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Risk factors for visceral leishmaniasis in India: further evidence on the role of domestic animals
No full textSummary Objective Studies investigating risk factors for visceral leishmaniasis (VL) on the Indian Subcontinent have shown contradictory results related to the role of domestic animals. In some studies having animals in or around the house was a risk factor, in others it was protective. We investigated the specific hypothesis that keeping domestic animals inside the house at night is a risk factor for VL. Methods Individually matched case-control study. All patients with VL diagnosed in the study area in Bihar, India between March 1st, 2007 and December 1st, 2008 were eligible. For each case, we selected two random controls, with no history of previous VL; matched on sex, age group and neighbourhood. Patients and controls were subjected to a structured interview on the main exposure of interest and potential confounders; a conditional logistic regression model was used to analyse the data. Results We enrolled 141 patients and 282 controls. We found no significant associations between VL and keeping domestic animals inside the house (OR of 0.88 for bovines and 1.00 for 'any animal') or ownership of domestic animals (OR of 0.97 for bovines and 1.02 for 'any animal'). VL was associated with housing conditions. Living in a thatched house (OR 2.60, 95% CI 1.50-4.48) or in a house with damp floors (OR 2.60, 95% CI 1.25-5.41) were risk factors, independently from socio economic status. Conclusion Keeping animals inside the house is not a risk factor for VL in Bihar, India. Improving housing conditions for the poor has the potential to reduce VL incidenc
Molecular diagnostics for sleeping sickness: what is the benefit for the patient?
No full textSleeping sickness, or human African trypanosomiasis, is a vector-borne disease caused by two subspecies of the protozoan parasite Trypanosoma brucei, and is geographically restricted to sub-Saharan Africa. Although the disease causes major public-health and socioeconomic problems among affected populations, sleeping sickness is one of the world's most neglected diseases. Within the rapidly evolving field of biotechnology, many molecular diagnostics have been developed to detect the parasite. These range from conventional, high-tech, and low-tech PCR formats (eg, isothermal nucleic-acid-amplification techniques), to direct visualisation of the parasite's nucleic acids by fluorescent probes. Besides reviewing the most important molecular diagnostics available, we discuss their current role in diagnosis and disease control. Although powerful, molecular diagnostics are confined to research settings and do not reach the patient or national control programmes. The current formats are not applicable to field conditions, and simplification, standardisation, and proper test evaluation in the target setting should be the main focus for future developmen
A cross-sectional study on bovine tuberculosis in Hawassa town and its surroundings, Southern Ethiopia
No full textA cross-sectional study was conducted in Hawassa town and its surroundings from October 2007 to May 2008 to estimate the prevalence of bovine tuberculosis (BTB) based on comparative interadermal tuberculin test (CIDT) and abattoir survey. Accordingly, 39 herds comprising 413 cattle were subjected to CIDT, and the herd and individual animal prevalence were 48.7% (19/39) and 11.6% (48/413), respectively. One of the 16 milk samples collected from tuberculin-positive cows was culture positive. The prevalence significantly differed among the age group (P = 0.001) and management system (P = 0.001). Thus, age group over four (OR = 7.9) and animal with poor management system (OR = 4.1) had a higher odds for tuberculin reactivity compared to those with age group under four and cattle with good management system, respectively. Of the total 1,023 cattle subjected to postmortem examination, 11 (1.1%) were found to be positive for gross tuberculous lesions. Larger proportion (50%) of TB lesion was recorded in the respiratory pathway followed by digestive system (28.6%) and prescapular lymph nodes (21.4%). Of 14 tissue specimens collected from the gross lesions, four (28.6%) were positive for histopathological TB lesions. In conclusion, this study revealed the importance of BTB in the study area in particular and the region in general
Differential activity of candidate microbicides against early steps of HIV-1 infection upon complement virus opsonization
