day 9, and a second GnRH injection on day 11. Timed artificial insemination (TAI) was performed 16 and 24 hours after the second GnRH injection. Eleven buffalypso females (n=11) were bred after spontaneous estrus was detected (control group). Oestrous behaviour and intensity were recorded in all the experimental animals, transrectal palpation and ultrasound was performed 60 days postinsemination to determine conception rate. Results: All buffalypsoes treated with the doublesynch protocol elicited signs of swollen vulva and frequent urination which are classical signs of behavioural estrus. The pregnancy rates were 54.5% using TAI in all the treated buffalypsoes and 45.5% for the control group buffalypsoes. The conception rate between doublesynch treatment and Aripo farm herd were also compared and it was found that doublesynch treated buffalypsoes had higher conception rate (54.5%) compared to the overall Aripo farm herd (24.0%) by artificial insemination. Conclusion: The doublesynch protocol effectively synchronized the estrus in buffalypsoes. The study also demonstrated that this protocol followed by TAI enhanced the pregnancy rate with classical signs of estrus in the buffalypsoes.

Molecular analysis of Salmonella isolates from poultry by pulsed-field gel electrophoresis

Objective: The study was conducted to determine geneticrelatedness of Salmonella serotypes by pulsed field gel electrophoresis (PFGE). Design and Methodology: A total of 1503 caecal samples of freshly slaughtered poultry were randomly collected from 'pluck shops' across the country. The samples were screened for Salmonella by biochemical, serological and molecular methods. The Salmonella serotypes were analyzed for genetic relatedness for phenotypic antimicrobial resistance, resistance and virulence gene profiles by PFGE generated by digestion with XbaI. Results: Ten different serotypes were detected from all 91 Salmonella isolates. PFGE fingerprinting profiles showed that the Salmonella serotypes in general, were genetically diverse with the detection of a total of 20 PFGE groups. The antibiograms of the isolates were also clearly very variable, which suggest that genotypic antimicrobial resistance may not relate to the phenotypic antibiograms in dendrograms, except for qnrB gene. Results demonstrated a varied spectrum of antimicrobial resistance and PFGE patterns among Salmonella isolates and signify the importance of sustained surveillance of foodborne pathogens in retail poultry pluck shops. Conclusions: The findings provide evidence that poultry from pluck shops are colonized by pathogenic Salmonella harboring antimicrobial resistance genes. The study also reported for the first time in Trinidad, molecular characterization of Salmonella isolates from poultry regarding the relatedness of antibiograms, possession of resistance and virulence genes using their PFGE profiles. The epidemiological surveillance of these serotypes would be necessary to evaluate their possible impact on human health in the country and possibly in the Caribbean region.

Prevalence of Salmonella species in broilers during slaughtering by processing plants in Trinidad using three isolation methods

Objective: To determine the prevalence of Salmonella species during slaughtering and dressing of broiler chickens at four poultry processing plants in Trinidad using three isolation methods. Design and Methodology: In this cross-sectional study, a total of 396 samples were collected from all four commercial poultry processing plants in Trinidad. Samples collected comprised swabs of cloacae pre-slaughter, pre evisceration and post evisceration carcasses; immersion chiller water, neck skins, whole carcasses and chicken parts (final product). Isolation and identification of Salmonella spp. were performed using standard bacteriological techniques (whole carcass enrichment, whole carcass rinse and neck skin methods). Results: The overall prevalence of Salmonella spp. was 27.5% (109/396). The prevalence of Salmonella spp. was 2.2% (2/90), 55.6% (25/45), 37.8% (17/45), 27.8% (25/90), 5.6% (2/36), 44.4% (20/45) and 40.0% (18/45) for cloacal swabs, preevisceration carcasses, post evisceration carcass swabs, neck skins, immersion chiller water, whole carcass and chicken parts respectively (p<0.001). Salmonella was isolated from 52.3% (46/88), 19.3% (34/176), 11.4% (5/44) and 27.3% (24/88) of the samples from Plant A, B, C and D respectively (p<0.001). Overall, Salmonella was detected in 27.2% (49/180), 27.8% (25/90) and 39.4% (71/180) carcasses by whole carcass rinse, neck skin method and whole carcass enrichment method respectively (p= 0.028). Conclusion: Data from the study indicate the extent of contamination by Salmonella spp. throughout the various stages of broiler processing at the four plants studied and, of significance is the risk of salmonellosis posed to consumers of contaminated, undercooked chicken sold to retail outlets by these processing plants in the country.

