Triple Infection Research Articles

High Circulation of Malaria and Low Prevalence of Bacteremia in Febrile and Afebrile Children in Northeastern Gabon.

The epidemiology of febrile illness etiologies is under-explored in resource-poor settings. Establishing a local repertory of microorganisms circulating in blood of febrile and afebrile people is important for physicians. Blood was collected from 428 febrile and 88 afebrile children in Makokou (Gabon) and analyzed using polymerase chain reaction. Plasmodium spp. were the pathogens, which were most detected in febrile children (69.6%; 298/428) and in afebrile children (31.8%; 28/88) (P < 0.0001). Plasmodium falciparum was the most prevalent species in both febrile and afebrile children (66.8% and 27.3%, respectively). No differences were observed between febrile and afebrile children for Plasmodium malariae and Plasmodium ovale (8.2% versus 10.2% and 3.3% versus 3.4%, respectively). Triple infection with P. falciparum, P. malariae, and P. ovale was also detected in 1% of febrile children (4/428). Filariasis due to Mansonella perstans was detected in 10 febrile patients (2.3%), whereas Loa loa was detected in both febrile and afebrile children (1.4% and 2.3%, respectively). Bacterial DNA was detected in only 4.4% (19/428) of febrile children, including 13 (68.4%) who were coinfected with at least one Plasmodium species. These were Haemophilus influenzae (1.6%, 7/428), Streptococcus pneumoniae and Staphylococcus aureus (1.2%, 5/428), and Rickettsia felis (0.9%, 4/428). Coxiella burnetii, Bartonella spp., Borrelia spp., Tropheryma whipplei, Anaplasma spp., Leptospira spp., Streptococcus pyogenes, and Salmonella spp. were not detected. This study also highlights the over-prescription and the overuse of antibiotics and antimalarials. Overall, malaria remains a major health problem in Makokou. Malaria control measures must be reconsidered in this region.

Bovine ticks harbour a diverse array of microorganisms in Pakistan

BackgroundTicks and tick-borne pathogens (TTBP) are a major constraint to livestock production in Pakistan; despite a high prevalence of TTBPs, knowledge on the capacity of Pakistani ticks to carry pathogens and endosymbionts is limited. Furthermore, mixed infections with multiple microorganisms further complicate and limit the detection potential of traditional diagnostic methods. The present study investigated the tick-borne microorganisms in bovine ticks in Pakistan, employing a high-throughput microfluidic real-time PCR based technique.MethodsTicks were collected from clinically healthy cattle (n = 116) and water buffaloes (n = 88) from 30 villages across six districts located in five agro-ecological zones (AEZs) of Pakistan from September to November 2017. The microfluidic real-time PCR was used to test the genomic DNA of individual ticks for the presence of 27 bacterial and eight parasitic microorganisms. Phylogenetic methods were used to assess the genetic relationship of DNA sequences determined herein.ResultsPCR detected DNA of at least one microorganism in each of 221 ticks tested (94.4%, 221/234). DNA-based detection inferred that single pathogens/endosymbionts were the most common (43.4%, 96/221) followed by double (38.9%, 86/221), triple (14.5%, 32/221), quadruple (2.3%, 5/221) and quintuple (0.9%, 2/221) mixed infections. Piroplasms (Babesia/Theileria spp.) were the most prevalent (31.6%, 74/234), followed by Ehrlichia spp. (20%, 47/234) and Anaplasma marginale (7.7%, 18/234). Anaplasma phagocytophilum, A. ovis, A. centrale, Babesia ovis, Borrelia spp., Rickettsia spp., R. massiliae, Bartonella spp. and Hepatozoon spp. were also detected. Endosymbionts such as Francisella-like (91.5%, 214/234) and Coxiella-like (1.3%, 3/234) organisms were also detected in ticks. The highest diversity of microorganisms was detected in Hyalomma anatolicum ticks (test-positive for 14/14 microorganisms), followed by Rhipicephalus microplus (4/14), Hy. hussaini (3/14) and Rh. annulatus (2/14). Ticks collected from cattle carried significantly more frequently piroplasms (41.2%, 54/131; P < 0.05) than those from buffaloes (19.4%, 20/103). However, the overall prevalence of microorganisms did not vary significantly among ticks from the two host species as well as across different AEZs.ConclusionsTo our knowledge, this is the first study to investigate a wide range of tick-borne microorganisms in bovine ticks using a high-throughput diagnostic method from different AEZs in Pakistan. These findings will aid in establishing the distribution patterns and the control of tick-borne pathogens of bovines in Pakistan.

