Difference In Prevalence Of Infection Research Articles

Tuberculosis case fatality is higher in male than female patients in Europe: a systematic review and meta-analysis.

Epidemiological TB data indicate differences in infection prevalence, progression rates, and clinical disease incidence between sexes. In contrast, evidence on sex-specific differential (post) TB case fatality in Europe has not been synthesized systematically. We searched electronic databases and grey literature up to December 2020 for studies reporting sex-stratified TB death data for Europe. The JBI critical appraisal tools served for bias risk assessment and subgroup analyses for studying heterogeneity. Random-effects models meta-analyses enabled estimating pooled relative risks of sex-associated TB fatality. Considering associations of comorbidities and risk factors on fatality differences, we applied relative risk meta-regression. Based on 17,400 records screened, 117 studies entered quantitative analyses. Seventy-five studies providing absolute participant data with moderate quality and limited sex stratification reported 33 to 235,000 TB cases and 7 to 27,108 deaths. The pooled male-to-female TB fatality risk ratio was 1.4 [1.3-1.5]. Heterogeneity was high between studies and subgroups. Study time, concurrent comorbidities (e.g., HIV, diabetes, cancers), and mean participant ages showed no effect modification. We identified higher male TB fatality in studies with higher homelessness (coefficient 3.18, 95% CI [-0.59 to 6.94], p-value 0.10) and lower migrants proportion (coefficient -0.24, 95% CI [-0.5 to 0.04], p-value 0.09). We found 30-50% higher TB case fatality for males in Europe. Except for homelessness, migration, and a trend for some comorbidities, assessing effect modification could not reduce our meta-analysis' high heterogeneity. Public health authorities should take heed of this higher risk of dying in male patients' treatment services.

Molecular epidemiology, clinical analysis, and genetic characterization of Zika virus infections in Thailand (2020–2023)

To investigate the clinical and molecular characteristics and evolution of the Zika virus (ZIKV) in Thailand from March 2020 to March 2023. In all, 751 serum samples from hospitalized patients in Bangkok and the surrounding areas were screened for ZIKV using real-time RT-PCR. Demographic data and clinical variables were evaluated. Phylogenetic and molecular clock analysis determined the genetic relationships among the ZIKV strains, emergence timing, and their molecular characteristics. Among the 90 confirmed ZIKV cases, there were no significant differences in infection prevalence when comparing age groups and sexes. Rash was strongly associated with ZIKV infection. Our ZIKV Thai isolates were categorized into two distinct clades: one was related to strains from Myanmar, Vietnam, Oceania, and various countries in the Americas, and the other was closely related to previously circulating strains in Thailand, one of which shared a close relation to a neurovirulent ZIKV strain from Cambodia. Moreover, ZIKV Thai strains could be further classified into multiple sub-clades, each exhibiting specific mutations suggesting the genetic diversity among the circulating strains of ZIKV in Thailand. Understanding ZIKV epidemiology and genetic diversity is crucial for tracking the virus's evolution and adapting prevention and control strategies.

COVID-19 Exposure in Urban and Rural Areas

The COVID-19 pandemic has majorly impacted the lives of people living in different living environments, such as large cities or small towns. However, there is limited knowledge about the difference in infection prevalence between urban and rural populations. To examine these differences, this study examined SARS-CoV-2 antibody levels in blood serum from 36 unvaccinated subjects of urban and rural backgrounds with no self-reported history of COVID-19 infection. Enzyme Linked Immunosorbent Assays (ELISA) detected the presence of SARS-CoV-2 antibodies in the subjects’ blood. IgG and IgM assays were used to distinguish between prior (recovered) and more recent infections, respectively. A t-test was conducted to identify a statistically significant difference, or lack thereof, between the antibody levels detected in urban and rural participants. The results indicated that there was no significant difference between the two experimental groups for both IgG and IgM (p = 0.09, 0.93, respectively), although the p-value for IgG was low enough to be notable. Overall, this study suggests that there is no major difference between urban and rural environments that impact susceptibility to SARS-CoV-2 infection, although more research with a greater sample size should be conducted.