Angiostrongylus cantonensis and the giant African snail ­ threat or not?

Objective: Angiostrongylus cantonensis or the rat lungworm can cause eosinophilic meningitis in humans. The Giant African snail has been reported to be a suitable intermediate host for this parasite. As the population of Giant African snails has recently exploded, there is an increased risk of transmission of this helminths to humans residing in this country. Therefore the objective of this study is to detect the presence of the rat lungworm in the Giant African Snails in Trinidad by conventional polymerase chain reaction (PCR). Design and Methodology: A total of 178 Giant African snails were collected from ten different locations throughout Trinidad. DNA was extracted from 25 mg of the mantle of each Giant African snail using the DNeasy® PoweSoil® Kit. Conventional PCR was performed using the primers AngioF1 and AngioR1 to amplify a 1,134bp fragment of the 18S rRNA gene of Angiostrongylus spp. The PCR reactions and conditions were are adapted from Qvarnstrom et al in 2007(1). Results: Six of the DNA extracted samples were positive for Angiostrongylus spp. by conventional PCR. Conclusion: Giant African snails in Trinidad are a suitable intermediate host for the rat lungworm and can increase transmission of these helminths to humans. Therefore Angiostrongylus cantonensis infection should be considered to be a differential for eosinophilic meningitis in humans.

Survey of ticks of domestic dogs and cattle in Trinidad and Tobago

Objective: Ticks and the pathogens they transmit can cause high morbidity and mortality in domestic animals. As part of a larger study to determine the tickborne pathogens infesting domestic animals and wildlife, the aim of this study was to survey the tick species infesting the canine and cattle populations in Trinidad and Tobago. Design and Methodology: A total of 1,990 ticks were collected off of 179 dogs from 48 areas in Trinidad (n=163) and Tobago (n=16) only between June 2016 and 2018. Ticks were also collected from cattle throughout Trinidad (n=1098) and Tobago (n=306). Collected ticks were morphologically identified using standard taxonomic keys. Results: Only two tick species, Rhipicephalus sanguineus (1,926; 96.8%) and Amblyomma ovale (64; 3.2%) were found on the dogs sampled in Trinidad and Tobago (T&T). A total of 169 (94.4%) dogs and 10 (17.9%) dogs were infested with R. sanguineus and A. ovale respectively. Three dogs (1.7%) were infested with both tick species. Only hunting dogs or those closely associated with them were infested with A. ovale. R. sanguineus was very common throughout both islands whereas A. ovale was restricted to small foci in three rural settlements in both Trinidad (n=2) and Tobago (n=1). Rhipicephalus (Boophilus) microplus was the only tick species found infesting cattle on both islands. Conclusion: R. sanguineus is the most common tick infesting domestic dogs in T&T while A. ovale was found on fewer dogs. Only R. (B). microplus was detected on cattle. R. sanguineus is a known vector of tick-borne diseases in domestic dogs and humans while R. B. microplus can transmit harmful pathogens to cattle. These preliminary findings will aid in determining if there are any possible links between ticks and tick-borne pathogens associated with domestic and wildlife species and possibly humans and give further insight into the potential movement of ticks and their pathogens between the human, animal and tropical forest interface.