HIV-hepatitis co-infection in a rural community in Northern Nigeria.

IntroductionHIV, hepatitis B and hepatitis C pose a public health challenge in sub-Saharan Africa and there are only few studies on co-infection of these viruses done in rural areas in Northern Nigeria. This study provides a rural perspective on HIV-hepatitis co-infection in a Northern Nigerian community.Methodsthis cross-sectional study was carried out amongst people living with HIV/AIDS (PLWHA) in a rural community hospital over a three-month period. Socio-demographic data and other relevant information were obtained from the participants and case notes using an interviewer-administered questionnaire. Hepatitis B surface antigen and antibody to Hepatitis C virus were assayed from serum using enzyme-linked immunosorbent assay (ELISA) kits developed by LabACON®. Chi-square test was used to compare categorical variables and logistic regression modelling was used to determine correlates of co-infection in the population.Resultsa total of 281 individuals participated in the study. The prevalence of Hepatitis B co-infection, Hepatitis C co-infection and triple infection was 6.0%, 14.6% and 1.1% respectively. Using Chi-square test, none of the socio-demographic characteristics, WHO Clinical Stage, viral suppression had significant association with Hepatitis B co-infection, however marital status was significantly associated with Hepatitis C co-infection and level of education was significantly associated with triple infection (p < 0.05). Logistic regression modelling generated no significant results.Conclusionco-infection of viral hepatitis (particularly Hepatitis C) in PLWHA is common in rural Northern Nigeria, and significant correlates include lack of formal education and being married. There is need for provider-initiated routine counselling and screening of PLWHA for viral hepatitis, with adequate follow-up and treatment of co-infected individuals and Hepatitis B vaccination for those without co-infection.

Host conservation through their parasites: molecular surveillance of vector-borne microorganisms in bats using ectoparasitic bat flies

Most vertebrates host a wide variety of haematophagous parasites, which may play an important role in the transmission of vector-borne microorganisms to hosts. Surveillance is usually performed by collecting blood and/or tissue samples from vertebrate hosts. There are multiple methods to obtain samples, which can be stored for decades if properly kept. However, blood sampling is considered an invasive method and may possibly be harmful to the sampled individual. In this study, we investigated the use of ectoparasites as a tool to acquire molecular information about the presence and diversity of infectious microorganism in host populations. We tested the presence of three distinct vector-borne microorganisms in both bat blood and bat flies: Bartonella bacteria, malaria-like Polychromophilus sp. (Apicomplexa), and Trypanosoma sp. (Kinetoplastea). We detected the presence of these microorganisms both in bats and in their bat flies, with the exception of Trypanosoma sp. in South African bat flies. Additionally, we found Bartonella sp. in bat flies from one population in Spain, suggesting its presence in the host population even if not detected in bats. Bartonella and Polychromophilus infection showed the highest prevalence in both bat and bat fly populations. Single, co- and triple infections were also frequently present in both. We highlight the use of haematophagous ectoparasites to study the presence of infectious microorganism in host blood and its use as an alternative, less invasive sampling method.

Viral hepatitis B and C co-infection with Human Immunodeficiency Virus among adult patients attending selected highly active anti-retroviral therapy clinics in Nigeria’s capital

ABSTRACTHepatitis B and C are liver diseases caused by hepatitis B and C viruses, and co-infection in HIV-positive individuals is common, with increased mortality and morbidity. This study determined the seroprevalence of HIV co-infection with the two viruses among patients attending three major hospitals in the Federal Capital Territory, Nigeria. From February to July 2019, 311 sera samples were collected from HIV positive patients and screened for Hepatitis B and C infection. Immunochromatographic and ELISA techniques for HBsAg and HCV were used. Socio-demographic features and responses to risk factors were obtained using questionnaires. Patients’ data and results obtained were analyzed with SPSS version 25. The prevalence of HIV/HBV/HCV, HIV/HBV, and HIV/HCV co-infection were 0.64%, 6.43%, and 3.86%, respectively. The triple infection and both co-infections were preponderant among females than males, with a prevalence rate of 0.64%, 3.85%, 2.57%, and 0%, 2.57%, 1.29%, respectively. People aged 31–40 years had the highest triple infection (0.64%) and HIV/HCV infection rate (2.57%), while patients aged 21–30 years had the highest HBV co-infection (3.22%) rates. Widowed patients had the most co-infection rate in all cases. High-risk behavior indicated that there was a significant association between blood donation/reception and engagement in unprotected sex and HIV/HBV/HCV co-infection. The other risk factors revealed no significant effect (p > .05). There was generally a low rate of exposure to associated risk factors. This study highlighted the endemicity of hepatitis virus co-infection in Abuja and the existence of few reports of HIV co-infection with HBV and HCV compared to the nation’s population.

