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1.
Medicine (Baltimore) ; 100(10): e24890, 2021 Mar 12.
Artigo em Inglês | MEDLINE | ID: mdl-33725845

RESUMO

RATIONALE: Cystoisosporiasis is an intestinal infectious disease caused by a coccidian protozoa, Cystoisospora belli (C. belli). It can cause prolonged and refractory diarrhea most commonly in immunocompromised patients, while immunocompetent individuals usually exhibit no symptoms or self-limited diarrhea. PATIENT CONCERNS: We herein report a case of chronic cystoisosporiasis in an immunocompetent patient. A 62-year-old man, who had been first diagnosed with cystoisosporiasis 15 years ago and had been treated with oral administration of trimethoprim-sulfamethoxazole (TMP-SMX), complained of persistent watery diarrhea. He was negative for anti-human immunodeficiency virus antibody and anti-human T-cell leukemia virus type 1 (HTLV-1) antibody. DIAGNOSIS: Biopsy specimens from the duodenum revealed oocysts in the atrophic absorptive epithelium and protozoa were detected through stool examination, indicating the recurrence of cystoisosporiasis. Capsule endoscopy showed diffuse atrophic mucosa with white villi in the entire small intestine. We diagnosed him with chronic cystoisosporiasis that occurred in an immunocompetent adult. INTERVENTIONS: Since oral administration of TMP-SMX and ciprofloxacin were ineffective, the intravenous administration of TMP-SMX was initiated. OUTCOMES: Intravenous TMP-SMX exhibited a significant improvement. LESSONS: This case indicates that even immunocompetent individuals may develop recurrent and refractory cystoisosporiasis. Furthermore, intravenous treatment of antibiotic agents should be considered when the impaired absorptive ability from the small intestine is suspected.


Assuntos
Antiprotozoários/administração & dosagem , Enteropatias Parasitárias/diagnóstico , Enteropatias Parasitárias/tratamento farmacológico , Isosporíase/diagnóstico , Isosporíase/tratamento farmacológico , Combinação Trimetoprima e Sulfametoxazol/administração & dosagem , Administração Intravenosa , Administração Oral , Antiprotozoários/uso terapêutico , Endoscopia por Cápsula , Doença Crônica , Diarreia/parasitologia , Humanos , Imunocompetência , Masculino , Pessoa de Meia-Idade , Recidiva , Combinação Trimetoprima e Sulfametoxazol/uso terapêutico
2.
Parasit Vectors ; 13(1): 70, 2020 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-32113470

RESUMO

BACKGROUND: Gastrointestinal nematodes are parasites that commonly infect dogs, and infections can be subclinical or may cause considerable clinical disease. Some species are zoonotic and may also cause clinical disease in humans. Year-round treatment of dogs is recommended to eliminate existing infections, which also indirectly reduces the potential for subsequent human exposure to zoonotic species. Here we present two studies that evaluated the safety and efficacy of a novel chewable oral tablet containing sarolaner, moxidectin and pyrantel against gastrointestinal nematode infections in dogs presented as veterinary patients in Europe and the USA. METHODS: Dogs naturally infected with Toxocara canis, Toxascaris leonina, Ancylostoma caninum and/or Uncinaria stenocephala were enrolled in the European study, and dogs naturally infected with T. canis were enrolled in the USA study. The animals were treated once orally with Simparica Trio™ tablets to provide 1.2-2.4 mg/kg sarolaner, 24-48 µg/kg moxidectin and 5-10 mg/kg pyrantel (as pamoate salt) or with a commercially available product according to the label directions as positive control. Efficacy was based on the post-treatment reduction in geometric mean egg counts (per gram feces) 7 or 10 days after treatment compared to pre-treatment egg counts. RESULTS: Simparica Trio™ was well tolerated in both studies. In the European study, geometric mean egg counts for T. canis, T. leonina, A. caninum and U. stenocephala were reduced by ≥ 98.3% in the Simparica Trio™ group and by ≥ 97.4% in the afoxolaner + milbemycin oxime group. In the USA study, geometric mean egg counts for T. canis were reduced by 99.2% in the Simparica Trio™ group and by 98.6% in the ivermectin + pyrantel group. In the USA study, 48 and 10 dogs in the Simparica Trio™ and the ivermectin + pyrantel group, respectively, were co-infected with A. caninum and the reduction in the post-treatment mean fecal egg counts were 98.6% and 74.7%, respectively. CONCLUSIONS: A single oral administration of Simparica Trio™ chewable tablets was well tolerated and was effective in the treatment of dogs with naturally occurring gastrointestinal nematode infections presented as veterinary patients in Europe and the USA.


Assuntos
Antinematódeos/administração & dosagem , Doenças do Cão/tratamento farmacológico , Enteropatias Parasitárias/veterinária , Nematoides/efeitos dos fármacos , Infecções por Nematoides/veterinária , Administração Oral , Animais , Azetidinas/administração & dosagem , Cães , Combinação de Medicamentos , Europa (Continente) , Feminino , Enteropatias Parasitárias/tratamento farmacológico , Macrolídeos/administração & dosagem , Masculino , Nematoides/classificação , Infecções por Nematoides/tratamento farmacológico , Contagem de Ovos de Parasitas , Pirantel/administração & dosagem , Compostos de Espiro/administração & dosagem , Resultado do Tratamento , Estados Unidos
3.
Parasit Vectors ; 13(1): 71, 2020 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-32113482

