1.  Title: Impact of intestinal permeability, inflammation status and parasitic infections on infant growth faltering in rural Bangladesh. Author: Goto R; Mascie-Taylor CG; Lunn PG Source: British Journal of Nutrition. 2009 May;101(10):1509-16. Abstract: A longitudinal study of 298 rural Bangladeshi infants found evidence of growth faltering starting at 3 months of age. Anthropometric status declined substantially in the first 2 years of life, with weight-for-height (WHZ) falling from - 0.49 to - 1.75, weight-for-age (WAZ) from - 1.18 to - 2.87 and height-for-age (HAZ) from - 1.00 to - 1.88. Higher concentrations of the acute-phase protein alpha-1-acid glycoprotein (AGP) and higher gut mucosal damage (as signified by raised lactulose:mannitol (L:M) ratios) were both associated with chronic malnutrition as indicated by poorer HAZ and WAZ scores (P = 0.011 and 0.005 for AGP and 0.039 and 0.019 for L:M ratio, respectively). Higher Hb levels were related to improved z-scores, while elevation of Giardia-specific IgM titre (GSIgM) was associated with poor WAZ and WHZ (P = 0.015 and 0.039, respectively). IgG did not show any significant association with z-scores and the L:M ratio did not correlate with any of the inflammation markers or Giardia infection. The prevalence of geohelminth infections was low (only 4 % in the total study period). However, the level of GSIgM indicated high endemicity of Giardia infection from early in life, although very few cysts were detected from stool samples. These findings suggest that rural Bangladeshi infants are being exposed to high levels of infection with concomitant gut damage and growth faltering. Language: English Keywords: BANGLADESH | RURAL AREAS | RESEARCH REPORT | LONGITUDINAL STUDIES | INFANT | PARASITIC DISEASES | GASTROINTESTINAL EFFECTS | GROWTH | MALNUTRITION | ANTHROPOMETRY | LABORATORY PROCEDURES | IMMUNOLOGIC FACTORS | Developing Countries | Asia, Southern | Asia | Geographic Factors | Population | Studies | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Diseases | Physiology | Biology | Child Development | Nutrition Disorders | Measurement | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Immunity | Immune System Document Number: 342008 |
| 2. Peer Reviewed Title: Geophagy (Soil-eating) in relation to Anemia and Helminth infection among HIV-infected pregnant women in Tanzania. Author: Kawai K; Saathoff E; Antelman G; Msamanga G; Fawzi WW Source: American Journal of Tropical Medicine and Hygiene. 2009 Jan;80(1):36-43. Abstract: Geophagy, the regular and deliberate consumption of soil, is prevalent among pregnant women in sub-Saharan Africa. We examined the associations of geophagy with anemia and helminth infection among 971 human immunodeficiency virus (HIV)-positive pregnant women in Tanzania. About 29% of pregnant women regularly consumed soil. Occupation, marital status, and gestational age were associated with geophagy. Ascaris lumbricoides infection was associated with the prevalence of geophagy (adjusted-prevalence ratio 1.81; 95% confidence interval [CI] = 1.37-2.40); however, hookworm, Trichuris trichiura, and Strongyloides stercoralis showed no association. Anemia and red blood cell characteristics suggestive of iron deficiency were strongly correlated with geophagy at baseline. In longitudinal analyses, we found evidence suggesting that soil consumption may be associated with an increased risk of anemia (adjusted-relative risk 1.16; 95% CI = 0.98-1.36) and a lower hemoglobin concentration (adjusted-mean difference -3.8 g/L; 95% CI [-7.3, -0.4]). Pregnant women should be informed about the potential risks associated with soil consumption. Language: English Keywords: TANZANIA | RESEARCH REPORT | EPIDEMIOLOGIC METHODS | CLINICAL RESEARCH | PERSONS LIVING WITH HIV/AIDS | WOMEN IN DEVELOPMENT | PREGNANT WOMEN | PREVALENCE | PARASITIC DISEASES | ANEMIA | COMPLICATIONS | OCCUPATIONS | MARITAL STATUS | GESTATIONAL AGE | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Research Methodology | Persons Living With HIV/AIDS | HIV Infections | Viral Diseases | Diseases | Economic Development | Economic Factors | Population Characteristics | Demographic Factors | Population | Measurement | Human Resources | Nuptiality | Fetus | Pregnancy | Reproduction Document Number: 330314 |
| 3. Peer Reviewed Title: Relationship between intestinal parasitic infection in children and soil contamination in an urban slum. Author: Korkes F; Kumagai FU; Belfort RN; Szejnfeld D; Abud TG; Kleinman A; Florez GM; Szejnfeld T; Chieffi PP Source: Journal of Tropical Pediatrics. 2009 Feb;55(1):42-5. Abstract: PURPOSE: Urban slums are well known for their high infant mortality and morbidity rates, and parasitic infections seem to be a common problem among these children. The aim of the present study was to determine protozoa and nematodes prevalence among children of a selected community located in Sao Paulo, Brazil, and access the relation between soil and children infection. METHODS: Soil contamination samples from 15 strategic locations in the slum area as well as stool samples (examined for protozoa and nematodes through five different methods) from 120 children aged 2-14 years (49% M: 51% F, mean +/- SD = 7.9 +/- 3.8 years) were assessed in a cross-sectional study. Children's domicile locations were determined, and a comparative analysis was undertaken to correlate children and soil infection. RESULTS: Overall infection rate was 30.8% (n = 37), without difference between genders. The most frequent intestinal protozoa were Endolimax nana (20.8%), Entamoeba coli (15.8%) and Giardia lamblia (16.7%). Frequencies of Ascaris lumbricoides and Enterobius vermicularis in stool samples were 2.5 and 1.7%, respectively. No cases of hookworms, Schistosoma mansoni or Tricuris trichiura were identified. Polyparasitism occurred in 10.8% of the children, while 69.2% were free of parasitic infections. Out of the 15 soil samples analyzed, Ascaris sp. eggs were found in 20% and hookworm eggs in 6.7%. CONCLUSION: Helminth infection is not as prevalent as previously reported in urban slums in Sao Paulo, neither as clinical disease nor in soil samples. Protozoa intestinal infection, however, is still frequent in some marginalized populations in Sao Paulo. Improvement in living standards, mostly sanitation might decrease the prevalence of these diseases. Language: English Keywords: BRAZIL | RESEARCH REPORT | EPIDEMIOLOGIC METHODS | CLINICAL RESEARCH | CROSS SECTIONAL ANALYSIS | CHILDREN | SLUMS | PREVALENCE | SOIL QUALITY | ENVIRONMENTAL POLLUTION | PARASITIC DISEASES | GASTROINTESTINAL EFFECTS | SCHISTOSOMIASIS | Developing Countries | South America, Eastern | South America | Latin America | Americas | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Urbanization | Urban Population Distribution | Population Distribution | Geographic Factors | Measurement | Environment | Environmental Degradation | Diseases | Physiology | Biology Document Number: 330412 |