Haemosporidian infection prevalence varies temporally and spatially and Leucocytozoon infections are male biased in Song Sparrows

Abstract Haemosporidian parasites are significant global drivers of avian disease and infections are affected by complex ecological and biological interactions. We quantified variation in haemosporidian infection prevalence of Plasmodium, Haemoproteus, and Leucocytozoon in 311 Song Sparrows (Melospiza melodia) from 2 breeding populations across years, seasons, age classes, and sexes, finding significant differences in infection prevalence across years, seasons, and sites, as well as sex differences in Leucocytozoon infection prevalence. We also found that birds were more likely to be infected with Plasmodium than Leucocytozoon and coinfections were more likely than expected. Many avian haemosporidian studies use data collected over a short period of time at one location, and few studies investigate multi-year infection dynamics across populations. However, such long-term studies are important because ecological factors can affect the distribution and prevalence of vector-borne pathogens like malaria. Because biological factors can also affect the likelihood of exposure to vector-borne pathogens, it is also important to determine how host traits influence infection dynamics. Our results demonstrate that the prevalence and composition of avian haemosporidian infections can be highly variable, making sampling regimes a key consideration when drawing conclusions from study results. To better understand the fitness consequences of haemosporidian infection in avian hosts, future work should take ecological and biological variation into account when evaluating the effects of infection on aspects of condition and quality, reproductive success, and survival.

Temporal Dynamics of Anaplasma marginale Infections and the Composition of Anaplasma spp. in Calves in the Mnisi Communal Area, Mpumalanga, South Africa.

Bovine anaplasmosis, caused by Anaplasma marginale, is one of the most important tick-borne diseases of cattle. Anaplasma marginale is known to be present in the Mnisi community, Mpumalanga Province, with frequent cases of anaplasmosis reported. This study investigated the infection dynamics in calves (n = 10) in two habitats in the study area over 12 months. A duplex real-time PCR assay targeting the msp1β gene of A. marginale and the groEL gene of A. centrale confirmed the presence of A. marginale in five calves in a peri-urban area from the first month, but in only two calves at the wildlife-livestock interface and only after six months. These results were confirmed by 16S rRNA microbiome analysis. Over 50 A. marginale msp1α genotypes were detected in the calves along with five novel Msp1a repeats. Calves in the peri-urban area were more likely to be infected with A. marginale than calves in the wildlife-livestock interface. Cattle management, acaricide treatment, and cattle density could explain differences in infection prevalence in the two areas. Our results revealed that most calves were superinfected by distinct A. marginale strains within the study period, indicating continuous challenge with multiple strains that should lead to robust immunity in the calves and endemic stability in the area.

Double trouble: trypanosomatids with two hosts have lower infection prevalence than single host trypanosomatids

AbstractTrypanosomatids are a diverse family of protozoan parasites, some of which cause devastating human and livestock diseases. There are two distinct infection life cycles in trypanosomatids; some species complete their entire life cycle in a single host (monoxenous) while others infect two hosts (dixenous). Dixenous trypanosomatids are mostly vectored by insects, and the human trypanosomatid diseases are caused mainly by vectored parasites. While infection prevalence has been described for subsets of hosts and trypanosomatids, little is known about whether monoxenous and dixenous trypanosomatids differ in infection prevalence. Here, we use meta-analyses to synthesise all published evidence of trypanosomatid infection prevalence for the last two decades, encompassing 931 unique host-trypansomatid systems. In examining 584 studies that describe infection prevalence, we find, strikingly, that monoxenous species are two-fold more prevalent than dixenous species across all hosts. We also find that dixenous trypanosomatids have significantly lower infection prevalence in insects than their non-insect hosts. To our knowledge, these results reveal for the first time, a fundamental difference in infection prevalence according to host specificity where vectored species might have lower infection prevalence as a result of a potential ‘jack of all trades, master of none’ style trade-off between the vector and subsequent hosts.

Infected Ixodes scapularis Nymphs Maintained in Prolonged Questing under Optimal Environmental Conditions for One Year Can Transmit Borrelia burgdorferi (Borreliella genus novum) to Uninfected Hosts.

