Endemic Parasitic Disease Research Articles

Unusual occurrence of brain hydatid disease in a patient with previous surgical intervention for hemorrhagic venous infarct

Hydatid disease is an endemic parasitic disease and can occur anywhere in the body and has a variable presentation. On imaging, thelesions have varied appearance ranging from cystic to solid appearing lesions, solitary to multiples. We present a case of 35-year-oldfemale who underwent decompression craniectomy for right temporoparietal hemorrhagic venous infarct and now presented withacute onset of right-sided weakness. Magnetic resonance imaging was suggestive of cerebral hydatid disease. The presented caseemphasizes that hydatid cyst should be considered as a possibility whenever a cystic lesion is encountered during imaging.

Epidemiological Characteristics of Re-emerging Vivax Malaria in the Republic of Korea (1993-2017).

Historically, Plasmodium vivax malaria has been one of the most highly endemic parasitic diseases in the Korean Peninsula. Until the 1970s, vivax malaria was rarely directly lethal and was controlled through the Korean Government Program administered by the National Malaria Eradication Service in association with the World Health Organization’s Global Malaria Eradication Program. Vivax malaria has re-emerged in 1993 near the Demilitarized Zone between South and North Korea and has since become an endemic infectious disease that now poses a serious public health threat through local transmission in the Republic of Korea. This review presents major lessons learned from past and current malaria research, including epidemiological and biological characteristics of the re-emergent disease, and considers some interesting patterns of diversity. Among other features, this review highlights temporal changes in the genetic makeup of the parasitic population, patient demographic features, and spatial distribution of cases, which all provide insight into the factors contributing to local transmission. The data indicate that vivax malaria in Korea is not expanding exponentially. However, continued surveillance is needed to prevent future resurgence.

Schistosomiasis (bilharziasis) and male infertility.

Schistosomiasis (bilharziasis) is an endemic parasitic disease of a major source of morbidity and mortality for developing countries. It is caused by different species of blood flukes (trematode worms) of the genus Schistosoma, the most important of which are S.haematobium which infests the genitourinary tract and S.mansoni and S.japonicum which infest the gastrointestinal tract. The incidence of schistosome-induced male infertility is not known and probably underestimated being overshadowed by the more severe and often fatal urinary and gastrointestinal complications. Several causes may contribute to schistosomiasis-induced male infertility, such as hormonal imbalance, testicular tissue damage and genital ductal system obstruction, in addition to decreased libido and erectile dysfunction due to associated hormonal imbalance and prostatic infestation. Demonstration of the schistosome ova in seminal plasma or testicular tissue confirms the diagnosis. Treatment of schistosomiasis-induced male infertility depends on clinical evaluation and includes, besides anthelmintic treatment, hormonal replacement and assisted reproduction (IVF/ICSI) in cases of severe oligozoospermia and or obstructive and nonobstructive azoospermia.

Sparganosis as an accidental human parasitic disease

Sparganosis is an endemic or potentially endemic parasitic disease which has already been noted in 48 countries, most cases occur in Asian countries (South Korea, Japan, Thailand and China). Sparganosis can manifest through a variety nonspecific symptoms, such as discomfort, local pain, palpable bumps, headaches. The infection may be caused by ingestion of water or raw meat of frogs or snakes and skin wraps of the above mentioned animals.

Are We on Our Way to Achieving the 2020 Goals for Schistosomiasis Morbidity Control Using Current World Health Organization Guidelines?

BackgroundSchistosomiasis remains an endemic parasitic disease affecting millions of people around the world. The World Health Organization (WHO) has set goals of controlling morbidity to be reached by 2020, along with elimination as a public health problem in certain regions by 2025. Mathematical models of parasite transmission and treatment impact have been developed to assist in controlling the morbidity caused by schistosomiasis. These models can inform and guide implementation policy for mass drug administration programs, and help design monitoring and evaluation activities.MethodsWe use these models to predict whether the guidelines set by the WHO are on track for achieving their 2020 goal for the control of morbidity, specifically for Schistosoma mansoni. We examine whether programmatic adaptations; namely increases in treatment coverage and/or expansion to adult inclusion in treatment, will improve the likelihood of reaching the WHO goals.ResultsWe find that in low-prevalence settings, the goals are likely to be attainable under current WHO guidelines, but in moderate to high-prevalence settings, the goals are less likely to be achieved unless treatment coverage is increased and expanded to at least 85% for school-aged children and 40% for adults.ConclusionsTo improve the likelihood of reaching the WHO goals, programmatic adaptations are required, particularly for moderate- to high-prevalence settings. Furthermore, improvements in adherence to treatment, potential development of candidate vaccines, and enhanced snail control and WASH (water, sanitation, and hygiene) measures will all assist in achieving the goals.

