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1.
Am J Trop Med Hyg ; 103(1_Suppl): 50-57, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32400344

RESUMO

The Schistosomiasis Consortium for Operational Research and Evaluation (SCORE) was funded in 2008 to conduct research that would support country schistosomiasis control programs. As schistosomiasis prevalence decreases in many places and elimination is increasingly within reach, a sensitive and specific test to detect infection with Schistosoma mansoni and Schistosoma haematobium has become a pressing need. After obtaining broad input, SCORE supported Leiden University Medical Center (LUMC) to modify the serum-based antigen assay for use with urine, simplify the assay, and improve its sensitivity. The urine assay eventually contributed to several of the larger SCORE studies. For example, in Zanzibar, we demonstrated that urine filtration, the standard parasite egg detection diagnostic test for S. haematobium, greatly underestimated prevalence in low-prevalence settings. In Burundi and Rwanda, the circulating anodic antigen (CAA) assay provided critical information about the limitations of the stool-based Kato-Katz parasite egg-detection assay for S. mansoni in low-prevalence settings. Other SCORE-supported CAA work demonstrated that frozen, banked urine specimens yielded similar results to fresh ones; pooling of specimens may be a useful, cost-effective approach for surveillance in some settings; and the assay can be performed in local laboratories equipped with adequate centrifuge capacity. These improvements in the assay continue to be of use to researchers around the world. However, additional work will be needed if widespread dissemination of the CAA assay is to occur, for example, by building capacity in places besides LUMC and commercialization of the assay. Here, we review the evolution of the CAA assay format during the SCORE period with emphasis on urine-based applications.


Assuntos
Antígenos de Helmintos/imunologia , Glicoproteínas/imunologia , Proteínas de Helminto/imunologia , Schistosoma/imunologia , Esquistossomose/diagnóstico , Animais , Biomarcadores , Burundi/epidemiologia , Criança , Testes Diagnósticos de Rotina , Fezes/parasitologia , Feminino , Humanos , Testes Imunológicos , Masculino , Modelos Animais , Papio/parasitologia , Contagem de Ovos de Parasitas , Prevalência , Ruanda/epidemiologia , Santa Lúcia/epidemiologia , Schistosoma/isolamento & purificação , Schistosoma haematobium/imunologia , Schistosoma haematobium/isolamento & purificação , Schistosoma japonicum/imunologia , Schistosoma japonicum/isolamento & purificação , Schistosoma mansoni/imunologia , Schistosoma mansoni/isolamento & purificação , Esquistossomose/epidemiologia , Sensibilidade e Especificidade , Tanzânia/epidemiologia , Urina/parasitologia
2.
Am J Trop Med Hyg ; 103(1_Suppl): 42-49, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32400347

RESUMO

Efforts to control Schistosoma mansoni infection depend on the ability of programs to effectively detect and quantify infection levels and adjust programmatic approaches based on these levels and program goals. One of the three major objectives of the Schistosomiasis Consortium for Operational Research and Evaluation (SCORE) has been to develop and/or evaluate tools that would assist Neglected Tropical Disease program managers in accomplishing this fundamental task. The advent of a widely available point-of-care (POC) assay to detect schistosome circulating cathodic antigen (CCA) in urine with a rapid diagnostic test (the POC-CCA) in 2008 led SCORE and others to conduct multiple evaluations of this assay, comparing it with the Kato-Katz (KK) stool microscopy assay-the standard used for more than 45 years. This article describes multiple SCORE-funded studies comparing the POC-CCA and KK assays, the pros and cons of these assays, the use of the POC-CCA assay for mapping of S. mansoni infections in areas across the spectrum of prevalence levels, and the validation and recognition that the POC-CCA, although not infallible, is a highly useful tool to detect low-intensity infections in low-to-moderate prevalence areas. Such an assay is critical, as control programs succeed in driving down prevalence and intensity and seek to either maintain control or move to elimination of transmission of S. mansoni.


Assuntos
Antígenos de Helmintos/imunologia , Glicoproteínas/imunologia , Proteínas de Helminto/imunologia , Schistosoma mansoni/imunologia , Esquistossomose mansoni/diagnóstico , Animais , Criança , Testes Diagnósticos de Rotina , Fezes/parasitologia , Feminino , Humanos , Testes Imunológicos , Masculino , Sistemas Automatizados de Assistência Junto ao Leito , Prevalência , Esquistossomose mansoni/epidemiologia , Sensibilidade e Especificidade , Urina/parasitologia
3.
PLoS Negl Trop Dis ; 14(4): e0007973, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-32339185

