The open tropical medicine journal最新文献

{"title":"Influence of Anemia on Plasmodium falciparum Gametocyte Sex Ratios in Acutely Symptomatic Children","authors":"A. Sowunmi, S. Balogun, G. Gbotosho, C. Happi","doi":"10.2174/1874315300801010013","DOIUrl":"https://doi.org/10.2174/1874315300801010013","url":null,"abstract":"Anemia is common in African children but little is known about how malarial anemia influences Plasmodium falciparum gametocyte sex ratios (PfGSR) and transmission in endemic areas in Africa. We investigated the changes in PfGSR in 1126 consecutive children with acute, symptomatic, uncomplicated falciparum malaria who did (n = 99) or did not (n = 1027) have anemia (defined as a hematocrit 3 d was associated with a male-biased sex ratio (defined as PfGSR > 0.5) (P = 0.029). Hematocrit correlated negatively with PfGSR in non-anemic but not in anemic children (r = -0.219, P = 0.027 and r = -0.106, P = 0.697, respectively) sug- gesting that the critical hematocrit producing 'all or none effect' on PfGSR was a value below 25% in this cohort of chil- dren. Temporal changes showed that, in general, in anemic children, PfGSR was significantly higher at enrolment than in non-anemic children treated with chloroquine (CQ), amodiaquine (AQ) and amodiaquine-sulfalene-pyrimethamine (ASP) (P < 0.0007 in all cases), and remained significantly higher by day 7 or 14 in those treated with AQ and pyrimethamine- sulfadoxine plus probenecid (PSP) (P < 0.007 in all cases). In children who received the same treatment, the ratio of the sex specific half-life male:female, the 'gametocyte maleness index', was one and a half to two folds higher in anemic than non-anemic children suggesting anemia prolongs the survival of microgametocytes and may encourage transmission. These findings have implications for malaria control efforts in endemic sub-Saharan countries where malarial anemia is common. (defined as a hematocrit < 25%) in an endemic area of south- west Nigeria. Our aims were to: determine the contribution of anemia to PfGSR on presentation; determine the factors associated with a male biased PfGSR in children who did or did not have anemia on presentation; and evaluate the tempo- ral changes in PfGSR in children following treatment with antimalarial drugs in these children.","PeriodicalId":88762,"journal":{"name":"The open tropical medicine journal","volume":"1 1","pages":"13-20"},"PeriodicalIF":0.0,"publicationDate":"2008-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68068454","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Age- and Risk-Targeted Control of Schistosomiasis-Associated Morbidity Among Children and Adult Age Groups","authors":"D. Gurarie, C. King, Ohio Usa","doi":"10.2174/1874315300801010021","DOIUrl":"https://doi.org/10.2174/1874315300801010021","url":null,"abstract":"For helminth parasites, selection of optimal chemotherapy-based control of infection-related morbidity can take cues from several perspectives. One can focus on limiting intensity of infection or its spread within the community at any given time, and ask for efficient interventions to reduce either type of infectious burden. Alternatively, one can look at the long-term effects of infection and ask for control strategies aimed only at preventing long-term morbidity through struc- tured treatments that vary by age. The latter approach is currently favored for schistosomiasis, where acute infection per se is believed to be less detrimental to health than the cumulative damage caused by long-term heavy infection. Here, we extend earlier approaches to modeling control of late-onset morbidity using age-stratified interventions, and then addition- ally consider population heterogeneity in terms of subgroups at high and low risk for development of chronic disease. We study the long-term effect age-structured mass therapy applied to the whole population vs. varying coverage for different population age strata. Given different subgroup risks for chronic disease, we also examine the possible utility of pretreat- ment risk screening towards optimal allocation of treatment resources.","PeriodicalId":88762,"journal":{"name":"The open tropical medicine journal","volume":"1 1","pages":"21-30"},"PeriodicalIF":0.0,"publicationDate":"2008-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68068495","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Q Fever Outbreaks in Dalmatia, Croatia","authors":"M. Morović, Nedjeljka Babic Milutin, Duska Grgi, O. D. Rode","doi":"10.2174/1874315300801010063","DOIUrl":"https://doi.org/10.2174/1874315300801010063","url":null,"abstract":"The aim of the study was to describe the clinical and epidemiological features of the first greater outbreaks of Q fever in Dalmatia, Croatia. In 2003, January to April, 97 patients with Q fever pneumonia were hospitalized in three Dalmatian hospitals - Zadar, Sibenik and Split. In 2004, January to May, the outbreak involved 100 hospitalized patients. Many cases were epidemiologically connected