Prevalence of selected intestinal protozoan infections in marginalized rural communities in Palestine

BackgroundIntestinal parasitic infections are common in rural areas with poor infrastructure and low socioeconomic status. The aim of this study was to estimate the prevalence of selected parasitic infections in marginalized rural areas in the northern part of the Palestinian West Bank Region, using conventional and PCR-based methods, and also to assess risk predictors of infection.MethodsA cross-sectional study was conducted on 104 individuals from three rural villages in the Jordan Valley. Stool samples were collected and examined by a battery of tests that included microscopy of wet fecal samples in normal saline with iodine, concentration by ethyl acetate sedimentation and also by zinc sulfate floatation, a conventional PCR and a real-time PCR (qPCR). Risk factors were assessed that included demographic, socioeconomic, and behavioral characteristics. Data on method performance was analyzed by kappa-statistic, Cochrane’s Q, and McNemar post hoc test. Mid-P exact test and odds ratio were used to discern association between outcome and risk predictors.ResultsThe overall prevalence of intestinal parasitic infections was 48% (49/102). The predominant parasites were Giardia lamblia at 37% (37/102) and Hymenolepis nana at 9% (9/102). To concentrate cysts and eggs, sedimentation can be used as an alternative to floatation with a loss of 1% of positive cases. The methods employing PCRs proved crucial as it increased the detected infection rate of G. lamblia approximately three-fold from 13% by the conventional methods to 37% by the qPCR. Multiple infections were present in 13% (13/102) of the study group, which included double (10%) and triple (3%) infections. Regarding the genus Entamoeba, E. dispar and E. coli were detected at rates of 2 and 8%, respectively. While none of the individuals were infected with the pathogenic E. histolytica, E. nana (4%) was detected for the first time in the area. Age was a risk predictor for infection (OR = 2.61, CI 95% 1.05–6.45, P = 0.038).ConclusionsThe increased prevalence of intestinal parasitic infections in children in marginalized rural areas in Palestine is worrying. The addition of PCR-based methods is important for the diagnosis of such infections as, with cautious interpretation, it increases proficiency and overcomes underestimation and misdiagnosis of cases. Control measures including education on personal hygiene and environmental sanitation, should be introduced to reduce the prevalence of the intestinal parasites and, thus, the infections they cause in this and other areas.

High prevalence of norovirus and rotavirus co-infection in children with acute gastroenteritis hospitalised in Brazzaville, Republic of Congo.

To evaluate the clinical severity of diarrhoea associated to viral co-infection in children with acute gastroenteritis. About 461 children under five years hospitalised with acute diarrhoea (266 males and 187 females) were enrolled in the study. Using stool samples, rotavirus and adenovirus infections were investigated by ELISA, and norovirus infections by nested duplex RT-PCR. We assessed social, demographic, clinical and behavioural conditions that might influence the occurrence of rotavirus, adenovirus and norovirus infections. Mono-viral infection was detected in 49% and mixed viral infection in 12% of patients. The prevalence of mixed infection was neither dependent on age nor sex. Three samples were infected with all three viruses. A significant association was found between fever (axillary temperature>37.5°C) and rotavirus-norovirus dual infection (aOR (CI 95%) = 2.1 (1.14-3.84), P=0.016; aOR (CI 95%) = 0.37 (0.19-0.73), P=0.004). Mixed infection was the most common during the dry season from June to October (71.4% versus 54.7%, P=0.023). Co-infection with both rotavirus and norovirus is common in under-five hospitalised children but does not contribute to the severity of the disease.

Development of a multiplex RT-PCR for the detection of major diarrhoeal viruses in pig herds in China.

