Giardiasis in HIV: A possible role in patients with severe immune deficiency

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Angarano, Gioacchino; Maggi, Paolo; Di Bari, Maria Assunta; Larocca, Angela Maria Vittoria; Congedo, Pierpaolo; De Bari, Cesare; Brandonisio, Olga; Chiodo, Francesco

1997-01-01

We report the epidemiological, clinical and therapeutic characteristics of giardiasis in a population of HIV-infected patients with diarrhoic syndrome. During the period between 1988 and 1995, 720 HIV-patients with diarrhoic syndrome were evaluated. Fecal specimens were submitted to parasitological examination according to the Ritchie formalin-ethil acetate centrifugal sedimentation method and stained with iodine. Samples also underwent modified Ziehl-Neelsen staining and standard bacteriologic testing. Cystis of G. intestinalis were identified in stool sample of 25 patients. Two patients were classified as in stage A2 and 23 in C3. Mean CD4 values of patients with giardiasis (26.9 cells/mmc) were compared with those of 65 patients from whom, during the study, was isolated Cryptosporidium parvum (63.12, cells/mmc): the difference resulted highly significant (p < 0.001). Among the patients with full-blown AIDS, giardiasis occurred following a single previous AIDS-defining event in 13 individuals, in seven and in five subjects giardiasis was the 3rd and, respectively, the 4th relevant AIDS-defining condition. Death occurred within the following 2 months in nine patients and within 6, 12 and 24 months in seven, six and two patients, respectively; at present only three AIDS patients are still alive. In general, G. intestinalis in HIV+, is not considered a major cause of enteritis; nevertheless, in our experience enteritis due to G. intestinalis is a frequent event among AIDS patients, especially in the most advanced stage of disease, irrespectively of the risk factor. The increase in mean survival of AIDS patients will probably lead to a progressive emergence of this pathogen which could determine a severe diarroic syndrome with hydroelectrolytic impairments

Absorption and transport of radioactive 57Co-vitamin B12 in experimental giardiasis in rats

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Deka, N.C.; Sehgal, A.K.; Chnuttani, P.N.

1981-01-01

Giardiasis was produced in weanling albino rats by feeding suspension of Giardia lamblia cysts isolated from human stool. Experiments were carried out to assess the absorption and transport through intestinal wall of 57 Co-vitamin B 12 in these rats. The results showed a significant impairment of the absorption of the vitamin in the rats with experimental giardiasis. However, the transport of the vitamin B 12 was unimpaired. (author)

Giardiasis in children living in post-earthquake camps from Armenia (Colombia).

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Lora-Suarez, Fabiana; Marin-Vasquez, Carolina; Loango, Nelsy; Gallego, Martha; Torres, Elizabeth; Gonzalez, Maria Mercedes; Castaño-Osorio, Jhon Carlos; Gómez-Marín, Jorge Enrique

2002-03-14

An earthquake in the coffee growing region of Colombia on January 25, 1999 destroyed 70% of the houses in Armenia city. Transitory housing camps still remained until two years after the disaster. Parasitological studies found that, in this population, giardiasis was the most frequent parasitic infection. This study was carried out in order to determine the epidemiological risk factors associated with this high prevalence. Fecal samples were obtained from 217 children aged between 3 and 13 years. Stool samples were studied by direct wet examination and stained with ferric hematoxilin for microscopical examination. Epidemiological data were collected by questionnaire and analyzed by using the Epi-info software (CDC, Atlanta 2001). Giardia cysts were observed in 60.4% of the samples presented and trophozoites in 4.6%. The following epidemiological and laboratory factors were significantly associated with Giardia infection: 1. Use of communal toilet (vs. individual toilet) OR: 3.9, CI95%: 1.2-16; 2. water provision by municipal ducts (vs. water provision by individual tanks) OR: 3.5, CI95% 1.1-14, and 3. presence of mucus in stool OR: 2.3, IC95%: 0.9-6.7. A high prevalence of giardiasis was found in children living in temporary houses after the 1999 earthquake in Armenia (Colombia). Giardiasis is an emerging disease in post-disaster situations and adequate prevention measures should be implemented during these circumstances.

Giardiasis in Bergen. Outbreak and clinical consequences.

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Wensaas, Knut-Arne

2011-01-01

Background Giardia lamblia is a common cause of waterborne disease. It is endemic in many parts of the world, especially where sanitation is poor, but in Europe and North America it is most often encountered in outbreaks following contamination of drinking water. The first registered outbreak of giardiasis affecting a large community in Norway happened in Bergen in the autumn of 2004. The reservoir “Svartediket” was the source, and the water probably held Giardia cysts for s...

Giardiasis in children living in post-earthquake camps from Armenia (Colombia

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Gonzalez Maria

2002-03-01

Full Text Available Abstract Background An earthquake in the coffee growing region of Colombia on January 25, 1999 destroyed 70% of the houses in Armenia city. Transitory housing camps still remained until two years after the disaster. Parasitological studies found that, in this population, giardiasis was the most frequent parasitic infection. This study was carried out in order to determine the epidemiological risk factors associated with this high prevalence. Methods Fecal samples were obtained from 217 children aged between 3 and 13 years. Stool samples were studied by direct wet examination and stained with ferric hematoxilin for microscopical examination. Epidemiological data were collected by questionnaire and analyzed by using the Epi-info software (CDC, Atlanta 2001. Results Giardia cysts were observed in 60.4% of the samples presented and trophozoites in 4.6%. The following epidemiological and laboratory factors were significantly associated with Giardia infection: 1. Use of communal toilet (vs. individual toilet OR: 3.9, CI95%: 1.2–16; 2. water provision by municipal ducts (vs. water provision by individual tanks OR: 3.5, CI95% 1.1–14, and 3. presence of mucus in stool OR: 2.3, IC95%: 0.9–6.7. Conclusions A high prevalence of giardiasis was found in children living in temporary houses after the 1999 earthquake in Armenia (Colombia. Giardiasis is an emerging disease in post-disaster situations and adequate prevention measures should be implemented during these circumstances.

Psycho-vegetative status of children suffering from giardiasis

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I.B. Yershova

2017-09-01

Full Text Available Background. The study of psycho-vegetative disorders in children with Giardia lamblia infection was the objective of the study. Materials and methods. The study involved 86 children with giardiasis aged 7–18 years. To evaluate the autonomic changes, there were applied a questionnaire by A. Wayne. The autonomic tone was determined by the table of Guillaume-Veyn, vegetative reactivity — using Dagnini-Aschner reflex, vegetative supply of reactivity — by means of orthostatic test. Psychological examination of children was conducted using the methodology “Personality disorder diagnosis” by Z. Karpenko, Rosenberg Self-Esteem Scale, Beck Depression Inventory. Results. 75.6 % of сhildren had signs of autonomic dysfunction syndrome, 41.9 % — the parasympathetic autonomic tone, 43.0 % — the vagotonic type of autonomic reactivity. Inadequate maintenance of vegetative reactivity was detected in 39.5 % of patients. Psychological testing showed uncertainty in 55.9 % of child­ren, anxiety — in 42.6 %, decrease in self-esteem — in 41.2 %; depression — in 38.2 %, isolation — in 27.9 %. Conclusions. Vegetative disorders in children with giardiasis occur in 75.6 % of cases. There is a tendency to vagotonia. Changes of psycho-functional status are manifested by increasing isolation, depression, anxiety.

Immune reconstitution syndrome in a human immunodeficiency virus infected child due to giardiasis leading to shock

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Sneha Nandy

2015-01-01

Full Text Available Human immunodeficiency virus (HIV-associated immune reconstitution inflammatory syndrome has been reported in association with tuberculosis, herpes zoster (shingles, Cryptococcus neoformans, Kaposi′s sarcoma, Pneumocystis pneumonia, hepatitis B virus, hepatitis C virus, herpes simplex virus, Histoplasma capsulatum, human papillomavirus, and Cytomegalovirus. However, it has never been documented with giardiasis. We present a 7-year-old HIV infected girl who developed diarrhea and shock following the initiation of antiretroviral therapy, and her stool showed the presence of giardiasis.

Irritable bowel syndrome and chronic fatigue 3 years after acute giardiasis: historic cohort study.

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Wensaas, Knut-Arne; Langeland, Nina; Hanevik, Kurt; Mørch, Kristine; Eide, Geir Egil; Rortveit, Guri

2012-02-01

Giardia lamblia is a common cause of gastroenteritis worldwide, but there is limited knowledge about the long-term complications. To estimate the relative risk of irritable bowel syndrome (IBS) and chronic fatigue 3 years after acute giardiasis. Controlled historic cohort study with 3 years' follow-up. Data collected by mailed questionnaire. Waterborne outbreak of giardiasis in the city of Bergen, Norway. 817 patients exposed to Giardia lamblia infection verified by detection of cysts in stool samples and 1128 matched controls. IBS and chronic fatigue. The prevalence of IBS in the exposed group was 46.1%, compared with 14.0% in the control group, and the adjusted RR=3.4 (95% CI 2.9 to 3.8). Chronic fatigue was reported by 46.1% of the exposed group and 12.0% of the controls, the adjusted RR was 4.0 (95% CI 3.5 to 4.5). IBS and chronic fatigue were associated and the RR for the exposed group of having a combination of the two outcomes was 6.8 (95% CI 5.3 to 8.5). The RR was also increased for having just one of the two syndromes, 1.8 for IBS (95% CI 1.4 to 2.3) and 2.2 for chronic fatigue (95% CI 1.7 to 2.8). Infection with Giardia lamblia in a non-endemic area was associated with a high prevalence of IBS and chronic fatigue 3 years after acute illness, and the risk was significantly higher than in the control group. This shows that the potential consequences of giardiasis are more serious than previously known. Further studies are needed, especially in areas where giardiasis is endemic.

Contaminated water caused the first outbreak of giardiasis in Finland, 2007: a descriptive study.

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Rimhanen-Finne, Ruska; Hänninen, Marja-Liisa; Vuento, Risto; Laine, Janne; Jokiranta, T Sakari; Snellman, Marja; Pitkänen, Tarja; Miettinen, Ilkka; Kuusi, Markku

2010-08-01

The severe sewage contamination of a drinking water distribution network affected inhabitants in the town of Nokia, Finland in November 2007-February 2008. One of the pathogens found in patient and environmental samples was Giardia, which for the first time was detected as the causal agent of an outbreak in Finland. To describe the existence and the importance of Giardia infections related to this outbreak, we described characteristics of the giardiasis cases and calculated the incidence of giardiasis as well as the frequency of positive Giardia tests both before and during the outbreak. Persons reported to the Finnish Infectious Disease Registry (FIDR) with Giardia infections were interviewed. The number of persons tested for Giardia was obtained from the Centre for Laboratory Medicine at the Tampere University Hospital. The investigations provided strong evidence that Giardia infections in Nokia resulted from the contaminated water. The proportion of persons testing positive for Giardia and the incidence of giardiasis multiplied during the outbreak. To improve outbreak management, national guidelines on testing environmental samples for Giardia should be developed, and further resources should be allocated to both clinical and environmental laboratories that perform parasitological analyses.

[Parasitic zoonoses transmitted by drinking water. Giardiasis and cryptosporidiosis].

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Exner, M; Gornik, V

2004-07-01

Nowadays, the parasitic zoonose organisms Giardia lamblia und Cryptosporidium spp. are among the most relevant pathogens of drinking water-associated disease outbreaks. These pathogens are transmitted via a fecal-oral route; in both cases the dose of infection is low. Apart from person-to-person or animal-to-person transmissions, the consumption of contaminated food and water are further modes of transmission. The disease is mainly characterized by gastrointestinal symptoms. In industrialized countries, the prevalence rate of giardiasis is 2-5 % and of cryptosporidiosis 1-3%. Throughout the world, a large number of giardiasis and cryptosporidiosis outbreaks associated with drinking water were published; in 2001 the first case in Germany was identified. Giardia and Cryptosporidium are detected in surface water and sporadically in unprotected groundwater. Use of these waters for drinking water abstraction makes high demands on the technology of the treatment process: because of the disinfectant resistance of the parasites, safe elimination methods are needed, which even at high contamination levels of source water guarantee safe drinking water. Further measures for prevention and control are implementation of the HACCP concept, which includes the whole chain of procedures of drinking water supply from catchment via treatment to tap and a quality management system.

Evolution of Socioeconomic Conditions and Its Relation to Spatial-Temporal Changes of Giardiasis and Helminthiasis in Amazonian Children.

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Delfino, B M; Campos, R G; Pereira, T M; Mantovani, S A S; Oliart-Guzmán, H; Martins, A C; Braña, A M; Branco, F L C C; Filgueira-Júnior, J A; Santos, A P; Araújo, T S; Oliveira, C S M; Ramalho, A A; Muniz, P T; Codeço, C T; da Silva-Nunes, M

2016-12-01

This study analyzed the evolution of socioeconomic, sanitary, and personal factors as well as spatiotemporal changes in the prevalence of helminthiasis and giardiasis in urban Amazonian children between 2003 and 2011. Child age, lack of sanitation, and lack of access to bottled water were identified as significant associated factors for helminthiasis and giardiasis. There was an overall improvement in socioeconomic and sanitary conditions in the city resulting in decreased helminth prevalences from 12.42 to 9.63% between 2003 and 2010, but the prevalence increased to 15.03% in 2011 due to migratory movement and unstable sanitary conditions. As for Giardiasis, socioeconomic and environmental changes were not enough to reduce prevalence (16% in 2003 and 23% in 2011). Spatial analysis identified a significant cluster for helminthiasis in an area of poor housing conditions. Control programs in the Amazon need to target high-risk areas focusing changes in sanitation, water usage, and health education.

Prophylactic Potential of Synbiotic (Lactobacillus casei and Inulin) in Malnourished Murine Giardiasis: an Immunological and Ultrastructural Study.

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Shukla, Geeta; Sharma, Anuj; Bhatia, Ruchika; Sharma, Mridul

2017-12-19

Giardiasis is a re-emerging infectious disease with outbreaks reported globally specially in children and malnourished individuals leading to malabsorption, growth retardation, and severe diarrhea. Thus, in the present study, prophylactic administration of synbiotic as the functional food was used to assess its antigiardial potential in malnourished murine giardiasis. Interestingly, prior administration of synbiotic (Lactobacillus casei + inulin) even to malnourished-Giardia-infected mice led to increased body mass, small intestine mass, lactobacilli counts, and reduced severity of giardiasis as evident by decreased cyst and trophozoite counts. Synbiotic therapy further boosted the innate and acquired immune response resulting into increase in nitric oxide, antigiardial secretory IgA and IgG antibody levels along with IL-6 and IL-10 cytokines, and decreased levels of inflammatory TNF-α cytokine in both serum and intestinal fluid in malnourished-synbiotic-Giardia-infected mice compared with malnourished-Giardia-infected mice. More specifically, histopathological and scanning electron microscopy analysis of the small intestine also confirmed the modulatory potentials of synbiotic in malnourished-synbiotic-Giardia mice which had less cellular and mucosal damage compared with severely damaged, mummified, and blunted villi in malnourished-Giardia-infected mice. Taken together, this is the first experimental study to report that prior supplementation of synbiotic restored the gut morphology and improved the immune status of the malnourished-Giardia-infected mice, and could be considered as the prophylactic adjunct therapy for malnourished individuals.

Drugs for treating giardiasis.

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Granados, Carlos E; Reveiz, Ludovic; Uribe, Luis G; Criollo, Claudia P

2012-12-12

Giardiasis infection may be asymptomatic, or can cause diarrhoea (sometimes severe), weight loss, malabsorption, and, in children, failure to thrive. It is usually treated with metronidazole given three times daily for five to 10 days. To evaluate the relative effectiveness of alternative antibiotic regimens for treating adults or children with symptomatic giardiasis. We searched the Cochrane Infectious Disease Group Specialized Register, the Cochrane Central Register of Controlled Trials (CENTRAL) (Issue 6 2012); MEDLINE, EMBASE, LILACS and the International Clinical Trials Registry Platform Search Portal (3 July 2012). We included randomized controlled trials (RCT) comparing metronidazole administered for five to 10 days with any of the following drugs: metronidazole (single dose), tinidazole, albendazole, mebendazole, and nitazoxanide. The primary outcomes were parasitological and clinical cure. Two authors independently assessed studies for inclusion, performed the risk of bias assessment, and extracted data. We summarized data using risk ratios and mean differences and we presented the results in forest plots and performed meta-analyses where possible. We assessed heterogeneity using the Chi(2) test, I(2) statistic and visual inspection; and we explored this by using subgroup analyses.We assessed the quality of evidence by using the GRADE approach. We included 19 trials, involving 1817 participants, of which 1441 were children. Studies were generally small, with poor methods reporting. . Most reported parasitological outcomes rather than clinical improvement.Ten trials, from India, Mexico, Peru, Iran, Cuba, and Turkey, compared albendazole (400 mg once daily for five to 10 days) with metronidazole (250 mg to 500 mg three times daily for five to 10 days). This once-daily regimen of albendazole is probably equivalent to metronidazole at achieving parasitological cure (RR 0.99, 95% CI 0.95 to 1.03; 932 participants, 10 trials; moderate quality evidence), and

Post epidemic giardiasis and gastrointestinal symptoms among preschool children in Bergen, Norway. A cross-sectional study

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Eide Geir E

2010-03-01

Full Text Available Abstract Background A surprisingly low number of children became ill with giardiasis during the large waterborne outbreak of Giardia lamblia in Bergen, Norway during autumn 2004. The aim of the present study was to evaluate the prevalence of giardiasis among exposed children one year after an outbreak and compare faecal carriage of Giardia and abdominal symptoms among exposed versus unexposed children one year after the epidemic. Methods Children between 1 and 6 years old were recruited from the local health care centres in Bergen municipality in the period between June 2005 and January 2006. One faecal sample per child was collected and examined for presence of Giardia with a rapid immunoassay antigen test, and parents were asked to answer a questionnaire. A total of 513 children participated, 378 in the group exposed to contaminated water, and 135 in the in the group not exposed. Results In the exposed group eleven children had been treated for giardiasis during the epidemic and none in the unexposed group. Giardia positive faecal tests were found in six children, all in the exposed group, but the difference between the groups did not reach statistical significance. All six Giardia positive children were asymptomatic. No differences were found between the groups regarding demographic data, nausea, vomiting, different odour from stools and eructation. However, the reported scores of abdominal symptoms (diarrhoea, bloating and stomach ache during the last year were higher in the exposed group than in the unexposed group. Conclusions A low prevalence of asymptomatic Giardia infection (1.7% was found among exposed children around one year after the epidemic (1.2% overall prevalence in the study. In the present setting, pre-school children were therefore unlikely to be an important reservoir for continued transmission in the general population.

Factores de riesgo de giardiasis en niños de 0 a 6 años

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Felipe Rolando Delgado López

1997-06-01

Full Text Available Se realizó un estudio sobre la giardiasis con el objetivo de analizar algunos factores biopsicosociales asociados con esta entidad y su relación con determinadas variables. Se utilizó como muestra a 60 niños parasitados pertenecientes al Policlínico Docente "Luis Pasteur" y se compararon con igual número de niños aparentemente sanos. Observamos asociación significativa entre este parasitismo y diferentes variables como: grupo sanguíneo A, tiempo de lactancia materna inferior a 4 meses, asistencia al círculo infantil, vectores mecánicos presentes en el hogar, inadecuados hábitos higiénicos y el funcionamiento familiar no adecuado.A study on giardiasis was conducted aimed at analyzing some biopsychosocial factors associated with this disease and their relation with certain variables. 60 children with parasites from the "Luis Pasteur" Teaching Polyclinic were used as a sample and compared with the same number of apparently sound children. We observed a significant association between this parasitism and different variables such as: A blood group, breast feeding for less than 4 months, attendance to to the day care center, presence of mechanical vectors at home, inadequate hygienic habits, and unappropriated family functioning.

Survey the Outbreak of Giardiasis Among Food Supply and Distribution Staff of South Pars Economic Zone Petrochemicals

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Sadegh Niazi

2013-12-01

Full Text Available Background & Objectives: Giardiasis is one of the parasitic infections in the gastrointestinal tract which caused by flagellate protozoa that called giardia and it causes diarrhea. Giardia cysts defecate from infected people. These cysts can enter the body through contaminated hands, water, and food products. Diarrhea, weight loss, abdominal pains, growth failure, malabsorption of carbohydrates, fats and vitamins are the giardiasis symptoms. Methods: In this study, samples were taken from 203 people that were working in different food supply and distribution centers in the South Pars petrochemical. After sampling, samples were analyzed according to standard procedures. The results of examinations were studied after verification them by laboratory chief and their related physicians. Results: Out of the whole examined people in this study, kitchen (28% and salad maker (14% centers were the maximum and minimum population, respectively. 8.87% of the total populations were infected by giardia, which salad making center had the greatest share. As well as, the rate of infectious by giardia among the administrative and dishes washing centers was the lowest. Conclusion: Education level and personal hygiene such as hand washing with a detergent can be important in reducing infection due to giardia. So, the training of workers and also periodic testing of individuals can reduce these pollutants.

Comparison of two techniques for diagnosis of giardiasis in dogs

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Decock C.

2003-03-01

Full Text Available Giardiasis is an intestinal parasitosis affecting dogs and able to infect human beings. Its diagnosis can not be done with the only clinical signs, the main of which is non characteristic diarrhoea. It implicates to perform further tests to detect the parasite. The zinc sulfate concentration technique (ZSCT is the more effective one if performed on two or three successive days. Fecal ELISA kits have been developed to detect Giardia in humans and were found to be less sensitive than the ZSCT in dogs. In this study, we used 30 infected Beagles to compare the sensitivity of one, two or three fecal examinations following ZSCT and one or two ELISA tests. We conclude that if a single ZSCT is insufficient, two or three ZSCT and one or two ELISA using the commercial kit ProSpecT® Giardia have almost the same sensitivity.

Plant species used in giardiasis treatment: ethnopharmacology and in vitro evaluation of anti-Giardia activity

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Vanessa do A. Neiva

Full Text Available The aim of this study was to compile the traditional knowledge about plants used for the treatment of giardiasis, and also to carry out experimental research to evaluate the anti-Giardia activity of five species.To reach this objective, 398 interviews were performed using a previously prepared questionnaire, followed by an in vitro evaluation of giardicidal potential of hydroalcoholic leaf extracts of Anacardium occidentale L., Chenopodium ambrosioides L., Passiflora edulis Sims, Psidium guajava L., and Stachytarpheta cayennensis(Rich. Vahl. Among the interviewed people, 55.53% reported the use of plants to treat diarrhea, the most severe symptom of giardiasis. The results indicated 36 species used by this population for these problems. The use of leaves (72.50% of a single plant (64.25% collected from backyards and gardens (44.34% and prepared by decoction were predominant. The majority of the interviewees (85.52% attributed their cure to the use of plants. In the experimental tests, all extracts inhibited the growth of Giardia lambliatrophozoites in different intensities: A. occidentale and P. guajava extracts elicited a moderate activity (250 ≤ IC50 ≤ 500 μg/ml, C. ambrosioides and S. cayennensis extracts evoked a high activity (100 ≤ IC50 ≤ 250 μg/ml, and P. edulis extract showed very high activity (IC50≤ 100 μg/ml. This study shows that an ethnopharmacological approach is useful in the selection of plant materials with potential giardicidal activity.

Antigiardial Effect of Kramecyne in Experimental Giardiasis

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Pontifez-Pablo, Elida; Pérez-Gutiérrez, Salúd

2017-01-01

A variety of drugs are used in giardiasis treatment with different levels of efficiency, presence of side effects, and even formation of resistant strains, so that it is important to search new only-one-dose treatments with high efficiency and less side effects. Kramecyne, an anti-inflammatory compound isolated from methanolic extract of Krameria cytisoides, does not present toxicity, even at doses of 5,000 mg/kg. The objective was to determine the antigiardial effect of kramecyne over Giardia intestinalis in vitro and in vivo and analyze the expression of genes ERK1, ERK2, and AK on kramecyne treated trophozoites by Real Time Polymerase Chain Reaction (RTPCR). The median lethal dose (LD50) was 40 μg/mL and no morphological changes were observed by staining with blue trypan and light microscopy; experimental gerbil infection was eliminated with 320 μg/Kg of weight. After treatment there were no differences between intestines from treated and untreated gerbils. Kramecyne did not have significant effect over ERK1 and AK, but there are differences in ERK2 expression (p = 0.04). Results show antigiardial activity of kramecyne; however the mode of action is still unclear and the evaluation of ultrastructural damage and expressed proteins is an alternative of study to understand the action mechanism. PMID:29387130

[Chonic diarrhea and malabsorption due to common variable immunodeficiency, gastrectomy and giardiasis infection: a difficult nutritional management].

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Domínguez-López, M E; González-molero, I; Ramírez-Plaza, C P; Soriguer, F; Olveira, G

2011-01-01

Gastric cancer is a frequent cause of cancer-related mortality in the world. Surgery is the only potentially curative therapy, although the adverse effects of surgery are common and considerable. Common variable immunodeficiency is in many cases cause of gastrointestinal system problems such as chronic diarrhea caused by infestation with giardia lamblia, nodular lymphoid hiperplasia ad loss of villi leading frequently to malapsortion and malnutrition. Nutritional deficiencies due to malapsorption (postgastrectomy and secondary to loss of villi, giardiasis and common variable inmunodeficiency) are common. We present the case of a patient with gastric cancer who underwent a gastrectomy with common variable hipogammaglobulinemia and chronic infestation by giardia lamblia, with serious diarrhea resistant to treatment and malabsorption.

The effects of nitric oxide on the immune response during giardiasis

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Wander Rogério Pavanelli

Full Text Available Nitric oxide (NO is a free radical synthesized from L-arginine by different isoforms NO-synthases. NO possesses multiple and complex biological functions. NO is an important mediator of homeostasis, and changes in its generation or actions can contribute or not to pathological states. The knowledge of effects of NO has been not only important to our understanding of immune response, but also to new tools for research and treatment of various diseases. Knowing the importance of NO as inflammatory mediator in diverse infectious diseases, we decided to develop a revision that shows the participation/effect of this mediator in immune response induced against Giardia spp. Several studies already demonstrated the participation of NO with microbicidal and microbiostatic activity in giardiasis. On the other hand, some works report that Giardia spp. inhibit NO production by consuming the intermediate metabolite arginine. In fact, studies in vitro showed that G. lamblia infection of human intestinal epithelial cells had reduced NO production. This occurs due to limited offer of the crucial substrate arginine (essential aminoacid for NO production, consequently reducing NO production. Therefore, the balance between giardial arginine consumption and epithelial NO production could contribute to the variability of the duration and severity of infections by this ubiquitous parasite.

Giardiasis as zoonosis: between proof of principle and paradigm in the Northwestern region of São Paulo State, Brazil

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Aline Cardoso Caseca Volotão

Full Text Available OBJECTIVE: In order to evaluate the potential zoonotic transmission of Giardia duodenalis, isolates from humans and dogs in the Northwestern region of the São Paulo State, Brazil were characterized based on the β-giardin gene. METHODS: The samples were analyzed by sequencing of the Nested-PCR products. RESULTS: The A1 and A2 subgenotypes were detected in human and dogs. Cysts of assemblage B, C and D have not been found in any isolates studied. CONCLUSIONS: These results are consistent with the view that giardiasis in the largest endemic region of the Brazil should not be seen as a single entity.

Asociación entre los índices antropométricos nutricionales, los niveles de hemoglobina y la giardiasis intestinal en niños preescolares. centro poblado california, virú – la libertad, 2013

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Olivos Gonzáles, Yuri

2014-01-01

Objectives: To determine the differences in anthropometric indices of nutritional and hemoglobin levels among preschool children with and without intestinal giardiasis. Material and Methods: Quantitative, descriptive , transversal and comparative study involved 92 preschool children, selected by simple random sampling, residents of the California populated center, Viru -La Libertad. To determine the nutritional status participants were classified into 2 categories: Eutrophic and chronic maln...

Albendazole versus metronidazole in the treatment of adult giardiasis: a randomized, double-blind, clinical trial.

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Cañete, Roberto; Rodríguez, Pablo; Mesa, Lumey; Brito, Katia; Prior, Ada; Guilhem, Dirce; Novaes, M R C G

2012-01-01

Albendazole (ABZ) is a benzimidazole carbamate compound currently in use for human medical practice against enterobiasis and soil-transmitted helminthiasis (STH); However, its spectrum of activity is broad and goes beyond these infections. This study compares the efficacy and safety of ABZ versus metronidazole (MTZ) in human giardiasis. A randomized, double-blind, clinical trial was carried out at the Centre of Hygiene, Epidemiology and Microbiology in Matanzas City, Cuba. Adult patients with confirmed symptomatic G. duodenalis mono-infection were randomly assigned to receive either ABZ [400 mg daily (n = 75)] or MTZ [250 mg t.i.d. (n = 75)], both for 5 days. Follow-up fecal samples were obtained at 3, 5, 7 days after treatment end. The efficacy was similar for both treatment groups: ABZ (82.6%) and MTZ (85.3%); p > 0.05. Side-effects including bitter taste, headache, vomiting and dizziness were significantly higher in the MTZ group. Abdominal pain was significantly higher in ABZ group. ABZ was found as effective as MTZ in the treatment of G. duodenalis infections in adult patients from Cuba and could be a useful drug in areas where co-infection with STH infections is common.

The influence of serial fecal sampling on the diagnosis of giardiasis in humans, dogs, and cats.

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Uchôa, Flávia Fernandes de Mendonça; Sudré, Adriana Pittella; Macieira, Daniel de Barros; Almosny, Nádia Regina Pereira

2017-08-24

Giardia infection is a common clinical problem in humans and pets. The diagnosis of giardiasis is challenging as hosts intermittently excrete protozoan cysts in their feces. In the present study, we comparatively evaluated two methods of serial fecal sampling in humans, dogs, and cats from Rio de Janeiro, Brazil. The Faust et al. technique was used to examine fecal specimens collected in triplicate from 133 patients (52 humans, 60 dogs, and 21 cats). Specimens from 74 patients were received from the group assigned to carry out sampling on consecutive days - 34 humans, 35 dogs, and 5 cats, and specimens from 59 patients were received from the group assigned to carry out sampling on non-consecutive, separate days - 18 human beings, 25 dogs, and 16 cats. G. duodenalis cysts were found in stools of 30 individuals. Multiple stool sampling resulted in an increase in the number of samples that were positive for Giardia in both groups. The authors therefore conclude that multiple stool sampling increases the sensitivity of the Faust et al . technique to detect G. duodenalis cysts in samples from humans, cats and dogs.

TLR2−/− Mice Display Decreased Severity of Giardiasis via Enhanced Proinflammatory Cytokines Production Dependent on AKT Signal Pathway

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Xin Li

2017-09-01

Full Text Available Giardia infection is one of the most common causes of waterborne diarrheal disease in a wide array of mammalian hosts, including humans globally. Although numerous studies have indicated that adaptive immune responses are important for Giardia defense, however, whether the host innate immune system such as TLRs recognizes Giardia remains poorly understood. TLR2 plays a crucial role in pathogen recognition, innate immunity activation, and the eventual pathogen elimination. In this study, we investigated the role of TLR2 as a non-protective inflammatory response on controlling the severity of giardiasis. RT-PCR analysis suggested that TLR2 expression was increased in vitro. We demonstrated that Giardia lamblia-induced cytokines expression by the activation of p38 and ERK pathways via TLR2. Interestingly, the expression of IL-12 p40, TNF-α, and IL-6, but not IFN-γ, was enhanced in TLR2-blocked and TLR2−/− mouse macrophages exposed to G. lamblia trophozoites compared with wild-type (WT mouse macrophages. Further analysis demonstrated that G. lamblia trophozoites reduced cytokines secretion by activating AKT pathway in WT mouse macrophages. Immunohistochemical staining in G. lamblia cysts infected TLR2−/− and WT mice showed that TLR2 was highly expressed in duodenum in infected WT mice. Also, infected TLR2−/− and AKT-blocked mice showed an increased production of IL-12 p40 and IFN-γ compared with infected WT mice at the early stage during infection. Interestingly, infected TLR2−/− and AKT-blocked mice displayed a decreased parasite burden, an increased weight gain rate, and short parasite persistence. Histological morphometry showed shortened villus length, hyperplastic crypt and decreased ratio of villus height/crypt depth in infected WT mice compared with in infected TLR2−/− and AKT-blocked mice. Together, our results suggested that TLR2 deficiency leads to alleviation of giardiasis and reduction of parasite burden through

Giardia y giardiasis Giardia and giardiasis

OpenAIRE

Hugo D. Luján

2006-01-01

Giardia lamblia es un protozoario parásito que habita el intestino delgado de los seres humanos y de muchos otros vertebrados y es una de las más comunes causas de diarrea en todo el mundo. Durante su ciclo de vida Giardia sufre significativos cambios bioquímicos y morfológicos que le permiten sobrevivir en ambientes y condiciones que de otro modo lo destruirían. Para sobrevivir fuera del intestino del hospedador, los trofozoítos de Giardia se diferencian a quistes, los que se caracterizan po...

Giardia y giardiasis Giardia and giardiasis

Directory of Open Access Journals (Sweden)

Hugo D. Luján

2006-02-01

Full Text Available Giardia lamblia es un protozoario parásito que habita el intestino delgado de los seres humanos y de muchos otros vertebrados y es una de las más comunes causas de diarrea en todo el mundo. Durante su ciclo de vida Giardia sufre significativos cambios bioquímicos y morfológicos que le permiten sobrevivir en ambientes y condiciones que de otro modo lo destruirían. Para sobrevivir fuera del intestino del hospedador, los trofozoítos de Giardia se diferencian a quistes, los que se caracterizan por poseer una rígida pared glicoproteica externa que les permiten sobrevivir inclusive frente a la acción de los desinfectantes más comunes. Otro de los mecanismos de adaptación de este parásito es la variación de los antígenos de superficie que le permite a los trofozoítos evadir la respuesta inmune del huésped y generar infecciones tanto agudas como crónicas o recurrentes en individuos infectados. Durante los últimos años se han producido importantes avances en el conocimiento de las bases moleculares de los procesos de enquistamiento y variación antigénica en Giardia que pronostican el pronto hallazgo de nuevos agentes quimioterapéuticos y/o inmunoprofilácticos contra este importante parásito intestinal.Giardia lamblia is a protozoan parasite that inhabits the upper small intestine of humans and several other vertebrates and one of the most frequent cause of intestinal disease worldwide. During its life cycle, G. lamblia undergoes significant biochemical and morphological changes that allow the parasite to survive under hostile environmental conditions. To survive outside the host’s intestine, Giardia differentiates into resistant cysts, which are characterized by a rigid extracellular cyst wall that protect the parasite even to the action of the most common chemical disinfectants. Another adaptive mechanism of Giardia is the switching of its surface antigens, a mechanism that allows the trophozoites to evade the host’s immune responses and produce acute, chronic and/or recurrent infections. During the last years, important advances in the knowledge of the molecular basis underlying the mechanisms of encystation and antigenic variation in Giardia suggest that novel chemotherapeutic and/or immunoprophylactic reagents against this important human pathogen could soon be available.

Perceived food intolerance and irritable bowel syndrome in a population 3 years after a giardiasis-outbreak: a historical cohort study.

Science.gov (United States)

Litleskare, Sverre; Wensaas, Knut-Arne; Eide, Geir Egil; Hanevik, Kurt; Kahrs, Gudrun Elise; Langeland, Nina; Rortveit, Guri

2015-11-19

Studies have shown an increased prevalence of irritable bowel syndrome (IBS) after acute gastroenteritis. Food as a precipitating and perpetuating factor in IBS has gained recent interest, but food intolerance following gastroenteritis is less investigated. The aims of this study were firstly, to compare perceived food intolerance in a group previously exposed to Giardia lamblia with a control group; secondly, to explore the relation with IBS status; and thirdly, to investigate associations with content of fermentable oligosaccharides, disaccharides, monosaccharides and polyols (FODMAP) in foods reported. This is a historical cohort study with mailed questionnaire to 1252 Giardia exposed and a control cohort matched by gender and age. Differences between groups were investigated using bivariate and multivariate analyses. The questionnaire response rate in the exposed group was 65.3 % (817/1252) and in the control group 31.4 % (1128/3598). The adjusted odds ratio (OR) for perceived food intolerance for the exposed group was 2.00 with 95 % confidence interval (CI): 1.65 to 2.42, as compared with the control group. Perceived intolerance for dairy products was the most frequently reported intolerance, with an adjusted OR for the exposed of 1.95 (95 % CI: 1.51 to 2.51). Perceived intolerance for fatty foods, vegetables, fruit, cereals and alcohol was also significantly higher in the exposed group. The groups did not differ in perceived intolerance to spicy foods, coffee or soda. The association between exposure to Giardia infection and perceived food intolerance differed between the IBS group and the no-IBS group, but IBS was not a significant effect modifier for the association. Perceived intolerance for high FODMAP foods (adjusted OR 1.91) and low FODMAP foods (adjusted OR 1.55) was significantly associated with exposure status. Exposure to Giardia infection was associated with perceived food intolerance 3 years after giardiasis. IBS status did not alter the

Lymphocyte proliferation in Peyer's patches of Giardia muris-infected mice.

OpenAIRE

Hill, D R

1990-01-01

Gastrointestinal immune events in giardiasis are important in controlling infection. In this study, Peyer's patch lymphocytes from mice infected with Giardia muris developed specific, proliferative responses to G. muris antigen. This proliferation correlated with clearance of infection. Further understanding of the gut immune response will be helpful in developing immunoprophylactic strategies in the control of giardiasis.

Giardia Infection (Giardiasis)

Science.gov (United States)

... one of the most common causes of waterborne disease in the United States. The parasites are found in backcountry streams and lakes but also in municipal water supplies, swimming pools, whirlpool spas and wells. Giardia infection can be transmitted through food and person-to-person contact. Giardia ...

(Influence of environmental factors on the spread of lambliasis in collectivities of small children)

Energy Technology Data Exchange (ETDEWEB)

Munteanu, E.; Munteanu, I.; Csueroes, V.

1980-01-01

In 1977, coproparazitological examinations, prophylactic and therapeutical studies were carried on 225 children in 14 day nurseries and homes in Cluj-Napoca; 21.57% of children suffered from intestinal parasitosis, giardiasis being found in 92.13% of the infested children. The high incidence of giardiasis led the authors to investigate the hygienic level of the environment. The high frequency of enterobacteriaceae opportunists (77.59%), identified on the hands of the personnel and on certain objects manipulated by the children, pointed to fecal pollution and poor sanitary conditions. The contaminated objects are sources of propagation of Giardia lamblia cysts. The increased incidence of giardiasis and of enterobacteriaceae opportunists in the environment were found both in the communities with many children and in those with few children.

Giardiasis intestinal: estudio de 60 pacientes Intestinal giardiasis: study of 60 patients

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Nuris Rodríguez Vargas

2006-06-01

Full Text Available Se investiga, en un período de tiempo de 6 meses, a 60 pacientes en edades comprendidas entre 1 y 14 años. Los pacientes provenían del área de salud del Policlínico «19 de Abril» y acudieron a consulta por presentar vómitos y dolor abdominal de forma aislada o conjunta. Se analizaron variables como la edad y el sexo y se realizaron estudios relacionados con la búsqueda de enfermedades enterales por parásitos protozoarios, específicamente ocasionadas por Giardias lamblia. Para ello se indicó estudio parasitológico de las heces, estudio parasitológico del contenido duodenal mediante intubación, examen radiológico contrastado de esófago, estómago y duodeno y análisis de la inmunidad humoral. El mayor número de niños estaba en el grupo de 1 a 4 años (28 pacientes y le siguieron en frecuencia los de 5 a 8 años (20 niños. Predominó el sexo masculino con un total de 38 pacientes. El hallazgo de Giardias lamblia en las heces recién emitidas se registró en más de la mitad de los casos (33 pacientes, mientras que el estudio duodenal fue positivo en 45 pacientes, lo cual evidencia un mayor valor diagnóstico en el análisis del aspirado duodenal. Los resultados de la radiografía de estómago y duodeno detectaron 41 casos de duodenitis, lo cual corroboró los hallazgos de la exploración física. En 43 pacientes se pudo realizar un estudio de inmunoelectroforesis y 29 de ellos presentaron disminución de la IgA.

Molecular Genotyping of Giardia duodenalis Isolates from Symptomatic Individuals Attending Two Major Public Hospitals in Madrid, Spain.

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Aida de Lucio

Full Text Available The flagellate protozoan Giardia duodenalis is an enteric parasite causing human giardiasis, a major gastrointestinal disease of global distribution affecting both developing and industrialised countries. In Spain, sporadic cases of giardiasis have been regularly identified, particularly in pediatric and immigrant populations. However, there is limited information on the genetic variability of circulating G. duodenalis isolates in the country.In this longitudinal molecular epidemiological study we report the diversity and frequency of the G. duodenalis assemblages and sub-assemblages identified in 199 stool samples collected from 184 individual with symptoms compatible with giardiasis presenting to two major public hospitals in Madrid for the period December 2013-January 2015. G. duodenalis cysts were initially detected by conventional microscopy and/or immunochomatography on stool samples. Confirmation of the infection was performed by direct immunofluorescence and real-time PCR methods. G. duodenalis assemblages and sub-assemblages were determined by multi-locus genotyping of the glutamate dehydrogenase (GDH and β-giardin (BG genes of the parasite. Sociodemographic and clinical features of patients infected with G. duodenalis were also analysed.Of 188 confirmed positive samples from 178 giardiasis cases a total of 124 G. duodenalis isolates were successfully typed at the GDH and/or the BG loci, revealing the presence of sub-assemblages BIV (62.1%, AII (15.3%, BIII (4.0%, AI (0.8%, and AIII (0.8%. Additionally, 6.5% of the isolates were only characterised at the assemblage level, being all of them assigned to assemblage B. Discordant genotype results AII/AIII or BIII/BIV were also observed in 10.5% of DNA isolates. A large number of multi-locus genotypes were identified in G. duodenalis assemblage B, but not assemblage A, isolates at both the GDH and BG loci, confirming the high degree of genetic variability observed in other molecular surveys

Overview of biofilm formation in distribution systems and its impact on the deterioration of water quality

CSIR Research Space (South Africa)

Momba, MNB

2000-01-01

Full Text Available in drinking water have long been known to cause disease and death in consumers (Craun, 1986). The health risks associated with these pathogens range from viral and bacterial gastroenteric diseases to infections such as hepatitis A and giardiasis... range from viral and bacterial gastro-enteric diseases to infections such as hepatitis A and giardiasis. Recently there have also been reports of the survival of Campylobacter spp., Helicobacter pylori and Cryptosporidium parvum in biofilms...