and came from the well-known endemic foci but a number of sporadic cases among strictly urban population was also noted. During the outbreaks period antibodies to Coxiella burnetii were detected in 10.8% of 1378 domestic animals from the main foci. Since during this period nothing unusual happened in the sheep and goat flocks and in the windborne spread of coxiella spores, other risk factors may have contributed to these changes.","PeriodicalId":88762,"journal":{"name":"The open tropical medicine journal","volume":"1 1","pages":"63-67"},"PeriodicalIF":0.0,"publicationDate":"2008-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68068012","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of Human Immune Deficiency Virus in Suspected Tuberculosis Patients Attending Clinics in Benin City NIGERIA","authors":"L. Okoror, F. Esumeh, P. Umolu, A. Enaigbe, R. Akpe, H. Obiazi, F. Aisabokhale, I. Imahia","doi":"10.2174/1874315300801010008","DOIUrl":"https://doi.org/10.2174/1874315300801010008","url":null,"abstract":"Tuberculosis and HIV have been closely linked since the emergence of acquired immune deficiency syndrome. HIV has contributed to a significant increase in the incidence of tuberculosis worldwide by producing a progressive de- cline in cell immunity. Four hundred and seventy sputum samples were collected from different clinics in and around Be- nin City and tested for tuberculosis and HIV. Of the 470 samples tested, only 147 (32%) were positive while 323 (68%) were negative for tuberculosis. 71 (15%) were positive for HIV alone while 56 (11%) were co-infected with both tubercu- losis and HIV. Of the 103 patients who received BCG at childhood 18.2% tested positive. More males tested positive than their female counterparts, while traders had the highest number of positive case and also had the highest attributable risk. Oredo Local Government Area of Edo State Nigeria had the highest number of positive cases. It could be said that HIV has contributed to the prevalence of tuberculosis in Edo State Nigeria. The high rate of tuberculosis is then associated with increase in HIV infection.","PeriodicalId":88762,"journal":{"name":"The open tropical medicine journal","volume":"1 1","pages":"8-12"},"PeriodicalIF":0.0,"publicationDate":"2008-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68068440","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative Evaluation of Methods Used for Sampling Malaria Vectors in the Kilombero Valley, South Eastern Tanzania","authors":"Fredros O. Okumu, M. Kotas, J. Kihonda, E. Mathenge, G. Killeen, S. Moore","doi":"10.2174/1874315300801010051","DOIUrl":"https://doi.org/10.2174/1874315300801010051","url":null,"abstract":"To monitor malaria transmission, effective sampling methods for host seeking vectors are necessary. The suit- ability of these methods can be determined by field measurements of their trapping efficiencies. We compared the effi- ciencies of the Human Landing Catch (HLC), the Centers for Disease Control light trap (CDC-LT) placed next to occu- pied bednets and the Mbita trap for sampling Anopheles gambiae s.l and Anopheles funestus. The sampling methods were rotated through three houses, each with a human bait, for 8 cycles in a 3 x 3 Latin-square design. Relative to the HLC, the efficiency (and 95% c. i) of the CDC-LT for sampling An. gambiae s.l. was 0.331 (0.237 - 0.460) while that for Mbita trap was 0.031 (0.013 - 0.077). For An. funestus however, the sampling efficiencies were 0.818 (0.611 - 1.096) and 0.022 (0.003-0.165) respectively. We conclude that both the CDC-LT placed next to an occupied bednet and the Mbita trap are less efficient than HLC, the latter being evidently unsuitable for use in the Kilombero Valley.","PeriodicalId":88762,"journal":{"name":"The open tropical medicine journal","volume":"1 1","pages":"51-55"},"PeriodicalIF":0.0,"publicationDate":"2008-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68067978","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Accuracy of Clinical Signs in the Diagnosis of Pulmonary Tuberculosis: Comparison of Three Reference Standards Using Data from a Tertiary Care Centre in Rwanda","authors":"M. Julie, Boelaert Marleen, S. Joseph, S. Eric, B. Paulin, Musemakweli André, Van der Stuyft, B. Zeno, M. Juan, Van Den, Ende Jef","doi":"10.2174/1874315300801010001","DOIUrl":"https://doi.org/10.2174/1874315300801010001","url":null,"abstract":"Objective: To determine the prevalence of TB, and the diagnostic sensitivity and specificity of major disease characteristics in a tertiary hospital setting in Rwanda, relative to three reference standards. Study Design and Setting: A prospective study was conducted in which 300 consecutive patients with cough of at least 2-weeks duration were evaluated at a tertiary healthcare facility. We compared the estimates of TB prevalence and the di- agnostic accuracy of fever, haemoptysis, sputum smear microscopy, radiological signs, and HIV infection as generated by a latent class analysis (LCA) with those given by culture and by a composite reference standard (CRS), which relied on bacteriological confirmation and/or cavities. Results: LCA estimated the prevalence of TB at 44%. The most sensitive characteristics were fever (90%) and HIV infec- tion (86%), but both lacked specificity. The most specific characteristics were microscopy (99%), X-Ray cavities (97%) and apical infiltrates (93%). When culture was taken as a reference standard, the prevalence was 38%; for the CRS, it was 45%. For both, the diagnostic sensitivity and specificity were comparable to those obtained with LCA.","PeriodicalId":88762,"journal":{"name":"The open tropical medicine journal","volume":"1 1","pages":"1-7"},"PeriodicalIF":0.0,"publicationDate":"2008-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68068370","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementing Intermittent Preventive Treatment for Malaria in Pregnancy: Review of Prospects, Achievements, Challenges and Agenda for Research.","authors":"Godfrey Martin Mubyazi, Pascal Magnussen, Catherine Goodman, Ib Christian Bygbjerg, Andrew Yona Kitua, Oystein Evjen Olsen, Jens Byskov, Kristian Schultz Hansen, Paul Bloch","doi":"10.2174/1874315300801010092","DOIUrl":"10.2174/1874315300801010092","url":null,"abstract":"<p><p>INTRODUCTION: Implementing Intermittent Preventive Treatment for malaria in Pregnancy (IPTp) with sulfadoxine-pyrimethamine (SP) through antenatal care (ANC) clinics is recommended for malaria endemic countries. Vast biomedical literature on malaria prevention focuses more on the epidemiological and cost-effectiveness analyses of the randomised controlled trials carried out in selected geographical settings. Such studies fail to elucidate the economic, psychosocial, managerial, organization and other contextual systemic factors influencing the operational effectiveness, compliance and coverage of the recommended interventions. OBJECTIVE: To review literature on policy advances, achievements, constraints and challenges to malaria IPTp implementation, emphasising on its operational feasibility in the context of health-care financing, provision and uptake, resource constraints and psychosocial factors in Africa. RESULTS: The importance of IPTp in preventing unnecessary anaemia, morbidity and mortality in pregnancy and improving childbirth outcomes is highly acknowledged, although the following factors appear to be the main constraints to IPTp service delivery and uptake: cost of accessing ANC; myths and other discriminatory socio-cultural values on pregnancy; target users, perceptions and attitudes towards SP, malaria, and quality of ANC; supply and cost of SP at health facilities; understaffing and demoralised staff; ambiguity and impracticability of user-fee exemption policy guidelines on essential ANC services; implementing IPTp, bednets, HIV and syphilis screening programmes in the same clinic settings; and reports on increasing parasite resistant to SP. However, the noted increase in the coverage of the delivery of IPTp doses in several countries justify that IPTp implementation is possible and better than not. CONCLUSION: IPTp for malaria is implemented in constrained conditions in Africa. This is a challenge for higher coverage of at least two doses and attainment of the Abuja targets. Yet, there are opportunities for addressing the existing challenges, and one of the useful options is the evaluation of the acceptability and viability of the existing intervention guidelines.</p>","PeriodicalId":88762,"journal":{"name":"The open tropical medicine journal","volume":"1 ","pages":"92-100"},"PeriodicalIF":0.0,"publicationDate":"2008-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2782184/pdf/ukmss-4823.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28535831","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chloroquine Resistant Plasmodium falciparum in Nigeria: Relationship between pfcrt and pfmdr1 Polymorphisms, In-Vitro Resistance and Treatment Outcome.","authors":"O A Folarin,&nbsp;G O Gbotosho,&nbsp;A Sowunmi,&nbsp;O O Olorunsogo,&nbsp;A M J Oduola,&nbsp;T C Happi","doi":"10.2174/1874315300801010074","DOIUrl":"https://doi.org/10.2174/1874315300801010074","url":null,"abstract":"<p><p>This study was designed to evaluate the association between polymorphisms in pfcrt and pfmdr1 genes and in-vitro chloroquine (CQ) sensitivity in fresh isolates of P. falciparum and patients' treatment outcome. The modified schizont inhibition assay was used to determine in-vitro sensitivity of P. falciparum. Polymorphisms in pfcrt and pfmdr1 genes were detected using nested PCR and RFLP techniques in 84 P. falciparum isolates obtained from patients with acute uncomplicated malaria.Eighty five percent (71/84) and 15% (13/84) of the parasites were resistant and sensitive in-vitro to CQ respectively. Molecular analysis showed presence of mutant pfcrtT76, pfmdr1Y86 and pfmdr1F184 alleles in 60%, 33% and 14% of the isolates respectively. There was a significant association between in-vitro and in-vivo CQ resistance (p=0.029) and also between the presence of mutant pfcrtT76+pfmdr1 Y86-Y184 haplotype and in-vitro (p=0.013) or in-vivo CQ resistance (p=0.024).Overall results from this study demonstrates that the presence of pfcrtT76+ pfmdr1 Y86-Y184 haplotype in Nigerian isolates of Plasmodium falciparum is predictive of in-vitro and in-vivo CQ resistance and therefore may be useful for monitoring resistance to this drug.