Prevalence of gastrointestinal parasites in bonnet macaque and possible consequences of their unmanaged relocations.

Relocation is one of the mitigating measures taken by either local people or related officers to reduce the human-bonnet macaque Macaca radiata conflict in India. The review on relocations of primates in India indicates that monkeys are unscreened for diseases or gastrointestinal parasites (henceforth endoparasites) before relocation. We collected 161 spatial samples from 20 groups of bonnet macaque across their distribution range in south India and 205 temporal samples from a group in Chiksuli in the central Western Ghats. The isolation of endoparasite eggs/cysts from the fecal samples was by the centrifugation flotation and sedimentation method. All the sampled groups, except one, had an infection of at least one endoparasite taxa, and a total of 21 endoparasite taxon were recorded. The number of helminth taxon (16) were more than protozoan (5), further, among helminths, nematodes (11) were more common than cestodes (5). Although the prevalence of Ascaris sp. (26.0%), Strongyloides sp. (13.0%), and Coccidia sp. (13.0%) were greater, the load of Entamoeba coli, Giardia sp., Dipylidium caninum and Diphyllobothrium sp. were very high. Distant groups had more similarity in composition of endoparasites taxon than closely located groups. Among all the variables, the degree of provisioning was the topmost determinant factor for the endoparasite taxon richness and their load. Temporal sampling indicates that the endoparasite infection remains continuous throughout the year. Monthly rainfall and average maximum temperature in the month did not influence the endoparasite richness. A total of 17 taxon of helminths and four-taxon of protozoan were recorded. The prevalence of Oesophagostomum sp., and Strongyloides sp., and mean egg load of Spirurids and Trichuris sp. was higher than other endoparasite taxon. The overall endoparasite load and helminth load was higher in immatures than adults, where, adult females had the highest protozoan load in the monsoon. The findings indicate that relocation of commensal bonnet macaque to wild habitat can possible to lead transmission of novel endoparasites that can affect their population. Thus, we suggest avoidance of such relocations, however, if inevitable the captured animals need to be screened and treated for diseases and endoparasites before relocations.

Ascaris Larval Infection and Lung Invasion Directly Induce Severe Allergic Airway Disease in Mice.

Ascaris lumbricoides (roundworm) is the most common helminth infection globally and a cause of lifelong morbidity that may include allergic airway disease, an asthma phenotype. We hypothesize that Ascaris larval migration through the lungs leads to persistent airway hyperresponsiveness (AHR) and type 2 inflammatory lung pathology despite resolution of infection that resembles allergic airway disease. Mice were infected with Ascaris by oral gavage. Lung AHR was measured by plethysmography and histopathology with hematoxylin and eosin (H&E) and periodic acid-Schiff (PAS) stains, and cytokine concentrations were measured by using Luminex Magpix. Ascaris-infected mice were compared to controls or mice with allergic airway disease induced by ovalbumin (OVA) sensitization and challenge (OVA/OVA). Ascaris-infected mice developed profound AHR starting at day 8 postinfection (p.i.), peaking at day 12 p.i. and persisting through day 21 p.i., despite resolution of infection, which was significantly increased compared to controls and OVA/OVA mice. Ascaris-infected mice had a robust type 2 cytokine response in both the bronchoalveolar lavage (BAL) fluid and lung tissue, similar to that of the OVA/OVA mice, including interleukin-4 (IL-4) (P < 0.01 and P < 0.01, respectively), IL-5 (P < 0.001 and P < 0.001), and IL-13 (P < 0.001 and P < 0.01), compared to controls. By histopathology, Ascaris-infected mice demonstrated early airway remodeling similar to, but more profound than, that in OVA/OVA mice. We found that Ascaris larval migration causes significant pulmonary damage, including AHR and type 2 inflammatory lung pathology that resembles an extreme form of allergic airway disease. Our findings indicate that ascariasis may be an important cause of allergic airway disease in regions of endemicity.

[ERRORS IN DIAGNOSIS AND TREATMENT OF IMMUNODEPENDENT PATHOLOGY (ORIGINAL CONCEPT)].