The major enteric RNA viruses in pigs include porcine epidemic diarrhoea virus (PEDV), transmissible gastroenteritis virus (TGEV), porcine rotavirus A (PRV‐A), porcine kobuvirus (PKV), porcine sapovirus (PSaV) and porcine deltacoronavirus (PDCoV). For differential diagnosis, a multiplex RT‐PCR method was established on the basis of the N genes of TGEV, PEDV and PDCoV, the VP7 gene of PRV‐A, and the polyprotein genes of PKV and PSaV. This multiplex RT‐PCR could specifically detect TGEV, PEDV, PDCoV, PRV‐A, PKV and PSaV without cross‐reaction to any other major viruses circulating in Chinese pig farms. The limit of detection of this method was as low as 100–101 ng cDNA of each virus. A total of 398 swine faecal samples collected from nine provinces of China between October 2015 and April 2017 were analysed by this established multiplex RT‐PCR. The results demonstrated that PDCoV (144/398), PSaV (114/398), PEDV (78/398) and PRV‐A (70/398) were the main pathogens, but TGEV was not found in the pig herds in China. In addition, dual infections, for example, PDCoV + PSaV, PDCoV + PRV‐A, PRA‐V + PSaV and PEDV + PDCoV, and triple infections, for example, PDCoV + PRV‐A + PSaV and PEDV + PDCoV + PKV, were found among the collected samples. The multiplex RT‐PCR provided a valuable tool for the differential diagnosis of swine enteric viruses circulating in Chinese pig farms and will facilitate the prevention and control of swine diarrhoea in China.

Comparison of suspension MDCK cells, adherent MDCK cells, and LLC-MK2 cells for selective isolation of influenza viruses to be used as vaccine seeds.

BackgroundCell‐based influenza vaccines can solve the problem of the frequent occurrence of egg adaptation–associated antigenic changes observed in egg‐based vaccines. Seed viruses for cell‐based vaccines can be prepared from clinical specimens by cell culture; however, clinical samples risk harboring respiratory viruses other than influenza virus. Therefore, it is necessary to investigate the patterns of co‐infection in clinical samples and explore whether cell culture technology can selectively propagate influenza viruses from samples containing other respiratory viruses.MethodsA total of 341 clinical specimens were collected from patients with influenza or influenza‐like illness and analyzed by ResPlex II assay to detect 18 respiratory viruses. The patterns of co‐infection were statistically analyzed with Fisher's exact test. The samples with double or triple infections were passaged in suspension MDCK cells (MDCK‐S), adherent MDCK cells (MDCK‐A), and LLC‐MK2D cells. Cell‐passaged samples were analyzed by ResPlex II assay again to investigate whether each cell line could amplify influenza viruses and eliminate other respiratory viruses.ResultsDouble infections were detected in 8.5% and triple infections in 0.9% of the collected clinical specimens. We identified four pairs of viruses with significant correlation. For all samples with double and triple infection, MDCK‐S and MDCK‐A could selectively propagate influenza viruses, while eliminating all contaminating viruses. In contrast, LLC‐MK2D showed lower isolation efficiency for influenza virus and higher isolation efficiency for coxsackievirus/echovirus than MDCK‐S and MDCK‐A.ConclusionsBoth MDCK‐S and MDCK‐A are considered suitable for the preparation of influenza vaccine seed viruses without adventitious agents or egg‐adaptation mutations.

Etiologic and epidemiologic features of acute respiratory infections in adults from Shanghai, during 2015-2017

Objective: To analyze the etiologic and epidemiological characteristics of adult acute respiratory infections in Shanghai during 2015-2017. Methods: Data was collected from outpatients with acute respiratory infections who visited the Fever Clinics in three hospitals of different levels in three administrative regions of Shanghai, from 2015 to 2017. Basic information and nasopharyngeal swabs were collected from cases in line with the inclusion criteria. Multiplex RT-PCR and bacterial cultures were performed to detect the respiratory pathogens. Results: A total of 806 individuals were enrolled from 2015 to 2017. Respiratory pathogens were identified in 73.45% (592/806) of the cases, with the virus detection rate as 66.75% (538/806). It was found that the major respiratory pathogens for virus detection were influenza A in 326 (40.45%), influenza B in 116 (14.39%), rhinovirus/enterovirus in 39 (4.84%) of the cases. The overall detection rate of bacteria was 16.13% (130/806), including Klebsiella pneumoniae in 90 (11.17%) cases, Staphylococcus Aureus in 46 (5.71%) cases. Other kind of bacteria were not detected in our study. The detection rates on Mycoplasma pneumoniae was 5.33% (43/806) and on Chlamydia pneumonia was 0.37% (3/806). Co-infection with multiple pathogens was detected in 18.61% (150/806) of the cases, including 135 with double infection (accounting for 90.00%), 14 with triple infection and 1 with quadruple infection (accounted for 9.33% and 0.67%, respectively). Among the 150 cases with co-infections, the main identified pathogens were influenza A, Klebsiella pneumoniae, Staphylococcus aureus, and Mycoplasma pneumoniae. Pathogens of acute respiratory infections that identified among the outpatients from the Fever Clinics at different time, region or population, the characteristics were different (P<0.001). Conclusions: In 2015-2017, outpatients with acute respiratory infections in Shanghai were mainly caused by influenza virus or other viruses, however dynamically with its composition, time, region and characteristics of the population. It is necessary to strengthen and combine related medical and preventive services and to develop the appropriate strategies regarding clinical diagnosis and treatment.

