Wuchereria Bancrofti Research Articles

POS-098 MILKY URINE IN RENAL ALLOGRAFT RECIPIENT - CAN NATIVE KIDNEY BE THE CULPRIT ?

Milky urine can be caused due to both infectious and non-infectious causes. We present a case of 48 years old male, 6 years post kidney transplant who presented as milky urine and was initially managed with diethylcarbamazine (DEC) and intravenous antibiotics. As he was not responding he was evaluated further to be diagnosed as candiduria arising from left native kidney. He had a quick response to left native nephrectomy and liposomal amphotericin. 48 years old male patient, who was 6 years post kidney transplant (Basic disease - diabetic nephropathy), with normal graft function on triple drug immunosupressants ( tacrolimus, mycophenolate and pednisolone) presented with complaint of milky white urine during morning hours only. He was afebrile and had no symptoms of burning or pain during micturition. His urine examination showed few pus cells and was hazy in appearance. Urine cytology for malignant cells showed no evidence of atypical cells. Urine for fat globules was negative though triglycerides were 470 mg/dl and urine was labelled as chylous. His ultrasound was suggestive of mild pelvicalyceal fullness of transplant kidney which was confirmed by CT scan. His leucocyte counts, calcium and phosphorus were within normal range. His early morning smear sample showed no evidence of wuchereria bancrofti microfilariae. He was emperically started on DEC 6mg/kg. After 5 days his urine culture yielded growth of klebsiella species and was treated with injectable ceftriaxone-sulbactum combination as per culture sensitivity report for 2 weeks. He was asymptomatic till the time he was on antibiotics and again developed episodes of milky urine. He also passed some fleshy material in urine was sent for histology. He was posted for cystoscopy which revealed whitish efflux from left native uretric orifice, which was sent for cytology and left uretric catheterization was done. Both the tissue and fluid showed colonies of budding yeast cell and pseudohyphae suggestive of candida species. Considering the non functional status of left native kidney (by imaging and history of anuria pre transplant), left laproscopic native nephrectomy was done and in view of post transplant immunosupressed state, intravenous liposomal amphotericin was given for 2 weeks. He had a quick response to the treatment. In post transplant urinary tract infections, we should also focus on native kidneys especially in diabetic population. There are many case reports of recurrent urinary tract infections post transplant due to native pyelonephritis requiring native nephrectomy.

Microfilaria in achylous hematuria: Can it imitate urolithiasis?

Wuchereria bancrofti is the major species resulting in filarial cases in India. Filariasis may present with various clinical presentations: asymptomatic, microfilaremia, lymphedema, acute adenolymphangitis and chronic lymphatic disease. Microfilariae of W. bancrofti have been detected in various clinical samples, but incidental detection of microfilaria in achylous urine is a rare finding with unexplained pathology. We report a case of microfilaria in achylous urine of a 30-year-old female who presented with pain abdomen and ureteric calculus on ultrasonography.

Ocular filariasis: "Dancing sensation in the anterior chamber".

We report a case of ocular filariasis in a 28–year-old male who presented with a 2-month history of irritated acute red eye. Examination revealed a living and active large worm dancing in the anterior chamber of the left eye causing acute iridocyclitis, leading to drop in vision to 6/36. The worm whose size was approximately 33 mm in length was extracted under local anesthesia in toto using viscoelastics without damaging the ocular structures. Microscopic examination confirmed adult Wuchereria bancrofti.

Microfilaria in fine-needle aspiration cytology of renal mass – an unusual site: A rare case report

In tropical countries like India, filariasis is one among the major public health problems. Most commonly (90%) cases of lymphatic filariasis caused by wuchereria bancrofti, and rest (10%) cases by Brugia malayi. In India, filariasis is transmitted by the bite of culex or mansonia mosquito species. The diagnostic method of choice in filariasis is the detection of microfilaria in peripheral blood film examinations. Microfilaria was incidentally detected in fine-needle aspiration cytology (FNAC) smears from different tissues, organs, and serous cavities. However, the presence of a filarial worm in renal mass aspirate is unusual, and no literature has been published with best of our knowledge. We report a case in which ultrasound-guided FNAC renal mass revealed the presence of microfilaria in the background of renal cell carcinoma cells.

