Pneumocystis jirovecii and microsporidia: An unusual coinfection in HIV patients?

Pneumocystis jirovecii and microsporidia species are recognized as opportunistic infectious pathogens in AIDS patients. Coinfection of both in one patient has been rarely reported. The aim of the present study was to investigate the coinfection of P. jirovecii and microsporidia in different tissues from AIDS deceased patients. Post mortem histological finding of P. jirovecii and microsporidia was demonstrated by means of the Grocott’smethenamine silver and Brown Brenn staining, respectively. Molecular technique was used for identification and characterization of both fungi. Out of the 514 autopsied cases P. jirovecii andmicrosporidia species were identified in 53 (10.3%) and 62 (12.1%) cases respectively. A total of five cases (0.97%) coinfected with Pneumocystis and microsporidia were recovered from all analyzed autopsies. Coinfection of Pneumocystis and microsporidia is very challenging and raises interesting issues about host-parasite relationship. The early diagnosis of both pathogens must be crucial to establish correct and early treatments, improve the patient’s evolution, reducing the risk of death

Syphilis and HIV infection in indigenous Mbya Guarani communities of Puerto Iguazu (Argentina): diagnosis, contact tracking, and follow-up

The aim of study was to assess the prevalence of Treponema pallidum and HIV infection in Amerindian people (Mbya Guarani) over the age of 11 in Puerto Iguazu (Argentina) and to describe the contact tracking of cases. The method was a cross-sectional study in the Mbya Guarani people living in three villages of Puerto Iguazu (community A, pop. 1,146; community B, pop. 369; and community C, pop. 149). Participants were randomly invited to participate in the survey and in blood testing. Of the 551 participants, 48 were infected by T. pallidum (8.71%; 95% confidence interval [CI] 7.38-10.04). The infection prevalence decreased with age, standing at 9.66% in the 11-19 age group, 8.42% in 20-39 age group and 4.54% in people aged 40 and older. We tracked 130 contacts for the 48 T. pallidum cases; 39/40 (97.5%) sexual contacts tested positive for syphilis. Among the 90 children born to infected mothers, 76 aged 18 months or older tested negative, while 8/14 younger children were still at risk for congenital syphilis. There were four cases of HIV infection (0.72%, 95% CI 0.31-1.13). Prevalence of T. pallidum infection and HIV infection are relevant in this indigenous community of Argentina, representing a public health concern

Hookworm-like eggs in children’s faecal samples from a rural area of Rwanda

Background: Hookworm eggs identification and quantification is usually carried out by Kato-Katz method. However various structures present in the smear may be confused with eggs of such parasites.Objective: To document the presence of structures in Kato-Katz slides that could initially be misinterpreted as hookworm eggs.Method: 497 faecal samples were analysed by Kato-Katz technique, diphasic concentration technique, agar-plate coprocultive and larvae obtained were analysed by PCR and characterized by sequencing.Result: Hookworm-like eggs were found in 159 (32%) of the samples by Kato Katz, finally identified as Caenorhabditis elegans by PCR technique.Conclusion: The diagnosis of human hookworm eggs, only by the use of Kato Katz technique can lead to false positives because of similarities with eggs of other free-living worms, from wet soils like those of Rwanda that could contaminate stool samples.Keywords: Hookworm eggs, Kato-Katz method, misclassification, Rwand

Anemia and undernutrition in intestinally parasitized schoolchildren from Gakenke district, Northern Province of Rwanda

Background: Rwanda is a sub-Saharan country, where intestinal parasite infections, anemia and undernutrition coexist. The purpose of this research is to study the relationship between intestinal parasite infections and undernutrition/anemia to clarify the priorities of intervention in the rural area of Gakenke district in the Northern Province of Rwanda. Materials and methods: A total of 674 students from Nemba I School, participated in a cross-sectional study, in which their parasitological and nutritional status were analysed. Statistical analysis was performed by χ2 test, univariate analysis and Odds ratios (OR). Results: A total of 95.3% of children presented intestinal parasitism, most of whom (94.5%) infected by protozoa and 36.1% infected by soil-transmitted helminths (STH), with Trichuris trichiura (27.3%) being the most prevalent. Multiple infections were found to be high (83.8%), with protozoa and STH co-infections in 30.6%. STH infections were mainly of low/moderate intensity. Neither infection nor STH infection of any intensity profile, was significantly related to anemia. In addition, STH infection, regardless of the intensity profile, was not associated with stunting, underweight or thinness. There was no difference between genders nor among ages in odds of anemia and nutritional status in STH-infected schoolchildren. Conclusion: Multiparasitism remains high among Rwandan schoolchildren and is likely to cause nutritional problems. This work emphasizes the importance of keeping up health programs to reduce the prevalence of infection

Primera caracterización molecular de Leishmania infantum en pacientes con leishmaniosis visceral de la Provincia de Misiones, Argentina

Introducción. La leishmaniosis cutánea por Leishmania braziliensis ha sidotradicionalmente endémica en Argentina y se han sido descritos casos de compromiso visceral después de una leishmaniosis cutánea inicial. La leishmaniosis visceral emergió en Argentina en el año 2006 en la ciudad de Posadas, provincia de Misiones, afectando tanto a humanos como a perros. Objetivo. Identificar el agente etiológico a nivel de especie de los pacientes diagnosticados con leishmaniosis visceral en Misiones y describir sus características clínico-epidemiológicas.Materiales y métodos. Se estudió una serie de 24 pacientes con diagnóstico confirmado de leishmaniosis visceral en la provincia de Misiones en el período 2009 al 2016. Para la identificación de Leishmania spp., los pacientes fueron sometidos a estudios diagnósticos indirectos (serológicos) y directos (microscopía, detección de ADN y secuenciación). También, se estudiaron variables como edad, sexo, lugar de residencia, y signos y síntomas clínicos indicativos de leishmaniosis visceral. Resultados. De los 24 pacientes estudiados, 18 (75 %) eran hombres y 6 (25 %) eran menores de cuatro años. La manifestación clínica más frecuente fue el síndrome febril prolongado en 21 (87,5 %) de los pacientes, seguido de esplenomegalia en 17 (70,8 %). Se identificó la especie Leishmania infantum en todos los pacientes estudiados. Conclusión. Este hallazgo constituye la primera identificación de la especie L. infantum en pacientes autóctonos de la provincia de Misiones. El estudio evidenció la importancia de la PCR para el manejo epidemiológico de la leishmaniosis visceral en Argentina