ABSTRACTIn recent decades, Lyme disease has been expanding to previous nonendemic areas. We hypothesized that infected I. scapularis nymphs that retain host-seeking behavior under optimal environmental conditions are fit to fulfil their transmission role in the enzootic cycle of B. burgdorferi. We produced nymphal ticks in the laboratory under controlled temperature (22–25°C), humidity (80–90%), and natural daylight cycle conditions to allow them to retain host-seeking/questing behavior for 1 year. We then analyzed differences in B. burgdorferi infection prevalence in questing and diapause nymphs at 6 weeks postmolting (prime questing) as well as differences in infection prevalence of questing nymphs maintained under prolonged environmental induced questing over 12 months (prolonged questing). Lastly, we analyzed the fitness of nymphal ticks subjected to prolonged questing in transmission of B. burgdorferi to naive mice over the course of the year. B. burgdorferi infected unfed I. scapularis nymphal ticks maintained under optimal environmental conditions in the laboratory not only survived for a year in a developmental state of prolonged questing (host-seeking), but they retained an infection prevalence sufficient to effectively fulfil transmission of B. burgdorferi to uninfected mice after tick challenge. Our study is important for understanding and modeling Lyme disease expansion into former nonendemic regions due to climate change.IMPORTANCE Lyme disease is rapidly spreading from its usual endemic areas in the Northeast, Midwest, and Midatlantic states into neighboring areas, which could be due to changing climate patterns. Our study shows that unfed I. scapularis nymphal ticks kept under optimal environmental conditions in the laboratory survived for a year while exhibiting aggressive host-seeking behavior, and they maintained a B. burgdorferi infection prevalence which was sufficient to infect naive reservoir hosts after tick challenge. Our study raises important questions regarding prolonged survival of B. burgdorferi infected host-seeking nymphal I. scapularis ticks that can potentially increase the risk of Lyme disease incidence, if conditions of temperature and humidity become amenable to the enzootic cycle of B. burgdorferi in regions currently classified as nonendemic.

Gender-related differences in prevalence, intensity and associated risk factors of Schistosoma infections in Africa: A systematic review and meta-analysis.

BackgroundSchistosomiasis remains a global-health problem with over 90% of its burden concentrated in Africa. Field studies reflect the complex ways in which socio-cultural and socio-economic variables, affect the distribution of Schistosoma infections across different populations. This review set out to systematically investigate and quantify the differences in Schistosoma infection burdens between males and females in Africa for two of the most prevalent Schistosoma species—Schistosoma mansoni and Schistosoma haematobium.MethodologyWe searched (from inception to 11th March 2020) Embase, MEDLINE, PubMed, and Web of Science for relevant studies on schistosomiasis. We included studies that report S. mansoni and/or S. haematobium prevalence and/or intensity data distributed between males and females. We conducted meta-analyses on the male to female (M:F) prevalence of infection ratios. Subgroup analyses were performed according to study baseline prevalence, sample size and the lower and upper age limit of study participants. We also present a descriptive analysis of differential risk and intensity of infection across males and females. Evidence for differences in the prevalence of schistosomiasis infection between males and females is presented, stratified by Schistosoma species.ResultWe identified 128 relevant studies, with over 200,000 participants across 23 countries. Of all the reported differences in the prevalence of infection between males and females, only 41% and 34% were statistically significant for S. mansoni and S. haematobium, respectively. Similar proportions of studies (27% and 34% for for S. haematobium and S. mansoni, respectively) of the reported differences in intensity of infection between males and females were statistically significant. The meta-analyses summarized a higher prevalence of infection in males; pooled random-effects weighted M:F prevalence of infection ratios were 1.20 (95% CI 1.11–1.29) for S. haematobium and 1.15 (95% CI 1.08–1.22) for S. mansoni. However, females are underrespresented in some of the studies. Additionally, there was significant heterogeneity across studies (Higgins I2 statistic (p-values < 0.001, I2values>95%)). Results of the subgroup analysis showed that the baseline prevalence influenced the M:F prevalence ratios for S. haematobium and S. mansoni, with higher M:F prevalence of infection ratios in settings with a lower baseline prevalence of infection. Across the studies, we identified four major risk factors associated with infection rates: occupational and recreational water contact, knowledge, socio-economic factors and demographic factors. The effect of these risk factors on the burden of infection in males and females varied across studies.ConclusionsWe find evidence of differences in prevalence of infection between males and females which may reflect differences in gender norms and water contact activities, suggesting that policy changes at the regional level may help ameliorate gender-related disparities in schistosomiasis infection burden. Collecting, robustly analysing, and reporting, sex-disaggregated epidemiological data, is currently lacking, but would be highly informative for planning effective treatment programmes and establishing those most at risk of schistosomiasis infections.