RESUMO

BACKGROUND: Ascarid infections are among the most prevalent intestinal parasitic infections occurring in dogs around the world, with Toxocara canis and Toxascaris leonina commonly observed. Toxocara canis can cause considerable disease in dogs and humans, and year-round prophylactic treatment and control in dogs is recommended. Elimination of immature stages of these parasites before egg-laying will reduce environmental contamination and the risk of infection for both dogs and humans. Studies were conducted to evaluate the efficacy of a novel, oral chewable tablet containing sarolaner, moxidectin and pyrantel (Simparica Trio™) against induced immature adult (L5) and adult T. canis, and adult T. leonina infections in dogs. METHODS: Six negative-controlled, masked, randomized laboratory studies were conducted. Two studies each evaluated efficacy against immature adult (L5) T. canis, adult T. canis, and adult T. leonina. Sixteen to 40 dogs were included in each study. Dogs experimentally infected with the target parasite were dosed once on Day 0 with either placebo tablets or Simparica Trio™ tablets to provide minimum dosages of 1.2 mg/kg sarolaner, 24 µg/kg moxidectin and 5.0 mg/kg pyrantel (as pamoate salt). Efficacy was based on the number of worms recovered at necropsy 7-10 days after treatment compared to placebo control. RESULTS: Based on geometric mean worm counts, efficacy of the sarolaner + moxidectin + pyrantel combination was ≥ 95.2% against immature adult T. canis, ≥ 97.3% against adult T. canis, and ≥ 89.7% against adult T. leonina. There were no treatment-related adverse events in any study. CONCLUSIONS: These studies confirm the efficacy of a single dose of a new oral chewable tablet containing sarolaner, moxidectin and pyrantel (Simparica Trio™) against immature adult and adult T. canis, and adult T. leonina infections in dogs.


Assuntos
Antinematódeos/administração & dosagem , Infecções por Ascaridida/veterinária , Doenças do Cão/tratamento farmacológico , Enteropatias Parasitárias/veterinária , Administração Oral , Animais , Infecções por Ascaridida/tratamento farmacológico , Azetidinas/administração & dosagem , Cães , Combinação de Medicamentos , Feminino , Enteropatias Parasitárias/tratamento farmacológico , Macrolídeos/administração & dosagem , Masculino , Contagem de Ovos de Parasitas , Pirantel/administração & dosagem , Compostos de Espiro/administração & dosagem , Comprimidos , Toxascaris/efeitos dos fármacos , Toxascaris/fisiologia , Toxocara canis/efeitos dos fármacos , Toxocara canis/fisiologia , Resultado do Tratamento
4.
Pol J Vet Sci ; 22(4): 753-760, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31867918

RESUMO

We described a first case of resistance to eprinomectin in goat herd in Poland in which resistance to benzimidazoles had been previously reported. The herd was established in 2011 by purchasing several goats from a single herd in south-eastern Poland. Resistance to benzimidazoles in the herd was first reported in 2017. Shortly after the owner started to signal low effectiveness of the treatment with eprinomectin. In June 2018 the larval development test from pooled faecal sample was performed and the results indicated the presence of resistance to macrocyclic lactones and levamisole. In July 2018 a faecal egg count (FEC) reduction test was performed in 39 animals with levamisole, eprinomectin and one untreated control group. Drugs were used in doses recommended for goats. Three methods of calculation of FEC reduction were compared. After eprinomectin treatment, FEC reduction ranged from 0 to 20%, depending on the method of calculation. FEC reduction following levamisole treatment was 100%. Main species present in the faecal samples after treatment and in larvicidal concentrations in larval development test was Haemonchus contortus. This is the first report of anthelminthic resistance to macrocylic lactones (eprinomectin) in goats in Poland.


Assuntos
Benzimidazóis/farmacologia , Doenças das Cabras/tratamento farmacológico , Enteropatias Parasitárias/veterinária , Ivermectina/análogos & derivados , Nematoides/efeitos dos fármacos , Infecções por Nematoides/veterinária , Animais , Anti-Helmínticos/uso terapêutico , Resistência a Medicamentos , Fezes/parasitologia , Doenças das Cabras/parasitologia , Cabras , Enteropatias Parasitárias/tratamento farmacológico , Enteropatias Parasitárias/parasitologia , Ivermectina/uso terapêutico , Infecções por Nematoides/tratamento farmacológico , Infecções por Nematoides/parasitologia , Contagem de Ovos de Parasitas
6.
Ann Parasitol ; 65(3): 217-223, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31578845

RESUMO

The majority of the population in Yemen lives in rural areas and suffers from parasitic infections. Therefore, the present study aimed to determine the prevalence of intestinal parasitoses and schistosome infections among the students enrolled in the primary schools in Hajjah governorate ­ north of Yemen, along with an assessment of praziquantel (PZQ) in the treatment of microscopy-confirmed cases of Schistosoma mansoni and Schistosoma haematobium. For this purpose, 780 samples (320 stool and 460 urine) were examined microscopically. The present study revealed an overall infection rate of 75.3% (241/320) with intestinal parasites and Schistosoma mansoni. The detected parasite species included Entamoeba histolytica (27.8%), Hymenolepis nana (12.2%), Giardia lamblia (9.7%), Entamoeba coli (9.4%), S. mansoni (9.1%), Ascaris lumbricoides (6.9%), Trichuris trichiura (3.1%), Enterobius vermicularis (2.8%) and Ancylostoma duodenale (2.2%). Schistosoma haematobium was prevalent among 1.7% (8/460) of the investigated students. On the other hand, PZQ yielded a cure rate of 75.7% of Schistosoma-infected students when administered at 40 mg/kg body weight. However, a 100% cure rate was achieved when administered at 60 mg/kg body weight. Therefore, the findings of the present study highlight the importance of monitoring PZQ efficacy through large-scale studies in different settings endemic for schistosomosis in the country.