Prevalence of Malaria and TB Coinfection at a National Tuberculosis Treatment Centre in Uganda.

The prevalence of malaria and tuberculosis (TB) coinfection is not well established in countries that are highly burdened for both diseases. Malaria could impair TB containment and increase mortality of TB patients. The objective of this study was to determine the prevalence of malaria/TB coinfection among bacteriologically confirmed adult TB patients at a national TB treatment centre in Uganda. Using a cross-sectional study design we enrolled 363 bacteriologically confirmed adult TB patients, and data on demographics and medical history was collected. Blood samples were tested for malaria blood smear, rapid malaria diagnostic test (RDT), complete blood count, haematological film analysis, HIV serology, and CD4+ and CD8+ cell counts. Malaria was defined as either a positive blood smear or RDT. The study participants were mostly male (61.4%), with a median age of 31 (interquartile range, IQR: 25-39) years, and 35.8% were HIV positive. The prevalence of malaria was 2.2% (8/363) on the overall and 5% (3/58) among participants with rifampicin resistance. A triple infection of HIV, malaria, and rifampicin resistant TB was observed in 3 participants. The prevalence of malaria among TB patients is low, and further evaluation of the epidemiological, clinical, and immunological interaction of the two diseases is warranted.

Molecular epidemiology and risk factors of Anaplasma spp., Babesia spp. and Theileria spp. infection in cattle in Chongqing, China.

Tick-borne pathogens (TBPs) seriously affect cattle production and can be economically damaging. The epidemiology of these organisms in the Chongqing municipality of China is not well described. This study aimed to investigate the prevalence and risk factors of TBPs including Anaplasma spp., Babesia spp. and Theileria spp. in cattle in Chongqing municipality. The results showed that 43.48% (150/345) of cattle were infected with at least one TBP, of which single infections were detected in 104 (30.14%), double infections in 34 cattle (9.86%) and triple infections in 12 (3.48%) of the cattle. The overall prevalence of Anaplasma spp., Theileria spp. and B. bigemina were 22.32%, 23.19% and 7.24%, respectively. Among these, the prevalence of A. bovis, A. central, A. phagocytophilum, A. platys, A. marginale, T. sinensisi and T. orientalis were 8.41%, 7.83%, 4.93%, 4.35%, 2.61%, 22.32% and 2.60%, respectively. We could not detect B. bovis, T. annulata, T. luwenshuni or T. uilenbergi in cattle. Cattle ≥1-year-old were more likely to be infected with Theileria spp. [adjusted odd ratio (AOR) = 2.70, 95% CI = 1.12–6.56)] compared with younger cattle, while cattle ≥1-year-old had reduced susceptibility to B. bigemina (AOR = 0.14, 95% CI = 0.03–0.60). Cattle living at higher altitude (≥500 m) were more susceptible to B. bigemina (AOR = 6.97, 95% CI = 2.08–23.35) and Theileria spp. infection (AOR = 1.87, 95% CI = 1.06–3.32). The prevalence of Theileria spp. on farms with cats was significantly higher than that without cats (AOR = 2.56, 95% CI = 1.12–5.88). Infection with A. bovis and A. central were significantly associated with A. phagocytophilum infection. Furthermore, there were significant associations between A. bovis and A. central infection, T. sinensisi and A. marginale infection, and B. bigemina and T. orientalis infection. This study provides new data on the prevalence of Anaplasma spp., Babesia spp. and Theileria spp. in cattle in Chongqing, and for the first time we reveal a possible relationship between the afore-mentioned pathogens, which will help in formulating appropriate control strategies for these pathogens in this area.

