Tropical Parasitology最新文献

Background: Rhinosporidiosis is a polypoidal disease of mucocutaneous tissues mainly affecting the nose. Rhinosporidium seeberi is believed to be the causative pathogen; however, the exact identity remains obscure. The main symptoms of the disease include the presence of mass, discharge, epistaxis, and nasal obstruction. The disease is characterized by friable polyps mostly pink to purple giving typical strawberry- or raspberry-like appearance. The infection is caused by bathing in ponds having stagnant waters. Disease is more common in people of lower socioeconomic status. There is no effective medical therapy. Surgical excision with base cauterization is the current treatment modality but recurrences are common. Personal hygiene measures may be effective in reducing the incidence of disease.

Aims and objectives: Analysis of epidemiological factors and clinical presentation of rhinosporidiosis cases from an endemic region and elaboration of essential features of the causative agent of rhinosporidiosis.

Results: In this series, male, rural, and lower-income populations were preponderant. Maximum (45.2%) patients belonged to the age group 18-32 years with a mean age of 23.9 years. Out of 104 operated cases, rhino mass was on the right side in 59, on the left in 39, and bilateral in 6 patients. 74 patients presented with nasal discharge. Epistaxis was present in 63 and shortness of breath in 3 patients. Extension of disease was noticed in 11 patients (10.58%). The passage was blocked in 102 patients. Four patients had dysphagia and nine patients presented with a change in voice. Many patients repeatedly came from a particular area of the old Raipur division (14%-18%). The color of the polyps was light pink or red, raspberry- or strawberry-like. Polyp appeared to be soft and friable with pin head dot-like round bodies (RBs) or sporangia. Mature RBs were seen discharging spores, each one of which is believed to develop into an RB and this cycle continues leading to an increase in the size of the polyp.

Materials and methods: This is an observational cross-sectional study comprising of 104 rhinsosporidiosis patients at a tertiary care hospital over a period of three years between March 2022 and January 2024. Disease was clinically diagnosed and histopathologically confirmed. Patients were examined endoscopically. Spread of mass was confirmed by CT scan. The mass was excised with base cauterization and aseptically collected rhinsosporidiosis biopsies were analysed morpho-histopathologically and microscopically. Epidemiology, demographic factors, and aetiology of disease were analysed. Descriptive statistics were used to summarise the important epidemiological characteristics.

Conclusions: Patients from rural areas and those having lower socioeconomic status having exposure to pond bathing were more affected (73%). As there is no effect

Koch's postulates have long served as a foundational framework in microbiology for establishing causal relationships between microorganisms and diseases. However, when applied to parasitic infections, these postulates often reveal limitations due to the unique complexities associated with parasites. The intricate life cycles, diverse clinical presentations, and interactions between hosts and parasites necessitate a reformed approach. This paper proposes a set of postulates specifically designed for parasitic diseases. The revised criteria underscore the consistent identification of the parasite, its correlation with clinical manifestations, the specificity and sensitivity of diagnostic methods, experimental infections in appropriate animal models, therapeutic responses, host-parasite dynamics, and molecular epidemiology. By integrating these elements, the postulates provide a more comprehensive framework for establishing causality in parasitic diseases. As our understanding of these infections evolves, so must our approaches to defining causation, especially with technological advancements and research on host-parasite interactions. This adaptability will help maintain an accurate and current understanding of parasitic diseases.

Background: Different kinds of leishmaniasis can be distinguished based on the range and complexity of clinical presentations, which can vary from asymptomatic infection to severe illness that greatly affects one's quality of life.

Aims of the study: Determining the relationship between inflammatory cytokines and the severity of leishmaniasis.

Methodology: A case-control study comprising 150 patients diagnosed with cutaneous leishmaniasis (75 males and 75 females) with 50 healthy controls. The individuals in question ranged in age from 35 to 45. The study was carried out at Nasiriyah General Hospital and Al-Habobbi Teaching Hospital between January 1, 2024, and August 1, 2024. Inclusion criteria required patients aged 35-45 years, with clinically confirmed leishmaniasis and positive serological results, who provided consent for participation. Exclusion criteria included individuals with immunological disorders and pregnant people. The infected group was clinically evaluated to exclude other infections or inflammatory conditions that could affect cytokine levels. Patients were categorized into mild, moderate, and severe leishmaniasis based on clinical criteria, including lesion size, number, complications, and infection duration, following established guidelines. The serum was isolated using centrifugation and preserved at a temperature of -20°C to quantify the concentrations of anti-Leishmania antibodies, interferon-gamma (IFN-γ), tumor necrosis factor-alpha (TNF-α), interleukin-10 (IL-10), and CRP using the enzyme-linked immunosorbent assay (ELISA) method. The ELISA kits used to measure cytokine levels and antibody titers were sourced from Bio-Techne, an American company.