Prevalence and associated risk factors for Giardia and Cryptosporidium infections among children of northwest Mexico: a cross-sectional study

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Luis Quihui-Cota

2017-10-01

Full Text Available Abstract Background G. intestinalis and Cryptosporidium spp. are responsible for gastrointestinal infections worldwide. Contaminated food, feces, drinking water and predictors such as poverty, cultural and behavioral aspects have been involved in their transmission. Published studies about these infections are limited in Mexico. Cananea, Sonora is located in northwest Mexico and is one of the regions with the lowest marginalization index in the Sonora state. However, its rate of gastrointestinal infections increased from 48.7/1000 in 2003 to 77.9/1000 in 2010 in the general population. It was estimated that the prevalence of giardiasis can range from 20 to 30% in the Sonoran childhood population. However, the prevalence of giardiasis and cryptosporidiosis are unknown in Cananea, Sonora and they are likely contributing to its gastrointestinal infections rates. Methods A total of 173 children (average age 8.8 ± 2.8 years participated in this cross-sectional study. Anthropometric measurements and stool analysis were performed. Socioeconomic, cultural and symptomatology information were collected. The association between the risk factors and intestinal parasitic infections was analyzed by multivariate analysis using the STATA/SE package at a significance level of p ≤ 0.05. Results More than half of the children (n = 103, 60% had intestinal parasitic infections. Cryptosporidium spp. showed the highest prevalence (n = 47, 27%, which was followed by G. intestinalis (n = 40, 23%. Children with giardiasis and cryptosporidiosis had lower H/A and BMI/A Z scores than children who were free of these infections. Children with giardiasis were at higher risk (OR = 4.0; 95%CI = 1.11–13.02; p = 0.030 of reporting abdominal pain, and children who drank tap water were at higher risk (OR = 5.0; 95% CI = 1.41–17.20; p = 0.012 of cryptosporidiosis. Conclusions This was the first epidemiological study conducted in

Prevalence and associated risk factors for Giardia and Cryptosporidium infections among children of northwest Mexico: a cross-sectional study.

Science.gov (United States)

Quihui-Cota, Luis; Morales-Figueroa, Gloria Guadalupe; Javalera-Duarte, Aarón; Ponce-Martínez, José Antonio; Valbuena-Gregorio, Edith; López-Mata, Marco Antonio

2017-10-30

G. intestinalis and Cryptosporidium spp. are responsible for gastrointestinal infections worldwide. Contaminated food, feces, drinking water and predictors such as poverty, cultural and behavioral aspects have been involved in their transmission. Published studies about these infections are limited in Mexico. Cananea, Sonora is located in northwest Mexico and is one of the regions with the lowest marginalization index in the Sonora state. However, its rate of gastrointestinal infections increased from 48.7/1000 in 2003 to 77.9/1000 in 2010 in the general population. It was estimated that the prevalence of giardiasis can range from 20 to 30% in the Sonoran childhood population. However, the prevalence of giardiasis and cryptosporidiosis are unknown in Cananea, Sonora and they are likely contributing to its gastrointestinal infections rates. A total of 173 children (average age 8.8 ± 2.8 years) participated in this cross-sectional study. Anthropometric measurements and stool analysis were performed. Socioeconomic, cultural and symptomatology information were collected. The association between the risk factors and intestinal parasitic infections was analyzed by multivariate analysis using the STATA/SE package at a significance level of p ≤ 0.05. More than half of the children (n = 103, 60%) had intestinal parasitic infections. Cryptosporidium spp. showed the highest prevalence (n = 47, 27%), which was followed by G. intestinalis (n = 40, 23%). Children with giardiasis and cryptosporidiosis had lower H/A and BMI/A Z scores than children who were free of these infections. Children with giardiasis were at higher risk (OR = 4.0; 95%CI = 1.11-13.02; p = 0.030) of reporting abdominal pain, and children who drank tap water were at higher risk (OR = 5.0; 95% CI = 1.41-17.20; p = 0.012) of cryptosporidiosis. This was the first epidemiological study conducted in children in the region of Cananea, Sonora in northwest Mexico. The

A meta-analysis of the effectiveness of albendazole compared with metronidazole as treatments for infections with Giardia duodenalis.

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Shahram Solaymani-Mohammadi

2010-05-01

Full Text Available Metronidazole is the most commonly used drug for the treatment of giardiasis in humans. In spite of its therapeutic efficacy for giardiasis, low patient compliance, especially in children, side effects, and the emergence of metronidazole-resistant strains may restrict its use. Albendazole has been used to treat Giardia duodenalis infections in recent years. However, efficacy studies in vivo and in vitro have produced diverse results as to its effectiveness. A moderately benign side effect profile, combined with established efficacy against many helminths, renders it promising for treatment of giardiasis in humans.We performed a search in the PubMed, Scopus, EMBASE, the ISI Web of Science, LILIACS, and Cochrane Controlled Trials Register for trials published before February 2010 as well as in references of relevant research and review articles. Eight randomized clinical trials (including 900 patients comparing the effectiveness of albendazole with that of metronidazole were included in meta-analysis. After extracting and validating the data, the pooled risk ratio (RR was calculated using an inverse-variance random-effects model. Albendazole was found to be equally as effective as metronidazole in the treatment of giardiasis in humans (RR 0.97; 95% CI, 0.93, 1.01. In addition, safety analysis suggested that patients treated with albendazole had a lower risk of adverse effects compared with those who received metronidazole (RR 0.36; 95% CI, 0.10, 1.34, but limitations of the sample size precluded a definite conclusion.The effectiveness of albendazole, when given as a single dose of 400 mg/day for 5 days, was comparable to that of metronidazole. Patients treated with albendazole tended to have fewer side effects compared with those who took metronidazole. Given the safety, effectiveness, and low costs of albendazole, this drug could be potentially used as an alternative and/or a replacement for the existing metronidazole therapy protocols in the

Diagnosis of Neglected Tropical Diseases Among Patients With Persistent Digestive Disorders

Science.gov (United States)

2016-10-24

Soil-transmitted Helminthiasis; Schistosomiasis; Strongyloidiasis; Shigellosis; Intestinal Salmonellosis; Campylobacteriosis; Aeromonas Spp. Infections; Giardiasis; Amoebiasis; Dientamoebiasis; Cryptosporidium Spp. Infections

Chronic fatigue syndrome after Giardia enteritis: clinical characteristics, disability and long-term sickness absence

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Naess Halvor

2012-02-01

Full Text Available Abstract Background A waterborne outbreak of Giardia lamblia gastroenteritis led to a high prevalance of long-lasting fatigue and abdominal symptoms. The aim was to describe the clinical characteristics, disability and employmentloss in a case series of patients with Chronic Fatigue Syndrome (CFS after the infection. Methods Patients who reported persistent fatigue, lowered functional capacity and sickness leave or delayed education after a large community outbreak of giardiasis enteritis in the city of Bergen, Norway were evaluated with the established Centers for Disease Control and Prevention criteria for CFS. Fatigue was self-rated by the Fatigue Severity Scale (FSS. Physical and mental health status and functional impairment was measured by the Medical Outcome Severity Scale-short Form-36 (SF-36. The Hospital Anxiety and Depression Scale (HADS was used to measure co-morbid anxiety and depression. Inability to work or study because of fatigue was determined by sickness absence certified by a doctor. Results A total of 58 (60% out of 96 patients with long-lasting post-infectious fatigue after laboratory confirmed giardiasis were diagnosed with CFS. In all, 1262 patients had laboratory confirmed giardiasis. At the time of referral (mean illness duration 2.7 years 16% reported improvement, 28% reported no change, and 57% reported progressive course with gradual worsening. Mean FSS score was 6.6. A distinctive pattern of impairment was documented with the SF-36. The physical functioning, vitality (energy/fatigue and social functioning were especially reduced. Long-term sickness absence from studies and work was noted in all patients. Conclusion After giardiasis enteritis at least 5% developed clinical characteristics and functional impairment comparable to previously described post-infectious fatigue syndrome.

[Knowledge, perceptions and practice of dermatologists with respect to Giardia lamblia infection].

Science.gov (United States)

Iglesias Hernández, Tania; Almannoni, Saleh Ali; Rodríguez, Maria Elena; Sánchez Valdés, Lizet; Pupo, Deisy Martín; Manzur Katrib, Julián; Fonte Galindo, Luis

2010-01-01

to ascertain the level of knowledge, the perceptions and practice of dermatologists in the City of Havana with respect to Giardia lamblia infection. with prior informed consent given by the dermatologists from the City of Havana, 50 dermatologists- a number very close to the universe of these experts in the province- were administered a survey of their knowledge, perceptions and practice about this parasitosis. The survey was prepared in 4 phases; that is, interviews to physicians on diagnosis, treatment and control of giardiasis; drafting of a preliminary questionnaire based on the interview results; submission of this instruments to the experts, and finally its validation through its application to a small group of physicians. it was evinced that the dermatologists in the City of Havana had poor knowledge about giardiasis, particularly its cutaneous manifestations (out of 19 questions on cognitive aspects, the correct answer mean was 10,18), inadequate perceptions on this disease and practice was not good. with the aim of mitigating these difficulties, some academic intervention is needed to make emphasis on the formative aspects related to parasitic diseases in general and giardiasis in particular

Medical Surveillance Monthly Report (MSMR). Volume 16, Number 4, April 2009

Science.gov (United States)

2009-04-01

years, sexually-transmitted infections (due to chlamydia, gonorrhea , syphilis, and nongonococcal urethritis) accounted for most (n=17,535; 87.4%) of...3 3 2 5 1 Ehrlichiosis 0 2 2 3 2 Encephalitis 3 1 0 1 0 Filariasis 1 0 0 0 0 Giardiasis 37 35 16 23 43 Gonorrhea 1,977 1,821 1,818 1,872 2,126 H. infl...0 0 E. coli O157:H7 1 2 2 2 0 Ehrlichiosis 0 2 1 2 1 Encephalitis 0 0 0 0 0 Filariasis 1 0 0 0 0 Giardiasis 21 17 11 13 17 Gonorrhea 1,398 1,501

Human infective potential of Cryptosporidium spp., Giardia duodenalis and Enterocytozoon bieneusi in urban wastewater treatment plant effluents

Data.gov (United States)

U.S. Environmental Protection Agency — Cryptosporidiosis, giardiasis, and microsporidiosis are important waterborne diseases. In the standard for wastewater treatment plant (WWTP) effluents in China and...

A review of sexually transmitted diseases (STDs) of parasitic origin ...

African Journals Online (AJOL)

STORAGESEVER

2008-12-29

Dec 29, 2008 ... damage, cancer, heart disease, infertility and other ab- normalities of the reproductive system, ... TRANSMISSION OF GIARDIASIS THROUGH SEX. Established and more ... through the faeco-anal-oral route and transmission.

Ascariasis (For Parents)

Science.gov (United States)

... be checked for other intestinal parasites, such as pinworm. Home Treatment If your child has ascariasis, the ... Ova and Parasites (O&P) Tapeworm Toxoplasmosis Giardiasis Pinworm Salmonella Infections Pinworms Hand Washing Tapeworm Cholera Salmonellosis ...

Identification of Zoonotic Genotypes of Giardia duodenalis

DEFF Research Database (Denmark)

Sprong, H.; Cacciò, S.M.; van der Giessen, J.W.B

2009-01-01

Giardia duodenalis, originally regarded as a commensal organism, is the etiologic agent of giardiasis, a gastrointestinal disease of humans and animals. Giardiasis causes major public and veterinary health concerns worldwide. Transmission is either direct, through the faecal-oral route, or indirect......, through ingestion of contaminated water or food. Genetic characterization of G. duodenalis isolates has revealed the existence of seven groups (assemblages A to G) which differ in their host distribution. Assemblages A and B are found in humans and in many other mammals, but the role of animals......, mixtures of genotypes in individual isolates were repeatedly observed. Possible explanations are the uptake of genetically different Giardia cysts by a host, or subsequent infection of an already infected host, likely without overt symptoms, with a different Giardia species, which may cause disease. Other...

Human infective potential of Cryptosporidium spp., Giardia duodenalis and Enterocytozoon bieneusi in urban wastewater treatment plant effluents

Science.gov (United States)

Cryptosporidiosis, giardiasis, and microsporidiosis are important waterborne diseases. In the standard for wastewater treatment plant (WWTP) effluents in China and other countries, fecal coliform is the only microbial indicator, raising concerns about the potential for pathogen t...

76 FR 51376 - Government-Owned Inventions; Availability for Licensing

Science.gov (United States)

2011-08-18

... Computed Tomography Description of Technology: Vertebral fractures due to osteoporosis result in loss of... humanization required. Highly potent neutralizing antibodies. Biological materials available. Development Stage...; [email protected] . Methods of Treating Giardiasis Using FDA-Approved Compounds Description of...

[Helminthiasis in children--possible variants of symbiosis].

Science.gov (United States)

Kucheria, T V

2010-01-01

protozoal diseases and helminthiases are an essential part of infectious diseases. The massive spread of parasitic diseases had been identified in all regions of the world, including in children., number of suffering from parasitic infections exceeds 20 million and has a tendency to increase in Russia. The magnitude of damage to people's health, intestinal helminthiases are among the four leading causes of all diseases. under the supervision was a child with mixed-infestation of 7 helminths and parasites: enterobiosis + giardiasis, enterobiosis + ascariasis, ascariasis + trihotsefalez; enterobiosis giardiasis + toxocariasis. the case is of interest to clinicians and pediatricians in terms of diagnosis, because the helminthiasis was proceeded under the guise of somatic diseases associated with severe visceral injuries. Highlight helminthiasis on the stage of mixed-infestation among several helminths and parasites indicates a lack of pediatricians' alertness on parasitosis.

Gastrointestinal helminthiasis presenting with acute diarrhoea and constipation: report of two cases with a second pathology.

Science.gov (United States)

Sobani, Z A; Shakoor, S; Malik, F N; Malik, E Z; Beg, M A

2010-08-01

Gastrointestinal helminthiasis in developing countries contributes to malnutrition and anemia. Diagnosis and treatment of helminthiasis, especially with low worm load is an unmet public health need in such settings. The infection may sometimes become manifest when a second pathology leads to purgation of the gastrointestinal tract. Two cases of helminthiasis are presented in which the infections only became amenable to diagnosis due to acute diarrhoea caused by giardiasis and lactulose administration. In the first case, acute giardiasis revealed Ascaris lumbricoides infestation, and in the second case primary helminthiasis (strongyloidiasis) was revealed by lactulose, and also led to Vibrio cholera bacteremia. These cases highlight the need to diagnose helminth infestations especially with low worm burdens by means of public health surveillance programmes. These cases highlight the need to diagnose helminth infestations especially with low worm burdens by means of public health surveillance programmes.

Prevalence of Entamoeba histolytica , Giardia lamblia , and ...

African Journals Online (AJOL)

Introduction: The intestinal protozoa Entamoeba histolytica, Giardia lamblia, and Cryptosporidium spp. are the causative agents of giardiasis, amebiasis, and cryptosporidiosis, respectively. Adequate knowledge of the geographical distribution of parasites and the demographic variables that influence their prevalence is ...

Protection against diarrhea associated with Giardia intestinalis is lost with Multi-Nutrient Supplementation: A Study in Tanzanian Children

NARCIS (Netherlands)

Veenemans, J.; Mank, T.; Ottenhof, M.; Baidjoe, A.Y.; Mbugi, E.V.; Demir, A.Y.; Wielders, J.P.M.; Savelkoul, H.F.J.; Verhoef, J.C.M.

2011-01-01

Background - Asymptomatic carriage of Giardia intestinalis is highly prevalent among children in developing countries, and evidence regarding its role as a diarrhea-causing agent in these settings is controversial. Impaired linear growth and cognition have been associated with giardiasis, presumably

Cryptosporidium and Giardia: new challenges to the water industry

NARCIS (Netherlands)

Medema, Gerriet Jan

1999-01-01

The protozoan parasites Cryptosporidium parvum and Giardia intestinalis have emerged as significant waterborne pathogens over the past decades. Many outbreaks of waterborne cryptosporidiosis and giardiasis have been recorded,primarily in the United States and the United Kingdom.Chapter 1 gives an

Click Chemistry-Facilitated Structural Diversification of Nitrothiazoles, Nitrofurans, and Nitropyrroles Enhances Antimicrobial Activity against Giardia lamblia

Science.gov (United States)

Kim, Wan Jung; Korthals, Keith A.; Li, Suhua; Le, Christine; Kalisiak, Jarosław; Sharpless, K. Barry; Fokin, Valery V.; Miyamoto, Yukiko

2017-01-01

ABSTRACT Giardia lamblia is an important and ubiquitous cause of diarrheal disease. The primary agents in the treatment of giardiasis are nitroheterocyclic drugs, particularly the imidazoles metronidazole and tinidazole and the thiazole nitazoxanide. Although these drugs are generally effective, treatment failures occur in up to 20% of cases, and resistance has been demonstrated in vivo and in vitro. Prior work had suggested that side chain modifications of the imidazole core can lead to new effective 5-nitroimidazole drugs that can combat nitro drug resistance, but the full potential of nitroheterocycles other than imidazole to yield effective new antigiardial agents has not been explored. Here, we generated derivatives of two clinically utilized nitroheterocycles, nitrothiazole and nitrofuran, as well as a third heterocycle, nitropyrrole, which is related to nitroimidazole but has not been systematically investigated as an antimicrobial drug scaffold. Click chemistry was employed to synthesize 442 novel nitroheterocyclic compounds with extensive side chain modifications. Screening of this library against representative G. lamblia strains showed a wide spectrum of in vitro activities, with many of the compounds exhibiting superior activity relative to reference drugs and several showing >100-fold increase in potency and the ability to overcome existing forms of metronidazole resistance. The majority of new compounds displayed no cytotoxicity against human cells, and several compounds were orally active against murine giardiasis in vivo. These findings provide additional impetus for the systematic development of nitroheterocyclic compounds with nonimidazole cores as alternative and improved agents for the treatment of giardiasis and potentially other infectious agents. PMID:28396548

Click Chemistry-Facilitated Structural Diversification of Nitrothiazoles, Nitrofurans, and Nitropyrroles Enhances Antimicrobial Activity against Giardia lamblia.

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Kim, Wan Jung; Korthals, Keith A; Li, Suhua; Le, Christine; Kalisiak, Jarosław; Sharpless, K Barry; Fokin, Valery V; Miyamoto, Yukiko; Eckmann, Lars

2017-06-01

Giardia lamblia is an important and ubiquitous cause of diarrheal disease. The primary agents in the treatment of giardiasis are nitroheterocyclic drugs, particularly the imidazoles metronidazole and tinidazole and the thiazole nitazoxanide. Although these drugs are generally effective, treatment failures occur in up to 20% of cases, and resistance has been demonstrated in vivo and in vitro Prior work had suggested that side chain modifications of the imidazole core can lead to new effective 5-nitroimidazole drugs that can combat nitro drug resistance, but the full potential of nitroheterocycles other than imidazole to yield effective new antigiardial agents has not been explored. Here, we generated derivatives of two clinically utilized nitroheterocycles, nitrothiazole and nitrofuran, as well as a third heterocycle, nitropyrrole, which is related to nitroimidazole but has not been systematically investigated as an antimicrobial drug scaffold. Click chemistry was employed to synthesize 442 novel nitroheterocyclic compounds with extensive side chain modifications. Screening of this library against representative G. lamblia strains showed a wide spectrum of in vitro activities, with many of the compounds exhibiting superior activity relative to reference drugs and several showing >100-fold increase in potency and the ability to overcome existing forms of metronidazole resistance. The majority of new compounds displayed no cytotoxicity against human cells, and several compounds were orally active against murine giardiasis in vivo These findings provide additional impetus for the systematic development of nitroheterocyclic compounds with nonimidazole cores as alternative and improved agents for the treatment of giardiasis and potentially other infectious agents. Copyright © 2017 American Society for Microbiology.

Antiprotozoal activity of extracts of Elaeodendron trichotomum ...

African Journals Online (AJOL)

Background: Chagas disease, amebiasis, giardiasis and trichomoniasis represent a serious health problem in Latin America. The drugs employed to treat these illnesses produce important side effects and resistant strains have appeared. The present study was aimed to evaluate the antiprotozoal activity of leaves, stem ...

Evaluation of Military Field-Water Quality. Volume 5. Infectious Organisms of Military Concern Associated with Consumption: Assessment of Health Risks, and Recommendations for Establishing Related Standards

Science.gov (United States)

1986-02-01

influence duration, incidence, and severity of giardiasis.44 Acquired resistance in mice to Giardia muris has been demonstrated. 4 2 ’ 4 5 Human milk...ntaamoeba histoletica ........ ....................... 65 Giardia lamblia ............. ......................... 66 Summary- Ri•k-Assessment Results...Concentration in the Environment ......... .................. .. 227 References ................. ............................ .. 228 2. Giardia lamblia

Deconjugated bile salts produced by extracellular bile-salt hydrolase-like activities from the probiotic Lactobacillus johnsonii La1 inhibit Giardia duodenalis in vitro growth

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Marie-Agnès Travers

2016-09-01

Full Text Available Giardiasis, currently considered a neglected disease, is caused by the intestinal protozoan parasite Giardia duodenalis and is widely spread in human as well as domestic and wild animals. The lack of appropriate medications and the spread of resistant parasite strains urgently call for the development of novel therapeutic strategies. Host microbiota or certain probiotic strains have the capacity to provide some protection against giardiasis. By combining biological and biochemical approaches, we have been able to decipher a molecular mechanism used by the probiotic strain Lactobacillus johnsonii La1 to prevent Giardia growth in vitro. We provide evidence that the supernatant of this strain contains active principle(s not directly toxic to Giardia but able to convert non-toxic components of bile into components highly toxic to Giardia. By using bile acid profiling, these components were identified as deconjugated bile-salts. A bacterial bile-salt-hydrolase of commercial origin was able to mimic the properties of the supernatant. Mass spectrometric analysis of the bacterial supernatant identified two of the three bile-salt-hydrolases encoded in the genome of this probiotic strain. These observations document a possible mechanism by which L. johnsonii La1, by secreting or releasing BSH-like activity(ies in the vicinity of replicating Giardia in an environment where bile is present and abundant, can fight this parasite. This discovery has both fundamental and applied outcomes to fight giardiasis, based on local delivery of deconjugated bile salts, enzyme deconjugation of bile components, or natural or recombinant probiotic strains that secrete or release such deconjugating activities in a compartment where both bile salts and Giardia are present.

Severity of Giardia infection associated with post-infectious fatigue and abdominal symptoms two years after

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Rortveit Guri

2009-12-01

Full Text Available Abstract Background A high rate of post-infectious fatigue and abdominal symptoms two years after a waterborne outbreak of giardiasis in Bergen, Norway in 2004 has previously been reported. The aim of this report was to identify risk factors associated with such manifestations. Methods All laboratory confirmed cases of giardiasis (n = 1262 during the outbreak in Bergen in 2004 received a postal questionnaire two years after. Degree of post-infectious abdominal symptoms and fatigue, as well as previous abdominal problems, was recorded. In the statistical analyses number of treatment courses, treatment refractory infection, delayed education and sick leave were used as indices of protracted and severe Giardia infection. Age, gender, previous abdominal problems and symptoms during infection were also analysed as possible risk factors. Simple and multiple ordinal logistic regression models were used for the analyses. Results The response rate was 81% (1017/1262, 64% were women and median age was 31 years (range 3-93, compared to 61% women and 30 years (range 2-93 among all 1262 cases. Factors in multiple regression analysis significantly associated with abdominal symptoms two years after infection were: More than one treatment course, treatment refractory infection, delayed education, bloating and female gender. Abdominal problems prior to Giardia infection were not associated with post-infectious abdominal symptoms. More than one treatment course, delayed education, sick leave more than 2 weeks, and malaise at the time of infection, were significantly associated with fatigue in the multiple regression analysis, as were increasing age and previous abdominal problems. Conclusion Protracted and severe giardiasis seemed to be a risk factor for post-infectious fatigue and abdominal symptoms two years after clearing the Giardia infection.

A review of sexually transmitted diseases (STDs) of parasitic origin ...

African Journals Online (AJOL)

fore a now recognized mode of transmission – sexual contact. This in turn has led to giardiasis being classified as a sexually transmitted disease by the Centre for Disease Control and Prevention (CDC) in the United States. This review identifies its occurrence mainly in homosexual populations of the developed world ...

Prevalence of Giardia duodenalis and Cryptosporidium species infections among children and cattle in North Shewa Zone, Ethiopia.

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Wegayehu, Teklu; Adamu, Haileeyesus; Petros, Beyene

2013-09-08

Giardia and Cryptosporidium are the most common causes of protozoan diarrhea that lead to significant morbidity and mortality worldwide. The purpose of this study was to determine the prevalence of Giardia duodenalis and Cryptosporidium species infections among children and cattle, and to assess the potential risk of zoonotic transmission. This cross-sectional study was conducted between January and April 2009 in Girar Jarso and Dera Districts of North Shewa Zone, Oromia Region, Ethiopia. A total of 768 stool specimens were collected and examined for intestinal parasites using direct wet mount with saline and formalin ether concentration methods. The modified Ziehl-Neelsen staining method was used for the detection of Cryptosporidium species. Statistical analysis was performed using SPSS software version 15. Out of 384 children examined, 53 (13.8%) and 28 (7.3%) were positive for Giardia and Cryptosporidium infections, respectively. Similarly, of the total 384 cattle examined, 9 (2.3%) were positive for Giardia duodenalis and 30 (7.8%) were positive for Cryptosporidium infection. The prevalence of giardiasis was significantly higher among children who had close contact with cattle 33 (18.7%) compared to children who had no contact with cattle 20 (9.6%) (P < 0.05). Higher number of Cryptosporidium infection was also recorded in children who had close contact with cattle 15 (8.5%). Difference in prevalence of giardiasis and cryptosporidiosis among children was not statistically significant between males and females. On the other hand, difference in the prevalence of giardiasis among children was statistically significant between age groups. Higher prevalence of Giardia duodenalis infection detected among children was significantly associated with contact with cattle and manure that the children had. Further analysis using molecular techniques is needed to explain the existence of zoonotic transmission in the study area.

Intestinal microsporidiosis in renal transplant recipients: Prevalence, predictors of occurrence and genetic characterization

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U Ghoshal

2015-01-01

Full Text Available Purpose: Intestinal microsporidiosis, which occurs in immunocompromised states such as acquired immunodeficiency syndrome, has rarely been studied in patients with renal transplantation (RT on immunosuppressive therapy. Materials and Methods: Three hundred and twenty-four consecutive RT recipients on immunosuppressive treatment and 170 healthy subjects were evaluated for intestinal microsporidiosis and other parasites by modified trichrome staining, wet mount using normal saline, iodine and polymerase chain reaction (PCR. Clinical, demographic and laboratory parameters associated with occurrence of intestinal microsporidiosis were studied using univariate and multivariate analysis. The species of microsporidia were studied using PCR-restriction fragment length polymorphism (RFLP. Patients were treated with albendazole (400 mg twice daily for 2 weeks. Results: Of 324 RT recipients initially screened, 52 were excluded from final analysis due to incomplete data. Patients with RT [n = 272, age 42 ± 12.54 years, 222 (81.6% male] more often had microsporidiosis than healthy subjects by modified trichrome stain and PCR [n = 170, age 33.8 ± 6.7 years, 123 (72.3% male] [16/272 (5.8% vs. 0/170 (0%, P < 0.001]. Patients with intestinal microsporidiosis were younger (33.9 ± 8.3 years vs. 42.3 ± 12.6 years; P = 0.009, had diarrhoea more often (13/16, 81% vs. 123/256, 48%; P = 0.02, which was longer in duration (60, 32.5-105 days vs. 12, 6.2-18 days; P < 0.001 and had associated giardiasis (2/16, 12.5% vs. 2/256, 0.8%; P = 0.018. Younger age, presence of diarrhoea and associated giardiasis were significant on multivariate analysis. Enterocytozoon bieneusi was detected in 15/16 (93% patients with intestinal microsporidiosis. Conclusion: Intestinal microsporidiosis occurs frequently in patients with RT on immunosuppressive treatment, particularly among younger patients with longer diarrhoea duration and associated giardiasis. E. bieneusi is the major

Effect of Giardia infection on growth and psychomotor development of children aged 0-5 years.

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Simsek, Z; Zeyrek, F Yildiz; Kurcer, M A

2004-04-01

Giardiasis, an intestinal protozoan infection caused by Giardia intestinalis, is common in southeastern Anatolia, Turkey. In this cross-sectional survey, to investigate the role of giardiasis on growth and psychomotor development, we studied 160 children aged 0-5 years. Data were collected using a structured questionnaire, anthropometry, Ankara Developmental Screening Inventory, and laboratory analysis of fecal samples. The results showed that 50 per cent of the subjects were infected with at least one pathogen of intestinal parasitic infections. Giardia intestinalis was the most frequent pathogenic parasite. Giardia-infected children had a risk for stunted (OR = 7.67, 95 per cent CI = 2.25-26.16; p = 0.001) and poor psychomotor development (OR = 2.68, 95 per cent CI = 1.09-6.58; p = 0.030). The data indicate that Giardia intestinalis infection has an adverse impact on child linear growth and psychomotor development. In the primary healthcare centers, during the programme of the monitoring growth and developmental status of children, following children in terms of Giardia, diagnosis and treatment will have a positive effect on child health.

Saliva and sera IgA and IgG in Egyptian Giardia-infected children.

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El-Gebaly, Naglaa Saad M; Halawa, Eman Fawzy; Moussa, Hanaa M Ezzat; Rabia, Ibrahim; Abu-Zekry, Maha

2012-08-01

Giardiasis is a gastrointestinal infection of wide distribution that is more prevalent in childhood. Easy and rapid diagnosis of giardiasis is essential for reduction of this infection. This cross-sectional study included 62 children in which collection of saliva, stool and serum samples was performed. An enzyme-linked immunosorbent assay (ELISA) technique was evaluated to detect IgA and IgG responses in both saliva and serum samples. Twenty-two children were positive for Giardia duodenalis infection by direct examination of faecal specimens, 20 non-infected and 20 infected with other parasites. Salivary and serum IgA and IgG responses against G. duodenalis infection were significantly higher in Giardia parasitized than non-Giardia parasitized children (p < 0.001). This concludes that specific salivary IgA may serve as a diagnostic tool and specific salivary IgG as a screening tool in monitoring the exposure of various populations to Giardia duodenalis. The advantage of salivary assays over serum immunoglobulin assay is being easy and non-invasive in sampling technique which is important especially for young children.

Plants and chemical constituents with giardicidal activity

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Flavia M.M. Amaral

Full Text Available Intestinal infection caused by Giardia lamblia represents a serious public health problem, with increased rates of prevalence in numerous countries. Increased resistance of the parasite and the side-effects of the reference drugs employed in the treatment of giardiasis make necessary to seek new therapeutic agents. Natural products, especially of plant origin, represent excellent starting point for research. The objective of this study is to review the literature on plant extracts, fractions and chemical constituents whose giardicidal activity has been investigated in vitro. The review describes 153 (one hundred and fifty-three plant species from 69 (sixty-nine families that were evaluated for their giardicidal activity. The geographical distribution of the plant species, the part used, preparation, strain of Giardia lamblia tested and the results obtained by the authors are also given. One hundred and one compounds isolated from plant species, classified by chemical class, are presented. Recent aspects of research on natural products of plant origin employed in the treatment of giardiasis are also discussed.

Burden of Disease Attributed to Waterborne Transmission of Selected Enteric Pathogens, Australia, 2010.

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Gibney, Katherine B; O'Toole, Joanne; Sinclair, Martha; Leder, Karin

2017-06-01

AbstractUniversal access to safe drinking water is a global priority. To estimate the annual disease burden of campylobacteriosis, nontyphoidal salmonellosis, cryptosporidiosis, giardiasis, and norovirus attributable to waterborne transmission in Australia, we multiplied regional World Health Organization (WHO) estimates of the proportion of cases attributable to waterborne transmission by estimates of all-source disease burden for each study pathogen. Norovirus was attributed as causing the most waterborne disease cases (479,632; 95% uncertainty interval [UI]: 0-1,111,874) followed by giardiasis and campylobacteriosis. The estimated waterborne disability-adjusted life year (DALY) burden for campylobacteriosis (2,004; 95% UI: 0-5,831) was 7-fold greater than other study pathogens and exceeded the WHO guidelines for drinking water quality (1 × 10 -6 DALY per person per year) by 90-fold. However, these estimates include disease transmitted via either drinking or recreational water exposure. More precise country-specific and drinking water-specific attribution estimates would better define the health burden from drinking water and inform changes to treatment requirements.

Quantitative microbial risk assessment of Cryptosporidium and Giardia in well water from a native community of Mexico.

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Balderrama-Carmona, Ana Paola; Gortáres-Moroyoqui, Pablo; Álvarez-Valencia, Luis Humberto; Castro-Espinoza, Luciano; Balderas-Cortés, José de Jesús; Mondaca-Fernández, Iram; Chaidez-Quiroz, Cristóbal; Meza-Montenegro, María Mercedes

2015-01-01

Cryptosporidium and Giardia are gastrointestinal disease-causing organisms transmitted by the fecal-oral route, zoonotic and prevalent in all socioeconomic segments with greater emphasis in rural communities. The goal of this study was to assess the risk of cryptosporidiosis and giardiasis of Potam dwellers consuming drinking water from communal well water. To achieve the goal, quantitative microbial risk assessment (QMRA) was carried out as follows: (a) identification of Cryptosporidium oocysts and Giardia cysts in well water samples by information collection rule method, (b) assessment of exposure to healthy Potam residents, (c) dose-response modelling, and (d) risk characterization using an exponential model. All well water samples tested were positive for Cryptosporidium and Giardia. The QMRA results indicate a mean of annual risks of 99:100 (0.99) for cryptosporidiosis and 1:1 (1.0) for giardiasis. The outcome of the present study may drive decision-makers to establish an educational and treatment program to reduce the incidence of parasite-borne intestinal infection in the Potam community, and to conduct risk analysis programs in other similar rural communities in Mexico.

Occurrence and quantitative microbial risk assessment of Cryptosporidium and Giardia in soil and air samples

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Ana Paola Balderrama-Carmona

2014-09-01

Conclusions: Soil and air inhalation and/or ingestion are important vehicles for these parasites. To our knowledge, the results obtained in the present study represent the first QMRAs for cryptosporidiosis and giardiasis due to soil and air inhalation/ingestion in Mexico. In addition, this is the first evidence of the microbial air quality around these parasites in rural zones.

Association between Whipple's disease and Giardia lamblia infection Asociación de enfermedad de Whipple e infección por Giardia lamblia

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J. A. Gil Ruiz

2005-07-01

Full Text Available Whipple'disease is mainly characterized by affecting the digestive system, although it can be a multisystemic process with different clinical symptoms. The bacillus causing the disease has been isolated and cultivated in 2000 and the genome sequence has been recently analyzed in 2003, which means new perspectives for its diagnosis and treatment. Giardiasis is an infestation caused by a protozoo and may cause a malabsorption syndrome or run in a subclinic way. The case of a middle-aged male is described, who after a three-year period of migratory arthralgias, showed weight loss, diarrheas and abdominal pain, being diagnosed of Giardiasis, and after the persistent symptoms and a number of studies, was diagnosed with Whipple disease. Nineteen cases of Giardia-Whipple coinfection have been described in the literature, but the reason of this association has not been found yet. The discussion on whether there is an alteration in the inmunitary system which facilitates infections or, the development of an infection lead to the other one, goes on.La enfermedad de Whipple se caracteriza por afectar principalmente al aparato digestivo, aunque puede ser un proceso multisistémico con variadas manifestaciones clínicas. En el año 2000 se ha conseguido aislar y cultivar el bacilo causante y recientemente, en el 2003, se ha analizado la secuencia completa del genoma, lo que supone nuevas perspectivas para el diagnóstico y el tratamiento. La giardiasis es una infección originada por un protozoo que puede evolucionar de forma subclínica o dar lugar a un síndrome de malabsorción. Describimos el caso de un paciente varón de mediana edad, que tras un periodo de tres años de artralgias migratorias en articulaciones periféricas, presentó un cuadro de pérdida de peso, con aumento del número de deposiciones y molestias abdominales siendo diagnosticado de Giardiasis y ante la persistencia de los síntomas y la posterior realización de diferentes estudios

Factores de riesgo de la infección por Giardia lamblia en niños de guarderías infantiles de Ciudad de La Habana, Cuba Risk factors for Giardia lamblia in children in daycare centers in Havana, Cuba

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Fidel Ángel Núñez

2003-04-01

Full Text Available En un estudio longitudinal sobre giardiasis desarrollado durante 18 meses en tres guarderías infantiles de Ciudad de La Habana, describimos un grupo de niños con tendencia o "predisposición" a la infección por Giardia lamblia; a los que se les encontró con síntomas clínicos más asociados a las diarreas. Este estudio de casos y controles se desarrolló para conocer si algunos factores socioeconómicos y hábitos higiénicos estaban asociados con este fenómeno. No se encontraron diferencias entre ambos grupos en las tasas de hacinamiento, el índice de personas por cama, en la carencia de determinados equipos eléctricos, en el nivel escolar de las madres, y en el promedio del ingreso familiar; sin embargo, predominó una frecuencia mayor de padres con nivel escolar menor de 12 grado en los casos que en los controles. No se encontraron diferencias entre ambos grupos en cuanto a la ausencia de lavado de manos antes de comer y después de defecar, pero se encontró un mayor porcentaje de lavado incorrecto de vegetales, y una menor frecuencia del hábito de hervir el agua de consumo en las familias de los casos. Estos resultados demuestran el papel del agua como vehículo de transmisión en la giardiasis y la importancia de algunos factores epidemiológicos.We conducted a longitudinal study on giardiasis in three daycare centers in Havana City for a period of 18 months and described a group of children with a "predisposition" or tendency towards re-infection with Giardia lamblia. This group was found to be more frequently associated with clinical symptoms such as diarrhea. A case-control study was designed to determine whether socioeconomic factors and hygiene were associated with this phenomenon. We found no differences between the groups with regard to overcrowding rates, number of persons per bed, absence of certain electric appliances, mother's schooling, or mean family income. However, there were proportionally more fathers with less

Tratamiento de la giardiasis por el clorhidrato de cloroguanida

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Alberto Albornoz Plata

1950-05-01

Full Text Available Este trabajo experimental se refiere al empleo de una droga antimalárica, la cloroguanida (clorhidrato o paludrina en individuos parasitados por giardias; se hizo este estudio al observar que otras droga antimaláricas como la (Atebrina y Cloroquina tienen alguna acción sobre este parásito intestinal. Las personas que sirvieron para esta experiencia son todas pacientes que acuden a las Consultas de Prenatal y Pediatría del Centro de Higiene Modelo del Barrio Ricaurte, dependencia que mantiene en Bogotá el Servicio Cooperativo Interamericano de Salud Pública. Este Centro de Higiene controla en la Zona VI de Bogotá, unos 55.000 habitantes; casi todos pertenecen a la clase media y obrera; las condiciones sanitarias de esta Zona de la ciudad (agua, alcantarillado son bastante aceptables, pero seguramente el suministro y preparación de los alimentos en general, cuenta con fallas higiénicas.

Genome and transcriptome studies of the protozoan parasites Trypanosoma cruzi and Giardia intestinalis

OpenAIRE

Franzén, Oscar

2012-01-01

Trypanosoma cruzi and Giardia intestinalis are two human pathogens and protozoan parasites responsible for the diseases Chagas disease and giardiasis, respectively. Both diseases cause su ering and illness in several million individuals. The former disease occurs primarily in South America and Central America, and the latter disease occurs worldwide. Current therapeutics are toxic and lack e cacy, and potential vaccines are far from the market. Increased knowledge about the bio...

Challenges in developing methods for quantifying the effects of weather and climate on water-associated diseases: A systematic review

OpenAIRE

Lo Iacono, Giovanni; Armstrong, Ben; Fleming, Lora E.; Elson, Richard; Kovats, Sari; Vardoulakis, Sotiris; Nichols, Gordon L.

2017-01-01

Infectious diseases attributable to unsafe water supply, sanitation and hygiene (e.g. Cholera, Leptospirosis, Giardiasis) remain an important cause of morbidity and mortality, especially in low-income countries. Climate and weather factors are known to affect the transmission and distribution of infectious diseases and statistical and mathematical modelling are continuously developing to investigate the impact of weather and climate on water-associated diseases. There have been little critica...

Molecular characterization of Giardia duodenalis in Yemen.

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Alyousefi, Naela A; Mahdy, Mohammed A K; Xiao, Lihua; Mahmud, Rohela; Lim, Yvonne A L

2013-06-01

Giardia duodenalis is an important intestinal protozoan in Yemen with infection rates ranging from 18% to 27%. To date, there has been no genotyping study to provide a better understanding of the transmission dynamic. This study was conducted to genotype and subtype G. duodenalis in Yemen. Stool samples were collected from 503 Yemeni outpatients between 1 and 80 years old, including 219 males and 284 females. Giardia cysts were detected via microscopy after the formal-ether concentration. Genotyping of Giardia was carried out using PCR and sequence analysis of the 16s rRNA and b-giardin genes. Of the 89 microscopy-positive Giardia samples, 65 were successfully sequenced, of which 66% (43 of 65) were identified as G. duodenalis assemblage A and 34% (22 of 65) as assemblage B. Further subtyping analysis based on b-giardin gene identified the presence of subtypes A2 and A3, which belong to the anthroponotic sub-assemblage AII. Data of the study suggest that anthroponotic transmission played a potential role in the transmission of giardiasis in the community. However, further genotyping and subtyping studies of specimens from humans and animals living in the same households are needed for a more definitive understanding of giardiasis transmission in Yemen. Copyright © 2013 Elsevier Inc. All rights reserved.

Prevalence of Helicobacter pylori and parasites in symptomatic children examined for Helicobacter pylori antibodies, antigens, and parasites in Yemen.