| 4. Title: Aetiology of acute gastro-enteritis in children at Saint Camille Medical Centre, Ouagadougou, Burkina Faso. Author: Simpore J; Ouermi D; Ilboudo D; Kabre A; Zeba B; Pietra V; Pignatelli S; Nikiema JB; Kabre GB; Caligaris S; Schumacher F; Castelli F Source: Pakistan Journal of Biological Sciences. 2009 Feb 1;12(3):258-63. Abstract: The present study aims at identifying the infectious agents responsible for child Acute GastroEnteritis (AGE) in Ouagadougou. From May 5 2006 to June 22 2008, 648 children aged from 2 to 41 months, with at least an average of 3 loose stools per day have been enrolled for coproculture, parasitology and virology test. Among them, 34 (5.25%) were HIV seropositive. A single sample of faeces from each child was used to identify enteropathogens. An infectious aetiology was identified in 41.20% of cases. The pathogenic agents detected as responsible for the AGE are: Rotavirus 21.1%; Adenovirus 1.9%; Giardia 7.6% Entamoeba; 1.08%; entero-pathogenic E. coli 41.7%; Salmonella 3.40%; Shigella 1.85% and Yersinia 1.70%. Conclusion: Therefore, these AGE etiologic agents constitute a problem of public health in Burkina Faso. Their control for the child would require: (1) a regular paediatric and clinical follow up; (2) health education of the population for food hygiene and (3) in case of absence of HIV infection in the mother, a promotion of exclusive breast-feeding up to the age of 4 months. Language: English Keywords: BURKINA FASO | RESEARCH REPORT | SAMPLING STUDIES | CHILDREN | GASTROINTESTINAL EFFECTS | DIARRHEA | ROTAVIRUS | BACTERIAL AND FUNGAL DISEASES | PARASITIC DISEASES | HIV INFECTIONS | PREVALENCE | ANTHROPOMETRY | Africa, Western | Africa, Sub Saharan | Africa | Developing Countries | Studies | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Physiology | Biology | Diseases | Viral Diseases | Infections | Measurement Document Number: 342150 |
| 5. Peer Reviewed Title: Malaria and intestinal helminth co-infection among pregnant women in Ghana: prevalence and risk factors. Author: Yatich NJ; Yi J; Agbenyega T; Turpin A; Rayner JC; Stiles JK; Ellis WO; Funkhouser E; Ehiri JE; Williams JH; Jolly PE Source: American Journal of Tropical Medicine and Hygiene. 2009 Jun;80(6):896-901. Abstract: Both malaria and intestinal helminths are endemic in sub-Saharan Africa, and their co-infection occurs commonly. This cross-sectional study assessed the prevalence of malaria and intestinal helminth co-infection in a sample of > 700 pregnant women in Ghana and identified risk factors for co-infection. The prevalence of malaria infection, intestinal helminth infection(s), and co-infection was 36.3%, 25.7%, and 16.6%, respectively. Women with intestinal helminth infection(s) were 4.8 times more likely to have malaria infection. Young age, low income, being single, and being primigravid were each associated with increased odds of co-infection. These associations were present when assessed separately for primi- and multigravid women, but the strength of associations varied considerably for the two groups of women. Young age had the strongest association among both primigravid (odds ratio = 5.2) and multigravid (odds ratio = 3.2) women. This study shows relatively high prevalence rates of malaria, intestinal helminths, and co-infection in pregnant women in Ghana. Language: English Keywords: GHANA | RESEARCH REPORT | CROSS SECTIONAL ANALYSIS | SAMPLING STUDIES | PREGNANT WOMEN | MALARIA | PARASITIC DISEASES | GASTROINTESTINAL EFFECTS | PREVALENCE | RISK FACTORS | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Research Methodology | Studies | Population Characteristics | Demographic Factors | Population | Diseases | Physiology | Biology | Measurement | Health Document Number: 341763 |
6.  Peer Reviewed Title: Demographic and biochemical features associated to children infected with intestinal helminths. Author: Airauhi LU; Idogun ES Source: Pakistan Journal of Medical Sciences. 2008 Apr-Jun;24 Pt 1(2):269-273. Abstract: The objective of the study was to characterize demographic and clinical presentations of children with intestinal helminthiasis and also assess the effects of ascariasis on some plasma biochemical parameters. It was a cross-sectional community-based study carried out amongst rural children aged between 0-16 years. One stool sample per child was collected and examined microscopically for parasites. Stool smear positive children were studied and evaluated for clinical signs and symptoms. Blood was obtained from them and total protein, serum albumin, packed cell volume, vitamin C and E were determined in them as well as among children with stool parasite negative which served as controls. A total of 239 children were enrolled and had their stool samples collected, 147(61.5%) of the stool were infected. The most prevalent intestinal helminth was Ascaris lumbricoides 105(43.9%), Trichuris trichuria 28(11.7%) and Hookworm 14(5.9%). The commonest complain among the children was diarrhea 40(27.2%) and theleast vomiting 4(2.7%). The commonest clinical finding was pallor 15(10.2%) and the least wheezing 3(2.0%). Biochemically, the plasma total protein, albumin, Vitamin C and E as well as the PCV were significantly reduced in children with moderate and heavy Ascaris infection than controls. Heavy and moderate ascariasis are associated with various morbidities evident by both clinical and biochemical findings. Our findings should re-emphasize the need for all stakeholders to support and implement community-based control programmes of intestinal helminthiasis in Nigeria and other tropical countries. (author's) Language: English Keywords: NIGERIA | RESEARCH REPORT | CROSS SECTIONAL ANALYSIS | CHILDREN | RURAL POPULATION | GASTROINTESTINAL EFFECTS | PARASITIC DISEASES | LABORATORY EXAMINATIONS AND DIAGNOSES | SIGNS AND SYMPTOMS | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Physiology | Biology | Diseases | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 327271 |
| 7. Peer Reviewed Title: Anaemia and iron deficiency anaemia among aboriginal schoolchildren in rural Peninsular Malaysia: An update on a continuing problem. Author: Al-Mekhlafi MH; Surin J; Atiya AS; Ariffin WA; Mahdy AK Source: Transactions of the Royal Society of Tropical Medicine and Hygiene. 2008 Oct;102(10):1046-1052. Abstract: A cross-sectional study to determine the current prevalence of anaemia and iron deficiency anaemia (IDA) and to investigate the possible risk factors for IDA was carried out on 241 aboriginal schoolchildren (120 boys, 121 girls) aged 7-12 years and living in remote areas in Pos Betau, Pahang, Malaysia. Haemoglobin (Hb) level was measured and serum iron status was assessed by serum ferritin (SF), serum iron (SI) and total iron binding capacity measurements. Socioeconomic data were collected using pre-tested questionnaires. All children were screened for intestinal parasitic infections. Overall, 48.5% (95% CI 42.3-54.8) of children were anaemic (Hb < 12 g/dl). The prevalence of IDA was 34% (95% CI 28.3-40.2), which accounted for 70.1% of the anaemia cases. The prevalence of IDA was significantly higher in females than males. Low levels of mothers' education and low household income were identified as risk factors for IDA. Severe trichuriasis also found to be associated with low SF and SI. Logistic regression confirmed low levels of mothers' education and gender as significant risk factors for IDA. Improvement of socioeconomic status and health education together with periodic mass deworming should be included in public health strategies for the control and prevention of anaemia and IDA in this population. (author's) Language: English Keywords: MALAYSIA | RESEARCH REPORT | CROSS SECTIONAL ANALYSIS | ANEMIA | IRON | DEFICIENCY DISEASES | PARASITIC DISEASES | RISK FACTORS | SCHOOL AGE POPULATION | CHILDREN | RURAL AREAS | BODY HEIGHT | BODY WEIGHT | Developing Countries | Asia, Southeastern | Asia | Research Methodology | Diseases | Metals | Vitamins and Minerals | Physiology | Biology | Nutrition Disorders | Population Characteristics | Demographic Factors | Population | Youth | Age Factors | Geographic Factors Document Number: 328166 |