Based on many years of experience in 2009, we developed the original concept of a mixed approach to the treatment of infectious diseases in patients. During 2.5 years(from 2013 to June 2015) to have applied for consultative-diagnostic help of 3965 patients who had not verified the primary diagnosis. The basic principle of verification of the pathology of the removal of various causes immunosuppression. Based on our extensive, research and observation was often found in patients ascaridosis (55%) and giardiasis (65%), as a possible cause of immunosuppression. In 13% of patients was found the mucosal candidiasis. Among frequently and chronically ill persons we identified the active forms of Epstein-Barr virus (quantitative polymerase chain reaction in saliva) in 40%. The criterion for assessing performance immunogram was a decrease of two sigmal deviation from the lower age limit. In the study of neutrophil myeloperoxidase content observed decline (< 60%) in 99 (9.7%) of 1015 patients, indicating a fairly common cause of long-term permit infection in the tissues and persistence C. albicans. In the study of lymphocyte subpopulations often demonstrated reduction in the number of natural killer cells (26.7% of subjects), which shows a decline of one of the most important factors of congenital immunity. Among the humoral immune disorders often noted the decrease of total IgG (2.4%) and its subclass IgG1 (22.1%), indicating a significant diagnostic value determination of IgG subclasses it even with normal serum total. Thus, approximately 76% of patients often suffer set of a decrease immunity. Patients developed with mixed infections caused by various bacterial, fungal, viral and protozoan agents and worms. Immunological study of patients should be redynamics after eliminating the causes immunosuppression and sanitation foci of infection. Only multi-level examination of the patient will determine the final diagnosis and adequate treatment.

Complicaciones quirúrgicas de la ascaridiasis en la infancia / Surgical complications of childhood ascariasis

Introducción: La infestación por áscaris consttuye un problema de salud pública importante en áreas endémicas, provocando en algunos casos complicacionesque requieren la intervención del cirujano. El propósito del presente estudio es analizar las complicaciones quirúrgicas de la ascaridiasis,en nuestro medio.Diseño, lugar y partcipantes: se realizó un estudio descriptvo retrospectvo de los pacientes que presentaron complicaciones quirúrgicas debido a lainfestación por A. lumbricoides de enero de 1999 a marzo de 2015 que fueron tratados en la unidad de cirugía pediátrica del hospital general San Juande Dios.Resultados: Ingresaron 47 pacientes con infestación por áscaris, comprendidos en las edades de 1 a 13 años. Hubo 39 pacientes con obstrucción intestnal,7 con ascaridiasis en el colédoco y 1 con apendicits por áscaris. El diagnóstco de los 39 pacientes con oclusión intestnal por áscaris fue clínicoy con rayos X simple de abdomen, 19 resolvieron con tratamiento médico y 20 requirieron de tratamiento quirúrgico. Los pacientes con áscaris en elcolédoco fueron diagnostcados por USG a 1 se le logró extraer el áscaris por CPRE mientras que a los 6 restantes fue necesario la exploración de la víabiliar por laparotomía. El diagnóstco de la apendicits secundario a la obstrucción por áscaris se realizó trans operatoriamente. La morbilidad observadafue del 21% (10/47) de los pacientes: 8 presentaron respuesta infamatoria sistémica y 2 dehisencias de la anastomosis intestnal. La mortalidadfue del 2% (1/47): un paciente con fallo orgánico múltple por sepsis abdominal y desnutrición.Conclusiones: en este estudio, las complicaciones de la infestación por áscaris fueron la obstrucción intestnal, obstrucción de la vía biliar y apendicits...

