Parasitic diarrhea among children is a significant health problem worldwide. This cross sectional study described the burden of parasitic diarrhea among children. The objectives of this study were to evaluate the impact of risk factors on the parasitic diarrhea, and to determine the parasitic profile among children in Baghdad-Iraq, during the period extending from September 2003 to June 2004. A total number of 2033 cases were included in the study. The estimated prevalence rate of parasitic diarrhea was 22%. We identified the following major diarrhea determinants were large households size, residential location, water source, low socioeconomic status, and low parent education. Giardia lamblia was found to be the most prevalent parasite with an infection rate of 45.54% followed by Entamoeba histolytica 23.44%, Enterobius vermicularis 12.7%, Hymenolepis nana 9.82%, Trichuris trichiura 5.4%, and Ascaris lumbricoides 2.2%. In conclusion, this study demonstrates that poor sanitation, inadequate environmental conditions, and low socioeconomic status are the main determining factors that predispose children to parasitic diarrhea. Mass deworming programs are recommended for school children, as this population is easily accessible.
Dengue serotype surveillance is important as any changes in serotype distribution may result in an outbreak or increase in severe dengue cases. This study aimed to determine circulating dengue serotypes in two hospitals in Selangor. Serum samples were collected from patients admitted for dengue at these two major public hospitals i.e. Hospital Sungai Buloh (HSB) and Hospital Tunku Ampuan Rahimah (HTAR) between November 2010 and August 2011 and subjected to real-time RT-PCR using SYBR® Green. All four dengue serotypes were detected in samples from both hospitals. The predominating serotype was dengue 1 in samples from both hospitals (HSB, DENV-1; 25.53 % and HTAR, DENV-1; 32.1 %).
Cx. quinquefasciatus is a common nuisance mosquito widely distributed in tropical and subtropical areas. This mosquito is also a vector of urban filariasis. Control with chemicals has been hampered by the development of resistance against chemical insecticides and rising problems of environmental contamination associated with them. Therefore, it is important to adopt more integrated mosquito management approaches that include sustainable, non chemical solutions. The mermithid nematode Romanomermis iyengari is one of several natural control alternatives to synthetic pesticides for mosquito suppression. This study evaluated the effectiveness of the nematode R. iyengari for control of Cx. quinquefasciatus. The nematode R. iyengari was mass-produced, and pre-parasitics (J2) were used for laboratory and field experiments. In laboratory experiments, two concentrations of pre-parasitics (5 and 10 J2 per larva) were tested against L1, L2 and L3 instars larvae of Cx. quinquefasciatus. Infected larvae were observed daily to determine their mortality rate and the number of postparasitic nematodes emerging from dead larvae. In field experiments, 1000, 2000 and 3000 J2/m2 were sprayed in separate natural Cx. quinquefasciatus breeding sites. After treatment, the larval mosquito density in the breeding sites was assessed every 5 days. Laboratory results showed that all tested Cx. quinquefasciatus instars larvae were susceptible to nematode infection. The mortality rates observed for each larval stage indicated that the concentration of 10 J2 kills larvae faster, and that the L1 larvae died earlier than older larvae. The average number of post-parasitic nematodes emerging per larva increases with increasing nematode concentration; also more post-parasitic nematodes emerged from the L2 larvae. Field data showed that, in breeding site treated with 3000 J2 per square meter, larval mosquito reduction reached 97% after nematode application. The dosage of 1000 J2 per square meter did not reduce the larval density. The insect parasitic nematode R. iyengari could be easily used as component of integrated mosquitoes control program in lymphatic filariasis endemic countries.
