First detection of intestinal microsporidia in Northern Nigeria

Microsporidia are intracellular spore-forming protozoa that are increasingly being recognized as pathogens in humans. Faecal samples were taken from 2250 HIV/AIDS and 1050 HIV-negative patients from Kano and Makurdi in Northern Nigeria, and were investigated for microsporidial infections by Giemsa staining technique (Light microscopy). In Kano, Enterocytozoon bienuesi was detected in 8 (14.17%) and Encephalitozoon intestinalis in 5 (2.60%) out of 192 HIV/AIDS patients screened. A mixed infection of both 0.52% was observed. Results from Makurdi showed that Enterocytozoon bienuesi was detected in 13 (0.65%) and Encephalitozoon intestinalis in 96 (4.78%) out of 2008 HIV/AIDS patients examined. No mixed infection was observed. Microsporidial spores were not found in 1050 HIV-negative patients screened from both areas. There was a significant difference (X2, p<0.05) in infection rates between the HIV/AIDS and HIV-negative patients. This study aimed at detecting the prevalence of intestinal microsporidia to provide baseline data on the status of this disease in Nigeria. Detection of Microsporidia in Immuno-compromised patients has not been described previously in this area

Adverse childhood experiences and suicide attempts in morbidly obese adults

Introdução: As tentativas de suicídio surgem frequentemente associadas a problemas alimentares, tanto anorexia quanto bulimia. Do mesmo modo, tem-se verifi cado uma elevada ocorrência de suicídio entre obesos. Investigações têm mostrado que a adversidade na infância pode ser um fator de risco para as tentativas de suicídio. Objetivos: Caracterizar e compreender a relação entre experiências de adversidade na infância e tentativas de suicídio em 100 obesos mórbidos candidatos a cirurgia bariátrica. Métodos: Um total de 100 pacientes foram selecionados de setembro de 2007 a outubro de 2007 e de janeiro de 2008 a janeiro de 2009, sendo que 20 pacientes eram do sexo feminino. A média de idade era de 38,89±9,87 anos, e a média do peso máximo era de 136,43±14 kg. O Questionário da História de Adversidade na Infância foi utilizado para avaliar experiências adversas. Resultados: 88% dos pacientes relataram a existência de pelo menos uma experiência de adversidade na infância, e 25% relataram já ter realizado pelo menos uma tentativa de suicídio. A adversidade na infância esteve associada a um risco aumentado para realizar tentativas de suicídio (odds ratio = 2,026). Conclusão: Esses dados devem ser levados em consideração na avaliação e no acompanhamento desses pacientes.Introduction: Suicide attempts are often associated with eating disorders, both anorexia and bulimia. Likewise, a high incidence of suicide has been observed among obese patients. Previous studies have shown that adverse experiences in childhood may be a risk factor for suicide attempts. Objectives: To characterize and to understand the relationship between adverse experiences and suicide attempts in 100 morbidly obese patients referred for bariatric surgery. Methods: A total of 100 patients were selected from September 2007 to October 2007 and from January 2008 to January 2009. Of these, 20 patients were females. Mean age was 38.89±9.87 years, and mean maximum weight was 136.43±14 kg. The Portuguese version of the Family ACE (Adverse Childhood Experiences) Questionnaire was used to assess the occurrence of adverse events. Results: 88% of the patients reported the existence of at least one adverse experience in childhood, and 25% reported at least one previous suicide attempt. Adversity in childhood was associated with an increased risk for suicide attempts (odds ratio = 2.026). Conclusion: These data should be taken into account in the assessment and monitoring of these patients.Fundação para a Ciência e a Tecnologia (FCT); (SFRH/BD/37069/2007)

Cerebrospinal fluid biomarker candidates associated with human WNV neuroinvasive disease

During the last decade, the epidemiology of WNV in humans has changed in the southern regions of Europe, with high incidence of West Nile fever (WNF) cases, but also of West Nile neuroinvasive disease (WNND). The lack of human vaccine or specific treatment against WNV infection imparts a pressing need to characterize indicators associated with neurological involvement. By its intimacy with central nervous system (CNS) structures, modifications in the cerebrospinal fluid (CSF) composition could accurately reflect CNS pathological process. Until now, few studies investigated the association between imbalance of CSF elements and severity of WNV infection. The aim of the present study was to apply the iTRAQ technology in order to identify the CSF proteins whose abundances are modified in patients with WNND. Forty-seven proteins were found modified in the CSF of WNND patients as compared to control groups, and most of them are reported for the first time in the context of WNND. On the basis of their known biological functions, several of these proteins were associated with inflammatory response. Among them, Defensin-1 alpha (DEFA1), a protein reported with anti-viral effects, presente

Efficacy of single-dose amodiaquine co-administered with sulfadoxine/pyrimethamine against falciparum infection in Barkin Ladi, an area of multi-drug resistant malaria

A study was conducted in Barkin Ladi on the North Central plateau of Nigeria to assess the efficacy and tolerability of a single-dose (10 mg/kg) amodiaquine co-administered with sulfadoxine/pyrimethamine (SP) against Plasmodium falciparum malaria in children less than 5 years of age using a 14-day protocol. The combination was highly efficacious in 41 patients involved in the trial, producing rapid parasite clearance (MPCR= 2.73 days) and faster clearance of fever (MFCR= 1.2 days). Adequate clinical and parasitological response (ACPR) achieved was 97.6%, while there was 1 (2.4%) case of late parasitological failure (LPF). The single-dose combination produced a significant improvement in PCV (

Declining efficacies of chloroquine and sulfadoxine-pyrimethamine combination against Plasmodium falciparum on the North Central Plateau, Nigeria: parasitological performance of the drugs

The sensitivity of Plasmodium falciparum to chloroquine (CQ) and sulfadoxine-pyrimethamine (SP) combination was assessed in vivo in children under five years of age in Barkin Ladi, in the cool Plateau of North Central Nigeria using the standard 14-day protocol. This was the first study of its kind, in this part of the country, under the new roll-back-malaria (RBM) initiative of the World Health Organization (WHO) Plasmodium infection was detected in 42% of the children screened: pure P. falciparum, 97% pure P. malariae, 2 mixed P. falciparum and P. malariae, 1%. The computed parasite density index (PDI) was 7.42. Children who qualified for enrolment into the study (54 for CQ and 55 for SP) were on average 31.1+14.7 and 26.5 + 14.9 months old, weighing 12.1+2.9 and 10.8+3.6 kg, respectively. Average drug consumptions were 304.0+72.3 mg for CQ and 0.6+0.2 tablet for SP. Cure rates were only 43% and 85%, while mean parasite clearance times (MPCTs) were 5.07 and 3.37 days, respectively confirming a significant decline in sensitivity of P.falciparum to the drugs. The need for an effective first-line drug as well as for combining SP with an effective anti-malaria drug is strongly emphasized

Amodiaquine treatment of uncomplicated malaria in children, in an area of chloroquine-resistant Plasmodium falciparum in north-central Nigeria

The efficacy of amodiaquine against Plasmodium falciparum malaria was assessed in an area of confirmed chloroquine resistance in the cool, north-central plateau of Nigeria, using a 14-day protocol. The patients were all children aged 0.05). The results justify the use of amodiaquine to treat P. falciparum malaria in those who have failed treatment with chloroquine and the second-line drugs (e.g. sulfadoxine-pyrimethamine) currently used in Nigeria. As the amodiaquine would be better employed as one part of a combination than on its own, there is a need to identify suitable partner compounds