Introducton: In endemic areas, ascariasis is an important public health problem. In cases of severe infestaton, some cases need to be surgically treated.The aim of this study is to analyze surgical complicatons of childhood ascariasis in our insttuton.Design, Place and Partcipants: A retrospectve study of all patents with ascariasis, from 1999 to 2015, evaluated in the surgical pediatric unit at SanJuan de Dios General Hospital.Results: We analyzed 47 patents with ascariasis, age range 1 to 13 years old. There were 39 patents with intestnal obstructon due to ascariasis, 7 withcholedochal ascariasis and 1 with appendiceal ascariasis. Diagnosis of intestnal obstructon due to ascariasis was made with clinical evaluaton andplain abdominal radiography. Of the 39 patents with abdominal obstructon, 19 resolved with medical treatment and 20 required surgical interventon.Patents with choledochal ascariasis were diagnosed by ultrasonography. In one patent, extracton of the worm was possible with endoscopic retrogradecholangiopancreatography, in the remaining 6 patents, open common bile duct exploraton was required. Diagnosis of the appendiceal ascariasiswas made during appendectomy without previous clinical suspicion. Serious morbidity was 21% (10/47): 8 patents with severe infammatory responseand 2 anastomosis dehiscences. Mortality was 2% (1/47), a patent with multple organ failure, abdominal sepsis and malnourishment. Morbidity andmortality occurred only in patents with intestnal obstructon due to ascariasis. Conclusions: In this study, complicatons of ascariasis were intestnal obstructon, choledochal obstructon and acute appendicits...

Ascaris lumbricoides: complicaciones graves en niños hospitalizados en el Centro Hospitalario Pereira Rossell / Ascaris lumbricoides: serious complications in children hospitalized in the Centro Hospitalario Pereira Rossell

La infección por Ascaris lumbricoides (AL) es una geohelmintiasis que constituye un problema de salud pública, especialmente en niños con vulnerabilidad socio económica y ambiental. La carencia de saneamiento y agua potable, el hacinamiento, la precariedad de la vivienda y las malas condiciones de higiene constituyen los principales factores de riesgo. El impacto de esta enfermedad en Uruguay no está claramente definido. La existencia de casos graves de infección por AL sugiere la presencia de zonas de alta prevalencia. El objetivo de esta comunicación es alertar sobre la presencia de complicaciones y formas graves de esta enteroparasitosis. Se revisaron los aspectos patogénicos y modalidades de evaluación y tratamiento. Se incluyeron siete niños hospitalizados entre el 1 de enero de 2007 y el 31 de mayo de 2012, edad mínima 18 meses y máxima 59 meses. Todos habitaban viviendas precarias, de las cuales cinco carecían de saneamiento y cuatro de baño interno. Las complicaciones asociadas fueron: abscesos múltiples pulmonares y hepáticos, síndrome suboclusivo, oclusión intestinal, síndrome de Loffler, peritonitis biliar por perforación del conducto hepático común y colangitis. Los síntomas abdominales fueron los más frecuentes. La media de la estadía hospitalaria fue 11 días. Ingresaron a Unidad de cuidado intensivo cuatro niños, dos requirieron alimentación parenteral y dos apoyo ventilatorio. En todos los casos se realizaron estudios imagenológicos. Requirieron tratamiento quirúrgico tres niños. Todos sobrevivieron. Esta enfermedad es un “marcador de pobreza” y se relaciona directamente con las condiciones de vida de la población. Fortalecer las medidas de promoción y prevención contribuye al control de esta enfermedad. Erradicar el problema exige políticas dirigidas a superar las condiciones de exclusión social, identificando zonas de riesgo con intervenciones intersectoriales.

Other helminthic infections: Ascariasis, Dracontiasis, Lagochilascariasis, Micronemiasis.

There are a number of nematode infections that rarely involve the central nervous system. Ascaris lumbricoides and the pig nematode A. suum have been associated with encephalitis. Adult Dracunculus medinensis may invade the spinal cord resulting in epidural abscess and paralysis. Lagochiloascaris spp. are free-living nematodes reported mainly in Brazil. Lagochiloascaris minor infection may cause diseases of the head and neck and the central nervous system. Halicephalobus (Micronema) parasitizes horses and may also involve the human central nervous system.

Determining the prevalence of intestinal parasites in three Orang Asli (Aborigines) communities in Perak, Malaysia.