Ocorrência e comportamento sociodemográfico de pacientes com leishmaniose tegumentar americana em Vicência, Pernambuco, no período de 2007 a 2014

A leishmaniose é uma doença negligenciada que está entre as cinco doenças infecto-parasitárias endêmicas de maior relevância. O trabalho teve por objetivo analisar a frequência e o perfil epidemiológico e sociodemográfico dos pacientes com Leishmaniose Tegumentar Americana e acompanhar as medidas de controle. Trata-se de um estudo quantitativo de caráter retrospectivo. Do total dos pacientes acometidos, verificou-se que 59,4% deles eram do sexo masculino, 33,5% possuíam idade menor do que 12 anos, 83,1 % eram pardos e 79,3% estudaram até o ensino fundamental incompleto. Observou-se que a maioria dos diagnósticos para leishmaniose tegumentar americana é emitido baseando-se apenas pelo critério clínico epidemiológico, tendo em vista que os exames parasitológicos e imunológicos foram raramente utilizados para diagnóstico. O maior foco da doença concentrou-se nas áreas de abrangência da Unidade da Saúde da Família (USF) do Imbu, correspondendo a 79,3% dos casos. Em relação às medidas de controle, observou-se que 69,2% dos profissionais possuíam conhecimentos sobre leishmaniose, 84,6% das unidades de saúde da família não desenvolviam programas de ação e estratégias, 76,9% dos profissionais não participaram de atividades educativas na comunidade, porém, há divulgação à população sobre a ocorrência dos casos de LTA (69,2%). Apesar da alta frequência da ocorrência de leishmaniose tegumentar americana no município, as USFs não estavam atuantes no que concernem as medidas de controle referente ao agravo e não participavam de programas de educação em saúde.

Classification and prediction of river network ephemerality and its relevance for waterborne disease epidemiology

The transmission of waterborne diseases hinges on the interactions between hydrology and ecology of hosts, vectors and parasites, with the long-term absence of water constituting a strict lower bound. However, the link between spatio-temporal patterns of hydrological ephemerality and waterborne disease transmission is poorly understood and difficult to account for. The use of limited biophysical and hydroclimate information from otherwise data scarce regions is therefore needed to characterize, classify, and predict river network ephemerality in a spatially explicit framework. Here, we develop a novel large-scale ephemerality classification and prediction methodology based on monthly discharge data, water and energy availability, and remote-sensing measures of vegetation, that is relevant to epidemiology, and maintains a mechanistic link to catchment hydrologic processes. Specifically, with reference to the context of Burkina Faso in sub-Saharan Africa, we extract a relevant set of catchment covariates that include the aridity index, annual runoff estimation using the Budyko framework, and hysteretical relations between precipitation and vegetation. Five ephemerality classes, from permanent to strongly ephemeral, are defined from the duration of 0-flow periods that also accounts for the sensitivity of river discharge to the long-lasting drought of the 70’s-80’s in West Africa. Using such classes, a gradient-boosted tree-based prediction yielded three distinct geographic regions of ephemerality. Importantly, we observe a strong epidemiological association between our predictions of hydrologic ephemerality and the known spatial patterns of schistosomiasis, an endemic parasitic waterborne disease in which infection occurs with human-water contact, and requires aquatic snails as an intermediate host. The general nature of our approach and its relevance for predicting the hydrologic controls on schistosomiasis occurrence provides a pathway for the explicit inclusion of hydrologic drivers within epidemiological models of waterborne disease transmission.