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Bin Mohanna, Mabrook A; Al-Zubairi, Lutf M; Sallam, Abdul K

2014-11-01

To estimate the prevalence of Helicobacter pylori (H. pylori) and parasites in symptomatic children examined for H. pylori antibodies, antigens, and parasites in Yemen. A record-based study was carried out at Specialized Sam Pediatric Center in Sana'a, Yemen for 3 years between 2011-2013. Out of the 43,200 patients seen for different causes through that period, 1008 (2.3%) (females: 675 [67%]; males: 333 [33%]) had gastric complaints, and were subjected to an examination of blood and stool for H. pylori and parasites. Data regarding age and gender was also collected. The age of the patients ranged from 3-15 years. The prevalence of H. pylori among children examined for H. pylori was 65%, 30% of them were males, and 35% were females (chi square [I2]=142, p<0.01]). The prevalence in the 6-8 years age group was 83%, and it was 52% in the age group of 12-15 years. The prevalence of giardiasis was 10%, and amoebiasis was 25%. Prevalence of H. pylori infection among children was high, and was more prevalent in the age group of 6-8 years than in the other age groups. Females were more affected than males. Parasites (amoebiasis and giardiasis) infestation was less prevalent.

High occurrence of giardiasis in children living on a 'landless farm workers' settlement in Araras, São Paulo, Brazil Alta ocorrência de giardíase em crianças do Assentamento Sem Terra, Araras, São Paulo, Brasil

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Oswaldo Aparecido de Lima Junior

2013-06-01

Full Text Available Enteric parasitosis remains an important public health problem in many areas around the world including in Brazil, and it is frequently associated with poverty and lack of sanitation facilities. Research carried out over the course of a year revealed that 96.6% (28/29 of children randomly selected from a 'landless farm workers' settlement in Araras, São Paulo, aged 4 - 15 years, presented Giardia intestinalis cysts. After referral to the neighborhood Health Office, all the children received tinidazole, given as a single dose of 50 mg/kg and 12 months later, new fecal samples were collected and analyzed. Despite the low adherence to the study, a high percentage (64.3% - 9/14 of the children remained positive for the parasite. This study showed a high positivity of giardiasis in child residents of the settlement, even after treatment; adults were not sensitized to the study and did not collected and/or deliver children fecal samples. The precarious living conditions are consistent with a high susceptibility to parasitic diseases, suggesting that the treatment of the infected individuals without identifying and eradicating the means of contamination is simply a palliative measure.Enteroparasitoses continuam a ser um importante problema de saúde pública em muitas áreas ao redor do mundo, bem como no Brasil, e está frequentemente associada com a pobreza e à falta de saneamento básico. Pesquisa realizada em um ano revelou que 96,6% (28/29 das crianças com idades entre quatro e 15 anos, recrutadas aleatoriamente no Assentamento Sem Terra em Araras, São Paulo, apresentaram cistos de Giardia intestinalis. Após o encaminhamento ao Posto de Saúde do bairro, todos receberam tinidazol, dose única de 50 mg/kg. Após 12 meses, novas amostras de fezes foram coletadas e analisadas. Apesar da baixa adesão ao estudo, um percentual elevado (64,3% - 9/14 de crianças permaneceu positivo para o protozoário. Este estudo mostrou alta positividade de giard

Echinococcosis and other parasitic infections in domestic dogs from urban areas of an argentinean Patagonian city

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Flores, Verónica; Viozzi, Gustavo; Garibotti, Gilda; Zacharias, Daniela; Debiaggi, María Florencia; Kabaradjian, Surpik

2017-01-01

In urban populations of South America, dogs with free access to public areas represent a public health concern. The primary consequence of roaming dogs on human health is the transmission of infectious and parasitic diseases mainly through feces contamination. The main diseases likely to be transmitted are hydatidosis or echinococcosis, larva migrans, and giardiasis. In Argentina, hydatidosis ranks among the most prevalent zoonosis. Although it is considered a rural disease, the circulation o...

The effect of irrigated urban agriculture on malaria, schistosomiasis and soil-transmitted helminthiasis in different settings of Côte d'Ivoire

OpenAIRE

Matthys, Barbara

2006-01-01

Malaria is responsible for more than one million deaths every year, mainly children under the age of five years living in sub-Saharan Africa. At least one billion people harbor one or several of the three main soil-transmitted helminths, namely Ascaris lumbricoides, hookworms and Trichuris trichiura, and about 207 million people are infected with schistosomes. An estimated 70,000 people die each year from amoebiasis, caused by Entamoeba histolytica. Giardiasis, caused by Giardia duodenalis, i...

Intestinal infection with Giardia spp. reduces epithelial barrier function in a myosin light chain kinase-dependent fashion.

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Scott, Kevin G-E; Meddings, Jonathon B; Kirk, David R; Lees-Miller, Susan P; Buret, André G

2002-10-01

Giardiasis causes malabsorptive diarrhea, and symptoms can be present in the absence of any significant morphologic injury to the intestinal mucosa. The effects of giardiasis on epithelial permeability in vivo remain unknown, and the role of T cells and myosin light chain kinase (MLCK) in altered intestinal barrier function is unclear. This study was conducted to determine whether Giardia spp. alters intestinal permeability in vivo, to assess whether these abnormalities are dependent on T cells, and to assess the role of MLCK in altered epithelial barrier function. Immunocompetent and isogenic athymic mice were inoculated with axenic Giardia muris trophozoites or sterile vehicle (control), then assessed for trophozoite colonization and gastrointestinal permeability. Mechanistic studies using nontransformed human duodenal epithelial monolayers (SCBN) determined the effects of Giardia on myosin light chain (MLC) phosphorylation, transepithelial fluorescein isothiocyanate-dextran fluxes, cytoskeletal F-actin, tight junctional zonula occludens-1 (ZO-1), and MLCK. Giardia infection caused a significant increase in small intestinal, but not gastric or colonic, permeability that correlated with trophozoite colonization in both immunocompetent and athymic mice. In vitro, Giardia increased permeability and phosphorylation of MLC and reorganized F-actin and ZO-1. These alterations were abolished with an MLCK inhibitor. Disruption of small intestinal barrier function is T cell independent, disappears on parasite clearance, and correlates with reorganization of cytoskeletal F-actin and tight junctional ZO-1 in an MLCK-dependent fashion.

Persistent G. lamblia impairs growth in a murine malnutrition model.

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Bartelt, Luther A; Roche, James; Kolling, Glynis; Bolick, David; Noronha, Francisco; Naylor, Caitlin; Hoffman, Paul; Warren, Cirle; Singer, Steven; Guerrant, Richard

2013-06-01

Giardia lamblia infections are nearly universal among children in low-income countries and are syndemic with the triumvirate of malnutrition, diarrhea, and developmental growth delays. Amidst the morass of early childhood enteropathogen exposures in these populations, G. lamblia–specific associations with persistent diarrhea, cognitive deficits, stunting, and nutrient deficiencies have demonstrated conflicting results, placing endemic pediatric giardiasis in a state of equipoise. Many infections in endemic settings appear to be asymptomatic/ subclinical, further contributing to uncertainty regarding a causal link between G. lamblia infection and developmental delay. We used G. lamblia H3 cyst infection in a weaned mouse model of malnutrition to demonstrate that persistent giardiasis leads to epithelial cell apoptosis and crypt hyperplasia. Infection was associated with a Th2-biased inflammatory response and impaired growth. Malnutrition accentuated the severity of these growth decrements. Faltering malnourished mice exhibited impaired compensatory responses following infection and demonstrated an absence of crypt hyperplasia and subsequently blunted villus architecture. Concomitantly, severe malnutrition prevented increases in B220+ cells in the lamina propria as well as mucosal Il4 and Il5 mRNA in response to infection. These findings add insight into the potential role of G. lamblia as a "stunting" pathogen and suggest that, similarly, malnourished children may be at increased risk of G. lamblia– potentiated growth decrements.

Comparison of ELISA, nested PCR and sequencing and a novel qPCR for detection of Giardia isolates from Jordan.

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Hijjawi, Nawal; Yang, Rongchang; Hatmal, Ma'mon; Yassin, Yasmeen; Mharib, Taghrid; Mukbel, Rami; Mahmoud, Sameer Alhaj; Al-Shudifat, Abdel-Ellah; Ryan, Una

2018-02-01

Little is known about the prevalence of Giardia duodenalis in human patients in Jordan and all previous studies have used direct microscopy, which lacks sensitivity. The present study developed a novel quantitative PCR (qPCR) assay at the β-giardin (bg) locus and evaluated its use as a frontline test for the diagnosis of giardiasis in comparison with a commercially available ELISA using nested PCR and sequencing of the glutamate dehydrogenase (gdh) locus (gdh nPCR) as the gold standard. A total of 96 human faecal samples were collected from 96 patients suffering from diarrhoea from 5 regions of Jordan and were screened using the ELISA and qPCR. The analytical specificity of the bg qPCR assay revealed no cross-reactions with other genera and detected all the Giardia isolates tested. Analytical sensitivity was 1 Giardia cyst per μl of DNA extract. The overall prevalence of Giardia was 64.6%. The clinical sensitivity and specificity of the bg qPCR was 89.9% and 82.9% respectively compared to 76.5 and 68.0% for the ELISA. This study is the first to compare three different methods (ELISA, bg qPCR, nested PCR and sequencing at the gdh locus) to diagnose Jordanian patients suffering from giardiasis and to analyze their demographic data. Copyright © 2018 Elsevier Inc. All rights reserved.

Asociación de enfermedad de Whipple e infección por Giardia lamblia

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Gil Ruiz, J. A.; Gil Simón, P.; Aparicio Duque, R.; Mayor Jerez, J. L.

2005-01-01

Whipple'disease is mainly characterized by affecting the digestive system, although it can be a multisystemic process with different clinical symptoms. The bacillus causing the disease has been isolated and cultivated in 2000 and the genome sequence has been recently analyzed in 2003, which means new perspectives for its diagnosis and treatment. Giardiasis is an infestation caused by a protozoo and may cause a malabsorption syndrome or run in a subclinic way. The case of a middle-aged male is...

Medical Surveillance Monthly Report (MSMR). Volume 17, Number 04, April 2010

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2010-04-01

of these factors. Sexually-transmitted infections: In 2009, as in prior years, sexually-transmitted infections (due to chlamydia, gonorrhea ...chlamydia, gonorrhea , and syphilis in 2009 were similar to those in 2008. NGU was discontinued as a notifi able medical event in 2009 (as of 31 July...arboviral 1 0 1 1 1 Filariasis 0 0 0 0 0 Giardiasis 35 16 23 49 30 Gonorrhea 1,852 1,831 1,892 2,632 2,336 H. infl uenzae, invasive 0 2 2 15 1

Giardia duodenalis Surface Cysteine Proteases Induce Cleavage of the Intestinal Epithelial Cytoskeletal Protein Villin via Myosin Light Chain Kinase.

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Amol Bhargava

Full Text Available Giardia duodenalis infections are among the most common causes of waterborne diarrhoeal disease worldwide. At the height of infection, G. duodenalis trophozoites induce multiple pathophysiological processes within intestinal epithelial cells that contribute to the development of diarrhoeal disease. To date, our understanding of pathophysiological processes in giardiasis remains incompletely understood. The present study reveals a previously unappreciated role for G. duodenalis cathepsin cysteine proteases in intestinal epithelial pathophysiological processes that occur during giardiasis. Experiments first established that Giardia trophozoites indeed produce cathepsin B and L in strain-dependent fashion. Co-incubation of G. duodenalis with human enterocytes enhanced cathepsin production by Assemblage A (NF and S2 isolates trophozoites, but not when epithelial cells were exposed to Assemblage B (GSM isolate trophozoites. Direct contact between G. duodenalis parasites and human intestinal epithelial monolayers resulted in the degradation and redistribution of the intestinal epithelial cytoskeletal protein villin; these effects were abolished when parasite cathepsin cysteine proteases were inhibited. Interestingly, inhibition of parasite proteases did not prevent degradation of the intestinal tight junction-associated protein zonula occludens 1 (ZO-1, suggesting that G. duodenalis induces multiple pathophysiological processes within intestinal epithelial cells. Finally, this study demonstrates that G. duodenalis-mediated disruption of villin is, at least, in part dependent on activation of myosin light chain kinase (MLCK. Taken together, this study indicates a novel role for parasite cathepsin cysteine proteases in the pathophysiology of G. duodenalis infections.

Epidemiology and geographical distribution of enteric protozoan infections in Sydney, Australia

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Stephanie Fletcher

2014-07-01

Full Text Available Background. Enteric protozoa are associated with diarrhoeal illnesses in humans; however there are no recent studies on their epidemiology and geographical distribution in Australia. This study describes the epidemiology of enteric protozoa in the state of New South Wales and incorporates spatial analysis to describe their distribution. Design and methods. Laboratory and clinical records from four public hospitals in Sydney for 910 patients, who tested positive for enteric protozoa over the period January 2007-December 2010, were identified, examined and analysed. We selected 580 cases which had residence post code data available, enabling us to examine the geographic distribution of patients, and reviewed the clinical data of 252 patients to examine possible links between protozoa, demographic and clinical features. Results. Frequently detected protozoa were Blastocystis spp. (57%, Giardia intestinalis (27% and Dientamoeba fragilis (12%. The age distribution showed that the prevalence of protozoa decreased with age up to 24 years but increasing with age from 25 years onwards. The geographic provenance of the patients indicates that the majority of cases of Blastocystis (53.1% are clustered in and around the Sydney City Business District, while pockets of giardiasis were identified in regional/rural areas. The distribution of cases suggests higher risk of protozoan infection may exist for some communities. Conclusions. These findings provide useful information for policy makers to design and tailor interventions to target high risk communities. Follow-up investigation into the risk factors for giardiasis in regional/rural area is needed.

Factores de riesgo de la infección por Giardia lamblia en niños de guarderías infantiles de Ciudad de La Habana, Cuba

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Fidel Ángel Núñez

Full Text Available En un estudio longitudinal sobre giardiasis desarrollado durante 18 meses en tres guarderías infantiles de Ciudad de La Habana, describimos un grupo de niños con tendencia o "predisposición" a la infección por Giardia lamblia; a los que se les encontró con síntomas clínicos más asociados a las diarreas. Este estudio de casos y controles se desarrolló para conocer si algunos factores socioeconómicos y hábitos higiénicos estaban asociados con este fenómeno. No se encontraron diferencias entre ambos grupos en las tasas de hacinamiento, el índice de personas por cama, en la carencia de determinados equipos eléctricos, en el nivel escolar de las madres, y en el promedio del ingreso familiar; sin embargo, predominó una frecuencia mayor de padres con nivel escolar menor de 12 grado en los casos que en los controles. No se encontraron diferencias entre ambos grupos en cuanto a la ausencia de lavado de manos antes de comer y después de defecar, pero se encontró un mayor porcentaje de lavado incorrecto de vegetales, y una menor frecuencia del hábito de hervir el agua de consumo en las familias de los casos. Estos resultados demuestran el papel del agua como vehículo de transmisión en la giardiasis y la importancia de algunos factores epidemiológicos.

Factores de riesgo de la infección por Giardia lamblia en niños de guarderías infantiles de Ciudad de La Habana, Cuba

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Núñez Fidel Ángel

2003-01-01

Full Text Available En un estudio longitudinal sobre giardiasis desarrollado durante 18 meses en tres guarderías infantiles de Ciudad de La Habana, describimos un grupo de niños con tendencia o "predisposición" a la infección por Giardia lamblia; a los que se les encontró con síntomas clínicos más asociados a las diarreas. Este estudio de casos y controles se desarrolló para conocer si algunos factores socioeconómicos y hábitos higiénicos estaban asociados con este fenómeno. No se encontraron diferencias entre ambos grupos en las tasas de hacinamiento, el índice de personas por cama, en la carencia de determinados equipos eléctricos, en el nivel escolar de las madres, y en el promedio del ingreso familiar; sin embargo, predominó una frecuencia mayor de padres con nivel escolar menor de 12 grado en los casos que en los controles. No se encontraron diferencias entre ambos grupos en cuanto a la ausencia de lavado de manos antes de comer y después de defecar, pero se encontró un mayor porcentaje de lavado incorrecto de vegetales, y una menor frecuencia del hábito de hervir el agua de consumo en las familias de los casos. Estos resultados demuestran el papel del agua como vehículo de transmisión en la giardiasis y la importancia de algunos factores epidemiológicos.

In vitro anti-Giardia lamblia activity of 2-aryl-3-hydroxymethyl imidazo[1,2-a]pyridines and -pyrimidines, individually and in combination with albendazole.

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Velázquez-Olvera, Stephanía; Salgado-Zamora, Héctor; Jiménez-Cardoso, Enedina; Campos-Aldrete, Maria-Elena; Pérez-González, Cuauhtémoc; Ben Hadda, Taibi

2016-03-01

Giardiasis is a major diarrheal disease found throughout the world, the causative agent being the flagellate protozoan Giardia intestinalis. Infection is more common in children than in adults. The appearance of drug resistance has complicated the treatment of several parasitic diseases, including giardiasis. Thus, the aim of this investigation was to make an in vitro evaluation of the antigiardia response of synthetic derivatives 2-aryl-3-hydroxymethylimidazo[1,2-a]pyridines 1 and -pyrimidines 2 against trophozoites of Giardia lamblia WB, in comparison with the reference drug, albendazole. Additionally, the synergistic action of albendazole in combination with each of the most active 2-aryl-3-hydroxymethyl imidazo[1,2-a]pyridines and pyrimidines was also assessed. Based on the IC50 values obtained, the best anti-Giardia activity was provided by the 3-hydroxymethyl-4-fluorophenylimidazo[1,2-a]pyrimidine derivative 2c and the corresponding imidazo[1,2-a]pyrimidine with the p-tolyl substituent 2d, followed by 2a and 2b. These four compounds showed effectiveness at a concentration similar to that of albendazole. Regarding synergism, the IC50 of the combination of albendazole with 2a, 2b or 2c gave the best anti-Giardia action, showing greater efficacy than albendazole alone. Hence, G. lamblia WB showed high susceptibility to some 2-aryl-3-hydroxymethyl imidazo[1,2-a] pyrimidines, which acted synergistically when used in combination with albendazole. Copyright © 2015 Elsevier B.V. All rights reserved.

Immunophenotyping in post-giardiasis functional gastrointestinal disease and chronic fatigue syndrome

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Hanevik Kurt

2012-10-01

Full Text Available Abstract Background A Giardia outbreak was associated with development of post-infectious functional gastrointestinal disorders (PI-FGID and chronic fatigue syndrome (PI-CFS. Markers of immune dysfunction have given conflicting results in CFS and FGID patient populations. The aim of this study was to evaluate a wide selection of markers of immune dysfunction in these two co-occurring post-infectious syndromes. Methods 48 patients, reporting chronic fatigue in a questionnaire study, were clinically evaluated five years after the outbreak and grouped according to Fukuda criteria for CFS (n=19 and idiopathic chronic fatigue (n=5 and Rome II criteria for FGIDs (n=54. 22 Giardia exposed non-fatigued individuals and 10 healthy unexposed individuals were recruited as controls. Peripheral blood lymphocyte subsets were analyzed by flow cytometry. Results In peripheral blood we found significantly higher CD8 T-cell levels in PI-FGID, and significantly lower NK-cell levels in PI-CFS patients. Severity of abdominal and fatigue symptoms correlated negatively with NK-cell levels. A tendency towards lower T-cell CD26 expression in FGID was seen. Conclusion Patients with PI-CFS and/or PI-FGID 5 years after Giardia lamblia infection showed alterations in NK-cell and CD8-cell populations suggesting a possible immunological abnormality in these conditions. We found no significant changes in other markers examined in this well-defined group of PI-CFS and PI-FGID elicited by a gastrointestinal infection. Controlling for co-morbid conditions is important in evaluation of CFS-biomarkers.

Giardia-specific cellular immune responses in post-giardiasis chronic fatigue syndrome.

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Hanevik, Kurt; Kristoffersen, Einar; Mørch, Kristine; Rye, Kristin Paulsen; Sørnes, Steinar; Svärd, Staffan; Bruserud, Øystein; Langeland, Nina

2017-01-28

The role of pathogen specific cellular immune responses against the eliciting pathogen in development of post-infectious chronic fatigue syndrome (PI-CFS) is not known and such studies are difficult to perform. The aim of this study was to evaluate specific anti-Giardia cellular immunity in cases that developed CFS after Giardia infection compared to cases that recovered well. Patients reporting chronic fatigue in a questionnaire study three years after a Giardia outbreak were clinically evaluated five years after the outbreak and grouped according to Fukuda criteria for CFS and idiopathic chronic fatigue. Giardia specific immune responses were evaluated in 39 of these patients by proliferation assay, T cell activation and cytokine release analysis. 20 Giardia exposed non-fatigued individuals and 10 healthy unexposed individuals were recruited as controls. Patients were clinically classified into CFS (n = 15), idiopathic chronic fatigue (n = 5), fatigue from other causes (n = 9) and recovered from fatigue (n = 10). There were statistically significant antigen specific differences between these Giardia exposed groups and unexposed controls. However, we did not find differences between the Giardia exposed fatigue classification groups with regard to CD4 T cell activation, proliferation or cytokine levels in 6 days cultured PBMCs. Interestingly, sCD40L was increased in patients with PI-CFS and other persons with fatigue after Giardia infection compared to the non-fatigued group, and correlated well with fatigue levels at the time of sampling. Our data show antigen specific cellular immune responses in the groups previously exposed to Giardia and increased sCD40L in fatigued patients.

Notification, an Important Neglected Essential Education for Children in Kindergartens and Primary Schools (Education about Parasitic Infections in Kindergartens

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Emad Ahmadiara

2017-09-01

Full Text Available One of the most important threats to global public health, especially in developing countries is parasitic infections. These infections are very common in children and young people especially those who kept in kindergarten and primary schools. Because of the high population density and sometimes by the lack of adequate hygiene, these places are prone to parasitic infections. Infestation causes by ectoparasites like pediculosis, water-borne protozoan infections like giardiasis and the last but not less important, helminth infection like as Oxyuris are a permanent threat for children in this places.

La atención ginecológica en niñas de 0 a 10 años

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Miguel Lugones Botell

2002-06-01

Full Text Available Se realizó un estudio retrospectivo de 150 pacientes de 0 a 10 años de edad atendidas con historias clínicas en la consulta de ginecología infantojuvenil en el municipio Playa, entre el 1ro. de septiembre de 1996 y el 30 de noviembre de 2001, y se analizaron las variables siguientes: principales motivos de consulta en relación con la edad, principales causas de leucorrea o vulvovaginitis, causas de trastornos de la pubertad y causas de dolor pelviano. Se concluyó que los principales motivos de consulta fueron la leucorrea o vulvovaginitis, los trastornos de la pubertad y el dolor pelviano. Fue la vaginosis bacteriana la principal causa de leucorrea, la telarquia precoz la principal causa de trastorno de la pubertad, y el dolor pelviano fue ocasionado en la mayoría de las niñas por giardiasis.A retrospective study of 150 patients aged 0-10 years, seen at the infant-juvenile gynecological service in Playa municipality from September 1996 to November, 2001, was made. The following variables were analyzed: main reasons for going to doctor´s in related to age, main causes of leukorrea or vulvovaginits, causes of disorders in puberty and causes of pelvic pain. It was concluded that the main reasons for going to the doctor´s were leukorrea, vulvovaginits, puberty disorders and pelvic pain. Bacterial vaginosis was the main cause of leukorrea, early telarchia was the main cause of puberty disorders whereas pelvic pain was due to giardiasis in most of the girls.

Atención Ginecológica en pediatría: Algunos resultados de nuestro trabajo

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Miguel Lugones Botell

2002-06-01

Full Text Available Se realizó un estudio descriptivo y transversal de 150 pacientes de 0 a 10 años de edad, atendidas con historias clínicas en la consulta de Ginecología Infanto Juvenil en el municipio Playa, entre el 1ro. de septiembre de 1996 y el 30 de noviembre del 2001, donde se analizaron las siguientes variables: principales motivos de consulta en relación con la edad, principales causas de leucorrea o vulvovaginitis, causas de trastornos de la pubertad y causas de dolor pelviano. Se concluye que los principales motivos de consulta fueron la leucorrea o vulvovaginitis, los trastornos de la pubertad y el dolor pelviano, y las principales causas de éstas fueron la vaginosis bacteriana como principal causa de leucorrea; la telarquia precoz, en el trastorno de la pubertad y la giardiasis, en el dolor pelviano en la mayoría de las niñas.A descriptive cross-sectional study was conducted on 150 patients aged 0-10 years, seen with their medical histories at the Pediatric-Juvenile Gynecology Outpatient Service in Playa municipality from September 1st,1996 to November 30th,2001. The study analyzed the following variables: principal reasons for going to see the gynecologist according to age, main causes of leukorrhea or vulvovaginitis, causes of puberty disorders and of pelvic pain. It was concluded that the main reasons for going to the gynecologist were leukorrhea or vulvovaginitis, puberty disorders and pelvic pain, whereas the main cause of leukorrhea was bacterial vaginosis, puberty disorders resulted from premature thelarche, and pelvic pain was caused by giardiasis in most of the girls.

Jejunal brush border microvillous alterations in Giardia muris-infected mice: role of T lymphocytes and interleukin-6.

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Scott, K G; Logan, M R; Klammer, G M; Teoh, D A; Buret, A G

2000-06-01

Intestinal colonization with the protozoan Giardia causes diffuse brush border microvillous alterations and disaccharidase deficiencies, which in turn are responsible for intestinal malabsorption and maldigestion. The role of T cells and/or cytokines in the pathogenesis of Giardia-induced microvillous injury remains unclear. The aim of this study was to assess the role of T cells and interleukin-6 (IL-6) in the brush border pathophysiology of acute murine giardiasis in vivo. Athymic nude (nu(-)/nu(-)) CD-1 mice and isogenic immunocompetent (nu(+)/nu(+)) CD-1 mice (4 weeks old) received an axenic Giardia muris trophozoite inoculum or vehicle (control) via orogastric gavage. Weight gain and food intake were assessed daily. On day 6, segments of jejunum were assessed for parasite load, brush border ultrastructure, IL-6 content, maltase and sucrase activities, villus-crypt architecture, and intraepithelial lymphocyte (IEL) infiltration. Despite similar parasitic loads on day 6, infected immunocompetent animals, but not infected nude mice, showed a diffuse loss of brush border microvillous surface area, which was correlated with a significant reduction in maltase and sucrase activities and a decrease in jejunal IL-6 concentration. In both athymic control and infected mice, jejunal brush border surface area and disaccharidases were high, but levels of tissue IL-6 were low and comparable to the concentration measured in immunocompetent infected animals. In both immunocompetent and nude mice, infection caused a small but significant increase in the numbers of IELs. These findings suggest that the enterocyte brush border injury and malfunction seen in giardiasis is, at least in part, mediated by thymus-derived T lymphocytes and that suppressed jejunal IL-6 does not necessarily accompany microvillous shortening.

Cytokines, antibodies and histopathological profiles during Giardia infection and VSP-based vaccination.

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Serradell, Marianela C; Gargantini, Pablo R; Saura, Alicia; Oms, Sergio R; Rupil, Lucía L; Berod, Luciana; Sparwasser, Tim; Luján, Hugo D

2018-03-19

Giardiasis is one of the most common human intestinal diseases worldwide. Several experimental animals have been used to evaluate Giardia infections, with gerbils ( Meriones unguiculatus ) being the most valuable model due to their high susceptibility to Giardia infection, abundant shedding of cysts, and pathophysiological alterations and signs of disease similar to those observed in humans. Here we report cytokine and antibody profiles both during the course of Giardia infection in gerbils and after immunization with a novel oral vaccine comprising a mixture of purified Variant-specific Surface Proteins (VSPs). Transcript levels of representative cytokines of different immune profiles as well as macro- and micro-tissue alterations were assessed in Peyer's patches, mesenteric lymph nodes and spleens. During infection, cytokine responses showed a biphasic profile: an early induction of Th1 (IFN-γ, IL-1β, IL-6 and TNF), Th17 (IL-17) and Th2 (IL-4) cytokines, together with intestinal alterations typical of inflammation, followed by a shift toward a predominant Th2 (IL-5) response, likely associated with a counter-regulatory mechanism. Conversely, immunization with an oral vaccine comprising the entire repertoire of VSPs specifically showed high levels of IL-17, IL-6, IL-4 and IL-5, without obvious signs of inflammation. Both immunized and infected animals developed local (intestinal S-IgA) and systemic (serum IgG) humoral immune responses against VSPs; however, only infected animals showed evident signs of giardiasis. This is the first comprehensive report of cytokine expression and anti- Giardia antibody production during infection and VSP vaccination in gerbils, a reliable model of the human disease. Copyright © 2018 American Society for Microbiology.

Bile Salt Hydrolase Activities: A Novel Target to Screen Anti-Giardia Lactobacilli?

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Thibault Allain

2018-02-01

Full Text Available Giardia duodenalis is a protozoan parasite responsible for giardiasis, a disease characterized by intestinal malabsorption, diarrhea and abdominal pain in a large number of mammal species. Giardiasis is one of the most common intestinal parasitic diseases in the world and thus a high veterinary, and public health concern. It is well-established that some probiotic bacteria may confer protection against this parasite in vitro and in vivo and we recently documented the implication of bile-salt hydrolase (BSH-like activities from strain La1 of Lactobacillus johnsonii as mediators of these effects in vitro. We showed that these activities were able to generate deconjugated bile salts that were toxic to the parasite. In the present study, a wide collection of lactobacilli strains from different ecological origins was screened to assay their anti-giardial effects. Our results revealed that the anti-parasitic effects of some of the strains tested were well-correlated with the expression of BSH-like activities. The two most active strains in vitro, La1 and Lactobacillus gasseri CNCM I-4884, were then tested for their capacity to influence G. duodenalis infection in a suckling mice model. Strikingly, only L. gasseri CNCM I-4884 strain was able to significantly antagonize parasite growth with a dramatic reduction of the trophozoites load in the small intestine. Moreover, this strain also significantly reduced the fecal excretion of Giardia cysts after 5 days of treatment, which could contribute to blocking the transmission of the parasite, in contrast of La1 where no effect was observed. This study represents a step toward the development of new prophylactic strategies to combat G. duodenalis infection in both humans and animals.

Unusual disease conditions in pet and aviary birds.

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Panigrahy, B; Mathewson, J J; Hall, C F; Grumbles, L C

1981-02-15

Ninety percent ot 100% mortality in budgerigar (Melopsittacus undulatus) nestlings from 2 aviaries was attributed to giardiasis. Treatment with dimetridazole in drinking water was effective in controlling mortality. Aeromonas hydrophila infection incriminated in acute deaths of aviary canaries (Serinus canarius) was successfully treated with chlortetracycline. Aeromonas hydrophila also was isolated in pure culture from a toucan (ramphastos toco) with acute nephrosis and a cockatiel (Nymphicus hollandicus) with chlamydiosis (psittacosis). Coccidiosis associated with hemorrhagic enteritis, diarrhea, and mortality was diagnosed in budgerigars originating from 3 aviaries. Sporulated oocysts from 1 group of budgerigars were identified as Eimera sp. Sulfamethazine in drinking water was an effective treatment.

Giardiasis in mice: analysis of humoral and cellular immune responses to Giardia muris.

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Anders, R F; Roberts-Thomson, I C; Mitchell, G F

1982-01-01

Humoral and cellular immune responses have been evaluated in two inbred strains of mice which differ markedly in their susceptibility to infection with Giardia muris. Serum IgG and IgA antibody levels and IgA levels in intestinal washes were determined by a solid-phase radioimmunoassay using G. muris antigen prepared by sonication of trophozoites, while cell-mediated immunity was assessed by a radiometric ear-assay for delayed-type hypersensitivity. Following infection of BALB/c mice (resistant) and C3H/He mice (susceptible), the IgG and IgA antibody levels in serum progressively increased over the period of study with C3H/He mice having significantly higher titres of IgA antibodies than BALB/c late in the infection. Systemic immunization with G. muris trophozoites resulted in high titres of IgG antibodies in the serum. IgA antibodies were detected in intestinal washes 2 weeks after infection with a subsequent fall in levels in BALB/c mice but a progressive increase levels in C3H/He mice. Prior immunization resulted in IgA antibodies being detected earlier in the intestinal washings after a challenge infection. Delayed-type hypersensitivity to G. muris antigens could not be detected during an infection but a positive response was elicited following antigen priming in mice pretreated with cyclophosphamide. The immune responses evaluated in this study were assessed using a whole G. muris trophozoite sonicate and variations in the quantitative aspects of the responses did not account for observed differences in the course of infection in the two strains of mice.

Giardiasis and Poor Vitamin A Status among Aboriginal School Children in Rural Malaysia

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Al-Mekhlafi, Hesham M.; Surin, Johari; Sallam, Atiya A.; Abdullah, Ariffin W.; Mahdy, Mohammed A. K.

2010-01-01

A cross-sectional study was carried out on 241 primary schoolchildren in Pahang, Malaysia to update their vitamin A status and to investigate the association of poor vitamin A status with their health and socioeconomic factors. All children were screened for intestinal parasitic infections. Blood samples were collected and vitamin A status was assessed. Socioeconomic data were collected by using pre-tested questionnaires. The results showed that 66 (27.4%) children had low serum retinol levels (Malaysia. Vitamin A supplementation and treatment of intestinal parasitic infections should be distributed periodically to these children to improve their health and nutritional status. PMID:20810815

Bile-Salt-Hydrolases from the Probiotic Strain Lactobacillus johnsonii La1 Mediate Anti-giardial Activity in Vitro and in Vivo

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Thibault Allain

2018-01-01

Full Text Available Giardia duodenalis (syn. G. lamblia, G. intestinalis is the protozoan parasite responsible for giardiasis, the most common and widely spread intestinal parasitic disease worldwide, affecting both humans and animals. After cysts ingestion (through either contaminated food or water, Giardia excysts in the upper intestinal tract to release replicating trophozoites that are responsible for the production of symptoms. In the gut, Giardia cohabits with the host's microbiota, and several studies have revealed the importance of this gut ecosystem and/or some probiotic bacteria in providing protection against G. duodenalis infection through mechanisms that remain incompletely understood. Recent findings suggest that Bile-Salt-Hydrolase (BSH-like activities from the probiotic strain of Lactobacillus johnsonii La1 may contribute to the anti-giardial activity displayed by this strain. Here, we cloned and expressed each of the three bsh genes present in the L. johnsonii La1 genome to study their enzymatic and biological properties. While BSH47 and BSH56 were expressed as recombinant active enzymes, no significant enzymatic activity was detected with BSH12. In vitro assays allowed determining the substrate specificities of both BSH47 and BSH56, which were different. Modeling of these BSHs indicated a strong conservation of their 3-D structures despite low conservation of their primary structures. Both recombinant enzymes were able to mediate anti-giardial biological activity against Giardia trophozoites in vitro. Moreover, BSH47 exerted significant anti-giardial effects when tested in a murine model of giardiasis. These results shed new light on the mechanism, whereby active BSH derived from the probiotic strain Lactobacillus johnsonii La1 may yield anti-giardial effects in vitro and in vivo. These findings pave the way toward novel approaches for the treatment of this widely spread but neglected infectious disease, both in human and in veterinary medicine.

Genetic characterizations of Giardia duodenalis in sheep and goats in Heilongjiang Province, China and possibility of zoonotic transmission.

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Weizhe Zhang

Full Text Available BACKGROUND: Giardia duodenalis is a widespread intestinal protozoan of both humans and mammals. To date, few epidemiological studies have assessed the potential and importance of zoonotic transmission; and the human giardiasis burden attributable to G. duodenalis of animal origin is unclear. No information about occurrence and genotyping data of sheep and goat giardiasis is available in China. The aim of the present study was to determine prevalence and distribution of G. duodenalis in sheep and goats in Heilongjiang Province, China, and to characterize G. duodenalis isolates and assess the possibility of zoonotic transmission. METHODOLOGY/PRINCIPAL FINDINGS: A total of 678 fecal specimens were collected from sheep and goats on six farms ranging in age from one month to four years in Heilongjiang Province, China. The average prevalence of G. duodenalis infection was 5.0% (34/678 by microscopy after Lugol's iodine staining, with 5.6% (30/539 for the sheep versus 2.9% (4/139 for the goats. Molecular analysis was conducted on 34 G. duodenalis isolates based on the triosephosphate isomerase (tpi gene. 29 tpi gene sequences were successfully obtained and identified as assemblages A (n = 4, B (n = 2 and E (n = 23. High heterogeneity was observed within assemblage E at the tpi locus, with five novel subtypes found out of seven subtypes. Two subtypes of assemblage A were detected, including subtype AI (n = 3 and a novel subtype (designated as subtype AIV (n = 1. Two assemblage B isolates were identical to each other in the tpi gene sequences. CONCLUSIONS/SIGNIFICANCE: This is the first report of G. duodenalis infections in sheep and goats in China. The present data revealed the unique endemicity on prevalence, distribution and genetic characterization of G. duodenalis in sheep and goats in Heilongjiang Province. The findings of assemblages A and B in sheep and goats implied the potential of zoonotic transmission.

Role of Endoscopic Findings and Biopsies in Renal Transplant Recipients With Gastrointestinal Complications: A Tertiary Care Experience.

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Wadhwa, Rajesh Kumar; Nazeer, Aisha; Rai, Ayesha Aslam; Luck, Nasir Hassan

2018-03-09

We investigated the incidence of gastrointestinal disorders requiring endoscopic and histopathologic diagnoses in renal transplant recipients. In this retrospective analysis, we examined records of patients seen at the Department of Hepato-Gastroenterology and Transplantation Sciences, Sindh Institute of Urology and Trans?lantation (Karachi, Pakistan) from January 2010 to December 2014. Renal transplant recipients with gastrointestinal disorders who required endoscopy, including proctoscopy and upper and lower gastrointestinal endoscopy as per indication, were included. Of 1770 patients included in this study, most were male patients (n = 1517; 85.7%). In this patient group, 1957 endoscopies, including proctoscopies, were performed, which included 1033 esophagogastroduodenoscopies (52.8%), 571 sigmoidoscopies (29.2%), and 107 colonoscopies (5.5%). The most common indications were diarrhea (n = 697; 31.2%) and weight loss (n = 690; 31%). Findings showed esophageal candidiasis in 127 patients (12%); however, biopsy revealed Candida species in 33 patients (34%). Cytomegalovirus and herpes esophagitis were observed in 8 (8.3%) and 5 patients (5.2%). Helicobacter pylori gastritis was seen in 119 patients (15.4%), cytomegalovirus gastritis in 9 patients (1.2%), and gastric lymphoma in 1 patient (0.1%). Duodenal fissuring was the most common pathology observed during endoscopy (396 patients; 33.9%), followed by decreased height of duodenal folds in 157 patients (13.4%), with biopsy showing sprue in 325 patients (37.6%) and giardiasis in 118 patients (13.7%). Lower gastrointestinal endoscopy showed ulcers in 198 patients (24.6%) and polyps in 31 patients (3.9%). Histopathologic examination showed cytomegalovirus colitis in 89 patients (15.5%), amebic colitis in 21 (3.7%), and tuberculosis in 11 (1.9%). We observed a wide spectrum of pathologic lesions, including opportunistic infections, in endoscopic biopsies from our renal transplant patients. Cytomegalovirus colitis was

Peripheral ulcerative keratitis associated with chronic malabsorption syndrome and miliary tuberculosis in a child

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Tarun Arora

2015-01-01

Full Text Available A 16-year-old girl presented with pain, redness, watering, and blurring of vision in her right eye. Slit lamp examination revealed the presence of peripheral ulcerative keratitis (PUK and nodular scleritis. On clinical examination, the patient had stunted growth, low body mass index, and enlarged axillary nodes. Giardia cysts were present in the stool sample and histopathology of axillary lymph nodes showed caseating necrosis suggestive of tuberculosis (TB. A diagnosis of PUK with chronic malabsorption syndrome secondary to giardiasis and miliary TB was made. Oral metronidazole, anti-tubercular treatment, high protein diet and vitamin supplements were started. Topical steroids were started for peripheral ulcerative lesions following, which the PUK resolved.

ESTIMACIÓN DE LA FRECUENCIA DE INFECCIÓN POR GIARDIA INTESTINALIS EN COMUNIDADES INDÍGENAS Y AFROS DE COLOMBIA: ESTUDIO DE CORTE TRASVERSAL

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María Carolina Merchán Garzón

2016-04-01

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Introducción: Las infecciones parasitarias intestinales son un importante problema de salud púbica. Las parasitosis como la giardiasis, son de particular relevancia para el estudio de la salud en comunidades aisladas en Colombia.

Objetivo: describir la frecuencia de infección por G. intestinalis en 21 comunidades aisladas colombianas (18 comunidades indígenas y 3 comunidades negras.

Materiales y Métodos: análisis microscópico en campo de muestras de materia fecal de 671 muestras de voluntarios de 21 comunidades aisladas colombianas. Cálculo de prevalencia por comunidad y descripción de las condiciones nutricionales y de manejo de agua y excretas en las comunidades.

Resultados: la prevalencia global de infección por G. intestinalis en las comunidades aisladas estudiadas fue del 11% en comunidades indígenas y del 9% en comunidades negras. Las prevalencias por comunidad varían entre 0% hasta el 63%. El 100% de los individuos evaluados presentó algún tipo de parasitismo intestinal.

Discusión: el parasitismo intestinal por G. intestinalis tiene prevalencias similares a otros grupos indígenas de Sur América. La causa del parasitismo intestinal debe ser considerada según comunidad y de acuerdo a factores de riesgo conocidos, como manejo de excretas y acceso a agua potable.

GIARDIA INTESTINALIS INFECTION FREQUENCY ESTIMATE AMONG ABORIGINAL AND BLACK COMMUNITIES IN COLOMBIA: A CROSS-SECTIONAL STUDY

ABSTRACT

Introduction: Intestinal parasitic infections are a major problem of public health. Parasitic diseases such as giardiasis, are relevant for the study of health in isolated communities in Colombia.