Successful treatment of HBV, HCV, & HEV, with 12-week long use of tenofovir, sofosbuvir, daclatasvir, and ribavirin: A case report

Hepatitis C virus (HCV) is the leading cause of morbidity and mortality worldwide. It causes both chronic and acute infections and it has been estimated that about 80% of HCV infected patients develop chronic HCV infection of which 15–30% develop liver complications specifically liver cirrhosis and hepatocellualar carcinoma (HCC). Interferon therapy was previously used standard of care therapy associated with poor efficacy in major proportion of HCV infected population whereas, the recent development of interferon-free therapy or direct-acting antiviral (DAA) drugs are able to achieve sustained virological response (SVR) in 95% of patients. These new drugs are still not properly explored and currently there is minimal clinical experience regarding an efficacious treatment option suitable for triple infection i.e, Hepatitis B virus (HBV), HCV, and Hepatitis E virus (HEV). Here, we suggest well-tolerated sofsobuvir-based treatment regimen in patient infected with HBV, HCV, and HEV. Twelve weeks long treatment with sofsobuvir, daclatasvir, ribavirin, and tenofovir resulted in sustained virological response (SVR) and cleared HBV, HCV, and HEV in diabetic and asthmatic patient.

Multiple infections in questing nymphs and adult female Ixodes ricinus ticks collected in a recreational forest in Denmark

During its lifecycle, the generalist Ixodes ricinus takes up three blood meals from a wide selection of vertebrate hosts, some of which are reservoirs for multiple vector-associated pathogens. Since I. ricinus also readily bites humans, pets, and livestock, these hosts are at risk of becoming infected with more than one tick-borne pathogen. Multiple tick-borne infections are a public health concern, since they may increase diversity and duration of symptoms and complicate differential diagnosis and therapy. We used an existing Fluidigm real-time PCR chip to identify the minimum risk of exposure to infected/co-infected ticks in Denmark. We screened 509 nymphs and 504 adult female I. ricinus ticks for 17 different vector-associated pathogenic agents. The questing ticks were collected by flagging during the same season in two consecutive years in Grib forest in the capital region of Copenhagen. Overall, 19.1% of the nymphs and 52.2% of the adult female ticks harbored at least one zoonotic pathogen. The main agents were Borrelia spp., Anaplasma phagocytophilum and Rickettsia helvetica, while Candidatus Neoehrlichia mikurensis and Babesia venatorum both were present in less than 1% of the ticks. In 3.5% of the nymphs and 12.3% of adults we found more than one tick-borne pathogen. Of these, 15% were potentially triple or quadruple infections. Whereas mixed infections with Borrelia were equally distributed among both life stages, the adult ticks hosted 84.5% of the co-infections with different species of tick-borne pathogens, chiefly involving Borrelia species in combination with either R. helvetica or A. phagocytophilum. Statistical analyses indicated non-random co-occurrence of Borrelia spielmanii/Borrelia garinii in both life stages and B. garinii/Borrelia afzelii and B. garinii/Borrelia valaisiana in the nymphs. Although the overall prevalence of ticks hosting more than one infection only constituted 7.9% at the particular site investigated in this study, our results still underline that co-infections should be considered in diagnosis and treatment of tick-borne diseases in northern Europe.

Dual and Triple Infections With Influenza A and B Viruses: A Case-Control Study in Southern Brazil.

Influenza surveillance is important for disease control and should consider possible coinfection with different viruses, which can be associated with disease severity. This study analyzed 34 459 patients with respiratory infection from 2009 to 2018, of whom 8011 were positive for influenza A virus (IAV) or influenza B virus (IBV). We found 18 cases of dual influenza virus infection, including coinfection with 2009 pandemic influenza A(H1N1) virus (A[H1N1]pdm09) and influenza A(H3N2) virus (1 case), A(H1N1)pdm09 and IBV (6 cases), A(H3N2) and IBV (8 cases), and nonsubtyped IAV and IBV (3 cases); and 1 case of triple infection with A(H3N2), A(H1N1)pdm09, and IBV. Compared with 76 monoinfected patients, coinfection was significantly associated with cardiopathy and death. Besides demographic characteristics and clinical symptoms, we assessed vaccination status, antiviral treatment, timeliness of antiviral use, hospitalization, and intensive care unit admission, but no significant differences were found between coinfected and monoinfected cases. Our findings indicate that influenza virus coinfection occurs more often than previously reported and that it can lead to a worse disease outcome.