RESUMO

BACKGROUND: This paper reports on the baseline prevalence and associated risk factor findings of a pilot, longitudinal study exploring community-wide treatment of schistosomiasis and soil-transmitted helminthiasis, using albendazole plus praziquantel in the Greater Accra region of Ghana. METHOD: From three communities, at least, 658 individuals were enrolled into the study via random household selection. Prevalence and intensity of schistosomiasis and STH infection were determined from stool and urine samples with a questionnaire being administered in order to explore other morbidities and risk factors. Factor analysis of household demographic variables was undertaken to generate a socioeconomic score; this was then further categorised into tertiles. Proportional-odds cumulative logit generalised estimating equation (GEE) models were used to investigate categorical ordinal intensity of infection associations with morbidity. Separately, logistic GEE models were used to investigate risk factor associations with infection prevalence. RESULTS: Both Schistosoma haematobium and S. mansoni were prevalent in the three communities, with the prevalence of S. haematobium ranging from 3.3% (24/679; 95% CI = 1.9-4.7) to 19% (114/632; 95% CI = 15.8-22.2) and S. mansoni ranging from 30% (202/679; 95% CI = 26.5-33.5) to 78.3% (409/536; 95% CI = 74.7-81.9). The total prevalence of STH across all three sites was negligible at 1.3% (24/1847; 95% CI = 0.8-1.9) comprising mainly hookworm (10/1847). Multivariable statistical models indicated males to be 2.3 (95% CI = 1.7-3.3) times more likely to have a high intensity S. mansoni infection and 1.5 (95% CI = 1.1-2) times more likely to have a high intensity of S. haematobium infection compared to females. There was no significant difference in the likelihood of infection with S. mansoni between adults and school age children (SAC), however S. haematobium infections were found to be 2.5 (95% CI = 1.8-3.5) times more likely to occur in school age children than in adults. Multivariable statistical models (adjusted for age and sex) indicated an association between schistosomiasis and a number of self-reported morbidity indicators (notably diarrhoea and blood in stool and urine). Low socio-economic status was also associated with SCH infection (OR: 2; 95% CI = 1.3-3.2). CONCLUSION: The communities targeted by this study showed a range of Schistosoma prevalence's of infection, from hypo-endemic through to meso-endemic and hyper-endemic. The prevalence of SCH across the different age groups in the study locations highlights the large number of individuals currently being left out of the standard morbidity control method of annual treatment of the SAC.


Assuntos
Esquistossomose/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Animais , Anti-Helmínticos/administração & dosagem , Criança , Pré-Escolar , Controle de Doenças Transmissíveis/métodos , Demografia , Transmissão de Doença Infecciosa/prevenção & controle , Fezes/parasitologia , Gana/epidemiologia , Humanos , Lactente , Recém-Nascido , Estudos Longitudinais , Masculino , Administração Massiva de Medicamentos/métodos , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , Esquistossomose/prevenção & controle , Urina/parasitologia , Adulto Jovem
4.
PLoS Negl Trop Dis ; 14(3): e0008189, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-32196506

RESUMO

BACKGROUND: Preventive chemotherapy with praziquantel (PZQ) is the cornerstone of schistosomiasis control. However, a single dose of PZQ (40 mg/kg) does not cure all infections. Repeated doses of PZQ at short intervals might increase efficacy in terms of cure rate (CR) and intensity reduction rate (IRR). Here, we determined the efficacy of a single versus four repeated treatments with PZQ on Schistosoma mansoni infection in school-aged children from Côte d'Ivoire, using two different diagnostic tests. METHODS: An open-label, randomized controlled trial was conducted from October 2018 to January 2019. School-aged children with a confirmed S. mansoni infection based on Kato-Katz (KK) and point-of-care circulating cathodic antigen (POC-CCA) urine cassette test were randomly assigned to receive either a single or four repeated doses of PZQ, administered at two-week intervals. The primary outcome was the difference in CR between the two treatment arms, measured by triplicate KK thick smears 10 weeks after the first treatment. Secondary outcomes included CR estimated by POC-CCA, IRR by KK and POC-CCA, and safety of repeated PZQ administration. PRINCIPAL FINDINGS: During baseline screening, 1,022 children were assessed for eligibility of whom 153 (15%) had a detectable S. mansoni infection, and hence, were randomized to the standard treatment group (N = 70) and the intense treatment group (N = 83). Based on KK, the CR was 42% (95% confidence interval (CI) 31-52%) in the standard treatment group and 86% (95% CI 75-92%) in the intense treatment group. Observed IRR was 72% (95% CI 55-83%) in the standard treatment group and 95% (95% CI 85-98%) in the intense treatment group. The CR estimated by POC-CCA was 18% (95% CI 11-27%) and 36% (95% CI 26-46%) in the standard and intense treatment group, respectively. Repeated PZQ treatment did not result in a higher number of adverse events. CONCLUSION/SIGNIFICANCE: The observed CR using KK was significantly higher after four repeated treatments compared to a single treatment, without an increase in adverse events. Using POC-CCA, the observed CR was significantly lower than measured by KK, indicating that PZQ may be considerably less efficacious as concluded by KK. Our findings highlight the need for reliable and more accurate diagnostic tools, which are essential for monitoring treatment efficacy, identifying changes in transmission, and accurately quantifying the intensity of infection in distinct populations. In addition, the higher CR in the intense treatment group suggests that more focused and intense PZQ treatment can help to advance schistosomiasis control. TRIAL REGISTRATION: www.clinicaltrials.gov NCT02868385.