Hydatid cysts in trapezius muscles: A narrative review

Aims: A hydatid cyst is an endemic parasitic disease that can be formed anywhere in the body, including muscles (3–5% of cases). The cyst can be misdiagnosed in early stages with muscular trigger points. Needling is the popular physical therapy approach in trigger point treatments. Misuse in needling can cause punctures in hydatid cysts and lead to death. The aim of this study was to summarise the available evidence on the manifestation of hydatid cysts in the trapezius muscle. Methods: A search was conducted for any reports of differential diagnosis or misdiagnosis of hydatid cysts and trigger points. Computerised literature searches were performed among publications between 1950 and December 2015 using the following databases: PubMed, Science Direct, SCOPUS, Ovid MEDLINE, CINAHL, Cochrane, and AMED. Results: Only three studies met the inclusion criteria. All three patients were females under 30 and all three had undergone surgery; two received medical treatment. No misdiagnosis with trigger points was reported and consequently there was no case of needling misuse in hydatid cysts either. However, it does not imply the absence of any clinical case. Conclusions: The current study intends to remind the importance of an accurate diagnosis before using needling as a trigger point treatment.

The Algorithm for the Diagnosis and Treatment of Patients with Chronic Opisthorchiasis Complicated with Obstructive Jaundice

Актуальность Хронический описторхоз - эндемичное паразитарное заболевание Западно-Сибирского региона, которое в41,6% случаев сопровождается билиарной гипертензией. Разработка лечебно-диагностического алгоритма для больных схроническим описторхозом, осложненным механической желтухой является актуальным научным исследованием.Целью исследования Разработка и оценка эффективности применения лечебно-диагностического алгоритма у пациентовс хроническим описторхозом, осложненным механической желтухой.Материалы и методы В исследование включен 91 пациент с хроническим описторхозом, осложненным механической жел-тухой. Пациенты разделены на основную и контрольную группы. В основной группе применен разработанный нами лечеб-но-диагностический алгоритм. Среди лучевых методов диагностики применены ультразвуковое исследование, магнитно-резонансная холангиопанкреатография (МРХПГ) и эндоскопическая ретроградная холангиопанкреатография (ЭРХПГ). Сцелью декомпрессии желчевыводящих путей применялись эндоскопическое, чрескожное чреспеченочное и хирургическоедренирование желчных протоков.Результаты и их обсуждение По данным лучевых методов определены пять типов архитектоники желчевыводящихпутей при хроническом описторхозе. При склеротических изменениях, осложнённых механической желтухой при хрони-ческом описторхозе, чувствительность МРХПГ составила 97,7%, специфичность 83,3%, общая точность 96%. Чувстви-тельность ЭРХПГ в основной группе составила 97,4%, специфичность 100%, общая точность 97,7%, в контрольной груп-пе 92,1%, 100% и 92,7% соответственно. Эндоскопические методы устранения желтухи были эффективными у 84,0%пациентов основной и 80,6% контрольной группы.Выводы Разработанный лечебно-диагностический алгоритм для больных хроническим описторхозом, осложненным меха-нической желтухой, позволяет сократить диагностический этап и обеспечивает оптимальный выбор метода декомпрес-сии желчных путей. Проведенный анализ свидетельствуют о высокой информативности МРХПГ и ЭРХПГ.Ключевые слова Осложнения хронического описторхоза, механическая желтуха, магнитно-резонансная холангиопанкре-атография

Biompha-LAMP: A New Rapid Loop-Mediated Isothermal Amplification Assay for Detecting Schistosoma mansoni in Biomphalaria glabrata Snail Host.

