Inflammatory Nasal Swelling due to Leishmania tropica

Since its discovery in the 19th century, cutaneous leishmaniasis has been a major public health problem, especially with the appearance of more and more unusual cases of cutaneous lesions due to this parasite. Indeed, the present study joins the previous studies and describes a typical case of a nasal lesion due to Leishmania infection. This is a 20-year-old young man, with no particular pathological history, from an epidemic focus who presented with inflammatory nasal swelling similar to a mucocutaneous form. However, the X-ray data showed that no lysis of the bones proper to the nose was detected and no damage to the underlying mucosa was observed. Nevertheless, the parasitological diagnosis confirmed the presence of amastigotes, and the results of the molecular study showed that the electrophoretic profile was comparable to that of L. tropica. After diagnosis and confirmation, treatment with meglumine antimonate at the rate of two ampoules/injection (one ampoule = 5 ml) of antimony salt for one month was administered intramuscularly with favorable outcome. Atypical forms of cutaneous leishmaniasis constitute a rare and unusual entity often leading to diagnostic delay. For this, the clinical examination must take into account both exceptional presentations of Leishmania infection, in particular in subjects living or having stayed in an endemic area, in order to ensure appropriate and early treatment.

Alopecia and Dermatitis Caused by Lepoarcarus gibbus in a New Zealand White Rabbit (Oryctolagus cuniculus) – Clinical and Parasitological Diagnosis and Treatment

Aim: Ectoparasites associated dermatological disorders are frequently encountered in laboratory and pet rabbit medicine practice, however, L. gibbus is the only ectoparasite rarely reported in either pet and laboratory rabbits or hares as L. gibbus are usually asymptomatic. The aim of the present report is to describe a case of alopecia and dermatitis associated with Lepoarcarus gibbis in a rabbit from India. Presentation of Case: A 1.5 year old female New Zealand White rabbit was presented to the Dermatology Unit with erythema and poorly demarcated alopecia on the dorsal neck and face. A skin scraping and coat brushings were performed. On microscopic evaluation of hair samples, L. gibbus infestation was confirmed. Treatment with ivermectin (0.3 mg/kg) biweekly once for 3 doses proved effective. Discussion and Conclusion: L.gibbus may be presented with severe hairfall in the absence of other mites and treatment with ivermectin is effective. Based on the literature research this may be the first case report on alopecia and dermatitis due to L.gibbus in rabbit from India. Further studies should be planned on the prevalence of the mite as it is reported to have zoonotic potential.

Feasibility of near-infrared spectroscopy for species identification and parasitological diagnosis of freshwater snails of the genus Biomphalaria (Planorbidae)

Near Infrared Spectroscopy (NIRS) has been applied in epidemiological surveillance studies of insect vectors of parasitic diseases, such as the Dengue’s mosquitoes. However, regarding mollusks, vectors of important worldwide helminth diseases such as schistosomiasis, fascioliasis and angiostrongyliasis, NIRS studies are rare. This work proposes to establish and standardize the procedure of data collection and analysis using NIRS applied to medical malacology, i.e., to mollusk vectors identifications. Biomphalaria shells and live snails were analyzed regarding several operational aspects, such as: moisture, shell side and position of the live animal for acquisition of NIR spectra. Representative spectra of Biomphalaria shells and live snails were collected using an average of 50 scans per sample and resolution of 16 cm-1. For shells, the sample should first be dried for a minimum of 15 days at an average temperature of 26±1°C, and then placed directly in the equipment measurement window with its left side facing the light beam. Live animals should be dried with absorbent paper; placed into a glass jar, and analyzed similarly to the shells. Once standardized, the technique was applied aiming at two objectives: identification of Biomphalaria using only the shells and parasitological diagnosis for Schistosoma mansoni infection. The discrimination of the three Biomphalaria species intermediate hosts of S. mansoni only by shell has technical limit due to the scarcity of organic material. Nevertheless, it was possible to differentiate B. straminea from B. tenagophila and B. glabrata with 96% accuracy. As for the parasitological diagnosis, it was possible to differentiate infected mollusks shedding S. mansoni cercariae from the non-infected ones with 82, 5% accuracy. In conclusion, the Near Infrared Spectroscopy (NIR’s) technique has proven to be an innovative and sound tool to detect infection by S. mansoni in the different species of Biomphalaria intermediate hosts.