Assuntos
Anti-Helmínticos/administração & dosagem , Antígenos de Helmintos/urina , Monitoramento de Medicamentos/métodos , Glicoproteínas/urina , Proteínas de Helminto/urina , Parasitologia/métodos , Praziquantel/administração & dosagem , Schistosoma mansoni/isolamento & purificação , Esquistossomose mansoni/tratamento farmacológico , Adolescente , Animais , Quimioprevenção/métodos , Criança , Pré-Escolar , Costa do Marfim , Feminino , Humanos , Masculino , Esquistossomose mansoni/prevenção & controle , Instituições Acadêmicas , Resultado do Tratamento , Urina/parasitologia
5.
Int Health ; 12(2): 86-94, 2020 02 12.
Artigo em Inglês | MEDLINE | ID: mdl-31290969

RESUMO

BACKGROUND: Schistosomiasis and soil-transmitted helminths (STH) infections are major public health problems. We aimed to study the 6-mo impact of mass drug administration with praziquantel and albendazole on urinary schistosomiasis and STH. METHODS: We examined children (aged 2-15 y) from one hamlet, who provided urine and faeces samples at baseline (n=197), 1 mo (n=102) and 6 mo (n=92); 67 completed the protocol. RESULTS: At baseline, 47/67 (70.1%) children presented Schistosoma haematobium (75.8% in the baseline total sample) and 12/67 (17.9%) with STH (30.5% in the initial sample, p=0.010). Among the children, 47.3% had heavy Schistosoma haematobium infection. The most frequent STH was Trichuris trichiura in 9.0%. We also found Hymenolepis nana (13.2%) and Plasmodium falciparum (9.1%) infections and anaemia (82.1%). One mo after chemotherapy there was a significant (p=0.013) reduction of Schistosoma haematobium prevalence (23.5%) and a high egg reduction rate (86.9%). Considering the sample of 67 children, the mean egg concentration was 498 at baseline, 65 at 1 mo and 252 at 6 mo (p<0.05). We also observed a reduction in STH infections, 50% in Ascaris lumbricoides, 33.3% in T. trichiura and 50% in hookworms. At 6 mo, the prevalence of Schistosoma haematobium (76.1%) was similar to the baseline and the STH reduction was not significant. CONCLUSIONS: Longitudinal studies have reported many losses in these settings, but we were able to show that mass drug administration for control of schistosomiasis and STH present low effectiveness, that reinfections occur rapidly and that stand alone anthelmintic therapy is not a sustainable choice.


Assuntos
Serviços de Saúde Comunitária/organização & administração , Helmintíase/tratamento farmacológico , Administração Massiva de Medicamentos , Esquistossomose Urinária/tratamento farmacológico , Solo/parasitologia , Adolescente , Albendazol/uso terapêutico , Angola/epidemiologia , Animais , Anti-Helmínticos/uso terapêutico , Criança , Pré-Escolar , Fezes/parasitologia , Feminino , Humanos , Masculino , Praziquantel/uso terapêutico , Prevalência , Avaliação de Programas e Projetos de Saúde , Estudos Prospectivos , Schistosoma haematobium/isolamento & purificação , Esquistossomose Urinária/epidemiologia , Urina/parasitologia
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.
Turkiye Parazitol Derg ; 43(3): 152-154, 2019 Sep 10.
Artigo em Inglês | MEDLINE | ID: mdl-31502807

RESUMO

Urogenital myiasis is a parasitic infestation caused by larvae of Psychoda spp. and it is very rare in humans. A 10- year old female was presented with urogenital myiasis and 4th stage Larvae of Psychoda albipennis (Diptera: Psychodidae) were found in urine. The patient was complained of painful sensation, discomfort and burning while urination. Urinary tract antiseptics were prescribed for the patient and advised to drink plenty of water for hydration. Local health authorities should take proper measures to maintain hygienic conditions for the people under risk.


Assuntos
Doenças Urogenitais Femininas/parasitologia , Miíase/parasitologia , Psychodidae/classificação , Animais , Anti-Infecciosos Urinários/uso terapêutico , Criança , Ingestão de Líquidos , Feminino , Doenças Urogenitais Femininas/terapia , Humanos , Larva , Líbia , Miíase/terapia , Psychodidae/crescimento & desenvolvimento , Urina/parasitologia
8.
Adv Exp Med Biol ; 1154: 437-471, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31297770

RESUMO

Digenetic trematodes form a major group of human parasites, affecting a large number of humans, especially in endemic foci. Over 100 species have been reported infecting humans, including blood, lung, liver, and intestinal parasites. Traditionally, trematode infections have been diagnosed by parasitological methods based on the detection and the identification of eggs in different clinical samples. However, this is complicated due to the morphological similarity between eggs of different trematode species and other factors such as lack of sensitivity or ectopic locations of the parasites. Moreover, the problem is currently aggravated by migratory flows, international travel, international trade of foods, and changes in alimentary habits. Although efforts have been made for the development of immunological and molecular techniques, the detection of eggs through parasitological techniques remains as the gold standard for the diagnosis of trematodiases. In this chapter, we review the current status of knowledge on diagnostic techniques used when examining feces, urine, and sputum and also analyze the most relevant characteristics used to identify eggs with a quick key for the identification of eggs.


