Annals of Tropical Medicine and Parasitology

Although intestinal parasitic infections (IPI) among children remain a global issue, the current information on such infections in Albanian children is very limited. A cross-sectional study of the IPI in 321 children living in the Albanian counties of Tirana (152) and Elbasan (169) was therefore conducted in 2008, with a pre-tested standard questionnaire employed to gather the relevant personal and clinical data. Using formalin–ether concentration and permanent stains, stool samples were examined microscopically for the ova, cysts and oocysts of any parasites. The overall prevalence of IPI was 19% (61 of 321), with protozoan infections (11·5%) apparently more common than infections with soil-transmitted helminths (STH; 8·1%). Giardia duodenalis was the parasite most frequently detected (10·9%), followed by hookworm (5·6%), Ascaris lumbricoides (1·9%), Trichuris trichiura (0·6%), Cryptosporidium (0·3%) and Entamoeba histolytica/dispar (0·3%). The results of a univariate analysis indicated that the children from Tirana county were significantly more likely to be found infected with STH compared with the children from Elbasan county (12·5% v. 4·1%; P = 0·006). Children sampled in the community were also more likely to be found STH-positive than the children sampled as they attended hospitals and health clinics (10·5% v. 6·0%) but this difference did not reach statistical significance. The children found STH-positive were five times more likely to be suffering from diarrhoea than the other children checked in clinical settings (P = 0·004) and were also more likely to be suffering from abdominal pain (P = 0·054) and/or diminished appetite (P = 0·016).

A Sejdini

R Mahmud

Y A L Lim

M Mahdy

F Sejdini

V Gjoni

K Xhaferraj

G Kasmi

Intestinal parasitic infections among children in central Albania

阿尔巴尼亚中部儿童的肠道寄生虫感染情况

Although the expression of matrix metalloproteinase-12 (MMP-12) appears to be increased in most inflammatory diseases, the role of this enzyme in the pathogenesis of toxoplasmosis in pregnant women, if any, is unknown. In a recent study in Taiwan, the serum concentrations of MMP-12 and its substrate elastin were evaluated in pregnant women with Toxoplasma gondii infection. Compared with the healthy pregnant and non-pregnant women used as controls, the pregnant women with toxoplasmosis had significantly higher serum concentrations of MMP-12 and significantly higher levels of elastin synthesis and degradation. Interaction between MMP-12 and elastin in the serum samples was confirmed by co-immunoprecipitation. It seems possible that MMP-12 may contribute to elastin degradation occurring during the pathogenesis of toxoplasmosis in pregnant women.

P-H Chou

S-C Lai

Elevated concentrations of matrix metalloproteinase-12 and elastin degradation products in the sera of pregnant women infected withToxoplasma gondii

孕妇感染弓形虫血清中基质金属蛋白酶-12和弹性蛋白降解产物浓度升高

Until the last few years, most cases of sleeping sickness or human African trypanosomiasis (HAT) occurred in Angola, the Democratic Republic of Congo and Sudan, with 17,673 cases detected in Angola alone among the 1,660,111 Angolans who were screened between 2001 and 2007 (T. Josenando, unpubl. obs.).

Angola is divided into 18 provinces (see Figure). The chronic form of HAT, caused by Trypanosoma brucei gambiense, occurs in seven of the 14 provinces where tsetse flies are present (in Bengo, Cuanza Norte, Uige, Cuanza Sul, Zaire, Malange, and the periphery of Luanda). The acute form of the disease, caused by T. b. rhodesiense transmitted by Glossina morsitans centralis, could once be found in the southern province of Cuando Cubango (where 30% of new Angolan HAT cases were diagnosed between 1964 and 1974; T. Josenando, unpubl. obs.). Most of the human population of this province moved to northern Angola during the civil war that ran from 1975 to 2002, however, probably leading to the disappearance of T. b. rhodesiense from Cuando Cubango and, therefore, from Angola as a whole (T. Josenando, unpubl. obs.).



Map of Angola, showing the provinces where human African trypanosomiasis (HAT) is endemic (hatched) and the location of the village of Maria Teresa, in and around which tsetse were caught in pyramidal traps. Note that HAT is only endemic on the periphery ...