Parasitological and epidemiological studies of Wuchereria bancrofti in Imobi, Ijebu East, Local Government Area of Ogun State, South Western Nigeria

Background Lymphatic filariasis is a mosquito-borne parasitic disease caused by Wuchereria bancrofti. It is a neglected tropical disease that constitutes a public health challenge in rural endemic communities in Nigeria. This is a debilitating disease of global concern, because of its effect on per capital income and its stigmatization on affected individuals. The Program for Elimination for Lymphatic filariasis has set a goal towards possible elimination. Results Communities in Imobi, in Ijedu East Local Government Area in Ogun State, have been undergoing Mass Drug Administration (MDA). However, there is need for a baseline data to assess, monitor and evaluate the progress of MDA in these communities towards eventual elimination. Systematic random sampling and cluster survey were used to gather 246 participants from six communities in Imobi to a central point at the Local Government Health Centre. Parasitological diagnosis was done using microscopy, while structured questionnaires, which probed into respondents Knowledge, Attitude and Practices, were administered. An overall prevalence of 50 (20.3%) was observed with 17 (21.5%) males being more infected than 24 (19.8%) females. Prevalence of infection was significantly higher in younger age groups 4 (28.6%) than in older age groups 20 (14.6%) at p < 0.05. Overall microfilarial density of 25.7 mf/ml was obtained among infected population. Microfilariae prevalence was not observed in people that had received treatment with both albendazole and ivermectin. Higher prevalence of infection was observed in people who did not made use of Long Lasting Insecticidal Nets 45 (21.1%), than in people who did 5 (15.2%). However, it was not statistically significant (p > 0.05). Most of the respondents had little or no knowledge of the disease, its cause, transmission, prevention and treatment. The prevalence level is also higher than 1% for which MDA is required. Conclusions It is recommended that MDA be intensified in the study area, together with vector control and awareness campaign on the disease.

Evaluation of a Rapid Diagnostic Test Currently Being Used in the Management of Malaria in Patients of the Hia/Chu-Parakou and the Boko Zone Hospital in Northern Benin

Parasitological diagnosis is a fundamental element in the adequate management of the disease. In the last decade, there has been a resurgence of interest in the development of malaria Rapid Diagnostic Test (RDT) kits. This is the case with SD Bioline Malaria Ag Pf, which searches for HRP2 antigen by immunochromatography. The objective of this study is to compare the results of RDT SD Bioline Malaria Ag Pf in use with the results of Thick Gout (TG) in the biological diagnosis of malaria. This was a cross-sectional, descriptive and evaluative study carried out at the Hôpital d’Instruction des Armées-Center Hospitalier et Universitaire de Parakou and at the Boko zone hospital from April 20 to July 30, 2015. Patient identification, we used the non-probabilistic method and the convenience choice technique. The study involved 503 patients. The results of this study showed a good performance of the RDT SD Bioline Malaria Ag Pf. Among the 503 patients, 199 or 39.6% were positive for the RDT against 180 or 35.8% positive for the Thick Gout (TG). Sensitivity, specificity, positive and negative predictive values of the test compared to the thick film were respectively (91.7%, 89.5%, 82.9, 95) and the Kappa coefficient of 0.88 testifies a good match. False positive cases are noted in patients on treatment and even after recovery due to the persistence of the HRP2 antigen in the blood. However, it constitutes an interesting alternative to the management of malaria. At the end of this study, we suggest continuing the use of RDTs in health centers where microscopy is absent and/or reinforcing microscopy, and to strengthen staff training in the management of malaria cases.

Confirmed malaria cases among under five children with fever and history of fever in Masogo sub-county, Kisumu county-Kenya

Background: The World Health Organization recommends that malaria treatment should begin with parasitological diagnosis. This will help to regulate misuse of anti-malarial drugs in areas with high transmission. Aim: Aim was to assess the prevalence of parasitological confirmed malaria among under five years children presenting with fever or history of fever attending medication at Masogo sub-county hospital. Setting: The study was conducted in Masogo Sub County, Kisumu County, Kenya. Data and methodology: The study used 2020 dataset from the laboratory MOH 706 reporting tool with a total number of 6787 children under five years old tested in the lab. Result: Of the 6787 test performed in the year 2020, 2225 (32.8%) turn positive to malaria parasite where there was high prevalence in female children at 1141 (51.3%) than male children 1084 (48.7%) of the total positive examined. Prevalence of the malaria among the age group bracket was high at 48-59 months old at 625 (28.1%) followed by 36-47 months 620 (27.9%), 24-35 months 450 (20.2%), 12-23 months 410 (18.4%) and lastly 0-11 months old at 120 (5.4%). Conclusions: Reasons for the increased of the prevalence as the age increased among the under five children need to be further explored and addressed, there is enough evidence that immediate action is needed to address the unique needs of this population. Such factors could include lack of net used and separation of the mother and the child from sleeping together or early birth after the child. Keywords: malaria; under five children; fever.