| 8. Peer Reviewed Title: Complexity of the msp2 locus and the severity of childhood malaria, in south-western Nigeria. Author: Amodu OK; Oyedeji SI; Ntoumi F; Orimadegun AE; Gbadegesin RA Source: Annals of Tropical Medicine and Parasitology. 2008;102(2):95-102. Abstract: As the genetic diversity of Plasmodium falciparum infections in humans is implicated in the pathogenesis of malaria, the association between P. falciparum diversity at the merozoite surface protein-2 (msp2) locus and the severity of childhood malaria was investigated in Ibadan, in south-western Nigeria. The 400 children enrolled had acute uncomplicated malaria (144), cerebral malaria (64), severe malarial anaemia (67) or asymptomatic infections with P. falciparum (125). Nested PCR was used to investigate the msp2 genotype(s) of the parasites infecting each child. In terms of the complexity of infection and frequency of polyinfection, the children with asymptomatic infection were significantly different from those with uncomplicated malaria or severe malaria. The median number of FC27 alleles detected was higher in the asymptomatic children than in the symptomatic. After controlling for age and level of parasitaemia (with 'asymptomatic infection' as the reference category), a child in whom no FC27 alleles were detected was found to be at five-fold greater risk of uncomplicated malaria, and a child without polyinfection was found to have a three-fold increased risk of severe malarial anaemia and a six-fold increased risk of cerebral malaria. It therefore appears that msp2 genotypes are associated with asymptomatic carriage and that children with mono-infections are more likely to develop severe malaria than children with polyinfections. (author's) Language: English Keywords: NIGERIA | RESEARCH REPORT | CLINICAL TRIALS | STATISTICAL STUDIES | CHILD | MALARIA | POPULATION GENETICS | PARASITIC DISEASES | SIGNS AND SYMPTOMS | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Clinical Research | Research Methodology | Studies | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Diseases | Genetics | Biology Document Number: 325067 |
| 9. Title: Role of Escherichia coli in acute diarrhoea in tribal preschool children of central India. Author: Anvikar AR; Dolla C; Dutta S; Rao VG; Gadge VS Source: Paediatric and Perinatal Epidemiology. 2008 Jan;22(1):40-46. Abstract: Five hundred and eighty preschool children belonging to tribal areas of Madhya Pradesh were followed up daily for the presence of diarrhoea for a period of 1 year. In all, 1236 episodes of diarrhoea were recorded with an average of 2.13 episodes per child per year. Stool samples were collected during 780 episodes. They were cultured to isolate Escherichia coli as well as non-E. coli enteropathogens. Ten different genes were detected to identify all diarrhoeagenic E. coli using multiplex polymerase chain reaction. Enteroaggregative E. coli was the commonest diarrhoeagenic E. coli and was isolated from 64 children, followed by enteropathogenic E. coli (27), enterotoxigenic E. coli (10) and enterohaemorrhagic E. coli (2). Other enteropathogens detected were bacteria such as Shigella sp, Vibrio cholerae and Salmonella sp, parasites such as Giardia lamblia and Entameba histolytica, and rotavirus. Most of the bacterial pathogens were multi-drug resistant. The study shows that diarrhoeagenic E. coli contribute significantly to the burden of acute diarrhoea in tribal preschool children. (author's) Language: English Keywords: INDIA | RESEARCH REPORT | FOLLOW-UP STUDIES | GENETIC TECHNIQUES | CLINICAL RESEARCH | EPIDEMIOLOGIC METHODS | CHILDREN | INDIGENOUS POPULATION | BACTERIAL AND FUNGAL DISEASES | DIARRHEA | DRUG RESISTANCE | PREVALENCE | PARASITIC DISEASES | ROTAVIRUS | Developing Countries | Asia, Southern | Asia | Studies | Research Methodology | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Infections | Diseases | Treatment | Measurement | Viral Diseases Document Number: 323206 |
| 10. Peer Reviewed Title: Cryptosporidium species causing acute diarrhoea in children in Antananarivo, Madagascar. Author: Areeshi M; Dove W; Papaventsis D; Gatei W; Combe P Source: Annals of Tropical Medicine and Parasitology. 2008 Jun;102(4):309-315. Abstract: A 13-month study of children presenting with acute diarrhoeal disease at hospitals and rehydration clinics in Antananarivo, Madagascar, was undertaken between May 2004 and May 2005. Cryptosporidiosis accounted for diarrhoea in 12 (5.6%) of the 215 children investigated. Cases of cryptosporidiosis were detected only in the rainy season, and the median age of cases was 13.5 months (range = 1 day-27 months). As 11 of the cases of cryptosporidiosis were caused by Cryptosporidium hominis and only one by C. parvum, most of the cases were probably the result of anthroponotic transmission. GP60/45/15 gene polymorphisms indicated that the causative pathogens were of subtypes Ia, Id, Ie and IIc. (author's) Language: English Keywords: MADAGASCAR | RESEARCH REPORT | CHILDREN | AGE FACTORS | DIARRHEA | ORAL REHYDRATION | PARASITIC DISEASES | ROTAVIRUS | ANTIGENS | TRANSMISSION | LABORATORY PROCEDURES | Africa, Southern | Africa, Sub Saharan | Africa | Developing Countries | Youth | Population Characteristics | Demographic Factors | Population | Diseases | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Viral Diseases | Immunologic Factors | Immunity | Immune System | Physiology | Biology | Infections | Laboratory Examinations and Diagnoses | Examinations and Diagnoses Document Number: 327217 |
| 11. Peer Reviewed Title: Cryptosporidium and Giardia infection and drinking water sources among children in Lege Dini, Ethiopia. Author: Ayalew D; Boelee E; Endeshaw T; Petros B Source: Tropical Medicine and International Health. 2008 Apr;13(4):1-4. Abstract: We assessed the prevalence of Cryptosporidium and Giardia infections among children using protected and unprotected water sources in the Lege Dini watershed, Eastern Ethiopia, in November 2005 and May 2006. Of 655 children examined, 80 (12.2%) were infected with Cryptosporidium and 231 (35.3%) with Giardia. No difference was observed in the prevalence of cryptosporidiosis and giardiasis (P greater than 0.05) between children drinking water from protected and unprotected sources. (author's) Language: English Keywords: ETHIOPIA | RESEARCH REPORT | EPIDEMIOLOGIC METHODS | CLINICAL RESEARCH | CHILDREN | WATER SUPPLY | SANITATION | INFECTION TRANSMISSION | PARASITIC DISEASES | SEASONAL VARIATION | GASTROINTESTINAL EFFECTS | PREVALENCE | Developing Countries | Africa, Eastern | Africa, Sub Saharan | Africa | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Natural Resources | Environment | Public Health | Health | Infections | Diseases | Population Dynamics | Physiology | Biology | Measurement Document Number: 324681 |
| 12. Title: Enteric parasitic infections HIV/AIDS patients before and after the highly active antiretroviral therapy. Author: Bachur TP; Vale JM; Coelho IC; de Queiroz TR; Chaves CD Source: Brazilian Journal of Infectious Diseases. 2008 Apr;12(2):115-122. Abstract: Enteroparasites are related to gastrointestinal alterations among patients with HIV/AIDS, some causing severe manifestations in the period before the institution of the highly active antiretroviral therapy (HAART). The prevalence of enteroparasitoses in patients with HIV/AIDS seen at two hospitals in Ceará, Brazil, was compared in the pre-HAART (Group 1; n = 482) and HAART (Group 2; n = 100) eras. Fecal parasitologic examinations (FPE) were performed using the direct, Lutz, Baermann-Moraes and modified Ziehl-Neelsen methods. The following parasites were detected in Groups 1 and 2, respectively: Strongyloides stercoralis -30.1% and 11% (p<0.0001), Ascaris lumbricoides -15.6% and 2% (p<0.0001), hookworms -13.7% and 2% (p<0.0001), Trichuris trichiura -13.1% and 1% (p<0.0001), Hymenolepis nana -0 and 1% (p = 0.1718), Giardia duodenalis -7.9% and 1% (p = 0.0076), Entamoeba histolytica/ dispar -3.3% and 1% (p = 0.3301), Isospora belli -4.8% and 1% (p = 0.0993), Cryptosporidium sp. -8.1% and 0 (p = 0.0007), and non-pathogenic protozoans as well. There was a significant reduction in the prevalence of enteroparasites between the eras (63.9% to 24%; p<0.0001). In the HAART era, the following observations were made: greater frequency of enteroparasites in patients without antiretroviral therapy (p = 0.0575), as in those with