A field study on the occurrence of gastrointestinal nematodes in sheep over the wet and dry seasons in two West Indian islands

Objective: Gastrointestinal nematode (GIN) infestations of sheep are considered a major constraint to sheep production in the West Indies. Sheep are semiintensively managed under tropical conditions which are favorable for the development and survival of GIN. This study was conducted to determine if there was a relationship between GIN burdens in sheep with seasonality and management practices of farmers in Trinidad and Tobago (TT). Design and Methodology: Eighteen (18) farms were visited in Trinidad and 23 in Tobago on a monthly basis between January and December 2017. A maximum of ten sheep between three to nine months of age were selected using non-random sampling at each farm. Results: A total of 3053 fecal samples were collected and analyzed using the Modified McMaster Technique. A mixed effects Poisson regression model was constructed to analyze the relationship between eggs per gram (EPG) with season, management and deworming. The standard error was adjusted for clustering according to farm. EPG decreased according to wet season vs. dry season (coef. = - 0.6, 95% CI = -1.17 - -0.03, p = 0.039). Semiintensive management system experienced higher EPG than intensive system (coef. = 1.43; 95% CI = 0.72, - 2.14; p < 0.001). EPG did not vary significantly according to whether the farmer dewormed or not over the period (p = 0.54). Conclusion: Proper management is required for reducing the occurrence of GIN in sheep of TT throughout the year. Further investigation is needed to elucidate why EPG appear to be higher in the dry season than the wet season.

Validation of a Social Networks and Support Measurement Tool for Use in International Aging Research: The International Mobility in Aging Study.

The purpose of this study was to develop and validate a new instrument to assess social networks and social support (IMIAS-SNSS) for different types of social ties in an international sample of older adults. The study sample included n = 1995 community dwelling older people aged between 65 and 74 years from the baseline of the longitudinal International Mobility in Aging Study (IMIAS). In order to measure social networks for each type of social tie, participants were asked about the number of contacts, the number of contacts they see at least once a month or have a very good relationship with, or speak with at least once a month. For social support, participants had to rate the level of social support provided by the four types of contacts for five Likert scale items. Confirmatory Factor Analysis was conducted to determine the goodness of fit of the measurement models. Satisfactory goodness-of-fit indices confirmed the satisfactory factorial structure of the IMIAS-SNSS instrument. Reliability coefficients were 0.80, 0.81, 0.85, and 0.88 for friends, children, family, and partner models, respectively. The models were confirmed by CFA for each type of social tie. Moreover, IMIAS-SNSS detected gender differences in the older adult populations of IMIAS. These results provide evidence supporting that IMIAS-SNSS is a psychometrically sound instrument and of its validity and reliability for international populations of older adults.

Maternal Health Literacy Is Associated with Early Childhood Nutritional Status in India.

BACKGROUND: The global burden of child undernutrition is concentrated in South Asia, where gender inequality and female educational disadvantage are important factors. Maternal health literacy is linked to women's education and empowerment, can influence multiple malnutrition determinants, and is rapidly modifiable. OBJECTIVE: This study investigated whether maternal health literacy is associated with child undernutrition in 2 resource-poor Indian populations. METHODS: We conducted cross-sectional surveys in an urban and a rural site, interviewing 1 woman with a child aged 12-23 mo/household. Multivariate logistic regression analyses were conducted independently for each site. The main exposure was maternal health literacy. We assessed respondents' ability to understand, appraise, and apply health-related information with the use of Indian health promotion materials. The main outcomes were severe stunting, severe underweight, and severe wasting. We classified children as having a severe nutritional deficiency if their z score was <-3 SDs from the WHO reference population for children of the same age and sex. Analyses controlled for potential confounding factors including parental education and household wealth. RESULTS: Rural and urban analyses included 1116 and 657 mother-child pairs, respectively. In each site, fully adjusted models showed that children of mothers with high health literacy had approximately half the likelihood of being severely stunted (rural adjusted OR: 0.50; 95% CI: 0.33, 0.74; P = 0.001; urban adjusted OR: 0.58; 95% CI: 0.35, 0.94; P = 0.028) or severely underweight (rural adjusted OR: 0.57; 95% CI: 0.38, 0.87; P = 0.009; urban adjusted OR: 0.48; 95% CI: 0.25, 0.91; P = 0.025) than children of mothers with low health literacy. Health literacy was not associated with severe wasting. CONCLUSIONS: In resource-poor rural and urban settings in India, maternal health literacy is associated with child nutritional status. Programs targeting health literacy may offer effective entry points for intervention.

Surgical and endovascular revision of brachio-basilic vein fistula.