No full textABSTRACT: BACKGROUND: HIV-1 in genital secretions may be opsonized by several molecules including complement components. Opsonized HIV-1 by complement enhances the infection of various mucosal target cells, such as dendritic cells (DC) and epithelial cells. RESULTS: We herein evaluated the effect of HIV-1 complement opsonization on microbicide candidates activity, by using three in vitro mucosal models: CCR5-tropic HIV-1JR-CSF transcytosis through epithelial cells, HIV-1JR-CSF attachment on immature monocyte-derived dendritic cells (iMDDC), and infectivity of iMDDC by CCR5-tropic HIV-1BaL and CXCR4-tropic HIV-1NDK. A panel of 10 microbicide candidates [T20, CADA, lectines HHA & GNA, PVAS, human lactoferrin, and monoclonal antibodies IgG1B12, 12G5, 2G12 and 2F5], were investigated using cell-free unopsonized or opsonized HIV-1 by complements. Only HHA and PVAS were able to inhibit HIV trancytosis. Upon opsonization, transcytosis was affected only by HHA, HIV-1 adsorption on iMDDC by four molecules (lactoferrin, IgG1B12, IgG2G5, IgG2G12), and replication in iMDDC of HIV-1BaL by five molecules (lactoferrin, CADA, T20, IgG1B12, IgG2F5) and of HIV-1NDK by two molecules (lactoferrin, IgG12G5). CONCLUSION: These observations demonstrate that HIV-1 opsonization by complements may modulate in vitro the efficiency of candidate microbicides to inhibit HIV-1 infection of mucosal target cells, as well as its crossing through mucos
Low occurrence of tuberculosis drug resistance among pulmonary tuberculosis patients from an urban setting, with a long-running DOTS program in Zambia
No full textWe set out to determine the levels of Mycobacterium tuberculosis resistance to first- and second-line TB drugs in an urban
population in Zambia. Sputum samples were collected consecutively from all smear-positive, new and previously treated patients,
from four diagnostic centres in Ndola between January and July 2006. Drug susceptibility testing was performed using the
proportion method against four first- and two second-line TB drugs. Results. Among 156 new cases, any resistance was observed
to be 7.7%, monoresistance to isoniazid and rifampicin was 4.5% and 1.3%, respectively. Of 31 retreatment cases, any resistance
was observed to be 16.1%, monoresistance to isoniazid and rifampicin was 3.3% for each drug, and one case of resistance to both
isoniazid and rifampicin (multidrug resistance) was detected. No resistance to kanamycin or ofloxacin was detected. Conclusion.
Although not representative of the country, these results show low levels of drug resistance in a community with a long-standing
DOTS experience. Resource constrained countries may reduce TB drug resistance by implementing community-based strategies
that enhance treatment completion
Residual insecticidal activity of long-lasting deltamethrin-treated curtains after 1 year of household use for dengue control
No full textObjective To evaluate the residual insecticidal activity of the PermaNet((R)) curtains on Aedes aegypti after 1 year of use in Thai households and to assess the influence of sun and dust exposure, washing practices and detergent use. Methods We sampled UV-protected PermaNet((R)) curtains made of a long-lasting deltamethrin-[55 mg/m(2)] treated polyester netting, before (10 curtains) and after 8 (10 curtains) and 12 months (66 curtains) of household use in a field site in Chon Buri, Thailand. We assessed the residual insecticidal activity of the curtains by standard WHO bioassay, using a deltamethrin-susceptible insectarium Aedes aegypti strain. Results Mosquito mortality was 100% before distribution, 100% at 8 months and 98.2% (95% CI 97.9-98.5) at 12 months of use. Sunlight, hand-washing and detergent use had no effect on the residual insecticidal activity after 12 months. However, the mosquito survival rate increased by a factor of 6.4 (95% CI 3.5-11.8) on machine-washed curtains and by a factor of 2.0 (95% CI 1.4-2.9) on curtains not covered by dust. Conclusion The residual insecticidal activity of PermaNet(R) curtains remains high after 12 months use under field condition
Evaluation of a rapid and simple fourth-generation HIV screening assay for qualitative detection of HIV p24 antigen and/or antibodies to HIV-1 and HIV-2