Objective: To describe the frequency of G. intestinalis infection in 21 isolated communities in Colombia (18 indigenous communities and 3

Giardiasis: Serum antibodies and coproantigens in brown rats (Rattus norvegicus from Grenada, West Indies

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Keshaw Tiwari

2018-03-01

Full Text Available Aim: Giardia is a serious zoonotic parasite, which causes diarrheal disease in humans and animals including rodents. The purpose of this study was to estimate the prevalence of Giardia spp. in brown rats (Rattus norvegicus in Grenada. Materials and Methods: Intestinal contents from 99 and serum samples from 169 brown rats (R. norvegicus from Grenada were collected. These samples were examined for the Giardia coproantigens using Cryptosporidium/Giardia Quik Chek assay (Tech lab® Inc., USA, and the serum was screened through an enzyme-linked immunosorbent assay (ELISA test kit for Giardia antibody (anti-GD ELISA kit (MyBioSource, San Diego, CA, USA. Results: Giardia coproantigens were positive in 17.17% (95% confidence interval [CI]; 10.33-26.06% rats, whereas 55% (95% CI: 47.20-62.68 were positive with serum antibodies (anti-GD to Giardia. Conclusion: The prevalence of Giardia spp. in brown rats in Grenada was moderate based on the presence of coproantigens in the intestinal contents and antibody in serum. The findings of Giardia infections and prevalence in brown rats will help veterinarians and physicians to better plan diagnostic and preventative strategies. This is the first report of prevalence of Giardia in brown rats in Grenada.

Terminalia ferdinandiana extracts as inhibitors of Giardia duodenalis proliferation: a new treatment for giardiasis.

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Rayan, P; Matthews, B; McDonnell, P A; Cock, I E

2015-07-01

Giardisis is a debilitating disease caused by gastrointestinal parasites of the genus Giardia. High-antioxidant T. ferdinandiana fruit extracts were investigated for the ability to block Giardia duodenalis growth. Methanolic and aqueous extracts had the most potent growth inhibitory activity (IC50 values of approximately 700 and 140 μg/ml, respectively). Ethyl acetate and chloroform extracts also inhibited G. duodenalis growth, albeit with lower potency. The hexane extract was completely devoid of G. duodenalis growth inhibitory activity. All extracts were nontoxic in the Artemia fransiscana bioassay. Nontargeted HPLC-quadrupole time-of-flight (QTOF) mass spectroscopy (with screening against three compound databases) putatively identified 17 compounds in all of the inhibitory extracts but not in the inactive hexane extract. The low toxicity of the Terminalia ferdinandiana fruit extracts and their potent G. duodenalis growth inhibitory bioactivity indicate their potential as medicinal agents in the treatment and prevention of this disease.

Effect of olive leaf, Satureja khuzestanica, and Allium sativum extracts on Giardia lamblia cysts compared with metronidazole in vitro.

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Fallahi, Sh; Rostami, A; Delfan, B; Pournia, Y; Rashidipour, M

2016-12-01

Giardia lamblia is one of the common causes of worldwide diarrhea in children. Appropriate medicinal treatment for giardiasis is available but there are some evidences of drug resistance, insufficient efficacy, and unpleasant side effects. In order to reach a more natural drug with suitable efficacy and the lowest side effects, the effects of the hydroalcoholic extracts of olive leaf, Satureja khuzestanica , and Allium sativum on G. lamblia cysts were evaluated in vitro, as well as antigiardial effect of the extracts was compared with metronidazole as the drug of choice. 2 and 5 mg of the plants extracts and powder of metronidazole 250 mg pills were added to 1 ml of G. lamblia cysts suspension (containing 5,000 cyst/ml normal saline), and the percentages of bioavailability of G. lamblia cysts were examined at the 2nd and 4th h after exposure and in 4 and 37 °C temperatures using eosin 0.1 % and a haemocytometer. The data were analyzed by multiway ANOVA test, Tukey's test, and the SPSS software, version 18. The examinations demonstrated that olive leaf extract had the most fatality rate on G. lamblia cysts in vitro (37.90 ± 7.01 %), followed by the extract of S. khuzestanica (32.52 ± 9.07 %). Metronidazole 250 mg pills had relatively effective fatality rate on G. lamblia cysts in vitro (28.75 ± 10.30 %), whereas A. sativum (garlic) had the lowest fatality effect on G. lamblia cysts in vitro (22.65 ± 10.47 %). With respect to higher fatality effect of olive leaf and S. khuzestanica extracts compared with metronidazole in vitro, these plants can be used as suitable candidates to make new antigiardial drugs with low side effects and without drug resistance in the treatment of giardiasis in children.

Identification of zoonotic genotypes of Giardia duodenalis.

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Hein Sprong

Full Text Available Giardia duodenalis, originally regarded as a commensal organism, is the etiologic agent of giardiasis, a gastrointestinal disease of humans and animals. Giardiasis causes major public and veterinary health concerns worldwide. Transmission is either direct, through the faecal-oral route, or indirect, through ingestion of contaminated water or food. Genetic characterization of G. duodenalis isolates has revealed the existence of seven groups (assemblages A to G which differ in their host distribution. Assemblages A and B are found in humans and in many other mammals, but the role of animals in the epidemiology of human infection is still unclear, despite the fact that the zoonotic potential of Giardia was recognised by the WHO some 30 years ago. Here, we performed an extensive genetic characterization of 978 human and 1440 animal isolates, which together comprise 3886 sequences from 4 genetic loci. The data were assembled into a molecular epidemiological database developed by a European network of public and veterinary health Institutions. Genotyping was performed at different levels of resolution (single and multiple loci on the same dataset. The zoonotic potential of both assemblages A and B is evident when studied at the level of assemblages, sub-assemblages, and even at each single locus. However, when genotypes are defined using a multi-locus sequence typing scheme, only 2 multi-locus genotypes (MLG of assemblage A and none of assemblage B appear to have a zoonotic potential. Surprisingly, mixtures of genotypes in individual isolates were repeatedly observed. Possible explanations are the uptake of genetically different Giardia cysts by a host, or subsequent infection of an already infected host, likely without overt symptoms, with a different Giardia species, which may cause disease. Other explanations for mixed genotypes, particularly for assemblage B, are substantial allelic sequence heterogeneity and/or genetic recombination. Although the

Comparative characterisation of two nitroreductases from Giardia lamblia as potential activators of nitro compounds

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Joachim Müller

2015-08-01

Full Text Available Giardia lamblia is a protozoan parasite that causes giardiasis, a diarrhoeal disease affecting humans and various animal species. Nitro drugs such as the nitroimidazole metronidazole and the nitrothiazolide nitazoxanide are used for treatment of giardiasis. Nitroreductases such as GlNR1 and GlNR2 may play a role in activation or inactivation of these drugs. The aim of this work is to characterise these two enyzmes using functional assays. For respective analyses recombinant analogues from GlNR1 and GlNR2 were produced in Escherichia coli. E. coli expressing GlNR1 and GlNR2 alone or together were grown in the presence of nitro compounds. Furthermore, pull-down assays were performed using HA-tagged GlNR1 and GlNR2 as baits. As expected, E. coli expressing GlNR1 were more susceptible to metronidazole under aerobic and semi-aerobic and to nitazoxanide under semi-aerobic growth conditions whereas E. coli expressing GlNR2 were susceptible to neither drug. Interestingly, expression of both nitroreductases gave the same results as expression of GlNR2 alone. In functional assays, both nitroreductases had their strongest activities on the quinone menadione (vitamin K3 and FAD, but reduction of nitro compounds including the nitro drugs metronidazole and nitazoxanide was clearly detected. Full reduction of 7-nitrocoumarin to 7-aminocoumarin was preferentially achieved with GlNR2. Pull-down assays revealed that GlNR1 and GlNR2 interacted in vivo forming a multienzyme complex. These findings suggest that both nitroreductases are multifunctional. Their main biological role may reside in the reduction of vitamin K analogues and FAD. Activation by GlNR1 or inactivation by GlNR2 of nitro drugs may be the consequence of a secondary enzymatic activity either yielding (GlNR1 or eliminating (GlNR2 toxic intermediates after reduction of these compounds.

Occurrence and distribution of Giardia species in wild rodents in Germany.

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Helmy, Yosra A; Spierling, Nastasja G; Schmidt, Sabrina; Rosenfeld, Ulrike M; Reil, Daniela; Imholt, Christian; Jacob, Jens; Ulrich, Rainer G; Aebischer, Toni; Klotz, Christian

2018-03-27

Giardiasis is an important gastrointestinal parasitic disease in humans and other mammals caused by the protozoan Giardia duodenalis. This species complex is represented by genetically distinct groups (assemblages A-H) with varying zoonotic potential and host preferences. Wild rodents can harbor potentially zoonotic assemblages A and B, and the rodent-specific assemblage G. Other Giardia spp. found in these animals are Giardia muris and Giardia microti. For the latter, only limited information on genetic typing is available. It has been speculated that wild rodents might represent an important reservoir for parasites causing human giardiasis. The aim of this study was to investigate the occurrence and distribution of Giardia spp. and assemblage types in wild rodents from different study sites in Germany. Screening of 577 wild rodents of the genera Apodemus, Microtus and Myodes, sampled at eleven study sites in Germany, revealed a high overall Giardia prevalence. Giardia species determination at the SSU rDNA gene locus revealed that Apodemus mice, depending on species, were predominantly infected with one of two distinct G. muris sequence types. Giardia microti was the predominant parasite species found in voles of the genera Microtus and Myodes. Only a few animals were positive for potentially zoonotic G. duodenalis. Subtyping at the beta-giardin (bg) and glutamine dehydrogenase (gdh) genes strongly supported the existence of different phylogenetic subgroups of G. microti that are preferentially harbored by distinct host species. The present study highlights the preference of G. muris for Apodemus, and G. microti for Microtus and Myodes hosts and argues for a very low prevalence of zoonotic G. duodenalis assemblages in wild rodents in Germany. It also provides evidence that G. muris and G. microti subdivide into several phylogenetically distinguishable subgroups, each of which appears to be preferentially harbored by species of a particular rodent host genus

The prevalence of Giardia infection in dogs and cats, a systematic review and meta-analysis of prevalence studies from stool samples.

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Bouzid, Maha; Halai, Kapil; Jeffreys, Danielle; Hunter, Paul R

2015-01-30

Giardia has a wide range of host species and is a common cause of diarrhoeal disease in humans and animals. Companion animals are able to transmit a range of zoonotic diseases to their owners including giardiasis, but the size of this risk is not well known. The aim of this study was to analyse giardiasis prevalence rates in dogs and cats worldwide using a systematic search approach. Meta-analysis enabled to describe associations between Giardia prevalence and various confounding factors. Pooled prevalence rates were 15.2% (95% CI 13.8-16.7%) for dogs and 12% (95% CI 9.2-15.3%) for cats. However, there was very high heterogeneity between studies. Meta-regression showed that the diagnostic method used had a major impact on reported prevalence with studies using ELISA, IFA and PCR reporting prevalence rates between 2.6 and 3.7 times greater than studies using microscopy. Conditional negative binomial regression found that symptomatic animals had higher prevalence rates ratios (PRR) than asymptomatic animals 1.61 (95% CI 1.33-1.94) in dogs and 1.94 (95% CI 1.47-2.56) in cats. Giardia was much more prevalent in young animals. For cats >6 months, PRR=0.47 (0.42-0.53) and in dogs of the same age group PRR=0.36 (0.32-0.41). Additionally, dogs kept as pets were less likely to be positive (PRR=0.56 (0.41-0.77)) but any difference in cats was not significant. Faecal excretion of Giardia is common in dogs and slightly less so in cats. However, the exact rates depend on the diagnostic method used, the age and origin of the animal. What risk such endemic colonisation poses to human health is still unclear as it will depend not only on prevalence rates but also on what assemblages are excreted and how people interact with their pets. Copyright © 2015 The Authors. Published by Elsevier B.V. All rights reserved.

A sewage disposal failure as a cause of ascariasis and giardiasis epidemic in a family.

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Totkova, A; Klobusicky, M; Holkova, R; Valent, M; Stojkovicova, H

2004-01-01

In monitoring the incidence of intestinal parasites in children and employees of a nursery the authors examined 31 children with 8 (25.81%) and 16 employees with 3 (18.75%) positive results. The authors wanted to examine also the family members of 8 positive children and 3 positive employees but except from the cleaner's family, (Ascaris lumburicoides, Enterobius vermicularis and Entamoeba coli) nobody accepted the offer. All 8 members of a large family except for Patient 1 (a cleaner) and her grandson were without clinical and laboratory findings. They constitute 3 independent families who lived in 1st category flats. On August 31 there was an extensive sewage disposal failure in the ground floor flat of Family II and the flat was flooded by sewage. All family members worked solidarily on cleaning and also the members of Family IV who are friends of Family II. As shown by clinical symptoms of 'virosis', during the pre-patent period and after an outbreak within 73-78 days, laboratory findings of the family members demonstrated a severe family infection equal to a epidemic of intestinal parasitosis. Ascaris lumbricoides was diagnosed in 8 family members (61.54%) and Giardia intestinalis in 7 family members (53.85%) involved in cleaning. Enterobius vermicularis was found in 2 and Etamoeba coli in 1 family member. In monitored persons, in extreme hygienic conditions during the failure and later, a mass contraction arose on the basis of infection. The fact, that family epidemic arose subsequently, proved, in contrast to sporadic findings in children and adults, a 6.4 and 3.3 times higher incidence of Ascaris lumbricoides and a 5.6 and 8.6 times higher incidence of Giardia intestinalis. The authors discus the reasons of incidence and also preventive measures in population. (Tab. 3, Ref. 29.).

Case-Control Study of Risk Factors for Sporadic Giardiasis and Parasite Assemblages in North West England.

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Minetti, Corrado; Lamden, Kenneth; Durband, Caroline; Cheesbrough, John; Platt, Katherine; Charlett, Andre; O'Brien, Sarah J; Fox, Andrew; Wastling, Jonathan M

2015-10-01

Giardia duodenalis is a major cause of infectious gastroenteritis worldwide, and it is diversified into eight genetic assemblages (A to H), which are distinguishable only by molecular typing. There is some evidence that the assemblages infecting humans (assemblages A and B) may have different transmission routes, but systematically acquired data, combining epidemiological and molecular findings, are required. We undertook a case-control study with Giardia genotyping in North West England, to determine general and parasite assemblage-specific risk factors. For people without a history of foreign travel, swimming in swimming pools and changing diapers were the most important risk factors for the disease. People infected with assemblage B reported a greater number of symptoms and higher frequencies of vomiting, abdominal pain, swollen stomach, and loss of appetite, compared with people infected with assemblage A. More importantly, keeping a dog was associated only with assemblage A infections, suggesting the presence of a potential zoonotic reservoir for this assemblage. This is the first case-control study to combine epidemiological data with Giardia genotyping, and it shows the importance of integrating these two levels of information for better understanding of the epidemiology of this pathogen. Copyright © 2015, Minetti et al.

78 FR 42532 - Prospective Grant of Start-Up Exclusive Evaluation Option License: Methods of Treating Giardiasis...

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2013-07-16

.../US2011/055902 filed October 12, 2011 (E-211-2010/2-PCT-01); US patent application No. 13/878,832 filed April 11, 2013 (E-211-2010/2-US-06); European patent application No. 11773158.8 filed May 2, 2013 (E-211-2010/2-EP-04); Canadian application No. 2,814,694 filed April 11, 2013 (E-211-2010/2-CA-03); Australia...

Giardia intestinalis and nutritional status in children participating in the complementary nutrition program, Antioquia, Colombia, May to October 2006 Giardia intestinalis e estado nutricional em crianças participantes do programa de nutrição complementar, melhoramento alimentar e nutricional da Antioquia (MANA - Instituto Colombiano de Bem-Estar Familiar (ICBF, Antióquia, Colombia, maio a outubro de 2006

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Jorge H. Botero-Garcés

2009-06-01

Full Text Available Giardia intestinalis infection is prevalent throughout the world and widely distributed in developing countries. In general, children display serious consequences to their state of health, including slow height-weight development; therefore, the main aim of this study was to determine the association between Giardia infection and the nutritional status of children who participate in the program of complementary feeding (Mejoramiento Alimentario y Nutricional de Antioquia (MANA - Instituto Colombiano de Bienestar Familiar (ICBF. A cross-sectional study examining the association of giardiasis with nutritional status was conducted. A total of 2035 children aged eight months to six years-old were studied. Data were collected using structured questionnaires, anthropometric measurements and laboratory analysis of blood and stool samples. Analysis of the results showed that 27.6% of children were infected with G. intestinalis, while 8.1% and 1.9% were mildly and significantly underweight, respectively, and 14.1% presented stunting. Giardiasis was statistically identified as a strong predictor of stunting in this study population.A infecção pela Giardia intestinalis está amplamente distribuída no mundo apresentando a maior prevalência nos países em desenvolvimento. Em crianças, esta parasitose pode ter conseqüências graves no estado geral de saúde assim como no ganho de peso e estatura. O objetivo desta pesquisa foi estabelecer a associação entre a infecção com Giardia e o estado nutricional das crianças beneficiárias do programa de complementação alimentar - MANA. Um estudo de corte no qual foram avaliadas 2035 crianças entre os oito meses e os seis anos de idade foi realizado. A informação foi obtida a partir de questionários estruturados, medições antropométricas e exame de fezes. Os resultados mostraram que 27,6% das crianças estavam infectadas com Giardia intestinalis, das quais 8,1% apresentaram desnutrição moderada

Prevalence of Irritable Bowel Syndrome and Chronic Fatigue 10 Years After Giardia Infection.

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Litleskare, Sverre; Rortveit, Guri; Eide, Geir Egil; Hanevik, Kurt; Langeland, Nina; Wensaas, Knut-Arne

2018-03-06

Irritable bowel syndrome (IBS) is a complication that can follow gastrointestinal infection, but it is not clear if patients also develop chronic fatigue. We investigated the prevalence and odds ratio of IBS and chronic fatigue 10 years after an outbreak of Giardia lamblia, compared with a control cohort, and changes in prevalence over time. We performed a prospective follow-up study of 1252 laboratory-confirmed cases of giardiasis (exposed), which developed in Bergen, Norway in 2004. Statistics Norway provided us with information from 2504 unexposed individuals from Bergen, matched by age and sex (controls). Questionnaires were mailed to participants 3, 6, and 10 years after the outbreak. Results from the 3- and 6-year follow-up analyses have been published previously. We report the 10-year data and changes in prevalence among time points, determined by logistic regression using generalized estimating equations. The prevalence of IBS 10 years after the outbreak was 43% (n = 248) among 576 exposed individuals and 14% (n = 94) among 685 controls (adjusted odds ratio for development of IBS in exposed individuals, 4.74; 95% CI, 3.61-6.23). At this time point, the prevalence of chronic fatigue was 26% (n = 153) among 587 exposed individuals and 11% (n = 73) among 692 controls (adjusted odds ratio, 3.01; 95% CI, 2.22-4.08). The prevalence of IBS among exposed persons did not change significantly from 6 years after infection (40%) to 10 years after infection (43%; adjusted odds ratio for the change 1.03; 95% CI, 0.87-1.22). However, the prevalence of chronic fatigue decreased from 31% at 6 years after infection to 26% at 10 years after infection (adjusted odds ratio for the change 0.74; 95% CI, 0.61-0.90). The prevalence of IBS did not change significantly from 6 years after an outbreak of Giardia lamblia infection in Norway to 10 years after. However, the prevalence of chronic fatigue decreased significantly from 6 to 10 years afterward. IBS and chronic fatigue were

Catarrhal proventriculitis associated with a filamentous organism in pet birds.

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Tsai, S S; Park, J H; Hirai, K; Itakura, C

1992-12-01

Catarrhal proventriculitis due to infection by an unidentified organism was diagnosed in 79 of 534 pet birds examined histologically. It was more prevalent in domestic birds (70 cases) than in imported ones (9 cases). A high incidence of the disease was encountered in budgerigars (Melopsittacus undulatus) and it was occasionally found in finches (Poephila gouldiae gouldiae), parakeets (Psittacula Krameri manillensis), Amazona parrots (Amazona aestiva aestiva) and cockatiels (Nymphicus hollandicus). The agent was a large filamentous rod, and was stained positively with Gram, GMS and PAS methods. Histologically, it induced a mild to moderate exudative or proliferative inflammation in the proventriculus. All the cases had an erosion in the gizzard. Ultrastructurally, the organism had a eukaryotic nucleus and three cell-wall layers. Concurrent infections were very common, including adenoviruses (37 cases), giardiasis (31 cases), candidiasis (13 cases), papovaviruses (11 cases) and knemidocoptic mites (11 cases).

Direct healthcare costs of selected diseases primarily or partially transmitted by water.

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Collier, S A; Stockman, L J; Hicks, L A; Garrison, L E; Zhou, F J; Beach, M J

2012-11-01

Despite US sanitation advancements, millions of waterborne disease cases occur annually, although the precise burden of disease is not well quantified. Estimating the direct healthcare cost of specific infections would be useful in prioritizing waterborne disease prevention activities. Hospitalization and outpatient visit costs per case and total US hospitalization costs for ten waterborne diseases were calculated using large healthcare claims and hospital discharge databases. The five primarily waterborne diseases in this analysis (giardiasis, cryptosporidiosis, Legionnaires' disease, otitis externa, and non-tuberculous mycobacterial infection) were responsible for over 40 000 hospitalizations at a cost of $970 million per year, including at least $430 million in hospitalization costs for Medicaid and Medicare patients. An additional 50 000 hospitalizations for campylobacteriosis, salmonellosis, shigellosis, haemolytic uraemic syndrome, and toxoplasmosis cost $860 million annually ($390 million in payments for Medicaid and Medicare patients), a portion of which can be assumed to be due to waterborne transmission.

Seasonal prevalence and incidence of Cryptosporidium spp. and Giardia duodenalis and associated diarrhoea in children attending pre-schools in Kafue, Zambia

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Siwila, J.; Phiri, I.G.K.; Enemark, Heidi L.

2011-01-01

Prevalence, incidence and seasonal variation of Cryptosporidium and Giardia duodenalis were studied over a 12-month period in 100 children from four pre-schools in Kafue, Zambia. Questionnaire data and a single stool sample were collected monthly from each child. Samples were processed using...... a commercial kit (Meridian Diagnostics Inc., USA) and oo(cysts) visualised by immunofluorescence microscopy. Cryptosporidium was detected in 30.7% (241/786; 95% CI = 27.5-33.9) while G. duodenalis was detected in 29.0% (228/786; 95% CI = 25.8-32.2). A total of 86% experienced one or more episodes...... of cryptosporidiosis while 75% had giardiasis. Cumulative incidence per 100 children was 75.4 for Cryptosporidium and 49.0 for G. duodenalis. Both infections were significantly more common in the wet compared to the dry season (34.8%, 162/466 vs. 24.7%, 79/320, P = 0.003 and 35.2%, 164/466 vs. 20.0%, 64/320, P

Comparison of microscopic and immunoassay examination in the diagnosis of intestinal protozoa of humans in Mansoura, Egypt.

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Elswaifi, Shaadi F; Palmieri, James R; El-Tantawy, Nora; El-Hussiny, Mona; Besheer, Tarek; Abohashem, Ekbal

2016-09-01

Protozoal diseases are prevalent globally and especially in developing countries that have relatively lower socioeconomic populations such as Egypt. Direct microscopic examination (DME) is used for the detection and identification of protozoa but lacks sufficient reliability, and thus may be detrimental in obtaining accurate diagnostic or epidemiological data. In this study, we determine the prevalence of infections by Giardia intestinalis, Cryptosporidium sp., and Entamoeba histolytica in humans in Egypt. Furthermore, we determine the reliability of DME in determining infections caused by these protozoa and compare the results to enzyme linked Immunosorbent assays (ELISA). Our results indicate that the prevalence of giardiasis, cryptosporidiosis, and entamoebiasis is 38, 22, and 16 %, respectively. The sensitivity and specificity of DME for detection of G. intestinalis is 45 and 99 %, for Cryptosporidium 66 and 99 %, and for Entamoeba 45 and 100 %, respectively. Our findings demonstrate that ELISA is more reliable for diagnostic and epidemiologic study purposes.

Synthesis and Electrochemistry of 2-Ethenyl and 2-Ethanyl Derivatives of 5-Nitroimidazole and Antimicrobial Activity against Giardia lamblia

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Valdez, Carlos A.; Tripp, Jonathan C.; Miyamoto, Yukiko; Kalisiak, Jaroslaw; Hruz, Petr; Andersen, Yolanda S.; Brown, Sabrina E.; Kangas, Karina; Arzu, Leo V.; Davids, Barbara J.; Gillin, Frances D.; Upcroft, Jacqueline A.; Upcroft, Peter; Fokin, Valery V.; Smith, Diane K.; Sharpless, K. Barry; Eckmann, Lars

2009-01-01

Infections with the diarrheagenic pathogen, Giardia lamblia, are commonly treated with the 5-nitroimidazole (5-NI) metronidazole (Mz), and yet treatment failures and Mz resistance occur. Using a panel of new 2-ethenyl and 2-ethanyl 5-NI derivatives, we found that compounds with a saturated bridge between the 5-NI core and a pendant ring system exhibited only modestly increased antigiardial activity and could not overcome Mz resistance. By contrast, olefins with a conjugated bridge connecting the core and a substituted phenyl or heterocyclic ring showed greatly increased antigiardial activity without toxicity, and several overcame Mz resistance and were more effective than Mz in a murine giardiasis model. Determination of the half-wave potential of the initial one-electron transfer by cyclic voltammetry revealed that easier redox activation correlated with greater antigiardial activity and capacity to overcome Mz resistance. These studies show the potential of combining systematic synthetic approaches with biological and electrochemical evaluations in developing improved 5-NI drugs. PMID:19480409

A systematic review of the effects of Iranian pharmaceutical plant extracts on Giardia lamblia

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Hajar Ziaei Hezarjaribi

2015-12-01

Full Text Available This study aimed to provide a systematic review regarding anti-Giardia effect of different Iranian plant extracts used in vivo and in vitro on cysts and trophozoites. Many reports indicated that most of plant extracts used as anti-Giardia were obtained from Liliaceae, Apiaceae, Asteraceae, and Myrtaceae. These extracts included different fractions such as aqueous, alcoholic and chloroform extracts as well as Soxhlet extraction of juice or essence. The findings of this review showed that hydroalcoholic extract of asafoetida, Chenopodium botrys, and chloroformic extract of feverfew (Tanacetum parthenium have the maximum effect (100% efficacy on in vitro application against Giardia. However, the highest in vivo effect of 100% therapeutic significance was recorded for the extract of Allium sativum at 80 mg/mL concentration. Given the plant species richness of Iran in terms of herbal medicines with fewer side effects, it can be a good alternative to chemical drugs used to treat giardiasis.

[Tropical sprue (author's transl)].

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Gras, C; Chapoy, P; Aubry, P

1981-01-01

Tropical sprue is a disease of the small intestine characterized by a malabsorption syndrome with a subtotal or partial mucosal atrophy. It is observed in Asia and Central America. It appears to be rare in Africa but its real frequency is unknown as small bowel biopsys are not routinely done. Bacterial overgrowth as well as giardiasis may be trigger factors of the disease the pathogenesis of which is still incompletely understood. The disease beginning as chronic diarrhea is later on characterized by an aphtoïd stomatitis and a macrocytic anemia. Treatment with antibiotics and folic acid is efficient and has a diagnostic value. If treatment is started lately, vitamin B 12 is then also necessary. In any intestinal syndrome observed in tropical areas without an ascertained etiologic diagnosis, peroral biopsie of the small intestine is requested. However, with the use of pediatric endoscope it will be possible to appreciate the respective incidence of tropical sprue and asymptomatic tropical sprue in Africa South of the Sahara.

Fascioliasis and Eosinophilia in the Highlands of Cuzco, Peru and Their Association with Water and Socioeconomic Factors

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Cabada, Miguel M.; Goodrich, Mary R.; Graham, Brittany; Villanueva-Meyer, Pablo G.; Lopez, Martha; Arque, Eulogia; White, A. Clinton

2014-01-01

There are limited data about the epidemiology of fascioliasis in Cuzco, Peru. We studied children 3–12 years old from six communities in the highlands of Cuzco to evaluate the epidemiology of fascioliasis; 227 children were included, one-half were female, the mean age was 7.5 (±2.6) years, and 46.2±% had one or more parasites, including Fasciola (9.7%), Ascaris (12.8%), Hymenolepis (9.3%), Trichuris (1.3%), hookworm (1.8%), Strongyloides (0.9%), and Giardia (27.8%). Fasciola was associated with the number of siblings in the household, drinking untreated water, and giardiasis. Eosinophilia was encountered in 21% of children and more common in those drinking untreated water at home and those infected with a parasite, but the differences were not significant. Eating water plants was not associated with Fasciola or eosinophilia. Fascioliasis and eosinophilia were common in the highlands of Cuzco. Fascioliasis was associated with socioeconomic factors and drinking water. PMID:25200257

Fascioliasis and eosinophilia in the highlands of Cuzco, Peru and their association with water and socioeconomic factors.

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Cabada, Miguel M; Goodrich, Mary R; Graham, Brittany; Villanueva-Meyer, Pablo G; Lopez, Martha; Arque, Eulogia; White, A Clinton

2014-11-01

There are limited data about the epidemiology of fascioliasis in Cuzco, Peru. We studied children 3-12 years old from six communities in the highlands of Cuzco to evaluate the epidemiology of fascioliasis; 227 children were included, one-half were female, the mean age was 7.5 (±2.6) years, and 46.2±% had one or more parasites, including Fasciola (9.7%), Ascaris (12.8%), Hymenolepis (9.3%), Trichuris (1.3%), hookworm (1.8%), Strongyloides (0.9%), and Giardia (27.8%). Fasciola was associated with the number of siblings in the household, drinking untreated water, and giardiasis. Eosinophilia was encountered in 21% of children and more common in those drinking untreated water at home and those infected with a parasite, but the differences were not significant. Eating water plants was not associated with Fasciola or eosinophilia. Fascioliasis and eosinophilia were common in the highlands of Cuzco. Fascioliasis was associated with socioeconomic factors and drinking water. © The American Society of Tropical Medicine and Hygiene.

ANTIPROTOZOAL ACTIVITY OF EXTRACTS OF ELAEODENDRON TRICHOTOMUM (CELASTRACEAE).

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Roca-Mézquita, Carolina; Graniel-Sabido, Manlio; Moo-Puc, Rosa E; Leon-Déniz, Lorena V; Gamboa-León, Rubí; Arjona-Ruiz, Carely; Tun-Garrido, Juan; Mirón-López, Gumersindo; Mena-Rejón, Gonzalo J

2016-01-01

Chagas disease, amebiasis, giardiasis and trichomoniasis represent a serious health problem in Latin America. The drugs employed to treat these illnesses produce important side effects and resistant strains have appeared. The present study was aimed to evaluate the antiprotozoal activity of leaves, stem bark and root bark of Elaeodendron trichotomum , a celastraceus, that is used in Mexico as an anti-infective in febrile-type diseases. Dichloromethane and methanol extracts of leaves, bark and roots of Elaeodendron trichotomum were tested against Entamoeba histolytica , Giardia lamblia , Trichomonas vaginalis , and Trypanosoma cruzi . A quantitative HPLC analysis of pristimerin and tingenone was performed. The dichloromethane extract of roots was active against E. histolytica , G. lamblia , T. vaginalis , and T. cruzi , at IC50's of 0.80, 0.44, 0.46, and 2.68 μg/mL, respectively. The HPLC analysis revealed the presence of tingenone (3.84%) and pristimerin (0.14%). The dichloromethane extract of the roots bark showed significant activity against all screened protozoa.

[Parasitosis and irritable bowel syndrome].

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Ibarra, Catalina; Herrera, Valentina; Pérez de Arce, Edith; Gil, Luis Carlos; Madrid, Ana María; Valenzuela, Lucía; Beltrán, Caroll J

2016-06-01

Irritable bowel syndrome (IBS) is a functional disorder of the gastrointestinal tract characterised by multi-factorial aetiology. In IBS physiopathology are involved diverse factors between them biological, psychosocial, and environmental components which affect the immune activation status of gut mucosa. Among these factors is recognized the intestinal parasitosis. Post-infection IBS (PI-IBS) is recognised as a subgroup of functional disorders whose symptoms onset appear after a symptomatic intestinal infection caused by microbial agents. There are few studies regarding of relationship between IBS and intestinal parasitosis in Chile. However, is has been well described a positive association between IBS and Blastocystis hominis infections, one of prevalent parasites in Chile. In other countries, is also described a relationship between IBS and amebiasis and giardiasis. Both, characterized by a common mode of transmission through water as well as contaminated food. Because the high prevalence of parasitosis in our country it is necessary to expand the association studies to clarify the strength of the parasites ethiology in IBS.

Prevalência e aspectos epidemiológicos da giardíase em creches no município de Aracaju, SE, Brasil

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Gileno de Sá Cardoso

1995-03-01

Full Text Available A survey of the giardiasis prevalence was done in children from 2 till 5 years old who frequented two day nurseries ("A " and "B ". Its relation with some epidemiological aspects through the realization of parasitological exams of stool and an inquiry applied to mothers. Inday nursery "A " with a higth standard of life, 20 (66.6% of 30 inquired children were parasitised and all the children in day nursery "B" had some enteroparasite. Giardia lamblia wasfound in 15 (50% of the children-in better standart of life and in 19 (63.3% of the children with a lower one. The ingesting of vegetables was the only allied factor to the high degree of giardiasis, in day nursery "A ". The day nursery "B " suffered influences from other aspects: no potable water in the residences, the inappropriate destiny of the garbage, the ingesting of vegetables habit and collective bedroom. The adequate sanitation and the existence of domestic animals were not related to parasitism by Giardia lamblia.Foi feito um levantamento da prevalência de giardíase entre crianças na faixa etária de 2 a 5 anos que frequentam duas creches ("A " e "B '' e sua relação com alguns aspectos epidemia lógicos, através da realização de exames parasitológicos de fezes e de inquérito familiar aplicado às mães. Na creche "A ", com padrão sócio-econômico elevado, 20 (66,6% das 30 crianças pesquisadas apresentavam-se parasitadas e na creche "B " todas possuíam algum enteroparasita. Giardia lamblia foi encontrada em 15 (50,0% das crianças da creche com melhor nível sócio-econômico e em 19 (63,3 %das crianças com nívelmais baixo. O hábito de ingerir hortaliças foi o único fator aliado ao alto grau de giardíase na creche "A A creche "B" sofreu influência de outros aspectos: água não potávelnas residências, destino inadequado do lixo, hábito de ingerir hortaliças e dormitório coletivo. O destino inadequado dos dejetos e a existência de animais domésticos n

Disease Burden of 32 Infectious Diseases in the Netherlands, 2007-2011.

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Alies van Lier

Full Text Available Infectious disease burden estimates provided by a composite health measure give a balanced view of the true impact of a disease on a population, allowing the relative impact of diseases that differ in severity and mortality to be monitored over time. This article presents the first national disease burden estimates for a comprehensive set of 32 infectious diseases in the Netherlands.The average annual disease burden was computed for the period 2007-2011 for selected infectious diseases in the Netherlands using the disability-adjusted life years (DALY measure. The pathogen- and incidence-based approach was adopted to quantify the burden due to both morbidity and premature mortality associated with all short and long-term consequences of infection. Natural history models, disease progression probabilities, disability weights, and other parameters were adapted from previous research. Annual incidence was obtained from statutory notification and other surveillance systems, which was corrected for under-ascertainment and under-reporting. The highest average annual disease burden was estimated for invasive pneumococcal disease (9444 DALYs/year; 95% uncertainty interval [UI]: 8911-9961 and influenza (8670 DALYs/year; 95% UI: 8468-8874, which represents 16% and 15% of the total burden of all 32 diseases, respectively. The remaining 30 diseases ranked by number of DALYs/year from high to low were: HIV infection, legionellosis, toxoplasmosis, chlamydia, campylobacteriosis, pertussis, tuberculosis, hepatitis C infection, Q fever, norovirus infection, salmonellosis, gonorrhoea, invasive meningococcal disease, hepatitis B infection, invasive Haemophilus influenzae infection, shigellosis, listeriosis, giardiasis, hepatitis A infection, infection with STEC O157, measles, cryptosporidiosis, syphilis, rabies, variant Creutzfeldt-Jakob disease, tetanus, mumps, rubella, diphtheria, and poliomyelitis. The very low burden for the latter five diseases can be

Disease Burden of 32 Infectious Diseases in the Netherlands, 2007-2011

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Bouwknegt, Martijn; Kretzschmar, Mirjam E.; Mangen, Marie-Josée J.; Wallinga, Jacco; de Melker, Hester E.

2016-01-01

Background Infectious disease burden estimates provided by a composite health measure give a balanced view of the true impact of a disease on a population, allowing the relative impact of diseases that differ in severity and mortality to be monitored over time. This article presents the first national disease burden estimates for a comprehensive set of 32 infectious diseases in the Netherlands. Methods and Findings The average annual disease burden was computed for the period 2007–2011 for selected infectious diseases in the Netherlands using the disability-adjusted life years (DALY) measure. The pathogen- and incidence-based approach was adopted to quantify the burden due to both morbidity and premature mortality associated with all short and long-term consequences of infection. Natural history models, disease progression probabilities, disability weights, and other parameters were adapted from previous research. Annual incidence was obtained from statutory notification and other surveillance systems, which was corrected for under-ascertainment and under-reporting. The highest average annual disease burden was estimated for invasive pneumococcal disease (9444 DALYs/year; 95% uncertainty interval [UI]: 8911–9961) and influenza (8670 DALYs/year; 95% UI: 8468–8874), which represents 16% and 15% of the total burden of all 32 diseases, respectively. The remaining 30 diseases ranked by number of DALYs/year from high to low were: HIV infection, legionellosis, toxoplasmosis, chlamydia, campylobacteriosis, pertussis, tuberculosis, hepatitis C infection, Q fever, norovirus infection, salmonellosis, gonorrhoea, invasive meningococcal disease, hepatitis B infection, invasive Haemophilus influenzae infection, shigellosis, listeriosis, giardiasis, hepatitis A infection, infection with STEC O157, measles, cryptosporidiosis, syphilis, rabies, variant Creutzfeldt-Jakob disease, tetanus, mumps, rubella, diphtheria, and poliomyelitis. The very low burden for the latter five

Disease Burden of 32 Infectious Diseases in the Netherlands, 2007-2011.

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van Lier, Alies; McDonald, Scott A; Bouwknegt, Martijn; Kretzschmar, Mirjam E; Havelaar, Arie H; Mangen, Marie-Josée J; Wallinga, Jacco; de Melker, Hester E

2016-01-01

Infectious disease burden estimates provided by a composite health measure give a balanced view of the true impact of a disease on a population, allowing the relative impact of diseases that differ in severity and mortality to be monitored over time. This article presents the first national disease burden estimates for a comprehensive set of 32 infectious diseases in the Netherlands. The average annual disease burden was computed for the period 2007-2011 for selected infectious diseases in the Netherlands using the disability-adjusted life years (DALY) measure. The pathogen- and incidence-based approach was adopted to quantify the burden due to both morbidity and premature mortality associated with all short and long-term consequences of infection. Natural history models, disease progression probabilities, disability weights, and other parameters were adapted from previous research. Annual incidence was obtained from statutory notification and other surveillance systems, which was corrected for under-ascertainment and under-reporting. The highest average annual disease burden was estimated for invasive pneumococcal disease (9444 DALYs/year; 95% uncertainty interval [UI]: 8911-9961) and influenza (8670 DALYs/year; 95% UI: 8468-8874), which represents 16% and 15% of the total burden of all 32 diseases, respectively. The remaining 30 diseases ranked by number of DALYs/year from high to low were: HIV infection, legionellosis, toxoplasmosis, chlamydia, campylobacteriosis, pertussis, tuberculosis, hepatitis C infection, Q fever, norovirus infection, salmonellosis, gonorrhoea, invasive meningococcal disease, hepatitis B infection, invasive Haemophilus influenzae infection, shigellosis, listeriosis, giardiasis, hepatitis A infection, infection with STEC O157, measles, cryptosporidiosis, syphilis, rabies, variant Creutzfeldt-Jakob disease, tetanus, mumps, rubella, diphtheria, and poliomyelitis. The very low burden for the latter five diseases can be attributed to the

Draft genome sequencing of giardia intestinalis assemblage B isolate GS: is human giardiasis caused by two different species?

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Oscar Franzén

2009-08-01

Full Text Available Giardia intestinalis is a major cause of diarrheal disease worldwide and two major Giardia genotypes, assemblages A and B, infect humans. The genome of assemblage A parasite WB was recently sequenced, and the structurally compact 11.7 Mbp genome contains simplified basic cellular machineries and metabolism. We here performed 454 sequencing to 16x coverage of the assemblage B isolate GS, the only Giardia isolate successfully used to experimentally infect animals and humans. The two genomes show 77% nucleotide and 78% amino-acid identity in protein coding regions. Comparative analysis identified 28 unique GS and 3 unique WB protein coding genes, and the variable surface protein (VSP repertoires of the two isolates are completely different. The promoters of several enzymes involved in the synthesis of the cyst-wall lack binding sites for encystation-specific transcription factors in GS. Several synteny-breaks were detected and verified. The tetraploid GS genome shows higher levels of overall allelic sequence polymorphism (0.5 versus <0.01% in WB. The genomic differences between WB and GS may explain some of the observed biological and clinical differences between the two isolates, and it suggests that assemblage A and B Giardia can be two different species.

Environmental change and enteric zoonoses in New Zealand: a systematic review of the evidence.

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Lal, Aparna; Lill, Adrian W T; Mcintyre, Mary; Hales, Simon; Baker, Michael G; French, Nigel P

2015-02-01

To review the available evidence that examines the association between climatic and agricultural land use factors and the risks of enteric zoonoses in humans and consider information needs and possible pathways of intervention. The electronic databases PubMed, Web of Science and Embase and government websites were searched systematically for published literature that investigated the association of climatic and/or agricultural exposures with the incidence of the four most common enteric zoonotic diseases in New Zealand (campylobacteriosis, salmonellosis, cryptosporidiosis and giardiasis). Results The 16 studies in the review demonstrated significant associations between climate, agricultural land use and enteric disease occurrence. The evidence suggests that enteric disease risk from environmental reservoirs is pathogen specific. In some rural regions, environmental pathogen load is considerable, with multiple opportunities for zoonotic transmission. Enteric disease occurrence in NZ is associated with climate variability and agricultural land use. However, these relationships interact with demographic factors to influence disease patterns. Improved understanding of how environmental and social factors interact can inform effective public health interventions under scenarios of projected environmental change. © 2014 Public Health Association of Australia.

