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Epidemiology of Leishmania donovani infection in high-transmission foci in Nepal
No full textSummary Objective Nepal reports a visceral leishmaniasis (VL) incidence of 5 per 10 000 per year on the basis of notification by health facilities, but little community-based epidemiological information exists. We report data on prevalence rates of Leishmania donovani infection in ten communities in East Nepal. Methods Ten clusters with highest VL incidence rates were purposefully selected in Nepal. All households were mapped and socio-demographic data and data on past VL incidence were collected. An exhaustive serological survey was performed of individuals aged >2 years, by collecting finger prick blood on filter paper in November-December 2006. The samples were tested by direct agglutination, and a titre >/=1:1600 was taken as marker of infection. A generalized estimating equation (GEE) model was used to assess risk factors for Direct Agglutination Test (DAT) positivity taking into account the clustering at household and village level. Results The sero-survey (n = 5397) showed an infection prevalence rate of 9%, (range 5-15% per cluster) with higher prevalence in men (9.9%) than in women (8.3%) (P = 0.049). Male gender, increasing age and poverty were significant risk factors in the final GEE model. Conclusion Leishmania infection rate in high-transmission areas in Nepal is associated with gender, age and socio-economic statu
Management of visceral leishmaniasis in rural primary health care services in Bihar, India
No full textAdherence to 7-day primaquine treatment for the radical cure of P. vivax in the Peruvian Amazon
No full textDespite being free of charge, treatment adherence to 7-day primaquine for the radical cure of Plasmodium vivax was estimated at 62.2% among patients along the Iquitos-Nauta road in the Peruvian Amazon. The principal reason for non-adherence was the perceived adverse effects related to local humoral illness conceptions that hold that malaria produces a hot state of body, which is further aggravated by the characteristically hot medical treatment. Notably, patients were willing to adhere to the first 3 days of treatment during which symptoms are most apparent and include the characteristic chills. Nevertheless, as symptoms abate, the perceived aggravating characteristics of the medication outweigh the perceived advantages of treatment adherence. Improving community awareness about the role of primaquine to prevent further malaria transmission and fostering a realistic system of direct observed treatment intake, organized at community level, can be expected to improve adherence to the radical cure of P. vivax in this are
Common mental disorders in TB/HIV co-infected patients in Ethiopia
No full textBACKGROUND-: The relationship between TB/HIV co-infection and common mental disorders (CMD) has been scarcely investigated. In this study, we compared the occurrence of CMD in TB/HIV co-infected and non-co-infected HIV patients in Ethiopia. METHODS-: We conducted a cross sectional study in three hospitals in Ethiopia from February to April, 2009. The study population consisted of 155 TB/HIV co-infected and 465 non-co-infected HIV patients. CMD was assessed through face to face interviews by trained clinical nurses using the Kessler 10 scale. Several risk factors for CMD were assessed using a structured questionnaire. RESULTS-: TB/HIV co-infected patients had significantly (p = 0.001) greater risk of CMD (63.7%) than the non-co-infected patients (46.7%). When adjusted for the effect of potential confounding variables, the odds of having CMD for TB/HIV co-infected individuals was 1.7 times the odds for non-co-infected patients [OR = 1.7, (95%CI: 1.0, 2.9)]. Individuals who had no source of income [OR = 1.7, (95%CI: 1.1, 2.8)], and day labourers [OR = 2.4, 95%CI: 1.2, 5.1)] were more likely to have CMD as compared to individuals who had a source of income and government employees respectively. Patients who perceived stigma [OR = 2.2, 95%CI: 1.5, 3.2)] and who rate their general health as "poor" [OR = 10.0, 95%CI: 2.8, 35.1)] had significantly greater risk of CMD than individual who did not perceive stigma or who perceived their general health to be "good". CONCLUSION-: TB/HIV control programs should develop guidelines to screen and treat CMD among TB/HIV co-infected patients. Screening programs should focus on individuals with no source of income, jobless people and day labourer
Molecular identification of Entamoeba spp. in captive nonhuman primates