Raccoons As an Important Reservoir for Trypanosoma cruzi: A Prevalence Study from Two Metropolitan Areas in Louisiana.

Raccoons are an important reservoir for Trypanosoma cruzi infection, having been reported to maintain a high and lengthy parasitemia. Although raccoon populations have historically been abundant in Louisiana, the prevalence rate of T. cruzi infection in raccoons in this state is unknown. Here, we tested raccoon tissues from two urban areas in Louisiana, namely Orleans Parish (OP) and East Baton Rouge Parish (EBRP), to investigate prevalence in these areas using direct detection through polymerase chain reaction. Overall, 33.6% of raccoons tested were positive. The prevalence in OP (42.9%) was significantly higher than the prevalence in EBRP (23.2%). There was no significant difference in prevalence between sexes or based on age, but there was a significant difference in infection prevalence based on season of trapping. These results suggest the importance of raccoons as a reservoir host, maintaining T. cruzi infection and potentially posing a risk to human health.

Soil-transmitted helminths and schistosomiasis among pre-school age children in a rural setting of Busia County, Western Kenya: a cross-sectional study of prevalence, and associated exposures

BackgroundSoil-transmitted helminths (STH) and schistosomiasis continue to cause serious health problems among affected communities. To ensure that infection transmission levels are reduced, repeated mass drug administration at regular intervals has been recommended by World Health Organization. Pre-school age children (PSAC) have been neglected both in terms of research activities and in control programmes in the past for reasons that they carry insignificant infection levels. The current study determined risk factors that contribute to differences in infection prevalence among enrolled and non-enrolled PSAC in Busia County, western Kenya.MethodsThis was a comparative cross-sectional study that compared STH and Schistosoma mansoni infections among enrolled and non-enrolled PSAC in Busia County. Simple random sampling was used to select study participants. A total of 327 enrolled and 326 non-enrolled PSAC (n = 653) were recruited from five participating schools, and the neighboring villages. Statistical analysis was performed using STATA version 14 (STATA Corporation, College Station, TX, USA). Differences in proportions were assessed using the z-test statistic for testing sample proportions. Univariable and multivariable logistic regression were used to test the associations between the variables.ResultsThe prevalence of STH and Schistosoma mansoni infection was 17.0% (95%CI: 13.1–22.1), and 11.8% (95%CI:11.0–12.9) respectively. Specific STH species prevalence were 12.9% (95%CI:7.0–23.5) for Trichuris trichiura, 8.3% (95%CI:8.2–8.3) for Ascaris lumbricoides, and 1.2% (95%CI:1.2–1.2) for hookworms. Prevalence of T. trichiura was higher among enrolled PSAC 16.9% (95%CI: 6.8–41.9); p = 0.003, compared to the non-enrolled 8.9% (95%CI:4.3–18.2). From univariable analysis, lack of improved water source for drinking OR 2.01, (95%CI:1.29–3.13); p = 0.002, and not wearing shoes OR 3.42, (95%CI:1.14–10.29); p = 0.028, were some of the significant factors associated with STH infection. While for multivariable analysis, bathing/swimming in a river daily, aOR 3.99 (95%CI:1.98–8.06); p = 0.001 was a key significant factor for S. mansoni infections.ConclusionThere was high prevalence of STH infection among enrolled PSAC despite having participated in the national school-based deworming programme. Hence the need for continued mass drug administration to reduce the intensity of infections among these age group. In addition, further research maybe needed to identify drivers of STH infection particularly T. trichiura among PSAC.