Molecular characterization of Giardia intestinalis assemblage E from goat kids in Bangladesh

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Mohammad Alamgir Hossain

2015-05-01

Full Text Available Objective: To molecularly characterize Giardia in goat kids to elucidate the possible zoonotic hazards in Bangladesh and find out the role of Giardia protozoan parasite as a source of human infection. Methods: Fecal samples of 100 goat kids were genotyped by nested PCR amplification of β-giardin gene fragment followed by sequencing and analysis. Results: The total prevalence of Giardia in goat kids was 3% (3/100 and the infection is more widespread in younger (P = 0.36, Black Bengal breed (P = 0.81 and female goat kids (P = 0.58. Further analysis ofβ-giardin gene locus has shown that the gene clustered in assemblage E rather than assemblages A and B. Conclusions: The present study suggests the low zoonotic transmission frequency from the goat kids and and giardiasis has least epidemiological significance to humans. Further study on this field is prerequisite in terms of broad geographical areas, age groups, sex and evaluation of zoonotic significance along with genetic diversity in other host species as well.

[Giardia muris infection in laboratory rats (Rattus norvegicus) and treatment with metronidazole].

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Beyhan, Yunus Emre; Hökelek, Murat

2014-01-01

This study was conducted to determine the effectiveness of metronidazole for treatment of Giardia muris infection in laboratory rats. The feces of rats was yellow watery diarrhea and brought to the surgery research center of University of Ondokuz Mayis in order to be a study. Stool samples were examined by native examination, evaluation of infection rates was done with an X40 lens, and results were recorded as positive from 1 to 4. Metronidazole was administered to infected animals orally for 5 days with a 20 mg/kg dose. As a result of fecal examination of 64 rats held in groups of four in cages, 15 of the cages (60 rats) were found to be infected with G. muris. While agents were not observed in collected stool samples following 5, 7, and 14 days of drug administration of 14 groups, trophozoite density in one cage was decreased (75%), and adverse effects were not seen in rats. Metronidazole was found to be an effective drug for the treatment of giardiasis.

Comparative analysis of enzyme-linked immunosorbent assay and direct microscopy for the diagnosis of Giardia intestinalis in fecal samples

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Shipra Singhal

2015-01-01

Full Text Available Context: Giardiasis is one of the most common nonviral infections causing diarrheal illness worldwide. In this prospective cross-sectional study, we evaluated the RIDASCREEN ® Giardia kit for detection of Giardia intestinalis in stool samples and compared the results with direct microscopy. Materials and methods: A total of 360 fecal samples were collected. They were then processed by wet film, iodine preparation and an enzyme-linked immunosorbent assay (ELISA kit to determine the presence of Giardia trophozoites and cysts. Statistical analysis was performed by sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy. Results and Conclusion: Of the 360 cases, 17.2% samples were positive for Giardia by direct microscopy and 23.6% were found to be positive by ELISA (sensitivity ~97%, but specificity was ~92% only. Because of less specificity, we need to perform ELISA in congruence with direct microscopy, etc. Further studies need to be performed on a larger sample size using other molecular tests in order to get more accurate estimations.

Hospitalization records as a tool for evaluating performance of food- and water-borne disease surveillance systems: a Massachusetts case study.

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Mor, Siobhan M; DeMaria, Alfred; Naumova, Elena N

2014-01-01

We outline a framework for evaluating food- and water-borne surveillance systems using hospitalization records, and demonstrate the approach using data on salmonellosis, campylobacteriosis and giardiasis in persons aged ≥65 years in Massachusetts. For each infection, and for each reporting jurisdiction, we generated smoothed standardized morbidity ratios (SMR) and surveillance to hospitalization ratios (SHR) by comparing observed surveillance counts with expected values or the number of hospitalized cases, respectively. We examined the spatial distribution of SHR and related this to the mean for the entire state. Through this approach municipalities that deviated from the typical experience were identified and suspected of under-reporting. Regression analysis revealed that SHR was a significant predictor of SMR, after adjusting for population age-structure. This confirms that the spatial "signal" depicted by surveillance is in part influenced by inconsistent testing and reporting practices since municipalities that reported fewer cases relative to the number of hospitalizations had a lower relative risk (as estimated by SMR). Periodic assessment of SHR has potential in assessing the performance of surveillance systems.

Hospitalization records as a tool for evaluating performance of food- and water-borne disease surveillance systems: a Massachusetts case study.

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Siobhan M Mor

Full Text Available We outline a framework for evaluating food- and water-borne surveillance systems using hospitalization records, and demonstrate the approach using data on salmonellosis, campylobacteriosis and giardiasis in persons aged ≥65 years in Massachusetts. For each infection, and for each reporting jurisdiction, we generated smoothed standardized morbidity ratios (SMR and surveillance to hospitalization ratios (SHR by comparing observed surveillance counts with expected values or the number of hospitalized cases, respectively. We examined the spatial distribution of SHR and related this to the mean for the entire state. Through this approach municipalities that deviated from the typical experience were identified and suspected of under-reporting. Regression analysis revealed that SHR was a significant predictor of SMR, after adjusting for population age-structure. This confirms that the spatial "signal" depicted by surveillance is in part influenced by inconsistent testing and reporting practices since municipalities that reported fewer cases relative to the number of hospitalizations had a lower relative risk (as estimated by SMR. Periodic assessment of SHR has potential in assessing the performance of surveillance systems.

[ERRORS IN DIAGNOSIS AND TREATMENT OF IMMUNODEPENDENT PATHOLOGY (ORIGINAL CONCEPT)].

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Kazmirchuk, V E; Tsaryk, V V; Maltsev, D V; Dyseeva, V V; Voytyuk, T V; Sidorenko, E I; Solon'ko, I I; Pyankova, A V

2015-01-01

Based on many years of experience in 2009, we developed the original concept of a mixed approach to the treatment of infectious diseases in patients. During 2.5 years(from 2013 to June 2015) to have applied for consultative-diagnostic help of 3965 patients who had not verified the primary diagnosis. The basic principle of verification of the pathology of the removal of various causes immunosuppression. Based on our extensive, research and observation was often found in patients ascaridosis (55%) and giardiasis (65%), as a possible cause of immunosuppression. In 13% of patients was found the mucosal candidiasis. Among frequently and chronically ill persons we identified the active forms of Epstein-Barr virus (quantitative polymerase chain reaction in saliva) in 40%. The criterion for assessing performance immunogram was a decrease of two sigmal deviation from the lower age limit. In the study of neutrophil myeloperoxidase content observed decline (Immunological study of patients should be redynamics after eliminating the causes immunosuppression and sanitation foci of infection. Only multi-level examination of the patient will determine the final diagnosis and adequate treatment.

Intestinal parasitosis among Yemeni patients with cancer, Sana'a, Yemen.

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Al-Qobati, Salah A; Al-Maktari, Mohamed T; Al-Zoa, Abdulla M Bin; Derhim, Mohamed

2012-12-01

The profile of intestinal parasitosis was assessed among patients on anticancer chemotherapy in Sana'a city, Yemen during the period from April to December 2011. A total of 206 patients (115 males & 91 females), aged 3 to 18 years with mean of 14.17 +/- 3.13 were subjected to stool examinations by different techniques. The overall rate of intestinal parasites was 63.1%. Cryptosporidium parvum was the highest (30.1%) followed by G. lamblia (18.0%) and then C. cayetanensis (5.3%). Blastocystis hominis and E. histolytica/dispar were detected in 4.9% & 2.4% respectively. E. coli, H. nana and A. lumbricoides were diagnosed in an equal of 1.5% and S. stercoralis was seen in one case only. The majority of infected patients suffered from diarrhea. They showed 4.64 risk of protozoan infections compared to those who passed formed stool with statistically significant difference. Diarrhea was associated with higher risk of cryptosporidiosis and giardiasis (OR = 2.73 & 2.67 respectively). The risk of intestinal parasitosis neither differed significantly with patients' age nor sex.

Predictors of intestinal parasitosis in school children of Kashmir: a prospective study.

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Singh, Charanjit; Zargar, Showkat Ali; Masoodi, Ibrahim; Shoukat, Abid; Ahmad, Bilal

2010-01-01

To identify the factors associated with intestinal parasitosis in rural and urban school children of Kashmir. Single fresh stool samples from rural and urban school children in three age groups: a) 5 to intestinal helminths. Concentration methods were used if egg count was low. 274 stool samples from rural school children and 240 samples were taken from urban school children respectively. 214 (46.7%) students had stool tests positive for parasitosis. Ascariasis was the most prevalent parasitosis (28%) followed by Giardiasis (7%), Trichuriasis( 5%) and Taeniasis( 4%). There was higher prevalence of parasitosis among rural orphanage children compared to urban orphanage students (76% vs. 48% p parasitosis compared to those who were using tap water. 202 students were found to have poor personal hygiene and parasitosis was higher in them compared to students with good personal hygiene (p intestinal infestation besides socio economic status. Regular deworming programmes need to be adopted at school level especially in 8-11 years old children to check the surge of intestinal parasites and their subsequent morbidities.

Characterization of the local immune response to cyst antigens during the acute and elimination phases of primary murine giardiasis.

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Abdul-Wahid, Aws; Faubert, Gaétan

2008-05-01

During the course of a giardial infection, the host's immune system is presented with a variety of Giardia antigens as trophozoites differentiate, through encysting cells, to form the infective cysts. Previous studies examining the host's immune response during giardial infections have focused on trophozoite-derived antigens (Ags). In this study, we were interested to determine if the host's immune system reacts to cyst Ags during the acute and elimination phases, when there is cyst shedding. For this purpose, we used antigenic extracts from trophozoites (Troph), encysting cells (ENC), and purified giardial cyst walls (PCW), as well as purified recombinant cyst wall protein 2 (rCWP2). Comparative analysis of the parasite extracts using SDS-PAGE analysis and surface-enhanced laser desorption/ionization time of flight mass spectrometry resulted in the detection of 175 protein entities, of which 26 were Troph-specific proteins, 17 ENC-specific proteins, and 31 were PCW-specific proteins. On the other hand, we detected 34 proteins shared between Troph and ENC, 19 proteins that were shared between ENC and PCW, and 29 proteins that were common to Troph and PCW. Finally, we detected 19 proteins that were shared by all three extract samples. BALB/c mice were infected with 10(5)Giardia muris cysts and sacrificed either at the acute or elimination phases of infection (days 12 and 40, respectively), and lymphocytes were isolated from the Peyer's patches (PP). Using flow cytometry, we detected significant increases in the number of PP-derived CD4(+) and CD19(+), but not CD8(+) lymphocytes. Quantification of the number of mucosal IL-4 and IFN-gamma secreting T-lymphocytes by enzyme-linked immunosorbent spot assay showed that these cells reacted by secreting similar levels of IL-4 and IFN-gamma, regardless of the Ag or the phase of infection. Analysis of intestinal humoral immune responses by ELISA resulted in the detection of Ag-specific IgA and IgG intestinal antibodies. Regardless of the Ag tested, a trend was consistently observed where the concentration of local antibodies was found to be slightly increased by the acute phase, where we detected approximately 200microg/mg of specific IgA and approximately 300ng/ml of specific IgG in intestinal lavage of infected mice. By the elimination phase, the amount of specific antibodies was found to increase to approximately 600microg/mg of specific IgA and approximately 1300ng/ml of specific IgG antibodies. Finally, we tested the biological activity of these antibodies and found that they were able to reduce the ability of trophozoites to differentiate into cysts in vitro. Collectively, we believe these results demonstrate for the first time the existence of significant cellular and humoral immune responses against Giardia cyst Ags that may contribute to the reduction of cyst shedding in infected animals.

Ultrastructural observations on giardiasis in a mouse model. II. Endosymbiosis and organelle distribution in Giardia muris and Giardia lamblia.

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Nemanic, P C; Owen, R L; Stevens, D P; Mueller, J C

1979-08-01

Ultrastructural observations of Giardia muris in a mouse model revealed endosymbiotic microbes not previously reported in Giardia. Endosymbionts 240--360 nm wide, 600--1,400 nm long, and with an internal structure similar to that of bacilli were not seen entering Giardia but were found and appeared to divide within Giardia. No evidence was found of digestion of the endosymbionts by the giardia host in either the trophozoite or the cyst form. Endosymbionts were concentrated centrally around the nuclear area and were uncommon in peripheral feeding regions. The same cellular organelles seen in G. muris were found in Giardia lamblia from human jejunal biopsy material, but no endosymbionts were identified in G. lamblia trophozoites from the seven patients examined. Endosymbionts within Giardia may be found to alter trophozoite pathogenicity, metabolism, range of infectivity, antigenic surface characteristics, and host specificity, as they do in other protozoa.

Host-Parasite Interaction: Parasite-Derived and -Induced Proteases That Degrade Human Extracellular Matrix

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Carolina Piña-Vázquez

2012-01-01

Full Text Available Parasitic protozoa are among the most important pathogens worldwide. Diseases such as malaria, leishmaniasis, amoebiasis, giardiasis, trichomoniasis, and trypanosomiasis affect millions of people. Humans are constantly threatened by infections caused by these pathogens. Parasites engage a plethora of surface and secreted molecules to attach to and enter mammalian cells. The secretion of lytic enzymes by parasites into host organs mediates critical interactions because of the invasion and destruction of interstitial tissues, enabling parasite migration to other sites within the hosts. Extracellular matrix is a complex, cross-linked structure that holds cells together in an organized assembly and that forms the basement membrane lining (basal lamina. The extracellular matrix represents a major barrier to parasites. Therefore, the evolution of mechanisms for connective-tissue degradation may be of great importance for parasite survival. Recent advances have been achieved in our understanding of the biochemistry and molecular biology of proteases from parasitic protozoa. The focus of this paper is to discuss the role of protozoan parasitic proteases in the degradation of host ECM proteins and the participation of these molecules as virulence factors. We divide the paper into two sections, extracellular and intracellular protozoa.

[Experimental model of activated Lamblia (Giardia) muris infection in albino mice].

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Irikov, O A; Kovalenko, F P

2007-01-01

Experimental L. muris infection was reproduced in 100% of the intact albino mice intragastrically given levomycin in an average total dose of 15.88-34.84 or 0.88-1.02 g/kg for 18-34 days. With levomycin administration, the intensity of giardiasis was 1121.6-8540.1 (mean 4830.9) thousand L. muris trophozoites per animal. The total number of trophozoites per animal decreased to 302.2-3481.4 (mean 1546.4) thousand and 28.1-324.0 (mean 109.4) thousand specimens 5-8 and 11-13 days after discontinuation of the antibiotic, respectively. The maximum number of L. muris trophozoites was observed in the proximal and middle portions of the murine small intestine during and after the administration oflevomycin. The highest isolation of cysts was seen 12-14 days after the initiation of administration of the antibiotic. Following 8-10 days of terminations of a course of levomycin therapy the native smear of animal feces showed no Lamblia cysts. In mice with activated infection, the isolation rate of Lamblia cysts was directly related to the intensity of intestinal infection with trophozoites of the parasite.

Intestinal parasitosis: data analysis 2006-2011 in a teaching hospital of Ancona, Italy.

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Silvestri, Carmela; Greganti, Gianfranco; Arzeni, Daniela; Morciano, Angela; Castelli, Pamela; Barchiesi, Francesco; Cirioni, Oscar; Giacometti, Andrea

2013-03-01

Intestinal parasites are a serious problem in developing countries, but should not be underestimated in industrialised countries either. Between January 2006 and December 2011, stool specimens and the scotch tests of 5323 Italian and non Italian patients (adults and children) attending the laboratory of our Infectious Diseases Clinic in a teaching Hospital at Ancona were analyzed specifically for intestinal parasites. The present study shows that, over a six-year period, of a total of 5323 patients 305 harboured at least one species of parasite (5.7%). Among the pathogenic protozoa Giardia lamblia was the most common, the overall prevalence of giardiasis being 1.8 % (99/5323). Helminths were found in 0.9% of the patients (48/5323). In particular, Hymenolepis nana, Strongyloides stercoralis and Trichuris trichiura were most commonly recovered in non-Italian children, suggesting that certain intestinal parasites are restricted to endemic areas in the tropics. Eighteen of the 305 infected patients had more than one parasite in their stools. Our study demonstrates that intestinal parasites must be considered even in industrialised areas and stool examination should be supported by epidemiological data and clinical features.

Prevalence and risk factors of intestinal parasitism among two indigenous sub-ethnic groups in Peninsular Malaysia.

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Chin, Yuee Teng; Lim, Yvonne Ai Lian; Chong, Chun Wie; Teh, Cindy Shuan Ju; Yap, Ivan Kok Seng; Lee, Soo Ching; Tee, Mian Zi; Siow, Vinnie Wei Yin; Chua, Kek Heng

2016-07-18

Intestinal parasitic infections (IPIs) among indigenous people have been widely documented in Malaysia, however, the prevalence of these infections remains high. In the past, most studies have focused on specific species of parasites but polyparasitism has received limited attention. In addition, epidemiology studies on indigenous people tend to consider them as a homogenous group, whereas in reality different sub-ethnic groups have different cultural and living practices. Variations in living habits such as personal hygiene practices may predispose different groups to different parasitic infections. To better understand prevalence and risk factors of intestinal parasitism among different sub-ethnic groups, the present study was conducted among two sub-ethnic groups of indigenous people (Temuan and Mah Meri) residing in Selangor state, Malaysia. A cross-sectional study that focused on two distinct sub-ethnic groups was carried out from February to September 2014. Faecal samples were collected from 186 participants and examined using the formalin-ether sedimentation technique. A molecular approach was adopted to conduct a genetic characterisation of the parasites. Additionally, questionnaires were administered to obtain information on the demographics, socio-economic backgrounds and behavioural risks relating to the participants, as well as information about their environments. Statistical analyses (i.e. binary and multivariate logistic regression analyses) were performed to measure risk factors. For Temuan communities, trichuriasis (64.2 %) was the most common infection found, preceding hookworm infection (34 %), ascariasis (7.5 %), giardiasis (14.2 %) and amoebiasis (7.5 %). As for the Mah Meri communities, trichuriasis (77.5 %) prevailed over ascariasis (21.3 %), hookworm (15 %), giardiasis (7.5 %) and amoebiasis (3.8 %). Significant differences in proportions of trichuriasis, ascariasis and hookworm infections were observed between the Temuan and Mah

Enteric parasites in HIV-1/AIDS-infected patients from a Northwestern São Paulo reference unit in the highly active antiretroviral therapy era

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Luciana Ventura Cardoso

2011-12-01

Full Text Available INTRODUCTION: We describe the epidemiology of intestinal parasites in patients from an AIDS reference service in Northeastern São Paulo, Brazil. METHODS: Retrospective evaluation was done for all HIV-1/AIDS-positive patients whose Hospital de Base/São José do Rio Preto laboratorial analysis was positive for enteroparasites after diagnosis of HIV-1 infection, from January 1998 to December 2008. Statistical analysis was performed using the R statistical software version 2.4.1. The level of significance adopted was 5%. RESULTS: The most frequent protozoan was Isospora belli (4.2%, followed by Giardia lamblia (3.5%, Entamoeba coli (2.8%, and Cryptosporidium parvum (0.3%. Ancylostoma duodenale (1.4% was the most frequently detected helminth, while Taenia saginata and Strongiloides stercoralis were found in 0.7% of the samples. The results showed that diarrhea was significantly associated with giardiasis and isosporiasis. However, no association was observed between CD4+ cell counts, viral load, and the characteristics of any particular parasite. CONCLUSIONS: Our data may be useful for further comparisons with other Brazilian regions and other developing countries. The data may also provide important clues toward improving the understanding, prevention, and control of enteric parasites around the world.

Parasitic infections of wild rabbits and hares

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Ilić Tamara

2014-01-01

Full Text Available The paper presents the most important parasitic infections of wild rabbits and hares, which harmful effect in this animal population is manifested as a gradual weakening of the immune system, reduction in fertility, weight loss and constant exhaustion. Order of Lagomorpha (hares or lagomorphs belongs to superorder of higher mammals which includes the family of rabbits (Leporidae which are represented in Europe as well as the family of whistleblowers (Ochotonidae which live only in North America and Northern regions of Asia. The most important representatives of Leporidae family are European hare (Lepus europeus and wild rabbit (Oryctolagus cuniculus. The most important endoparasitosis of hares and wild rabbits are: coccidiosis, encephalitozoonosis (nosemosis, toxoplasmosis, sarcocystosis, giardiasis, cryptosporidiosis, protostrongylosis, trichostrngylodosis, passalurosis, anoplocephalidosis, cysticercosis and fasciolosis. The most frequent ectoparasites of rabbits and wild hares are fleas, lice and ticks. Reduction in hare population, which is noticed in whole Europe including Serbia, is caused by changed living conditions, quantitatively and qualitatively insufficient nutrition, increased use of herbicides as well as various infectious diseases and the diseases of parasitic etiology. Since wild rabbits and hares pose a threat to health of domestic rabbits and people, knowledge of parasitic fauna of these wild animals is of extreme epizootiological and epidemiological importance.

Cryptosporidium and Giardia in Surface Water: A Case Study from Michigan, USA to Inform Management of Rural Water Systems

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Erin A. Dreelin

2014-10-01

Full Text Available Cryptosporidium and Giardia pose a threat to human health in rural environments where water supplies are commonly untreated and susceptible to contamination from agricultural animal waste/manure, animal wastewater, septic tank effluents and septage. Our goals for this paper are to: (1 explore the prevalence of these protozoan parasites, where they are found, in what quantities, and which genotypes are present; (2 examine relationships between disease and land use comparing human health risks between rural and urban environments; and (3 synthesize available information to gain a better understanding of risk and risk management for rural water supplies. Our results indicate that Cryptosporidium and Giardia were more prevalent in rural versus urban environments based on the number of positive samples. Genotyping showed that both the human and animal types of the parasites are found in rural and urban environments. Rural areas had a higher incidence of disease compared to urban areas based on the total number of disease cases. Cryptosporidiosis and giardiasis were both positively correlated (p < 0.001 with urban area, population size, and population density. Finally, a comprehensive strategy that creates knowledge pathways for data sharing among multiple levels of management may improve decision-making for protecting rural water supplies.

Larrea tridentata: A novel source for anti-parasitic agents active against Entamoeba histolytica, Giardia lamblia and Naegleria fowleri.

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Bharat Bashyal

2017-08-01

Full Text Available Protozoan parasites infect and kill millions of people worldwide every year, particularly in developing countries where access to clean fresh water is limited. Among the most common are intestinal parasites, including Giardia lamblia and Entamoeba histolytica. These parasites wreak havoc on the epithelium lining the small intestines (G. lamblia and colon (E. histolytica causing giardiasis and amebiasis, respectively. In addition, there are less common but far more deadly pathogens such as Naegleria fowleri that thrive in warm waters and infect the central nervous systems of their victims via the nasal passages. Despite their prevalence and associated high mortality rates, there remains an unmet need to identify more effective therapeutics for people infected with these opportunistic parasites. To address this unmet need, we have surveyed plants and traditional herbal medicines known throughout the world to identify novel antiparasitic agents with activity against G. lamblia, E. histolytica, and N. fowleri. Herein, we report Larrea tridentata, known as creosote bush, as a novel source for secondary metabolites that display antiparasitic activity against all three pathogens. This report also characterizes the lignan compound classes, nordihydroguairetic acid and demethoxyisoguaiacin, as novel antiparasitic lead agents to further develop more effective drug therapy options for millions of people worldwide.

Larrea tridentata: A novel source for anti-parasitic agents active against Entamoeba histolytica, Giardia lamblia and Naegleria fowleri.

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Bashyal, Bharat; Li, Linfeng; Bains, Trpta; Debnath, Anjan; LaBarbera, Daniel V

2017-08-01

Protozoan parasites infect and kill millions of people worldwide every year, particularly in developing countries where access to clean fresh water is limited. Among the most common are intestinal parasites, including Giardia lamblia and Entamoeba histolytica. These parasites wreak havoc on the epithelium lining the small intestines (G. lamblia) and colon (E. histolytica) causing giardiasis and amebiasis, respectively. In addition, there are less common but far more deadly pathogens such as Naegleria fowleri that thrive in warm waters and infect the central nervous systems of their victims via the nasal passages. Despite their prevalence and associated high mortality rates, there remains an unmet need to identify more effective therapeutics for people infected with these opportunistic parasites. To address this unmet need, we have surveyed plants and traditional herbal medicines known throughout the world to identify novel antiparasitic agents with activity against G. lamblia, E. histolytica, and N. fowleri. Herein, we report Larrea tridentata, known as creosote bush, as a novel source for secondary metabolites that display antiparasitic activity against all three pathogens. This report also characterizes the lignan compound classes, nordihydroguairetic acid and demethoxyisoguaiacin, as novel antiparasitic lead agents to further develop more effective drug therapy options for millions of people worldwide.

The proteasome of the differently-diverged eukaryote Giardia lamblia and its role in remodeling of the microtubule-based cytoskeleton.

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Ray, Atrayee; Sarkar, Srimonti

2017-08-01

Giardia lamblia is the causative agent of the diarrheal disease giardiasis, against which only a limited number of drugs are currently available. Increasing reports of resistance to these drugs makes it necessary to identify new cellular targets for designing the next generation of anti-giardial drugs. Towards this goal, therapeutic agents that target the parasitic cellular machinery involved in the functioning of the unique microtubule-based cytoskeleton of the Giardia trophozoites are likely to be effective as microtubule function is not only important for the survival of trophozoites within the host, but also their extensive remodeling is necessary during the transition from trophozoites to cysts. Thus, drugs that affect microtubule remodeling have the potential to not only kill the disease-causing trophozoites, but also inhibit transmission of cysts in the community. Recent studies in other model organisms have indicated that the proteasome plays an integral role in the formation and remodeling of the microtubule-based cytoskeleton. This review draws attention to the various processes by which the giardial proteasome may impact the functioning of its microtubule cytoskeleton and highlights the possible differences of the parasitic proteasome and some of other cellular machinery involved in microtubule remodeling, compared to that of the higher eukaryotic host.

Histological outcome of duodenal biopsies in patients with clinically suspected celiac disease - a study of 100 cases

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Sarfraz, T.; Khan, S.A.; Tariq, H.

2018-01-01

To see the histological outcome of duodenal biopsies done in patients clinically suspected of celiac disease. Study Design: Prospective descriptive study. Place and Duration of Study: Histopathology Department, Army Medical College Rawalpindi, from 1 Jan 2017 to 30 Jun 2017. Material and Methods: One hundred (100) cases were included in the study. Duodenal biopsies done in patients clinically suspected of celiac disease were included in the study. Inadequate biopsies were excluded from the study. All the normal and abnormal histological features were noted to make the diagnosis. Data was entered and analyzed by using SPSS version 17. Results: Duodenal biopsies of 100 patients, done in clinically suspected cases of celiac disease were analyzed histologically. Out of these 100 cases, 46 cases (46%) showed histological features consistent with celiac disease, while 38 cases (38%) revealed chronic non specific duodenitis, 2 cases (2%) were of giardiasis, while 14 biopsies (14%) were unremarkable with no significant pathology. Conclusion: A significant number of cases clinically suspected of celiac disease may not be showing histological features consistent with celiac disease on duodenal biopsies. Due to the changing presentation of disease, as well as the recognition of a number of potential clinical and histopathological mimics, communication between pathologists and gastroenterologists is essential for appropriate interpretation of duodenal biopsy specimens. (author)

[Circumstances for diagnosis and treatment of intestinal parasitosis in France].

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Bouchaud, Olivier

2013-01-01

In a compatible context, hypereosinophilia is suggestive of helminthosis. When the count is higher than 1000/mm(3), a primo-invasion syndroma may be considered, especially if allergic signs are present. Below that level, the helminthosis is probably at the adult stage (chronic phase). In a chronic diarrhoea occurring after a journey abroad, "emerging" protozoa (crypto-microsporidia, Isospora, Cyclospora…) are possibly in cause. A presumptive treatment may be considered. A systematic screening for schistosomiasis (serology and stool examination) is recommended in travellers exposed to the risk (contacts with fresh water) and in immigrant from endemic areas (mainly sub-Saharan Africa) since the disease may be asymptomatic. In young children living communally, two courses at 15 days interval against giardiosis or enterobiasis are recommended for both infected and contact persons. In order to avoid disseminated strongyloidiasis, severe and possibly lethal, a systematic course of ivermectine is strongly recommended before any immunosuppressive treatment in patients having stayed in tropical areas even for a short period and even decades ago. Albendazole became the reference drug for intestinal helminthiasis with in addition a good efficacy on giardiasis. Since some intestinal parasites are not pathogenic, a treatment is not necessarily required when a parasite is found in a stool examination. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

Prevalencia de protozoos intestinales en 79 niños de 2 a 5 años de edad de un hogar infantil estatal en Circasia, Quindío Prevalence of intestinal Protozoa in79 Children 2 to 5 years old from a state nursery in Circasia, Quindío

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Jonathan Andrés Arias

2010-03-01

Full Text Available Introducción: Los parásitos intestinales se consideran un problema de salud pública en los países en desarrollo y afecta a individuos de todas las edades y sexos, pero se presentan, sobre todo, en los primeros años de vida. En la actualidad, entre las parasitosis más reportadas para el departamento del Quindío se encuentra la giardiasis, producida por Giardia intestinalis (G. duodenalis o G. lamblia, y la blastocistocis, producida por Blastocystis sp. Objetivo: Determinar la prevalencia de protozoos intestinales en 79 niños con edades comprendidas entre los 2 y 5 años, de un hogar infantil en el municipio de Circasia, Quindío. Materiales y métodos: Se recolectaron tres muestras de heces en 79 niños con previo consentimiento del tutor legal. Las muestras fueron sometidas al análisis de laboratorio por examen directo macroscópico y microscópico, utilizando lugol al 1%, solución salina al 0,83%, solución salina-eosina y la técnica de concentración de Ritchie o formol-éter. Resultados: Para los tres muestras, los parásitos con potencial patógeno tuvieron las siguientes prevalencias: Blastocystis sp., 49,4%, 57% y 64,6%; G. lamblia, 16,5%, 22,8% y 15,2 %; complejo Entamoeba histolytica/dispar, 5,1%, 5,1% y 1,3%, respectivamente. Conclusiones: Este estudio muestra la elevada prevalencia de parásitos protozoarios, y Blastocystis sp. fue el más prevalente. Durante el seguimiento se detectó reinfestación de los niños que participaron en el estudio.Introduction: Intestinal parasites are a public health problem in developing countries, and they affect individuals of all ages and sexes; nevertheless they are frequent in early childhood. At present, the most reported intestinal parasite conditions in Quindío are giardiasis, caused by Giardia intestinalis (G. lamblia or G.duodenalis, and blastocystosis caused by Blastocystis sp. Objective: The objective is to determine the prevalence of intestinal parasites in children 2 to 5 years

Evaluation of chronic diarrhea.

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Juckett, Gregory; Trivedi, Rupal

2011-11-15

Chronic diarrhea, defined as a decrease in stool consistency for more than four weeks, is a common but challenging clinical scenario. It can be divided into three basic categories: watery, fatty (malabsorption), and inflammatory. Watery diarrhea may be subdivided into osmotic, secretory, and functional types. Watery diarrhea includes irritable bowel syndrome, which is the most common cause of functional diarrhea. Another example of watery diarrhea is microscopic colitis, which is a secretory diarrhea affecting older persons. Laxative-induced diarrhea is often osmotic. Malabsorptive diarrhea is characterized by excess gas, steatorrhea, or weight loss; giardiasis is a classic infectious example. Celiac disease (gluten-sensitive enteropathy) is also malabsorptive, and typically results in weight loss and iron deficiency anemia. Inflammatory diarrhea, such as ulcerative colitis or Crohn disease, is characterized by blood and pus in the stool and an elevated fecal calprotectin level. Invasive bacteria and parasites also produce inflammation. Infections caused by Clostridium difficile subsequent to antibiotic use have become increasingly common and virulent. Not all chronic diarrhea is strictly watery, malabsorptive, or inflammatory, because some categories overlap. Still, the most practical diagnostic approach is to attempt to categorize the diarrhea by type before testing and treating. This narrows the list of diagnostic possibilities and reduces unnecessary testing. Empiric therapy is justified when a specific diagnosis is strongly suspected and follow-up is available.

Transmission and epidemiology of zoonotic protozoal diseases of companion animals.

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Esch, Kevin J; Petersen, Christine A

2013-01-01

Over 77 million dogs and 93 million cats share our households in the United States. Multiple studies have demonstrated the importance of pets in their owners' physical and mental health. Given the large number of companion animals in the United States and the proximity and bond of these animals with their owners, understanding and preventing the diseases that these companions bring with them are of paramount importance. Zoonotic protozoal parasites, including toxoplasmosis, Chagas' disease, babesiosis, giardiasis, and leishmaniasis, can cause insidious infections, with asymptomatic animals being capable of transmitting disease. Giardia and Toxoplasma gondii, endemic to the United States, have high prevalences in companion animals. Leishmania and Trypanosoma cruzi are found regionally within the United States. These diseases have lower prevalences but are significant sources of human disease globally and are expanding their companion animal distribution. Thankfully, healthy individuals in the United States are protected by intact immune systems and bolstered by good nutrition, sanitation, and hygiene. Immunocompromised individuals, including the growing number of obese and/or diabetic people, are at a much higher risk of developing zoonoses. Awareness of these often neglected diseases in all health communities is important for protecting pets and owners. To provide this awareness, this review is focused on zoonotic protozoal mechanisms of virulence, epidemiology, and the transmission of pathogens of consequence to pet owners in the United States.

Histopathological survey of protozoa, helminths and acarids of imported and local psittacine and passerine birds in Japan.

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Tsai, S S; Hirai, K; Itakura, C

1992-12-01

A total of 534 psittacine and passerine birds consisting of 241 imported and 293 local birds were examined histologically. As a result, the following parasites were found: Giardia (86 cases), Knemido-coptes (26 cases), coccidia (10 cases), Ascaridia (6 cases), Cryptosporidium (5 cases), Sarcocystis (5 cases), tapeworm (4 cases), microfilaria (2 cases), Hexamita (1 case), and Spiroptera (1 case). High incidences of giardiasis and knemido-coptic infestation were detected in the local birds, but rarely in the imported birds. Giardial trophozoites were observed mainly in the duodenum of budgerigars (Melopsittacus undulatus). Knemidocoptic mites burrowed into the epidermis producing proliferative dermatitis in 25 budgerigars and 1 African Grey Parrot (Psittacus erithacus erithacus). This ectoparasite often infested the skin around the cloaca. Coccidiosis was seen only in the small intestines of the finch (Poephila gouldiae gouldiae), African Grey Parrot, Rainbow lory (Trichoglossus haematodus), Indian Ring-necked parakeet (Psittacula krameri manillensis) and peach-faced lovebird (Agapornis roseicollis). Two parrots (Amazona aestiva aestiva and Psittacus erithacus erithacus) and two budgerigars had intestinal cryptosporidiosis. Conjunctivitis associated with cryptosporidial infection was seen in a lovebird. Sarcocystis cysts containing crescent-shaped bradyzoites were found not only in the thigh and breast but also in the heart and cloacal muscles. Other organisms such as Ascaridia, tapeworm, microfilaria, Hexamita, and Spiroptera were clinically less significant. However, infections such as Giardia and Cryptosporidim might have zoonotic implications.

Prevalence and direct costs of emergency department visits and hospitalizations for selected diseases that can be transmitted by water, United States.

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Adam, E A; Collier, S A; Fullerton, K E; Gargano, J W; Beach, M J

2017-10-01

National emergency department (ED) visit prevalence and costs for selected diseases that can be transmitted by water were estimated using large healthcare databases (acute otitis externa, campylobacteriosis, cryptosporidiosis, Escherichia coli infection, free-living ameba infection, giardiasis, hepatitis A virus (HAV) infection, Legionnaires' disease, nontuberculous mycobacterial (NTM) infection, Pseudomonas-related pneumonia or septicemia, salmonellosis, shigellosis, and vibriosis or cholera). An estimated 477,000 annual ED visits (95% CI: 459,000-494,000) were documented, with 21% (n = 101,000, 95% CI: 97,000-105,000) resulting in immediate hospital admission. The remaining 376,000 annual treat-and-release ED visits (95% CI: 361,000-390,000) resulted in $194 million in annual direct costs. Most treat-and-release ED visits (97%) and costs ($178 million/year) were associated with acute otitis externa. HAV ($5.5 million), NTM ($2.3 million), and salmonellosis ($2.2 million) were associated with next highest total costs. Cryptosporidiosis ($2,035), campylobacteriosis ($1,783), and NTM ($1,709) had the highest mean costs per treat-and-release ED visit. Overall, the annual hospitalization and treat-and-release ED visit costs associated with the selected diseases totaled $3.8 billion. As most of these diseases are not solely transmitted by water, an attribution process is needed as a next step to determine the proportion of these visits and costs attributable to waterborne transmission.

Europe's neglected infections of poverty.

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Hotez, Peter J; Gurwith, Meredith

2011-09-01

To review the prevalence, incidence, and geographic distribution of the major neglected infections of poverty in Europe as a basis for future policy recommendations. We reviewed the literature from 1999 to 2010 for neglected tropical diseases listed by PLoS Neglected Tropical Diseases (http://www.plosntds.org/static/scope.action) and the geographic regions and countries of (continental) Europe. Reference lists of identified articles and reviews were also hand searched, as were World Health Organization databases. In Eastern Europe, the soil-transmitted helminth infections (especially ascariasis, trichuriasis, and toxocariasis), giardiasis, and toxoplasmosis remain endemic. High incidence rates of selected food-borne helminthiases including trichinellosis, opisthorchiasis, taeniasis, and echinococcosis also occur, while brucellosis and leptospirosis represent important bacterial zoonoses. Turmoil and economic collapse following the war in the Balkans, the fall of Communism, and Europe's recent recession have helped to promote their high prevalence and incidence rates. In Southern Europe, vector-borne zoonoses have emerged, including leishmaniasis and Chagas disease, and key arboviral infections. Additional vulnerable populations include the Roma, orphans destined for international adoption, and some immigrant groups. Among the policy recommendations are increased efforts to determine the prevalence, incidence, and geographic distribution of Europe's neglected infections, epidemiological studies to understand the ecology and mechanisms of disease transmission, and research and development for new control tools. Copyright © 2011 International Society for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

Biological and genetic characterization of Cryptosporidium spp. and Giardia duodenalis isolates from five hydrographical basins in northern Portugal.

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Almeida, André; Moreira, Maria João; Soares, Sónia; de Lurdes Delgado, Maria; Figueiredo, João; Magalhães, Elisabete Silva; Castro, António; Viana Da Costa, Alexandra; Correia da Costa, José Manuel

2010-06-01

To understand the situation of water contamination with Cryptosporidium spp. and Giardia spp. in the northern region of Portugal, we have established a long-term program aimed at pinpointing the sources of surface water and environmental contamination, working with the water-supply industry. Here, we describe the results obtained with raw water samples collected in rivers of the 5 hydrographical basins. A total of 283 samples were analyzed using the Method 1623 EPA, USA. Genetic characterization was performed by PCR and sequencing of genes 18S rRNA of Cryptosporidium spp. and beta-giardin of Giardia spp. Infectious stages of the protozoa were detected in 72.8% (206 of 283) of the water samples, with 15.2% (43 of 283) positive for Giardia duodenalis cysts, 9.5% (27 of 283) positive for Cryptosporidium spp. oocysts, and 48.1% (136 of 283) samples positive for both parasites. The most common zoonotic species found were G. duodenalis assemblages A-I, A-II, B, and E genotypes, and Cryptosporidium parvum, Cryptosporidium andersoni, Cryptosporidium hominis, and Cryptosporidium muris. These results suggest that cryptosporidiosis and giardiasis are important public health issues in northern Portugal. To the authors' knowledge, this is the first report evaluating the concentration of environmental stages of Cryptosporidium and Giardia in raw water samples in the northern region of Portugal.

Curcumin alters the cytoskeleton and microtubule organization on trophozoites of Giardia lamblia.

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Gutiérrez-Gutiérrez, Filiberto; Palomo-Ligas, Lissethe; Hernández-Hernández, José Manuel; Pérez-Rangel, Armando; Aguayo-Ortiz, Rodrigo; Hernández-Campos, Alicia; Castillo, Rafael; González-Pozos, Sirenia; Cortés-Zárate, Rafael; Ramírez-Herrera, Mario Alberto; Mendoza-Magaña, María Luisa; Castillo-Romero, Araceli

2017-08-01

Giardia lamblia is a worldwide protozoan responsible for a significant number of intestinal infections. There are several drugs for the treatment of giardiasis, but they often cause side effects. Curcumin, a component of turmeric, has antigiardial activity; however, the molecular target and mechanism of antiproliferative activity are not clear. The effects of curcumin on cellular microtubules have been widely investigated. Since tubulin is the most abundant protein in the cytoskeleton of Giardia, to elucidate whether curcumin has activity against the microtubules of this parasite, we treated trophozoites with curcumin and the cells were analyzed by scanning electron microscopy and confocal microscopy. Curcumin inhibited Giardia proliferation and adhesion in a time-concentration-dependent mode. The higher inhibitory concentrations of curcumin (3 and 15μM) disrupted the cytoskeletal structures of trophozoites; the damage was evident on the ventral disk, flagella and in the caudal region, also the membrane was affected. The immunofluorescence images showed altered distribution of tubulin staining on ventral disk and flagella. Additionally, we found that curcumin caused a clear reduction of tubulin expression. By docking analysis and molecular dynamics we showed that curcumin has a high probability to bind at the interface of the tubulin dimer close to the vinblastine binding site. All the data presented indicate that curcumin may inhibit Giardia proliferation by perturbing microtubules. Copyright © 2017. Published by Elsevier B.V.

Transient small-bowel intussusception in children on CT

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Strouse, Peter J.; DiPietro, Michael A.; Saez, Fermin

2003-01-01

To determine the frequency and significance of small-bowel intussusception identified in children on CT. All abdomen CT reports between July 1995 and April 2002 were reviewed to identify patients with small-bowel intussusception. Intussusceptions were identified as an intraluminal mass with a characteristic layered appearance and/or continuity with adjacent mesenteric fat. Ileocolic intussusceptions and intussusceptions related to feeding tubes were excluded. Imaging studies and medical records were reviewed. Twenty-five pediatric patients (16 boys, 9 girls; mean age 11.2 years) were identified with small-bowel intussusception on CT. No patient had a persistent intussusception requiring surgery. Fourteen had limited immediate repeat CT images as part of the same examination, ten of which demonstrated resolution of the CT abnormality. Follow-up CT [n=13 (6 within 24 h)], ultrasound (n=3), small-bowel follow-through (n=4) and surgery (n=3) showed no intussusception. In four patients with persistent symptoms, underlying pathology was identified requiring treatment (giardiasis, 2; small-bowel inflammation/strictures, 1; abscess and partial small-bowel obstruction after perforated appendicitis, 1). In 21 other patients, direct correlation of symptoms to CT abnormality was absent or questionable, no treatment was required, and there was no clinical or imaging evidence of persistence or recurrence. Most small-bowel intussusceptions identified in children by CT are transient and of no clinical significance. (orig.)