Assuntos
Enteropatias Parasitárias , Infecções por Trematódeos , Animais , Fezes/parasitologia , Humanos , Enteropatias Parasitárias/diagnóstico , Enteropatias Parasitárias/parasitologia , Escarro/parasitologia , Trematódeos/citologia , Infecções por Trematódeos/diagnóstico , Infecções por Trematódeos/parasitologia , Urina/parasitologia
9.
Acta Trop ; 199: 105116, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31356786

RESUMO

Globally over 200 million people are infected with schistosomiasis, and approximately 80% are caused by just two of five species, Schistosoma haematobium and Schitosoma mansoni that are broadly distributed, and often overlap across sub-Saharan Africa. Like most neglected tropical diseases, mortality is low (an estimated 200,000 deaths annually) and morbidity is considerably high and probably underestimated. Surprisingly, little attention has been given to co-infection with these two species. We have studied co-infection with S. mansoni and S. haematobium in a peri-urban community in Ghana, one of the most highly endemic countries for schistosomiasis. We collected and examined snails of the two intermediate host species from the reservoir adjacent to the community. We also used microscopical examination of stool and urine samples to determine the level of concurrent S. mansoni and S. haematobium infections in school and administered questionnaires to assess water contact activities that predispose pupils to infections Examination of the snail hosts revealed that 0.7% (7/896) of Bulinus truncatus and 1.7% (14/780) of Biomphalaria pfeifferi snails were found to be hosting cercariae morphologically consistent with that of S. haematobium and S. mansoni respectively. The overall prevalence values for urogenital and intestinal schistosomiasis were 66.8% (135/202) and 90.1% (163/181) respectively. Only 50 of 181 schistosome-infected pupils had single-species infections and the remaining 131 pupils presented concurrent infections. Among the 131 infected with both species were 50 individuals having only S. mansoni eggs in stool and S. haematobium eggs in urine (conventional presentation). Eighty-one children (81) had eggs of both species in either urine and/or stool (ectopic presentation). From these 81, 63 had eggs of both species in urine, 6 had both species in stool, and 12 had eggs of both species present in both urine and stool. A comparatively large number of individuals from the concurrent infected group presented high and moderate infection intensities than the single infected groups. The overwhelmingly high prevalence of concurrent infections indicates further study of co-infection is needed, and points to a need call for a holistic disease control plan so Ghana can be part of nations to achieve the WHO roadmap target for schistosomiasis control by 2020.


Assuntos
Coinfecção/epidemiologia , Esquistossomose Urinária/epidemiologia , Esquistossomose mansoni/epidemiologia , Adolescente , Adulto , Animais , Criança , Pré-Escolar , Fezes/parasitologia , Feminino , Gana/epidemiologia , Humanos , Masculino , Prevalência , Esquistossomose Urinária/prevenção & controle , Esquistossomose mansoni/prevenção & controle , Caramujos , Urina/parasitologia , Adulto Jovem
10.
PLoS Negl Trop Dis ; 13(5): e0007268, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-31059495

RESUMO

BACKGROUND: The Zanzibar Elimination of Schistosomiasis Transmission (ZEST) project aimed to eliminate urogenital schistosomiasis as a public health problem from Pemba and to interrupt Schistosoma haematobium transmission from Unguja in 5 years. METHODOLOGY: A repeated cross-sectional cluster-randomized trial was implemented from 2011/12 till 2017. On each island, 45 shehias were randomly assigned to receive one of three interventions: biannual mass drug administration (MDA) with praziquantel alone, or in combination with snail control or behavior change measures. In cross-sectional surveys, a single urine sample was collected from ~9,000 students aged 9- to 12-years and from ~4,500 adults aged 20- to 55-years annually, and from ~9,000 1st year students at baseline and the final survey. Each sample was examined for S. haematobium eggs by a single urine filtration. Prevalence and infection intensity were determined. Odds of infection were compared between the intervention arms. PRINCIPAL FINDINGS: Prevalence was reduced from 6.1% (95% confidence interval (CI): 4.5%-7.6%) to 1.7% (95% CI: 1.2%-2.2%) in 9- to 12-year old students, from 3.9% (95% CI: 2.8%-5.0%) to 1.5% (95% CI: 1.0%-2.0%) in adults, and from 8.8% (95% CI: 6.5%-11.2%) to 2.6% (95% CI: 1.7%-3.5%) in 1st year students from 2011/12 to 2017. In 2017, heavy infection intensities occurred in 0.4% of 9- to 12-year old students, 0.1% of adults, and 0.8% of 1st year students. Considering 1st year students in 2017, 13/45 schools in Pemba and 4/45 schools in Unguja had heavy infection intensities >1%. There was no significant difference in prevalence between the intervention arms in any study group and year. CONCLUSIONS/SIGNIFICANCE: Urogenital schistosomiasis was eliminated as public health problem from most sites in Pemba and Unguja. Prevalence was significantly reduced, but transmission was not interrupted. Continued interventions that are adaptive and tailored to the micro-epidemiology of S. haematobium in Zanzibar are needed to sustain and advance the gains made by ZEST.