Surveillance system evaluation of lymphatic filariasis in Ga south, Ghana, 2016

Introduction : lymphatic filariasis is one of the neglected tropical diseases caused by nematodes wuchereria bancrofti and transmitted by mosquitoes. It is a chronic disease that causes disfiguring and debilitating symptoms. In Ghana, greater Accra is known to be endemic for lymphatic filariasis. The Country has made significant progress towards the global programme of elimination of lymphatic filariasis (GPELF) by 2020 through mass drug administration with albendazole plus diethylcarbamazine or ivermectin. We evaluated the Lymphatic surveillance system in Ga south to assess whether the objectives of the surveillance system are being met and to assess the attributes of the system. Methods : the updated guideline for evaluating surveillance systems from CDC was used to interviewer-administer questions. Stakeholders actively involved in the operation of the system were interviewed. Data from Ga South Municipal between 2011 to 2015 was collected, reviewed and analyzed

Population genetics of the filarial worm wuchereria bancrofti in a post-treatment region of Papua New Guinea: insights into diversity and life history.

Background Wuchereria bancrofti (Wb) is the primary causative agent of lymphatic filariasis (LF). Our studies of LF in Papua New Guinea (PNG) have shown that it is possible to reduce the prevalence of Wb in humans and mosquitoes through mass drug administration (MDA; diethylcarbamazine with/without ivermectin). While MDAs in the Dreikikir region through 1998 significantly reduced prevalence of Wb infection, parasites continue to be transmitted in the area.MethodsWe sequenced the Wb mitochondrial Cytochrome Oxidase 1 (CO1) gene from 16 people infected with Wb. Patients were selected from 7 villages encompassing both high and moderate annual transmission potentials (ATP). We collected genetic data with the objectives to (i) document contemporary levels of genetic diversity and (ii) distinguish between populations of parasites and hosts across the study area.Principle FindingsWe discovered 109 unique haplotypes currently segregating in the Wb parasite population, with one common haplotype present in 15 out of 16 infections. We found that parasite diversity was similar among people residing within the same village and clustered within transmission zones. For example, in the high transmission area, diversity tended to be more similar between neighboring villages, while in the moderate transmission area, diversity tended to be less similar.ConclusionsIn the Dreikikir region of PNG there are currently high levels of genetic diversity in populations of Wb. High levels of genetic diversity may complicate future MDAs in this region and the presence of dominant haplotypes will require adjustments to current elimination strategies.

Molecular modeling, dynamics, and an insight into the structural inhibition of cofactor independent phosphoglycerate mutase isoform 1 from Wuchereria bancrofti using cheminformatics and mutational studies

Phosphoglycerate mutase catalyzes the interconversion between 2-phosphoglycerate and 3-phosphoglycerate in the glycolytic and gluconeogenic pathways. They exist in two unrelated forms, that is either cofactor (2,3-diphosphoglycerate) dependent or cofactor-independent. These two enzymes have no similarity in amino acid sequence, tertiary structure, and in catalytic mechanism. Wuchereria bancrofti (WB) contains the cofactor-independent form, whereas other organisms can possess the dependent form or both. Since, independent phosphoglycerate mutase (iPGM) is an essential gene for the survival of nematodes, and it has no sequence or structural similarity to the cofactor-dependent phosphoglycerate mutase found in mammals, it represents an attractive drug target for the filarial nematodes. In this current study, a putative cofactor-iPGM gene was identified in the protein sequence of the WB. In the absence of crystal structure, a three-dimensional structure was determined using the homology modeling approximation, and the most stable protein conformation was identified through the molecular dynamics simulation studies, using GROMACS 4.5. Further, the functional or characteristic residues were identified through the sequence analysis, potential inhibitors were short-listed and validated, and potential inhibitors were ranked using the cheminformatics and molecular dynamics simulations studies, Prime MM-GBSA approach, respectively.

Determination of vectorial potential of Mansonia species in the transmission of Wuchereria bancrofti in Tana-Delta District, Coast-Kenya

Background: Wuchereria bancrofti are parasites causing bancroftian filariasis which is transmitted by different species of mosquitoes. Mosquitoes of Anopheles, Culex and Aedes species are known to transmit W. bancrofti parasites. Objective: To determining the potential of Mansonia species; Ma. africanus and Ma. uniformis in the transmission of W. bancrofti. Design: Cross sectional study. Setting: Villages in Tana Delta district, Kenya. Subjects: In-door collected mosquitoes. Results: A total of one thousand, six hundred and sixty two (1632) female mosquitoes were collected by gravid traps, CDC light traps and Pyrethrum spray methods. Of these, 236 representing 14.5% were identified as Mansonia species. Two filarial larvae of stage two (L2) were obtained from the dissected mosquitoes. Polymerase chain reaction assays did not show any amplified W. bancrofti DNA from the obtained larvae or the mosquitoes. Conclusion: There was no evidence that Mansonia species play a role in the transmission of W. bancrofti .