Results: The results showed nonstatistically significant differences in mean age or gender distribution between patients and healthy controls. However, fever was more common in patients, and the severity of the disease was classified into three grades. Levels of antibodies, IFN-γ, tumor necrosis factor, IL-10, and C-reactive protein were also significantly higher in patients than in healthy controls, suggesting an association with leishmaniasis infection.

Conclusions: The results confirm the relationship between levels of antibodies and immune complexes, such as IFN-γ and TNF-α, with the severity of leishmaniasis infection. These high levels indicate an intense immune response, reflecting the body's inflammatory reaction to the infection.

Context: Nutritional status played significant roles in preventing infection of pathogens, expression of disease severity, and prognosis following treatment. Leishmaniasis is a neglected tropical disease affecting the poorest people and is generally undernourished. In the Indian subcontinent, malnutrition is found to be associated with visceral leishmaniasis (VL) but such reports for post kala-azar dermal leishmaniasis (PKDL) are not available.

Objectives: Assessment of nutritional status among PKDL cases from West Bengal, India.

Methodology: PKDL cases were searched by door-to-door visits. The nutritional status of the study participants was assessed by analyzing clinical, anthropometrical, and biochemical parameters. The data were analyzed using standard statistical methods with Minitab software.

Results: A total of 42 PKDL (Group A), 38 with VL history (Group B), and 80 healthy control participants (Group C) were included. We noticed a higher rate of ocular and dermal abnormalities due to Vitamin A deficiency among PKDL patients. A lower range of body mass index was recorded among both Group A and B. The mean hemoglobin and Vitamin B12 level of Group A were significantly lower than Group C. The mean white blood cell count was significantly higher in Group A than other two groups.

Conclusion: The study revealed that PKDL patients were undernourished as evident by few clinical, anthropometrical, and biochemical parameters. The initiative of providing nutrient-rich food during the treatment of leishmaniasis by the Government of West Bengal is justified. A case-control study is highly suggested to evaluate the impact of such food supply during treatment on disease prognosis.

Context: Laboratory diagnosis of strongyloidiasis is most often based on the detection of antibodies against antigens in an enzyme-linked immunosorbent assay (ELISA).

Aims: The aim of the study was to validate the efficacy of the B-cell epitope peptide antigens of fatty acid and retinal binding protein in using antibodies against Strongyloides stercoralis.

Settings and design: Patient samples were identified by an anonymous code and collected from volunteers at Suranaree University of Technology Hospital, Thailand.

Subjects and methods: The synthesized peptides and cell lysate of Strongyloides ratti were used as antigens in an in-house ELISA format. A total of 78 serum samples were collected from patients infected with S. stercoralis, other parasites, and healthy persons.

Statistical analysis used: The receiver operating characteristic curve was used to assess the diagnostic performance of peptide antigens and analysis of variance was utilized to examine differences in peptide reactivity between groups.

Results: The peptide-1 and cell lysate of S. ratti could clearly differentiate serums among infected and noninfected groups. The peptide-1, peptide-2 of S. stercoralis, and lysate of S. ratti antigen had been measured to reveal sensitivities at about 75.00%, 50.00%, and 75.00% with 75.86%, 86.21%, and 89.66% specificities, respectively.

Conclusions: These results could be useful for routine clinical laboratory diagnostic testing and possibly apply for surveillance investigations in the future.

A 10-year-old girl presented to the outpatient department with a complaint of burning micturition for the past 1 week, which did not resolve with over-the-counter medication. Urine culture came out to be sterile, while on follow-up, the patient complained of severe itching in the perianal region. Microscopic examination of urine wet mount revealed a planoconvex helminthic egg and the case is discussed further.

Lymphatic filariasis (LF), one of the 21 Neglected Tropical Diseases (NTD) which is the second leading cause for disability globally. Wuchereria Bancrofti, Brugia malayi and Brugia timori are the parasites causing this infection. World Health Assembly in 1997 declared LF to be eliminated and the Global Program to eliminate LF (GPELF) was launched by WHO in 2000 with the two strategies viz, 1) stop transmission of infection through Mass Drug Administration (MDA) and 2) to alleviate the suffering of the people affected with the disease through Morbidity Management and Disability Prevention (MMDP. The 'Filariasis research unit' recommended by WHO TDR and ICMR was established in Alappuzha, Kerala in 1989 for research studies related to LF. Over the last three decades 23 studies have been completed, which included different trials to find out the dose, effectiveness and safety of the various drugs used in preventive chemotherapy as single drug or combinations, for treatment of microfilaraemia,, various studies related to morbidity management in filarial disease, socio-economic aspects of filarial disability, Pharmacokinetic study of antifilarial drugs, Study on lymphatic filariasis in children, Studies on dignostics of LF, efficacy of drugs in management of lymphedema etc. In this article an attempt is made to explain the lessons learned from these studies and its importance in development of policy decision making for GPELF.