No full textThe performance was assessed of a new, rapid, visual and qualitative immunoassay for the detection of HIV p24 antigen (Ag) and antibodies (Ab) to HIV-1 and HIV-2. Characterised serum or plasma specimens from patients diagnosed with HIV infection were tested: 179 samples of known Ab-positive patients harbouring different subtypes of HIV-1 (n=154) and HIV-2 (n=25) and 200 samples from individuals not infected with HIV. The assay's Ag sensitivity was assessed by testing HIV seroconversion panels (n=10) and primary HIV infection specimens (n=57). In addition, the influence of the genetic variability of HIV-1 on Ag detection was evaluated using dilutions of culture supernatants infected with different subtypes (n=50). The performance of the rapid test was compared to a "gold standard" testing algorithm with the use of a single Ag ELISA and with the Vironostika((R)) HIV Uni-Form II Ag/Ab test, a fourth-generation ELISA. The new assay, the Determine HIV 1&2 Combo demonstrated 100% (98.2-100.0) Ab specificity (200/200) and 100% (98.0-100.0) Ab sensitivity (179/179). In these samples, the observed Ag sensitivity was 86.6% (58/67) with the Determine HIV 1&2 Combo test and 92.5% (62/67) with the Vironostika compared to the reference single Ag ELISA. The assay could not detect Ag in one group O, one subtype F and two subtype H cell supernatant isolates. None of the HIV-2 Ag could be detecte
Mirror, mirror on the wall: the face of HIV-positive women in Europe today
No full textSexual and reproductive health (SRH) and rights are important components of quality of life. This cross-sectional study describes HIV-positive women's SRH aspirations and needs and the predictive value of selected SRH factors on condom use with steady sexual partners. Data were collected in a European multi-centre study in 17 HIV centres in 14 European countries by a standardised anonymous self-administered questionnaire. Descriptive statistics and hierarchical regression analysis were carried out and qualitative data from related formative research illustrated the findings. Among 387 HIV-positive women, 57% had children and 35% had become pregnant since their HIV-diagnosis. Contraceptive needs were largely unmet: 14% had undergone a pregnancy termination. About 83% changed their sexual behaviour after HIV-diagnosis in some ways. Sixty-two percent had at least one sexual encounter with a steady partner during the past six months and 51% used condoms consistently. Significant correlations with condom use were identified for childbearing since HIV-diagnosis (r= - 0.21, p<0.01), miscarriage since HIV-diagnosis (r= - 0.24, p<0.01), the use of contraception (r=0.47, p<0.001) and changes in sexual behaviour after HIV-diagnosis (r=0.20, p<0.01). Hierarchical regression analysis controlled for education, migration background, age, undetectable viral load and partners' serostatus. The following significant predictors for condom use were established: the use of contraceptives (beta=0.33, p<0.001); miscarriage since HIV-diagnosis (beta=- 0.16, p<0.01); childbearing since HIV-diagnosis (beta =- 0.12, p<0.05); and having an HIV-positive partner (beta=- 0.13, p<0.05). For study population, consistent condom use performed a challenge. Selected SRH-issues predicted condom use. Sexual risk reduction and positive prevention should be discussed in the context of family planning and integrate SRH perspectives in routine HIV car
Detecting spatial clusters of Taenia solium infections in a rural block in South India
No full textNeurocysticercosis (NCC) is a major cause of seizures/epilepsy in countries endemic for the disease. The objectives of this study were to spatially map the burden of active epilepsy (AE), NCC, taeniasis, seroprevalence for cysticercal antibodies and positivity to circulating cysticercal antigens in Kaniyambadi block (approximately 100 villages comprising 100 000 population) of Vellore district and to detect spatial clusters of AE, NCC, taeniasis and seroprevalence. Using geographic information system (GIS) techniques, all 21 study villages with over 8000 houses (population of 38 105) were mapped. Clustering of different indices of Taenia solium infection was determined using a spatial scan statistic (SaTScan). There was a primary spatial cluster of AE with a log likelihood ratio (LLR) of 10.8 and relative risk (RR) of 22.4; however, no significant clustering for NCC was detected. Five significant spatial clusters of seropositivity for cysticercal antibodies, two clusters of seropositivity for cysticercal antigens and one for taeniasis were detected (LLR of 8.35 and RR of 36.67). Our study has demonstrated the use of GIS methods in mapping and identifying 'hot spots' of various indices of T. solium infection in humans. This spatial analysis has identified pockets with high transmission rates so that preventive measures could be focused on an intensive scal