BackgroundSchistosomiasis remains one of the most common endemic parasitic diseases affecting over 230 million people worlwide. Schistosoma mansoni is the main species causing intestinal and hepatic schistosomiasis and the fresh water pulmonate snails of the genus Biomphalaria are best known for their role as intermediate hosts of the parasite. The development of new molecular monitoring assays for large-scale screening of snails from transmission sites to detect the presence of schistosomes is an important point to consider for snail control interventions related to schistosomiasis elimination. Our work was focussed on developing and evaluating a new LAMP assay combined with a simple DNA extraction method to detect S. mansoni in experimentally infected snails as a diagnostic tool for field conditions.Methodology/Principal findingsA LAMP assay using a set of six primers targeting a sequence of S. mansoni ribosomal intergenic spacer 28S-18S rRNA was designed. The detection limit of the LAMP assay was 0.1 fg of S. mansoni DNA at 63°C for 50 minutes. LAMP was evaluated by examining S. mansoni DNA in B. glabrata snails experimentally exposed to miracidia at different times post-exposure: early prepatent period (before cercarial shedding), light infections (snails exposed to a low number of miracidia) and detection of infected snails in pooled samples (within a group of uninfected snails). DNA for LAMP assays was obtained by using a commercial DNA extraction kit or a simple heat NaOH extraction method. We detected S. mansoni DNA in all groups of snails by using no complicated requirement procedure for DNA obtaining.Conclusions/SignificanceOur LAMP assay, named Biompha-LAMP, is specific, sensitive, rapid and potentially adaptable as a cost-effective method for screening of intermediate hosts infected with S. mansoni in both individual snails and pooled samples. The assay could be suitable for large-scale field surveys for schistosomes control campaigns in endemic areas.

Epidemiological characteristics of visceral leishmaniasis in Morocco (1990–2014): an update

Leishmaniases are parasitic diseases frequent in the Mediterranean Basin. Visceral leishmaniasis (VL) is a notifiable parasitic disease that increased in incidence in Morocco over the past few years and has recently emerged in several new foci, causing a public health problem in Morocco. The aim of this study is to describe the spatio-temporal distribution of VL in Morocco between 1990 and 2014 period in order to highlight important features and trends of VL and its epidemiology and to assess whether the activity of the unit reflects the situation of the disease at the national level and whether it could constitute an indicator of public health relevance. Two thousand four hundred and twenty one cases were reported in Morocco between 1990 and 2014 with an average annual reported incidence rate of 0.4 cases per 100.000 inhabitants. Before 1996 the average annual incidence of VL was 50 cases on average. After this date the number of cases increased and then remained stable with around 100–150 cases per year. Children whose age varies between 1 and 4 years old are the most affected with 1327 (74%) of total cases; nevertheless the adult starts to be affected by the disease. In 2000, 65% of positive cases of VL are concentrated at both northern regions: Taza-Al Hoceima- Taounate with 45% of cases, Tanger- Tetouan mainly represented by Chefchaoun with 20% of cases. The Fez-Boulemane region located in the center recorded 12% of cases. Throughout the years the map VL distribution has been progressively changed and spatial spread of the disease to the center is noted in 2007. 2014 has been marked by an even greater extension of the disease to the center and south of Morocco. Nationally in 2014, 34 of 75 provinces and prefectures are affected compared to 2000, when 22 out of 82 provinces and prefectures were affected. Leishmania infantum was identified the causative agent based on species- specific PCR-Lei70 assay. VL remains a sporadically endemic parasitic disease in Morocco with a progressive extension of its range of distribution. Such a situation would relate to the geographical succession of Phlebotomine sand fly vectors, the difficulty of actions against the canine population reservoirs of L. infantum and unfavorable socio-economic factors.

The Inhibition of Cysteine Proteases Rhodesain and TbCatB: A Valuable Approach to Treat Human African Trypanosomiasis.

Human African Trypanosomiasis (HAT) is an endemic parasitic disease of sub-Saharan Africa, caused by two subspecies of protozoa belonging to Trypanosoma genus: T. brucei gambiense and T. brucei rhodesiense. In this context the inhibition of the papain-family cysteine proteases rhodesain and TbCatB has to be considered a promising strategy for HAT treatment. Rhodesain, the major cathepsin L-like cysteine protease of T. brucei rhodesiense, is a lysosomal protease essential for parasite survival. It is involved in parasite invasivity, allowing it to cross the blood-brain barrier (BBB) of the human host, causing the second lethal stage of the disease. Moreover, it plays an important role in immunoevasion, being involved in the turnover of variant surface glycoproteins of the T. brucei coat and in the degradation of immunoglobulins, avoiding a specific immune response by the host cells. On the other hand TbCatB, a cathepsin B-like cysteine protease, present in minor abundance in T. brucei, showed a key role in the degradation of host transferrin, which is necessary for iron acquisition by the parasite. In this review article we now discuss the most active peptide, peptidomimetic and non-peptide rhodesain and TbCatB inhibitors as valuable strategy to treat HAT, due also to the complementary role of the two T. brucei proteases.