Gastrointestinal helminths of local chickens slaughtered in live bird markets in Makurdi Metropolis, Benue State, Nigeria

The local chicken constitutes a major part of our poultry population providing eggs and meat for domestic and commercial purposes. They however get very little or no medical attention making them vulnerable to parasitic infection. This study was conducted to determine the prevalence of gastrointestinal (GI) helminths of local chickens slaughtered in four Live Bird Markets (LBMs) in Makurdi between September and December, 2016. A total of 200 gastrointestinal samples were collected from male and female chickens and were examined for GI helminths using the flotation method. A total of 110 chickens were infected with an overall prevalence of 55.0% with 69(34.5%) having single infection, 32(16.0%) double infection, 8(4.0%) triple infection and 1(0.50%) had quadruple infection. Ten species of GI helminths were encountered, three cestodes and seven nematodes. Rallietina species with 73(36.5%) was the most prevalent followed by Ascaridia galli 36(18.0%), Amidostomum anseris 1(0.5%) and Davainea proglottina 1(0.5%) as the least prevalent. There was no statistical significant difference between the four different LBMs (p = 0.058) but there was statistical significant difference in the infection rate based on sex (P= 0.041) and site of preference by the parasite (p = 0.00). Based on location of parasites in the GIT 60.5% of the species were restricted to the small intestine, with the large intestine having 19.5%. This study confirms the presence of GI parasites in the local chickens slaughtered in Makurdi. There is need to institute proper measures in the control of GI helminthes which will further improve the productivity of our local chicken.Keywords: Local chickens; gastrointestinal helminthes; live bird markets; Makurdi

Prevalence of intestinal parasites and its risk factors among food handlers in food services in Nekemte town, west Oromia, Ethiopia.

BackgroundFood-borne diseases are a public-health problem in developed and developing countries. The World Health Organization (WHO) estimated that in developed countries, up to 30% of the population suffers from food borne diseases each year and more in developing countries, where up to 2 million deaths are estimated per years.ObjectiveTo assess the prevalence of intestinal parasites and its associated risk factors among food handlers in Nekemte town.MethodsA cross-sectional study was conducted in Nekemte from April to May, 2016. A total of 240 food handlers were selected using a simple random-sampling technique from hotels, bars, and restaurants. Data were collected using pretested questions and stool-specimen examination for intestinal parasites. For intestinal parasites, stool-sample examinations were done using wet-mount and concentration methods. Data analysis was done using SPSS version 20. Associations among intestinal parasites and risk factors were determined using logistic regression and P<0.05 considered significant.ResultsThe prevalence of intestinal parasites in this study was 52.1%. Entamoeba histolytica/dispar was the most predominant parasite (56.8%), followed by Ascaris lumbricoides (26.4%), Taenia saginata (16%), and hookworm (16.8%). Hygienic practice such as hand washing after toilet by water, hand washing after toilet by water and soap, trimming of finger nail, wearing proper working clothes and shoes were statistically significant with intestinal parasitic infection if not regularly performed (P<0.05).ConclusionThe prevalence of intestinal parasites in this study was high, with single double, and triple infection. Food handlers should practice safe food preparation and food service to reduce the probability of intestinal parasite infection.

Identification of Tomato yellow leaf curl virus, Pepper huasteco yellow vein virus and Pepper golden mosaic virus associated with pepper diseases in northern Mexico

New diseases in pepper plantations were discovered in La Comarca Lagunera (CL) region in September 2014, the severity of which increased by October 2016. Pepper plants exhibited mild and severe yellow leaf mosaic, deformation, stunting and chlorotic leaves. In addition, whiteflies were observed on symptomatic plants, suggesting a possible begomovirus aetiology. In this study, naturally infected pepper plants were collected during three consecutive years to identify the potential begomovirus present in pepper in CL. PCR detection using degenerate and specific primers indicated that 47 out of 49 pepper plants were infected by begomoviruses mainly in mixed infection. The complete begomovirus genomes were isolated from a representative symptomatic pepper plant and two clones for each begomovirus were fully sequenced for the corresponding year of collection (2014 to 2016). Phylogenetic analysis of complete genomes of CL begomovirus pepper isolates indicated a close homology with Tomato yellow leaf curl virus (designated TYLCV-CL) displaying 99.9–100% identity with TYLCV Sinaloa isolate, and the bipartite Pepper huasteco yellow vein virus (designated PHYVV-CL) displaying 94.5% and 84.2% identity with first PHYVV isolate from Tamaulipas for DNA A and DNA B, respectively, and 97–98% identity with PHYVV Sinaloa isolate for DNA B. In 2016, Pepper golden mosaic virus (designated PepGMV-CL) was also found that consisted of DNA-A and DNA-B genome displaying 97% and 93.5% identity with PepGMV isolate Tamaulipas. To our knowledge, this is the first report of a pepper disease associated with TYLCV in double or triple infection either with PHYVV and/or PepGMV in Mexico.