Assuntos
Enteropatias Parasitárias , Praziquantel , Esquistossomose , Animais , Criança , Fezes/parasitologia , Humanos , Enteropatias Parasitárias/tratamento farmacológico , Enteropatias Parasitárias/epidemiologia , Enteropatias Parasitárias/parasitologia , Praziquantel/uso terapêutico , Prevalência , Schistosoma haematobium , Esquistossomose/tratamento farmacológico , Esquistossomose/epidemiologia , Esquistossomose/parasitologia , Esquistossomose Urinária/tratamento farmacológico , Esquistossomose Urinária/epidemiologia , Esquistossomose Urinária/parasitologia , Esquistossomose mansoni/tratamento farmacológico , Esquistossomose mansoni/epidemiologia , Esquistossomose mansoni/parasitologia , Estudantes , Resultado do Tratamento , Urina/parasitologia , Iêmen/epidemiologia
7.
Vet Parasitol ; 275: 108932, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31600614

RESUMO

This study describes the in vitro anthelmintic activity of a hydroalcoholic extract from the fruit of Piper cubeba and its major isolated components against the eggs and larvae of gastrointestinal nematodes obtained from naturally-infected ovines. In vitro anthelmintic activity was evaluated using the egg hatch test (EHT), larval development test (LDT) and L3 migration inhibition test (LMT). The extract showed ovicidal and larvicidal activity, with an EC50 of 200 µg/mL and 83.00 µg/mL in the EHT and LDT, respectively. The extract inhibited 100% of larval migration at the lowest tested concentration (95 µg/mL). The crude extract was purified using successive silica gel chromatographic columns, which revealed the lignans hinokinin, cubebin and dihydrocubebin as the major compounds that were present, which were then used in in vitro tests. Cubebin, dihydrocubebin and hinokinin showed higher activity than the crude extract, with an EC50 for ovicidal activity of 150.00 µg/mL, 186.70 µg/mL and 68.38 µg/mL, respectively. In the LDT, cubebin presented an EC50 of 14.89 µg/mL and dihydrocubebin of 30.75 µg/mL. Hinokinin inhibited 100% the larval development at all concentrations evaluated. In the LMT, dihydrocubebin inhibited 100% the larval migration in all concentrations evaluated while cubebin and hinokinin showed EC50 values of 0.89 µg/mL and 0.34 µg/mL, respectively. P. cubeba extract is rich in several classes of active compounds, but here we demonstrate that the described anthelmintic activity may be related to the presence of these lignans, which are present in larger concentrations than other components of the extract. Our results demonstrate for first time the anthelmintic activity against gastrointestinal nematodes in sheep for this class of special metabolites that are present in P. cubeba fruit. However, future detailed studies are needed to evaluate the effectiveness of P. cubeba fruits extract and active lignans in in vivo tests.


Assuntos
Enteropatias Parasitárias/veterinária , Lignanas/farmacologia , Nematoides/efeitos dos fármacos , Infecções por Nematoides/veterinária , Piper/química , Extratos Vegetais/farmacologia , 4-Butirolactona/análogos & derivados , 4-Butirolactona/química , 4-Butirolactona/isolamento & purificação , 4-Butirolactona/farmacologia , Animais , Benzodioxóis/química , Benzodioxóis/isolamento & purificação , Benzodioxóis/farmacologia , Cromatografia em Gel/veterinária , Dioxolanos/química , Dioxolanos/isolamento & purificação , Dioxolanos/farmacologia , Fezes/parasitologia , Frutas/química , Enteropatias Parasitárias/tratamento farmacológico , Enteropatias Parasitárias/parasitologia , Larva/efeitos dos fármacos , Larva/crescimento & desenvolvimento , Larva/fisiologia , Lignanas/química , Lignanas/isolamento & purificação , Microscopia Eletrônica de Varredura/veterinária , Nematoides/crescimento & desenvolvimento , Nematoides/fisiologia , Infecções por Nematoides/tratamento farmacológico , Infecções por Nematoides/parasitologia , Óvulo/efeitos dos fármacos , Óvulo/fisiologia , Extratos Vegetais/química , Ovinos , Doenças dos Ovinos/parasitologia
10.
Acta Trop ; 200: 105181, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31542370

RESUMO

China was once a country plagued by parasitic diseases. At the beginning of the founding of the People's Republic of China, nearly 80% of the population suffered from parasitic diseases because of poverty and poor sanitary conditions. After nearly 70 years of development, China has made remarkable achievements in the prevention and control of parasitic diseases, and the prevalence of parasitic diseases has been greatly reduced. In addition to organizational leadership from the government and various preventive measures, drug treatment and drug research & development are important and irreplaceable links in prevention and control work. Since the 1950s, China has begun to introduce, produce and imitate antiparasitic drugs from abroad, such as santonin, benzimidazole, and praziquantel. Chinese scientists have also contributed to the optimization of production techniques, improvements in drug formulation, the application in the clinic and the mechanisms of actions of generic drugs. At the same time, China has independently developed tribendimidine (TrBD, a broad spectrum anthelminthic), and its anthelminthic spectrum has been comprehensively studied. It is active against almost 20 parasites, is especially superior to benzimidazoles against Necator americanus, and surpasses the effectiveness of praziquantel against Clonorchis sinensis. In the treatment of tapeworm disease, the traditional Chinese medicines pumpkin seeds and betel nuts have good curative effects for taeniasis. Chinese scientists have explored the action modes and clinical administration methods of pumpkin seeds and betel nuts, which is still the main clinical regimen for the disease. This paper reviews the history and progress of the study of anthelmintics in intestinal helminth infections since the founding of the People's Republic of China and aiming to support clinicians and drug researchers in China and other countries.