Loop-Mediated Isothermal Amplification ( Lamp ) : Sensitive and Rapid Detection of Schistosoma Haematobium DNA in Urine Samples of Egyptian Suspected Cases

Schistosomiasis haemalobium is a major endemic parasitic disease in many tropical regions including Egypt. Typical infection results in haematuria, dysuria, anaemia, genital as well as urinary tract lesions, with prospect of kidney damage in complicated cases. In addition, deposited eggs in the tissue, eventually leads to squamous cell carcinoma of urinary bladder in chronically infected individuals. Microscopic detection of excreted ova in urine samples remains the gold standard diagnostic method, in spite of its inherited low sensitivity, inconsistent egg excretion and unreliable results in chronic phase of the disease. Moreover due to pre-requisite for skilled personals and pricey equipment, PCR-based technologies are of limited use especially in low-income endemic countries. So emergence of loop-mediated isothermal DNA amplification (LAMP) seemed a promising technique. Our study evaluated application of LAMP technique in detection of S. haematobium DNA in 69 urine samples of suspected patients for urogenital schistosomiasis, versus conventional urine filtration followed by microscopy ova detection method. Specificity of LAMP was tested using other parasites DNA samples that showed no cross reactivity. Furthermore our results of the calculated diagnostic parameters for sensitivity and specificity for LAMP assay were 100%, with 95% CI (88.78%-100%), and 63.16%, with 95% CI (45.99%-78.19%) respectively, moreover Positive likelihood ratio (LR+) 2.7, and Negative likelihood ratio (LR-) 0.0, which display that LAMP technique is an up-to-date simple, sensitive, diagnostic important tool that could be employed in clinical diagnosis in poorly equipped facilities, as well as in surveillance of infectious diseases. As authors knowledge, this is the first national report evaluation of LAMP technique as a promising diagnostic tool for urogenital schistosomiasis.

LOOP-MEDIATED ISOTHERMAL AMPLIFICATION (LAMP): SENSITIVE AND RAPID DETECTION OF SCHISTOSOMA HAEMATOBIUM DNA IN URINE SAMPLES OF EGYPTIAN SUSPECTED CASES.

Schistosomiasis haemalobium is a major endemic parasitic disease in many tropical regions including Egypt. Typical infection results in haematuria, dysuria, anaemia, genital as well as urinary tract lesions, with prospect of kidney damage in complicated cases. In addition, deposited eggs in the tissue, eventually leads to squamous cell carcinoma of urinary bladder in chronically infected individuals. Microscopic detection of excreted ova in urine samples remains the gold standard diagnostic method, in spite of its inherited low sensitivity, inconsistent egg excretion and unreliable results in chronic phase of the disease. Moreover due to pre-requisite for skilled personals and pricey equipment, PCR-based technologies are of limited use especially in low-income endemic countries. So emergence of loop-mediated isothermal DNA amplification (LAMP) seemed a promising technique. Our study evaluated application of LAMP technique in detection of S. haematobium DNA in 69 urine samples of suspected patients for urogenital schistosomiasis, versus conventional urine filtration followed by microscopy ova detection method. Specificity of LAMP was tested using other parasites DNA samples that showed no cross reactivity. Furthermore our results of the calculated diagnostic parameters for sensitivity and specificity for LAMP assay were 100%, with 95% CI (88.78%-100%), and 63.16%, with 95% CI (45.99%-78.19%) respectively, moreover Positive likelihood ratio (LR+) 2.7, and Negative likelihood ratio (LR-) 0.0, which display that LAMP technique is an up-to-date simple, sensitive, diagnostic important tool that could be employed in clinical diagnosis in poorly equipped facilities, as well as in surveillance of infectious diseases. As authors knowledge, this is the first national report evaluation of LAMP technique as a promising diagnostic tool for urogenital schistosomiasis.