A putative nuclear growth factor-like globular nematode specific protein

Expressed sequence tags (ESTs) are an effective approach for discovery of novel genes. In the current study, approximately 250 ESTs of the cattle parasitic nematode Setaria digitata were examined and a cDNA clone identified whose coding sequence could not be functionally annotated by searching over publicly available genome, protein, EST and STS databases. Here, we report the extensive characterization of this ORF (UP) and its homologues using a bioinformatic approach. Uncharacterized protein (SDUP) of S. digitata consists of 204 amino acids with a predicted molecular weight and isoelectric point of 22.8KDa and 9.94, respectively. A search carried out using SDUP over nucleotide, EST and protein databases at NCBI, NEMBASE3 and Parasite Genome Database (PGD) identified homologous counterparts from the human parasitic nematodes Wuchereria bancrofti (WB), Brugia malayi (BM), Onchocerca volvulus (OV), the mouse filarial worm Litomosoides sigmodontis (LS), swine parasitic nematodes Ascaris suum (AS) and diverged counterparts from the plant parasitic nematode Meloidogyne hapla (MH) and free living nematodes Caenorhabditis elegans (CE) and Caenorhabditis briggsae (CB). Phylogenetic analyses revealed the UPs to be undergoing divergent evolution. A search of the ESTs at PGD showed that UP is expressed in all the stages of BM. Secondary structure analyses of multiply-aligned sequences of homologues using Jpred server indicated UPs to be rich in beta-pleated structures. TMMHH server and beta barrel finder programme indicated, UPs to be neither transmembrane or beta barrels proteins but are likely to be globular proteins. Further, the Motif discovery tool of MEME identified three novel potential motifs for UPS, of which only two are present in CE, CB & MH. Analyses of UPs using Signal IP, TargetP, Psort servers predicted this group of proteins to be devoid of signal peptide cleavage sites, are not mitochondrial targeting peptides but appear to be localized to the nucleus, respectively. Further analyses of the UPs using ScanProsite server for phosphorylation revealed potential sites for cAMP- and cGMP-dependent protein kinase, Protein kinase C and Casein kinase II. Putative functional analysis using ProtFun 2.1 Server indicated UPs to be nonenzymatic, growth factor like protein. Finally, collating all the information derived from bioinformatic analyses, we conclude that the UPs of nematodes are most likely to be expressed at all stages in the life cycle, localized to the nucleus, regulated by phosphorylation, rich in beta-pleated strands and are growth factor like nematode specific proteins.

The Experience of Living with Co-Morbidities of Chronic Lymphatic Filariasis among Patients 15 Years and Older in Developing Countries: A Systematic Review.

Review Objectives The objective of this systematic review is to understand the experiences of persons 15 years and older living with Chronic Lymphatic Filariasis (CLF) in developing countries. The specific review questions are: 1. What are the experiences of persons living with CLF? 2. What are the experiences of persons with CLF about strategies used to prevent/ treat the condition? 3. What is the influence of CLF on social relationships of persons affected? Inclusion criteria Types of Participants The review will consider publications that focus on developing countries and specifically include people of 15 years and older with manifestations of CLF. Phenomena of Interest The review will focus on studies that investigate the experience of living with manifestations of CLF. The review will also focus on studies that address the experiences and subjective opinions of persons that have employed various strategies of prevention/ treatment of the condition. The review will also consider studies that address the social relationships of persons living with CLF.

Subcutaneous filariasis: An unusual case report

<i>Wuchereria bancrofti </i> presented in subcutaneous nodule is a very rare presentation. <i> Wuchereria bancrofti </i> first reported by Bancrofti in Brisbane in 1876 and the name filaria Bancrofti was given in 1877 and the generic name was given in 1878. A 15-year-old male patient's known case of pulmonary Koch's with incidentally detected subcutaneous nodule on right arm pit, cytology from the nodule shows many sheathed microfilaria along with segment of an adult female worm. Wet mount peripheral blood smear shows nocturnal motile microfilaria. The <i> Wuchereria bancrofti </i> is known to be associated with pulmonary Koch's. Nocturnal motility and cytomorphological features differentiate <i> Wuchereria bancrofti </i> from <i> Wuchereria loa loa</i> . After giving diethyl carbamazine (DEC 6 mg/kg) for 21 days without disturbing anti Koch's treatment schedule and microfilaria disappeared from peripheral blood.