HCV genotype 4 dominates the HCV epidemic in Egypt. Drug resistance was the most serious side effect that reflects bad clinical outcome. Several studies had demonstrated that baseline serum interferon-γ-inducible-protein 10 (IP-10) levels and interleukin 28B polymorphisms were associated with the resistance to the standard of care pegylated interferon alpha and ribavirin (PEG-IFNα/RBV) therapy and development of post-treatment relapse. Our purpose was to assess the predictive value of combining IP-10 levels and IL28B genotypes to PEG-IFNα/RBV therapy response in Egyptian chronic HCV infection patients with genotype 4. Ninety Egyptian patients chronically infected by HCV genotype-4 treated with pegylated interferon alpha and ribavirin (PEG-IFNα/RBV) therapy were enrolled. Serum IP-10 levels were determined by enzyme linked immunosorbent assay pre- and post- treatment. IL-28B (rs12979860 and rs8099917) polymorphisms were performed by PCR-RFLP in all patients. Overall, 38 patients (42.2%) achieved sustained virologic response (SVR) and 52 (57.8%) patients have non-viral response (NVR). Pretreatment serum IP-10 mean levels were significantly lower in patients who achieved SVR than in NVR (P<0.05). CC genotype in IL28B polymorphism (rs12979860) was the favorable genotype as 65.8% achieved SVR, while TT genotype in IL-28B polymorphism (rs8099917) was the favorable genotype as 81.5% achieved SVR. Baseline IP-10 was significantly correlated to genotypes CC in rs12979860 and TT in rs8099917. Combined use of serum baseline IP-10 levels with IL-28B polymorphisms could improve the prediction of SVR to PEG-IFNα/RBV therapy in Egyptian chronic HCV infection patients with genotype 4.
This study was carried out to determine from bacterial profiling to the bacterial profiles of head lice among the Orang Asli communities. The head lice were collected from Orang Asli community volunteers. The surface sterilized head lice pools were subjected to genomic DNA extraction while next generation sequencing of the 16S rRNA gene was performed using the Illumina MiSeq platform. Six female and three male head lice identified as Pediculus humanus capitis were collected. A total of 111 368 number of NGS sequencing reads were recorded while another 223 bacterial taxa sequences were obtained. Symbiotic bacteria showed the highest number of reads, with Arsenophonus and Rhodococcus sequences being the most abundant genera in the female and male samples, respectively. The female head lice contained a more distinct microbial diversity. Amongst the pathogenic bacterial species sequences noted were the methicillin-resistant Staphylococcus aureus, Streptobacillus moniliformis, Haemophilus influenzae, Bordetella pertussis and Acinetobacter baumannii. The 16S rRNA genome sequencing revealed a number of rare and pathogenic bacterial species within the head lice of the Orang Asli. The socio-economic practices of the community which involved forest foraging and hunting, and their poor living conditions potentially facilitated the transmission of zoonotic bacterial pathogens, including those found within the head lice. Hence, there is the possibility that the head lice could serve as vectors for the transmission of pathogenic bacteria. This study highlighted the diverse microbial community found within the head lice's gut of the Orang Asli, with the detection of multiple rare and pathogenic bacteria capable of causing severe infections.
This study was aimed to identify and characterize Leishmania amastigote, and axenic form antigens. Two in vitro techniques were used to change leishmania parasite isolates from promastigote form to amastigotes and amastigote like (axenic) forms. The main strategy relied upon in vitro infection of murine macrophages cell line J774 with leishmania promastigote, at 37°C with 5% CO2, while the second technique relied upon the culture of promastigote at 37°C with low pH (5.5), and 5-10% CO2. Proteins were extracted and fractionated utilizing 12% Sodium Dodecyl Sulphate Polyacrylamide Gel Electrophoresis (SDS PAGE). Antigens were recognized using both immune dot blot and western blot procedures. PCR was performed for recognition of leishmania parasites in infected J774 macrophages. L. major was quicker in infectivity of macrophages cell line than L. donovani. Shared proteins ranging from 26-116 kDa were identified by SDS PAGE in all stages. Immune Dot-blot method showed positive outcomes, while western blot identified an exceptional antigen band of 16 kDa in amastigote, this unique band could be of value in diagnosis and vaccination of leishmaniasis. PCR results confirmed presence of both isolates demonstrating that coinfection is conceivable, and no indications of hereditary recombination at kinetoplast DNA (kDNA) were identified in macrophages simultaneously infected by L. major and L. donovani.