PURPOSE: The brachio-basilic vein fistula (BBVF) is currently the third vascular access option for patients on hemodialysis, following radio-cephalic and brachio-cephalic arterio-venous fistulas. Like all types of hemodialysis vascular access, a variety of procedures may have to be performed in order to maintain long-term use of the BBVF. The aim of the present study was to perform a literature review of endovascular or surgical revisions of BBVFs. METHODS: On Pubmed search, 676 records were obtained and reviewed for relevance with the aim of the search. RESULTS: A variety of endovascular and surgical revision techniques has been described to manage BBVF poor maturation, dysfunction manifested as failing BBVF (most often the result of a stenosis at the transposed/swing segment), thrombosis, aneurysm formation and hemodialysis access-induced hand ischemia (steal syndrome). The role of revision is crucial in BBVF maintenance, taking into account that around 70% of these fistulas will require some intervention by 18 months and as a result of revision, secondary patency is preserved in the vast majority, according to the results of one study. Endovascular revision is the treatment of choice for most cases of BBVF dysfunction or thrombosis, with redo surgery reserved for failures of endovascular techniques or other specific indications. CONCLUSIONS: BBVF revision, more often in the form of endovascular surgery, plays a crucial role in BBVF maintenance and its continued use for hemodialysis, necessary for reducing graft and catheter use and the associated morbidity.

Reliability assessment of the endoscopic examination in patients with allergic rhinitis.

OBJECTIVE: To study if nasal endoscope can be a reliable tool in assessing patients with allergic rhinitis. MATERIALS AND METHODS: A prospective study. Patients who were diagnosed with allergic rhinitis underwent a nasal endoscopic examination performed by two physicians blinded to the scoring of each other. A correlation was made among symptom severity, endoscopic findings, and interrater variability. RESULTS: Ninety patients were included in the study: 34 patients had mild disease and 56 had moderate-to-severe allergic rhinitis according to the Allergic Rhinitis and its Impact on Asthma guidelines. Increases in mucosal edema and bluish discoloration were predictive of the severity of allergic rhinitis disease (p < 0.05). The presence of nasal secretions was not predictive of allergic rhinitis. Interrater reliability was fair for mucosal edema, moderate-to-almost perfect for the rest of the endoscopic findings. CONCLUSION: Nasal endoscopy may reveal signs that are predictive of the severity of allergic rhinitis. A detailed checklist is needed for the nasal endoscopic examination to decrease interrater variability.

Interventions to increase immunisation coverage among children 12-23†months of age in India through participatory learning and community engagement: pilot study for a cluster randomised trial.

OBJECTIVE: With the aim of conducting a future cluster randomised trial to assess intervention impact on child vaccination coverage, we designed a pilot study to assess feasibility and aid in refining methods for the larger study. TRIAL DESIGN: Cluster-randomised design with a 1:1 allocation ratio. METHODS: Clusters were 12 villages in rural Uttar Pradesh. All women residing in a selected village who were mothers of a child 0-23 months of age were eligible; participants were chosen at random. Over 4 months, intervention group (IG) villages received: (1) home visits by volunteers; (2) community mobilisation events to promote immunisation. Control group (CG) villages received community mobilisation to promote nutrition. A toll-free number for immunisation was offered to all IG and CG village residents. Primary outcomes were ex-ante criteria for feasibility of the main study related to processes for recruitment and randomisation (50% of villages would agree to participate and accept randomisation; 30 women could be recruited in 70% of villages), and retention of participants (50% of women retained from baseline to endline). Clusters were assigned to IG or CG using a computer-generated randomisation schedule. Neither participants nor those delivering interventions were blinded, but those assessing outcomes were blinded to group assignment. RESULTS: All villages contacted agreed to participate and accepted randomisation. 36 women were recruited per village; 432 participants were randomised (IG n=216; CG n=216). No clusters were lost to follow-up. The main analysis included 86% (373/432) of participants, 90% (195/216) from the IG and 82% (178/216) from the CG. CONCLUSIONS: Criteria related to feasibility were satisfied, giving us confidence that we can successfully conduct a larger cluster randomised trial. Methodological lessons will inform design of the main study. TRIAL REGISTRATION NUMBER: ISRCTN16703097.