Epidemiologia del parasitismo intestinal infantil en el Valle del Guadalquivir

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Pérez Armengol Cristina

1997-01-01

Full Text Available FUNDAMENTO: Las parasitosis intestinales en los niños constituyen un problema de salud pública que debe ser valorado periódicamente en cada región. En este trabajo se aborda, por primera vez en la región natural del Valle del Guadalquivir, un estudio amplio sobre la prevalencia del parasitismo intestinal en la población infantil de la zona. MÉTODOS: Durante el período 1994-1996, mediante análisis coprológico y método de Graham, se ha estudiado a 1.917 niños y niñas asintomáticos, con edades comprendidas entre seis y diez años, residentes en veinte localidades del Valle del Guadalquivir. RESULTADOS: El índice global de parasitación ha sido del 27,12 %. Las especies parásitas detectadas, así como sus prevalencias fueron: Enterobius vermicularis (20,44%, Giardia lamblia (5,05%, Entamoeba coli (2,45%, Endolimax nana (1,61%, Entamoeba histolytica (0,31%, Entamoeba hartmanni (0,05%, Iodamoeba bütschlii (0,05%. CONCLUSIONES: La prevalencia global encontrada es similar a la de otras regiones españolas, aunque quizás pueda considerarse algo más favorable. No se detectan geohelmintos, debido posiblemente a la mejora de la infraestructura higiénico-sanitaria y a los efectos de la prolongada sequía en la zona. La giardiasis, a diferencia de las restantes protozoosis, mantiene una prevalencia relativamente alta.

Community awareness of intestinal parasites and the prevalence of infection among community members of rural Abaye Deneba area, Ethiopia.

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Nyantekyi, Liza; Legesse, Mengistu; Medhin, Girmay; Animut, Abebe; Tadesse, Konjit; Macias, Chanda; Degarege, Abraham; Erko, Berhanu

2014-05-01

To assess the knowledge of Abaye Deneba community members regarding intestinal parasites and prevalence of intestinal parasitic infections. Knowledge about intestinal parasites was assessed by administering a questionnaire to 345 randomly selected household heads. Parasitological stool examination of 491 randomly selected individuals was done using the formol ether concentration technique. Knowledge of the Abaye Deneba community about parasitic diseases such as schistosomiasis, amoebiasis, ascariasis and taeniasis was very low. However, 204 (59.3%) members correctly responded that the cause of giardiasis is related to contaminated water and 176 (51.2%) knew how to prevent it. In some cases, respondents did correctly identify causes, symptoms of intestinal parasite infection and ways to prevent it, but they did not accurately link it to the appropriate disease caused by the different intestinal parasite species. Among the 491 stool samples examined, 50.2% of study participants showed infection with at least one intestinal parasite. Schistosoma mansoni was the most prevalent (41.3%) followed by Trichuris trichiura(9.4%), Ascaris lumbricoides (8.4%), Taenia saginata (2.4%), Enterobius vermicularis (2.0%) and hookworm (0.4%). Prevalence of schistosomiasis was highest in men aged 15-24 years. Intestinal parasitic infection is highly prevalent in communities of the Abaye Deneba area. Nevertheless, the knowledge of the community members about the parasite is less. Implementation of preventive chemotherapy, supplemented with health education, provision and use of sanitary facilities would be recommended to reduce morbidity and control transmission of intestinal parasites in this area.

Reduction in fecal excretion of Giardia cysts: effect of cholestasis and diet.

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Erlandsen, Stanley

2005-12-01

Bile is a major growth factor for the proliferation of Giardia spp. trophozoites in the small intestine and, at high concentrations, stimulates encystment of trophozoites. This report demonstrates that surgical cholestasis to interrupt the flow of bile from liver to intestine or the use of bile-binding resins in the diet can both dramatically decrease the fecal excretion of Giardia muris cysts. Cholestasis produced a 3 log reduction in excretion of G. muris cysts within 24 hr of surgery and a 4 log reduction after 3 days. Sham controls showed no difference in cyst excretion from presurgical control values. Two isocaloric diets were studied: a control diet (N) of Purina mouse chow containing 5% celufil and an experimental diet (CR) containing 5% cholestyramine, a resin that binds bile. Compared with the N diet, the CR diet was associated with reductions in cyst excretion of 3 logs within 1 day. Despite lowered excretion of G. muris cysts in mice fed the cholestyramine diet, the trophozoite recovery from the duodenum was similar with both diets. Cyclic feeding of the CR diet and the N diet at 3-day intervals produced significant oscillations (changes of 3-4 logs) in fecal cyst shedding. The significant reductions in fecal excretion of cysts observed with agents that bind bile suggests that diets capable of binding bile might be a therapeutic means to minimize the fecal excretion of cysts and thereby may help to reduce the risk of spreading giardiasis through fecal-oral contamination.

Expatriates ill after travel: results from the Geosentinel Surveillance Network.

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Lim, Poh-Lian; Han, Pauline; Chen, Lin H; MacDonald, Susan; Pandey, Prativa; Hale, DeVon; Schlagenhauf, Patricia; Loutan, Louis; Wilder-Smith, Annelies; Davis, Xiaohong M; Freedman, David O

2012-12-31

Expatriates are a distinct population at unique risk for health problems related to their travel exposure. We analyzed GeoSentinel data comparing ill returned expatriates with other travelers for demographics, travel characteristics, and proportionate morbidity (PM) for travel-related illness. Our study included 2,883 expatriates and 11,910 non-expatriates who visited GeoSentinel clinics ill after travel. Expatriates were more likely to be male, do volunteer work, be long-stay travelers (>6 months), and have sought pre-travel advice. Compared to non-expatriates, expatriates returning from Africa had higher proportionate morbidity (PM) for malaria, filariasis, schistosomiasis, and hepatitis E; expatriates from the Asia-Pacific region had higher PM for strongyloidiasis, depression, and anxiety; expatriates returning from Latin America had higher PM for mononucleosis and ingestion-related infections (giardiasis, brucellosis). Expatriates returning from all three regions had higher PM for latent TB, amebiasis, and gastrointestinal infections (other than acute diarrhea) compared to non-expatriates. When the data were stratified by travel reason, business expatriates had higher PM for febrile systemic illness (malaria and dengue) and vaccine-preventable infections (hepatitis A), and volunteer expatriates had higher PM for parasitic infections. Expatriates overall had higher adjusted odds ratios for latent TB and lower odds ratios for acute diarrhea and dermatologic illness. Ill returned expatriates differ from other travelers in travel characteristics and proportionate morbidity for specific diseases, based on the region of exposure and travel reason. They are more likely to present with more serious illness.

Investigation of zoonotic infections among Auckland Zoo staff: 1991-2010.

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Forsyth, M B; Morris, A J; Sinclair, D A; Pritchard, C P

2012-12-01

Investigation was undertaken to assess the occurrence of zoonotic infection among staff at Auckland Zoological Park, New Zealand, in 1991, 2002 and 2010. Serial cross-sectional health surveys in 1991, 2002 and 2010 comprising a health questionnaire, and serological, immunological and microbiological analysis for a range of potential zoonotic infections were performed. Laboratory results for zoo animals were also reviewed for 2004-2010 to assess the occurrence of potential zoonotic infections. Veterinary clinic, animal handler, grounds, maintenance and administrative staff participated in the surveys, with 49, 42 and 46 participants in the 1991, 2002 and 2010 surveys, respectively (29% of total zoo staff in 2010). A small number of staff reported work-related infections, including erysipelas (1), giardiasis (1) and campylobacteriosis (1). The seroprevalence of antibodies to hepatitis A virus and Toxoplasma gondii closely reflected those in the Auckland community. No carriage of hepatitis B virus (HBV) was detected, and most of those with anti-HBV antibodies had been vaccinated. Few staff had serological evidence of past leptospiral infection. Three veterinary clinic staff had raised Chlamydophila psittaci antibodies, all Auckland Zoo, this was uncommon and risks appear to be adequately managed under current policies and procedures. Nevertheless, ongoing assessment of risk factors is needed as environmental, human and animal disease and management factors change. Policies and procedures should be reviewed periodically in conjunction with disease monitoring results for both animals and staff to minimise zoonotic transmission. © 2012 Blackwell Verlag GmbH.

Self-reported infections during international travel and notifiable infections among returning international travellers, Sweden, 2009-2013.

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Viktor Dahl

Full Text Available We studied food and water-borne diseases (FWDs, sexually transmitted diseases (STDs, vector-borne diseases (VBDs and diseases vaccinated against in the Swedish childhood vaccination programme among Swedish international travellers, in order to identify countries associated with a high number of infections. We used the national database for notifiable infections to estimate the number of FWDs (campylobacteriosis, salmonellosis, giardiasis, shigellosis, EHEC, Entamoeba histolytica, yersinosis, hepatitis A, paratyphoid fever, typhoid fever, hepatitis E, listeriosis, cholera, STIs (chlamydia, gonorrhoea and acute hepatitis B, VBDs (dengue fever, malaria, West Nile fever, Japanese encephalitis and yellow fever and diseases vaccinated against in the Swedish childhood vaccination programme (pertussis, measles, mumps, rubella, diphtheria acquired abroad 2009-2013. We obtained number and duration of trips to each country from a database that monthly collects travel data from a randomly selected proportion of the Swedish population. We calculated number of infections per country 2009-2013 and incidence/million travel days for the five countries with the highest number of infections. Thailand had the highest number of FWDs (7,697, incidence 191/million travel days, STIs (1,388, incidence 34/million travel days and VBDs (358, incidence 9/million travel days. France had the highest number of cases of diseases vaccinated against in the Swedish childhood vaccination programme (8, 0.4/million travel days. Swedish travellers contracted most infections in Thailand. Special focus should be placed on giving advice to travellers to this destination.

Systematic review and meta-analysis of Saccharomyces boulardii in adult patients.

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McFarland, Lynne V

2010-05-14

This article reviews the evidence for efficacy and safety of Saccharomyces boulardii (S. boulardii) for various disease indications in adults based on the peer-reviewed, randomized clinical trials and pre-clinical studies from the published medical literature (Medline, Clinical Trial websites and meeting abstracts) between 1976 and 2009. For meta-analysis, only randomized, blinded controlled trials unrestricted by language were included. Pre-clinical studies, volunteer studies and uncontrolled studies were excluded from the review of efficacy and meta-analysis, but included in the systematic review. Of 31 randomized, placebo-controlled treatment arms in 27 trials (encompassing 5029 study patients), S. boulardii was found to be significantly efficacious and safe in 84% of those treatment arms. A meta-analysis found a significant therapeutic efficacy for S. boulardii in the prevention of antibiotic-associated diarrhea (AAD) (RR = 0.47, 95% CI: 0.35-0.63, P boulardii can be strongly recommended for the prevention of AAD and the traveler's diarrhea. Randomized trials also support the use of this yeast probiotic for prevention of enteral nutrition-related diarrhea and reduction of Helicobacter pylori treatment-related symptoms. S. boulardii shows promise for the prevention of C. difficile disease recurrences; treatment of irritable bowel syndrome, acute adult diarrhea, Crohn's disease, giardiasis, human immunodeficiency virus-related diarrhea; but more supporting evidence is recommended for these indications. The use of S. boulardii as a therapeutic probiotic is evidence-based for both efficacy and safety for several types of diarrhea.

[Hepatobiliary System Diseases as the Predictors of Psoriasis Progression].

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Smirnova, S V; Barilo, A A; Smolnikova, M V

2016-01-01

To assess the state of the hepatobiliary system in psoriasis andpsoriatic arthritis in order to establish a causal relationship and to identify clinical and functional predictors of psoriatic disease progression. The study includedpatients with extensive psoriasis vulgaris (n = 175) aged 18 to 66 years old and healthy donors (n = 30), matched by sex and age: Group 1--patients with psoriasis (PS, n = 77), group 2--patients with psoriatic arthritis (PsA, n = 98), group 3--control. The evaluation of functional state of the hepatobiliary system was performed by the analysis of the clinical and anamnestic data and by the laboratory-instrumental methods. We identified predictors of psoriasis: triggers (stress and nutritionalfactor), increased total bilirubin, aspartate aminotransferase, alkaline phosphatase, gamma-glutamyl transferase, eosinophilia, giardiasis, carriers of hepatitis C virus, ductal changes andfocal leisons in the liver, thickening of the walls of the gallbladder detected by ultrasound. Predictors ofpsoriatic arthritis: age over 50 years, dyspeptic complaints, the presence of hepatobiliary system diseases, the positive right hypochondrium syndrome, the clinical symptoms of chronic cholecystitis, excess body weight, high levels of bilirubin, cholesterol and low density lipoprotein, hepatomegaly, non-alcoholic fatty liver disease. High activity of hepatocytes cytolysis, cholestasis, inflammation, metabolic disorders let us considerpsoriatic arthritis as a severe clinical stage psoriatic disease when the hepatobiliary system, in turn, is one of the main target organs in systemic psoriatic process. Non-alcoholic fatty liver disease and chronic cholecystitis are predictors of psoriatic disease progression.

Level of awareness regarding some zoonotic diseases, among dog owners of ithaca, new york.

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Sandhu, Gursimrat Kaur; Singh, Devinder

2014-01-01

Worldwide, dogs and cats are the two most common household companion animals. Because of this, they can be direct or indirect source of many human infections. Fortunately, most of these zoonotic infections can be clinically prevented by appropriate prophylactic interventions. Present kind of cross-sectional study, for the first time, was conducted in city of Ithaca, New York. People visiting local animal hospitals, dog parks, library and shoppers at Walmart supermarket were personally interviewed and a pre-tested questionnaire was got filled from every individual. The collected data were analyzed for percentage proportions using Microsoft Excel(®) and the results had been presented in graphical as well as tabulated forms. Out of 100 participants responding to the request for participation, gender-wise, 45% of the participants were male while 55% of the participants were females. Demographically, 50% participants lived in rural, 35% in urban while 15% participants lived in suburban areas. Educational background of the participants ranged from High school pass-outs to Graduates. Participants were aware about the zoonotic potential of leptospirosis, giardiasis, rabies, hookworms, coccidiosis, lyme disease, roundworms, toxoplasma, leishmaniasis, salmonellosis and ringworm disease. Knowledge gaps in the sampled population, in terms of lack of awareness about zoonotic diseases vectored by mosquitoes, ticks and fleas; practice of not doing regular deworming and prophylactic control of fleas and ticks on pet dogs; and lack of practice among physicians to discuss zoonotic canine diseases with their clients were revealed by this study.

Duodenal nodularity in children: A clinical and pathologic study of 17 cases

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Çaltepe Dinler Gönül

2011-01-01

Full Text Available Aims: Duodenal nodularity is an uncommon endoscopic appearance of numerous visible mucosal nodules in the proximal duodenum. In this retrospective study we aimed to determine the clinical significance and histopathologic features of duodenal nodularity in children. Materials and Methods: The medical records of the patients who were defined to have duodenal nodularity by endoscopy were reviewed. Statistical Analysis Used: The data were expressed as mean ± SD and percentages (%. Results: Seventeen patients with endoscopically defined duodenal nodularity were chosen. The mean age at diagnosis was 12.1 years (range: 6-17 years, 9 males. Abdominal pain (47% was the most common clinical symptom and antral nodularity (41% was the most common endoscopic finding in children with duodenal nodularity. Histopathologic evaluation of duodenal nodules revealed chronic inflammation in all patients, increased intercryptal and intraepithelial numbers of eosinophils in 70.5%, and villous atrophy in 47% of patients. Giardia infestation was demonstrated in 6 patients by histologic examination and/or Giardia lamblia-specific antigen positivity in stools. The clinical diagnoses of the patients have shown variations, such as celiac disease, giardiasis, secretory IgA deficiency, and Helicobacter pylori gastritis, and some of them were associated with the others. Conclusions: Although the endoscopic appearance is similar, clinical spectrum and pathologic features are not so similar and there are no specific histomorphologic findings for nodularity. The most demonstrative findings we observed in children were increased lymphocyte and/or eosinophil infiltration in the duodenal mucosa. We suggested that care should be taken in the evaluation of microbiological and immunologic etiologies causing this prominent inflammatory reaction.

Expatriates ill after travel: Results from the Geosentinel Surveillance Network

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Lim Poh-Lian

2012-12-01

Full Text Available Abstract Background Expatriates are a distinct population at unique risk for health problems related to their travel exposure. Methods We analyzed GeoSentinel data comparing ill returned expatriates with other travelers for demographics, travel characteristics, and proportionate morbidity (PM for travel-related illness. Results Our study included 2,883 expatriates and 11,910 non-expatriates who visited GeoSentinel clinics ill after travel. Expatriates were more likely to be male, do volunteer work, be long-stay travelers (>6 months, and have sought pre-travel advice. Compared to non-expatriates, expatriates returning from Africa had higher proportionate morbidity (PM for malaria, filariasis, schistosomiasis, and hepatitis E; expatriates from the Asia-Pacific region had higher PM for strongyloidiasis, depression, and anxiety; expatriates returning from Latin America had higher PM for mononucleosis and ingestion-related infections (giardiasis, brucellosis. Expatriates returning from all three regions had higher PM for latent TB, amebiasis, and gastrointestinal infections (other than acute diarrhea compared to non-expatriates. When the data were stratified by travel reason, business expatriates had higher PM for febrile systemic illness (malaria and dengue and vaccine-preventable infections (hepatitis A, and volunteer expatriates had higher PM for parasitic infections. Expatriates overall had higher adjusted odds ratios for latent TB and lower odds ratios for acute diarrhea and dermatologic illness. Conclusions Ill returned expatriates differ from other travelers in travel characteristics and proportionate morbidity for specific diseases, based on the region of exposure and travel reason. They are more likely to present with more serious illness.

Current status and future trends in Cryptosporidium and Giardia epidemiology in Malaysia.

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Lim, Y A L; Ahmad, R A; Smith, H V

2008-06-01

Cryptosporidium and Giardia are major causes of diarrhoeal diseases of humans worldwide, and are included in the World Health Organisation's 'Neglected Diseases Initiative'. Cryptosporidium and Giardia occur commonly in Malaysian human and non-human populations, but their impact on disease, morbidity and cost of illness is not known. The commonness of contributions from human (STW effluents, indiscriminate defaecation) and non-human (calving, lambing, muck spreading, slurry spraying, pasturing/grazing of domestic animals, infected wild animals) hosts indicate that many Malaysian environments, particularly water and soil, are sufficiently contaminated to act as potential vehicles for the transmission of disease. To gain insight into the morbidity and mortality caused by human cryptosporidiosis and giardiasis, they should be included into differential diagnoses, and routine laboratory testing should be performed and (as for many infectious diseases) reported to a centralised public health agency. To understand transmission routes and the significance of environmental contamination better will require further multidisciplinary approaches and shared resources, including raising national perceptions of the parasitological quality of drinking water. Here, the detection of Cryptosporidium and Giardia should be an integral part of the water quality requirement. A multidisciplinary approach among public health professionals in the water industry and other relevant health- and environment-associated agencies is also required in order to determine the significance of Cryptosporidium and Giardia contamination of Malaysian drinking water. Lastly, adoption of validated methods to determine the species, genotype and subgenotype of Cryptosporidium and Giardia present in Malaysia will assist in developing effective risk assessment, management and communication models.

Echinococcosis and other parasitic infections in domestic dogs from urban areas of an Argentinean Patagonian city

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Verónica Flores

2017-12-01

Full Text Available In urban populations of South America, dogs with free access to public areas represent a public health concern. The primary consequence of roaming dogs on human health is the transmission of infectious and parasitic diseases mainly through feces contamination. The main diseases likely to be transmitted are hydatidosis or echinococcosis, larva migrans, and giardiasis. In Argentina, hydatidosis ranks among the most prevalent zoonosis. Although it is considered a rural disease, the circulation of this parasite in urban areas has been documented. The aim of this work was to survey intestinal parasites in canine feces from two low-income urban neighborhoods of Bariloche city, Argentina, and to assess their seasonal variation. During 2016, 188 fresh dog feces were collected from sidewalks in 40 randomly selected blocks from the neighborhoods. Each sample was processed by Sheater flotation and tested for a coproantigen (CAg by ELISA. The percentage of parasitized feces was 65.3% (95% CI: 55.9%-73.8%. Eleven parasite species were found, 3 protozoan, 3 cestodes, and 5 nematodes. Echinococcus sp. was present in 9.3% of the samples (95% CI: 4.7%-16.1%. Canine echinococcosis rates resulted similar to rates found previously in other neighborhoods of the city. The life cycle of Echinococcus sp. is sustained in urban areas by the entry of parasitized livestock, domiciliary slaughtering, and inadequate deposition of offal. The risk of Echinococcus sp. transmission to people in these neighborhoods is very high, due to high density of free-roaming dogs and high percentages of infected feces, similar to percentages observed in rural areas.

Level of awareness regarding some zoonotic diseases, among dog owners of Ithaca, New York

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Gursimrat Kaur Sandhu

2014-01-01

Full Text Available Objectives: Worldwide, dogs and cats are the two most common household companion animals. Because of this, they can be direct or indirect source of many human infections. Fortunately, most of these zoonotic infections can be clinically prevented by appropriate prophylactic interventions. Materials and Methods: Present kind of cross-sectional study, for the first time, was conducted in city of Ithaca, New York. People visiting local animal hospitals, dog parks, library and shoppers at Walmart supermarket were personally interviewed and a pre-tested questionnaire was got filled from every individual. The collected data were analyzed for percentage proportions using Microsoft Excel ® and the results had been presented in graphical as well as tabulated forms. Results: Out of 100 participants responding to the request for participation, gender-wise, 45% of the participants were male while 55% of the participants were females. Demographically, 50% participants lived in rural, 35% in urban while 15% participants lived in suburban areas. Educational background of the participants ranged from High school pass-outs to Graduates. Conclusions: Participants were aware about the zoonotic potential of leptospirosis, giardiasis, rabies, hookworms, coccidiosis, lyme disease, roundworms, toxoplasma, leishmaniasis, salmonellosis and ringworm disease. Knowledge gaps in the sampled population, in terms of lack of awareness about zoonotic diseases vectored by mosquitoes, ticks and fleas; practice of not doing regular deworming and prophylactic control of fleas and ticks on pet dogs; and lack of practice among physicians to discuss zoonotic canine diseases with their clients were revealed by this study.

Lactose intolerance and gastrointestinal cow's milk allergy in infants and children - common misconceptions revisited.

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Heine, Ralf G; AlRefaee, Fawaz; Bachina, Prashant; De Leon, Julie C; Geng, Lanlan; Gong, Sitang; Madrazo, José Armando; Ngamphaiboon, Jarungchit; Ong, Christina; Rogacion, Jossie M

2017-01-01

Lactose is the main carbohydrate in human and mammalian milk. Lactose requires enzymatic hydrolysis by lactase into D-glucose and D-galactose before it can be absorbed. Term infants express sufficient lactase to digest about one liter of breast milk daily. Physiological lactose malabsorption in infancy confers beneficial prebiotic effects, including the establishment of Bifidobacterium-rich fecal microbiota. In many populations, lactase levels decline after weaning (lactase non-persistence; LNP). LNP affects about 70% of the world's population and is the physiological basis for primary lactose intolerance (LI). Persistence of lactase beyond infancy is linked to several single nucleotide polymorphisms in the lactase gene promoter region on chromosome 2. Primary LI generally does not manifest clinically before 5 years of age. LI in young children is typically caused by underlying gut conditions, such as viral gastroenteritis, giardiasis, cow's milk enteropathy, celiac disease or Crohn's disease. Therefore, LI in childhood is mostly transient and improves with resolution of the underlying pathology. There is ongoing confusion between LI and cow's milk allergy (CMA) which still leads to misdiagnosis and inappropriate dietary management. In addition, perceived LI may cause unnecessary milk restriction and adverse nutritional outcomes. The treatment of LI involves the reduction, but not complete elimination, of lactose-containing foods. By contrast, breastfed infants with suspected CMA should undergo a trial of a strict cow's milk protein-free maternal elimination diet. If the infant is not breastfed, an extensively hydrolyzed or amino acid-based formula and strict cow's milk avoidance are the standard treatment for CMA. The majority of infants with CMA can tolerate lactose, except when an enteropathy with secondary lactase deficiency is present.

Intestinal parasitic infestations in children living in Warsaw

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Krzysztof Korzeniewski

2016-06-01

Full Text Available Background. Intestinal parasitic infestations pose one of the biggest health problems of the contemporary world. Objectives. The aim of this article was to present the prevalence of intestinal parasites among children living in a large urban agglomeration. Material and methods . 1823 children (916 girls and 907 boys, aged 3–6, attending 31 different pre-schools in Warsaw, were examined in 2014. Stool specimens were tested in the Department of Epidemiology and Tropical Medicine of the Military Institute of Medicine by light microscopy using three different diagnostic methods (direct smear in Lugol’s solution, decantation with distilled water, Fülleborn’s flotation. The material for testing, fixed in 10% formalin, was collected three times at 2–3-day intervals. Results . Parasitological examination of the stool specimens showed intestinal parasitic infestations in 47 children (2.57% of the study group. Only 7 children were infested with pathogenic parasites (6 cases of giardiasis and 1 enterobiasis and required antiparasitic treatment. 17 children were infested with potentially pathogenic protozoa (Blasocystis sp. and 26 with non-pathogenic protozoa ( Entamoeba coli , Endolimax nanai , but because of lack of gastrointestinal symptoms (asymptomatic carriage they did not require a treatment. Conclusions . Performed examination show low infection rates among children from a large urban agglomeration. In the absence of epidemiological surveillance over the prevalence of the majority of intestinal parasitic diseases in Poland, and because some diagnostic centres generate positive test results using valueless methods, the propagation of parasitological diagnostics in light microscopy in direction of prevalence of intestinal parasitic infestations, especially among patients with gastrointestinal symptoms, is strongly recommended.

Irritable bowel syndrome and chronic fatigue 6 years after giardia infection: a controlled prospective cohort study.

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Hanevik, Kurt; Wensaas, Knut-Arne; Rortveit, Guri; Eide, Geir Egil; Mørch, Kristine; Langeland, Nina

2014-11-15

Functional gastrointestinal disorders and fatigue may follow acute infections. This study aimed to estimate the persistence, prevalence, and risk of irritable bowel syndrome and chronic fatigue 6 years after Giardia infection. We performed a controlled prospective study of a cohort of 1252 individuals who had laboratory-confirmed Giardia infection during a waterborne outbreak in 2004. In total, 748 cohort cases (exposed) and 878 matched controls responded to a postal questionnaire 6 years later (in 2010). Responses were compared to data from the same cohort 3 years before (in 2007). The prevalences of irritable bowel syndrome (39.4%) by Rome III criteria and chronic fatigue (30.8%) in the exposed group 6 years after giardiasis were significantly elevated compared with controls, with adjusted relative risks (RRs) of 3.4 (95% confidence interval [CI], 2.9-3.9) and 2.9 (95% CI, 2.3-3.4), respectively. In the exposed group, the prevalence of irritable bowel syndrome decreased by 6.7% (RR, 0.85 [95% CI, .77-.93]), whereas the prevalence of chronic fatigue decreased by 15.3% from 3 to 6 years after Giardia infection (RR, 0.69 [95% CI, .62-.77]). Giardia exposure was a significant risk factor for persistence of both conditions, and increasing age was a risk factor for persisting chronic fatigue. Giardia infection in a nonendemic setting is associated with an increased risk for irritable bowel syndrome and chronic fatigue 6 years later. The prevalences of both conditions decrease over time, indicating that this intestinal protozoan parasite may elicit very long-term, but slowly self-limiting, complications. © The Author 2014. Published by Oxford University Press on behalf of the Infectious Diseases Society of America.

[Experimental infection of the gerbil (Meriones unguiculatus) by Colombian isolates of Giardia duodenalis].

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Arévalo, Adriana; Duque, Sofía; Nicholls, Rubén Santiago

2005-09-01

Natural and experimental Giardia infections have been reported from bovines, equines, goats, canines, felines and rodents such as mice, rats and gerbils. The latter have provided successful animal models for Giardia duodenalis and Giardia muris experimental infections. The gerbil model was used to establish the pattern of infection of Colombian Giardia human isolates. Giardia cysts were obtained from stool specimens of symptomatic giardiasis patients by means of sucrose-percoll gradients. Animal inoculation was performed by gastric intubation and injection with 5 x 10(3) Giardia cysts. The course of infection was established by counting cysts every day and trophozoites weekly throughout a period of 30 days. The pattern of cyst excretion was found to be intermittent. Cysts were released during the second and third weeks of infection but not during the first or fourth weeks. The mean minimal number of cysts released per 2-hr collection period was 79 and the mean maximum number was 17,943. Colonization of the small intestine by trophozoites was observed with a mean number ranging from 15,000 to 6,577,778 trophozoites/ml. Gerbils inoculated with G. duodenalis isolates obtained from geographical areas outside Colombia resolved the infection between 86 and 114 days after infection, whereas gerbils infected with Colombian G. duodenalis isolates resolved the infection at 30 days. The gerbil proved to be a good animal model for experimental infection with Colombian isolates of G. duodenalis. Experimental Giardia infection of gerbils permit a sufficient yield of cysts and trophozoites to be used as antigens for the immunization of other animals and to obtain Giardia antibodies that could be used for Giardia antigen detection assays in stool specimens.

Molecular characterisation of Cryptosporidium and Giardia in cats (Felis catus) in Western Australia.

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Yang, Rongchang; Ying, Joyce Lau Jie; Monis, Paul; Ryan, Una

2015-08-01

Little is known of the prevalence of Cryptosporidium and Giardia in domestic cats in Western Australia and their potential role as zoonotic reservoirs for human infection. In the present study, a total of 345 faecal samples from four different sources were screened for the presence of Cryptosporidium and Giardia by PCR and genotyped by sequence analysis. Oocyst numbers and cyst numbers for Cryptosporidium and Giardia respectively were also determined using quantitative PCR assays. Cryptosporidium and Giardia were detected in 9.9% (95% CI 6.7-13.0) and 10.1% (95% CI 7.0-13.3) of cats in Western Australia respectively. Sequence analysis at the 18S rRNA locus identified five Cryptosporidium species/genotypes; C. felis (n = 8), C. muris (n = 1), C. ryanae (n = 1), Cryptosporidium rat genotype III (n = 5) and a novel genotype most closely related to Cryptosporidium rat genotype III in one isolate. This is the first report of C. ryanae and Cryptosporidium rat genotype III in cats. For Giardia, assemblage F the most commonly identified species, while only 1 assemblage sequence was detected. Since most human cases of cryptosporidiosis are caused by C. parvum and C. hominis and human cases of giardiasis are caused by G. duodenalis assemblage A and B, the domestic cats in the present study are likely to be of low zoonotic risk to pet owners in Perth. Risk analyses identified that elderly cats (more than 6 years) were more prone to Cryptosporidium and Giardia infections than kittens (less than 6 months) (P = 0.009). Clinical symptoms were not associated with the prevalence of Cryptosporidium and Giardia infections in cats. Copyright © 2015 Elsevier Inc. All rights reserved.

Contamination by Helicobacter pylori measured by the 13C-Urea-Breath-Test and nutritional status of children with chronic diarrhoea syndrome in Havana City

International Nuclear Information System (INIS)

Hernandez-Triana, M.H.; Cabrera, A.; Sanchez, M. A.; Herrera, X.; Pawong, M.; Moreno, R.; Reyes, D.; Serrano, G.; Diaz, M.E.

2002-01-01

Diarrhoea morbidity shows a slow increasing tendency during the last 10 years in Cuba. In young children the compromise of the gastric acid barrier after a chronic infection with Helicobacter pylori (Hp) is discussed in pathogenic relation to gastritis, duodenal ulcer, chronic diarrhoea, short stature, malabsorption of the B-complex vitamins and malnutrition. The Hp contamination level of the population of the developing world is estimated to be considerably high. Endoscopic studies carried out in Cuban subjects with upper gastrointestinal symptoms show contamination values of 60 to 100%. The current treatment of chronic diarrhoea does not include the elimination of Hp. Cuban children with upper gastrointestinal symptoms show contamination values of more than 60%. There are not available data on the contamination level in apparently healthy Cuban children or those with chronic diarrhoea. In March-April 2000 the prevalence of Hp infection measured in serum by chromatographic immunoassay for detection of Hp IgG antibodies was found to be 94 % in 20 infants and young children with persistent chronic diarrhoea and 100% in 11 apparently healthy children in Havana City. Children with diarrhoea showed a more evident affection of their nutritional status and a higher percentage of positive personal or familiar history of parasitism, giardiasis, gastritis, ulcer, stomatitis and glositis. The validity of the immunological tests in infants is discussed from the point of view of the antibody transference with breast milk. In a sample of 16 different children studied by the 13C-Urea-Breath-Test the contamination level was 50% of the children not affected by diarrhoea and only one of the 6 children with diarrhoea showed positive values

FRUCTOSE MALABSORPTION IN CHILDREN WITH FUNCTIONAL DIGESTIVE DISORDERS

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Adriana Chebar LOZINSKY

2013-09-01

Full Text Available Context Fructose is a monosaccharide frequently present in natural and artificial juice fruits. When the concentration of fructose in certain food is present in excess of glucose concentration some individuals may develop fructose malabsorption. Objectives To report the frequency of fructose malabsorption utilizing the hydrogen breath test in children with gastrointestinal and/or nutritional disorders. Methods Between July 2011 and July 2012, 43 patients with gastrointestinal and/or nutritional disorders, from both sexes, were consecutively studied, utilizing the hydrogen breath test with loads of the following carbohydrates: lactose, glucose, fructose and lactulose. Fructose was offered in a 10% aqueous solution in the dose of 1 g/kg body weight. Samples were collected fasting and at every 15 minutes after the intake of the aqueous solution for a 2 hour period. Malabsorption was considered when there was an increase of >20 ppm of hydrogen over the fasting level, and intolerance was diagnosed if gastrointestinal symptoms would appear. Results The age of the patients varied from 3 months to 16 years, 24 were boys. The following diagnosis were established: irritable bowel syndrome with diarrhea in 16, functional abdominal pain in 8, short stature in 10, lactose intolerance in 3, celiac disease in 1, food allergy in 1 and giardiasis in 1 patient. Fructose malabsorption was characterized in 13 (30.2% patients, and intolerance in 1 (2.3% patient. The most frequent fructose malabsorption was characterized in 7 (16.3% patients with irritable bowel syndrome and in 4 (9.3% patients with functional abdominal pain. Conclusions Patients with irritable bowel syndrome and functional abdominal pain were the main cause of fructose malabsorption.

Prevalence and outcome of severe malnutrition in children less than five-year-old in Omdurman Paediatric Hospital, Sudan.

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Kanan, Shaza O H; Swar, Mohammed Osman

2016-01-01

This is a retrospective observational hospital-based study aimed to determine the prevalence and outcome of severe acute malnutrition in children less than five years admitted to Omdurman Paediatric Hospital during the period January 2014 to December 2014. Data was collected from patient's hospital records during the study period. Ethical approval and permission to access patients' record were obtained. A total of 593 children with severe malnutrition were identified; 305 of cases were male (51.4%) with a male: female ratio of 1:0.9. The mean age these children was 22.3 months. Children 36-59 months were least affected. 35.4% were classified as low socioeconomic class, 22.9% classified as an average class and there were no sufficient data to classify the remaining. The overall prevalence of severe malnutrition was 6.5%, and the general mortality rate was 2.4% while mortality rate among children with severe malnutrition was 9.3%. Among the 593 admitted children with malnutrition, 407 (68.6%) had marasmus, 141 (23.8%) had kwashiorkor and 45 (7.6%) had marasmic-kwashiorkor. The highest prevalence and mortality rate occurred in September. The most common clinical presentations were gastroenteritis, malaria, urinary tract infections, giardiasis, tuberculosis and AIDS. Only 10.8% of the admitted children were exclusively breast fed for the first three months. 33% were fully vaccinated. Overall 75.7% improved and discharged, 15% discharged against medical advice and 9.3% died. We concluded that prevalence and mortality among children with acute severe malnutrition at Omdurman paediatrics hospital were high, and the current management strategies require review to identify the causes. We recommended adopting policies to manage malnutrition in the community and hospitals.

Transmission of infectious diseases from internationally adopted children to their adoptive families.

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Sciauvaud, J; Rigal, E; Pascal, J; Nourrisson, C; Poirier, P; Poirier, V; Vidal, M; Mrozek, N; Laurichesse, H; Beytout, J; Labbe, A; Lesens, O

2014-08-01

Internationally adopted children may suffer from different pathologies, including infectious diseases contracted in the country of origin. We evaluated the frequency of infectious diseases that may disseminate from adoptees to adoptive families on their arrival in France. All children who attended the clinic for international adoption in Clermont-Ferrand from January 2009 through to December 2011 were eligible for inclusion in the study. Standardized medical records dedicated to international adoption were retrospectively reviewed for demographic data, clinical diagnosis, and biological and radiological results. Data were completed by phone interviews with adoptive families after informed consent. One hundred and forty-two medical records were retrospectively reviewed and 86% of families agreed to be interviewed. One hundred and seventy-one potentially transmissible infections were diagnosed in 142 children, 12% (n = 20) of which were transmitted to adoptive families. Most of these infections were benign and transmission was restricted to the close family. Tinea was diagnosed in 44 adoptees and transmitted in 15 cases. Panton Valentine leukocidin producing methicillin-sensitive S. aureus (MSSA) was transmitted to an adoptive father who required hospitalization for bursitis. Transmission also occurred for CMV (n = 1), hepatitis A (n = 1), giardiasis (n = 1), scabies (n = 1), Moluscum (n = 2) and pediculosis (n = 2). Two cases of chronic hepatitis B and latent tuberculosis were diagnosed without subsequent transmission. In conclusion, infectious diseases are common in internationally adopted children and should be detected shortly after arrival to avoid transmission. © 2013 The Authors Clinical Microbiology and Infection © 2013 European Society of Clinical Microbiology and Infectious Diseases.

Cryptosporidiosis outbreak in a child day-care center caused by an unusual Cryptosporidium hominis subtype.

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Goñi, Pilar; Almagro-Nievas, Diego; Cieloszyk, Joanna; Lóbez, Silvia; Navarro-Marí, José María; Gutiérrez-Fernández, José

2015-12-01

This work describes the genetic characterization of Cryptosporidium and Giardia involved in an outbreak in a nursery school in Granada, Spain, that affected seven children under the age of 4. Nucleic acids were extracted from the seven stool samples positive to Cryptosporidium or Giardia by microscopy and/or immunochromatography. The species and subtypes of Cryptosporidium were identified by PCR-RFLP and PCR of the SSUrRNA and gp60 genes, respectively. The assemblages of Giardia duodenalis isolates were characterized by PCR of the tpi gene. PCR products were sequenced and analyzed. All of the isolates were positive for Cryptosporidium hominis. Five of them belonged to subtype IaA11R2, one to subtype IbA10G2R2, and the other could not be identified. Three of these samples were positive for G. duodenalis by PCR, two belonging to the assemblage A, and the other one to assemblage B. This is the first report of Cryptosporidium hominis subtype IaA11R2 as a cause of an outbreak in Europe where subtype IbA10G2R2 is the most frequently identified. In the case of Giardia, an outbreak could not be confirmed because of the low number of positive samples and the low genetic variability of the amplified fragments for assemblage A of tpi gene. A new subtype, of Cryptosporidium hominis named IaA11R2, has been described as a cause of an outbreak in a nursery school in Granada, Spain. However an outbreak of giardiasis could not be confirmed. Copyright © 2015 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

Modeling long-term host cell-Giardia lamblia interactions in an in vitro co-culture system.

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Bridget S Fisher

Full Text Available Globally, there are greater than 700,000 deaths per year associated with diarrheal disease. The flagellated intestinal parasite, Giardia lamblia, is one of the most common intestinal pathogens in both humans and animals throughout the world. While attached to the gastrointestinal epithelium, Giardia induces epithelial cell apoptosis, disrupts tight junctions, and increases intestinal permeability. The underlying cellular and molecular mechanisms of giardiasis, including the role lamina propria immune cells, such as macrophages, play in parasite control or clearance are poorly understood. Thus far, one of the major obstacles in ascertaining the mechanisms of Giardia pathology is the lack of a functionally relevant model for the long-term study of the parasite in vitro. Here we report on the development of an in vitro co-culture model which maintains the basolateral-apical architecture of the small intestine and allows for long-term survival of the parasite. Using transwell inserts, Caco-2 intestinal epithelial cells and IC-21 macrophages are co-cultured in the presence of Giardia trophozoites. Using the developed model, we show that Giardia trophozoites survive over 21 days and proliferate in a combination media of Caco-2 cell and Giardia medium. Giardia induces apoptosis of epithelial cells through caspase-3 activation and macrophages do not abrogate this response. Additionally, macrophages induce Caco-2 cells to secrete the pro-inflammatory cytokines, GRO and IL-8, a response abolished by Giardia indicating parasite induced suppression of the host immune response. The co-culture model provides additional complexity and information when compared to a single-cell model. This model will be a valuable tool for answering long-standing questions on host-parasite biology that may lead to discovery of new therapeutic interventions.

One Health in Practice: A Pilot Project for Integrated Care of Zoonotic Infections in Immunocompromised Children and Their Pets in Chile.

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Peña, A; Abarca, K; Weitzel, T; Gallegos, J; Cerda, J; García, P; López, J

2016-08-01

Although pets provide physiological and psychological benefits to their owners, they are a potential source of zoonotic infections, especially for vulnerable individuals such as immunocompromised patients. During 1 year, we therefore performed a pilot project, which included 32 immunocompromised Chilean children and their family pets (35 dogs and 9 cats) with the aim of detecting, treating and preventing zoonotic infections. Children were examined by Infectious Diseases paediatricians and demographical and clinical information related to zoonotic infections were recorded. Pets were examined and sampled by veterinarians, who also administered missing routine vaccines and anti-parasitics. During family visits, all members were informed and educated about zoonoses and a satisfaction survey was performed. Visits also included vector control and indoor residual spraying with pyrethroids. Children were re-examined and re-tested according to the findings of their pets, and all detected zoonotic infections were treated both in children and pets. Physical examination revealed abnormalities in 18 dogs (51.4%) and three cats (33.3%). Twenty-eight (63.6%) of the pets were diagnosed with a zoonotic pathogen, and seven (15.9%) with a facultative pathogen. Most zoonotic agents were isolated from the pet's external ear and intestine. Bacteria with the highest pathogenic potential were Campylobacter jejuni and Brucella canis. In two children and their respective pets, the same zoonotic diseases were diagnosed (toxocariasis and giardiasis). Arthropods serving as potential vectors of zoonotic infections were found in 49% of dogs and 44% of cats. The pilot project was positively evaluated by the participating families. Our pilot project confirmed that pets are reservoir for various zoonotic agents in Chile and that the implementation of an integrated multidisciplinary programme was a valuable tool to prevent, diagnose and treat such zoonotic infections in vulnerable patients such as

Psidium guajava L., from ethnobiology to scientific evaluation: Elucidating bioactivity against pathogenic microorganisms.

