Anthelmintic resistance of gastrointestinal nematodes is considered as one of the main limiting factors causing significant economic losses to the small ruminant industry. The anthelmintic properties of some plants are among the suggested alternative solutions to control these parasitic worms. The present study investigated the anthelmintic activity of neem (Azadirachta indica) and cassava (Manihot esculenta) leaf extracts against the susceptible and resistant strains of one of the most important nematodes in small ruminants, Teladorsagia (Ostertagia) circumcincta. Three different in vitro tests: egg hatch test, larval development assay, and larval paralysis assay were used to determine the efficiency of neem and cassava extracts on three pre-parasitic stages of T. circumcincta. The LC(50) was determined for the most potent extract in each plant as well as the phytochemical tests, total tannin quantification and cytotoxicity on peripheral blood mononuclear cells of goats. The results revealed a high anthelmintic activity of neem methanol extract (NME) and cassava methanol extract (CME) on both strains of T. circumcincta without significant differences between the strains. The first stage larvae were more sensitive with the lowest LC(50) at 7.15 mg/ml and 10.72 mg/ml for NME and CME, respectively, compared with 44.20mg/ml and 56.68 mg/ml on eggs and 24.91 mg/ml and 71.96 mg/ml on infective stage larvae.
We report a 20-year-old college student presents with bilateral ankle edema associated with hypereosinophilia following a history of traveling in a rural area. Physical examinations and investigations failed to diagnose any underlying cause. She was treated with antihelminth medication and the edema subsided within a week and the eosinophil counts normalized within two weeks.
Data from the WHO state that up to 85% of cases of human schistosomiasis are from Africa. The common sites of this parasitic infection are the intestine and bladder. Testicular schistosomiasis is extremely rare but the number of reported cases worldwide has doubled over the past decade. The authors report a case of testicular schistosomiasis of a Myanmar immigrant in Malaysia who presented with a 6-month history of progressively enlarging left testicular swelling. His biochemical markers and cultures were not suggestive of an ongoing infection. Hence, a testicular malignancy was strongly suspected, for which, he underwent a left orchidectomy. Our clinical suspicion was proven wrong when the histopathology of the removed left testis revealed schistosomal eggs with granulamatous tissue formation. Subsequently, the patient was treated with praziquantel.
Hookworm-related cutaneous larva migrans (CLM) is characterized clinically by erythematous and slightly raised tracks, located especially on the feet. These tracks may be single or multiple, linear or serpiginous, more or less ramified and intertwined. The length is variable (up to many cm); the width ranges from 1 mm to 4 mm. Tracks are often accompanied by severe pruritus.
This letter advises the imminent formation of the Companion Animal Parasites Council for the Tropics (CAPCT). The CAPCT consists of region-specific (e.g., Asia-Pacific, Latin America and Caribbean, Africa) experts comprising academics, veterinarians, parasitologists, physicians and allied industry partners that will work together to inform, guide and develop best-practice recommendations for the optimal diagnosis, treatment and control of companion animal parasites in the tropics, with the aim of protecting the health of pets and that of the public.
Diphyllobothriasis is a disease caused by infection with adult tapeworms of the genus Diphyllobothrium. Humans acquire the infection by consuming the raw or inadequately cooked flesh, roe, liver, or other organs of infected fish. Diphyllobothrium latum infection has not been reported in Malaysia; we are reporting the first case. The patient was a 62 year old Chinese male seen at the outpatient clinic with complaints of watery stools and slight abdominal discomfort for four days. Physical examination was normal. He was treated for diarrhea. Two days after treatment, he passed out intact off-white proglottids in his stool. Diphyllobothriasis was confirmed by examination of these gravid proglottids; typical operculated eggs were seen after rupturing the gravid proglottids. The patient had a history of eating sashimi (Japanese raw fish). He was treated with a single dose of praziquantel and had been well since.
Study site: Gleneagles Intan Medical Centre, Kuala Lumpur, Malaysia
Trials using albendazole and mebendazole, as single 400 mg dose treatments, against soil-transmitted helminths, were carried out in 7-9 and 10-12 years-old schoolchildren living in urban and rural environments in Penang, Malaysia. Both drugs were equally effective in treating trichuriasis and ascariasis in both age groups and environments. However, mebendazole is not so effective in the treatment for hookworms when compared to albendazole. It is suggested that albendazole should be considered the drug of choice for mass chemotherapy for Penang.
