Research and Reports in Tropical Medicine最新文献

Mansonellosis is caused by three filarial parasite species from the genus Mansonella that commonly produce chronic human microfilaraemias: M. ozzardi, M. perstans and M. streptocerca. The disease is widespread in Africa, the Caribbean and South and Central America, and although it is typically asymptomatic it has been associated with mild pathologies including leg-chills, joint-pains, headaches, fevers, and corneal lesions. No robust mansonellosis disease burden estimates have yet been made and the impact the disease has on blood bank stocks and the monitoring of other filarial diseases is not thought to be of sufficient public health importance to justify dedicated disease management interventions. Mansonellosis´s Ceratopogonidae and Simuliidae vectors are not targeted by other control programmes and because of their small size and out-door biting habits are unlikely to be affected by interventions targeting other disease vectors like mosquitoes. The ivermectin and mebendazole-based mass drug administration (iMDA and mMDA) treatment regimens deployed by the WHO´s Elimination of Neglected Tropical Diseases (ESPEN) programme and its forerunners have, however, likely impacted significantly on the mansonellosis disease burden, principally by reducing the transmission of M. streptocerca in Africa. The increasingly popular plan of using iMDA to control malaria could also affect M. ozzardi parasite prevalence and transmission in Latin America in the future. However, a potentially far greater mansonellosis disease burden impact is likely to come from short-course curative anti-Wolbachia therapeutics, which are presently being developed for onchocerciasis and lymphatic filariasis treatment. Even if the WHO´s ESPEN programme does not choose to deploy these drugs in MDA interventions, they have the potential to dramatically increase the financial and logistical feasibility of effective mansonellosis management. There is, thus, now a fresh and urgent need to better characterise the disease burden and eco-epidemiology of mansonellosis so that effective management programmes can be designed, advocated for and implemented.

This is a review of the published contributions made by Brazilian researchers between 2010 and 2020 on the natural history of human toxocariasis and the effects of human toxocariasis on nonhuman paratenic hosts.

Plasmodium vivax (P. vivax) is a protozoan parasite that causes vivax malaria. Disease relapse post-treatment is reported in P. vivax co-infection with other bacterial and parasitic infections, but Plasmodium vivax reactivation is not very common with viral infections. Early recognition and diagnosis of a Plasmodium vivax malaria relapse in a non-endemic region pose a diagnostic dilemma. COVID-19 co-infection compounds this dilemma due to overlapping symptoms. Early diagnosis and treatment are essential for a favorable clinical outcome. We report a middle-aged gentleman with high-grade fever and headaches who had COVID-19 and was found to have a relapse of Plasmodium vivax malaria.

Intoduction: Patient-care equipment and inanimate objects contaminated with bacteria are a persistent problem in countries like Ethiopia, and remain overlooked. This study aimed to elucidate the magnitude of contaminations, diversity, and antimicrobial-susceptibility patterns of bacterial isolates from selected wards of Arba Minch General Hospital, Ethiopia.

Methods: Samples were inoculated into bacteriological media and identified by biochemical characterization, followed by antimicrobial-susceptibility tests.

Results: Of the 99 inanimate objects and items of patient-care equipment examined, 71 (71.7%) showed contamination: 26 (76.4%) from the surgical ward and 22 (66.6%) and 23 (71.8%), respectively, from the pediatric ward and neonatal intensive care unit. In the case of Gram-positive bacteria, coagulase-negative staphylococci (CoNS; 52.2%) were predominant, followed by Staphylococcus aureus (47.7%), whereas common Gram-negative counterparts were Acinetobacter spp. (28.5%) and Klebsiella spp. (23.8%). Antibiograms of S. aureus and CoNS showed 100% and 78% resistance, respectively, against penicillin. Isolates of Acinetobacter spp. showed 100% resistance to ceftriaxone and ampicillin, whereas those of Klebsiella spp. displayed complete resistance against ampicillin and trimethoprim-sulfamethoxazole. All isolates of Citrobacter spp., Enterobacter spp., Salmonella spp., Escherichia coli, and Serratia spp. exhibited 100% resistance to amoxicillin, ampicillin, and trimethoprim-sulfamethoxazole. Overall prevalence of multidrug-resistant bacteria was 57.7%.

Conclusion: A stringent infection-vigilance program comprising routine sampling from equipment and inanimate objects combined with antimicrobial-resistance surveillance and decontamination efforts must be instituted promptly.