AIDS (p = 0.08), and diarrhea (36% of the patients); lack of association with positive FPE (p = 0.626); and non-detection of Cryptosporidium sp. Strongyloides stercoralis showed an elevated prevalence in the two eras and was more frequent in men (32.41%) than women (19.04%) of Group 1 (p = 0.018), a finding suggesting the transmission of the helminth through sodomy. The advent of the HAART modified the profile of opportunistic infections, including parasites, probably due to the reconstitution of cellular immunity and the direct action of HAART on the parasites. (author's) Language: English Keywords: BRAZIL | RESEARCH REPORT | CLINICAL RESEARCH | COMPARATIVE STUDIES | EPIDEMIOLOGIC METHODS | PERSONS LIVING WITH HIV/AIDS | GASTROINTESTINAL EFFECTS | ANTIRETROVIRAL THERAPY | PARASITIC DISEASES | HIV INFECTIONS | COMPLICATIONS | AIDS | PREVALENCE | SEX FACTORS | IMMUNITY, CELLULAR | South America, Eastern | South America | Latin America | Americas | Developing Countries | Research Methodology | Studies | Viral Diseases | Diseases | Physiology | Biology | HIV | Measurement | Population Characteristics | Demographic Factors | Population | Immunity | Immune System Document Number: 329200 |
| 13. Title: Enteric parasitic infections in HIV/AIDS patients before and after the highly active antiretroviral therapy. Author: Bachur TP; Vale JM; Coelho IC; Queiroz TR; Chaves Cde S Source: Brazilian Journal of Infectious Diseases. 2008 Apr;12(2):115-22. Abstract: Enteroparasites are related to gastrointestinal alterations among patients with HIV/AIDS, some causing severe manifestations in the period before the institution of the highly active antiretroviral therapy (HAART). The prevalence of enteroparasitoses in patients with HIV/AIDS seen at two hospitals in Ceara , Brazil, was compared in the pre-HAART (Group 1; n = 482) and HAART (Group 2; n = 100) eras. Fecal parasitologic examinations (FPE) were performed using the direct, Lutz, Baermann-Moraes and modified Ziehl-Neelsen methods. The following parasites were detected in Groups 1 and 2, respectively: Strongyloides stercoralis--30.1% and 11% (p<0.0001), Ascaris lumbricoides--15.6% and 2% (p<0.0001), hookworms--3.7% and 2% (p<0.0001), Trichuris trichiura--13.1% and 1% (p<0.0001), Hymenolepis nana--0 and 1% (p = 0.1718), Giardia duodenalis--7.9% and 1% (p = 0.0076), Entamoeba histolytica/dispar--3.3% and 1% (p = 0.3301), Isospora belli--4.8% and 1% (p = 0.0993), Cryptosporidium sp.--8.1% and 0 (p = 0.0007), and non-pathogenic protozoans as well. There was a significant reduction in the prevalence of enteroparasites between the eras (63.9% to 24%; p<0.0001). In the HAART era, the following observations were made: greater frequency of enteroparasites in patients without antiretroviral therapy (p = 0.0575), as in those with AIDS (p = 0.08), and diarrhea (36% of the patients); lack of association with positive FPE (p = 0.626); and non-detection of Cryptosporidium sp. Strongyloides stercoralis showed an elevated prevalence in the two eras and was more frequent in men (32.41%) than women (19.04%) of Group 1 (p = 0.018), a finding suggesting the transmission of the helminth through sodomy. The advent of the HAART modified the profile of opportunistic infections, including parasites, probably due to the reconstitution of cellular immunity and the direct action of HAART on the parasites. Language: English Keywords: BRAZIL | RESEARCH REPORT | EPIDEMIOLOGIC METHODS | CLINICAL RESEARCH | PERSONS LIVING WITH HIV/AIDS | PREVALENCE | GASTROINTESTINAL EFFECTS | ANTIRETROVIRAL THERAPY | HIV INFECTIONS | COMPLICATIONS | PARASITIC DISEASES | AIDS | SEX FACTORS | ANAL SEX | IMMUNITY, CELLULAR | Developing Countries | South America, Eastern | South America | Latin America | Americas | Research Methodology | Persons Living With HIV/AIDS | Viral Diseases | Diseases | Measurement | Physiology | Biology | HIV | Population Characteristics | Demographic Factors | Population | Sex Behavior | Behavior | Immunity | Immune System Document Number: 329832 |
| 14. Peer Reviewed Title: High prevalence of Entamoeba moshkovskii in a Tanzanian HIV population. Author: Beck DL; Dogan N; Maro V; Sam NE; Shao J Source: Acta Tropica. 2008 Jul;107(1):48-49. Abstract: Entamoeba moshkovskii and Entamoeba dispar are microscopically indistinguishable from the pathogenic species Entamoeba histolytica. There are limited data on the prevalence of these commensal infections from Africa. We utilized PCR and antigen detection to evaluate the carriage rate of E. moshkovskii, E. dispar, and E. histolytica infection in stool from a cohort of HIV-suspected or confirmed inpatients from Tanzania. E. histolytica was detected by ELISA in 4% (5/118) while E. moshkovskii and E. dispar were detected by PCR in 13% (18/136) and 5% (7/136) of individuals, respectively (P less than 0.05). Supporting their commensal nature, neither E. moshkovskii nor E. dispar infection was statistically associated with HIV status, CD4 count, or the presence of diarrhea. These data suggest E. moshkovskii is a common infection in HIV-infected individuals in northern Tanzania and supports the concept that the microscopic detection of Entamoeba should be interpreted cautiously. (author's) Language: English Keywords: TANZANIA | RESEARCH REPORT | METHODOLOGICAL STUDIES | CLINICAL RESEARCH | EPIDEMIOLOGIC METHODS | PERSONS LIVING WITH HIV/AIDS | PREVALENCE | PARASITIC DISEASES | HIV INFECTIONS | COMPLICATIONS | LABORATORY EXAMINATIONS AND DIAGNOSES | Developing Countries | Africa, Eastern | Africa, Sub Saharan | Africa | Research Methodology | Persons Living With HIV/AIDS | Viral Diseases | Diseases | Measurement | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 308646 |
| 15. Peer Reviewed Title: Cost and cost-effectiveness of nationwide school-based helminth control in Uganda: Intra-country variation and effects of scaling-up. Author: Brooker S; Kabatereine NB; Fleming F; Devlin N Source: Health Policy and Planning. 2008 Jan;23(1):24-35. Abstract: Estimates of cost and cost-effectiveness are typically based on a limited number of small-scale studies with no investigation of the existence of economies to scale or intra-country variation in cost and cost-effectiveness. This information gap hinders the efficient allocation of health care resources and the ability to generalize estimates to other settings. The current study investigates the intracountry variation in the cost and cost-effectiveness of nationwide school-based treatment of helminth (worm) infection in Uganda. Programme cost data were collected through semi-structured interviews with district officials and from accounting records in six of the 23 intervention districts. Both financial and economic costs were assessed. Costs were estimated on the basis of cost in US$ per schoolchild treated, and an incremental cost-effectiveness ratio (cost in US$ per case of anaemia averted) was used to evaluate programme cost-effectiveness. Sensitivity analysis was performed to assess the effect of discount rate and drug price. The overall economic cost per child treated in the six districts was US$0.54 and the cost-effectiveness was US$3.19 per case of anaemia averted. Analysis indicated that estimates of both cost and cost-effectiveness differ markedly with the total number of children who received treatment, indicating economies of scale. There was also substantial variation between districts in the cost per individual treated (US$0.41-0.91) and cost per anaemia case averted (US$1.70-9.51). Independent variables were shown to be statistically associated with both sets of estimates. This study highlights the potential bias in transferring data across settings without understanding the nature of observed variations. (author's) Language: English Keywords: UGANDA | RESEARCH REPORT | INTERVIEWS | GOVERNMENT OFFICIALS | SCHOOLS | PARASITIC DISEASES | TREATMENT | PREVENTION AND CONTROL | INTERVENTIONS | ECONOMIC FACTORS | COST EFFECTIVENESS | COST BENEFIT ANALYSIS | Developing Countries | Africa, Eastern | Africa, Sub Saharan | Africa | Data Collection | Research Methodology | Administrative Personnel | Organization and Administration | Education | Diseases | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Programs | Evaluation Indexes | Quantitative Evaluation | Evaluation Document Number: 323130 |