Assuntos
Anti-Helmínticos/história , Anti-Helmínticos/uso terapêutico , Infecções por Cestoides/tratamento farmacológico , Helmintíase/tratamento farmacológico , Enteropatias Parasitárias/tratamento farmacológico , Doenças Parasitárias/tratamento farmacológico , Doenças Parasitárias/história , Animais , Infecções por Cestoides/epidemiologia , Infecções por Cestoides/história , China/epidemiologia , Clonorchis sinensis/efeitos dos fármacos , Helmintíase/história , História do Século XX , História do Século XXI , Humanos , Enteropatias Parasitárias/história , Doenças Parasitárias/epidemiologia , Fenilenodiaminas/uso terapêutico , Praziquantel/história , Praziquantel/uso terapêutico , Teníase/tratamento farmacológico , Teníase/história
11.
Lancet Glob Health ; 7(11): e1511-e1520, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31558383

RESUMO

BACKGROUND: Mass deworming against soil-transmitted helminthiasis, which affects 1 billion of the poorest people globally, is one of the largest public health programmes for neglected tropical diseases, and is intended to be equitable. However, the extent to which treatment programmes for deworming achieve equitable coverage across wealth class and sex is unclear and the public health metric of national deworming coverage does not include representation of equity. This study aims to measure both coverage and equity in global, national, and subnational deworming to guide future programmatic evaluation, investment, and metric design. METHODS: We used nationally representative, geospatial, household data from Demographic and Health Surveys that measured mother-reported deworming in children of preschool age (12-59 months). Deworming was defined as children having received drugs for intestinal parasites in the previous 6 months before the survey. We estimated deworming coverage disaggregated by geography, wealth quintile, and sex, and computed an equity index. We examined trends in coverage and equity index across countries, within countries, and over time. We used a regression model to compute the household correlates of deworming and ecological correlates of equitable deworming. FINDINGS: Our study included 820 883 children living in 50 countries from Africa, the Americas, Asia, and Europe that are endemic for soil-transmitted helminthiasis using 77 Demographic and Health Surveys from December, 2003, to October, 2017. In these countries, the mean deworming coverage in preschool children was estimated at 33·0% (95% CI 32·9-33·1). The subnational coverage ranged from 0·5% to 87·5%, and within-country variation was greater than between-country variation. Of the 31 countries reporting that they reached the WHO goal of more than 75% national coverage, 30 had inequity in deworming, with treatment concentrated in wealthier populations. We did not detect systematic differences in deworming equity by sex. INTERPRETATION: Substantial inequities in mass deworming programmes are common as wealthier populations have consistently higher coverage than that of the poor, including in countries reporting to have reached the WHO goal of more than 75% national coverage. These inequities seem to be geographically heterogeneous, modestly improving over time, with no evidence of sex differences in inequity. Future reporting of deworming coverage should consider disaggregation by geography, wealth, and sex with incorporation of an equity index to complement the conventional public health metric of national deworming coverage. FUNDING: Bill & Melinda Gates Foundation, Stanford University Medical Scientist Training Program.


Assuntos
Anti-Helmínticos/uso terapêutico , Controle de Doenças Transmissíveis/organização & administração , Helmintíase/tratamento farmacológico , Enteropatias Parasitárias/tratamento farmacológico , África , Anti-Helmínticos/economia , Ásia , Pré-Escolar , Controle de Doenças Transmissíveis/economia , Estudos Transversais , Países em Desenvolvimento , Europa (Continente) , Feminino , Helmintíase/economia , Helmintíase/epidemiologia , Humanos , Enteropatias Parasitárias/economia , Enteropatias Parasitárias/epidemiologia , Masculino , Pobreza/estatística & dados numéricos , Fatores Socioeconômicos , Solo/parasitologia
12.
Cochrane Database Syst Rev ; 9: CD000371, 2019 09 11.
Artigo em Inglês | MEDLINE | ID: mdl-31508807