Sudanese mucosal leishmaniasis (ML) is a rare clinical form of leishmaniasis and characterized by persistent ulcer of the oral and/or the nasal mucous membranes caused by Leishmania donovani. No data is available about the systemic and local immune responses in mucosal leishmaniasis. This study aimed to measure the systemic and the local cytokines responses of Sudanese ML patients compared to cured cutaneous leishmaniasis patients (Leishmanin skin test positive, LST+ve) and unexposed healthy controls (Leishmanin skin test negative, LST-ve). Six parasitological confirmed ML patients, 7 LST+ve, and 6 LST-ve were enrolled. Systemic Th-1 (IFN-γ and TNF-α), Th-2 (IL-10 and IL-13), Treg (TGF-β1), and inflammatory cytokines IL-6 and IL-8 concentration were measured in the supernatant of whole blood samples following stimulation with live L. donovani promastigotes using ELISA. Local intralesion IL-10, IFN-γ, and IL-13 expression was measured using Real Time PCR. A significant high concentrations of IFN-γ, TNFα, IL-10, TGFβ, IL-6, and IL-8 were detected in the supernatant of stimulated whole blood samples of ML patients compared with the LST+ve and LST-ve controls. Using Real Time-PCR and primers for various cytokines, a significant high expression of TH2 cytokines IL-10 and IL-13 mRNA was detected in contrast to a low TH1 cytokine IFN-γ mRNA in the mucosal lesion. There is a clear dichotomy in the cytokine response during Mucosal leishmaniasis. A significantly high TH1, inflammatory and Treg cytokines response is produced systemically, in contrast to a significant high TH2 cytokines response in the mucosal lesion.
Tuberculosis (TB) is a highly infectious disease on the rise caused by the organism Mycobacterium tuberculosis and health care workers working in emergency departments, medical wards and autopsy rooms are in danger of contacting this disease. We present a case of a 42 year old man found dead under a pedestrian bridge with no medical history available. Post mortem computed tomography showed multiple cavities involving upper lobes of both lungs and areas of consolidation in both lung fields raising the suspicion of pulmonary tuberculosis. This was followed by a computed tomography guided lung biopsy and a limited conventional autopsy done in situ in a special high risk autopsy suite with appropriate ventilation. This case highlights the importance of cross sectional imaging which can be coupled with image guided biopsy in cases of infectious disease to reduce the risk of transmission to health care workers.
The crude methanol extracts of Gelsemium elegans leaves were assessed for their cytotoxic activity using the microculture 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay for cellular viability. This study utilized two different types of human cancer cell lines, CaOV-3 (human ovarian cancer cells) and MDA-MB-231 (human estrogen receptor negative breast cancer cells), allowing for comparison of toxicity of G. elegans against these two cancer cells lines. Our results showed that the methanol extract of G. elegans exhibited high cytotoxicity against the human ovarian cancer cell line CaOV-3 with an IC50 value of 5microg/ml after 96 h incubation. However, G. elegans displayed discernibly less toxicity against the MDA-MB-231 cells with an IC50 value 40microg/ml after 96 h incubation and this effect was dose- and time-dependent, up to 72h and 20-30 microg/ml. In conclusion, our results demonstrated that G. elegans is potently cytotoxic against the human ovarian cancer cell line CaOV-3 and to a lesser extend towards the human breast carcinoma cancer MDA-MB-231 cells, suggesting that the extract is selective towards CaOV-3 cells and may have a chemotherapeutic role for ovarian cancer treatment in the future.
The present study was conducted to investigate the immunomodulatory and anti-inflammatory effects of Elettaria cardamomum essential oil (ECEO) for the control of acute Toxoplasma gondii infection. The effect of ECEO on T. gondii tachyzoites was measured by the tetrazolium bromide method. Mice received ECEO orally at doses of 1-4 mg/kg/day for 14 days. Once acute toxoplasmosis was induced in mice, their mortality rate and parasite load were recorded. The level of liver antioxidant/oxidant enzymes and the level of mRNA expression of interleukin-1 beta and interferongamma were also investigated. ECEO particularly at a concentration of 150 µg/ml has promising in vitro anti-Toxoplasma effects (p<0.001). After treatment with ECEO, the mortality rate (9th day) and parasite load decreased (p<0.001) in the infected mice. ECEO markedly (p < 0.05) restored hepatic oxidant and antioxidant enzyme levels, as well as increased cytokines. These results report a significant inhibitory effect of ECEO mainly at a dose of 4 mg/mL, against the T. gondii Rh strain through strengthening the immune system and reducing inflammation and oxidative stress; however, further research is needed to verify these results.