Treatment with doxycycline is effective in patients with Wuchereria bancrofti infections,

Treatment with doxycycline is effective in patients with Wuchereria bancrofti infections,

Ivermectin: pharmacology and application in dermatology

Ivermectin is a synthetic derivative of the antiparasitic class of compounds known as avermectins. It is a macrolide endectocide with activity against both endoparasites with cutaneous tropism (Strongyloides stercoralis, Ancylostoma braziliense, Cochliomyia hominivorax, Dermatobia hominis, Filaria bancrofti, Wucheria malayi, Onchocerca volvulus, Loa-loa) and ectoparasites such as Sarcoptes scabies, Pediculus humanus, Demodex folliculorum, and Cheyletiella sp. Ivermectin is of great interest in the treatment of patients with different forms of scabies, head lice, demodecidosis, cutaneous larva migrans, cutaneous larva currens, myiasis, and filariasis.

Microfilariae of wuchereria bancrofti in fine needle aspirate from a subcutaneous cystic swelling - A case report

Microfilariae of wuchereria bancrofti in fine needle aspirate from a subcutaneous cystic swelling - A case report

George Carmichael Low FRCP: twelfth President of the Society and underrated pioneer of tropical medicine

George Carmichael Low, like so many early pioneers of Tropical Medicine, had his origin(s) in Scotland. Following a distinguished undergraduate (and early postgraduate) career, he joined Dr Patrick Manson at the newly established London School of Tropical Medicine in 1899. His first major contribution to the speciality (in 1900) was to demonstrate filariae in the proboscis sheath of mosquitoes which had been infected with Filaria bancrofti in Australia, using a technique recently learned in Heidelberg and Vienna. Shortly afterwards, he led an expedition to the Roman Campagna; this established beyond doubt mosquito-transmission of Plasmodium vivax infection to Homo sapiens. In 1901–1902, Low undertook a demanding tour of the Caribbean where he made important contributions to the understanding of the filariases, and assisted in malaria eradication. In 1902 he led a small team (the Royal Society's first sleeping sickness expedition) to investigate the ‘negro lethargy’ which had emerged in epidemic proportions on the northern shores of Lake Victoria in East Africa. This expedition narrowly failed to establish the aetiological agent ( Trypanosoma sp.) of this disease. Following his return to London, Low became superintendent of the Albert Dock Hospital and from then onwards devoted most of his career to the London School of Tropical Medicine and the Hospital for Tropical Diseases (where he became senior physician). He wrote extensively, in addition to his clinical, teaching and administrative commitments. Perhaps Low's major contribution, however, was in establishing the Society (later Royal) of Tropical Medicine and Hygiene in 1907, with Mr (later Sir) James Cantlie. He devoted a vast amount of time and energy to this Society, becoming the 12th President in 1929–1933. He was largely instrumental in acquiring 26 Portland Place, London (Manson House) for the Society in 1931; the newly established headquarters was officially opened by the Prince of Wales in 1932. Low was also one of the most distinguished ornithologists of his day. Although the magnitude of his contribution to tropical medicine is unquestionable, and although he did receive certain academic honours, Low did not receive a civil honour and was not accepted in the front line of pioneers of the discipline—either in his lifetime or today; the reason(s) for this remain far from clear.

Factors influencing the development of Brugia pahangi Microfilariae in Culex quinquefasciatus and Aedes aegypti Mosquitoes

Culex quinquefasciatus (Wiedemann) mosquitoes, which are refractory to Brugia pahangi (Buckley and Edeson) microfilariae, were fed simultaneously on Wuchereria bancrofti (Cobbold) and B. pahangi microfilariae. A selected stock of Aedes aegypti (L) which is susceptible to both of these filariae was used as a control. The exsheathment and migration rates of B. pahangi in C. quinquefasciatus increased significantly as compared to those of B. pahangi when given as a feed by itself. These two processes did not show any trend with time. On dissection, 12 and 14 days postinfection, 27% of C. quinquefasciatus were found to be infected with an average of two larvae per mosquito. Of the total number of larvae found 78% were W. bancrofti while 22% were B. pahangi. Feeding C. quinquefasciatus on in vitro exsheathed B. pahangi microfilariae suspended in serum did not increase the rate of migration, whereas 71-100% of Ae. aegypti became infected with a mean of 3.5 larvae per mosquito. Inoculation of C. quinquefasciatus mosquitoes into the thorax and abdomen with exsheathed B. pahangi did not increase their infection rate, whereas in Ae. aegypti 67-82% became infected. Culex quinquefasciatus (Wiedemann), ces moustiques qui sont refractaires aux microfilaires du Brugia pahangi ont ete nourris simultanement avec des microfilaires du Wuchereria bancrofti (Cobbold) et du B. pahangi. Pour controler, une ligne selectionnee d’Aedes aegypti, sensibles a ces deux filiaires, a ete utilisee. Les taux de mue et de migration du B. pahangi dans les C. quinquefasciatus ont augmente d’une maniere plus significative que ceux des B. pahangi alimentes en Wuchereria bancrofti. Ces deux procedes n’ont rien demontre. Lors de la dissection des jours 12 et 14 postinfection, 27% des C. quinquefasciatus ont ete infectes avec une moyenne de 2 larves par moustiques. 78% du nombre total des larves trouvees furent des W. bancrofti tandis que 22% etaient des B. pahangi. Alimenter in vitro les C. quinquefasciatus avec les microfiiaires decouverts, baignant dans le serum n’a pas augmente le taux de migration alors que 71 % des Ae. aegypti devinrent infectes a raison de 3.5 larves par moustique. L’innoculation de B. pahangi mues dans le thorax et abdomen des moustiques C. quinquefasciatus, n’a pas augmente leur taux d’infection, tandis que dans l’Ae. aegypti 67.82% devinrent infectes.