HAT in Angola is poorly documented, with no recent publications on the disease in the country. In 2007, the French Institut de Recherche pour le Developpement (UMR 177) and the Angolan Instituto de Combate e Controlo das Tripanossomiases (ICCT) began collaborative research on the disease at Viana Hospital, which lies in Luanda province, 20 km to the east of Luanda city. The staff at the Viana Hospital only treat HAT cases, most of whom come from Bengo province. A year later, in an attempt to reinforce the tsetse-control capacity of the ICCT, an entomological study was conducted in and around the village of Maria Teresa (a community in Bengo province with particularly high incidences of HAT). The preliminary results of the collaborative research at Viana Hospital and the entomological survey in Maria Teresa are presented below.

P Truc

P Grébaut

A Lando

F Makiadi Donzoau

L Penchenier

S Herder

A Geiger

G Vatunga

T Josenando

Epidemiological aspects of the transmission of the parasites causing human African trypanosomiasis in Angola

安哥拉人类非洲锥虫病病原体传播的流行病学方面

Schistosomiasis mansoni is a fibrogenic liver disease that constitutes a major health problem in north–eastern Brazil. Although one common manifestation of the disease, periportal fibrosis (PPF), can be assessed by ultrasonography by well-trained physicians, the necessary equipment and personnel are not always readily available. Serum markers, including hyaluronic acid (HA), have been used as alternative means of measuring fibrosis. Recently serum concentrations of HA have been evaluated in 77 Brazilians (61 cases of schistosomiasis mansoni and 16 healthy controls) and compared against the ultrasound-evaluated PPF in the same subjects. The HA was measured using a non-competitive fluorescence-based assay, while the PPF was explored using a portable ultrasound scanner (SSD-500; Aloka, Tokyo) and graded, as patterns A–F, according to the World Health Organization’s ‘Niamey protocol’. In general, the serum concentrations of HA were found to be positively correlated with the severity of the PPF. The mean concentration of HA in the sera of the 16 controls was significantly lower than that recorded in the schistosomiasis cases who showed PPF of patterns D or E (P<0·001 for each). The cases who showed pattern-C PPF also had significantly less HA in their sera than the cases with PPF of patterns D or E (P<0·001 for each), and the cases with pattern-D fibrosis had significantly lower HA concentrations in their sera than the cases with PPF of pattern E (P<0·001).In an analysis based on a receiver-operating-characteristic (ROC) curve, an HA concentration of 20·2 μg/litre of serum was identified as a threshold that could be used to distinguish moderate cases of PPF (i.e. patterns C or D) from the more advanced cases (i.e. patterns E or F), with a sensitivity of 60% and specificity of 65%.In conclusion, it appears that serum concentrations of hyaluronic acid could be used as markers for periportal fibrosis in patients with schistosomiasis mansoni.

C C Silva

A L Domingues

E P Lopes

C N Morais

R B Santos

C F Luna

H B Nader

J R Martins

Schistosomiasis mansoni: ultrasound-evaluated hepatic fibrosis and serum concentrations of hyaluronic acid

曼氏血吸虫病：超声评估的肝纤维化与透明质酸血清浓度

There are currently 11–13 foci of human onchocerciasis recognised in Tanzania (Raybould and White, 1979; Maegga, 1991). The disease was first recorded in the country by Fischer (1932), from Rungwe (within the modern-day Tukuyu focus). Nine years later the disease was recorded by Gabathuler and Gabathuler (1947), from Ulanga district, in what is now known as the Mahenge focus. It was not until 1957 that a third focus was discovered in Tanzania, in the eastern block of the Usambara mountains (in Tanga region), by Mario Giaquinto-Mira (Woodman, 1958). Another focus was found in 1964, in the western block of the same mountains (Laing and Wegesa, 1965).

