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Scale up the provision of comprehensive PMTCT services, using the Linked Response approach in Cambodia
No full textAssociation of environmental traits with the geographic ranges of ticks (Acari: Ixodidae) of medical and veterinary importance in the western Palearctic; a digital data set
No full textWe compiled information on the distribution of ticks in the western Palearctic (11 degrees W, 45 degrees E; 29 degrees N, 71 degrees N), published during 1970-2010. The literature search was filtered by the tick's species name and an unambiguous reference to the point of capture. Records from some curated collections were included. We focused on tick species of importance to human and animal health, in particular: Ixodes ricinus, Dermacentor marginatus, D. reticulatus, Haemaphysalis punctata, H. sulcata, Hyalomma marginatum, Hy. lusitanicum, Rhipicephalus annulatus, R. bursa, and the R. sanguineus group. A few records of other species (I. canisuga, I. hexagonus, Hy. impeltatum, Hy. anatolicum, Hy. excavatum, Hy. scupense) were also included. A total of 10,280 records was included in the data set. Almost 42 % of published references are not adequately referenced (and not included in the data set), host is reported for only 61 % of records and a reference to time of collection is missed for 84 % of published records. Ixodes ricinus accounted for 44.3 % of total records, with H. marginatum and D. marginatus accounting for 7.1 and 8.1 % of records, respectively. The lack of homogeneity of the references and potential pitfalls in the compilation were addressed to create a digital data set of the records of the ticks. We attached to every record a coherent set of quantitative descriptors for the site of reporting, namely gridded interpolated monthly climate and remotely sensed data on vegetation (NDVI). We also attached categorical descriptors of the habitat: a standard classification of land biomes and an ad hoc classification of the target territory from remotely sensed temperature and NDVI data. A descriptive analysis of the data revealed that a principal components reduction of the environmental (temperature and NDVI) variables described the distribution of the species in the target territory. However, categorical descriptors of the habitat were less effective. We stressed the importance of building reliable collections of ticks with specific references as to collection point, host and date of capture. The data set is freely downloadable
Prospective European-wide multicentre study on a blood based real-time PCR for the diagnosis of acute schistosomiasis
No full textBACKGROUND: Acute schistosomiasis constitutes a rare but serious condition in individuals experiencing their first prepatent Schistosoma infection. To circumvent costly and time-consuming diagnostics, an early and rapid diagnosis is required. So far, classic diagnostic tools such as parasite microscopy or serology lack considerable sensitivity at this early stage of Schistosoma infection. To validate the use of a blood based real-time polymerase chain reaction (PCR) test for the detection of Schistosoma DNA in patients with acute schistosomiasis who acquired their infection in various endemic regions we conducted a European-wide prospective study in 11 centres specialized in travel medicine and tropical medicine. METHODS: Patients with a history of recent travelling to schistosomiasis endemic regions and freshwater contacts, an episode of fever (body temperature >/=38.5 degrees C) and an absolute or relative eosinophil count of >/=700/mul or 10%, were eligible for participation. PCR testing with DNA extracted from serum was compared with results from serology and microscopy. RESULTS: Of the 38 patients with acute schistosomiasis included into the study, PCR detected Schistosoma DNA in 35 patients at initial presentation (sensitivity 92%). In contrast, sensitivity of serology (enzyme immunoassay and/or immunofluorescence assay) or parasite microscopy was only 70% and 24%, respectively. CONCLUSION: For the early diagnosis of acute schistosomiasis, real-time PCR for the detection of schistosoma DNA in serum is more sensitive than classic diagnostic tools such as serology or microscopy, irrespective of the region of infection. Generalization of the results to all Schistosoma species may be difficult as in the study presented here only eggs of S. mansoni were detected by microscopy. A minimum amount of two millilitre of serum is required for sufficient diagnostic accuracy
Th17 cells are associated with pathology in human schistosomiasis
No full textBackground. Schistosome infections are often clinically silent, but some individuals develop severe pathological reactions. In several disease processes Th17 cells have been linked to tissue injuries, while regulatory T (Treg) cells are thought to down-modulate inflammatory reactions. We assessed whether bladder pathology in human Schistosoma haematobium infection is related to the balance of Th17 and Treg cells. Using a murine model of Schistosoma mansoni infection we further investigated whether the peripheral profiles reflected ongoing events in tissues. Methods. We characterized T helper subsets in the peripheral blood of children residing in a S. haematobium-endemic area and in peripheral blood as well as in spleen and hepatic granulomas of S. mansoni-infected high-pathology CBA and low-pathology C57BL/6 mice. S. haematobium-infected children with bladder pathology had a significantly higher percentage of Th17 cells than those without pathology. Moreover, the Th17/Treg ratios were significantly higher in children with pathology compared to infected children without pathology. Results. Percentages of IL-17-producing cells were significantly more abundant in the spleen and granulomas of CBA compared to C57BL/6 mice. This difference was also reflected in the peripheral blood. Conclusions. Our results indicate for the first time that Th17 cells may be involved in the pathogenesis of human schistosomiasis
Treatment practices in patients with suspected malaria in Provincial Hospital of Tete, Mozambique
No full textBACKGROUND: Nowadays, parasite-based diagnosis by microscopy or malaria rapid diagnostic tests (RDT) is universally promoted before malaria treatment. However, studies on adherence of primary caregivers to malaria test results have provided conflicting results. METHODS: The antimalarial and antibiotic prescription rates in patients with suspected malaria at Provincial Hospital of Tete, Mozambique, and the features associated with antibiotic prescription in non-severely ill parasite-negative patients were assessed. RESULTS: In March and April 2010, Plasmodium falciparum malaria was diagnosed by microscopy or RDT in 728 (27.2%) of 2672 patients tested. Almost all malaria patients were prescribed antimalarials and 20% were also given antibiotics. Of 1944 parasite-negative patients, 126 (6.5%) were prescribed antimalarials and 1213 (62.4%) antibiotics. Among non-severely ill parasite-negative patients with complete information (n = 1607), the antibiotic prescription rate was 68.8% and was more frequent with respiratory symptoms and leukocyte counts >10 000/muL (adjusted OR = 1.62, 95% CI 1.18-2.23 and adjusted OR = 2.12, 95% CI 1.66-2.71, respectively). CONCLUSIONS: Adherence to malaria test results was good in this reference setting, but antibiotic prescription was relatively frequent in clinically stable non-malaria patients. Optimal management of parasite-negative patients must be further defined along with programmatic deployment of the parasite-based strategy