RESUMO

BACKGROUND: The World Health Organization (WHO) recommends treating all school children at regular intervals with deworming drugs in areas where helminth infection is common. Global advocacy organizations claim routine deworming has substantive health and societal effects beyond the removal of worms. In this update of the 2015 edition we included six new trials, additional data from included trials, and addressed comments and criticisms. OBJECTIVES: To summarize the effects of public health programmes to regularly treat all children with deworming drugs on child growth, haemoglobin, cognition, school attendance, school performance, physical fitness, and mortality. SEARCH METHODS: We searched the Cochrane Infectious Diseases Group Specialized Register; Cochrane Central Register of Controlled Trials (CENTRAL); MEDLINE; Embase; LILACS; the metaRegister of Controlled Trials (mRCT); reference lists; and registers of ongoing and completed trials up to 19 September 2018. SELECTION CRITERIA: We included randomized controlled trials (RCTs) and quasi-RCTs that compared deworming drugs for soil-transmitted helminths (STHs) with placebo or no treatment in children aged 16 years or less, reporting on weight, height, haemoglobin, and formal tests of cognition. We also sought data on other measures of growth, school attendance, school performance, physical fitness, and mortality. DATA COLLECTION AND ANALYSIS: At least two review authors independently assessed the trials for inclusion, risk of bias, and extracted data. We analysed continuous data using the mean difference (MD) with 95% confidence intervals (CIs). Where data were missing, we contacted trial authors. We stratified the analysis based on the background burden of STH infection. We used outcomes at time of longest follow-up. We assessed the certainty of the evidence using the GRADE approach. MAIN RESULTS: We identified 51 trials, including 10 cluster-RCTs, that met the inclusion criteria. One trial evaluating mortality included over one million children, and the remaining 50 trials included a total of 84,336 participants. Twenty-four trials were in populations categorized as high burden, including nine trials in children selected because they were helminth-stool positive; 18 with intermediate burden; and nine as low burden.First or single dose of deworming drugsFourteen trials reported on weight after a single dose of deworming drugs (4970 participants, 14 RCTs). The effects were variable. There was little or no effect in studies conducted in low and intermediate worm burden groups. In the high-burden group, there was little or no effect in most studies, except for a large effect detected from one study area in Kenya reported in two trials carried out over 30 years ago. These trials result in qualitative heterogeneity and uncertainty in the meta-analysis across all studies (I2 statistic = 90%), with GRADE assessment assessed as very low-certainty, which means we do not know if a first dose or single dose of deworming impacts on weight.For height, most studies showed little or no effect after a single dose, with one of the two trials in Kenya from 30 years ago showing a large average difference (2621 participants, 10 trials, low-certainty evidence). Single dose probably had no effect on average haemoglobin (MD 0.10 g/dL, 95% CI 0.03 lower to 0.22 higher; 1252 participants, five trials, moderate-certainty evidence), or on average cognition (1596 participants, five trials, low-certainty evidence). The data are insufficient to know if there is an effect on school attendance and performance (304 participants, one trial, low-certainty evidence), or on physical fitness (280 participants, three trials, very low-certainty evidence). No trials reported on mortality.Multiple doses of deworming drugsThe effect of regularly treating children with deworming drugs given every three to six months on weight was reported in 18 trials, with follow-up times of between six months and three years; there was little or no effect on average weight in all but two trials, irrespective of worm prevalence-intensity. The two trials with large average weight gain included one in the high burden area in Kenya carried out over 30 years ago, and one study from India in a low prevalence area where subsequent studies in the same area did not show an effect. This heterogeneity causes uncertainty in any meta-analysis (I2 = 78%). Post-hoc analysis excluding trials published prior to 2000 gave an estimate of average difference in weight gain of 0.02 kg (95%CI from 0.04 kg loss to 0.08 gain, I2 = 0%). Thus we conclude that we do not know if repeated doses of deworming drugs impact on average weight, with a fewer older studies showing large gains, and studies since 2000 showing little or no average gain.Regular treatment probably had little or no effect on the following parameters: average height (MD 0.02 cm higher, 95% CI 0.09 lower to 0.13 cm higher; 13,700 participants, 13 trials, moderate-certainty evidence); average haemoglobin (MD 0.01 g/dL lower; 95% CI 0.05 g/dL lower to 0.07 g/dL higher; 5498 participants, nine trials, moderate-certainty evidence); formal tests of cognition (35,394 participants, 8 trials, moderate-certainty evidence); school performance (34,967 participants, four trials, moderate-certainty evidence). The evidence assessing an effect on school attendance is inconsistent, and at risk of bias (mean attendance 2% higher, 95% CI 5% lower to 8% higher; 20,650 participants, three trials, very low-certainty evidence). No trials reported on physical fitness. No effect was shown on mortality (1,005,135 participants, three trials, low-certainty evidence). AUTHORS' CONCLUSIONS: Public health programmes to regularly treat all children with deworming drugs do not appear to improve height, haemoglobin, cognition, school performance, or mortality. We do not know if there is an effect on school attendance, since the evidence is inconsistent and at risk of bias, and there is insufficient data on physical fitness. Studies conducted in two settings over 20 years ago showed large effects on weight gain, but this is not a finding in more recent, larger studies. We would caution against selecting only the evidence from these older studies as a rationale for contemporary mass treatment programmes as this ignores the recent studies that have not shown benefit.The conclusions of the 2015 edition have not changed in this update.


Assuntos
Anti-Helmínticos/uso terapêutico , Helmintíase/tratamento farmacológico , Enteropatias Parasitárias , Estado Nutricional , Solo/parasitologia , Ganho de Peso , Peso Corporal , Criança , Desenvolvimento Infantil/efeitos dos fármacos , Cognição , Doenças Endêmicas , Humanos , Enteropatias Parasitárias/complicações , Enteropatias Parasitárias/tratamento farmacológico , Saúde Pública , Ensaios Clínicos Controlados Aleatórios como Assunto
13.
Parasitol Res ; 118(10): 2901-2907, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31388787

RESUMO

Cooperia sp. and Ostertagia sp. are two cosmopolitan parasitic nematodes often found in mixed gastrointestinal infections in cattle across temperate regions. In light of the recent increase in the emergence of anthelmintic resistance in these and other nematodes derived from cattle around the globe, and their negative impact on animal health and productivity, novel molecular assays need to be put forth in order to facilitate the monitoring of parasite burden in infected herds, using pasture and/or fecal samples. Here, we describe a novel droplet digital PCR platform-based concept for precise identification and quantification of the two most abundant and important parasite genera in grazing western European cattle. By exploiting a single nucleotide difference in the two parasites' ITS2 sequence regions, we have developed two specific hydrolysis probes labeled with FAM™ or HEX™ fluorophores, which can not only distinguish between the DNA sequences of the two, but also quantify them in mixed DNA samples. A third, newly developed universal probe was also tested along the genus-specific probes to provide a robust and accurate reference. It was evident that the universal probe displayed congruent results to those obtained by the genus-specific probes when used with DNA from both parasites in a single sample. All in all, the results of our assay suggest that this novel protocol could be used to distinguish and quantify cattle parasites belonging to the two most important genera (i.e., Cooperia and Ostertagia) in a single mixed DNA sample.