</p>","PeriodicalId":88762,"journal":{"name":"The open tropical medicine journal","volume":"1 ","pages":"74-82"},"PeriodicalIF":0.0,"publicationDate":"2008-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2174/1874315300801010074","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28541536","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Possible Protective Role of the Il6-174GC Genotype in Dengue Fever","authors":"S. Moreira, D. M. Cardoso, J. Visentainer, U. Fonzar, R. Moliterno","doi":"10.2174/1874315300801010087","DOIUrl":"https://doi.org/10.2174/1874315300801010087","url":null,"abstract":"Dengue is the most important viral disease transmitted by arthropod vectors. At present, it is known four types of virus serotypes, DEN 1, 2, 3 and 4. Differences in the host susceptibility to infection as well as the severity of disease can not be due only to viral virulence. Variations in immune response as a consequence of polymorphisms in regulatory regions of cytokine genes may have influence on the disease outcome. The aim of this study was to verify the occurrence of associations between cytokine gene polymorphisms and Dengue Fever. Two hundred patients from Parana State and 313 control individuals from Southern and Southeastern Brazil were genotyped for single nucleotide polymorphisms (SNPs) of TNF -308 , IFNG +874 , IL6 -174 , IL10 -1082,-819,-592 and TGFB1 +869,+915 by PCR-SSP (kits One Lambda, CA, USA). Phenotype, genotype and allele frequencies were compared by chi-square test, with Yates' correction or Fisher's exact test. There was a negative association between IL6 -174 GC genotype and Dengue Fever (27.9% vs. 38.3%; P=0.015; OR=0.62; CI=0.42 - 0.91). Significant statistical differences with cytokine production phenotypes or alleles were not observed. These results suggest a protective role of IL6 -174 GC genotype for Dengue Fever.","PeriodicalId":88762,"journal":{"name":"The open tropical medicine journal","volume":"08 1","pages":"87-91"},"PeriodicalIF":0.0,"publicationDate":"2008-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68068063","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cerebrospinal Fluid Studies in Kenyan Children with Severe Falciparum Malaria.","authors":"N Mturi,&nbsp;G Keir,&nbsp;C A Maclennan,&nbsp;A Ross,&nbsp;A C Willis,&nbsp;B C Elford,&nbsp;J A Berkley,&nbsp;C R J C Newton","doi":"10.2174/1874315300801010056","DOIUrl":"10.2174/1874315300801010056","url":null,"abstract":"<p><p>The pathogenesis of the neurological complications of Plasmodium falciparum malaria is unclear. We measured proteins and amino acids in paired plasma and cerebrospinal fluid (CSF) samples in children with severe falciparum malaria, to assess the integrity of the blood brain barrier (BBB), and look for evidence of intrathecal synthesis of immunoglobulins, excitotoxins and brain damage. METHODS: Proteins of different molecular sizes and immunoglobulins were measured in paired CSF and plasma samples in children with falciparum malaria and either impaired consciousness, prostrate, or seizures. RESULTS: The ratio of CSF to plasma albumin (Q(alb)) exceeded the reference values in 42 (51%) children. The CSF concentrations of the excitotoxic amino acid aspartate and many non-polar amino acids, except alanine, were above the reference value, despite normal plasma concentrations. IgM concentrations were elevated in 21 (46%) and the IgM index was raised in 22 (52%). Identical IgG oligoclonal bands were found in 9 (35%), but only one patient had an increase in the CSF IgG without a concomitant increase in plasma indicating intrathecal synthesis of IgG. CONCLUSIONS: This study indicates that the BBB is mildly impaired in some children with severe falciparum malaria, and this impairment is not confined to cerebral malaria, but also occurs in children with prostrate malaria and to a lesser extent the children with malaria and seizures. There is evidence of intrathecal synthesis of immunoglobulins in children with malaria, but this requires further investigation. This finding, together with raised level of excitotoxic amino acid aspartate could contribute to the pathogenesis of neurological complications in malaria.</p>","PeriodicalId":88762,"journal":{"name":"The open tropical medicine journal","volume":"1 ","pages":"56-62"},"PeriodicalIF":0.0,"publicationDate":"2008-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2854806/pdf/ukmss-27938.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28926503","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}