Epidemiology of blood flukes (Digenea: Spirorchiidae) in sea turtles from Tyrrhenian and Adriatic Seas, off Italy

BackgroundThe Spirorchiidae is a family of blood flukes parasitizing turtles. Spirorchiids may cause a wide range of inflammatory reactions in the vascular system of their host being frequently implicated with stranding and death of sea turtles worldwide. Recent studies revealed the presence of two spirorchiid species in the Mediterranean basin. Our study presents comparative epidemiological data of spirorchiid infections in loggerhead turtles (Caretta caretta) stranded during an eight-year period from Adriatic and Tyrrhenian Seas, and the first report of Neospirorchis Neogen-11 in a green turtle (Chelonia mydas).MethodsWe screened a total of 319 carcasses of loggerhead turtles stranded from January 2011 to December 2018 along the Tyrrhenian coast (n = 111) and the north-western Adriatic coast (n = 208) of Italy using traditional (copromicroscopy and histopathology) and molecular assays. Three green turtles from the Tyrrhenian coast were also included in the study.ResultsA total of 56 (17.5%) loggerhead turtles and one green turtle (33.3%) were found to be infected with spirorchiid flukes. Amplification, sequencing of the ITS2 region of the ribosomal RNA gene cluster and BLAST analysis confirmed the presence of Hapalotrema mistroides and Neospirorchis Neogen-11 in 51 (16.0%) and 24 (7.5%) loggerhead turtles, respectively, and Neospirorchis Neogen-11 in an infected green turtle. Differences in prevalence of infection between the two sampling areas were found.ConclusionsThe risk of spirorchiid infection in the Tyrrhenian Sea is lower than in the Adriatic Sea and in general the risk of infection in the Mediterranean is lower than in other geographical locations. Differences in the prevalence of infection between the two sampling areas were related to the differences of regional habitats supporting different abundance of spirorchiid intermediate hosts. A systematic monitoring to evaluate the progress of the infection is recommended, as well as studies on the occurrence and distribution of spirorchiid species from other Mediterranean areas.

Prevalence of Infection and Co-Infection and Presence of Rickettsial Endosymbionts in Ixodes scapularis (Acari: Ixodidae) in Connecticut, USA

Ixodes scapularis is currently known to transmit 7 pathogens responsible for Lyme disease, anaplasmosis, babesiosis, tick-borne relapsing fever, ehrlichiosis, and Powassan encephalitis. Ixodes scapularis can also be colonized by endosymbiotic bacteria including those in the genus of Rickettsia. We screened 459 I. scapularis ticks submitted to the Connecticut Agricultural Experiment Station Tick Testing Laboratory with the objectives to (1) examine differences in infection prevalence of Borrelia burgdorferi, Anaplasma phagocytophilum, Babesia microti, and Borrelia miyamotoi, (2) evaluate whether prevalence of co-infections occur at the same frequency that would be expected based on single infection, and (3) determine the presence of rickettsial endosymbionts in I. scapularis. The prevalence of infection in I. scapularis was highest with Bo. burgdorferi sensu lato (nymph = 45.8%; female = 47.0%), followed by A. phagocytophilum (nymph = 4.0%; female = 6.9%), Ba. microti (nymph = 5.7%; female = 4.7%), and Bo. miyamotoi (nymph = 0%; female = 7.3%). We also identified rickettsial endosymbionts in 93.3% of I. scapularis. Nymphs were significantly more likely to be infected with Bo. burgdorferi if they were infected with Ba. microti, whereas adult females were significantly more likely to be infected with Bo. burgdorferi if they were infected with A. phagocytophilum. Our study suggests that the infection prevalence of Bo. burgdorferi is not independent of other co-circulating pathogens and that there is a substantially higher infection of Bo. miyamotoi in I. scapularis females compared with nymphs in this study. High prevalence of infection and co-infection with multiple pathogens in I. scapularis highlights the public health consequences in Connecticut, a state endemic for Lyme and other tick-borne diseases.

Diversity of Borrelia burgdorferi sensu lato species in Ixodes ticks (Acari: Ixodidae) associated with cave-dwelling bats from Poland and Romania