Malaria remains a major public health problem causing mortality and morbidity in tropical and subtropical countries. A cross-sectional study was carried out to determine malaria prevalence and its clinical pattern during malaria season in Yemen. Blood samples were collected from 511 patients with fever who voluntary participated in this study, of them 268 were males and 242 females. Malaria was screened using Giemsa-stained thick and thin blood films. Clinical profile was recorded through physical and laboratory examinations and biodata were collected by pre-tested standard questionnaire. The overall prevalence was 15.3%. Three malaria species (Plasmodium falciparum, Plasmodium vivax and Plasmodium malarae) were detected with the predominance of P. falciparum (83.33%). People living in the rural areas had higher infection rate compared to urban areas (p < 0.005). Children were at higher risk of developing severe malaria compared to adults (p < 0.05). Severe anaemia, respiratory distress, jaundice, convulsion and bleeding were more apparent among younger age groups of malaria cases compared to older children. The study indicates that malaria is still a public health problem with children being at high risk of developing severe malaria which may lead to death.
Studies show that the pH of the malaria parasite's digestive vacuole (DV) plays a key role in the physiological functions of this organelle and antimalarial drug accumulation, and yet is technically difficult to measure. In this study, a flow cytometry-based technique was developed to measure the DV pH using a ratiometric pH indicator, FITC-dextran loaded into the DV of saponin-permeabilized parasites. To calculate the DV pH, a standard pH calibration curve was generated by incubating the saponin-permeabilized cells in buffers with different pH in the presence of an ionophore, CCCP. The measured average pH of the DV was 5.27 ± 0.03 that is approximately the same in the parasites observed microscopically by Hayward et al. (2006) (5.50 ± 0.14) using the same probe. The removal of glucose from the medium, causing a rapid depletion of parasite ATP, resulted in an alkalization of the DV. The DV was reacidified upon restoration of glucose to the medium. This technique provides a rapid, simple and quantitative measurement of the DV pH on a large number of cells. It will also be useful in future attempts to evaluate the effect of antimalarial drugs (i.e. chloroquine and artemisinin-based drugs) in pH changes of the DV.
Poverty, as proven by several studies, is a driving force behind poor health and hygiene practices. This review attempts to outline common communicable and non-communicable diseases that disproportionately affect Malaysia's 2.91 million low-income households. The current study also looks into the government's housing and healthcare programmes for this demographic to improve their health and well-being. The initial examination yielded incredibly little research on this marginalised community, with event reporting typically generalised to the Malaysian community as a whole rather than analysing disease incidences based on household income, which would better reflect povertydriven diseases. As a result, there is an acute need for more accurate information on the epidemiology of diseases among the poor in order to address this public health issue and provide conclusions that can drive policy designs.
The present study was conducted to detect the therapeutic effect of Moringa oleifera and Thymus vulgaris oils on hepatic coccidiosis in experimentally infected rabbits. Also, immunomodulatory effect of the two oils was detected. Twenty-four Newzealand rabbits were used in this study and divided into 4 groups; healthy rabbits, experimentally infected rabbits with Eimeria stiedae oocysts, and two infected treated groups (one with moringa (200 mg/kg) and the other with thyme (500 mg/kg) oils). The results showed highly significant reduction in oocysts shedding (P<0.001 and P<0.05) in the two infected and treated rabbits than the infected non-treated rabbits in almost all days post infection (PI). Thyme oil was more potent and stopped oocysts shedding earlier at the day 34 PI compared to moringa oil at the day 41 PI. Microscopically, there was a damage in the oocysts shed by treated rabbits. Macroscopically, the livers of thyme oil treated rabbits showed more enhancement with protection percentage 75% than those treated with moringa oil in which protection percentage was 55%. The highest titer of antibodies was detected in moringa oil treated rabbits. It was concluded that both moringa and thyme oils had an anti-coccidial effect with thyme oil superiority. So, thyme oil could be useful as an alternative product for the control of rabbit coccidiosis.