Filarial Chyluria in Japan

The clinical manifestations of bancroftian filariasis may be roughly classified into three stages: subclinical, acute, and chronic. Filaria bancrofti has a special predilection for the lymphatic system. After a long period of so-called “incubation,” the symptoms of the acute stage appear, e.g., repeated fever attacks, called “Kusafurui,” often associated with lymphangioadenitis. The chronic complications, occurring from five to twenty years after the primary infestation, are represented by various conditions, such as elephantiasis of the leg, hydrocele testis, chyluria, or permanent swelling of the lymph nodes. A survey of filariasis among 7,766 people in Okinawa by Saigo (1) showed an incidence of 14.24 per cent for microfilaremia, 1.07 per cent for chyluria, and 1.94 per cent for elephantiasis. Sassa (2) found a microfilaremia incidence of 10.76 per cent in 22,698 people in the Amami-Oshima and Okierabu Islands. These islands are far south of Japan and just north of Okinawa. Since lymphographic demonstr...

ATTEMPTS TO TRANSMIT WUCHERERIA BANCROFTI TO CATS AND TO A TOQUE MONKEY.

ATTEMPTS TO TRANSMIT WUCHERERIA BANCROFTI TO CATS AND TO A TOQUE MONKEY.

NATURAL AND EXPERIMENTAL INFECTION OF BEDBUGS WITH WUCHERERIA BANCROFTI IN BRITISH GUIANA.

Summary In Georgetown, British Guiana, 100 Cimex hemipterus (older nymphs and adults) were collected from a bed used by two persons who were positive and two persons who were negative for microfilariae of Wuchereria bancrofti. Eighty-three of the bedbugs contained at least one living or dead parasite. Early first-stage larvae were found in the abdomen, thorax, legs, and antennae. Eight bugs had a total of 9 sausage forms, of which 2 were dead and 3 apparently moribund. Also found were 2 sluggish second-stage larvae, and 3 infective larvae of which 2 were non-motile. Rupture of the stomach from overengorgement and consequent release of the parasites into the hemocoele was observed in 12 bugs. The development of W. bancrofti was studied in five lots of bedbugs fed on a human carrier having 165 to 200 microfilariae per 20 cmm of blood at the time of feeding. Little development occurred in 100 first- and second-instar nymphs, which sucked up relatively few parasites. Four lots of 50 older bedbugs were given, respectively, 0, 1, 2, and 3 non-infective blood meals at 4-day intervals after the infective meal. It was found that as the number of additional feedings increased, the parasites survived longer and developed further. No infective larvae had developed by the 20th day. Because the mortality of larvae was high in both natural and experimental infections, and only a few developed to more advanced stages, it is concluded that C. hemipterus is not a suitable host for W. bancrofti.

A CASE OF WUCHERERIASIS ON THE SPERMATIC CORD

As taken up in the preface the diagnosis of Wuchereriasis on the spermatic cord is easy to make when chyluria or elephantiasis appear simultaneously, or the occurrence of the characteristic fever access in the past and the presence of microfilaria in blood can be confirmed. But when we touch only an induration in the scrotum the differentiation of it from tuberculosis of the spermatic cord, varicocele, tumor of the spermatic cord, etc. Is very difficult and diagnosis should be made with caution. As for the genetic mechanism of the ailment concerned, as Shida and Fukuda, Nakamura and Ichimura have indicated, the Filaria bancro fti penetrates into the lymph vessel of spermatic cord and brings about a lymphatic circulatory disturbance with a mechanical lesion caused by worms, which results in the cystic dilatation of the local lymph vessel. As long as the lesion cannot be removed at the stadium, the canal dilatation seems to develop into a hypertrophy of the wall until inflammatory regressive degeneration is brought about.