Genetic selection pressure in TLR9 gene may enforce risk for SLE in Indian Tamils

Objectives Lupus is a classical systemic autoimmune disease with genetics as one of the well known causative factors for the disease pathogenesis. Toll-like receptors are the major pattern recognition receptors associated with innate immunity and also act as an interface with the adaptive immunity. Genetic polymorphisms in genes encoding TLRs were implicated in the development of infections, malignancies and autoimmune diseases. TLR9 is a member of TLR family, and recognizes the CpG DNA motifs of pathogens. Though the incidence rate of lupus in Asians was reported to be low (30 - 50/100,000 population), poor disease prognosis due to higher incidence of renal complications and aggressive disease worsens the scenario. The ability of TLR9 to detect and elicit an immune response against double-stranded DNA makes TLR9 a relevant factor to be tested for its association with the clinical and serological phenotypes of lupus. However, lack of relevant genetic data on normative frequencies of the TLR9 (rs187084) polymorphism may serve as a constraint to derive the sample size to conduct case control association studies. Hence this study was conducted to establish the normative frequency of TLR9 (rs187084) polymorphism in Indian Tamils. Materials and methods The TLR9 (rs187084) polymorphism was screened in South Indian Tamils ( n = 208) by PCR-RFLP. Results and discussion We observed a higher occurrence of the mutant allele (65%) in South Indian Tamils. No gender disparity with respect to the mutant allele frequency was observed. The higher incidence of mutant allele in both genders suggests that this population had undergone a genetic selection pressure as an evolutionary genetic measure to withstand the prevailing endemic infections like TB and malaria. Though the enhanced expression of TLR9 was protective against infections, it may also influence the development of autoimmune diseases. Conclusion The higher incidence of theTLR9 (rs187084) over-expression mutation in Indian Tamils is suggestive of a genetic adaptation or selection pressure to withstand the prevailing endemic infectious and parasitic diseases. However, this genetic adaptation poses a greater risk to develop autoimmune diseases like SLE etc through complex gene environment interactions. The normative frequency of the TLR9 (rs187084) polymorphism established in our population could now be used to define the sample size for future case control studies.

Visceral Leishmaniasis in Southwestern Iran: A Retrospective Clinico-Hematological Analysis of 380 Consecutive Hospitalized Cases (1999-2014).

Visceral Leishmaniasis (VL) is an endemic parasitic disease and remains as a major health concern in southwestern Iran. The current study describes clinico-hematological, epidemiological and therapeutic features of VL cases, admitted to university-affiliated hospitals, during 1999–2014 in Fars province, southwestern Iran. A total of 380 VL cases were recorded during a 16 years period, giving an average annual admission of 23.75 cases/year in which 217 (57.1%) were male and 163 (42.9%) were female. Mean age of the patients was 3.7 years. The majority of the cases (91.5%) were ≤ 5 years old. Bone-marrow aspiration detected Leishmania amastigotes only in 26.6% of cases. Fever (98.1%), abdominal protrusion (65.1%) and hepatosplenomegaly (63.7%) were the most common clinical presentations of the patients. Pancytopenia was noted in 43.1, anemia in 87.3 and thrombocytopenia in 64% of cases. Increase in the level of AST (aspartate aminotransferase), ALT (alanine aminotransferase), alkaline phosphatase, LDH (lactate dehydrogenase) and CRP (C-Reactive Proteins) were seen in 84.9, 53.6, 44.4, 72.5 and 83.1% of cases, respectively. Mortality was noted in 5.3% of cases. Deranged haemato-biochemical parameters including total and direct bilirubin, PLT (platelet) and pancytopenia were significantly contributed to mortality from VL. Moreover, clinical features such as severe splenomegaly as well as bacterial infections were meaningfully contributed to death from VL. The majority of patients (74.9%) were treated with meglumine antimoniate. Amphotericin B was administrated in 59 of cases, 11 of them were initially treated with meglumine antimoniate with a shift to amphotericin B, because of treatment failure. Findings of the current study demonstrated that VL is present in southwest of Iran with a fairly continual rate during the last 16 years period. Deranged haemato-biochemical parameters along with severe splenomegaly contributed to mortality from VL.

