Is bisphenol-A exposure during pregnancy associated with blood glucose levels or diagnosis of gestational diabetes?

Recent epidemiological studies indicate bisphenol A (BPA), an estrogenic chemical used in production of epoxy, polycarbonate, and plastic may increase risk of insulin resistance and type 2 diabetes. Exposure to BPA during pregnancy may contribute to development of gestational diabetes mellitus (GDM), a precursor to type 2 diabetes in women. This pilot study examined the association between BPA exposure, fasting blood glucose levels (FBG), and GDM diagnosis during pregnancy. Banked urine samples from 22 cases of GDM and 72 controls were analyzed for total (free BPA + conjugates) urinary BPA concentrations (μg/L). FBG levels (mg/dl) were obtained from 1-h 50-g glucose tolerance tests (GTT) that women underwent for routine GDM screening (mean gestational age = 26.6 weeks, SD = 3.8). Those with an initial screening value ≥ 135 mg/dl underwent 3-h 100 g oral GTT. GDM diagnoses were made when the initial screening value was ≥ 200 mg/dl or when values at ≥ 2 time points exceeded 3-h oral GTT thresholds. Among controls, median FBG levels (mg/dL) did not differ across exposure tertiles, defined according to the distribution of total specific-gravity-adjusted urinary BPA concentrations. Logistic regression models controlling for race/ethnicity did not provide evidence of association between BPA exposure and case status across increasing tertiles of BPA exposure (number of GDM cases/controls in tertile1: 13/24; in tertile 2: 6/24; in tertile 3: 3/24). Findings do not support a relationship between total urinary BPA concentrations and altered glucose metabolism during pregnancy. However, due to study limitations, findings need to be interpreted with caution

Urinary phthalate metabolite concentrations and blood glucose levels during pregnancy

Purpose: To examine associations between phthalate metabolite urinary concentrations during early pregnancy and blood glucose levels obtained at the time of screening for gestational diabetes mellitus (GDM). Methods: Upon initiation of prenatal care, women with a mean gestational age of 12.8 weeks were recruited for a study of environmental chemical exposures (n = 110) and provided a spot urinary specimen. Blood glucose concentrations (mg/dl) were obtained from the electronic medical record for those patients who did not experience a pregnancy loss and did not transfer care to another facility prior to glucose screening (n = 72). Urinary concentrations of nine phthalate metabolites and creatinine were measured at the US Centers for Disease Control and Prevention. Associations between tertiles of phthalate metabolites concentrations and blood glucose levels were estimated using linear regression. Results: Compared to pregnant women in the lowest concentration tertile, women with the highest urinary concentrations (≥ 3 rd tertile) of mono-iso-butyl phthalate (tertile: ≥ 15.3 μg/l, β = -18.3, 95% CI: -35.4, -1.2) and monobenzyl phthalate (tertile: ≥ 30.3 μg/l, β = -17.3, 95% CI: -34.1, -0.4) had lower blood glucose levels at the time of GDM screening after adjustment for urinary creatinine and demographic covariates. Conclusion: Because maternal glucose levels increase during pregnancy to provide adequate nutrition for fetal growth and development, these findings may have implications for fetal health. However, given the limitations of our study, findings should be interpreted cautiously

Spatial Clustering of Porcine Cysticercosis in Mbulu District, Northern Tanzania

Taenia solium is a tapeworm that causes two different disease conditions. In its adult stage, it inhabits the small intestine of human, a condition known as taeniosis, which is characterised by mild symptoms including abdominal disconfort. In the larval stage, T. solium can infect humans and various animal species, mainly pigs, causing cysticercosis. Taeniosis is acquired through consumption of inadequately cooked infected meat, while cysticercosis is acquired through ingestion of tapeworm eggs in foodstuffs contaminated with faeces from a human tapeworm carrier. Cysticercosis of human central nervous tissues (neurocysticercosis) causes serious syndromes such as epilepsy. Transmission of T. solium is facilitated by several factors such as presence of tapeworm carriers, poor sanitation and poor pig husbandry, which allow pigs to access human faeces. Nevertheless, the role of these factors in parasite transmission may vary with different cultural settings. Following an incidence and a prevalence studies in a rural area of northern Tanzania, there was a significant spatial clustering of porcine cysticerocis, suggesting focal distribution of transmission risk factors, which could be targeted for interventions. The study also revealed that despite the low sensitivity of the lingual examination method to detect porcine cysticercosis, it could highlight the potential ‘hotspots’ of the infection

Accuracy of Serological Testing for the Diagnosis of Prevalent Neurocysticercosis in Outpatients with Epilepsy, Eastern Cape Province, South Africa

Epilepsy is a significant contributor to morbidity world-wide in persons of all ages. Little is known, however, about its causes. In the developing world, parasitic infections of the brain, in particular Taenia solium neurocysticercosis (NCC) are thought to be important factors. Determining whether or not there is infection in the brain is difficult since to be certain, specialized imaging studies, such as CT scans, are required. These are expensive and not widely available. In addition, they are not appropriate for use in large, population-based studies. Thus, blood tests for evidence of infection with T. solium are often done instead to estimate the presence of NCC. In this study's population of persons with epilepsy being seen at a hospital out-patient clinic in South Africa, 37% had CT evidence of NCC, a percentage similar to that reported in other developing countries. The study also found that blood tests were not generally useful compared to CT for correctly identifying those persons who did or did not have NCC, and thus, they cannot be relied upon for field studies of NCC