| 16. Peer Reviewed Title: High efficacy of two artemisinin-based combinations (artemether-lumefantrine and artesunate plus amodiaquine) for acute uncomplicated malaria in Ibadan, Nigeria. Author: Falade CO; Ogundele AO; Yusuf BO; Ademowo OG; Ladipo SM Source: Tropical Medicine and International Health. 2008 Mar;13(5):635-643. Abstract: The objective was to test the hypothesis that artesunate plus amodiaquine (ASAQ) is as effective as artemether-lumefantrine (AL) in the treatment of acute uncomplicated malaria in Nigerian children. In an open label, randomized controlled clinical trial, children aged 6 months to 10 years were randomized to receive artesunate (4 mg/kg daily) plus amodiaquine (10 mg/kg daily) or AL (5-14 kg, one tablet; 15-24 kg, two tablets and 25-34 kg, three tablets twice daily). Both drug regimens were given for 3 days and follow-up was for 28 days. A total of 132 children (66 in each group) were randomized to receive either ASAQ or AL. Day 28 cure rates in the per protocol (PP) population were 93% for ASAQ and 95% for AL (OR = 0.71, 95% CI = 0.12-3.99, q = 0.66). Using Kaplan-Meier product-limit estimates of failure, the median survival time for ASAQ was 21 days and for AL 28 days (P = 0.294). PCR corrected day 28 cure rate for PP populations were 98.4% for ASAQ and 100% for AL. Both drugs were well-tolerated.ASAQ is as effective as AL and both combinations were efficacious and safe. (author's) Language: English Keywords: NIGERIA | RESEARCH REPORT | CLINICAL TRIALS | CHILD | MALARIA | TREATMENT | DRUGS | ADMINISTRATION AND DOSAGE | PARASITIC DISEASES | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Clinical Research | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Diseases | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 325355 |
| 17. Peer Reviewed Title: Plasmodium falciparum and helminth coinfection in a semi urban population of pregnant women in Uganda. Author: Hillier SD; Booth M; Muhangi L; Nkurunziza P; Khihembo M Source: Journal of Infectious Diseases. 2008 Sep 15;198(6):920-7. Abstract: BACKGROUND: Helminth infections and malaria are widespread in the tropics. Recent studies suggest helminth infections may increase susceptibility to Plasmodium falciparum infection. If confirmed, this increased susceptibility could be particularly important during pregnancy-induced immunosuppression. OBJECTIVE: To evaluate the geographical distribution of P. falciparum-helminth coinfection and the associations between P. falciparum infection and infection with various parasite species in pregnant women in Entebbe, Uganda. METHODS: A cross-sectional study was conducted at baseline during a trial of antihelminthic drugs during pregnancy. Helminth and P. falciparum infections were quantified in 2,507 asymptomatic women. Subjects' socioeconomic and demographic characteristics and geographical details were recorded. RESULTS: Hookworm and Mansonella perstans infections were associated with P. falciparum infection, but the effect of hookworm infection was seen only in the absence of M. perstans infection. The odds ratio [OR] for P. falciparum infection, adjusted for age, tribe, socioeconomic status, HIV infection status, and location was as follows: for individuals infected with hookworm but not M. perstans, 1.53 (95% confidence interval [CI], 1.09-2.14); for individuals infected with M. perstans but not hookworm, 2.33 (95% CI, 1.47-3.69); for individuals infected with both hookworm and M. perstans, 1.85 (CI, 1.24-2.76). No association was observed between infection with Schistosoma mansoni, Trichuris, or Strongyloides species and P. falciparum infection. CONCLUSIONS: Hookworm-P. falciparum coinfection and M. perstans-P. falciparum coinfection among pregnant women in Entebbe is more common than would be expected by chance. Further studies are needed to elucidate the mechanism of this association. A helminth-induced increase in susceptibility to P. falciparum could have important consequences for pregnancy outcome and responses to P. falciparum infection in infancy. Language: English Keywords: UGANDA | RESEARCH REPORT | EPIDEMIOLOGIC METHODS | CLINICAL RESEARCH | CROSS SECTIONAL ANALYSIS | BASELINE SURVEYS | WOMEN IN DEVELOPMENT | PREGNANT WOMEN | URBAN POPULATION | PREVALENCE | MALARIA | PARASITIC DISEASES | COMPLICATIONS | HUMAN GEOGRAPHY | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Research Methodology | Surveys | Sampling Studies | Studies | Economic Development | Economic Factors | Population Characteristics | Demographic Factors | Population | Measurement | Diseases | Geography | Social Sciences | Science | Sociocultural Factors Document Number: 329111 |
| 18. Peer Reviewed Title: Lack of an adverse effect of Giardia intestinalis infection on the health of Peruvian children. Author: Hollm-Delgado MG; Gilman RH; Bern C; Cabrera L; Sterling CR Source: American Journal of Epidemiology. 2008 Sep 15;168(6):647-655. Abstract: Giardia intestinalis is a common gastrointestinal protozoan worldwide, but its effects on childhood growth in developing countries are not clearly understood. The authors aimed to describe its effects on child growth. They followed 220 Peruvian children daily for diarrhea, weekly for stool samples, and monthly for anthropometry. The authors modeled the effect of nutritional status on the risk of Giardia infection and the risk of diarrhea attributable to Giardia using negative binomial regression. They modeled the effects of Giardia infection on growth using linear regression, with 85% of children becoming infected with Giardia and 87% of these becoming reinfected. In multivariable analysis, the risk of Giardia infection did not vary with weight for age (relative risk = 1.00, 95% confidence interval: 0.89, 1.12) or height for age (relative risk = 0.92, 95% confidence interval: 0.82, 1.04). Giardiasis did not affect growth at 1 or 2 months following the first infection at any age interval. The longitudinal prevalence of Giardia between 6 and 24 months of age was not associated with height gain in that interval (p = 0.981). Giardia was not associated with an increased risk of diarrhea at any age interval. Study results question the importance of Giardia as a childhood pathogen in developing countries where giardiasis is hyperendemic. (author's) Language: English Keywords: PERU | DEVELOPING COUNTRIES | RESEARCH REPORT | LINEAR REGRESSION | PARASITIC DISEASES | CHILD | GROWTH | CHILD DEVELOPMENT | GASTROINTESTINAL EFFECTS | DIARRHEA | ANTHROPOMETRY | MALNUTRITION | RISK ASSESSMENT | South America, Western | South America | Latin America | Americas | Statistical Regression | Data Analysis | Research Methodology | Diseases | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Biology | Physiology | Measurement | Nutrition Disorders | Evaluation Document Number: 328164 |