Japanese encephalitis (JE) virus activity is an important cause of viral encephalitis in Southeast Asia. In Malaysia, JEV activity has been first detected in Culex gelidus in 1976. Since then, no study has fully addressed the seasonal dynamics of this mosquito. As irrigated rice production expands, the incidence of JEV vectors, particularly Cx. gelidus is expected to increase. We surveyed Penang Island to determine the breeding patterns of Cx. gelidus and their potential insect predators, in relation to habitat/niche and rice growing period. Six rice fields proper (RFP) and related drainage canals (DC) were visited through three cultivation cycles (CCs) over 17 months. Weekly visits were performed to each of the 36 sites and mosquito larvae and aquatic insects were sampled from RFP and DCs using dippers. Culex gelidus was abundant in RFP and almost absent in DCs. Its densities usually were high during the first and 3rd CC and when the RFs were in Fp, Pp and Gp. In DCs, the mosquito was abundant during Mp, e.g., 2nd CC. Predators, especially those belonging to the families Corixidae, Coenagrionidae and Dytiscidae, were more present in RFP. Predator numbers usually were high during the first CC; in some cases predator abundance peaked during other CCs, e.g., corixids and dysticids. In RFP, neither corixids nor coenagrionids showed any positive correlation with densities of Cx. gelidus. However, dytiscids' population peaked when the mosquito densities were on the rise. These observations suggest that Cx. gelidus is active during the period of rice cultivation. Operational vector control through bio-control or with insecticides near the end of the rice cultivation season in RFP may prove beneficial in reducing the density of Cx. gelidus, but also the amount of bio-agent or insecticide applied on riceland.
The assortment of paracentric chromosomal inversion 2La is associated with the maintenance of dieldrin resistance in laboratory colonies of the malaria vector Anopheles gambiae. This association has not been tested in field populations. The aim of this study was to test the association between inversion 2La and dieldrin resistance in a field population of An. coluzzii in Nigeria. Field collected immature stages of Anopheles were raised to adults and exposed to 4% dieldrin according to WHO criteria. Knockdown was recorded at 10 min intervals for 1 hour and final mortality was recorded 24 hours post exposure. Species and inversion 2La diagnostic PCR assays were conducted on the resistant and susceptible mosquitoes. The mosquitoes were highly resistant to 4% dieldrin (17.1% knock down and 25.7% final mortality; KDT50 and KDT95 calculated as 170 and 1, 514 minutes respectively). Frequencies of 2La in both the resistant and susceptible cohorts assorted within HardyWeinberg estimates (χ2=1.32, p=0.8 for dead/susceptible mosquitoes and χ2=2.54, p=0.5 for survivors or resistant mosquitoes). However, a higher number of heterozygous mosquitoes were observed in the resistant cohort compared to the susceptible, with significant variation in karyotype frequencies (χ2=11.08, DF=2, p<0.05) and a significantly higher frequency of the 2La inversion arrangement in the resistant cohort (Pearson's χ2 = 4.58, p = 0.03.). These data are the first to associate paracentric chromosome inversion 2La and dieldrin resistance in field population of An. coluzzii. Dieldrin resistance shows a weak but significant association with 2La whose assortment is affected by positive heterosis. Variation in the assortment of 2La inversion arrangements between resistant and susceptible cohorts of this An. coluzzii population suggests that dieldrin resistance is at least partially linked to inversion 2La which may explain the persistence of dieldrin resistance in this population despite a significant absence of selection for resistance to this insecticide.
Scanning electron microscope (SEM) images of dust mites, Suidasia pontifica, is presented to provide an improved visualization of the taxonomic characters of these mites. Suidasia pontifica can easily be identified by its scale-like cuticle, presence of external vertical setae (ve), longer external scapular setae (sce) compared to internal scapular setae (sci) and 3 ventral spines on apex of tarsus I. The differences in morphology of male and female S. pontifica are also discussed.