Prevalence of intestinal parasitic infections and associated risk factors among Jawi primary school children, Jawi town, north-west Ethiopia

BackgroundIntestinal parasitic infections (IPIs) have been major public health problems in low income countries primarily affecting school children. Previous studies in Ethiopia have shown high burden of intestinal parasitic infections in most children. In order to gain a deeper insight into the magnitude of the problem more information is needed from different localities where similar studies have not been conducted. The aim of this study was to assess the prevalence of IPIs and associated risk factors among school children in Jawi Primary School, Jawi town, north -west Ethiopia.MethodsA cross-sectional study was conducted from April to June 2017 to assess the prevalence of IPIs and associated risk factors among Jawi Primary School children, Ethiopia. A total of 422 children were selected using age-stratified systematic random sampling technique. Stool samples were examined microscopically using direct wet-mount and formal-ether concentration techniques. A structured questionnaire was used to obtain information regarding the associated risk factors. Data were analyzed using SPSS version 20 and p value < 0.05 was taken as statistically significant.ResultsOf 406 students examined for IPIs, 235 (57.88%) were positive for one or more intestinal parasites. Single, double and triple infections were 41.9, 6.2 and 1.2%, respectively. Overall infection rate was slightly higher in males (51.85%) than in females (45.30%) though the difference was not significant. Higher prevalence rate (about 51–53%) was recorded among 6 to 18 years old children. Prevalence of Giardia lamblia was the highest (19.95%), followed by hookworm (13.8%), Schistosoma mansoni (10.3%), Entamoeba histolytica/dispar (5.9%), Hymenolepsis nana (4.2%), Taenia species (3%) and Ascaris lumbricoides (0.73%), in that order. Among the risk factors assessed, age, hand washing habit before meals, open field defecation habit, consistency of wearing shoes, habit of eating raw and unwashed vegetables, and finger nail cleanliness and trimming habit were found to be the most important predictors associated with high risk of IPIs (p < 0.05).ConclusionHigh prevalence of IPIs among Jawi Primary school children demands improved health education on regular hand washing, latrine use, wearing shoes, cleaning finger nails, not crossing rivers with bare foot and avoiding eating raw vegetables.

PO 8524 MOLECULAR CHARACTERISATION OF THE NOROVIRUS STRAINS RESPONSIBLE FOR ACUTE DIARRHOEA IN CHILDREN UNDER FIVE YEARS OLD HOSPITALISED IN BRAZZAVILLE

BackgroundAcute gastroenteritis is a leading cause of morbidity and mortality among children under five years old worldwide. Viruses are the most common responsible agent and norovirus is second after rotavirus. There is no published data on the occurrence of this agent in Brazzaville. This study aimed to determine the prevalence of norovirus infection and’to evaluate the risk factors in hospitalised children in Brazzaville, Congo.MethodsFrom June 2012 to June 2013, stool samples were collected from children under five years old hospitalised with acute gastroenteritis at Makelekele hospital. Rotavirus and adenovirus infections were already characterised in this population. A total of 545 samples were tested for GI and GII norovirus infections using nested duplex reverse-transcription–polymerase chain reaction with specific primers. The positive samples will be sequenced and analysed to determine the corresponding genotype.ResultsThe GI and GII norovirus infection were found in 148 samples (27, 14%) in this study. Males (28, 85%) were more infected than females (25%) but the difference was not significant. Norovirus infection was detected only in children under 24 months with a higher prevalence in the age group of 7–12 months (p value=0,048). The norovirus infection was detected throughout the year, but it peaked during the dry season (August-September). Dual infection of rotavirus and norovirus was detected in 65 cases (11, 9%), rotavirus-adenovirus in 8 cases (1, 5%), norovirus-adenovirus in 4 cases (0, 73%). Triple infection was detected in 3 cases (0, 55%).ConclusionThis study suggests that norovirus infection is the second cause of gastroenteritis after rotavirus in the study area. However, further surveillance investigations need to be pursued in other sentinel sites of the country.