Assuntos
Doenças dos Bovinos/diagnóstico , DNA de Helmintos/genética , Enteropatias Parasitárias/veterinária , Ostertagia/genética , Trichostrongyloidea/genética , Animais , Anti-Helmínticos/uso terapêutico , Bovinos , Doenças dos Bovinos/tratamento farmacológico , Doenças dos Bovinos/parasitologia , Fezes/parasitologia , Gastroenteropatias , Enteropatias Parasitárias/diagnóstico , Enteropatias Parasitárias/tratamento farmacológico , Contagem de Ovos de Parasitas/veterinária , Reação em Cadeia da Polimerase/métodos
14.
Adv Exp Med Biol ; 1154: 181-213, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31297763

RESUMO

Intestinal trematodes are among the most common types of parasitic worms. About 76 species belonging to 14 families have been recorded infecting humans. Infection commonly occurs when humans eat raw or undercooked foods that contain the infective metacercariae. These parasites are diverse with regard to their morphology, geographical distribution, and life cycle, which make it difficult to study the parasitic diseases that they cause. Many of these intestinal trematodes have been considered as endemic parasites in the past. However, the geographical limits and the population at risk are currently expanding and changing in relation to factors such as growing international markets, improved transportation systems, new eating habits in developed countries and demographic changes. These factors make it necessary to better understand intestinal trematode infections. This chapter describes the main features of human intestinal trematodes in relation to their biology, epidemiology, host-parasite relationships, pathogenicity, clinical aspects, diagnosis, treatment, and control.


Assuntos
Interações Hospedeiro-Parasita , Enteropatias Parasitárias , Infecções por Trematódeos , Animais , Biodiversidade , Parasitologia de Alimentos , Interações Hospedeiro-Parasita/fisiologia , Humanos , Enteropatias Parasitárias/diagnóstico , Enteropatias Parasitárias/tratamento farmacológico , Enteropatias Parasitárias/epidemiologia , Enteropatias Parasitárias/prevenção & controle , Estágios do Ciclo de Vida , Trematódeos/fisiologia , Infecções por Trematódeos/diagnóstico , Infecções por Trematódeos/tratamento farmacológico , Infecções por Trematódeos/epidemiologia , Infecções por Trematódeos/prevenção & controle
15.
Korean J Parasitol ; 57(3): 243-248, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31284346

RESUMO

The purpose of this study was 2-fold: 1) to investigate the prevalence of gastrointestinal parasite infection in cats reared in Daegu, Republic of Korea and 2) to assess the efficacy and safety of a topical emodepside/praziquantel formulation for cats with parasitic infections. The gastrointestinal parasite infections were examined microscopically using the flotation method. Of 407 cats, 162 (39.8%) were infected by at least one gastrointestinal parasite, including Toxocara cati (63.0%), Toxascaris leonina (31.5%), Taenia taeniaeformis (3.7%), and Cystoisospora felis (1.9%). None of the infected animals had multiple infections. When the data were analyzed according to sex, age, and type of cat, stray cats showed statistically higher prevalence than companion cats (P<0.05). On the 5th day after treatment, no parasitic eggs were detected using microscopic examination. In addition, no adverse effects, such as abnormal behaviors and clinical symptoms, were observed in the cats treated with the drug. These results quantify the prevalence of gastrointestinal parasites in cats in Daegu, Republic of Korea, and show that topical emodepside/praziquantel is a safe and effective choice for treating the parasitic infections in cats.


Assuntos
Anti-Helmínticos/administração & dosagem , Doenças do Gato/tratamento farmacológico , Depsipeptídeos/administração & dosagem , Trato Gastrointestinal/parasitologia , Enteropatias Parasitárias/veterinária , Praziquantel/administração & dosagem , Animais , Doenças do Gato/parasitologia , Gatos , Composição de Medicamentos , Quimioterapia Combinada , Feminino , Enteropatias Parasitárias/tratamento farmacológico , Enteropatias Parasitárias/parasitologia , Masculino , República da Coreia , Taenia/efeitos dos fármacos , Taenia/isolamento & purificação , Taenia/fisiologia , Toxascaris/efeitos dos fármacos , Toxascaris/isolamento & purificação , Toxascaris/fisiologia , Toxocara/efeitos dos fármacos , Toxocara/isolamento & purificação , Toxocara/fisiologia
16.
Vet Parasitol Reg Stud Reports ; 17: 100292, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31303239

RESUMO

This is the first report about anthelmintic resistance (AR) in hair sheep farms determined in a sub-humid tropical climate, in an area known as Huasteca Potosina, Mexico. Faecal egg count reduction tests (FECRT) and egg hatch in vitro tests were conducted to identify the level of AR against benzimidazole (BZ) in parasitic gastrointestinal nematode (GIN) populations. An allele-specific polymerase chain reaction (AS-PCR) was performed to obtain a 250 bp band, indicating resistance, and a 550 bp band, indicating susceptibility to BZ. Macrocyclic lactones (ML) and imidazothiazole (IMZ) drugs were also tested with the FECRT. A PROBIT analysis was conducted using SAS to determine the 50% lethal doses (LD50) of the drugs according to the egg hatch in vitro test. Resistance to BZ and ML was found on all farms (0-70% effectiveness), whereas the susceptibility of nematodes to IMZ was detected with the FECRT (93-100% effectiveness). The LD50 was higher than the discriminating dose (0.1 µg ml-1) for BZ and confirmed AR to this anthelmintic; we also confirmed a high AR frequency with AS-PCR. Therefore, we suggest that strategic deworming should be performed to avoid the development of resistance to imidazothiazole.