Bats comprise one quarter of the world’s mammal species. In Europe, three nidicolous Ixodes tick species, I. vespertilionis, I. simplex and I. ariadnae are specifically associated with cave-dwelling bats, but their role as potential vectors of zoonotic agents is unknown. In this study, we used PCR-based methods to provide the first evidence of Borrelia burgdorferi sensu lato (s.l.) infections in the three bat-associated tick species collected from ten bat species sampled in Poland and Romania. B. burgdorferi s.l. was detected in 24% (64/266) of tick samples, and 40.3% (60/149) of the bats carried infected chiropterophilic ticks.In Poland, the B. burgdorferi s.l. infection prevelance of I. ariadnae ticks parasitizing Myotis species was four times higher compared to the I. vespertilionis ticks derived from Rhinolophus hipposideros bats (44.4% vs.10%, respectively). The observed differences in infection prevalence could be explained by differences in reservoir potential between bat species. Bats from the genus Myotis and Miniopterus schreibersii carried more infected ticks than R. hipposideros regardless of the tick species. Analysis of the flaB gene sequences revealed seven species from the B. burgdorferi s.l. complex (B. afzelii, B. carolinensis, B. garinii, B. lanei, B. spielmanii, B. burgdorferi s.s., and B. valaisiana), of which five are considered as human pathogens. This large diversity of Borrelia species may reflect differences in susceptibility of chiropteran hosts and/or the tick vectors. Generally, mammal-associated B. burgdorferi s.l. species were more common than bird-associated species. Our study provides evidence for new enzootic transmission cycles of B. burgdorferi s.l. spirochetes involving nidicolous Ixodes tick species and cave-dwelling bats.

Quill mite infestation of rock ptarmigan Lagopus muta (Aves: Phasianidae) in relation to year and host age, sex, body condition, and density

A total of 1209 ptarmigan were examined for Mironovia lagopus, including 721 juvenile birds (ca. 3months old) and 488 adult birds (15months or older). A total of 88 birds or 7.3% (n = 1209, 95% cl 5.9-8.9%) were infested with M. lagopus. There was an age difference in prevalence of infection, and more adults (10.7%, n = 488, 95% cl 8.2-13.7%) than juveniles (5.0%, n = 721, 95% cl 3.6-6.8%) were infested. There was a significant age effect in the mean intensity index, and adult birds had more advanced infestations compared with juvenile birds. There were no significant changes in either the interannual prevalence of infection or the mean intensity index of infection. Of the feather types inspected, there was no age-related difference in selection of feathers, nor was there any preference of mites for any one of the inspected feather types. Body dispersants were all adult females. There was an age-related difference in mean intensities of infection of body dispersants; it was higher in adult birds. The methods used to determine presence or absence of M. lagopus were not 100% accurate especially for juvenile hosts, and this at least partly explains the difference in prevalence among age groups. There was no relationship between host body condition or host density and infection by M. lagopus.

Human Contamination and Schistosome Infection Intensity in Bulinid and Planorbid Snail Vectors in Kadawa Irrigation Area, Kano State, Nigeria

Objectives of the Study: An Epidemiological Research, a cross-sectional study, was conducted to determine the magnitude of human contamination of irrigation canal perimeter as it relates to the prevalence and intensity of schistosome cercarial infection in snail vectors.&#x0D; Place and Duration of Study: The study was conducted along water canal located within an irrigation area, Kano River Project Phase I, Kadawa, between January and June, 2012.&#x0D; Methodology: The study area was categorized into Zone of Heavy Contamination (ZHC), Zone of Light Contamination (ZLC) and Zone of Free Contamination (ZFC) based on the density of faecal lumps observed along the canal perimeter using 1 m2 quadrat sampling technique. Snail vectors of schistosomiasis were collected from these zones, identified and subjected to cercarial shedding. Brevifurcate apharyngeate cercariae were identified as schistosome cercariae.&#x0D; Results: Of the 827 snails collected 28.54% shed schistosome cercariae. The breakdown of infection prevalence was 31.37%, 27.69% and 26.26% for ZHC, ZLC and ZFC respectively. Three snail species recovered in the study area, Bulinus globosus, B. rohlfsi and Biomphalaria pfeifferi had infection intensity of 8.6, 5.67 and 3.94 respectively, with total mean intensity of 4.67. A Chi-squared analysis did not show any significant difference in infection prevalence in the three zones (χ2cal. 0.025, χ22, 0.05 = 5.99). However, infection intensity was significantly different in the three zones and among the three snail species using analysis of variance (P&lt;0.05).&#x0D; Conclusion: Human environmental contamination with faeces and urine around irrigation canals remains the source of infection to snail hosts and then to humans. It is presumed that contact control through avoidance of defaecation in the open and building of pit latrines near water contact points along irrigation canals will be effective means of drawing a barrier to infection with schistosomes in the study area.

Transfusional Malaria and Associated Factors at the National Blood Transfusion Center of Niamey-Niger.