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Morais-Braga, Maria Flaviana B; Carneiro, Joara Nalyda P; Machado, Antonio Júdson T; Dos Santos, Antonia Thassya L; Sales, Débora L; Lima, Luciene F; Figueredo, Fernando G; Coutinho, Henrique Douglas M

2016-12-24

The use of popular plants has guided pharmaceutical research aimed at combating pathogenic microorganisms. Psidium guajava L. is a plant of great versatility and it has been used both as food and as a therapeutic agent. Root, bark, leaves, fruits, flowers and seeds are used for medicinal purposes, especially in infusions and decoctions for oral and topical use. P. guajava is utilized in symptomatology treatment related to organ malfunction and of diseases caused by the action of pathogenic and/or opportunistic microorganisms. Many pharmacological studies have been conducted to scientifically assess its therapeutic potential. The aim of the current study is to relate the popular use of this plant and its bioscientific assessment as a therapeutic agent in the treatment of diseases and symptoms caused by the action of protozoa, fungi, bacteria and viruses, and also evaluate the safety for the usage and the interaction with drugs. A bibliographic database the ethnobiology of Psidium guajava (2005-2015) and the pharmacological infections and parasitic diseases (2010-2015). Searches were done in scientific disclosure databases such as PubMed, Web of Science, and Scopus. P. guajava leaf extracts were scientifically investigated for the treatment of diseases caused by protozoa (leishmaniasis, malaria, giardiasis, amoebiasis and trichomoniasis), fungi (dermatosis, systemic and mucocutaneous diseases), bacteria (respiratory, mucocutaneous and gastrointestinal infections, cholera, gastritis and stomach ulcers, oral and periodontal infections, venereal diseases and urinary infections) and viruses (herpes, influenza, rotavirus disease and AIDS). The toxicity assays indicates the safet for usage. Highlight and elucidate the therapeutic potential and versatility of P. guajava. They also justify using ethnobiology efficiency to guide pharmacological studies. Some limitations can be observed in this kind of study, as the lack for ethnobiological informations and the absence of some

Vitamin B12 absorption capacity in healthy children

International Nuclear Information System (INIS)

Hjelt, K.; Krasilnikoff, P.A.

1986-01-01

B12 absorption was investigated in 47 healthy children aged 7 months to 15.8 years (median 4.9 years). The patients had either recovered from giardiasis, the post-gastroenteritis syndrome, or had celiac disease in remission (treated with a gluten-free diet). The B12 absorption was measured by a double-isotope technique using 57 CoB12 and 51 CrCl 3 , the latter being the inabsorbable marker. The radiation dose was minimal. The results were presented as fractional absorption of B12 (FAB12). Within the different age groups, the absorption test was performed by means of the following oral amounts of B12: 0- less than 1 year, 0.5 microgram; 1-3 years: 1.7 micrograms, 4-6 years, 2.5 micrograms; 7-10 years; 3.3 micrograms; and 11-15 years, 4.5 micrograms. When using these oral amounts of B12, the medians (and ranges) of FAB12 were found to be: 1-3 years (n = 18), 37% (16-80%); 4-6 years (n = 10), 27% (19-40%); 7-10 years (n = 9), 32% (21-44%); and 11-15 years (n = 8), 27% (19-59%). The FAB12 in two children aged 7 and 11 months was 31% and 32%, respectively. These results may be interpretated as reference values for B12 absorption in children. Further absorption tests were performed in seven children representing the four age groups from 1 to 15 years. When a high oral amount of B12 was given (i.e., three times the saturation dose), the FAB12 ranged from 0 to 20% (median 9%), whereas a low amount (i.e., one-ninth of the saturation dose) produced fractional absorptions from 65 to 82% (median 74%)

Descriptive study of enteric zoonoses in Ontario, Canada, from 2010 – 2012

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Yvonne Whitfield

2017-02-01

Full Text Available Abstract Background Contact with animals and their environment has long been recognized as an important source of enteric zoonoses. However, there are limited data available on the burden of illness associated with specific types of animals in Canada. This study describes the overall burden of enteric zoonoses in Ontario, Canada from 2010 to 2012. Methods Confirmed cases of seven enteric zoonotic diseases (campylobacteriosis, cryptosporidiosis, giardiasis, listeriosis, salmonellosis, verotoxin-producing E. coli (VTEC infection, and yersiniosis with episode dates from 2010 to 2012 were extracted from the integrated Public Health Information System (iPHIS. Reported exposures were categorized as animal contact, foodborne, waterborne and ‘other’, with animal contact grouped into nine sub-categories based on the type of animal or transmission setting. Overall incidence rates and proportions by animal exposure categories, age and sex-specific incidence rates and hospitalization and death proportions were calculated and sex proportions compared. Results Our study found that approximately 26% of the enteric pathogens assessed during the 2010 to 2012 period reported contact with animals and their environments as the mode of transmission. Of enteric disease cases reporting animal contact, farm exposures were reported for 51.3%, dog or cat exposures for 26.3%, and reptile or amphibian exposures for 8.9%. Conclusions Contact with animals was reported more frequently during the period 2010 to 2012 in comparison to the period 1997 to 2003 when 6% or less of enteric cases were associated with animal contact. Public health professionals, stakeholders associated with animals and their related industries (e.g., pet treats, mobile zoos, abattoirs, and the public should recognize that animal contact is an important source of enteric illnesses in order to take measures to reduce the burden of illness from animal sources.

Polymeric immunoglobulin receptor in intestinal immune defense against the lumen-dwelling protozoan parasite Giardia.

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Davids, Barbara J; Palm, J E Daniel; Housley, Michael P; Smith, Jennifer R; Andersen, Yolanda S; Martin, Martin G; Hendrickson, Barbara A; Johansen, Finn-Eirik; Svärd, Staffan G; Gillin, Frances D; Eckmann, Lars

2006-11-01

The polymeric Ig receptor (pIgR) is conserved in mammals and has an avian homologue, suggesting evolutionarily important functions in vertebrates. It transports multimeric IgA and IgM across polarized epithelia and is highly expressed in the intestine, yet little direct evidence exists for its importance in defense against common enteric pathogens. In this study, we demonstrate that pIgR can play a critical role in intestinal defense against the lumen-dwelling protozoan parasite Giardia, a leading cause of diarrheal disease. The receptor was essential for the eradication of Giardia when high luminal IgA levels were required. Clearance of Giardia muris, in which IgA plays a dominant role, was severely compromised in pIgR-deficient mice despite significant fecal IgA output at 10% of normal levels. In contrast, eradication of the human strain Giardia lamblia GS/M, for which adaptive immunity is less IgA dependent in mice, was unaffected by pIgR deficiency, indicating that pIgR had no physiologic role when lower luminal IgA levels were sufficient for parasite elimination. Immune IgA was greatly increased in the serum of pIgR-deficient mice, conferred passive protection against Giardia, and recognized several conserved giardial Ags, including ornithine carbamoyltransferase, arginine deiminase, alpha-enolase, and alpha- and beta-giardins, that are also detected in human giardiasis. Corroborative observations were made in mice lacking the J chain, which is required for pIgR-dependent transepithelial IgA transport. These results, together with prior data on pIgR-mediated immune neutralization of luminal cholera toxin, suggest that pIgR is essential in intestinal defense against pathogenic microbes with high-level and persistent luminal presence.

Occurrence of Cryptosporidium and Giardia genotypes and subtypes in raw and treated water in Portugal.

Science.gov (United States)

Lobo, M L; Xiao, L; Antunes, F; Matos, O

2009-06-01

Waterborne outbreaks of diarrhoeal illness reported worldwide are mostly associated with Cryptosporidium spp. and Giardia spp. Their presence in aquatic systems makes it essential to develop preventive strategies for water and food safety. This study was undertaken to monitor the presence of Cryptosporidium and Giardia in a total of 175 water samples, including raw and treated water from both surface and ground sources in Portugal. The samples were processed according to USEPA Method 1623 for immunomagnetic separation (IMS) of Cryptosporidium oocysts and Giardia cysts, followed by detection of oocysts/cysts by immunofluorecence (IFA) microscopy, PCR-based techniques were done on all water samples collected. Out of 175 samples, 81 (46.3%) were positive for Cryptosporidium and 67 (38.3%) for Giardia by IFA. Cryptosporidium spp. and G. duodenalis genotypes were identified by PCR in 37 (21.7%) and 9 (5.1%) water samples, respectively. C. parvum was the most common species (78.9%), followed by C. hominis (13.2%), C. andersoni (5.3%), and C. muris (2.6%). Subtype IdA15 was identified in all C. hominis-positive water samples. Subtyping revealed the presence of C. parvum subtypes IIaA15G2R1, IIaA16G2R1 and IIdA17G1. Giardia duodenalis subtype A1 was identified. The results of the present study suggest that Cryptosporidium spp. and Giardia spp. were widely distributed in source water and treated water in Portugal. Moreover, the results obtained indicate a high occurrence of human-pathogenic Cryptosporidium genotypes and subtypes in raw and treated water samples. Thus, water can be a potential vehicle in the transmission of cryptosporidiosis, and giardiasis of humans and animals in Portugal.

Vitamin B12 absorption capacity in healthy children

Energy Technology Data Exchange (ETDEWEB)

Hjelt, K.; Krasilnikoff, P.A.

1986-03-01

B12 absorption was investigated in 47 healthy children aged 7 months to 15.8 years (median 4.9 years). The patients had either recovered from giardiasis, the post-gastroenteritis syndrome, or had celiac disease in remission (treated with a gluten-free diet). The B12 absorption was measured by a double-isotope technique using /sup 57/CoB12 and /sup 51/CrCl/sub 3/, the latter being the inabsorbable marker. The radiation dose was minimal. The results were presented as fractional absorption of B12 (FAB12). Within the different age groups, the absorption test was performed by means of the following oral amounts of B12: 0- less than 1 year, 0.5 microgram; 1-3 years: 1.7 micrograms, 4-6 years, 2.5 micrograms; 7-10 years; 3.3 micrograms; and 11-15 years, 4.5 micrograms. When using these oral amounts of B12, the medians (and ranges) of FAB12 were found to be: 1-3 years (n = 18), 37% (16-80%); 4-6 years (n = 10), 27% (19-40%); 7-10 years (n = 9), 32% (21-44%); and 11-15 years (n = 8), 27% (19-59%). The FAB12 in two children aged 7 and 11 months was 31% and 32%, respectively. These results may be interpretated as reference values for B12 absorption in children. Further absorption tests were performed in seven children representing the four age groups from 1 to 15 years. When a high oral amount of B12 was given (i.e., three times the saturation dose), the FAB12 ranged from 0 to 20% (median 9%), whereas a low amount (i.e., one-ninth of the saturation dose) produced fractional absorptions from 65 to 82% (median 74%).

Food and water security issues in Russia III: food- and waterborne diseases in the Russian Arctic, Siberia and the Far East, 2000-2011.

Science.gov (United States)

Dudarev, Alexey A; Dorofeyev, Vitaliy M; Dushkina, Eugenia V; Alloyarov, Pavel R; Chupakhin, Valery S; Sladkova, Yuliya N; Kolesnikova, Tatjana A; Fridman, Kirill B; Nilsson, Lena Maria; Evengard, Birgitta

2013-01-01

The food- and waterborne disease situation in Russia requires special attention. Poor quality of centralized water supplies and sewage systems, biological and chemical contamination of drinking water, as well as contamination of food products, promote widespread infectious diseases, significantly exceeding nationwide rates in the population living in the two-thirds of Russian northern territories. The general aim was to assess the levels of food- and waterborne diseases in selected regions of Russian Arctic, Siberia and the Far East (for the period 2000-2011), and to compare disease levels among regions and with national levels in Russia. This study is the first comparative assessment of the morbidity in these fields of the population of 18 selected regions of Russian Arctic, Siberia and the Far East, using official statistical sources. The incidences of infectious and parasitic food- and waterborne diseases among the general population (including indigenous peoples) have been analyzed in selected regions (per 100,000 of population, averaged for 2000-2011). Among compulsory registered infectious and parasitic diseases, there were high rates and widespread incidences in selected regions of shigellosis, yersiniosis, hepatitis A, tularaemia, giardiasis, enterobiasis, ascariasis, diphyllobothriasis, opistorchiasis, echinococcosis and trichinellosis. Incidences of infectious and parasitic food- and waterborne diseases in the general population of selected regions of the Russian Arctic, Siberia and the Far East (2000-2011) are alarmingly high. Parallel solutions must be on the agenda, including improvement of sanitary conditions of cities and settlements in the regions, modernization of the water supply and of the sewage system. Provision and monitoring of the quality of the drinking water, a reform of the general healthcare system and the epidemiological surveillance (including gender-divided statistics), enhancement of laboratory diagnostics and the introduction of

An audit of Cryptosporidium and Giardia detection in Scottish National Health Service Diagnostic Microbiology Laboratories.

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Alexander, C L; Currie, S; Pollock, K; Smith-Palmer, A; Jones, B L

2017-06-01

Giardia duodenalis and Cryptosporidium species are protozoan parasites capable of causing gastrointestinal disease in humans and animals through the ingestion of infective faeces. Whereas Cryptosporidium species can be acquired locally or through foreign travel, there is the mis-conception that giardiasis is considered to be largely travel-associated, which results in differences in laboratory testing algorithms. In order to determine the level of variation in testing criteria and detection methods between diagnostic laboratories for both pathogens across Scotland, an audit was performed. Twenty Scottish diagnostic microbiology laboratories were invited to participate with questions on sample acceptance criteria, testing methods, testing rates and future plans for pathogen detection. Reponses were received from 19 of the 20 laboratories representing each of the 14 territorial Health Boards. Detection methods varied between laboratories with the majority performing microscopy, one using a lateral flow immunochromatographic antigen assay, another using a manually washed plate-based enzyme immunoassay (EIA) and one laboratory trialling a plate-based EIA automated with an EIA plate washer. Whereas all laboratories except one screened every stool for Cryptosporidium species, an important finding was that significant variation in the testing algorithm for detecting Giardia was noted with only four laboratories testing all diagnostic stools. The most common criteria were 'travel history' (11 laboratories) and/or 'when requested' (14 laboratories). Despite only a small proportion of stools being examined in 15 laboratories for Giardia (2%-18% of the total number of stools submitted), of interest is the finding that a higher positivity rate was observed for Giardia than Cryptosporidium in 10 of these 15 laboratories. These findings highlight that the underreporting of Giardia in Scotland is likely based on current selection and testing algorithms.

Travel-associated infection presenting in Europe (2008-12): an analysis of EuroTravNet longitudinal, surveillance data, and evaluation of the effect of the pre-travel consultation.

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Schlagenhauf, Patricia; Weld, Leisa; Goorhuis, Abraham; Gautret, Philippe; Weber, Rainer; von Sonnenburg, Frank; Lopez-Vélez, Rogelio; Jensenius, Mogens; Cramer, Jakob P; Field, Vanessa K; Odolini, Silvia; Gkrania-Klotsas, Effrossyni; Chappuis, Francois; Malvy, Denis; van Genderen, Perry J J; Mockenhaupt, Frank; Jauréguiberry, Stéphane; Smith, Catherine; Beeching, Nicholas J; Ursing, Johan; Rapp, Christophe; Parola, Philippe; Grobusch, Martin P

2015-01-01

Travel is important in the acquisition and dissemination of infection. We aimed to assess European surveillance data for travel-related illness to profile imported infections, track trends, identify risk groups, and assess the usefulness of pre-travel advice. We analysed travel-associated morbidity in ill travellers presenting at EuroTravNet sites during the 5-year period of 2008-12. We calculated proportionate morbidity per 1000 ill travellers and made comparisons over time and between subgroups. We did 5-year trend analyses (2008-12) by testing differences in proportions between subgroups using Pearson's χ(2) test. We assessed the effect of the pre-travel consultation on infection acquisition and outcome by use of proportionate morbidity ratios. The top diagnoses in 32 136 patients, ranked by proportionate morbidity, were malaria and acute diarrhoea, both with high proportionate morbidity (>60). Dengue, giardiasis, and insect bites had high proportionate morbidity (>30) as well. 5-year analyses showed increases in vector borne infections with significant peaks in 2010; examples were increased Plasmodium falciparum malaria (χ(2)=37·57, ptravel consultation was associated with significantly lower proportionate morbidity ratios for P falciparum malaria and also for acute hepatitis and HIV/AIDS. The pattern of travel-related infections presenting in Europe is complex. Trend analyses can inform on emerging infection threats. Pre-travel consultation is associated with reduced malaria proportionate morbidity ratios and less severe illness. These findings support the importance and effectiveness of pre-travel advice on malaria prevention, but cast doubt on the effectiveness of current strategies to prevent travel-related diarrhoea. European Centre for Disease Prevention and Control, University Hospital Institute Méditerranée Infection, US Centers for Disease Control and Prevention, and the International Society of Travel Medicine. Copyright © 2015 Elsevier Ltd

Novel structural components of the ventral disc and lateral crest in Giardia intestinalis.

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Kari D Hagen

2011-12-01

Full Text Available Giardia intestinalis is a ubiquitous parasitic protist that is the causative agent of giardiasis, one of the most common protozoan diarrheal diseases in the world. Giardia trophozoites attach to the intestinal epithelium using a specialized and elaborate microtubule structure, the ventral disc. Surrounding the ventral disc is a less characterized putatively contractile structure, the lateral crest, which forms a continuous perimeter seal with the substrate. A better understanding of ventral disc and lateral crest structure, conformational dynamics, and biogenesis is critical for understanding the mechanism of giardial attachment to the host. To determine the components comprising the ventral disc and lateral crest, we used shotgun proteomics to identify proteins in a preparation of isolated ventral discs. Candidate disc-associated proteins, or DAPs, were GFP-tagged using a ligation-independent high-throughput cloning method. Based on disc localization, we identified eighteen novel DAPs, which more than doubles the number of known disc-associated proteins. Ten of the novel DAPs are associated with the lateral crest or outer edge of the disc, and are the first confirmed components of this structure. Using Fluorescence Recovery After Photobleaching (FRAP with representative novel DAP::GFP strains we found that the newly identified DAPs tested did not recover after photobleaching and are therefore structural components of the ventral disc or lateral crest. Functional analyses of the novel DAPs will be central toward understanding the mechanism of ventral disc-mediated attachment and the mechanism of disc biogenesis during cell division. Since attachment of Giardia to the intestine via the ventral disc is essential for pathogenesis, it is possible that some proteins comprising the disc could be potential drug targets if their loss or disruption interfered with disc biogenesis or function, preventing attachment.

Multi-criteria decision analysis tools for prioritising emerging or re-emerging infectious diseases associated with climate change in Canada.

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Cox, Ruth; Sanchez, Javier; Revie, Crawford W

2013-01-01

Global climate change is known to result in the emergence or re-emergence of some infectious diseases. Reliable methods to identify the infectious diseases of humans and animals and that are most likely to be influenced by climate are therefore required. Since different priorities will affect the decision to address a particular pathogen threat, decision makers need a standardised method of prioritisation. Ranking methods and Multi-Criteria Decision approaches provide such a standardised method and were employed here to design two different pathogen prioritisation tools. The opinion of 64 experts was elicited to assess the importance of 40 criteria that could be used to prioritise emerging infectious diseases of humans and animals in Canada. A weight was calculated for each criterion according to the expert opinion. Attributes were defined for each criterion as a transparent and repeatable method of measurement. Two different Multi-Criteria Decision Analysis tools were tested, both of which used an additive aggregation approach. These were an Excel spreadsheet tool and a tool developed in software 'M-MACBETH'. The tools were trialed on nine 'test' pathogens. Two different methods of criteria weighting were compared, one using fixed weighting values, the other using probability distributions to account for uncertainty and variation in expert opinion. The ranking of the nine pathogens varied according to the weighting method that was used. In both tools, using both weighting methods, the diseases that tended to rank the highest were West Nile virus, Giardiasis and Chagas, while Coccidioidomycosis tended to rank the lowest. Both tools are a simple and user friendly approach to prioritising pathogens according to climate change by including explicit scoring of 40 criteria and incorporating weighting methods based on expert opinion. They provide a dynamic interactive method that can help to identify pathogens for which a full risk assessment should be pursued.

Multi-criteria decision analysis tools for prioritising emerging or re-emerging infectious diseases associated with climate change in Canada.

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Ruth Cox

Full Text Available Global climate change is known to result in the emergence or re-emergence of some infectious diseases. Reliable methods to identify the infectious diseases of humans and animals and that are most likely to be influenced by climate are therefore required. Since different priorities will affect the decision to address a particular pathogen threat, decision makers need a standardised method of prioritisation. Ranking methods and Multi-Criteria Decision approaches provide such a standardised method and were employed here to design two different pathogen prioritisation tools. The opinion of 64 experts was elicited to assess the importance of 40 criteria that could be used to prioritise emerging infectious diseases of humans and animals in Canada. A weight was calculated for each criterion according to the expert opinion. Attributes were defined for each criterion as a transparent and repeatable method of measurement. Two different Multi-Criteria Decision Analysis tools were tested, both of which used an additive aggregation approach. These were an Excel spreadsheet tool and a tool developed in software 'M-MACBETH'. The tools were trialed on nine 'test' pathogens. Two different methods of criteria weighting were compared, one using fixed weighting values, the other using probability distributions to account for uncertainty and variation in expert opinion. The ranking of the nine pathogens varied according to the weighting method that was used. In both tools, using both weighting methods, the diseases that tended to rank the highest were West Nile virus, Giardiasis and Chagas, while Coccidioidomycosis tended to rank the lowest. Both tools are a simple and user friendly approach to prioritising pathogens according to climate change by including explicit scoring of 40 criteria and incorporating weighting methods based on expert opinion. They provide a dynamic interactive method that can help to identify pathogens for which a full risk assessment should

Genetic analysis of the Gdh and Bg genes of animal-derived Giardia duodenalis isolates in Northeastern China and evaluation of zoonotic transmission potential.

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Aiqin Liu

Full Text Available BACKGROUND: Giardia duodenalis is a common intestinal parasite that infects humans and many other mammals, mainly distributing in some areas with poor sanitation. The proportion of the human giardiasis burden attributable to G. duodenalis of animal origin differs in different geographical areas. In Mainland China, genetic data of the gdh and bg genes of G. duodenalis from animals are only limited in dogs and cats. The aim of the study was to provide information on the genetic characterizations of animal-derived G. duodenalis isolates (from rabbits, sheep and cattle at both loci in Heilongjiang Province, Northeastern China, and to assess the potential for zoonotic transmission. METHODOLOGY/PRINCIPAL FINDINGS: 61 G. duodenalis isolates from animal feces (dairy and beef cattle, sheep and rabbits in Heilongjiang Province were characterized at the gdh and bg loci in the present study. The gdh and bg gene sequences of sheep-derived G. duodenalis assemblage AI, and the gdh sequences of rabbit-derived G. duodenalis assemblage B had 100% similarity with those from humans, respectively. Novel subtypes of G. duodenalis were identified, with one and seven subtypes for assemblages A and E at the gdh locus, and two and three subtypes for assemblages B and E at the bg locus, respectively. Three pairs of the same bg sequences of assemblage E were observed in sheep and cattle. CONCLUSIONS/SIGNIFICANCE: This is the first description of genetic characterizations of the gdh and bg genes of G. duodenalis from rabbits, sheep and cattle in Mainland China. Homology analysis of assemblages AI and B implied the possibility of zoonotic transmission. The novel subtypes of assemblages of G. duodenalis may represent the endemic genetic characteristics of G. duodenalis in Heilongjiang Province, China.

Association of Metronidazole with Cancer: A Potential Risk Factor or Inconsistent Deductions?

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Adil, Muhammad; Iqbal, Waheed; Adnan, Fazal; Wazir, Shabnam; Khan, Imran; Khayam, Mohammad Umar; Kamal, Mohammad Amjad; Ahmad, Shafiq; Ahmad, Jawad; Khan, Ishaq N

2018-03-29

Metronidazole is a synthetic derivative of nitroimidazole that has been widely used for the treatment of several bacterial and protozoal parasitic infections including trichomoniasis, amoebiasis, giardiasis, liver abscess, acute ulcerative gingivitis, syphilis and tropical phagedena. In addition to its toxicity in the gastrointestinal tract and central/peripheral nervous system, metronidazole has been reported to cause mucosal imbalance by affecting the expression of mucin (Muc2 gene), which is responsible to form an insoluble mucous barrier that protects the gut lumen from microbial colonization. Since metronidazole is a nitro-group containing compound and used significantly for therapeutic purposes, scientists evaluated its carcinogenicity in different preclinical in-vitro and in-vivo studies. In addition to the preclinical in-vitro validation of DNA damage, metronidazole has been reported to induce cancer in the variety of animal models including lung cancer, malignant lymphomas, breast cancer, hepatocellular carcinoma, pituitary tumors, testicular neoplasms and uterine cancer. Several retrospective cohort studies have reported metronidazole as a potential risk factor for lung cancer (n = 771), cervical cancer (n = 2500), breast cancer (n = 2), cholangiocarcinoma (n = 1), and neuroblastoma (n = 28). So far, all the reported data have confirmed metronidazole carcinogenicity in animals; however, it is still controversial in humans. Based on previous observations, the oxidative metabolites from metronidazole metabolism are shown to have more carcinogenic effects than the parent drug itself. Since ~40% of drug metabolism is reliant on cytochromes, the inter-patient' differences in metronidazole metabolism potentially indicate the individual susceptibility to developing cancer. Due to these potent carcinogenic behaviors, use of metronidazole for animals treatment and its uses in animal food products are barred in the USA and European countries; however, its clinical

Human Parasitic Diseases in Bulgaria in Between 2013-2014

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Rainova, Iskra; Harizanov, Rumen; Kaftandjiev, Iskren; Tsvetkova, Nina; Mikov, Ognyan; Kaneva, Eleonora

2018-01-01

Background: In Bulgaria, more than 20 autochthonous human parasitic infections have been described and some of them are widespread. Over 50 imported protozoan and helminthic infections represent diagnostic and therapeutic challenges and pose epidemiological risks due to the possibility of local transmission. Aims: To establish the distribution of autochthonous and imported parasitic diseases among the population of the country over a 2-year period (2013-2014) and to evaluate their significance in the public health system. Study Design: Cross sectional study. Methods: We used the annual reports by regional health inspectorates and data from the National Reference Laboratory at the National Centre of Infectious and Parasitic Diseases on all individuals infected with parasitic diseases in the country. Prevalence was calculated for parasitic diseases with few or absent clinical manifestations (oligosymptomatic or asymptomatic infections). Incidence per 100.000 was calculated for diseases with an overt clinical picture or those that required hospitalisation and specialised medical interventions (e.g. surgery). Results: During the research period, parasitological studies were conducted on 1441.244 persons, and parasitic infections were diagnosed in 22.039 individuals. Distribution of various parasitic pathogens among the population displayed statistically significant differences in prevalence for some intestinal parasites (enterobiasis 0.81%, giardiasis 0.34% and blastocystosis 0.22%). For certain zoonotic diseases such as cystic echinococcosis (average incidence of 3.99 per 100.000) and trichinellosis (average incidence of 0.8 per 100.000), the incidence exceeds several times the annual incidence recorded in the European Union. Conclusion: Parasitic diseases still pose a substantial problem with social and medical impacts on the residents of our country. Improved efficiency regarding autochthonous and imported parasitic diseases is essential in providing the public

Challenges in developing methods for quantifying the effects of weather and climate on water-associated diseases: A systematic review.

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Lo Iacono, Giovanni; Armstrong, Ben; Fleming, Lora E; Elson, Richard; Kovats, Sari; Vardoulakis, Sotiris; Nichols, Gordon L

2017-06-01

Infectious diseases attributable to unsafe water supply, sanitation and hygiene (e.g. Cholera, Leptospirosis, Giardiasis) remain an important cause of morbidity and mortality, especially in low-income countries. Climate and weather factors are known to affect the transmission and distribution of infectious diseases and statistical and mathematical modelling are continuously developing to investigate the impact of weather and climate on water-associated diseases. There have been little critical analyses of the methodological approaches. Our objective is to review and summarize statistical and modelling methods used to investigate the effects of weather and climate on infectious diseases associated with water, in order to identify limitations and knowledge gaps in developing of new methods. We conducted a systematic review of English-language papers published from 2000 to 2015. Search terms included concepts related to water-associated diseases, weather and climate, statistical, epidemiological and modelling methods. We found 102 full text papers that met our criteria and were included in the analysis. The most commonly used methods were grouped in two clusters: process-based models (PBM) and time series and spatial epidemiology (TS-SE). In general, PBM methods were employed when the bio-physical mechanism of the pathogen under study was relatively well known (e.g. Vibrio cholerae); TS-SE tended to be used when the specific environmental mechanisms were unclear (e.g. Campylobacter). Important data and methodological challenges emerged, with implications for surveillance and control of water-associated infections. The most common limitations comprised: non-inclusion of key factors (e.g. biological mechanism, demographic heterogeneity, human behavior), reporting bias, poor data quality, and collinearity in exposures. Furthermore, the methods often did not distinguish among the multiple sources of time-lags (e.g. patient physiology, reporting bias, healthcare access

Prevalence of and risk factors for malaria, filariasis, and intestinal parasites as single infections or co-infections in different settlements of Gabon, Central Africa.

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M'bondoukwé, Noé Patrick; Kendjo, Eric; Mawili-Mboumba, Denise Patricia; Koumba Lengongo, Jeanne Vanessa; Offouga Mbouoronde, Christelle; Nkoghe, Dieudonné; Touré, Fousseyni; Bouyou-Akotet, Marielle Karine

2018-01-30

Malaria, filariasis, and intestinal parasitic infections (IPIs) are common and frequently overlap in developing countries. The prevalence and predictors of these infections were investigated in three different settlements (rural, semi-urban, and urban) of Gabon. During cross-sectional surveys performed from September 2013 to June 2014, 451 individuals were interviewed. In addition, blood and stool samples were analysed for the presence of Plasmodium, filarial roundworm, intestinal protozoan, and helminth infections. Intestinal parasitic infections (61.1%), including intestinal protozoa (56.7%) and soil-transmitted helminths (STHs) (22.2%), predominated, whereas Plasmodium falciparum (18.8%), Loa loa (4.7%), and Mansonella perstans (1.1%) were less prevalent. Filariasis and STHs were mainly found in rural settlements, whereas a higher plasmodial infection prevalence rate was observed in the periurban area. The most common IPI was blastocystosis (48.6%), followed by ascaridiasis (13.7%), trichuriasis (11.8%), amoebiasis (9.3%), giardiasis (4.8%), and strongyloidiasis (3.7%). Hookworm was detected in one adult from rural Dienga. Adults had a higher prevalence of Blastocystis hominis and STHs, whereas Giardia duodenalis was more frequently observed among children aged below 5 years (P < 0.01). The polyparasitism rate was 41.5%, with 7.0% Plasmodium-IPIs and 1.8% Plasmodium-STH co-infections. The multivariate analysis showed that living in a suburban area, belonging to the age group of 5-15 years, having none or a secondary education, or having an open body water close to home were significant risk factors for malaria (P ≤ 0.01). For STH infections, identified risk factors were drinking untreated water and living in a rural area (P ≤ 0.04). No significant predictors were identified for IPIs and malaria-IPI co-infection. This study reports a high prevalence of IPIs and intestinal protozoa, but a low rate of malaria-IPI co-infections in the study sites

Prevalence and Genetic Diversity of Giardia duodenalis and Cryptosporidium spp. among School Children in a Rural Area of the Amhara Region, North-West Ethiopia.

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Aida de Lucio

Full Text Available Giardia duodenalis and Cryptosporidium spp. are enteric protozoan causing gastrointestinal illness in humans and animals. Giardiasis and cryptosporidiosis are not formally considered as neglected tropical diseases, but belong to the group of poverty-related infectious diseases that impair the development and socio-economic potential of infected individuals in developing countries.We report here the prevalence and genetic diversity of G. duodenalis and Cryptosporidium spp. in children attending rural primary schools in the Bahir Dar district of the Amhara Region, Ethiopia. Stool samples were collected from 393 children and analysed by molecular methods. G. duodenalis was detected by real-time PCR, and the assemblages and sub-assemblages were determined by multilocus sequence-based genotyping of the glutamate dehydrogenase and β-giardin genes of the parasite. Detection and identification of Cryptosporidium species was carried out by sequencing of a partial fragment of the small-subunit ribosomal RNA gene.The PCR-based prevalences of G. duodenalis and Cryptosporidium spp. were 55.0% (216/393 and 4.6% (18/393, respectively. A total of 78 G. duodenalis isolates were successfully characterized, revealing the presence of sub-assemblages AII (10.3%, BIII (28.2%, and BIV (32.0%. Discordant typing results AII/AIII and BIII/BIV were identified in 7.7% and 15.4% of the isolates, respectively. An additional five (6.4% isolates were assigned to assemblage B. No mixed infections of assemblages A+B were found. Extensive genetic variation at the nucleotide level was observed within assemblage B (but no within assemblage A, resulting in the identification of a large number of sub-types. Cryptosporidium diversity was demonstrated by the occurrence of C. hominis, C. parvum, and C. viatorum in the population under study.Our data suggest an epidemiological scenario with an elevated transmission intensity of a wide range of G. duodenalis genetic variants. Importantly

Multilocus typing of Cryptosporidium spp. and Giardia duodenalis from non-human primates in China.

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Karim, Md Robiul; Zhang, Sumei; Jian, Fuchun; Li, Jiacheng; Zhou, Chunxiang; Zhang, Longxian; Sun, Mingfei; Yang, Guangyou; Zou, Fengcai; Dong, Haiju; Li, Jian; Rume, Farzana Islam; Qi, Meng; Wang, Rongjun; Ning, Changshen; Xiao, Lihua

2014-11-01

Non-human primates (NHPs) are commonly infected with Cryptosporidium spp. and Giardia duodenalis. However, molecular characterisation of these pathogens from NHPs remains scarce. In this study, 2,660 specimens from 26 NHP species in China were examined and characterised by PCR amplification of 18S rRNA, 70kDa heat shock protein (hsp70) and 60kDa glycoprotein (gp60) gene loci for Cryptosporidium; and 1,386 of the specimens by ssrRNA, triosephosphate isomerase (tpi) and glutamate dehydrogenase (gdh) gene loci for Giardia. Cryptosporidium was detected in 0.7% (19/2660) specimens of four NHP species including rhesus macaques (0.7%), cynomolgus monkeys (1.0%), slow lorises (10.0%) and Francois' leaf monkeys (6.7%), belonging to Cryptosporidium hominis (14/19) and Cryptosporidium muris (5/19). Two C. hominis gp60 subtypes, IbA12G3 and IiA17 were observed. Based on the tpi locus, G. duodenalis was identified in 2.2% (30/1,386) of specimens including 2.1% in rhesus macaques, 33.3% in Japanese macaques, 16.7% in Assam macaques, 0.7% in white-headed langurs, 1.6% in cynomolgus monkeys and 16.7% in olive baboons. Sequence analysis of the three targets indicated that all of the Giardia-positive specimens belonged to the zoonotic assemblage B. Highest sequence polymorphism was observed at the tpi locus, including 11 subtypes: three known and eight new ones. Phylogenetic analysis of the subtypes showed that most of them were close to the so-called subtype BIV. Intragenotypic variations at the gdh locus revealed six types of sequences (three known and three new), all of which belonged to so-called subtype BIV. Three specimens had co-infection with C. hominis (IbA12G3) and G. duodenalis (BIV). The presence of zoonotic genotypes and subtypes of Cryptosporidium spp. and G. duodenalis in NHPs suggests that these animals can potentially contribute to the transmission of human cryptosporidiosis and giardiasis. Copyright © 2014 Australian Society for Parasitology Inc. All rights

Challenges in developing methods for quantifying the effects of weather and climate on water-associated diseases: A systematic review.

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Giovanni Lo Iacono

2017-06-01

Full Text Available Infectious diseases attributable to unsafe water supply, sanitation and hygiene (e.g. Cholera, Leptospirosis, Giardiasis remain an important cause of morbidity and mortality, especially in low-income countries. Climate and weather factors are known to affect the transmission and distribution of infectious diseases and statistical and mathematical modelling are continuously developing to investigate the impact of weather and climate on water-associated diseases. There have been little critical analyses of the methodological approaches. Our objective is to review and summarize statistical and modelling methods used to investigate the effects of weather and climate on infectious diseases associated with water, in order to identify limitations and knowledge gaps in developing of new methods. We conducted a systematic review of English-language papers published from 2000 to 2015. Search terms included concepts related to water-associated diseases, weather and climate, statistical, epidemiological and modelling methods. We found 102 full text papers that met our criteria and were included in the analysis. The most commonly used methods were grouped in two clusters: process-based models (PBM and time series and spatial epidemiology (TS-SE. In general, PBM methods were employed when the bio-physical mechanism of the pathogen under study was relatively well known (e.g. Vibrio cholerae; TS-SE tended to be used when the specific environmental mechanisms were unclear (e.g. Campylobacter. Important data and methodological challenges emerged, with implications for surveillance and control of water-associated infections. The most common limitations comprised: non-inclusion of key factors (e.g. biological mechanism, demographic heterogeneity, human behavior, reporting bias, poor data quality, and collinearity in exposures. Furthermore, the methods often did not distinguish among the multiple sources of time-lags (e.g. patient physiology, reporting bias

Isolated short stature as a presentation of celiac disease in Saudi children

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Asaad Mohamed Assiri

2010-06-01

Full Text Available The aim of this study is to assess the prevalence of isolated short stature as a clinical presentation of celiac disease in Saudi Arab children and whether some of the routine labora-tory tests performed to determine the cause of short stature could suggest the diagnosis of celiac disease. A total of 91 children with short stature were included in the study. Extensive endocrine and biochemical assessments, including total protein, serum albumin, calcium phosphate and alkaline phosphatase assays; renal function tests; coagulation profile; anti-endomysial antibodies and anti-tissue transglutaminase antibody, growth hormone, thyroid stimulating hormone, free-thyroxin (FT4 assays; stool tests for giardiasis; bone age; and endoscopic intestinal biopsies, were done for all children. Ten of the 91 children had positive intestinal biopsies in the form of total villous atrophy, an increase in crypt height, and an increase in intra-epithelial lymphocyte (IEL numbers up to >40 IEL/100 EC (Type 3C according to the Oberhuber classification, confirming the diagnosis of celiac disease. Five children had mild villous atrophy according to this classification (Type 3A, and they were considered to have potential celiac disease. Seventy-six children had normal intestinal biopsies. Therefore, the prevalence of celiac disease among Saudi children with short stature was 10.9%, and 4.3% of the children were diagnosed as having potential celiac disease. After confirming the diagnosis of celiac disease, all children were kept on a gluten-free diet and all of them showed improvement in their growth rate. We concluded that celiac disease is a very important cause of short stature in children without gastrointestinal complaints in Saudi Arabia. We highly recommend anti-tissue transglutaminase and anti-endomysial antibody screening tests, and a small bowel biopsy to confirm the diagnosis of celiac disease irrespective of the results of the antibody assays, in children with

High malnutrition rate in Venezuelan Yanomami compared to Warao Amerindians and Creoles: significant associations with intestinal parasites and anemia.

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Verhagen, Lilly M; Incani, Renzo N; Franco, Carolina R; Ugarte, Alejandra; Cadenas, Yeneska; Sierra Ruiz, Carmen I; Hermans, Peter W M; Hoek, Denise; Campos Ponce, Maiza; de Waard, Jacobus H; Pinelli, Elena

2013-01-01

Children in rural areas experience the interrelated problems of poor growth, anemia and parasitic infections. We investigated the prevalence of and associations between intestinal helminth and protozoan infections, malnutrition and anemia in school-age Venezuelan children. This cross-sectional study was conducted in 390 children aged 4-16 years from three rural areas of Venezuela: the Amazon Region, Orinoco Delta and Carabobo State. Stool samples were collected for direct parasitic examinations. Anthropometric indicators of chronic (height-for-age Z score) and acute (weight-for-height and Body Mass Index (BMI)-for-age Z score in respectively children under 5 years of age and children aged 5 years and above) malnutrition were calculated. Multivariate linear and logistic regression models were built to determine factors associated with nutritional status and polyparasitism. Hookworm and Strongyloides stercoralis prevalences were highest in children from the Amazon rainforest (respectively 72% and 18%) while children from the Orinoco Delta and Carabobo State showed higher rates of Ascaris lumbricoides (respectively 28% and 37%) and Trichuris trichiura (40% in both regions). The prevalence of Giardia lamblia infection was not significantly different between regions (average: 18%). Anemia prevalence was highest in the Amazon Region (24%). Hemoglobin levels were significantly decreased in children with a hookworm infection. Malnutrition was present in respectively 84%, 30% and 13% of children from the Amazon Region, Orinoco Delta and Carabobo State. In multivariate analysis including all regions, G. lamblia and helminth infections were significantly and negatively associated with respectively height-for-age and weight-for-height/BMI-for-age Z scores. Furthermore, hemoglobin levels were positively associated with the height-for-age Z score (0.11, 95% CI 0.02 - 0.20). In rural populations in Venezuela helminthiasis and giardiasis were associated with acute and chronic

High Malnutrition Rate in Venezuelan Yanomami Compared to Warao Amerindians and Creoles: Significant Associations WITH Intestinal Parasites and Anemia

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Verhagen, Lilly M.; Incani, Renzo N.; Franco, Carolina R.; Ugarte, Alejandra; Cadenas, Yeneska; Sierra Ruiz, Carmen I.; Hermans, Peter W. M.; Hoek, Denise; Campos Ponce, Maiza; de Waard, Jacobus H.; Pinelli, Elena

2013-01-01

Background Children in rural areas experience the interrelated problems of poor growth, anemia and parasitic infections. We investigated the prevalence of and associations between intestinal helminth and protozoan infections, malnutrition and anemia in school-age Venezuelan children. Methods This cross-sectional study was conducted in 390 children aged 4-16 years from three rural areas of Venezuela: the Amazon Region, Orinoco Delta and Carabobo State. Stool samples were collected for direct parasitic examinations. Anthropometric indicators of chronic (height-for-age Z score) and acute (weight-for-height and Body Mass Index (BMI)-for-age Z score in respectively children under 5 years of age and children aged 5 years and above) malnutrition were calculated. Multivariate linear and logistic regression models were built to determine factors associated with nutritional status and polyparasitism. Results Hookworm and Strongyloides stercoralis prevalences were highest in children from the Amazon rainforest (respectively 72% and 18%) while children from the Orinoco Delta and Carabobo State showed higher rates of Ascaris lumbricoides (respectively 28% and 37%) and Trichuris trichiura (40% in both regions). The prevalence of Giardia lamblia infection was not significantly different between regions (average: 18%). Anemia prevalence was highest in the Amazon Region (24%). Hemoglobin levels were significantly decreased in children with a hookworm infection. Malnutrition was present in respectively 84%, 30% and 13% of children from the Amazon Region, Orinoco Delta and Carabobo State. In multivariate analysis including all regions, G. lamblia and helminth infections were significantly and negatively associated with respectively height-for-age and weight-for-height/BMI-for-age Z scores. Furthermore, hemoglobin levels were positively associated with the height-for-age Z score (0.11, 95% CI 0.02 - 0.20). Conclusions In rural populations in Venezuela helminthiasis and giardiasis were

High malnutrition rate in Venezuelan Yanomami compared to Warao Amerindians and Creoles: significant associations with intestinal parasites and anemia.

