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HIV-1 immune suppression and antimalarial treatment outcome in Zambian adults with uncomplicated malaria
No full textBACKGROUND: Human immunodeficiency virus (HIV)-1 infected adults with low CD4 cell count have a higher risk of malaria infection and clinical malaria. We assessed the influence that HIV-1 immune suppression has on the efficacy of antimalarial treatment in adults with uncomplicated malaria. METHODS: This clinical trial included 971 Zambian adults with uncomplicated malaria. Patients were tested for HIV-1, and, if positive, a CD4 cell count was assessed. The primary outcome was recurrent parasitemia corrected by molecular genotyping within 45 days after treatment. RESULTS: HIV-1 infection was detected in 33% (320/971) of adult patients with malaria. Treatment failure was not associated with HIV-1 infection (relative risk [RR], 1.12 [95% confidence interval {CI}, 0.82-1.53]; P=.45). HIV-1-infected patients with a CD4 cell count or=300 cells/microL (RR, 2.24 [95% CI, 1.20-4.14]; P=.01). After genotyping, the risk of recrudescence was higher in HIV-1-infected patients with a CD4 cell count or=300 cells/microL or without HIV-1 infection. Trial registered at http://www.clinicaltrials.gov/; reference number NCT00304980
Agriculture urbaine et subsistence des ménages dans une zone de post-conflit en Afrique centrale
No full textFacteurs décisionnels dans la gestion des ressources hydriques par les éleveurs et les agro-éleveurs dans une zone semi-aride du Burkina-Faso
No full textImported non-Plasmodium falciparum malaria: a five-year prospective study in a European referral center
No full textFrom 2000 to 2005, we investigated prospectively 98 cases of imported non-Plasmodium falciparum malaria (48 Plasmodium vivax, 34 P. ovale, and 16 P. malariae). Latency period between return and clinical attack exceeded three months in 40% of the patients. It was longer in travelers who had taken chemoprophylaxis. Time to diagnosis was longer in patients with P. malariae infection and in those with late-onset first attack. Parasite density was often lower than 500/microL, especially in P. ovale malaria. Relapses were diagnosed in 18% of all malaria episodes. Eight (17%) P. vivax and 2 (6%) P. ovale malaria episodes were due to relapse despite standard primaquine therapy. Diagnosis of imported non-falciparum malaria is often challenged by long latency period and low parasite density. In addition, the substantial relapse rate despite standard primaquine therapy supports the use of a higher dose of primaquine to eradicate P. vivax and P. ovale malaria effectively
Actualisation et validation interne d'un outil d'aide à la décision clinique de l'encéphalopathie spongiforme bovine en Belgique
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Trypanosomosis in goats; current status
No full textTrypanosomosis is a major constraint on ruminant livestock production in Africa, Asia, and South America. The principal host species affected varies geographically, but buffalo, cattle, camels, and horses are particularly sensitive. Natural infections with Trypanosoma congolense, T. vivax, T. brucei, and T. evansi have been described in goats. Trypanosomosis in goats produces acute, subacute, chronic, or subclinical forms, being T. vivax, T. congolense, and T. evansi, the most invasive trypanosomes for goats. However, the role of goats in the epidemiology of trypanosomosis is largely discussed and not well understood. Thus, it has commonly been assumed that trypanosomosis presents a subclinical course and that goats do not play an important role in the epidemiology of the disease. This can partially be due to parasitemia caused by trypanosomes which has been considered low in goats. However, this assumption is currently undergoing a critical reappraisal because of goats may also serve as a reservoir of trypanosome infection for other species, including the human beings in the case of T. brucei rhodesiense. The present article describes the current status of trypanosomosis in goats in Africa, Asia, and South America. Pathogenesis, clinical features, diagnosis, and treatment of the different trypanosomes are also described. The possible role in the epidemiology of the disease in the different areas is also discussed
Detection of trypanosome-specific antibodies in saliva, towards non-invasive serological diagnosis of sleeping sickness
No full textThe definitive version is available at www3.interscience.wiley.comOBJECTIVE: The detection of trypanosome-specific antibodies in saliva is technically feasible, and, if clinically validated, could become an attractive option for non-invasive diagnosis of sleeping sickness. We wanted to optimize the test format of an enzyme-linked immunosorbent assay (ELISA)-based antibody detection system. METHODS: Different ELISA formats for antibody detection in serum and saliva were developed and standardized. Saliva and serum samples were collected from 78 patient and 128 endemic control samples, and sensitivity and specificity of saliva ELISAs, serum ELISAs and the card agglutination test for trypanosomiasis (CATT), were evaluated. RESULTS: All ELISA formats showed sensitivity and specificity above 90%. Saliva ELISAs showed a similar test performance as serum ELISAs and the CATT on whole blood or serum. CONCLUSIONS: This study confirms the potential of trypanosome-specific antibody detection in saliva
Virulent and attenuated lines of Leishmania major: DNA karyotypes and differences in metalloproteinase GP63
No full textThe Leishmania metalloproteinase GP63 has been reported to play important roles mainly in resistance of promastigotes to complement-mediated lysis and in interaction with macrophage receptors. On the other hand, its function in insect vectors is still unclear. We compared the structure and dosage of gp63 genes and the activity of GP63 in Leishmania major Yakimoff et Schokhor strains and lines differing in virulence for mice and ability to develop in sand flies. The results demonstrate considerable variability in amount and proteolytical activity of GP63 among L. major strains although genomic changes in the gp63 locus were not found. Attenuated LV561/AV line showed low amount and low enzymatic activity of GP63. Serial passages of attenuated parasites through either Phlebotomus duboscqi Neveu-Lemaire or through mice led to a recovery of GP63 proteolytical activity to the level present in virulent LV561/V line. Overexpression of GP63 was found in two L major strains (L119, Neal) with defective lipophosphoglycan (LPG); both these strains were capable to cause mice infection but unable to survive and multiply in sand flies. Differences were found also in karyotypes and in amount of minichromosomes amplified in some lines of the LV561 strain. The results suggest that parasite virulence is not simply correlated with the activity of GP63; however, this enzyme plays a significant role in association with other surface molecules, especially LPG. Overexpression of GP63 can compensate LPG defect in the vertebrate host but in sand flies both molecules fulfil quite different functions and the defect in LPG is lethal for the parasite. On the other hand, linear minichromosomes of about 200 kb found in some lines of the LV561 strain are associated with development in vitro and in the vector but they are not essential for the infection of the vertebrate host