Summary Problem. Transfusional malaria is an accidental transmission of Plasmodium via a blood transfusion. Its magnitude is underestimated and very little data on the assessment of this risk are available in Niger. Objective This study aimed to determine the prevalence of plasmodial infection of blood bags at the National Blood Transfusion Center of Niamey (NBTC). Methodology A cross-sectional study to diagnose Plasmodium infection by microscopy and Rapid Diagnostic Test (RDT) was carried out during the rainy season (September to November 2015). Blood grouping was performed by the BETH-VINCENT technique. Results One thousand three hundred and fifty-seven (1357) blood bags were collected. One hundred and fifty-seven (11.6%) of the donors were infected with Plasmodium by microscopy and 2.4% (9/369) by rapid diagnostic test. All infections were with P. falciparum (100%). The mean parasite density was 197 parasites/μL (SD=281; [80: 2000]). There were no significant differences in infection prevalence between the ABO blood groups (p = 0.3) or the rhesus positivity (p=08). There is also no significant difference in temporal (p = 0.1) and spatial (p = 0.6) distribution. Conclusion The transmission of transfusional malaria during the rainy season is a fact in Niger. Such risks were independent of the ABO blood type and positivity for the rhesus antigen. Pretransfusion diagnosis or posttransfusion therapy should be instituted to prevent it.

Geographical and behavioral risks associated with Schistosoma haematobium infection in an area of complex transmission

BackgroundSchistosoma haematobium infection in endemic areas varies depending on the nature and complexity of the transmission networks present. Studies of micro-geographical transmission of S. haematobium infection indicate that discrepancy in prevalence between households is associated with diverse water contact behaviors and transmission that is restricted to particular sites harboring snail intermediate hosts. Detection of variations in the transmission sources with complex transmission networks of water bodies is required for optimization of malacological control. Longitudinal parasitological and malacological surveys were conducted to investigate geographical variations in transmission of urogenital schistosomiasis in Ikingwamanoti village, Shinyanga District, Tanzania.MethodsUrine samples were collected at baseline and follow-up time points from 282 school-aged children and examined microscopically for the presence of S. haematobium eggs. Malacological surveys involved collection of Bulinus nasutus every month from 30 sites. Snails were examined for patent infections. Global positioning system was used to map household distances from S. haematobium transmission sites, while water contact behavior was assessed using a questionnaire.ResultsSchistosoma haematobium infection was observed to be prevalent among older children (12–14 years) compared to younger groups prior to treatment, but no significant difference in infection prevalence was observed at one-year. Boys were highly infected than girls at both time points. No spatial influence was observed between children’s infection and the distance from child’s residence to the nearby snail habitats nor was any significant association observed between children’s reported water contact behavior with S. haematobium infection. However, malacological surveys with cercarial shedding combined with GPS data detected significant variation among different water sources in the transmission of S. haematobium with children living in households near to ponds with high B. nasutus populations having the highest prevalence of infection.ConclusionsInteraction between malacological surveys with cercarial shedding combined with GPS mapping in endemic settings can help detection of transmission sources even in areas with complex transmission networks. Subsequent studies are needed to determine whether the combination of GPS mapping and parasitology screens can aid the detection of transmission hotspots across varied transmission settings to enhance schistosomiasis control programmes.

The impact of smoking, diabetes and the site of surgery on post-operative infection in foot and ankle surgery

Category: Diabetes Introduction/Purpose: Smoking and diabetes are thought to increase the risk of post-op infection. Surgery on the hindfoot and ankle is also thought to carry an increased risk. This study looks at whether this is demonstrated in a cohort of patients undergoing foot and ankle (F&amp;A) surgery. Methods: Six hundred and twenty patients underwent F&amp;A surgery between 2013 and 2016. Patients either underwent surgery electively (group 1; n= 383) or had open reduction and internal fixation for ankle fracture (group 2; n= 237). Data was collected on patient demographics, site of surgery, smoking and diabetes. The primary outcome was the rate of surgical site (SSI) and deep infection. A standard statistical online package was used for statistical analysis. Results: The mean age was 50.8 years and the standard deviation was 17.1 years. The incidence of SSI was 4.2%; 0.48% developed a deep infection. There was no significant difference in infection prevalence between group 1 and 2 (p = 1.0). When comparing the site of surgery, no significant differences were found for forefoot, midfoot, hindfoot or ankle surgery (p=0.16, p=0.22, p=1.0, p=0.48 respectively). There was no significant difference in the prevalence of smoking or diabetes in those who developed an SSI in the overall cohort (p=1, p=1) or in separate analysis within groups 1 and 2 (p=1). Conclusion: Both trauma and elective patients had a similar rate of SSI and deep infection; neither diabetes nor smoking had an impact on this rate. For elective patients, there wasn’t a relationship between site of surgery and infection incidence. However, due to the low SSI rate, group sizes were small for this comparison. There was no increase in the incidence of SSI in hindfoot or ankle surgery contrary to common belief.