This study was conducted to determine the prevalence of intestinal parasites among children and adult Orang Aslis (Aborigines) from different locations in Perak. Faecal samples were collected and analyzed using the direct smear and formal ether sedimentation technique. Some of the faecal samples were stained using the Modified Acid fast stain for Cryptosporidium. Nail clippings of the respondents and the soil around their habitat were also analyzed. Of the 77 stool samples examined, 39 (50.6%) were positive for at least one intestinal parasite. The most common parasite detected was Trichuris trichiura (39.0%) followed by Ascaris lumbricoides (26.9%), Entamoeba coli (5.2%), Giardia lamblia (5.2%), Blastocystis hominis (3.9%), hookworm (3.9%), Entamoeba histolytica (1.3%), Iodamoeba butschlii (1.3%) and Cryptosporidium sp. (1.3%) respectively. Some respondents had single parasites (24.7%), some with two parasites (18.2%). Some with three parasites (6.5%) and one had four parasites species (1.3%). The parasites were slightly more common in females (54.7%) than males ((41.7%). The parasites were more common in the 13-20 year age group (90.9%) followed by 1-12 years (69.6%), 21-40 year age group (34.8%) and least in the 41-60 year age group (27.8%). Nail examinations of the respondents did not show any evidence of parasites. One had a mite, three had pollen grains and one had yeast cells isolated from the finger nails. Soil samples taken around their houses showed only one sample with a nematode ova and one with oocyst which was of a non human origin.

Detecção e quantificação de ovos viáveis de Ascaris sp e outros ovos de helmintos em lodo de esgoto / Detection and quantification of Ascaris sp and other helminth eggs in sewage sludge

Introdução O lodo gerado em estações de tratamento de esgotos é um resíduo de composição variável e com potencial poluidor dependendo de sua origem, tipo de tratamento e sazonalidade; pode conter patógenos dentre os quais os parasitas. Porém, quando tratado adequadamente, o lodo de esgoto pode ser aplicado na agricultura como fertilizante ou condicionador de solo. Em países em desenvolvimento, estudos têm demonstrado que a incidência de enteroparasitoses é elevada, sendo Ascaris sp um dos mais prevalentes. Portanto, o uso agrícola do lodo de esgoto pode oferecer riscos à saúde humana. Com intuito de salvaguardar a saúde da população entrou em vigor a Resolução CONAMA nº375/06, que estabelece critérios e procedimentos para o uso do lodo em áreas agrícolas. Objetivo - Determinar e quantificar ovos de helmintos e de Ascaris sp em lodos provenientes de três ETEs de uma região metropolitana, verificando o atendimento ao padrão parasitológico estabelecido pela CONAMA nº375/06. Método Utilizou-se o método descrito no apêndice I da norma CFR 503 USEPA de 2003. Resultados Os lodos analisados no período do estudo apresentaram rica fauna parasitária onde foram observados ovos de Ancylostoma sp, Ascaris sp, Capillaria sp, Enterobius vermicularis, Fasciola hepatica, Hymenolepis sp, Taenia sp, Toxocara sp e Trichuris sp. Observou-se que ovos de Ascaris sp foram os mais prevalentes com 67,71 por cento , seguido por Toxocara sp (13,62 por cento ). Ovos viáveis de Ascaris sp estavam presentes em 10,16 por cento das amostras. Conclusão Pode-se concluir que o lodo gerado nas ETEs estudadas apresentaram amplo espectro de ovos de helmintos, sendo Ascaris sp o mais prevalente. Das três ETEs analisadas, nenhuma atendia os parâmetros parasitológicos para lodo classe A, segundo a Resolução CONAMA nº375/06.

Interactions between worms and malaria: good worms or bad worms?

In the past decade there have been an increasing number of studies on co-infections between worms and malaria. However, this increased interest has yielded results that have been at times conflicting and made it difficult to clearly grasp the outcome of this interaction. Despite the heterogeneity of study designs, reviewing the growing body of research may be synthesized into some broad trends: Ascaris emerges mostly as protective from malaria and its severe manifestations, whereas hookworm seems to increase malaria incidence. As efforts are made to de-worm populations in malaria endemic areas, there is still no clear picture of the impact these programmes have in terms of quantitative and qualitative changes in malaria.

Ascaris and ascariasis.

Ascaris lumbricoides and Ascaris suum are widespread parasitic nematodes of humans and pigs respectively. Recent prevalence data suggests that approximately 1.2 billion people are infected. Adult worms exhibit an overdispersed frequency distribution in their hosts and individuals harbouring heavy burdens display associated morbidity. In this review, we describe the parasite, its distribution and measures undertaken to control infection.