Association between maternal health literacy and child vaccination in India: a cross-sectional study.

BACKGROUND: Education of mothers may improve child health. We investigated whether maternal health literacy, a rapidly modifiable factor related to mother's education, was associated with children's receipt of vaccines in two underserved Indian communities. METHODS: Cross-sectional surveys in an urban and a rural site. We assessed health literacy using Indian child health promotion materials. The outcome was receipt of three doses of diphtheria-tetanus-pertussis (DTP3) vaccine. We used multivariate logistic regression to investigate the relationship between maternal health literacy and vaccination status independently in each site. For both sites, adjusted models considered maternal age, maternal and paternal education, child sex, birth order, household religion and wealth quintile. Rural analyses used multilevel models adjusted for service delivery characteristics. Urban analyses represented cluster characteristics through fixed effects. RESULTS: The rural analysis included 1170 women from 60 villages. The urban analysis included 670 women from nine slum clusters. In each site, crude and adjusted models revealed a positive association between maternal health literacy and DTP3. In the rural site, the adjusted OR was 1.57 (95% CI 1.11 to 2.21, p=0.010) for those with medium health literacy, and OR=1.30 (95% CI 0.89 to 1.91, p=0.172) for those with high health literacy. In the urban site, the adjusted OR was 1.10 (95% CI 0.65 to 1.88, p=0.705) for those with medium health literacy, and OR=2.06 (95% CI 1.06 to 3.99, p=0.032) for those with high health literacy. CONCLUSIONS: In these study settings, maternal health literacy is independently associated with child vaccination. Initiatives targeting health literacy could improve vaccination coverage.

Proteomic analysis of the Plasmodium male gamete reveals the key role for glycolysis in flagellar motility.

BACKGROUND: Gametogenesis and fertilization play crucial roles in malaria transmission. While male gametes are thought to be amongst the simplest eukaryotic cells and are proven targets of transmission blocking immunity, little is known about their molecular organization. For example, the pathway of energy metabolism that power motility, a feature that facilitates gamete encounter and fertilization, is unknown. METHODS: Plasmodium berghei microgametes were purified and analysed by whole-cell proteomic analysis for the first time. Data are available via ProteomeXchange with identifier PXD001163. RESULTS: 615 proteins were recovered, they included all male gamete proteins described thus far. Amongst them were the 11 enzymes of the glycolytic pathway. The hexose transporter was localized to the gamete plasma membrane and it was shown that microgamete motility can be suppressed effectively by inhibitors of this transporter and of the glycolytic pathway. CONCLUSIONS: This study describes the first whole-cell proteomic analysis of the malaria male gamete. It identifies glycolysis as the likely exclusive source of energy for flagellar beat, and provides new insights in original features of Plasmodium flagellar organization.

Melanotic pathology and vertical transmission of the gut commensal Elizabethkingia meningoseptica in the major malaria vector Anopheles gambiae.

BACKGROUND: The resident gut flora is known to have significant impacts on the life history of the host organism. Endosymbiotic bacterial species in the Anopheles mosquito gut are potent modulators of sexual development of the malaria parasite, Plasmodium, and thus proposed as potential control agents of malaria transmission. RESULTS: Here we report a melanotic pathology in the major African malaria vector Anopheles gambiae, caused by the dominant mosquito endosymbiont Elizabethkingiameningoseptica. Transfer of melanised tissues into the haemolymph of healthy adult mosquitoes or direct haemolymph inoculation with isolated E. meningoseptica bacteria were the only means for transmission and de novo formation of melanotic lesions, specifically in the fat body tissues of recipient individuals. We show that E. meningoseptica can be vertically transmitted from eggs to larvae and that E. meningoseptica-mono-associated mosquitoes display significant mortality, which is further enhanced upon Plasmodium infection, suggesting a synergistic impact of E. meningoseptica and Plasmodium on mosquito survival. CONCLUSION: The high pathogenicity and permanent association of E. meningoseptica with An. Gambiae through vertical transmission constitute attractive characteristics towards the potential design of novel mosquito/malaria biocontrol strategies.