Assuntos
Anti-Helmínticos/farmacologia , Lactonas/farmacologia , Infecções por Nematoides/veterinária , Nitroimidazóis/farmacologia , Doenças dos Ovinos/parasitologia , Tiazóis/farmacologia , Alelos , Animais , Anti-Helmínticos/uso terapêutico , Resistência a Medicamentos , Fezes/parasitologia , Feminino , Umidade , Enteropatias Parasitárias/tratamento farmacológico , Enteropatias Parasitárias/parasitologia , Enteropatias Parasitárias/veterinária , Lactonas/uso terapêutico , Dose Letal Mediana , Masculino , México , Infecções por Nematoides/tratamento farmacológico , Infecções por Nematoides/parasitologia , Nitroimidazóis/uso terapêutico , Contagem de Ovos de Parasitas , Reação em Cadeia da Polimerase/veterinária , Ovinos , Doenças dos Ovinos/tratamento farmacológico , Tiazóis/uso terapêutico , Clima Tropical
17.
J Infect Dis ; 220(7): 1188-1198, 2019 08 30.
Artigo em Inglês | MEDLINE | ID: mdl-31180118

RESUMO

Recent studies have illustrated the burden Cryptosporidium infection places on the lives of malnourished children and immunocompromised individuals. Treatment options remain limited, and efforts to develop a new therapeutic are currently underway. However, there are unresolved questions about the ideal pharmacokinetic characteristics of new anti-Cryptosporidium therapeutics. Specifically, should drug developers optimize therapeutics and formulations to increase drug exposure in the gastrointestinal lumen, enterocytes, or systemic circulation? Furthermore, how should researchers interpret data suggesting their therapeutic is a drug efflux transporter substrate? In vivo drug transporter-mediated alterations in efficacy are well recognized in multiple disease areas, but the impact of intestinal transporters on therapeutic efficacy against enteric diseases has not been established. Using multiple in vitro models and a mouse model of Cryptosporidium infection, we characterized the effect of P-glycoprotein efflux on bumped kinase inhibitor pharmacokinetics and efficacy. Our results demonstrated P-glycoprotein decreases bumped kinase inhibitor enterocyte exposure, resulting in reduced in vivo efficacy against Cryptosporidium. Furthermore, a hollow fiber model of Cryptosporidium infection replicated the in vivo impact of P-glycoprotein on anti-Cryptosporidium efficacy. In conclusion, when optimizing drug candidates targeting the gastrointestinal epithelium or gastrointestinal epithelial infections, drug developers should consider the adverse impact of active efflux transporters on efficacy.


Assuntos
Membro 1 da Subfamília B de Cassetes de Ligação de ATP/metabolismo , Criptosporidiose/tratamento farmacológico , Cryptosporidium/efeitos dos fármacos , Enteropatias Parasitárias/tratamento farmacológico , Naftalenos/metabolismo , Naftalenos/uso terapêutico , Piperidinas/metabolismo , Piperidinas/uso terapêutico , Pirazóis/metabolismo , Pirazóis/uso terapêutico , Pirimidinas/metabolismo , Pirimidinas/uso terapêutico , Quinolinas/metabolismo , Quinolinas/uso terapêutico , Animais , Transporte Biológico Ativo , Células CACO-2 , Permeabilidade da Membrana Celular/efeitos dos fármacos , Criptosporidiose/parasitologia , Modelos Animais de Doenças , Descoberta de Drogas/métodos , Enterócitos/efeitos dos fármacos , Enterócitos/metabolismo , Enterócitos/parasitologia , Feminino , Absorção Gastrointestinal/efeitos dos fármacos , Humanos , Interferon gama/genética , Camundongos , Camundongos Knockout , Naftalenos/química , Piperidinas/química , Pirazóis/química , Pirimidinas/química , Quinolinas/química , Resultado do Tratamento
18.
BMC Vet Res ; 15(1): 216, 2019 Jun 27.
Artigo em Inglês | MEDLINE | ID: mdl-31248417

RESUMO

BACKGROUND: This study aimed to evaluate the efficacy of anthelmintics in goats raised under mountain farming conditions in northern Italy. On 8 goat farms (n = 143 animals), a faecal egg count reduction (FECR) test was done after farmers conducted their routine anthelmintic treatments. Furthermore, on 5 goat farms (n = 135 animals) a FECR test was done under controlled conditions applying oral formulations of a macrocyclic lactone (ML), benzimidazole (BZ) (partly in combination with salicylanilide (SA)) or a combination of imidazothiazole (IT) and SA on the same farm. AR was assumed if FECR and the upper confidence interval (CI) was < 95% and the lower 95% CI was < 90%. RESULTS: Underdosing was found in 6 of the 8 farms tested after routine treatments. Out of the 6 routinely ML-treated goat flocks, only three were found where ML showed adequate efficacy. FECR in all others ranged between 64 and 93%. In one flock Trichostrongylus spp. and in one Haemonchus spp. larvae were identified after treatment. BZ-treated flocks had an efficacy of 99 and 37%. Larvae identified after treatment were Trichostrongylus spp. in one and Haemonchus spp. in the other flock. Under controlled conditions, ML had an adequate efficacy on 4 farms and a FECR of 88% on another one. BZ was effective on all farms. The combination of BZ and SA had a FECR of 99% on the farm it was tested. IT + SA in combination was effective on 2 farms and had a FECR of 91% on a third farm. Larvae identified after treatment were composed of Haemonchus spp. (ML and BZ), Trichostrongylus spp. (BZ) and Teladorsagia spp. (BZ and SA). CONCLUSIONS: This first report on the prevalence of AR in goats in the mountainous region of South Tyrol reveals a low efficacy of the most commonly used anthelmintics after routine treatments. This might be explained by a high level of underdosing as observed in the farms. However, results from the controlled FECR tests suggest that the observed level of AR was lower but cannot be solely explained by underdosing.