| 19. Peer Reviewed Title: Further support for the hypothesis that parental hormone levels around the time of conception are associated with human sex ratios at birth. Author: James WH Source: Journal of Biosocial Science. 2008;:1-7. Abstract: During the past year, data have been published on the offspring sex ratios of people diagnosed with toxoplasmosis, hepatitis B, and pre- and post-menopausal breast cancer. It is shown here how these offspring sex ratios constitute further support for the hypothesis that mammalian (including human) parental hormone concentrations around the time of conception partially control the sexes of the resulting infants. If this interpretation were correct, then hormonal treatments might be considered for some or all of these conditions. It is intended that anyone who has read the present note and my two previous papers (James, 1996, 2004) should be aware of all the data relating to the hypothesis. (author's) Language: English Keywords: GLOBAL | UNITED KINGDOM | RESEARCH REPORT | HORMONES | PARENTS | SEX RATIO | HEPATITIS | BREAST CANCER | PARASITIC DISEASES | TREATMENT | Developed Countries | Europe, Western | Europe | Endocrine System | Physiology | Biology | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Sex Distribution | Sex Factors | Population Characteristics | Demographic Factors | Population | Viral Diseases | Diseases | Cancer | Neoplasms | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 326913 |
| 20. Peer Reviewed Title: Age patterns in undernutrition and helminth infection in a rural area of Brazil: Associations with ascariasis and hookworm. Author: Jardim-Botelho A; Brooker S; Geiger SM; Fleming F; Lopes AC Source: Tropical Medicine and International Health. 2008 Apr;13(4):458-467. Abstract: The objective was to investigate the nutritional status of individuals from a rural area of Brazil, and associations with helminth infections in an age-stratified sample. A total of 1113 individuals aged from 6 months to 83 years from the rural community of Americaninhas in Minas Gerais were investigated. Assessments comprised anthropometric measurements of weight, height and body composition, examining faecal samples for helminth eggs, and peripheral blood assays for albumin, haemoglobin and ferritin concentrations. Ten percent of the participants were underweight, 12.8% were overweight and 28.3% of the children and adolescents were stunted. 11.6% had low lean body mass and 28.8% had low fat body mass. Hypoalbuminaemia was seen in 5.5%, anaemia in 12.5% and iron deficiency in 13.1%, although the prevalence of these two indices increased with age. Multivariate analysis showed that, after controlling for age, sex and socio-economic status, stunting was significantly associated with Ascaris lumbricoides infection among children and adolescents, whereas low body mass was significantly associated with hookworm infection among adults and the elderly. Helminth infections are associated with undernutrition in endemic populations, with important differences between the effects of hookworm and A. lumbricoides on age-related nutritional status. (author's) Language: English Keywords: BRAZIL | RESEARCH REPORT | INFANT | CHILD | ADULTS | RURAL AREAS | PARASITES | PARASITIC DISEASES | AGE FACTORS | MALNUTRITION | ANEMIA | IRON | South America, Eastern | South America | Latin America | Americas | Developing Countries | Youth | Population Characteristics | Demographic Factors | Population | Geographic Factors | Biology | Diseases | Nutrition Disorders | Metals | Vitamins and Minerals | Physiology Document Number: 325992 |
| 21. Peer Reviewed Title: Giardia duodenalis assemblage, clinical presentation and markers of intestinal inflammation in Brazilian children. Author: Kohli A; Bushen OY; Pinkerton RC; Houpt E; Newman RD Source: Transactions of the Royal Society of Tropical Medicine and Hygiene. 2008 Jul;102(7):718-725. Abstract: Data on the relationship between the two genotypes of Giardia duodenalis that infect humans, assemblages A and B, their clinical presentation and intestinal inflammation are limited. We analyzed 108 stool samples previously collected for a diarrhoeal study among Brazilian children, representing 71 infections in 47 children. Assemblage B was most prevalent, accounting for 43/58 (74.1%) infections, while assemblage A accounted for 9/58 (15.5%) infections and 6/58 (10.3%) infections were mixed (contained both assemblage A and B). There was no significant difference in diarrhoeal symptoms experienced during assemblage A, B or mixed infections. Children with assemblage B demonstrated greater variability in G. duodenalis cyst shedding but at an overall greater level (n = 43, mean 3.6×10(5), range 5.3×10(2)-2.5×10(6) cysts/ml) than children infected with assemblage A (n = 9, mean 1.4×10(5), range 1.5×10(4)-4.6×10(5) cysts/ml; P = 0.009). Children with mixed infections shed more cysts (mean 8.3×10(5), range 3.1×10(4)-2.8×10(6) cysts/ml) than children with assemblage A or B alone (P = 0.069 and P = 0.046 respectively). This higher rate of cyst shedding in children with assemblage B may promote its spread, accounting for its increased incidence. Additionally, second and third infections had decreasing faecal lactoferrin, suggesting some protection against severity, albeit not against infection, by prior infection. (author's) Language: English Keywords: BRAZIL | RESEARCH REPORT | GENETIC TECHNIQUES | CHILDREN | PARASITIC DISEASES | GASTROINTESTINAL EFFECTS | SIGNS AND SYMPTOMS | LABORATORY EXAMINATIONS AND DIAGNOSES | South America, Eastern | South America | Latin America | Americas | Developing Countries | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Diseases | Physiology | Biology Document Number: 327443 |
| 22. Title: Opportunistic and other intestinal parasitic infections in AIDS patients, HIV seropositive healthy carriers and HIV seronegative individuals in southwest Ethiopia. Author: Mariam ZT; Abebe G; Mulu A Source: East African Journal of Public Health. 2008 Dec;5(3):169-73. Abstract: BACKGROUND: Human Immunodeficiency Virus (HIV) infection leads to acquired immunodeficiency syndrome (AIDS) and major causes of morbidity and mortality of such patients are opportunistic infections caused by viral, bacterial, fungal and parasitic pathogens. OBJECTIVES: To determine the magnitude of opportunistic and non-opportunistic intestinal parasitic infections among AIDS patients and HIV positive carrier individuals. METHOD: Cross-sectional study was conducted among AIDS patients, HIV positive healthy carriers and HIV negative individuals in Jimma University Hospital, Mother Theresa Missionary Charity Centre, Medan Acts Projects and Mekdim HIV positive persons and AIDS orphans' national association from January to May, 2004. Convenient sampling technique was employed to identify the study subjects and hence a total of 160 subjects were included. A pre-tested structured questionnaire was used to collect socio-demographic data of the patients. Stool samples were examined by direct saline, iodine wet mount, formol-ether sedimentation concentration, oocyst concentration and modified Ziehl-Neelsen staining technique. RESULTS: Out of 160 persons enrolled in this study 100 (62.5%) (i.e. 65 male and 35 female) were infected with one or more intestinal parasites. The highest rate 36 (69.2%) of intestinal parasites were observed among HIV/AIDS patients, followed by HIV positive healthy carriers 35 (61.4%) of and HIV negative individuals (29 (56.9%). Isospora belli 2 (3.9%), Cryptosporidum parvum 8 (15.4%), Strongyloides stercoralis 6 (11.5%) and Blastocystis 2 (3.9%) were found only in HIV/AIDS groups CONCLUSION: I. belli, C. parvum, S. stercoralis and Blastocystis are the major opportunistic intestinal parasites observed in HIV/AIDS patients. Therefore, early detection and treatment of these parasites are important to improve the quality of life of HIV/AIDS patients with diarrhoea. Language: English Keywords: ETHIOPIA | RESEARCH REPORT | EPIDEMIOLOGIC METHODS | CLINICAL RESEARCH | CROSS SECTIONAL ANALYSIS | PERSONS LIVING WITH HIV/AIDS | PREVALENCE | HIV INFECTIONS | COMPLICATIONS | PARASITIC DISEASES | AIDS | GASTROINTESTINAL EFFECTS | DIARRHEA | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Research Methodology | Viral Diseases | Diseases | Measurement | Physiology | Biology Document Number: 331266 |