A cohort of one hundred 8-9 year old school children in Northeastern Peninsular Malaysia underwent stool examination, weight and height measurements. Seventy-three children were infected with Ascaris lumbricoides and/or Trichuris trichiura. All infected children were treated with albendazole at baseline, 6 months and 9 months. Measurements were repeated on all but 2 children at 1 year. Repeat stool examination (n = 94) at 1 year revealed a marked reduction in the level of Ascaris infection and a modest reduction in Trichuris infection. There was no difference in net growth between treated children and uninfected controls. Post-hoc analysis by gender however revealed that infected girls (n = 33) experienced significantly higher increments in weight, height and weight for age. Furthermore, children found to be infected at baseline level but worm free at follow-up, were observed to have experienced greater increments in height and height for age. The evidence suggests that periodic antihelminthic treatment may have a positive effect on the growth of subsets of pre-adolescent children but it is emphasised that further work is required to validate these findings.
Ninety-six randomly selected farms, located throughout peninsular Malaysia, were surveyed for goat nematodes resistant to benzimidazoles (BZ). On 33 farms BZ resistance was demonstrated by means of an egg hatch assay. Haemonchus contortus was found to be the main species involved in anthelmintic resistance. There was a positive association between the frequency of anthelmintic treatments on a farm and the presence of benzimidazole resistance. To assess the value of the egg hatch assay, faecal egg count reduction (FECR) tests were also performed on 20 farms. On six farms the LD50 of thiabendazole (TBZ) was less than 0.10 micrograms ml-1 and the FECR higher than 95% and on ten farms with an LD50 TBZ of over 0.10 micrograms ml-1 a FECR of less than 95% was measured. On four farms the FECR was less than 95%, although the egg hatch assay showed LD50 TBZ values of less than 0.10 micrograms ml-1 and on two of these three farms a controlled efficacy test confirmed the presence of BZ resistant H. contortus. From these results it can be concluded that the egg hatch assay underestimated the true incidence of benzimidazole resistance. Levamisole resistance was detected with a FECR test on two of ten farms investigated.
Serum IgG levels and complement C3 levels were assayed on Day 0, 1, 3-4, 7 and 56-70 post-treatment with diethylcarbamizine citrate (DEC) in a series to 26 patients with Brugia malayi infection and 6 volunteers without infection. On treatment, the microfilariae were cleared from the blood within 24 hours. The eosinophils decreased dramatically on Day 1 post-treatment but increased rapidly by Day 4 to 7 and then dropped to normal levels in 45 days. The serum IgG mean levels decreased briefly following treatment with DEC but then returned to original levels. However, the complement C3 levels gradually increased over the 2 months period of study reaching statistical significance levels (p less than 0.01) in patients with initial high blood microfilariae. The observation suggests that Brugia malayi infection probably induces a high rate of synthesis of complement C3 and this process continued in the post-treatment phase. Since, DEC treatment did not cause a decrease in complement C3 with the elimination of blood microfilariae, it would appear that the complement C3 is consumed following antibody attachment to the microfilariae as they enter the blood circulation.
Albendazole, a new anthelmintic drug was evaluated in Malaysia in 91 patients, with single or mixed infections of Ascaris, Trichuris, and hookworm. Albendazole was administered as a single dose of 400 mg, 600 mg, or 800 mg. The cure rate for Ascaris at all three doses was 100% at days 14 and 21 post-treatment; for hookworm it was 98.8%, 100% and 98%, respectively, at day 14 and 68.8%, 100% and 84%, respectively, at day 21; for Trichuris it was 31.2%, 57.1% and 42.3%, respectively, at day 14 and 27.3%, 60.9% and 48.0%, respectively, at day 21. The egg reduction rate at day 21 was 100% at all three doses for Ascaris, 94.5%, 100% and 96.1%, respectively, for hookworm; and 39.2%, 85.1% and 72.8%, respectively, for Trichuris. There were no side effects, and biochemical examination of blood and urine did not indicate any unfavourable changes. Based on this trial, the recommended dosage for Ascaris and hookworm is a 400 mg single dose, and for Trichuris is a 600 mg single dose. Albendazole appears to be more effective than other available anthelmintic drugs.
CGP 20376, a 5-methoxyl-6-dithiocarbamic-S- (2-carboxy-ethyl) ester derivative of benzothiazole was evaluated for its antifilarial properties and shown to be extremely effective against subperiodic Brugia malayi in the leaf-monkey, Presbytis cristata at oral doses of 20-100 mg/kg. The compound and/or its metabolites had complete micro- and microfilaricidal activities even when given at a single dose of 20 mg/kg. Lower doses had incomplete filaricidal action.