Assuntos
Anti-Helmínticos/administração & dosagem , Praziquantel/administração & dosagem , Schistosoma haematobium/fisiologia , Esquistossomose Urinária/prevenção & controle , Adolescente , Adulto , Animais , Criança , Estudos Transversais , Erradicação de Doenças , Feminino , Humanos , Ilhas do Oceano Índico/epidemiologia , Ilhas/epidemiologia , Masculino , Pessoa de Meia-Idade , Prevalência , Schistosoma haematobium/efeitos dos fármacos , Esquistossomose Urinária/epidemiologia , Esquistossomose Urinária/parasitologia , Caramujos/parasitologia , Urina/parasitologia , Adulto Jovem
11.
Acta Trop ; 195: 78-82, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31047864

RESUMO

Leptospirosis is a globally common zoonotic infectious disease in humans and animals. This disease is caused by pathogenic spirochetes belonging to the genus Leptospira. The pathogen is able to survive in mammalian kidneys after infection and is excreted in urine intermittently. Pathogenic leptospires infect humans either by direct contact with infected animal urine or through contaminated soil or water. In Sri Lanka, some studies have demonstrated the involvement of animals, such as livestock species and peridomestic rats, in the transmission of leptospirosis to humans. However, none of the previous studies focused on domesticated elephants, which are in close contact with humans during cultural and religious events and bathe in rivers together with humans. If domesticated elephants act as carriers of pathogenic leptospires, it could be a major public health issue in the country. In this study, 13 healthy domesticated elephants were subjected to leptospiral DNA detection from urine samples collected on three consecutive days. Four elephants (31%) were confirmed to shed pathogenic leptospires in their urine. DNA sequencing followed by phylogenetic distance measurements revealed that all positive elephants were infected with L. interrogans. This study reveals the possibility that elephants act as a source of infection of leptospires to humans and recommends the screening of all domesticated elephants that are in close contact with humans for the shedding of pathogenic leptospires.


Assuntos
Animais Domésticos/parasitologia , Elefantes/parasitologia , Leptospira interrogans/genética , Leptospira interrogans/isolamento & purificação , Urina/parasitologia , Zoonoses/genética , Animais , Humanos , Filogenia , Análise de Sequência de DNA , Sri Lanka
12.
Korean J Parasitol ; 57(2): 135-144, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31104405

RESUMO

There have been some reports on schistosomiasis of school children in Sudan's Nile River basin area; however, information about the infection status of Schistosoma species and intestinal helminths among village residents of this area is very limited. Urine and stool samples were collected from the 1,138 residents of the Al Hidaib and Khour Ajwal villages of White Nile State, Sudan in 2014. The prevalence of overall schistosomiasis and intestinal helminthiasis was 36.3% and 7.7%, respectively. Egg positive rates were 35.6% for Schistosoma haematobium, 2.6% for S. mansoni, and 1.4% were mixed. The prevalence of schistosomiasis was significantly higher in men (45.6%) than in women (32.0%), in Khou Ajwal villagers (39.4%) than in Al Hidaib villagers (19.2%), and for age groups ≤15 years old (51.5%) than for age groups >15 years old (13.2%). The average number of eggs per 10 ml urine (EP10) of S. haematobium infections was 18.9, with 22.2 eggs in men vs 17.0 in women and 20.4 in Khou Ajwal villagers vs 8.1 in Al Hidaib villagers. In addition to S. mansoni eggs, 4 different species of intestinal helminths were found in the stool, including Hymenolepis nana (6.6%) and H. diminuta (1.0%). Collectively, urinary schistosomiasis is still prevalent among village residents in Sudan's White Nile River basin and was especially high in men, children ≤15 years, and in the village without a clean water system. H. nana was the most frequently detected intestinal helminths in the 2 villages.


Assuntos
Helmintíase/epidemiologia , Enteropatias Parasitárias/epidemiologia , Esquistossomose/epidemiologia , Adolescente , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Animais , Criança , Pré-Escolar , Coinfecção/epidemiologia , Coinfecção/parasitologia , Estudos Epidemiológicos , Fezes/parasitologia , Feminino , Helmintíase/parasitologia , Humanos , Hymenolepis diminuta/isolamento & purificação , Hymenolepis nana/isolamento & purificação , Lactente , Recém-Nascido , Enteropatias Parasitárias/parasitologia , Masculino , Pessoa de Meia-Idade , Contagem de Ovos de Parasitas , Prevalência , População Rural , Schistosoma haematobium/isolamento & purificação , Schistosoma mansoni/isolamento & purificação , Esquistossomose/parasitologia , Fatores Sexuais , Sudão/epidemiologia , Urina/parasitologia , Adulto Jovem
13.
Infect Dis Poverty ; 8(1): 37, 2019 May 30.
Artigo em Inglês | MEDLINE | ID: mdl-31142379