| 23. Peer Reviewed Title: Giardia duodenalis infection and anthropometric status in preschoolers in Salvador, Bahia State, Brazil. Author: Matos SM; Assis AM; Prado Mda S; Strina A; Santos LA; Jesus SR; Barreto ML Source: Cadernos De Saude Publica. 2008 Jul;24(7):1527-35. Abstract: The aim of this study was to estimate the association between Giardia duodenalis infection and anthropometric deficits, as measured by weight-for-age and height-for-age. This cross-sectional study included 629 children from 12 to 48 months of age, selected from 30 geographic areas in the city of Salvador, Bahia State, Brazil. Poisson regression and linear regression were used for the multivariate statistical analyses. G. duodenalis was diagnosed in 13.5% of the children. The children's breastfeeding duration and living conditions (garbage collection and paved streets or sidewalks) modified the effect of G. duodenalis infection on anthropometric status. Among infected children, there were statistically significant associations between weight deficit and shorter breastfeeding (PR=2.22; 95%CI: 1.56-3.14) and inadequate paving of streets and sidewalks (PR=2.00; 95%CI: 1.37-2.92), while height deficit was associated with deficient public garbage collection (PR=2.21; 95%CI: 1.31-2.51). In the linear regression, the association with the anthropometric indicators remained positive and statistically significant. The child's unhealthy living environment aggravated the negative effect of G. duodenalis infection on anthropometric status, and breastfeeding was a protective factor in the outcome. Language: English Keywords: BRAZIL | RESEARCH REPORT | CROSS SECTIONAL ANALYSIS | CHILDREN | PARASITIC DISEASES | PREVALENCE | ANTHROPOMETRY | BREASTFEEDING | MALNUTRITION | SANITATION | HYGIENE | South America, Eastern | South America | Latin America | Americas | Developing Countries | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Diseases | Measurement | Infant Nutrition | Nutrition | Health | Nutrition Disorders | Public Health Document Number: 342211 |
| 24. Title: Intermittent preventive treatment of malaria in pregnancy: A community-based delivery system and its effect on parasitemia, anemia and low birth weight in Uganda. Author: Mbonye AK; Bygbjerg I; Magnussen P Source: International Journal of Infectious Diseases. 2008;12:22-29. Abstract: The main objective of the study was to assess the impact of a community-based delivery system of intermittent preventive treatment (IPT) for malaria in pregnancy with sulfadoxine-pyrimethamine (SP) on access, parasitemia, anemia and low birth weight as primary outcome measures. A study was designed to test the community-based delivery system of IPT through traditional birth attendants (TBAs), drug-shop vendors (DSVs), community reproductive health workers (CRHWs) and adolescent peer mobilizers (APMs), and to compare these with IPT at health units in an area of high malaria transmission - Mukono District, Uganda. Two thousand seven hundred and eighty-five pregnant women participated in the study. The majority of the women (92.4%) at the community-based approaches received their first dose of IPT during their second trimester compared to 76.1% at health units (p less than 0.0001). At both health units and the community-based approaches, IPT increased mean hemoglobin by 6.7% (p less than 0.0001) for all parities and by 10.2% among primigravidae. IPT reduced the prevalence of severe anemia from 5.7% to 3.1% (p less than 0.04). The prevalence of parasitemia was reduced from 24.5% to 16.1% (p less than 0.001), and parasite density reduced significantly (p less than 0.02) after the first dose and remained stable with the second dose. Overall the proportion of low birth weight was 6.3% (8.3% at health units versus 6.0% at the community-based approaches, p less than 0.03) highlighting the importance of access and adherence to IPT. This intervention was acceptable to 89.6% of the women at the community-based approaches intending to use IPT in the future, while 48.1% of them had recommended it to other women. The community-based approaches increased access and adherence to IPT with an effect on anemia, severe anemia, parasitemia and low birth weight. However, the reduced effect of IPT on parasitemia points to drug resistance with SP and this requires further evaluation; research into the identification of other more efficacious drugs for malaria prevention in pregnancy is also required. (author's) Language: English Keywords: UGANDA | RESEARCH REPORT | HEALTH PERSONNEL | PREGNANT WOMEN | MALARIA PREVENTION | TREATMENT | COMMUNITY-BASED DISTRIBUTION | ANEMIA | PARASITIC DISEASES | LOW BIRTH WEIGHT | PREVENTION AND CONTROL | DRUG RESISTANCE | Developing Countries | Africa, Eastern | Africa, Sub Saharan | Africa | Delivery of Health Care | Health | Population Characteristics | Demographic Factors | Population | Malaria | Diseases | Medical Procedures | Medicine | Health Services | Nonclinical Distribution | Distributional Activities | Program Activities | Programs | Organization and Administration | Birth Weight | Body Weight | Physiology | Biology Document Number: 323133 |
| 25. Peer Reviewed Title: Cryptosporidiosis in children in Sub-Saharan Africa: a lingering challenge. Author: Mor SM; Tzipori S Source: Clinical Infectious Diseases. 2008 Oct 1;47(7):915-21. Abstract: Hospital- and community-based studies in sub-Saharan Africa document a high prevalence of cryptosporidiosis in children aged 6-36 months, particularly among those who are malnourished or positive for human immunodeficiency virus (HIV) infection and during rainy seasons. This is despite advances in developed countries that have curbed the incidence of cryptosporidiosis in the general and HIV-positive populations. Transmission in sub-Saharan Africa appears to occur predominantly through an anthroponotic cycle. The preponderance of Cryptosporidium hominis, given its limited host range, and the dominance of the more ubiquitous Cryptosporidium parvum after coexposure to both species, however, suggest that the current knowledge of transmission is incomplete. Given the poor sanitation and hygiene, limited availability of antiretrovirals, and the high prevalence of cryptosporidiosis in children-independent of HIV infection-in this region, effective control measures for cryptosporidiosis are desperately needed. Molecular targets from the recently sequenced parasite genome should be exploited to develop an effective and safe treatment for children. Language: English Keywords: AFRICA, SUB SAHARAN | RESEARCH REPORT | PREVALENCE | CHILDREN | PARASITES | PARASITIC DISEASES | TREATMENT | Africa | Developing Countries | Measurement | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Biology | Diseases | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 342993 |
| 26. Title: Cerebral malaria and epilepsy. Author: Ngoungou EB; Preux PM Source: Epilepsia. 2008 Aug;49 Suppl 6:19-24. Abstract: Malaria, one of the most common parasitic diseases worldwide, is responsible for more than one million deaths among African children every year. Its neurological form, known as cerebral malaria (CM) is a potential cause of epilepsy in malaria-endemic regions of the world, primarily made up for the most part by the sub-Saharan Africa. Herein, we review recent African studies that examine the association between CM and epilepsy. Three studies suggest a modestly strong association between CM and epilepsy. Furthermore, there appears little doubt that this association is causal. Speculative considerations that may explain this causal association are discussed in this review. Additional research is however required in order to determine the clinical and electrographic behavior, the underlying structural and molecular basis, and course and outcome of this condition. Language: English Keywords: AFRICA | RESEARCH REPORT | PARASITIC DISEASES | MALARIA | EPIDEMIOLOGY | NEUROLOGIC EFFECTS | Developing Countries | Diseases | Public Health | Health | Physiology | Biology Document Number: 328517 |