Ethnic and racial difference in Helicobacter pylori infection in patients with immune thrombocytopenia treated at a major urban medical center

Immune thrombocytopenia (ITP) is an autoimmune disorder with a complex immunopathology and pathogenesis characterized by thrombocytopenia and bleeding manifestations. The disorder is separated into primary (idiopathic) ITP and secondary ITP, when associated with other immune or lymphoproliferative disorders and certain chronic infections. Helicobacter pylori (H. pylori) is a recognized bacterial cause of ITP. In regions with high prevalence of infection, bacterial eradication has resulted in improvement in platelet count. However, the prevalence of H. pylori infection and response to antimicrobial therapy in North American ITP patients is reportedly low. We evaluated the prevalence of H. pylori infection in ITP patients diagnosed and treated at a large urban medical center. Eighty-two patients were screened for H. pylori, by stool antigen (n = 54), H. pylori breath test (n = 11), and H. pylori antibodies (n = 16), of which 15 (18.3%) were white non-Hispanic (WNH), 55 (67%) Hispanic (H), 8 (9.8%) Asian (A), and 4 (4.9%) African-American (AA). Of the screened patients, 36/82 (43.9%) tested positive for H. pylori. The prevalence of H. pylori infection within the represented ethnic groups was 2/15 (13%) WNH, 29/55 (52.7%) H, 3/8 (37.5%) A, and 2/4 (50%) AA. There was a significant difference in prevalence of infection comparing WNH and H patients (p = 0.007). There were 36 treated patients, with H. pylori eradication documented in 26 patients. Fifteen of the 26 patients were evaluable for response with 8 of 15 (53%) having clinical responses, 6 complete responses, and 2 partial responses. Our study demonstrates an increased prevalence of H. pylori infection in the Hispanic ITP population with a reasonable platelet response among patients with H. pylori eradication.

Wolbachia and dengue virus infection in the mosquito Aedes fluviatilis (Diptera: Culicidae)

Dengue represents a serious threat to human health, with billions of people living at risk of the disease. Wolbachia pipientis is a bacterial endosymbiont common to many insect species. Wolbachia transinfections in mosquito disease vectors have great value for disease control given the bacterium’s ability to spread into wild mosquito populations, and to interfere with infections of pathogens, such as dengue virus. Aedes fluviatilis is a mosquito with a widespread distribution in Latin America, but its status as a dengue vector has not been clarified. Ae. fluviatilis is also naturally infected by the wFlu Wolbachia strain, which has been demonstrated to enhance infection with the avian malarial parasite Plasmodium gallinaceum. We performed experimental infections of Ae. fluviatilis with DENV-2 and DENV-3 isolates from Brazil via injection or oral feeding to provide insight into its competence for the virus. We also examined the effect of the native Wolbachia infection on the virus using a mosquito line where the wFlu infection had been cleared by antibiotic treatment. Through RT-qPCR, we observed that Ae. fluviatilis could become infected with both viruses via either method of infection, although at a lower rate than Aedes aegypti, the primary dengue vector. We then detected DENV-2 and DENV-3 in the saliva of injected mosquitoes, and observed that injection of DENV-3-infected saliva produced subsequent infections in naïve Ae. aegypti. However, across our data we observed no difference in prevalence of infection and viral load between Wolbachia-infected and -uninfected mosquitoes, suggesting that there is no effect of wFlu on dengue virus. Our results highlight that Ae. fluviatilis could potentially serve as a dengue vector under the right circumstances, although further testing is required to determine if this occurs in the field.