Since 1963 the human onchocerciasis in the Usambara mountains has been the subject of research based at the East African Institute of Malaria and Vector-borne Diseases in Amani (now the Amani Medical Research Centre of the National Institute for Medical Research). Data collected in 1963–1964 indicated that, in several study sites in the Eastern Usambara focus, the mean prevalence of human infection with Onchocerca volvulus was 32% (Laing and Wegesa, 1965). When four localities in this focus were resurveyed in 1970, mean prevalence in the four sites was found to have increased to 46% (from the 29% recorded in 1963–1964), possibly because increasing agricultural activity had resulted in increased exposure to vector biting (Wegesa and Chimtawi, 1971). In 1984, however, Muro and Mziray (1990) resurveyed nine localities from the 1963–1964 survey and found that mean prevalence had decreased to 26% (from the 33% recorded in the same sites in 1963–1964), possibly because of continuing deforestation. Compared with its eastern counterpart, the Western Usambara focus is less well known, but Sprengel (1967, 1968) did much to define it (finding a mean prevalence, of human infection, of 37%) and Dunbar (1975) extended its known range. In the 1990s about 5000 and 19,000 people were thought to be infected with O. volvulus in the Western and Eastern Usambara foci, respectively (Mwaiko et al., 1990; Walsh and Maegga, 1996). In 2001 the National Onchocerciasis Control Programme of the Tanzanian Ministry of Health started annual, community-directed treatment with ivermectin (CDTI) simultaneously over all of the endemic areas in Tanga region (i.e. the Eastern Usambara mountains within the Muheza and Mchinga districts and the Western Usambara mountains within the Korogwe and Lushoto districts).

The vector of O. volvulus throughout the Usambaras is Simulium woodi (a member of the S. neavei group) (Raybould and White, 1979). When Raybould (1967) studied transmission of the parasite, through weekly biting catches over 13 months (1963–1964) at a single site near Amani, in the Eastern Usambara focus, he found a mean daily biting rate (DBR) for S. woodi of 42·8, with 33·6% of the collected flies found parous and 17·3% of the parous flies found infected with O. volvulus. The corresponding mean DBR recorded in two catches at the same site in 1974–1975 was, however, only 5% of that recorded in 1963–1964 (Raybould, 1975), and Raybould (1975) reported that ‘periodic collections from other areas have shown that this [marked reduction in DBR] is not just a local phenomenon’. When they carried out vector collections from the same site near Amani over 12 months in 1985–1986, Muro and Raybould (1990) recorded a mean DBR for S. woodi of 5·64, with the percentage of the collected flies found parous ‘the same’ as seen in 1963–1964 but only 3·2% of the parous found infected. The falls seen in DBR since the 1960s were attributed by Muro and Raybould (1990) to deforestation, which had made the habitat unsuitable for S. woodi. Muro and Raybould (1990) postulated that the decline in S. woodi DBR may have come to an end at the time of their study because of then-recent programmes of re-afforestation. This suggestion appeared to be supported by Walsh and Maegga (1996), who visited Amani in November 1995 and reported that ‘the larvae and pupae of S. woodi were certainly common at traditional sites’.

To investigate whether the population decline in S. woodi has been arrested or has continued, the Western and Eastern Usambara foci were visited in March 2010, when human biting catches were carried out by a single vector collector for 5 h (06·30–09·30 and 16·30–18·30 hours) at each of seven sites (see Table). Since Raybould (1967) described the diurnal biting cycle at Amani-Mfenesini for March, it was possible to assume that the eight flies caught at this site, over 5 h, represented about 71·5% of a full day’s catch (06·30–18·30 hours), and, from this, to estimate a corresponding DBR of 11·2. Although all 21 flies caught were identified as members of the S. neavei group (and were, therefore, probably S. woodi), they were not dissected to see if they were parous or infected with O. volvulus because sample sizes were too small to make such investigation meaningful. It is clear, however, that anthropophagy is continuing among the blackflies in both the Eastern and Western Usambara foci. It is also clear that the DBR recorded at Amani-Mfenesini in March 2010 (11·2; present study) was substantially lower than those recorded in March 1964 (with a mean of 57 and a range of 35–76 over 4 days; Raybould, 1967), markedly higher than the value (5% of the earlier value, or about 2·8) apparently recorded in March 1975 (Raybould, 1975) and similar to the value (12) recorded by Muro and Raybould (1990) in March 1986. When the DBR recorded at Amani-Mfenesini are plotted against the collection dates (see Figure), they appear to have dropped between 1964 and 1975 but subsequently remained fairly stable for approximately 35 years, up to the recent (2010) survey.