| 27. Title: Lessons learned about opportunistic infections in southeast Asia. Author: Nissapatorn V Source: Southeast Asian Journal of Tropical Medicine and Public Health. 2008 Jul;39(4):625-41. Abstract: Southeast Asia is a region where the number of people infected with HIV/AIDS is one of the fastest growing in the world. Tuberculosis (TB) has grown along with the HIV epidemic. TB is not only the most common AIDS-defining illness but is also the leading cause of morbidity and mortality in AIDS patients. Cryptococcosis (meningitis or disseminated) is one of the most common opportunistic infections in AIDS patients. Cryptococcal meningitis is the first in the differential diagnosis considered with meningeal irritation. Penicillosis, a unique systemic mycosis, is an important emerging public health problem and has been classified as an AIDS defining illness in endemic areas like Thailand. Pneumocystis carinii (jiroveci) pneumonia has been one of the most important opportunistic infections in AIDS patients. Among parasitic infections, cryptosporidiosis is the most common intestinal protozoan infection relating to diarrhea in AIDS patients and toxoplasmosis is the only parasitic infection of the nervous system with a substantial incidence, up to 14.8%. Cytomegalovirus (CMV) retinitis has a lower prevalence compared to other opportunistic infections. In the era of highly active antiretroviral therapy (HAART), the incidence of opportunistic infections has significantly reduced in the past few years. Subsequently, the phenomena of immune restoration inflammatory syndrome (IRIS) in AIDS patients has been reported in this region as a result of HAART. Language: English Keywords: ASIA, SOUTHEASTERN | LITERATURE REVIEW | EPIDEMIOLOGIC METHODS | PERSONS LIVING WITH HIV/AIDS | PREVALENCE | TUBERCULOSIS | CAUSES OF DEATH | AIDS | COMPLICATIONS | MENINGITIS | BACTERIAL AND FUNGAL DISEASES | PNEUMONIA | PARASITIC DISEASES | CENTRAL NERVOUS SYSTEM EFFECTS | ANTIRETROVIRAL THERAPY | Asia | Developing Countries | Research Methodology | HIV Infections | Viral Diseases | Diseases | Measurement | Infections | Mortality | Population Dynamics | Demographic Factors | Population | Central Nervous System | Physiology | Biology | Pulmonary Effects | HIV Document Number: 330585 |
| 28. Title: Hookworm infestation in children presenting with melena-case series. Author: Saeed A; Cheema HA; Alvi A; Suleman H Source: Pakistan Journal of Medical Research. 2008 Oct-Dec;47(4):98-100. Abstract: Aims: Hookworm infection is common in children and can present with symptoms of upper gastrointestinal bleeding and severe anemia. Patients and Methods: Ten children below 5 years presenting with melena and severe pallor were seen from December 2006 to May 2007 in the gastroenterology and hepatology department of children's hospital, Lahore. All patients had history of transfusion. Complete blood picture, eosinophil count with peripheral smear, stool complete examination for oya and cysts were performed in all cases, while upper and lower gastrointestinal endoscopies were performed in three patients to locate the source of bleeding. Results. Stool routine examination in all these cases confirmed hook worm ova. These patients were managed with antihe menthic and stool complete examination was done three days after the medicine. There was no mortality. Conclusions. Though upper gastrointestinal bleeding with hookworm infestation is very rare but in the developing countries it should be considered when other causes of upper gastrointestinal bleeding are ruled out. Language: English Keywords: DEVELOPING COUNTRIES | RESEARCH REPORT | CHILDREN | PARASITES | PARASITIC DISEASES | BLEEDING | GASTROINTESTINAL EFFECTS | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Biology | Diseases | Signs and Symptoms | Physiology Document Number: 331315 |
| 29. Peer Reviewed Title: Fatal disseminated toxoplasmosis with congenital transmission in an African migrant [letter] Author: Schweickert B; Bollmann R; Loui A; Kaufmann O; Kluttig J Source: AIDS. 2008 Jul 31;22(12):1523-1525. Abstract: Migrants from HIV-endemic areas may be newly diagnosed with HIV in Western countries. A 27-year-old pregnant woman from sub-Saharan Africa presented with disseminated fatal toxoplasmosis and congenitally transmitted the parasite. Despite medical care, maternal infection was only diagnosed postmortem and diagnosis in the newborn was delayed. Problematic aspects of medical care in migrants in Western countries are discussed. (excerpt) Language: English Keywords: AFRICA, SUB SAHARAN | CASE STUDIES | PREGNANT WOMEN | MIGRANTS | INFANT | PARASITIC DISEASES | TRANSMISSION | PREGNANCY COMPLICATIONS | DEATH | HIV INFECTIONS | AIDS | Africa | Developing Countries | Studies | Research Methodology | Population Characteristics | Demographic Factors | Population | Migration | Population Dynamics | Youth | Age Factors | Diseases | Infections | Mortality | Viral Diseases Document Number: 328313 |
| 30. Peer Reviewed Title: A parasitological survey, in rural Zanzibar, of pre-school children and their mothers for urinary schistosomiasis, soil-transmitted helminthiases and malaria, with observations on the prevalence of anaemia. Author: Sousa-Figueiredo JC; Basanez MG; Mgeni AF; Khamis IS; Rollinson D; Stothard JR Source: Annals of Tropical Medicine and Parasitology. 2008 Dec;102(8):679-92. Abstract: 'Kick-out-Kichocho' is an integrated helminth-control initiative that is aimed at reducing the burden of urinary schistosomiasis and soil-transmitted helminthiases (STH) on Zanzibar Island (Unguja), in Tanzania. Like other initiatives based on preventive chemotherapy, the programme is mainly school-based and, consequently, pre-school children (aged < or =6 years) are not targeted specifically. To assess the importance of urinary schistosomiasis, STH and malaria, as well as the occurrence of anaemia and growth retardation among these younger children, an epidemiological survey has been undertaken, in a rural area of Unguja, among 152 pre-school children and their 113 mothers. In the pre-school children investigated, urinary schistosomiasis was rare because of the children's lack of contact with environmental water. Malaria was also rare in the children, probably as a consequence of the study season, the widespread use of insecticide-treated bednets and the good access to first-line antimalarial drugs. In contrast, the prevalences of infection with at least one soil-transmitted helminth and of anaemia were alarmingly high among the pre-school children, at 50.0% [95% confidence interval (CI)=40.4%-59.6%) and 73.4% (CI=?65.2%-80.5%), respectively; the corresponding values in the children's mothers were 35.2% (CI=25.4%-45.9%) and 25.9% (CI=18.0%-35.3%). In the rural study area, Kandwi was identified as a hamlet with particularly high levels of transmission of soil-transmitted helminths, and household aggregations of STH were common. To reduce the present health inequities, the future integration of pre-school children within ongoing anthelmintic-control programmes in schools is strongly recommended. Language: English Keywords: TANZANIA | RESEARCH REPORT | EPIDEMIOLOGIC METHODS | HEALTH SURVEYS | CLINICAL RESEARCH | RURAL POPULATION | CHILDREN | MOTHERS | PREVALENCE | SCHISTOSOMIASIS | PARASITIC DISEASES | ANEMIA | MALARIA | COMPLICATIONS | UROGENITAL EFFECTS | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Research Methodology | Health | Population Characteristics | Demographic Factors | Population | Youth | Age Factors | Parents | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Measurement | Diseases | Urogenital System | Physiology | Biology Document Number: 330398 |
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