Visseral Leşmanyaziste Dalakta Nodüller

Visceral leishmaniasis (VL) is transmitted to humans by the bite of sandflies. VL is an endemic parasitic disease which is characterized by fever, splenomegaly and pancytopenia in most of the cases. Delays in diagnosis of VL are common because of nonspecific symptoms and variable incubation time. Specific serology and polymerase chain reaction are useful for the diagnosis. Anti- K39 strip test is highly sensitive. Splenic multifocal hypoechoic nodules should be evaluated for VL with clinical and laboratory features in patient. Herein we report a twenty-two month-old female infant with diagnosis of VL who presented with recurrent fever, pancytopenia and ultrasonography revealed enlarged spleen with multifocal hypoechoic nodules. We considered that splenic nodules can help to diagnosis of VL in children as literature case reports support to this situation.

In vitro antileishmanial and antimalarial activity of selected plants of Nepal.

Background:Nepal is very rich in biodiversity, and no extensive effort has yet been carried out to screen plants that are used by traditional healers against parasitic diseases. The aim of this study was to evaluate the in vitro antileishmanial and antimalarial activity of crude methanolic or ethanolic extracts of 29 plant species that are currently used by local people of Nepal for treating different ailments.Methods:Crude extracts of leaves, twigs, aerial parts, and/or roots of the selected plants were evaluated for in vitro inhibitory activity against intracellular amastigotes of Leishmania infantum and against erythrocytic stages of Plasmodium falciparum. To determine the selectivity index (SI), cytotoxicity was assessed on MRC-5 cells in parallel.Results:Three plant species, namely Phragmites vallatoria and Ampelocissus tomentosa, for which no antiprotozoal activity has previously been reported, and Terminalia chebula revealed antiprotozoal activity. The extract of A. tomentosa exhibited moderate activity against L. infantum with an inhibitory concentration 50% (IC50) of 13.2 ± 4.3 µg/ml and SI >3, while T. chebula exhibited fairly good antiplasmodial activity with IC50 values of 4.5 ± 2.4 µg/ml and SI values >5.Conclusion:In countries like Nepal, where the current health system is unable to combat the burden of endemic parasitic diseases, evaluation of local plants as a potential source of the drug can help in expanding the treatment options. The extent of untapped resources available in these countries provides an opportunity for future bioprospecting.

Contribution of draft cattle to rural livelihoods in a district of southeastern Uganda endemic for bovine parasitic diseases: an economic evaluation.

BackgroundA study was conducted in Tororo District in eastern Uganda to assess the socio-economic contribution of draft cattle to rural livelihoods. The aim of the study was to empirically quantify the economic value of draft cattle thus contributing to understanding the impact of endemic parasitic diseases of cattle on livestock productivity and subsequently household income, labor and food security.MethodA total of 205 draft cattle keeping households (n = 205) were randomly selected and structured household questionnaires were administered, focusing on work oxen use, productivity, inputs and outputs. The data obtained was analyzed using standard statistical methods and used to calculate the gross margin from the draft cattle enterprise. Secondary data were obtained from focus group discussions and key informant interviews and these were analyzed using Bayesian methods.ResultsThe study showed that, apart from being labor saving, the use of animal traction is highly profitable with the gross margin per year from the use of draft cattle amounting to 245 United States dollars per work oxen owning household. The cash obtained from hiring out draft animals was equivalent to nearly a quarter of the average local household’s monetary receipts. It also revealed that endemic bovine parasitic diseases such as trypanosomiasis and tick-borne diseases reduced draft cattle output by 20.9 % and potential household income from the use of draft oxen by 32.2 %.ConclusionThe presence of endemic cattle diseases in rural Uganda is adversely affecting the productivity of draft cattle, which in turn affects household income, labor and ultimately food security. This study highlights the contribution of draft cattle to rural livelihoods, thus increasing the expected impact of cost-effective control strategies of endemic production limiting livestock diseases in Uganda.

Atypical Manifestations of Visceral Leishmaniasis in Children

Visceral leishmaniasis (VL) or kala-azar is an endemic parasitic disease caused predominantly, in its Mediterranean type, by Leishmania infantum. Fever and splenomegaly are the most common clinical manifestations, detected in more than 80% of patients. We present two cases with atypical manifestations, without fever and with spleen nodules in the context of an outbreak of VL in Spain.