Investigating the underlying mechanism of resistance to Ascaris infection.

The generative mechanism(s) of predisposition to Ascaris infection are currently unknown. While many factors play a role in interindividual infection intensity, much focus has been placed on the host's immunological response to infection and the underlying genetics. The present review describes the research conducted that has examined various immunological parameters and genetic factors that may play a role in resistance to ascariasis. We also discuss the contribution that animal models have made to our understanding of resistance to the parasitic roundworm and their role in possible future work.

Predisposition to ascariasis: patterns, mechanisms and implications.

Ascaris lumbricoides, the human roundworm, is a remarkably infectious and persistent parasite. It is a member of the soil-transmitted helminths or geohelminths and infects in the order of 1472 million people worldwide. Despite, its high prevalence and wide distribution it remains along with its geohelminth counterparts, a neglected disease. Ascariasis is associated with both chronic and acute morbidity, particularly in growing children, and the level of morbidity assessed as disability-adjusted life years is about 10.5 million. Like other macroparasite infections, the frequency distribution of A. lumbricoides is aggregated or overdispersed with most hosts harbouring few or no worms and a small proportion harbouring very heavy infections. Furthermore, after chemotherapeutic treatment, individuals demonstrate consistency in the pattern of re-infection with ascariasis, described as predisposition. These epidemiological phenomena have been identified, in a consistent manner, from a range of geographical locations in both children and adults. However, what has proved to be much more refractory to investigation has been the mechanisms that contribute to the observed epidemiological patterns. Parallel observations utilizing human subjects and appropriate animal model systems are essential to our understanding of the mechanisms underlying susceptibility/resistance to ascariasis. Furthermore, these patterns of Ascaris intensity and re-infection have broader implications with respect to helminth control and interactions with other important bystander infections.

Immune and genetic aspects of asthma, allergy and parasitic worm infections: evolutionary links.

There are important parallels in the immunobiology of allergy and asthma, and of the human host's response to parasitic worms. Th-2 immune actions with 'weep and sweep' mucosal biology are common to both - pathological in the first and protective in the second. Common up-regulating genetic variants of Th-2 immunity, notably in IL13 and STAT6, predict increased risk of asthma and allergy, but diminished intensity of infection by Ascaris and Schistosoma. Endemic exposures of humans to parasitic worms may have been one evolutionary force selecting for genetic variants that promote asthma and allergy.

Recent insights into the epidemiology and genetics of Ascaris in China using molecular tools.

Ascaris is a large parasitic roundworm (nematode) of the small intestine of humans and pigs, which causes the socio-economically important disease, ascariasis. To better understand the relationship of Ascaris between the 2 host species, recent studies in China have focused on investigating the genetics and epidemiology of Ascaris from humans and pigs using a mutation scanning-based approach. Findings provided support for a low level of gene flow between the human and porcine Ascaris populations. Extending the studies of genotypic variability within Ascaris from humans and pigs, experimental infections of mice and pigs with selected genotypes of Ascaris were carried out. Initial results indicate that there is a significant difference in the ability of Ascaris eggs of genotype G1 (derived from human) and G3 (derived from pig) to infect and establish as adults in pigs, supporting the difference in the frequencies of these genotypes in natural Ascaris populations between pigs and humans in China. Taken together, current information supports that there is limited cross-infection of Ascaris between humans and pigs in endemic regions and that pigs are not a significant reservoir of human infection with the adult nematode in such areas.

Studies on the interaction between Salmonella enterica ser. Typhimurium and intestinal helminths in pigs.

Concomitant infections with helminths and bacteria may affect the course and the resulting disease outcome of the individual infections. Salmonella, Oesophagostomum, Trichuris and Ascaris coexist naturally in pig herds in Denmark, and possible interactions were studied. Pigs in one experiment were trickle infected with low or moderate dose levels of Oesophagostomum spp. and challenge infected with S. Typhimurium. In another experiment, pigs were inoculated with S. Typhimurium followed by a challenge exposure to either Oesophagostomum, Trichuris or Ascaris. Enhancement of the Salmonella infection was not demonstrated in either experiment. The helminth effect on the pigs was modest and may explain the lack of influence on the Salmonella infection. A previous experiment with a larger Oesophagostomum infection level resulted in enhancement of the S. Typhimurium infection. A dose dependency of the interaction is therefore suggested. However, the relatively high worm burdens in the present study suggest that infection with these common pig helminths does generally not influence the course of concurrent S. Typhimurium infections under natural conditions.