No full textThis study describes the molecular identification of 520 Entamoeba positive faecal samples from a large and diverse population of captive nonhuman primates (NHP). The results revealed the presence of E. histolytica (NHP variant only), E. dispar, E. moshkovskii, E. hartmanni, E. coli and E. polecki-like organism
Occurrence of Theileria parva and other haemoprotozoa in cattle at the edge of Hluhluwe-iMfolozi Park, KwaZulu-Natal, South Africa
No full textTheileria parva, the most important bovine theilerial species in sub-Saharan Africa, causes widespread mortality and morbidity in endemic areas. A survey was conducted using buffy-coat specimens from 60 apparently healthy adult communally herded Nguni-type cattle at the northeastern edge of the Hluhluwe-iMfolozi Park to determine, by means of PCR and Reverse Line Blot (RLB) hybridisation, the occurrence of Theileria and Babesia species. The presence of Trypanosoma species was determined using PCR-RFLP. Results showed that 6.7 % of the specimens were positive for Theileria parva. This significant finding suggests that cattle in South Africa, and not only African buffaloes (Syncerus caffer), may be subclinical carriers of T. parva. Other species identified were T. mutans (83.3%), T. velifera (70.0%), Theileria sp. (sable) (46.8%) and T taurotragi (1.7%). Two specimens (3.3%) were positive for Babesia bovis and single specimens (1.7%) positive for B. bigemina and B. rossi, respectively. Mixed infections, of up to 4 species, were common (65.0%). Only 1 specimen was found to be positive for Trypanosoma vivax, and 2 for T theileri, of which only the first species is pathogeni
Interactions between global health initiatives and country health systems: the case of a neglected tropical diseases control program in Mali
No full textInhibition of HIV-1 by non-nucleoside reverse transcriptase inhibitors via an induced fit mechanism-importance of slow dissociation and relaxation rates for antiviral efficacy
No full textThe importance of slow dissociation of non-nucleoside reverse transcriptase inhibitors (NNRTIs) for antiviral effect has been investigated. The kinetic characteristics of a series of NNRTIs interacting with wild type and drug resistant variants of HIV-1 RT (EC 2.7.7.49) were analyzed by SPR biosensor technology. The antiviral effect was determined in MT-4 and peripheral blood mononuclear cells. Due to extremely slow dissociation rates and a complex interaction mechanism, rate constants could not be quantified. Instead, interaction characteristics were qualitatively analyzed using simulated sensorgrams. The simplest model describing these interactions adequately was an induced fit mechanism, i.e. a mechanism involving the formation of an initial enzyme-inhibitor complex subsequently transformed into a more stable complex. Differences in rates of dissociation from the initial complex and rates of relaxation from the induced complex explained (1) the differences in the amounts of formed complex, (2) the stability of the complex and (3) the antiviral efficacies of the compounds. The effect of NNRTI binding site mutations also correlated with these kinetic characteristics. MIV-170 was the most effective inhibitor of wild type and mutant HIV-1 in cell culture, a property that was associated with the formation of the largest amount of complex and the slowest relaxation and dissociation rates. This study supports the hypothesis that the efficacy of anti-HIV drugs is dependent on slow dissociation from the target, thereby maximizing the duration of the inhibitory effect. It also illustrates the strength of simulating interaction data for qualitative analysis of tight-binding drugs and the importance of resolving the kinetic mechanism of drug-target interaction
Detection of Leptomonas sp. parasites in clinical isolates of Kala-azar patients from India
No full textWe report here nine unusual cases of Kala-azar, of which parasites were isolated and found by 18S rRNA gene sequencing to be most similar to Leptomonas species. One of these isolates was used to inoculate Balb/c mice; organs were collected and directly submitted to a genus-specific rDNA-ITS1 PCR analysis: this revealed the presence of both Leptomonas sp. and Leishmania donovani. Therefore, we conclude that there was a mixed infection of Leptomonas sp. and L. donovani in this isolate. We consider that mixed infection may be present in the patients themselves, Leptomonas persisting in them because of the immuno-suppression associated with Kala-aza