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Lilly M Verhagen

Full Text Available Children in rural areas experience the interrelated problems of poor growth, anemia and parasitic infections. We investigated the prevalence of and associations between intestinal helminth and protozoan infections, malnutrition and anemia in school-age Venezuelan children.This cross-sectional study was conducted in 390 children aged 4-16 years from three rural areas of Venezuela: the Amazon Region, Orinoco Delta and Carabobo State. Stool samples were collected for direct parasitic examinations. Anthropometric indicators of chronic (height-for-age Z score and acute (weight-for-height and Body Mass Index (BMI-for-age Z score in respectively children under 5 years of age and children aged 5 years and above malnutrition were calculated. Multivariate linear and logistic regression models were built to determine factors associated with nutritional status and polyparasitism.Hookworm and Strongyloides stercoralis prevalences were highest in children from the Amazon rainforest (respectively 72% and 18% while children from the Orinoco Delta and Carabobo State showed higher rates of Ascaris lumbricoides (respectively 28% and 37% and Trichuris trichiura (40% in both regions. The prevalence of Giardia lamblia infection was not significantly different between regions (average: 18%. Anemia prevalence was highest in the Amazon Region (24%. Hemoglobin levels were significantly decreased in children with a hookworm infection. Malnutrition was present in respectively 84%, 30% and 13% of children from the Amazon Region, Orinoco Delta and Carabobo State. In multivariate analysis including all regions, G. lamblia and helminth infections were significantly and negatively associated with respectively height-for-age and weight-for-height/BMI-for-age Z scores. Furthermore, hemoglobin levels were positively associated with the height-for-age Z score (0.11, 95% CI 0.02 - 0.20.In rural populations in Venezuela helminthiasis and giardiasis were associated with acute and

Estado nutricional e prevalência de enteroparasitoses em crianças matriculadas em creche Nutritional status and enteroparasitosis prevalence among children enrolled in a day care center

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Terezinha Soares Biscegli

2009-09-01

giardiasis. It is important to adopt effective preventive measures against childhood obesity and protozoan infestations in the day care center as much as in children's homes.

Infection rate of Giardia duodenalis, Cryptosporidium spp. and Enterocytozoon bieneusi in cashmere, dairy and meat goats in China.

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Peng, Xian-Qi; Tian, Ge-Ru; Ren, Guan-Jing; Yu, Zheng-Qing; Lok, James Barron; Zhang, Long-Xian; Wang, Xue-Ting; Song, Jun-Ke; Zhao, Guang-Hui

2016-07-01

Cryptosporidiosis, microsporidiosis, and giardiasis contribute significantly to the high burden of zoonotic diarrhea worldwide. Goats constitute an important species in animal agriculture by providing cashmere wool, meat, and dairy products for human consumption. However, zoonotic pathogens with the potential to cause morbidity and to degrade production have been reported frequently in goats recently. The present study examined 629 fecal specimens from goats, including 315 cashmere goats, 170 dairy goats and 144 meat goats, in multiple cities of Shaanxi and Henan provinces, northwestern and central China, to investigate the infection rate and species/assemblages/genotypes of Giardia duodenalis, Cryptosporidium spp. and Enterocytozoon bieneusi. Of these samples, 274 (43.6%) were positive for three zoonotic pathogens, including 80 (12.7%), 104 (16.5%) and 179 (28.5%) for G. duodenalis, Cryptosporidium spp. and E. bieneusi, respectively. Infections with G. duodenalis, Cryptosporidium spp. and E. bieneusi existed in meat, dairy and cashmere goats, with the highest infection rate of each pathogen being observed in meat goats. DNA sequencing of the SSU rRNA gene from 104 Cryptosporidium-positive specimens revealed existence of Cryptosporidium xiaoi, and the zoonotic parasites Cryptosporidium parvum and Cryptosporidium ubiquitum. Genotyping of G. duodenalis based on the triosephosphate isomerase (TPI) gene identified parasites from zoonotic assemblage A in four cashmere goats and the animal-adapted assemblage E in a group of 76 goats that included cashmere, dairy and meat animals. Polymorphisms in the ribosomal internal transcribed spacer characterized E. bieneusi genotype CHG1 and a novel genotype named as SX1 in both dairy and cashmere goats, genotypes CHS7 and COSI in meat goats, the genotype CHG2 in dairy goats, and the human-pathogenic genotype BEB6 in dairy and meat goats. This is the first detailed study to compare infection rate of the zoonotic protozoan pathogens

Prevalence and molecular characterization of Cryptosporidium spp. and Giardia duodenalis in diarrhoeic patients in the Qikiqtani Region, Nunavut, Canada

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Asma Iqbal

2015-06-01

different Cryptosporidium and Giardia species and genotypes in diarrhoeic patients, it will be imperative to establish the extent of genetic diversity within these parasites through comprehensive studies of the molecular epidemiology of cryptosporidiosis and giardiasis in the Nunavut region.

Contamination by Helicobacter pylori measured by the 13C-urea-breast-test and nutritional status of children with chronic diarrhoea syndrome in Havana city

International Nuclear Information System (INIS)

Cabrera, A.; Hernandez-Triana, M.; Sanchez, M.; Herrera, X.; Pawong, M.; Moreno, R.; Reyes, D.; Serrano, G.; Diaz, M.E.; Valencia, M.

2000-01-01

Diarrhoea morbidity shows a slow increasing tendency during the last 10 years in Cuba. In young children the compromise of the gastric acid barrier after a chronic infection with Helicobacter pylori is discussed in pathogenic relation to gastritis, duodenal ulcer chronic diarrhoea, short stature, malabsorption of the B-complex vitamins and malnutrition. The Hp contamination level of the population of the developing world is estimated to be considerably high. Endoscopic studies carried out in Cuban subjects with upper gastrointestinal symptoms show contamination values of 60 to 100%. The current treatment of chronic diarrhoea does not include the elimination of Hp. Cuban children with upper gastrointestinal symptoms show contamination values of more than 60%. There are not available data on the contamination level in apparently healthy Cuban children or those with chronic diarrhoea. In March-April 2000 the prevalence of Hp infection measured in serum by chromatographic immunoassay for detection of Hp IgG antibodies was found to be 94% in 20 infants and young children with persistent chronic diarrhoea and 100% in 11 apparently healthy children in Havana City. Children with diarrhoea showed a more evident affection of their nutritional status and a higher percentage of positive personal or familiar history of parasitism, giardiasis, gastritis, ulcer stomatitis and glositis. The validity of the immunological tests in infants is discussed from the point of view of the antibody transference with breast milk. In a sample of 16 different children studied by the 13 C-Urea-Breath-Test the contamination level was 50% of the children not affected by diarrhoea and only one of the 6 children with diarrhoea showed positive values. This research contract proposes the study of contamination with Hp in Cuban children older than 2 years of age affected by chronic diarrhoea using the 13 C-Urea Breath Test and serological tests for detection of anti-Hp IgG antibodies. Their nutritional

Contamination by Helicobacter pylori measured by the {sup 13}C-urea-breast-test and nutritional status of children with chronic diarrhoea syndrome in Havana city

Energy Technology Data Exchange (ETDEWEB)

Cabrera, A; Hernandez-Triana, M; Sanchez, M; Herrera, X; Pawong, M; Moreno, R; Reyes, D; Serrano, G; Diaz, M E [Institute of Nutrition and Food Hygiene, Department of Biochemistry and Physiology, Havana (Cuba); Valencia, M [Centro de Investigacion en Alimentacion y Desarrollo, Department of Human Nutrition, Hermosillo, Sonora (Mexico)

2000-07-01

Diarrhoea morbidity shows a slow increasing tendency during the last 10 years in Cuba. In young children the compromise of the gastric acid barrier after a chronic infection with Helicobacter pylori is discussed in pathogenic relation to gastritis, duodenal ulcer chronic diarrhoea, short stature, malabsorption of the B-complex vitamins and malnutrition. The Hp contamination level of the population of the developing world is estimated to be considerably high. Endoscopic studies carried out in Cuban subjects with upper gastrointestinal symptoms show contamination values of 60 to 100%. The current treatment of chronic diarrhoea does not include the elimination of Hp. Cuban children with upper gastrointestinal symptoms show contamination values of more than 60%. There are not available data on the contamination level in apparently healthy Cuban children or those with chronic diarrhoea. In March-April 2000 the prevalence of Hp infection measured in serum by chromatographic immunoassay for detection of Hp IgG antibodies was found to be 94% in 20 infants and young children with persistent chronic diarrhoea and 100% in 11 apparently healthy children in Havana City. Children with diarrhoea showed a more evident affection of their nutritional status and a higher percentage of positive personal or familiar history of parasitism, giardiasis, gastritis, ulcer stomatitis and glositis. The validity of the immunological tests in infants is discussed from the point of view of the antibody transference with breast milk. In a sample of 16 different children studied by the {sup 13}C-Urea-Breath-Test the contamination level was 50% of the children not affected by diarrhoea and only one of the 6 children with diarrhoea showed positive values. This research contract proposes the study of contamination with Hp in Cuban children older than 2 years of age affected by chronic diarrhoea using the {sup 13}C-Urea Breath Test and serological tests for detection of anti-Hp IgG antibodies. Their

Comparison of supervised machine learning algorithms for waterborne pathogen detection using mobile phone fluorescence microscopy

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Ceylan Koydemir, Hatice; Feng, Steve; Liang, Kyle; Nadkarni, Rohan; Benien, Parul; Ozcan, Aydogan

2017-06-01

Giardia lamblia is a waterborne parasite that affects millions of people every year worldwide, causing a diarrheal illness known as giardiasis. Timely detection of the presence of the cysts of this parasite in drinking water is important to prevent the spread of the disease, especially in resource-limited settings. Here we provide extended experimental testing and evaluation of the performance and repeatability of a field-portable and cost-effective microscopy platform for automated detection and counting of Giardia cysts in water samples, including tap water, non-potable water, and pond water. This compact platform is based on our previous work, and is composed of a smartphone-based fluorescence microscope, a disposable sample processing cassette, and a custom-developed smartphone application. Our mobile phone microscope has a large field of view of 0.8 cm2 and weighs only 180 g, excluding the phone. A custom-developed smartphone application provides a user-friendly graphical interface, guiding the users to capture a fluorescence image of the sample filter membrane and analyze it automatically at our servers using an image processing algorithm and training data, consisting of >30,000 images of cysts and >100,000 images of other fluorescent particles that are captured, including, e.g. dust. The total time that it takes from sample preparation to automated cyst counting is less than an hour for each 10 ml of water sample that is tested. We compared the sensitivity and the specificity of our platform using multiple supervised classification models, including support vector machines and nearest neighbors, and demonstrated that a bootstrap aggregating (i.e. bagging) approach using raw image file format provides the best performance for automated detection of Giardia cysts. We evaluated the performance of this machine learning enabled pathogen detection device with water samples taken from different sources (e.g. tap water, non-potable water, pond water) and achieved a

Giardia lamblia: a major parasitic cause of childhood diarrhoea in patients attending a district hospital in Ghana.

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Nkrumah, Bernard; Nguah, Samuel Blay

2011-08-22

of children within the Ashanti Akim North Municipality and its prevalence significantly increases with age. Measures must be put in place to educate the community on proper personal hygiene to reduce giardiasis.

Comparison of supervised machine learning algorithms for waterborne pathogen detection using mobile phone fluorescence microscopy

KAUST Repository

Ceylan Koydemir, Hatice

2017-06-14

Giardia lamblia is a waterborne parasite that affects millions of people every year worldwide, causing a diarrheal illness known as giardiasis. Timely detection of the presence of the cysts of this parasite in drinking water is important to prevent the spread of the disease, especially in resource-limited settings. Here we provide extended experimental testing and evaluation of the performance and repeatability of a field-portable and cost-effective microscopy platform for automated detection and counting of Giardia cysts in water samples, including tap water, non-potable water, and pond water. This compact platform is based on our previous work, and is composed of a smartphone-based fluorescence microscope, a disposable sample processing cassette, and a custom-developed smartphone application. Our mobile phone microscope has a large field of view of ~0.8 cm2 and weighs only ~180 g, excluding the phone. A custom-developed smartphone application provides a user-friendly graphical interface, guiding the users to capture a fluorescence image of the sample filter membrane and analyze it automatically at our servers using an image processing algorithm and training data, consisting of >30,000 images of cysts and >100,000 images of other fluorescent particles that are captured, including, e.g. dust. The total time that it takes from sample preparation to automated cyst counting is less than an hour for each 10 ml of water sample that is tested. We compared the sensitivity and the specificity of our platform using multiple supervised classification models, including support vector machines and nearest neighbors, and demonstrated that a bootstrap aggregating (i.e. bagging) approach using raw image file format provides the best performance for automated detection of Giardia cysts. We evaluated the performance of this machine learning enabled pathogen detection device with water samples taken from different sources (e.g. tap water, non-potable water, pond water) and achieved

Comparison of supervised machine learning algorithms for waterborne pathogen detection using mobile phone fluorescence microscopy

KAUST Repository

Ceylan Koydemir, Hatice; Feng, Steve; Liang, Kyle; Nadkarni, Rohan; Benien, Parul; Ozcan, Aydogan

2017-01-01

Giardia lamblia is a waterborne parasite that affects millions of people every year worldwide, causing a diarrheal illness known as giardiasis. Timely detection of the presence of the cysts of this parasite in drinking water is important to prevent the spread of the disease, especially in resource-limited settings. Here we provide extended experimental testing and evaluation of the performance and repeatability of a field-portable and cost-effective microscopy platform for automated detection and counting of Giardia cysts in water samples, including tap water, non-potable water, and pond water. This compact platform is based on our previous work, and is composed of a smartphone-based fluorescence microscope, a disposable sample processing cassette, and a custom-developed smartphone application. Our mobile phone microscope has a large field of view of ~0.8 cm2 and weighs only ~180 g, excluding the phone. A custom-developed smartphone application provides a user-friendly graphical interface, guiding the users to capture a fluorescence image of the sample filter membrane and analyze it automatically at our servers using an image processing algorithm and training data, consisting of >30,000 images of cysts and >100,000 images of other fluorescent particles that are captured, including, e.g. dust. The total time that it takes from sample preparation to automated cyst counting is less than an hour for each 10 ml of water sample that is tested. We compared the sensitivity and the specificity of our platform using multiple supervised classification models, including support vector machines and nearest neighbors, and demonstrated that a bootstrap aggregating (i.e. bagging) approach using raw image file format provides the best performance for automated detection of Giardia cysts. We evaluated the performance of this machine learning enabled pathogen detection device with water samples taken from different sources (e.g. tap water, non-potable water, pond water) and achieved

Travel and migration associated infectious diseases morbidity in Europe, 2008

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Lopez-Velez Rogelio

2010-11-01

Full Text Available Abstract Background Europeans represent the majority of international travellers and clinicians encountering returned patients have an essential role in recognizing, and communicating travel-associated public health risks. Methods To investigate the morbidity of travel associated infectious diseases in European travellers, we analysed diagnoses with demographic, clinical and travel-related predictors of disease, in 6957 ill returned travellers who presented in 2008 to EuroTravNet centres with a presumed travel associated condition. Results Gastro-intestinal (GI diseases accounted for 33% of illnesses, followed by febrile systemic illnesses (20%, dermatological conditions (12% and respiratory illnesses (8%. There were 3 deaths recorded; a sepsis caused by Escherichia coli pyelonephritis, a dengue shock syndrome and a Plasmodium falciparum malaria. GI conditions included bacterial acute diarrhea (6.9%, as well as giardiasis and amebasis (2.3%. Among febrile systemic illnesses with identified pathogens, malaria (5.4% accounted for most cases followed by dengue (1.9% and others including chikungunya, rickettsial diseases, leptospirosis, brucellosis, Epstein Barr virus infections, tick-borne encephalitis (TBE and viral hepatitis. Dermatological conditions were dominated by bacterial infections, arthropod bites, cutaneous larva migrans and animal bites requiring rabies post-exposure prophylaxis and also leishmaniasis, myasis, tungiasis and one case of leprosy. Respiratory illness included 112 cases of tuberculosis including cases of multi-drug resistant or extensively drug resistant tuberculosis, 104 cases of influenza like illness, and 5 cases of Legionnaires disease. Sexually transmitted infections (STI accounted for 0.6% of total diagnoses and included HIV infection and syphilis. A total of 165 cases of potentially vaccine preventable diseases were reported. Purpose of travel and destination specific risk factors was identified for several

Comparison of supervised machine learning algorithms for waterborne pathogen detection using mobile phone fluorescence microscopy

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Ceylan Koydemir Hatice

2017-06-01

Full Text Available Giardia lamblia is a waterborne parasite that affects millions of people every year worldwide, causing a diarrheal illness known as giardiasis. Timely detection of the presence of the cysts of this parasite in drinking water is important to prevent the spread of the disease, especially in resource-limited settings. Here we provide extended experimental testing and evaluation of the performance and repeatability of a field-portable and cost-effective microscopy platform for automated detection and counting of Giardia cysts in water samples, including tap water, non-potable water, and pond water. This compact platform is based on our previous work, and is composed of a smartphone-based fluorescence microscope, a disposable sample processing cassette, and a custom-developed smartphone application. Our mobile phone microscope has a large field of view of ~0.8 cm2 and weighs only ~180 g, excluding the phone. A custom-developed smartphone application provides a user-friendly graphical interface, guiding the users to capture a fluorescence image of the sample filter membrane and analyze it automatically at our servers using an image processing algorithm and training data, consisting of >30,000 images of cysts and >100,000 images of other fluorescent particles that are captured, including, e.g. dust. The total time that it takes from sample preparation to automated cyst counting is less than an hour for each 10 ml of water sample that is tested. We compared the sensitivity and the specificity of our platform using multiple supervised classification models, including support vector machines and nearest neighbors, and demonstrated that a bootstrap aggregating (i.e. bagging approach using raw image file format provides the best performance for automated detection of Giardia cysts. We evaluated the performance of this machine learning enabled pathogen detection device with water samples taken from different sources (e.g. tap water, non-potable water, pond

Giardioza u dzieci – właściwe rozpoznanie może być trudne

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Małgorzata Sawicka-Parobczyk

2012-11-01

Full Text Available Giardioza (łac. giardiasis to choroba pasożytnicza przewodu pokarmowego wywoływana inwazją pierwotnia‑ ków – wiciowców z gatunku Giardia intestinalis (G. intestinalis. Zakażenie występuje na całym świecie, w nie‑ których regionach dotyczy nawet 30% ludności. Najczęściej chorują dzieci w wieku 2-5 lat. Źródłem zakażenia są osoby chore. Cykl życiowy Giardia odbywa się w jednym osobniku i obejmuje dwa stadia rozwojowe – tro‑ fozoit i cystę. Do zarażenia dochodzi drogą pokarmową poprzez wypicie wody lub spożycie żywności zawie‑ rających cysty lamblii. Możliwe jest również zarażenie poprzez kontakty bezpośrednie. Dotyczy to głównie dzie‑ ci przebywających w żłobkach i przedszkolach oraz osób wspólnie mieszkających. Przebieg kliniczny giardiozy jest różny, może być bezobjawowy; typowe, choć mało specyficzne objawy to bóle brzucha i gorączka. Choroba może stanowić przyczynę przewlekłych biegunek, zaburzeń wchłaniania, chudnięcia, może dawać odczyny aler‑ giczne. O diagnozie przesądza znalezienie cyst pasożyta w kale, zwykle konieczne jest wykonanie wielu badań. W celu wykrycia antygenów Giardia lamblia coraz powszechniej stosuje się badania immunofluorescencyjne i techniką immunoenzymatyczną (ELISA. Testy te charakteryzują się wysoką czułością i swoistością. Lekami pierwszego wyboru w leczeniu infekcji G. intestinalis są stosowane od wielu lat metronidazol i inne nitroimidazole. W niniejszej pracy zaprezentowano przypadki dwojga dzieci, u których przebieg kliniczny był odmienny, a trudności diagnostyczne opóźniły prawidłowe leczenie i powrót do zdrowia.

Eritromicina-carbarsone en el tratamiento de la amibiasis

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Alberto Albornoz Plata

1959-09-01

Full Text Available Se hace una experiencia clínica en 26 pacientes, 13 M - 13 F, comprendidos entre 6 y 56 años de edad que padecían amibiasis crónica, 22 casos, o aguda, 4 casos, como entidad única, 9 casos, o asociada a otro padecimiento, 17 casos. Se utilizó como tratamiento exclusivo una combinación de Eritromicina y Carbarsone. La dosis utilizada fue de 4 tabletas de la droga por día durante 10 días, una tableta contiene 125 miligramos de eritromicina y 100 miligramos de carbarsone. Los resultados controlados clínicamente y por laboratorio se catalogan así: excelente, 34.6 por ciento, 9 casos. Muy buenos, 11.5 por ciento, 3 casos. Buenos, 46.2 por ciento, 12 casos. Malos, 7.6 por ciento, 2 casos. El alivio de los síntomas se obtiene rápidamente con esta terapéutica, y el 69 por ciento de los pacientes tienen definida mejoría, a las 5 primeros días: 4 casos mejoran en 2 días, y uno requiere 20 días, cifras extremas. Los controles coprológicos indican que las heces se negativizan en los 6 primeros días del tratamiento, el 87.3 por ciento; en un caso, 4.1 por ciento, no se logra su negativización después de 15 días de control. La tolerancia a la droga fue perfecta en el 81 por ciento de los casos; hubo alergia, prurito, en el 7.7 por ciento; meteorismo en el 3.8 por ciento, y aumento de los síntomas dolorosos en el 7.7 por ciento. Otras enfermedades, úlcera péptica, enfermedades funcionales digestivas, insuficiencia cardíaca, etc., evolucionando conjuntamente con una amibiasis no se modifican ni se agravan con el tratamiento eritromicina-carbasone. La ascaridiasis y tricocefalosis no se modifican por este tratamiento: algunos casos de giardiasis sí se modifican, lo mismo que caos de parasitismo por yodamoeba. La acción sobres estos dos últimos parásitos merece una experiencia clínica más detallada. De acuerdo con esta experiencia se considera el tratamiento de la amibiasis con la combinación terapéutica eritromicina

Detection and molecular diversity of Giardia duodenalis and Cryptosporidium spp. in sheltered dogs and cats in Northern Spain.

Science.gov (United States)

Gil, Horacio; Cano, Lourdes; de Lucio, Aida; Bailo, Begoña; de Mingo, Marta Hernández; Cardona, Guillermo A; Fernández-Basterra, José A; Aramburu-Aguirre, Juan; López-Molina, Nuria; Carmena, David

2017-06-01

previously found in Spanish human populations. Dogs may also act as novel suitable hosts for C. hominis. We recommend to considerer companion animals as sentinel surveillance system for zoonotic giardiasis and cryptosporidiosis in order to minimize the risk of spreading of these parasitic diseases among the human population. Copyright © 2017 Elsevier B.V. All rights reserved.

Drinking water quality in Pakistan: a case study of Islamabad and Rawalpindi cities

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Kahlown, M. A.; Majeed, A.; Ashraf, M.; Tahir, M.A.

2005-01-01

Generally, major cities of Pakistan are facing problems of shortage of municipal water supplies as the water requirements are increasing due to rapid urbanization. The water being supplied to many cosmopolitan cities and towns is generally of poor quality. Microbial contamination of drinking water is responsible for directly or indirectly spreading major infections and parasitic diseases such as Cholera, Typhoid, Dysentery, Hepatitis, Giardiasis, Cryptosporidiosis and Guinea worm. The Pakistan Council of Research in Water Resources (PCRWR) has launched a major programme of water quality monitoring in the country to document the existing water quality status. The PCRWR has recently completed water quality assessment studies in twin cities of Islamabad and Rawalpindi. For monitoring purposes, grids of 2x2 and 3x3 km were established for Islamabad and Rawalpindi respectively. In total, thirty-nine water-sampling points were established. Apart from the groundwater samples, eight samples from surface water sources in Islamabad and one from Rawalpindi were collected. Water samples were collected in 200 ml sterilized containers during July 2001. In both cities, most of water samples except for Simly Reservoir in Islamabad, and Chitti Tanki in Rawalpindi were found fit with respect to color, odor and taste. The average EC values were 0.56 and 0.81 dS m/sup -1/ for Islamabad and Rawalpindi, respectively. The pH of collected samples varied from 7 to 8.3. Arsenic, chloride, chromium, fluoride, nitrate, sodium, and water hardness were within the safe limit. The Lead concentration however, was found within safe limits in only 21% samples. The quality of drinking water in both cities in respect of bacterial contamination was very poor. Only 25% samples in Islamabad and 13% samples in Rawalpindi were found fit for drinking purpose. Water samples collected from the points nearest to the source were free from bacterial contamination. It is concluded that the problem of bacterial

Enteric parasites in HIV-1/AIDS-infected patients from a Northwestern São Paulo reference unit in the highly active antiretroviral therapy era Enteroparasitas em pacientes infectados pelo HIV-1/AIDS em uma unidade de referência do noroeste paulista na era da terapia antirretroviral de alto impacto

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Luciana Ventura Cardoso

2011-12-01

Full Text Available INTRODUCTION: We describe the epidemiology of intestinal parasites in patients from an AIDS reference service in Northeastern São Paulo, Brazil. METHODS: Retrospective evaluation was done for all HIV-1/AIDS-positive patients whose Hospital de Base/São José do Rio Preto laboratorial analysis was positive for enteroparasites after diagnosis of HIV-1 infection, from January 1998 to December 2008. Statistical analysis was performed using the R statistical software version 2.4.1. The level of significance adopted was 5%. RESULTS: The most frequent protozoan was Isospora belli (4.2%, followed by Giardia lamblia (3.5%, Entamoeba coli (2.8%, and Cryptosporidium parvum (0.3%. Ancylostoma duodenale (1.4% was the most frequently detected helminth, while Taenia saginata and Strongiloides stercoralis were found in 0.7% of the samples. The results showed that diarrhea was significantly associated with giardiasis and isosporiasis. However, no association was observed between CD4+ cell counts, viral load, and the characteristics of any particular parasite. CONCLUSIONS: Our data may be useful for further comparisons with other Brazilian regions and other developing countries. The data may also provide important clues toward improving the understanding, prevention, and control of enteric parasites around the world.INTRODUÇÃO: Descrevemos a epidemiologia de enteroparasitoses em pacientes de um serviço de referência de AIDS, no noroeste paulista, Brasil. MÉTODOS: Durante o período de janeiro de 1998 a dezembro de 2008, foi realizado este estudo retrospectivo por meio da análise dos prontuários dos pacientes diagnosticados com HIV-1/AIDS atendidos no Ambulatório de Doenças Infecto-Parasitárias do Hospital de Base, São José do Rio Preto, São Paulo. As análises estatísticas foram realizadas usando a versão 2.4.1 do software estatístico R. O nível de significância adotado foi de 5%. RESULTADOS: O protozoário mais frequente foi o Isospora belli

Detection of a Giardia lamblia coproantigen by using a commercially available immunoenzymatic assay, in Belo Horizonte, Brazil Avaliação do ProSpeT Giardia ensaio em microplaca na detecção de coproantígenos de Giardia lamblia, em fezes de pacientes de Belo Horizonte, Brasil

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Míriam Oliveira e ROCHA

1999-05-01

Full Text Available It is known that fecal examination to detect Giardia lamblia cysts or trophozoites produces a high percentage of false-negative results. A commercially available immunoenzymatic assay (ProSpecT Giardia Microplate Assay, Alexon, Inc., BIOBRÁS to detect G. lamblia specific coproantigen was evaluated for the first time in Brazil. A total of 90 specimens were tested. Each specimen was first tested as unpreserved stool, and then it was preserved in 10% Formalin to be tested 2 months later. The assay was able to identify all the 30 positive patients (sensitivity = 100.0% by visual or spectrophotometric examination in the unpreserved specimens and was negative in 57 of the 60 patients without G. lamblia (specificity = 95.0%. The assay identified 27 of the 30 positive patients (sensitivity = 90.0% and was negative in 59 of the 60 negatives (specificity = 98.3% in the preserved stools according to both readings. A marked difference was observed in the optical densities in both groups, preserved and unpreserved stools, when the G. lamblia-positive specimens were compared to the negative or positive for other intestinal parasites than G. lamblia. The assay seems a good alternative for giardiasis diagnosis, especially when the fecal examination was repeatedly negative and the patient presents giardiasislike symptoms.O diagnóstico da giardíase através da pesquisa de trofozoítos ou cistos do parasita nas fezes apresenta uma elevada percentagem de resultados falso-negativos. No presente trabalho foi feita, pela primeira vez no Brasil, uma avaliação do ProSpecT Giardia Ensaio em Microplaca (Alexon, Inc., BIOBRÁS, utilizando amostras fecais de pacientes de Belo Horizonte, Brasil. Um total de 90 amostras fecais foram testadas, primeiramente como fezes frescas e, então, preservadas em formalina 10%, para um novo teste 2 meses após. Com as amostras frescas, o ensaio imunoenzimático, através de leitura visual ou no espectrofotômetro, foi capaz de

Guiana dolphins (Sotalia guianensis) as marine ecosystem sentinels: ecotoxicology and emerging diseases.

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de Moura, Jailson Fulgencio; Hauser-Davis, Rachel Ann; Lemos, Leila; Emin-Lima, Renata; Siciliano, Salvatore

2014-01-01

Guiana dolphins (Sotalia guianensis) are small cetaceans that inhabit coastal regions down to a 50 m depth. As a coastally distributed species, they are exposed to a variety of human-induced risks that include passive fishing nets, persistent environmental pollution, and emerging diseases. As a top predatorS. guianensis occupies an important ecological niche in marine ecosystems. However, this niche also exposes this dolphin to extensive biomagnification of marine contaminants that may accumulate and be stored throughout their life of about 30 years.In this paper, we have compiled available data on the Guiana dolphin as regards its exposure to chemical pollutants, pathogenic microbes, infectious diseases, and injuries caused by interactions with passive fishing gears. Our analysis of the data shows that Guiana dolphins are particularly sensitive to environmental changes.Although the major mortal threat to dolphins results from contact with fishing other human-related activities in coastal zones also pose risks and need more attention.Such human-related risks include the presence of persistent toxicants in the marine environment, such as PCBs and PBDEs. Residues of these chemicals have been detected in Guiana dolphin's tissues at similar or higher levels that exist in cetaceans from other known polluted areas. Another risk encountered by this species is the non lethal injuries caused by fishing gear. Several incidents of this sort have occurred along the Brazilian coast with this species. When injuries are produced by interaction with fishing gear, the dorsal fin is the part of the dolphin anatomy that is more affected, commonly causing severe laceration or even total loss.The Guiana dolphins also face risks from infectious diseases. The major ones thus far identified include giardiasis, lobomycosis, toxoplasmosis, skin and skeletal lesions. Many bacterial pathogens from the family Aeromonadaceae and Vibrionaceae have been isolated from Guiana dolphins. Several

Classic and molecular study of Giardia duodenalis in children from a daycare center in the region of Presidente Prudente, São Paulo, Brazil Estudo clássico e molecular de Giardia duodenalis em crianças atendidas em uma creche na região de Presidente Prudente, São Paulo, Brasil

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Nair Toshiko Tashima

2009-02-01

Full Text Available Epidemiological studies on giardiasis by using molecular techniques such as RAPD (Randomly Amplified Polymorphic DNA may give information on factors related to the transmission of Giardia duodenalis. The aim of this work was to assess the epidemiology of G. duodenalis in 101 children attended at a daycare center in Presidente Bernardes, SP, Brazil. After parasitological examinations in feces samples, 15 children presented cysts of G. duodenalis. Their respective parents, brothers and pets, besides the daycare center workers, also had their feces submitted to parasitological analysis. Seven mothers and nine brothers also presented G. duodenalis cysts, while fathers, daycare workers and pets (dogs did not presented the parasite. Besides the 15 cases with G. duodenalis, other 23 children presented other enteroparasites (Entamoeba coli, Endolimax nana, Enterobius vermicularis, Ascaris lumbricoides and Trichuris trichiura. Samples of G. duodenalis cysts from children and their relatives were submitted to molecular typing by RAPD after genomic DNA extraction and amplification of a fragment of the 18S rDNA region by PCR. After examining 31 isolates of G. duodenalis (children and their respective mothers and brothers, it was concluded that the parasite transmission occurred in children, probably during daily cohabitation at the daycare center, but not at home among their relatives or pets.Estudos epidemiológicos sobre giardíase por técnicas moleculares como a RAPD (Amplificação aleatória do DNA polimórfico podem contribuir para o entendimento de fatores relacionados à transmissão de Giardia duodenalis. O objetivo desse trabalho foi estudar a epidemiologia de G. duodenalis em 101 crianças atendidas em uma creche em Presidente Bernardes, SP, Brasil. Após exames parasitológicos em amostras de fezes, 15 crianças apresentaram cistos de G. duodenalis. Seus respectivos pais, irmãos e animais domésticos, além dos funcionários da creche, foram

Administration of kefir-fermented milk protects mice against Giardia intestinalis infection.

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Franco, Mariana Correa; Golowczyc, Marina A; De Antoni, Graciela L; Pérez, Pablo F; Humen, Martín; Serradell, María de los Angeles

2013-12-01

Giardiasis, caused by the protozoan Giardia intestinalis, is one of the most common intestinal diseases worldwide and constitutes an important problem for the public health systems of various countries. Kefir is a probiotic drink obtained by fermenting milk with 'kefir grains', which consist mainly of bacteria and yeasts that coexist in a complex symbiotic association. In this work, we studied the ability of kefir to protect mice from G. intestinalis infection, and characterized the host immune response to this probiotic in the context of the intestinal infection. Six- to 8-week-old C75BL/6 mice were separated into four groups: controls, kefir mice (receiving 1 : 100 dilution of kefir in drinking water for 14 days), Giardia mice (infected orally with 4×10(7) trophozoites of G. intestinalis at day 7) and Giardia-kefir mice (kefir-treated G. intestinalis-infected mice), and killed at 2 or 7 days post-infection. Kefir administration was able to significantly reduce the intensity of Giardia infection at 7 days post-infection. An increase in the percentage of CD4(+) T cells at 2 days post-infection was observed in the Peyer's patches (PP) of mice belonging to the Giardia group compared with the control and kefir groups, while the percentage of CD4(+) T cells in PP in the Giardia-kefir group was similar to that of controls. At 2 days post-infection, a reduction in the percentage of B220-positive major histocompatibility complex class II medium cells in PP was observed in infected mice compared with the other groups. At 7 days post-infection, Giardia-infected mice showed a reduction in RcFcε-positive cells compared with the control group, suggesting a downregulation of the inflammatory response. However, the percentages of RcFcε-positive cells did not differ from controls in the kefir and Giardia-kefir groups. An increase in IgA-positive cells was observed in the lamina propria of the kefir group compared with controls at 2 days post-infection. Interestingly, the

Prevalence and associated risk factors for Giardia lamblia infection among children hospitalized for diarrhea in Goiânia, Goiás State, Brazil Prevalência e fatores de risco associados à infecção por Giardia lamblia em crianças hospitalizadas com diarréia em Goiânia, Goiás, Brasil

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Maria das Graças Cabral Pereira

2007-06-01

Full Text Available The objective of this study was to determine the prevalence and to identify risk factors associated with Giardia lamblia infection in diarrheic children hospitalized for diarrhea in Goiânia, State of Goiás, Brazil. A cross-sectional study was conducted and a comprehensive questionnaire was administered to the child's primary custodian. Fixed effects logistic regression was used to determine the association between infection status for G. lamblia and host, sociodemographic, environmental and zoonotic risk factors. A total of 445 fecal samples were collected and processed by the DFA methodology, and G. lamblia cysts were present in the feces of 44 diarrheic children (9.9%. A variety of factors were found to be associated with giardiasis in these population: age of children (OR, 1.18; 90% CI, 1.0 - 1.36; p = 0.052, number of children in the household (OR 1.45; 90% CI, 1.13 - 1.86; p = 0.015, number of cats in the household (OR, 1.26; 90% CI, 1.03 -1.53; p = 0.059, food hygiene (OR, 2.9; 90% CI, 1.34 - 6.43; p = 0.024, day-care centers attendance (OR, 2.3; 90% CI, 1.20 - 4.36; p = 0.034, living on a rural farm within the past six months prior hospitalization (OR, 5.4; CI 90%, 1.5 - 20.1; p = 0.03 and the number of household adults (OR, 0.59; 90% CI, 0.42 - 0.83; p = 0.012. Such factors appropriately managed may help to reduce the annual incidence of this protozoal infection in the studied population.O objetivo desse estudo foi estimar a prevalência e identificar fatores de risco associados à infecção por Giardia lamblia em crianças hospitalizadas com diarréia no município de Goiânia, Estado de Goiás, Brasil. Foi realizado um estudo transversal e um questionário estruturado foi administrado ao responsável pela criança. Análise multivariada foi realizada por meio de regressão logística para se determinar a associação entre infecção por G. lamblia e as variáveis sociodemográficas, ambientais e zoonóticas relacionadas ao

Surveillance for travel-related disease--GeoSentinel Surveillance System, United States, 1997-2011.

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Harvey, Kira; Esposito, Douglas H; Han, Pauline; Kozarsky, Phyllis; Freedman, David O; Plier, D Adam; Sotir, Mark J

2013-07-19

probable travel-related diagnoses. Of these, 23,006 (16%) patients were evaluated in the United States, 10,032 (44%) of whom were evaluated after returning from travel outside of the United States (i.e., after-travel patients). Of the 10,032 after-travel patients, 4,977 (50%) were female, 4,856 (48%) were male, and 199 (2%) did not report sex; the median age was 34 years. Most were evaluated in outpatient settings (84%), were born in the United States (76%), and reported current U.S. residence (99%). The most common reasons for travel were tourism (38%), missionary/volunteer/research/aid work (24%), visiting friends and relatives (17%), and business (15%). The most common regions of exposure were Sub-Saharan Africa (23%), Central America (15%), and South America (12%). Fewer than half (44%) reported having had a pretravel visit with a health-care provider. Of the 13,059 diagnoses among the 10,032 after-travel patients, the most common diagnoses were acute unspecified diarrhea (8%), acute bacterial diarrhea (5%), postinfectious irritable bowel syndrome (5%), giardiasis (3%), and chronic unknown diarrhea (3%). The most common diagnostic groupings were acute diarrhea (22%), nondiarrheal gastrointestinal (15%), febrile/systemic illness (14%), and dermatologic (12%). Among 1,802 patients with febrile/systemic illness diagnoses, the most common diagnosis was Plasmodium falciparum malaria (19%). The rapid communication component of the GeoSentinel network has allowed prompt responses to important health events affecting travelers; during 2010 and 2011, the notification capability of the GeoSentinel network was used in the identification and public health response to East African trypanosomiasis in Eastern Zambia and North Central Zimbabwe, P. vivax malaria in Greece, and muscular sarcocystosis on Tioman Island, Malaysia. The GeoSentinel Global Surveillance System is the largest repository of provider-based data on travel-related illness. Among ill travelers evaluated in U.S. Geo

Disease Risk Assessments Involving Companion Animals: an Overview for 15 Selected Pathogens Taking a European Perspective.

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Rijks, J M; Cito, F; Cunningham, A A; Rantsios, A T; Giovannini, A

2016-07-01

companion animals to become infected were identified for eight of the 14 diseases found in Europe or parts of it. RFAs for leptospirosis were most numerous (four studies). The host related risk factor 'age' was identified as significant for dogs in at least two RFAs for cystic echinococcosis and giardiasis. Among husbandry and healthcare related factors, 'eating (uncooked) offal', 'being free roaming' and 'poor deworming practice' were associated with risk for dogs in at least two RFAs for cystic echinococcosis, while 'having received recent veterinary treatment' was identified as a risk factor in at least two studies on infection with extended spectrum beta lactamase-producing bacteria, one in horses and the other in dogs and cats. Finally, although the environmental factors 'season' and 'hydrological density' were identified as significant risk factors for dogs in at least two RFAs for leptospirosis, the inconsistent case definitions used in those studies made comparison of study results problematic. RFAs considering the risk of people becoming infected from companion animals were identified for eight of the 14 diseases found in Europe or parts of it. RFAs for human campylobacteriosis were the most numerous (n = 6). Most studies made an assessment as to whether keeping a pet per se, or keeping a pet with supposed or known risk factors, was a risk factor for people relative to other risks. This allowed some studies to report the population attributable risk or population attributable fraction of the incidence of human disease due to companion animals (for campylobacteriosis, salmonellosis and toxoplasmosis), which is a measure that is easy to perceive for laymen and policy makers. No RFAs were found that dealt with the risk to food animals from companion animals for any of the 15 pathogens investigated. Few risk method-based studies were identified that provided information on risk factors for companion animals and on their role as a source of these 15 selected diseases