Gastrointestinal nematode infection is associated with variation in innate immune responsiveness.

Ex vivo monocyte cytokine responses (IL-1beta, TNF-alpha, IL-12p70, IL-10, TGF-beta) to bacterial TLR2 and TLR4 ligands were quantified in 47 gastrointestinal (GI) nematode-exposed children in Pemba Island, Tanzania. Worminess (estimated by faecal egg counts (FEC)) had a positive relationship with pro-inflammatory TNF-alpha and IL-1beta responsiveness to the TLR ligands. In particular, there was a strong significant relationship with TNF-alpha response to TLR4 ligand (LPS). There were no significant associations between regulatory responses (IL-10, TGF-beta) and worminess. These results are consistent with the possibility that GI nematodes modulate innate responses and may indicate a potential mechanism for interactions between GI nematodiasis and important bystander pathogens.

Assessment of the health hazards associated with wastewater reuse: transmission of geohelminthic infections (Marrakech, Morocco).

To address the problem of water scarcity, wastewater has long been used for agricultural purposes in Marrakech (Morocco) and its benefits have long been recognized. However, the benefits of urban wastewater reuse may be limited by its potential health hazards associated essentially to the danger of transmission of pathogenic organisms to human beings. The current study aimed to evaluate the risks associated with raw wastewater reuse for agricultural purposes, and the incidence of geohelminthic infections among the children of the wastewater spreading area of Marrakech as compared to a control group. Faecal samples from 610 individuals were examined for Ascaris spp. ova and Trichuris spp. ova (323 children for the exposed group and 287 for the control group). The study duration was two months and a half, and was carried out in the summer period. A questionnaire-interview with children and parents was used to collect data on possible demographic, hygiene and behavioural-contact factors such as gender, age, family size, source of water supply, parental occupation. The investigations resulted in the detection of Ascaris spp. ova in 43 samples indicating a point-prevalence of 13.3% in the exposed group versus 1.7% for the control group. Trichuris spp. ova was detected in 43 faecal samples indicating a point-prevalence of 13.3% in the exposed group, and 3.8% in the control group. The Chi-square test showed that the differences observed between the exposed and control group are statistically significant (p < 0.01). Males are more infected with ascariasis and trichuriasis than females and children of 2-8 years of age are heavily infected as compared to 9 - 14-year-old children. Based upon the findings of this study, it is concluded that wastewater reuse for agricultural purposes presents an increased risk of infection in the exposed group.

Ozonation by-products issued from the destruction of microorganisms present in wastewaters treated for reuse.

This work demonstrates the reaction of ozone on the amino acids comprising the covering layer of resistant micro-organisms. A secondary aim was to check the byproducts generated when ozone was applied to synthetic samples (such as Vibrio cholerae NO 01 WFCC-449, Salmonella typhi ATTC-6539, faecal coliforms and Ascaris suum). The ozone was applied at a concentration of 18.4 mgO3/min at pH 3, for different lengths of time. In the case of bacteria, results showed that, at 8 minutes, the number was reduced to the level of the Official Mexican Standards set for treated water destined for irrigation purposes (1,000 MPN/100 mL). Excellent correlation coefficients (0.95 to 0.99) were obtained for microbial concentrations versus ozone contact time. Destruction times required for 100% removal of the initial bacteria population varied between 2 and 14 minutes, while Ascaris suum required 1 hour. When Gram-negative bacteria die due to the effects of ozone, cellular lysis and the liberation of endotoxins (biodegradable) were observed. The ozonation of amino acids in the shell of Ascaris suum eggs, leads to the formation of aldehydes, such as formaldehyde and acetaldehyde, in low concentrations (0.0003 and 0.0005 microg/mL respectively). These levels are not hazardous to human health.