Background: Intestinal parasitic infections are among the major public health problems in resource-poor countries such as Ethiopia. Certain segments of the population such as psychiatric patients are believed to be at higher risk of infection because of their poor hygiene practices. However, information on the prevalence and contributing factors among psychiatric patients is limited in Ethiopia.

Methods: A facility-based cross-sectional study was conducted among 432 psychiatric patients attending Felege Hiwot Comprehensive Specialized Referral Hospital, Northwest Ethiopia from May to July 2020. Participants were selected using a systematic random sampling technique. Data on socio-demography and associated factors were collected using a pre-tested structured questionnaire. Stool sample was collected and processed for parasitological examination using direct wet mount, modified Richie's concentration, Kato-Katz and modified Ziehl-Neelsen staining techniques following standard protocols. Data were entered and analyzed using Statistical Package for the Social Sciences software version 20. The prevalence of intestinal parasitosis and associated factors were computed by descriptive statistics and binary logistic regression at 95% confidence interval (CI), respectively. Association between variables was considered statistically significant only if P-value <0.05 at 95% confidence level.

Results: A total of 168 (38.9%) participants were positive for at least a single species of intestinal parasite. Hookworm, Entamoeba histolytica/Entamoeba dispar and Ascaris lumbricoides were the most frequent parasites, detected in 74 (17.1%), 47 (10.9%) and 37 (8.6%) participants, respectively. Double infection was detected in 16 (9.5%) participants where 8 (4.8%) had hookworm and Ascaris lumbricoides co-infections. Not washing raw fruits and vegetables before eating (adjusted odds ratio = 8.402; 95% CI: 3.055-23.109; P <0.001) and having a psychiatric diagnosis other than bipolar disorder (adjusted odds ratio = 3.104; 95% CI: 1.334-7.222; P = 0.009) were significantly associated with intestinal parasitic infections.

Conclusion: The prevalence of intestinal parasites among psychiatric patients was significant. Therefore, improving hygiene practice and implementing regular screening for intestinal parasitic infection among psychiatric patients are recommended so as to control parasite transmission and improve the health of psychiatric patients.

Asthma care has undergone significant changes over the past several years. Our understanding of the pathophysiology, risk factors, diagnosis, treatment, follow-up and prognosis has changed as more investigations shed new light on all of these aspects. This complexity has resulted in global guidelines aimed at improving the management of asthma patients. Among the multitude of guidelines, those published by the Global Initiative for Asthma (GINA) have achieved widespread and global acceptance. These guidelines cover the spectrum of factors that impact asthma care and include specific recommendations that treating physicians should follow to provide optimal patient care. In this review of asthma care in adult patients, we will outline some of the recommendations issued by GINA and discuss the challenges and limitations to the implementation of these guidelines in communities with limited resources. We will also propose recommendations to overcome these limitations in adult patients.

Background: Human Immunodeficiency Virus-1/AIDS and Schistosoma mansoni are widely spread in sub-Saharan Africa including Ethiopia and the co-infection is also prevalent, occurs commonly. Schistosoma mansoni infection has been suggested to be a risk factor for HIV transmission and progression. This study aims to assess the prevalence and intensity of Schistosoma mansoni infection and associated risk factors among individuals with and without human immunodeficiency virus (HIV) at Chuahit Health Center, West Dembia, Northwest Ethiopia.

Methods: Institutional based cross-sectional study was conducted from March to April 2019. Two hundred sixty-six study subjects were included in the study by using a systemic and convenient sampling technique. Pretested structured questionnaire was employed to collect data. Single stool samples were collected and examined for S. mansoni eggs. Finger prick and venous blood samples were collected for HIV-1 screening and viral load count. Data were analyzed using SPSS version 20. Independent t-test and one-way ANOVA were used to compare the mean of egg counts with HIV status and viral load counts, respectively. A P-value of less than 0.05 was taken as statistically significant.

Results: The overall prevalence and intensity of S. mansoni infection was 41 (15.4%) and 162.24 egg per gram of faeces (EPG), respectively. Prevalence of S. mansoni was higher in seronegative study participants though the difference is statistically insignificant. Higher intensity of infection was observed among seropositive study participants with high viral load counts (>1000 copies/mL).

Conclusion: Relatively higher prevalence and intensity of S. mansoni infection were found. Study participants' occupation was identified as potential risk factor to S. mansoni infection. Further studies are needed to know the impact of HIV on the prevalence and intensity of S. mansoni infection in the study area.