Bioprospecting of plant-based insecticides for vector control has become an area of interest within the last two decades. Due to drawbacks of chemical insecticides, phytochemicals of plant origin with mosquito control potential are being utilized as alternative sources in integrated vector control. In this regard, the present study aimed to investigate oviposition deterring and oviciding potentials of Ipomoea cairica (L.) (Family: Convolvulaceae) crude leaf extract against dengue vectors, Aedes aegypti and Aedes albopictus. Ipomoea cairica is an indigenous plant that has demonstrated marked toxicity towards larvae of Ae. aegypti and Ae. albopictus. Leaves of I. cairica were extracted using Soxhlet apparatus with acetone as solvent. Oviposition deterrent activity and ovicidal assay was carried out in oviposition site choice tests with three different concentrations (50, 100, 450 ppm). Acetone extract of I. cairica leaf strongly inhibited oviposition with 100% repellence to Ae. aegypti at lower concentration of 100 ppm, while for Ae. albopictus was at 450 ppm. The oviposition activity index (OAI) values which ranged from -0.69 to -1.00 revealed that I. cairica demonstrated deterrent effect. In ovicidal assay, similar trend was observed whereby zero hatchability was recorded for Ae. aegypti and Ae. albopictus eggs at 100 and 450 ppm, respectively. It is noteworthy that I. cairica leaf extract had significantly elicited dual properties as oviposition deterrent and oviciding agent in both Aedes species. Reduction in egg number through oviposition deterring activity, reduction in hatching percentage and survival rates, suggested an additional hallmark of this plant to be integrated in Aedes mosquito control. Ipomoea cairica deserved to be considered as one of the potential alternative sources for the new development of novel plant based insecticides in future.
A significant percentage of dengue patients develop Dengue Shock Syndrome (DSS) which is characterized by increased vascular permeability, circulatory failure and often death. Montelukast, a cysteinyl leukotriene receptor antagonist regulates vascular permeability and we hypothesized that it may be effective in protecting against DSS. An open label, parallel, randomized controlled trial (RCT) was thus carried out at Mayo Hospital, Department of Medicine, Lahore. A total of 200 patients of dengue fever were recruited and randomized into two groups. The group A was treated with Montelukast 10 mg once daily for 5 days along with general supportive treatment. Group B received the standard supportive treatment and served as the control group. The frequency of DSS was compared in the two groups by Chi square test. A binary logistic regression analysis was conducted to assess the effects of montelukast treatment on onset of DSS after adjusting for gender, age, white cell count, platelet count, haematocrit, serum alanine transaminase (ALT) and aspartate transaminase (AST). Relative risk (RR), absolute risk reduction (ARR), relative risk reduction (RRR) and numbers needed to treat (NNT) were calculated. Significance level was set at p0.001, Odds ratio=5.01, 95% CI=2.17-11.60) even after adjusting for confounders. Montelukast reduced the absolute risk (ARR=22%) and the relative risk (RRR=71%) of DSS in dengue fever. Numbers needed to treat were 4.55. We thus conclude that treatment with oral montelukast may protect patients of dengue fever from DSS and greatly reduce mortality.
Limited data is available on the prevalence of parasitic infections among the island communities in Malaysia with most studies performed between 1960s-1980s. This study was conducted to determine the current prevalence status of parasitic infections among communities living in Pangkor Island Peninsular Malaysia. A total of 131 stool and 298 serum samples were collected and subjected to microscopic examination for intestinal protozoa and helminths and detection of Toxoplasma gondii antibodies using commercial ELISA kits respectively. In addition, thin and thick peripheral blood films were microscopically screened for the presence of Plasmodium spp. and microfilariae respectively. The overall prevalence of intestinal parasitic infections among Pangkor Island community was 9.9% (13/131) with T. trichiura (5.3%) being the most common intestinal parasite detected. Toxoplasmosis was reported in almost 60% of the community with the seroprevalence being significantly high among females (64.7%) compared to males (52.8%) (p=0.038). None of those examined samples were infected with intestinal sarcocystosis, malaria and filariasis. This study revealed that the prevalence of intestinal parasitic infections among Pangkor Island community has been greatly reduced compared to that reported 35 years ago. Massive improvements in the socioeconomic status, personal hygiene, water facilities and sanitation may have contributed to the low prevalence of parasitic infections in this community. Nevertheless, further studies still need to be performed to determine the possible risk factors for the high prevalence of toxoplasmosis in this community.