Assuntos
Anti-Helmínticos/uso terapêutico , Doenças das Cabras/tratamento farmacológico , Enteropatias Parasitárias/veterinária , Infecções por Nematoides/veterinária , Animais , Fazendas , Feminino , Doenças das Cabras/parasitologia , Cabras , Enteropatias Parasitárias/tratamento farmacológico , Itália , Masculino , Nematoides/efeitos dos fármacos , Infecções por Nematoides/tratamento farmacológico , Contagem de Ovos de Parasitas/veterinária
19.
Parasitology ; 146(10): 1233-1246, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31104640

RESUMO

The gastrointestinal nematodes (GIN) stand out as an important cause of disease in small ruminant, especially on goat farm. Widespread resistance to synthetic anthelminthics has stimulated the research for alternative strategies of parasite control, including the use of medicinal plants. The present work summarizes the in vitro and in vivo studies of plants with activity against GIN of goats, focusing on the description of chemical constituents related to this effect. This review retrieved 56 scientific articles from 2008 to 2018 describing more than 100 different plant species. The most frequently investigated family was Fabaceae (30.7%). Most in vitro studies on the activity of plant extracts and fractions were carried out with of free-living stages nematodes. In vivo studies were conducted mainly with the use of plants in animal feed and generally showed lower effectiveness compared to in vitro assays. The main plant secondary metabolites associated with anthelmintic effect are condensed tannins, saponin and flavonoids. However, the studies with compounds isolated from plants and elucidation of their mechanisms of action are scarce. Herbal medicines are thought to be promising sources for the development of effective anthelmintic agents.


Assuntos
Anti-Helmínticos/farmacologia , Doenças das Cabras/parasitologia , Helmintíase Animal/parasitologia , Enteropatias Parasitárias/veterinária , Nematoides/efeitos dos fármacos , Infecções por Nematoides/veterinária , Extratos Vegetais/farmacologia , Animais , Anti-Helmínticos/isolamento & purificação , Anti-Helmínticos/uso terapêutico , Doenças das Cabras/tratamento farmacológico , Cabras , Helmintíase/tratamento farmacológico , Helmintíase/parasitologia , Helmintíase Animal/tratamento farmacológico , Enteropatias Parasitárias/tratamento farmacológico , Enteropatias Parasitárias/parasitologia , Nematoides/isolamento & purificação , Infecções por Nematoides/tratamento farmacológico , Infecções por Nematoides/parasitologia , Testes de Sensibilidade Parasitária , Extratos Vegetais/isolamento & purificação , Extratos Vegetais/uso terapêutico , Plantas Medicinais/química , Resultado do Tratamento
20.
Vet Parasitol ; 270 Suppl 1: S38-S44, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31104940

RESUMO

The efficacy and safety of a new topical formulation containing selamectin plus sarolaner (Revolution® Plus / Stronghold® Plus, Zoetis) was evaluated for the prevention of heartworm (Dirofilaria immitis) disease and the treatment of roundworm infection in cats enrolled as veterinary patients in two field studies conducted in Japan. In the heartworm field study, 91 cats negative for D. immitis antigen and anti-D. immitis antibody were enrolled and received 9 monthly topical treatments with selamectin plus sarolaner during the period of April to December 2015. Efficacy was assessed by testing post-treatment blood samples collected 8, 12, and 15 months after initiation of treatment for the presence of D. immitis antigen and anti-D. immitis antibody. Eighty-seven cats completed the entire study and were included in the determination of efficacy. No D. immitis antigen or anti-D. immitis antibody were detected in any of the post-treatment samples. In the roundworm field study, completed in the period from April to November 2015, 64 cats with ≥100 roundworm eggs per gram (EPG) of feces were enrolled and allocated randomly in a 1:1 ratio, to receive either selamectin plus sarolaner or emodepside plus praziquantel (Profender®, Bayer). Treatments were administered topically on Days 0 and 30, and efficacy was assessed by fecal EPG counts conducted on Days 14, 30, and 60. All cats completed the entire study. At enrollment, all cats were infected with Toxocara cati. Compared to pre-treatment, geometric mean T. cati EPG counts on Days 14, 30, and 60 were reduced by >99.9% in both treatment groups. There were no treatment-related adverse events in either study. Monthly topical administration of Revolution® Plus / Stronghold® Plus providing a minimum of 6 mg/kg selamectin and 1 mg/kg sarolaner was safe and effective in the prevention of heartworm disease and the treatment of roundworm infection in cats enrolled as veterinary patients in Japan.


Assuntos
Antiparasitários/administração & dosagem , Azetidinas/administração & dosagem , Doenças do Gato/prevenção & controle , Dirofilariose/prevenção & controle , Enteropatias Parasitárias/veterinária , Ivermectina/análogos & derivados , Infecções por Nematoides/veterinária , Compostos de Espiro/administração & dosagem , Administração Tópica , Animais , Doenças do Gato/tratamento farmacológico , Doenças do Gato/parasitologia , Gatos , Dirofilaria immitis/efeitos dos fármacos , Dirofilaria immitis/imunologia , Dirofilariose/tratamento farmacológico , Dirofilariose/parasitologia , Composição de Medicamentos/veterinária , Feminino , Helmintíase/tratamento farmacológico , Helmintíase/parasitologia , Helmintíase/prevenção & controle , Enteropatias Parasitárias/tratamento farmacológico , Enteropatias Parasitárias/parasitologia , Enteropatias Parasitárias/prevenção & controle , Ivermectina/administração & dosagem , Masculino , Infecções por Nematoides/tratamento farmacológico , Infecções por Nematoides/parasitologia , Infecções por Nematoides/prevenção & controle , Contagem de Ovos de Parasitas/veterinária , Distribuição Aleatória , Toxocara/efeitos dos fármacos , Resultado do Tratamento
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