RESUMO

BACKGROUND: The Kato-Katz technique is recommended worldwide for the diagnosis of intestinal schistosomiasis, detecting parasite eggs in feces of infected people. However, new tests have been developed in order to facilitate diagnosis, e.g. by detection of specific antigens secreted by schistosomes, such as the circulating cathodic antigen (CCA). The aim of this study was to evaluate the performance of the point-of-care circulating cathodic antigen test (POC-CCA) compared to the Kato-Katz technique in a low prevalence area in the Amazon Region, located in the municipality of Primavera, State of Pará, Brazil. METHODS: Positivity rates of the POC-CCA test and the Kato-Katz technique were calculated. The sensitivity, specificity, accuracy and kappa coefficient were determined by comparing both methods. The reference standard was established using 16 Kato-Katz slides, 12 of the first fecal sample, two of the second and two of the third one. The study also included the concordance between POC-CCA results and different numbers and combinations of Kato-Katz slides. RESULTS: The prevalence of schistosomiasis according to the reference standard or POC-CCA test reached a rate of 9.4% or 23.9%, respectively, among a total of 372 participants. The positivity rates by the Kato-Katz technique increased from 2.4 to 9.4%, according to the increase in the number of slides examined and fecal samples collected. A sensitivity of 55.6%, specificity 76.9%, accuracy 76% and κ coefficient of 0.06 was observed by comparing one slide of the first sample and POC-CCA. Comparing 6 slides from three different samples, two slides of each, with POC-CCA resulted in a sensitivity of 58.3%, specificity 78.4%, accuracy 77% and κ coefficient of 0.16. Finally, the comparison of 16 slides from three different samples with POC-CCA revealed a sensitivity of 65.7%, specificity 80.4%, accuracy 79%, and κ coefficient of 0.27. CONCLUSIONS: The immunochromatographic test has the potential to be an important tool to combat schistosomiasis because of its practicality and applicability but should be applied with caution in low prevalence areas and in programs that aim to eliminate this disease. TRIAL REGISTRATION: CAAE#21824513.9.0000.5091 . January 31st, 2014.


Assuntos
Antígenos de Helmintos/análise , Imunoensaio/métodos , Schistosoma mansoni/imunologia , Esquistossomose mansoni/diagnóstico , Adolescente , Adulto , Idoso , Animais , Brasil/epidemiologia , Criança , Fezes/parasitologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Sistemas Automatizados de Assistência Junto ao Leito , Schistosoma mansoni/isolamento & purificação , Esquistossomose mansoni/epidemiologia , Sensibilidade e Especificidade , Urina/parasitologia , Adulto Jovem
14.
Korean J Parasitol ; 57(1): 27-31, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30840796

RESUMO

PCR is known to be the most sensitive method for diagnosing Trichomonas vaginalis infections. This study aimed to compare the sensitivity of a PCR assay for trichomoniasis (HY-PCR) developed in Hanyang University with the use of a Seeplex Ace Detection Kit®, using urine collected from four Korean men with prostatic disease. Overall, HY-PCR was more sensitive than the Seeplex Kit. The use of Chelex 100 is recommended for DNA isolation in order to increase the sensitivity of the PCR test.


Assuntos
Técnicas de Diagnóstico Molecular/métodos , Reação em Cadeia da Polimerase/métodos , Doenças Prostáticas/diagnóstico , Tricomoníase/diagnóstico , Trichomonas vaginalis/isolamento & purificação , Humanos , Masculino , Doenças Prostáticas/parasitologia , Sensibilidade e Especificidade , Tricomoníase/parasitologia , Trichomonas vaginalis/genética , Urina/parasitologia
15.
Infect Dis Health ; 24(2): 98-106, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-30648601

RESUMO

BACKGROUND: Schistosomiasis and Soil-transmitted helminthiasis cause considerable morbidity and mortality in developing countries, especially among children. To this end it, a cross-sectional survey to determine the pattern of Schistosomiasis and Soil-transmitted helminthiasis co-infection was undertaken among primary school pupils in Oduma Community in Enugu State, Nigeria. METHODS: Fresh urine and stool samples were collected from pupils. The urine and stool samples were examined using sedimentation and Kat-Katz techniques respectively. RESULTS: Of the 236 pupils examined, 137 (58.1%) were found positive for at least one helminth infection. Ascaris lumbricoides was the most prevalent soil-transmitted helminth (STH), with a prevalence rate of 40.3%, followed by Trichuris trichiura (15.3%) and hookworm (8.9%). Infection with Schistosoma haematobium was detected in 13.6% of the pupils while Schistosoma mansoni infection prevalence was 7.2%. Age group 4 -7 years recorded the highest prevalence for S. haematobium, A. lumbricoides, T. Trichiura and hookworm infections. Multiple infections were also recorded, with 22.9% having double infections and 2.5% having triple infections. The most common double infection was A. lumbricoides with T. trichiura (8.9%), while the most common triple infection was A. lumbricoides, S. haematobium and hookworm (1.7%). CONCLUSION: The results from the present study revealed an evident need for the systematic and sustained administration of school-based chemotherapy program targeting the control of STH infection and Schistosomiasis using Albendazole and Praziquantel respectively in the community, instead of a one-off approach that was carried out.


Assuntos
Coinfecção/epidemiologia , Helmintíase/epidemiologia , Enteropatias Parasitárias/epidemiologia , Esquistossomose Urinária/epidemiologia , Adolescente , Criança , Pré-Escolar , Coinfecção/parasitologia , Estudos Transversais , Fezes/parasitologia , Feminino , Helmintíase/parasitologia , Humanos , Enteropatias Parasitárias/tratamento farmacológico , Masculino , Nigéria/epidemiologia , Prevalência , Esquistossomose Urinária/tratamento farmacológico , Instituições Acadêmicas , Fatores Sexuais , Solo/parasitologia , Inquéritos e Questionários , Urina/parasitologia
16.
Acta Trop ; 190: 284-287, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30521805