There is no doubt that on a global basis, Haemonchus contortus is by far the most important parasite of small ruminants (sheep and goats). This is particularly more so now, with the development of high levels of resistance to both the broad and narrow spectrum anthelmintic drugs in H. contortus throughout the world. Epidemiological studies describe the lower environmental limits for haemonchosis to occur in sheep, as being a mean monthly temperature of 18C and approximately 50mm rainfall. Thus it has been generally recognised that H. contortus is a problem parasite restricted to the warm, wet countries where sheep and goats are raised. However, recent evidence shows that this parasite is apparently common even in northern Europe. Thus the need for sustainable control strategies for H. contortus is becoming much more pressing. This report highlights two examples of sustainable and highly efficient control programmes for H. contortus, that can be implemented in regions at the extremes of its geographic range (Malaysia and Sweden), where the authors have had direct involvement.
An elicitation exercise was conducted to collect and identify pressing questions concerning the study of helminths in livestock, to help guide research priorities. Questions were invited from the research community in an inclusive way. Of 385 questions submitted, 100 were chosen by online vote, with priority given to open questions in important areas that are specific enough to permit investigation within a focused project or programme of research. The final list of questions was divided into ten themes. We present the questions and set them briefly in the context of the current state of knowledge. Although subjective, the results provide a snapshot of current concerns and perceived priorities in the field of livestock helminthology, and we hope that they will stimulate ongoing or new research efforts.
The World Health Organization has recommended the application of mass drug administration (MDA) in treating high prevalence neglected tropical diseases such as soil-transmitted helminths (STHs), schistosomiasis, lymphatic filariasis, onchocerciasis and trachoma. MDA-which is safe, effective and inexpensive-has been widely applied to eliminate or interrupt the transmission of STHs in particular and has been offered to people in endemic regions without requiring individual diagnosis. We propose two mathematical models to investigate the impact of MDA on the mean number of worms in both treated and untreated human subpopulations. By varying the efficay of drugs, initial conditions of the models, coverage and frequency of MDA (both annual and biannual), we examine the dynamic behaviour of both models and the possibility of interruption of transmission. Both models predict that the interruption of transmission is possible if the drug efficacy is sufficiently high, but STH infection remains endemic if the drug efficacy is sufficiently low. In between these two critical values, the two models produce different predictions. By applying an additional round of biannual and annual MDA, we find that interruption of transmission is likely to happen in both cases with lower drug efficacy. In order to interrupt the transmission of STH or eliminate the infection efficiently and effectively, it is crucial to identify the appropriate efficacy of drug, coverage, frequency, timing and number of rounds of MDA.
We studied asymptomatic primary schoolchildren in northeastern Malaysia with light to moderate trichuriasis to determine the effect of albendazole treatment on growth rates and TNF-alpha levels. Thirty-seven schoolchildren aged 6-7 years with stool samples positive for Trichuris trichiura and negative for other geohelminths and protozoa were randomized to receive albendazole 400 mg or a placebo daily for 2 days. Anthropometric parameters at baseline, 3, 6 and 12 months were compared between the 2 groups. The placebo group had a significantly greater increase in height (p = 0.04) than the albendazole treatment group. There were no significant differences in urinary TNF-alpha levels (p = 0.8) between the 2 groups and no significant changes between baseline and 1 month post-treatment levels. Further studies are needed to determine the etiology of this apparent association between the albendazole treatment group and the delay in growth rate at 6 months post-treatment.
This study aimed to represent the first report of the ovicidal and larvicidal activity of the methanolic leaf extract of Manihot esculenta (cassava) against eggs and larvae of susceptible and resistant strains of Trichostrongylus colubriformis. As well as, to determine the total tannin compounds, antioxidant activity and toxicity of the extract. The egg hatch test was used to evaluate ovicidal activity against unembryonated eggs, whereas larval feeding inhibition assay and MTT-formazan assay were used to evaluate larvicidal activity against first (L(1)) and infective (L(3)) larvae, respectively. The results showed no significant differences were detected between the sensitivities of susceptible and resistant strains of T. colubriformis to the extract. Eggs, L(1) and L(3) were significantly affected (P<0.001) compared with negative control, and L(1) were more sensitive than the eggs and L(3). The total tannin compounds were investigated using tannin quantification assay and determined by 254.44 TAE/mg. The antioxidant activity was evaluated using the DPPH radical scavenging assay and the median inhibition concentration (IC(50)) was determined by 2.638 mg/ml. Acute oral toxicity at dose of 5,000 mg/kg, and sub-chronic oral toxicity at 500 and 1,000 mg/kg of the extract were observed in male and female Sprague-Dawley (SD) rats. The acute oral toxicity revealed that the median lethal dose (LD(50)) of methanolic extract of cassava leaves on SD rats was greater than 5,000 mg/kg, whereas the sub-chronic oral toxicity did not show observed adverse effects at 500 and 1,000 mg/kg per day for 28 days. In conclusion, the methanolic extract of cassava leaves has direct ovicidal and larvicidal activity against T. colubriformis strains with a safety margin for animals, and it may be potentially utilized as a source of natural antioxidants.