Trends in daily biting rate (DBR) for the month of March, between 1964 and 2010, at Amani-Mfenesini. The values shown for 1975 and 2010 are estimates based on the limited data available.





The numbers of blackflies caught on human bait in March 2010, over 5 h of collection at each site



It is unclear whether the temporal trends seen in DBR (Fig.) have had any effect on the prevalence and intensity of onchocerciasis in the human populations living in the Usambara foci. Muro and Mziray (1990) reported a small drop in prevalence over a couple of decades, from 33% in 1963–1964 to 26% in 1984, which they attributed to lower vector populations. It is unclear whether S. woodi can maintain the transmission of O. volvulus when its DBR are as low as those recorded in the foci over the last three decades. It is possible that the stable transmission of O. volvulus is near its lower critical point in the Usambara foci and therefore might be very vulnerable to control efforts such as CDTI or vector control. In the Itwara focus in Uganda, S. neavei maintained transmission at DBR of around 20–60 (Garms et al., 2009). Probably because S. neavei is a highly anthropophilic and efficient vector, 4 years of ivermectin distribution in Itwara had little effect on transmission (Garms et al., 2009). As a consequence, a vector-elimination campaign was initiated and, since September 2003, S. neavei has never been seen in the focus (Garms et al., 2009). Members of the S. neavei group are often considered particularly vulnerable to vector elimination because of their limited flight range and restriction to well defined patches of forest (Garms et al., 2009). Raybould (1975) suggested the possibility of vector control in the Eastern Usambara focus, pointing out that, because of the long period of larval development of S. woodi near Amani (Raybould and Mhiddin, 1978), control operations would require no more than monthly application of insecticide. Garms et al. (2009) found that monthly treatments over approximately 18 months were sufficient to eliminate S. neavei from the various sub-foci in the Itwara focus. Although Walsh and Maegga (1996) considered that the limits of the Eastern Usambara focus needed to be better defined, they also thought that vector elimination was both feasible and desirable in the focus.

A Kalinga

R J Post

An apparent halt to the decline ofSimulium woodiin the Usambara foci of onchocerciasis in Tanzania

坦桑尼亚盘尾丝虫病乌桑巴拉疫区Simulium woodi数量下降明显停止

Onchocerciasis, lymphatic filariasis (LF), schistosomiasis and soil transmitted, helminthiasis (STH) are all co-endemic in Nigeria. Annual mass drug administration (MDA) with ivermectin (for onchocerciasis), albendazole (for STH and with ivermectin for LF) and praziquantel (for schistosomiasis) is the WHO-recommended treatment strategy for preventive chemotherapy. Separate delivery rounds for distribution of these drugs have been the usual approach to MDA. All three drugs, however, have now been shown to be clinically and programmatically safe for co-administration with what has come to be known as triple drug administration (TDA). We examined the cost savings of converting from separate delivery rounds to TDA in two states in Nigeria. In 2008, eight local government areas received a single round of ivermectin with albendazole followed at least 1 week later by a single round of praziquantel to school-aged children. The following year, a single round was administered with TDA. The number of treated individuals was essentially unchanged during both years (1 301 864 in 2008 and 1 297 509 in 2009) and no change in adverse events was reported. The total programmatic costs for the MDA, not including drug and overhead costs, reduced by 41% from $123, 624 to $72, 870. Cost savings were limited in larger populations due to economies of scale. TDA is recommended for mature MDA.

D Evans

D Mcfarland

W Adamani

A Eigege

E Miri

J Schulz

E Pede

C Umbugadu

P Ogbu-Pearse

F O Richards

Cost-effectiveness of triple drug administration (TDA) with praziquantel, ivermectin and albendazole for the prevention of neglected tropical diseases in Nigeria

尼日利亚预防被忽视的热带病的三药联合疗法（TDA）与吡喹酮、伊维菌素和阿苯达唑的成本效益分析

Background: The aim of present study was describing a real-time PCR assay for the diagnosis and direct identification of Leishmania species on Giemsa-stained slides in south-west of Iran.

