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Pulmonary cystic disease in HIV positive individuals in the Democratic Republic of Congo: three case reports
No full textPulmonary emphysema and bronchiectasis in HIV seropositive patients has been described in the presence of injection drug use, malnutrition, repeated opportunistic infections, such as Pneumocytis jirovici pneumonia and Mycobacterium tuberculosis infection, and has been linked to the presence of HIV virus in lung tissue. Given the high burden of pulmonary infections and malnutrition among people living with HIV in resource poor settings, these individuals may be at increased risk of developing pulmonary emphysema, potentially reducing the long term benefit of antiretroviral therapy (ART) if initiated late in the course of HIV infection.In this report, we describe three HIV-infected individuals (one woman and two children) presenting with extensive pulmonary cystic disease
Une médecine rurale de proximité: l'expérience des médecins de campagne au Mali
No full textThe main constraint to improving access to health services of quality in rural areas is to attract qualified health personnel in these areas. A fifteen years experience in rural health in Mali has shown that it is possible to develop community medicine practices in an African context that do integrate individual care and public health activities. The policy of decentralization of health services encouraged local communities and municipalities to recruit rural doctors themselves. An initiative of rural doctors materialized with this event as they founded a national association and adhere to the principles of a Charter to provide quality health care at an affordable cost. A mechanism of quality improvement was established with the participation of several partners: a professional association, a funding non-governmental organization, and groups of academic staff and health managers. This paper describes the evolution of the rural doctors' experience, its philosophy, conditions that made it successful, constraints it had to overcome and the attitude of partners. It highlights the potential of health care personnel in Africa to provide primary health care well beyond traditional programs on prevalent diseases and to respond to both urgent individual needs and pressing public health requirements
Implementation in low-income countries of colorimetric methods as novel rapid antimicrobial susceptibility tests for Mycobacterium tuberculosis
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Molecular diagnosis of leishmaniasis: current status and future applications
No full textLeishmania parasites are the etiological agents of the leishmaniases. The parasites are transmitted to mammals, including humans, by the bite of phlebotomine sand flies and occasionally, by sharing of needles, blood transfusion, and congenital transmission (18). In terms of global burden of disease, the leishmaniases are the third most important vector-borne disease, and it is estimated that worldwide there are an annual 1.5 to 2 million cases, with up to 350 million people at risk of infection and disease.
Surveillance data indicate that the global number of cases has increased in recent decades, and several important epidemics have been reported (e.g., Sudan and Afghanistan). Such increases can be explained, in part, by improved diagnosis and case notification but are also due to other factors such as inadequate vector or reservoir control; increased detection of disease associated with opportunistic infections (e.g., human immunodeficiency virus [HIV]/AIDS), urbanization, and deforestation; the emergence of antileishmanial drug resistance; economic hardship; armed conflict; and tourism. Particularly, the latter two factors have led to the increasing observation and management of leishmaniasis patients in clinical practices in areas where this disease is traditionally not endemic in North America and Northern Europe. Thus, more than 600 U.S. soldiers contracted leishmaniasis in Iraq since 2003, most of which were diagnosed and treated at the Walter Read Army Medical Center in Washington, D.C. (28). Similarly, in the United Kingdom the number of travelers with leishmaniasis seen by the Hospital of Tropical Diseases in London has more than quadrupled in the past 10 years (13). Here we critically review current molecular approaches for leishmaniasis diagnosis, primarily focusing on the detection of human disease rather than their applications in the veterinary field
Identification of a tryptophan-like epitope borne by the variable surface glycoprotein (VSG) of African trypanosomes
No full textAntibodies (Ab) directed against a tryptophan-like epitope (WE) were previously detected in patients with human African trypanosomiasis (HAT). We investigated whether or not these Ab resulted from immunization against trypanosome antigen(s) expressing a WE. By Western blotting, we identified an antigen having an apparent molecular weight ranging from 60 to 65 kDa, recognized by purified rabbit anti-WE Ab. This antigen, present in trypomastigote forms, was absent in procyclic forms and Trypanosoma cruzi trypomastigotes. Using purified variable surface glycoproteins (VSG) from various trypanosomes, we showed that VSG was the parasite antigen recognized by these rabbit Ab. Anti-WE and anti-VSG Ab were purified from HAT sera by affinity chromatography. Immunoreactivity of purified antibodies eluted from affinity columns and of depleted fractions showed that WE was one of the epitopes borne by VSG. These data underline the existence of an invariant WE in the structure of VSG from several species of African trypanosomes
Echinococcus multilocularis and Toxocara canis in urban red foxes (Vulpes vulpes) in Brussels, Belgium
No full textDuring the last decades, European red foxes (Vulpes vulpes) have been implicated in the transmission of several viral or parasitic pathogenic agents to domestic animals and humans. In urban areas, risks of zoonoses transmission are likely to increase as a result of a higher rate of intra- and inter-species contacts. Foxes occur on 35% of the Brussels-Capital Region area and local densities reach up to 4 family groups per square kilometre. According to the directive 2003/99/ECC, a first survey for the presence in foxes of Echinococcus multilocularis and Toxocara canis was conducted in Brussels from 2001 to 2004. None of 160 foxes were found to be infected with E. multilocularis and 24 of 134 foxes were found to be infected with T. canis. Considering numbers of examined foxes, the sensitivity and the specificity of tests used for diagnosis, the 95% credibility intervals for the true prevalence of E. multilocularis and T. canis were estimated in a Bayesian framework to be 0 to 1.87% (median value of 0%) and 12.7 to 26% (median value of 18.7%), respectively. For T. canis, a significantly higher risk to be a carrier occurs in cubs and a significantly lower risk in adults
Point mutations in mitochondrial topoisomerase enzymes of Trypanosoma congolense are not involved in isometamidium resistance
No full textQuantifying the wind dispersal of Culicoides species in Greece and Bulgaria
No full textThis paper tests the hypothesis that Culicoides (Diptera: Ceratopogonidae) species can be propagated by wind over long distances. Movement patterns of midges were inferred indirectly from patterns of the spread of bluetongue outbreaks between farms (using outbreak data from 1999-2001 for Greece, Bulgaria and Turkey) and then matched to concurrent wind patterns. The general methodology was to determine wind trajectories to and from each outbreak site based on the horizontal and vertical wind components of the European ReAnalysis-40 (ERA-40) dataset from the European centre for medium-range weather forecast (ECMWF). Forward trajectories (downwind or where the windvectors pointed to) and backward trajectories (upwind or where the wind-vectors originated from) were calculated for each outbreak for the period from one week before to one week after it had been recorded. These wind trajectories were then compared with the general outbreak patterns taking into consideration the different serotypes involved. It was found that the wind trajectories could be matched to the temporal distribution of the outbreak cases. Furthermore, the spread of the infected vector via the calculated wind trajectories was corroborated by molecular evidence. The conclusion is that the methodology presented is appropriate for quantifying the risk of spread of infected Culicoides midges by wind and that this approach could form an important component of a regional early-warning system for bluetongue