Hematological Parameters and Key Cytokines in Patients With Uncomplicated Falciparum Malaria in Hodeidah, Yemen

Immunity to malaria has a major role in controlling disease and pathogenesis with cytokine production being involved in almost each phase of the immune response. The present study aimed to assess hematological variables and to measure plasma levels of TNFα, IFNg and IL10, their ratios, and their relation to parasitemia among patients with uncomplicated falciparum malaria in Hodeidah, Yemen. Forty patients with uncomplicated P. falciparum monoinfection and 40 healthy age and sex matched controls were enrolled in the study. Parasitological diagnosis was confirmed, and parasite density estimated. Hematologic parameters, the presence of gametocytes, and plasma cytokine levels were determined. Results revealed lower Hb levels, RBC, lymphocyte and platelet counts and higher neutrophil and reticulocyte counts among patients compared to controls. TNFα, IFNg and IL10 were higher in patients than controls. A relatively higher IL10 production was demonstrated by the significantly lower TNFα/IL10 and IFNg/IL10 ratios in patients than controls. TNFα and IL10 correlated positively with parasite density. Reticulocyte count was higher and IFNg level was lower in the presence of gametocytes. Conclusively, uncomplicated falciparum malaria is associated with the ability to regulate the production of the pro-inflammatory and anti-inflammatory cytokines. This mediates parasite clearance while simultaneously avoiding severe pathology.

Automated parasitological diagnosis in clinical microbiology laboratories

Although there is a low prevalence of parasitological infections in Europe, the diagnosis of intestinal parasites is still difficult and laborious for microbiology laboratories. Currently, antigen detection assays and molecular biology allow a more accurate diagnosis, but these techniques have limitations as they cannot detect all the possible parasites present in the samples. The objective of the study was to evaluate the accuracy and the usefulness of automated microscopy SediMAX2 (77 Elektronika, Budapest, Hungary) in the detection of parasitic infections from feces. A total of 197 formol-fixed stool samples were processed in parallel by wet mount examination and by SediMAX2. Sensitivities, specificities and predictive values were analyzed, reaching a sensitivity of 89.51% and a specificity of 98.15% and a very good positive predictive value (99.22%). SediMAX2 is a good tool for a reliable diagnosis of intestinal parasitic infections. The rapid processing and the flexibilty of storage of images analyzed make its incorporation into the day to day laboratory routine recommendable.

In Vitro Reduced Susceptibility to Pentavalent Antimonials of a Leishmania infantum Isolate from a Human Cutaneous Leishmaniasis Case in Central Italy

Cutaneous leishmaniasis (CL) caused by Leishmania (Leishmania) infantum is endemic in the Mediterranean basin. Here we report an autochthonous case of CL in a patient living in central Italy with an unsatisfactory response to treatment with intralesional Meglumine Antimoniate and in vitro demonstration of reduced susceptibility to SbIII. Parasitological diagnosis was first achieved by histopathology on tissue biopsy and the patient was treated with a local infiltration of Meglumine Antimoniate. Since the clinical response at 12 weeks from the treatment’s onset was deemed unsatisfactory, two further skin biopsies were taken for histopathological examination, DNA extraction and parasite isolation. L. (L.) infantum was identified by molecular typing. The low susceptibility to Meglumine Antimoniate was confirmed in vitro: the promastigotes from the patient strain showed significantly lower susceptibility to SbIII (the active trivalent form of antimonial) compared to the reference strain MHOM/TN/80/IPT1. The patient underwent a new treatment course with intravenous liposomal Amphotericin B, reaching complete healing of the lesion. Additional studies are needed to confirm the epidemiological and clinical relevance of reduced susceptibility to SbIII of human L. (L.) infantum isolate in Italy.

Application of a Genus-Specific LAMP Assay for Schistosome Species to Detect Schistosoma haematobium x Schistosoma bovis Hybrids

Schistosomiasis is a disease of great medical and veterinary importance in tropical and subtropical regions caused by different species of parasitic flatworms of the genus Schistosoma. The emergence of natural hybrids of schistosomes indicate the risk of possible infection to humans and their zoonotic potential, specifically for Schistosoma haematobium and S. bovis. Hybrid schistosomes have the potential to replace existing species, generate new resistances, pathologies and extending host ranges. Hybrids may also confuse the serological, molecular and parasitological diagnosis. Currently, LAMP technology based on detection of nucleic acids is used for detection of many agents, including schistosomes. Here, we evaluate our previously developed species-specific LAMP assays for S. haematobium, S. mansoni, S. bovis and also the genus-specific LAMP for the simultaneous detection of several Schistosoma species against both DNA from pure and, for the first time, S. haematobium x S. bovis hybrids. Proper operation was evaluated with DNA from hybrid schistosomes and with human urine samples artificially contaminated with parasites’ DNA. LAMP was performed with and without prior DNA extraction. The genus-specific LAMP properly amplified pure Schistosoma species and different S. haematobium-S. bovis hybrids with different sensitivity. The Schistosoma spp.-LAMP method is potentially adaptable for field diagnosis and disease surveillance in schistosomiasis endemic areas where human infections by schistosome hybrids are increasingly common.