S Khademvatan

N Neisi

S Maraghi

J Saki

Diagnosis and identification ofLeishmaniaspp. from Giemsa-stained slides, by real-time PCR and melting curve analysis in south-west of Iran

伊朗西南部吉姆萨染色玻片中利什曼原虫种的诊断与鉴定：实时PCR与熔解曲线分析

Strongyloides stercoralis is a common intestinal parasitic nematode that infects a large portion of the world’s population, and is endemic to tropical and sub-tropical regions. Infected individuals are often asymptomatic, but may have abdominal pain, diarrhea and other nonspecific findings. Immunocompromised hosts may develop massive invasion of the gastrointestinal and respiratory tracts, which represents a constellation of symptoms known as hyperinfection syndrome. This condition is most commonly seen in immunosuppressed individuals including renal allograft recipients, patients with human T-lymphotropic virus, and patients using corticosteroids. Along these lines, sickle cell anaemia (SCA) is a condition that is marked by functional asplenia and a relative state of immunocompromise, which may increase the incidence of hyperinfection.

Along with the predisposition to encapsulated organisms, SCA patients may be unusually susceptible to parasitic infections, which may trigger sickle cell crises (Sodipo et al., 1997). Furthermore, blood samples from SCA patients have demonstrated increased eosinophil numbers and adhesion properties, which may also contribute to the vasoocclusive state (Canalli et al., 2004). Given the observations that strongyloidiasis is characterized by eosinophilia and eosinophils in SCA individuals may be implicated in vasoocclusive crisis (VOC), further data are necessarily to investigate the association between SCA and S. stercoralis infection. We describe a patient with SCA and chronic eosinophilia who presented to our hospital with diarrhea and VOC. She was found to have S. stercoralis infection, and experienced symptomatic improvement following the administration of ivermectin.

D E Ferastraoaru

N N Jariwala

S P Jariwala

Strongyloides stercoralisinfection in a patient with sickle cell disease

粪类圆线虫感染的镰状细胞病患者

Controlling malaria in pregnancy has been an important component of the millennium development goal and intermittent preventive treatment (IPT) is considered an important tool in controlling malaria among pregnant women. In this study, we evaluated the level of compliance to IPT use as well as its effect on malaria infection among pregnant women attending antenatal clinic in south eastern Nigeria. Peripheral blood smears and placental histology were used as diagnostic tools to determine infection rate. Our data show that compliance to IPT use was poor (33%) when compared with non-compliance (67%). Infection rate was significantly lower among IPT users (39%) than in non-users (71%) (X2 = 39·95; P<0·05). Maternal anaemia was also lower in IPT users (4%) than in non-users (18%). Taken together, IPT use appears to be important in reducing infection rate and maternal anaemia. Therefore, its adoption is highly recommended and this could be improved through public enlightenment campaign and adequate funding.

F O Nduka

E Nwosu

R M Oguariri

Evaluation of the effectiveness and compliance of intermittent preventive treatment (IPT) in the control of malaria in pregnant women in south eastern Nigeria

尼日利亚东南部孕妇间歇性预防治疗（IPT）在控制疟疾中的有效性和依从性评估

Trypanosoma cruzi displays clonal expansion, and genetic exchanges have contributed to the current complexity of its population (Machado and Ayala, 2001). Several clustering schemes have been propo...

L H Jaeger

A Brandao

Further characterization ofTrypanosoma cruzistrains through a simple sequence repeat (SSR) of ferredoxin-NADP+ reductase 5′ UTR

通过铁氧还蛋白-NADP+还原酶5′ UTR简单重复序列进一步鉴定克氏锥虫株系

Publication Information	Publisher: Maney Publishing，Publishing cycle: Bimonthly，Journal Type: journal，Open Access Journals: No
Basic data	Year of publication: 1907，Proportion of original research papers: 0.00%，Self Citation Rate:N.A.， Gold OA Rate: 0.00%
Average review cycle	网友分享经验：>12周，或约稿
Average recruitment ratio	网友分享经验：容易

Annals of Tropical Medicine and Parasitology

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