RESUMO

Strongyloides stercoralis is a soil-transmitted helminth with a wide distribution in tropical and subtropical areas. The diagnosis of S. stercoralisinfection can be challenging, due to the low sensitivity of microscopic examination of stool samples and coproculture. In the last decade, different in-house molecular biology techniques for S. stercoralis have been implemented. They demonstrated good accuracy, although sensitivity does not seem sufficiently high yet. Recently, a novel PCR technique has been evaluated for the detection of S. stercoralis DNA in urine. Aim of this work was to compare the sensitivity of the real-time PCR (qPCR) on feces routinely used at the Centre for Tropical Disease (CTD) of Negrar, Verona, Italy, with that of the novel based PCR on urine. As secondary objective, we evaluated a Urine Conditioning Buffer ® (Zymoresearch) with the aim of improving nucleic acid stability in urine during sample storage/transport at ambient temperatures. Patients attending the CTD and resulting positive at routine screening with serology for S. stercoralis were invited, previous written consent, to supply stool and urine samples for molecular biology. A convenience sample of 30 patients was included. The sensitivity of qPCR on feces resulted 63%, and that of based PCR on urine was 17%. In all the samples treated with the Urine Conditioning Buffer ® there was no detectable DNA. In conclusion, the sensitivity of the novel technique resulted low, and needs further implementation before being considered as a valid alternative to the validated method.


Assuntos
Fezes/parasitologia , Reação em Cadeia da Polimerase em Tempo Real/métodos , Strongyloides stercoralis/isolamento & purificação , Urina/parasitologia , Adulto , Animais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Strongyloides stercoralis/genética
17.
Infection ; 47(3): 395-398, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30377953

RESUMO

PURPOSE: To understand the frequency of urinary schistosomiasis, in migrants in clinical follow-up at the infectious disease outpatient clinic of ARNAS Civico Hospital in Palermo Italy, to raise awareness on this neglected tropical disease. METHODS: A retrospective analysis of migrant patients in clinical care in our centre during the triennium 2015-2017. RESULTS: 2639 migrants have been in clinical care during the triennium 2015-2017, 72% are male and 28% are female. 214 patients were tested for the presence of Schistosoma eggs in urine, these patients are all male. All the patients tested, reported macroscopic haematuria and the 54% had an increase in the peripheral blood eosinophil count. Ninety subjects had a positive microscopic examination for Schistosoma haematobium eggs. Patients were treated with a standard dose of praziquantel (40 mg/kg), and tested for Schistosoma 1 month after the end of therapy. All the subjects fully recovered. CONCLUSIONS: Considering the migration phenomenon, the observation of these tropical diseases in European hospitals is becoming more and more common and an increasing number of health care professionals will be dealing with migrants. Searching for haematuria and eosinophilia and then testing for Schistosoma in this specific population will increase the number of diagnosis and correct treatment of urinary schistosomiasis, improving the patients' quality of life and preventing severe complications of the disease.


Assuntos
Schistosoma haematobium/isolamento & purificação , Esquistossomose Urinária/epidemiologia , Migrantes/estatística & dados numéricos , Adolescente , Adulto , Animais , Anti-Helmínticos/uso terapêutico , Feminino , Humanos , Itália/epidemiologia , Masculino , Óvulo , Praziquantel/uso terapêutico , Estudos Retrospectivos , Esquistossomose Urinária/diagnóstico , Esquistossomose Urinária/tratamento farmacológico , Esquistossomose Urinária/parasitologia , Urina/parasitologia , Adulto Jovem
18.
J Clin Lab Anal ; 33(3): e22703, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30390337

RESUMO

BACKGROUND: The DiaPlexQ™ STI6 Detection Kit (DiaPlexQ; Solgent Co., Ltd., Daejeon, South Korea) is a multiplex real-time PCR assay for the detection of the following sexually transmitted disease (STD) pathogens: Chlamydia trachomatis, Neisseria gonorrhoeae, Mycoplasma hominis, Trichomonas vaginalis, Ureaplasma urealyticum, and Mycoplasma genitalium. We compared the performance of the DiaPlexQ assay with the GeneFinder™ STD I (CT/NG/UU) and STD II (MG/MH/TV) Multiplex Real-time PCR Kits (GeneFinder; Infopia Co., Ltd., Anyang, South Korea). METHODS: We evaluated the performance of the DiaPlexQ assay in comparison to that of GeneFinder using 1106 clinical specimens (542 genital swabs and 564 urine samples). The analytical performance of the DiaPlexQ assay, including the limit of detection (LOD) and analytical specificity, was evaluated using reference strains. RESULTS: The positive percent agreement, negative percent agreement, and kappa value between the two assays were 96.6%-99.4%, 98.2%-99.8%, and 0.93%-0.99%, respectively. No cross-reactivity was observed in a collection of 41 different microorganisms and the LOD of the DiaPlexQ assay ranged from 1 to 10 copies/reaction for each microorganism. CONCLUSION: The DiaPlexQ assay showed comparable performance to that of the GeneFinder assay so that it can be used for the screening and diagnosis of non-viral curable STD pathogens.