Monetary impact of Taenia solium cysticercosis in four countries

The societal monetary burden of cysticercosis in the Eastern Cape Province, South Africa, Honduras, India and the United States of America were estimated. Data on the frequency of infection and on associated morbidity in both human and pig populations and their costs were collected. Decision trees were used to assess the frequency of medical care and loss of value of pigs with their monetary impact

Factors Associated with the Prevalence of Circulating Antigens to Porcine Cysticercosis in Three Villages of Burkina Faso

Taenia solium cysticercosis is a neglected tropical infection transmitted between humans and pigs. This infection is particularly common in areas where sanitation, hygiene and pig management practices are poor, and can sometimes lead to epilepsy in humans. There is very little information about the importance of this infection in Burkina Faso, even though pork meat is widely consumed in many villages. We conducted a pilot study in three villages: two villages where pig rearing and pork consumption are common (Batondo and Pabré) but with different pig management practices, and one village with limited pig farming and pork consumption (Nyonyogo). Blood tests were done on pigs and information on pig raising was collected from farmers. Our study demonstrated that at least one third of pigs are infected with cysticercosis in villages where they are raised, and, particularly when pigs are left to roam some or all of the time. It also demonstrated that farmers may not be aware of this disease until one of their animals is found to be infected. Thus, the study concluded that there is an urgent need for improving education in order to control this tropical disease

Global burden of human brucellosis : a systematic review of disease frequency

BACKGROUND: This report presents a systematic review of scientific literature published between 1990-2010 relating to the frequency of human brucellosis, commissioned by WHO. The objectives were to identify high quality disease incidence data to complement existing knowledge of the global disease burden and, ultimately, to contribute towards the calculation of a Disability-Adjusted Life Years (DALY) estimate for brucellosis.METHODS/PRINCIPAL FINDINGS: Thirty three databases were searched, identifying 2,385 articles relating to human brucellosis. Based on strict screening criteria, 60 studies were selected for quality assessment, of which only 29 were of sufficient quality for data analysis. Data were only available from 15 countries in the regions of Northern Africa and Middle East, Western Europe, Central and South America, Sub-Saharan Africa, and Central Asia. Half of the studies presented incidence data, six of which were longitudinal prospective studies, and half presented seroprevalence data which were converted to incidence rates. Brucellosis incidence varied widely between, and within, countries. Although study biases cannot be ruled out, demographic, occupational, and socioeconomic factors likely play a role. Aggregated data at national or regional levels do not capture these complexities of disease dynamics and, consequently, at-risk populations or areas may be overlooked. In many brucellosis-endemic countries, health systems are weak and passively-acquired official data underestimate the true disease burden.CONCLUSIONS: High quality research is essential for an accurate assessment of disease burden, particularly in Eastern Europe, the Asia-Pacific, Central and South America and Africa where data are lacking. Providing formal epidemiological and statistical training to researchers is essential for improving study quality. An integrated approach to disease surveillance involving both human health and veterinary services would allow a better understand of disease dynamics at the animal-human interface, as well as a more cost-effective utilisation of resources

Use of Oxfendazole to Control Porcine Cysticercosis in a High-Endemic Area of Mozambique

A randomized controlled field trial to evaluate the effectiveness of a single oral dose of 30 mg/kg of oxfendazole (OFZ) treatment for control of porcine cysticercosis was conducted in 4 rural villages of Angónia district, north-western Mozambique. Two hundred and sixteen piglets aged 4 months were selected and assigned randomly to OFZ treatment or control groups. Fifty-four piglets were treated at 4 months of age (T1), while another 54 piglets were treated at 9 months of age (T2) and these were matched with 108 control pigs from the same litters and raised under the same conditions. Baseline data were collected on the prevalence of porcine cysticercosis using antigen ELISA (Ag-ELISA), as well as knowledge and practices related to Taenia solium transmission based on questionnaire interviews and observations. All animals were followed and re-tested for porcine cysticercosis by Ag-ELISA at 9 and 12 months of age when the study was terminated. Overall prevalence at baseline was 5.1% with no significant difference between groups. At the end of the study, 66.7% of the controls were found positive, whereas 21.4% of the T1 and 9.1% of the T2 pigs were positive, respectively. Incidence rates of porcine cysticercosis were lower in treated pigs as compared to controls. Necropsy of 30 randomly selected animals revealed that viable cysts were present in none (0/8) of T2 pigs, 12.5% (1/8) of T1 pigs and 42.8% (6/14) of control pigs. There was a significant reduction in the risk of T. solium cysticercosis if pigs were treated with OFZ either at 4 months (OR = 0.14; 95% CI: 0.05–0.36) or at 9 months of age (OR = 0.05; 95% CI: 0.02–0.16). Strategic treatment of pigs in endemic areas should be further explored as a means to control T. solium cysticercosis/taeniosis