Background: Globally, soil-transmitted helminths affect beyond a billion people and cause 1.9 million disability-adjusted life years worldwide. It affects children disproportionately due to their unaware activities like walking barefoot, playing with dirty objects that might be contaminated with feces. The control of soil-transmitted helminths principally relies on periodic deworming using either a single dose of albendazole/mebendazole. To assure the effectiveness of this measure, performing continuous parasitological survey is necessary. Herein, the prevalence, intensity and associated factors of soil-transmitted helminth infections were assessed among school-aged children in northwest Ethiopia.

Methods: A cross-sectional study design was conducted among school-aged children (6-14 years old) from January 21st to February 21st/2019. Multistage sampling technique was employed. A Kato-Katz concentration technique was utilized to detect STHs in stool samples. Moreover, risk factors for STH infections were assessed using well-structured questionnaire. Bivariate and multivariate analyses were used to assess the association between explanatory and the outcome variables. The magnitude of the association was measured using the adjusted odds ratio (AOR) and 95% confidence interval (CI). A P-value <0.05 was considered statistically significant.

Results: The overall STHs prevalence in this study was 32.3% (95% CI: 29-35.6%) with Ascaris lumbricoides being the predominant species (24.3%) followed by hookworm (8.9%) and Trichuris trichiura (1%). Most (80.3%) of the infected school-aged children had light-intensity infections. Age of 11 years and above (AOR, 12.9, 95% CI, 1.6-103.6, P=0.004), being residing in Chuahit district (AOR, 3.9, 95% CI, 2.3-6.5, P<0.001), and untreated water supply (AOR, 1.7, 95% CI, 1.1-2.7, P=0.018) were identified as predictors for the overall STH prevalence.

Conclusion: Our findings revealed STH infections are considerable health problems in the study areas. Thus, public health interventions such as provision of safe water supply, health education, and de-worming programs should be regularly implemented in the study areas.

Murine typhus and flea-borne spotted fever are undifferentiated febrile illnesses caused by Rickettsia typhi and Rickettsia felis, respectively. These organisms are small obligately intracellular bacteria and are transmitted to humans by fleas. Murine typhus is endemic to coastal areas of the tropics and subtropics (especially port cities), where rats are the primary mammalian host and rat fleas (Xenopsylla cheopis) are the vector. In the United States, a cycle of transmission involving opossums and cat fleas (Ctenocephalides felis) are the presumed reservoir and vector, respectively. The incidence and distribution of murine typhus appear to be increasing in endemic areas of the US. Rickettsia felis has also been reported throughout the world and is found within the ubiquitous cat flea. Flea-borne rickettsioses manifest as an undifferentiated febrile illness. Headache, malaise, and myalgia are frequent symptoms that accompany fever. The incidence of rash is variable, so its absence should not dissuade the clinician to consider a rickettsial illness as part of the differential diagnosis. When present, the rash is usually macular or papular. Although not a feature of murine typhus, eschar has been found in 12% of those with flea-borne spotted fever. Confirmatory laboratory diagnosis is usually obtained by serology; the indirect immunofluorescence assay is the serologic test of choice. Antibodies are seldom present during the first few days of illness. Thus, the diagnosis requires acute- and convalescent-phase specimens to document seroconversion or a four-fold increase in antibody titer. Since laboratory diagnosis is usually retrospective, when a flea-borne rickettsiosis is considered, empiric treatment should be initiated. The treatment of choice for both children and adults is doxycycline, which results in a swift and effective response. The following review is aimed to summarize the key clinical, epidemiological, ecological, diagnostic, and treatment aspects of flea-borne rickettsioses.

Neurocysticercosis (NCC) causes significant neurological morbidity around the world, and is the most common preventable factor for epilepsy in adults. It is endemic in most developing countries, and also diagnosed with some frequency in industrialized countries because of travel and migration. The clinical manifestations of NCC are extremely variable and may include almost any neurological symptom, depending on the number of lesions, location, size and evolutive stage of the infecting parasitic larvae and the immune response of the host. Thus, the diagnosis of NCC relies mostly on neuroimaging and immunological tests. Despite being a disease with a known etiology, the lack of specificity of clinical manifestations and auxiliary examinations makes its diagnosis difficult. In an attempt for developing a standard diagnosis approach, a chart of diagnostic criteria for NCC was initially published in 1996, and revised in 2001 and 2017. This chart of diagnostic criteria systematized the diagnosis of NCC and became widely used worldwide. This manuscript describes the structure of the chart, the principles behind the changes for each revision, as well as the context of its use and potential for improvement.