Assuntos
Reação em Cadeia da Polimerase Multiplex/normas , Reação em Cadeia da Polimerase em Tempo Real/normas , Doenças Sexualmente Transmissíveis/diagnóstico , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , DNA Bacteriano/genética , DNA de Protozoário/genética , Feminino , Genitália/microbiologia , Genitália/parasitologia , Humanos , Masculino , Pessoa de Meia-Idade , Reação em Cadeia da Polimerase Multiplex/métodos , Reação em Cadeia da Polimerase em Tempo Real/métodos , Reprodutibilidade dos Testes , Doenças Sexualmente Transmissíveis/microbiologia , Doenças Sexualmente Transmissíveis/parasitologia , Urina/microbiologia , Urina/parasitologia , Adulto Jovem
19.
Front Immunol ; 9: 2492, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30459767

RESUMO

Schistosomiasis is a major cause of morbidity in humans invoked by chronic infection with parasitic trematodes of the genus Schistosoma. Schistosomes have a complex life-cycle involving infections of an aquatic snail intermediate host and a definitive mammalian host. In humans, adult male and female worms lie within the vasculature. Here, they propagate and eggs are laid. These eggs must then be released from the host to continue the life cycle. Schistosoma mansoni and Schistosoma japonicum reside in the mesenteric circulation of the intestines with egg excreted in the feces. In contrast, S. haematobium are present in the venus plexus of the bladder, expelling eggs in the urine. In an impressive case of exploitation of the host immune system, this process of Schistosome "eggs-iting" the host is immune dependent. In this article, we review the formation of the egg granuloma and explore how S. mansoni eggs laid in vasculature must usurp immunity to induce regulated inflammation, to facilitate extravasation through the intestinal wall and to be expelled in the feces. We highlight the roles of immune cell populations, stromal factors, and egg secretions in the process of egg excretion to provide a comprehensive overview of the current state of knowledge regarding a vastly unexplored mechanism.


Assuntos
Ovos , Granuloma/imunologia , Inflamação/parasitologia , Intestinos/parasitologia , Schistosoma/fisiologia , Esquistossomose/imunologia , Bexiga Urinária/parasitologia , Animais , Fezes/parasitologia , Granuloma/parasitologia , Interações Hospedeiro-Patógeno , Humanos , Estágios do Ciclo de Vida , Esquistossomose/parasitologia , Urina/parasitologia
20.
PLoS Negl Trop Dis ; 12(10): e0006852, 2018 10.
Artigo em Inglês | MEDLINE | ID: mdl-30332403

RESUMO

BACKGROUND: The recommended strategy for control of schistosomiasis is preventive chemotherapy with praziquantel (PZQ). Pre-school children (PSC) are excluded from population treatment programs. In high endemic areas, these children are also at risk, and require treatment with PZQ. The Government of Kenya initiated the National School-Based Deworming Programme (NSBDP) where PSC in Early Childhood Development Education (ECDE) Centers are only eligible for treatment with albendazole (ABZ) but not with PZQ. METHODOLOGY/PRINCIPAL FINDINGS: 400 PSC were enrolled, from 10 randomly selected ECDE Centers in Kwale County, Kenya where children were treated with crushed PZQ tablets mixed with orange juice, at a single dose of 40 mg/kg. Adverse events were assessed 24 hours post-treatment through questionnaires administered to the parents or guardians. Acceptability was determined by observing if the child spat and/ or vomited all or part of the PZQ dose immediately after treatment. Efficacy was assessed by examining urine samples for Schistosoma haematobium eggs in the 5 weeks post-treatment follow-up. Children testing negative for S. haematobium during the follow-up were considered cured. Egg reduction rate (ERR) was calculated as the decrement in the infection intensity (group's geometric mean egg counts per 10 ml of urine) following treatment expressed as a proportion of the pre-treatment infection intensity. Before treatment, 80 out of the 400 children enrolled in the study tested positive for S. haematobium (20.0% (95% confidence interval (CI) 16.4-24.2%). Of these, 41 had infections of heavy intensity (51.3%) while the rest (48.7%) were of light intensity. Five weeks post-treatment, 10 children who had heavy intensity infection were diagnosed with S. haematobium (prevalence: 2.5% (95% CI 1.5-4.9%). Infection intensities decreased significantly from 45.9 (95% CI: 31.0-68.0) eggs/ 10 ml urine to1.4 (95% CI: 1.1-1.7) eggs/ 10 ml urine during pre-and post-treatment respectively. The ERR was 96.9%. There were no severe adverse events during follow up 24 hours post treatment. Treatment tolerability among the 400 children was high as none of the children spat and/ or vomited as observed in this study. CONCLUSION/SIGNIFICANCE: The study revealed that crushed PZQ is safe and effective in the treatment of urogenital schistosomiasis in this age group. It is therefore recommended that PZQ should be administered to the PSC in Kwale County.


Assuntos
Anti-Helmínticos/administração & dosagem , Anti-Helmínticos/efeitos adversos , Aceitação pelo Paciente de Cuidados de Saúde , Praziquantel/administração & dosagem , Praziquantel/efeitos adversos , Esquistossomose Urinária/tratamento farmacológico , Animais , Criança , Pré-Escolar , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/epidemiologia , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/patologia , Feminino , Humanos , Lactente , Recém-Nascido , Quênia , Estudos Longitudinais , Masculino , Contagem de Ovos de Parasitas , Schistosoma haematobium/isolamento & purificação , Resultado do Tratamento , Urina/parasitologia
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