Autochthonous Outbreak of Cutaneous Leishmaniasis due to Leishmania infantum in Corrientes Province, Argentina

Endemic cutaneous leishmaniasis (CL) in northern Argentina has traditionally been caused by Leishmania braziliensis. This study aims to describe an outbreak of Leishmania infantum-caused human CL in the Department Capital of Corrientes Province, Argentina. We retrospectively analyzed the reported cases of CL in this area from May 2015 to December 2016. Eighty cases of CL were clinically and analytically diagnosed, and there was one case of visceral leishmaniasis in a boy who also had CL. Patients' median age was 33.6 years (range 1-89 years), and 18.5% were younger than 15 years; the male:female ratio was 3.5:1. Cases lived mostly in the municipality of Corrientes (72.8%), whereas 27.2% resided in Riachuelo. Although 67.9% had a single lesion, 32.1% had several. Molecular analyses showed that L. infantum was the causative species in all cases. Our results show that for the first time, there was an outbreak of CL by L. infantum in an urban area of Argentina

Evidence for Transmission of Taenia solium Taeniasis/Cysticercosis in a Rural Area of Northern Rwanda

Cysticercosis is a parasitic infection caused by the metacestode larval stage (cysticercus) of Taenia solium. In humans, cysticercosis may infect the central nervous system and cause neurocysticercosis, which is responsible for over 50,000 deaths per year worldwide and is themajor cause of preventable epilepsy cases, especially in low-income countries. Cysticercosis infection is endemic in many less developed countries where poor hygiene conditions and free-range pig management favor their transmission. A cross-sectional study was conducted in 680 children from a rural primary school in Gakenke district (Northern province of Rwanda). Stool samples were collected from participants and analyzed using the Kato-Katz method (KK), formol-ether concentration (FEC), and/or copro-antigen enzyme-linked immunosorbent assay (CoAg-ELISA) to detect taeniasis. Blood samples were collected and analyzed using enzyme-linked immunoelectrotransfer blot (EITB) and antigen enzyme-linked immunosorbent assay (Ag-ELISA) to detect human cysticercosis. The overall proportion of taeniasis positivity was 0.3%(2/680), and both cases were also confirmed by CoAg-ELISA. A total of 13.3% (76/572) of the children studied were positive to cysticercosis (T. solium-specific serum antibodies detected by EITB), of whom 38.0% (27/71) had viable cysticercus (T. solium antigens by Ag-ELISA). This study provides evidence of the highest cysticercosis prevalence reported in Rwanda in children to date. Systematic investigations into porcine and human cysticercosis as well as health education and hygiene measures for T. solium control are needed in Gakenke district

Microsporidia as a Potential Threat to the Iberian Lynx (Lynx pardinus)

Lynx pardinus is one of the world’s most endangered felines inhabiting the Iberian Peninsula. The present study was performed to identify the presence of microsporidia due to the mortality increase in lynxes. Samples of urine (n = 124), feces (n = 52), and tissues [spleen (n = 13), brain (n = 9), liver (n = 11), and kidney (n = 10)] from 140 lynxes were studied. The determination of microsporidia was evaluated using Weber’s chromotrope stain and Real Time-PCR. Of the lynxes analyzed, stains showed 10.48% and 50% positivity in urine and feces samples, respectively. PCR confirmed that 7.69% and 65.38% belonged to microsporidia species. The imprints of the tissues showed positive results in the spleen (38.46%), brain (22.22%), and liver (27.27%), but negative results in the kidneys. PCR confirmed positive microsporidia results in 61.53%, 55.55%, 45.45%, and 50%, respectively. Seroprevalence against Encephalitozoon cuniculi was also studied in 138 serum samples with a positivity of 55.8%. For the first time, the results presented different species of microsporidia in the urine, feces, and tissue samples of Lynx pardinus. The high titers of anti-E. cuniculi antibodies in lynx sera confirmed the presence of microsporidia in the lynx environment. New studies are needed to establish the impact of microsporidia infection on the survival of the Iberian lynx

A canine leishmaniasis pilot survey in an emerging focus of visceral leishmaniasis: Posadas (Misiones, Argentina)

<p>Abstract</p> <p>Background</p> <p>An increasing number of reports are calling our attention to the worldwide spread of leishmaniasis. The urbanization of zoonotic visceral leishmaniasis (VL) has been observed in different South American countries, due to changes in demographic and ecological factors. In May 2006, VL was detected for the first time in the city of Posadas (Misiones, Argentina). This event encouraged us to conduct a clinical and parasitological pilot survey on domestic dogs from Posadas to identify their potential role as reservoirs for the disease.</p> <p>Methods</p> <p>One hundred and ten dogs from the city of Posadas were included in the study. They were selected based on convenience and availability. All dogs underwent clinical examination. Symptomatology related to canine leishmaniasis was recorded, and peripheral blood and lymph node aspirates were collected. Anti-<it>Leishmania </it>antibodies were detected using rK39-immunocromatographic tests and IFAT. Parasite detection was based on peripheral blood and lymph node aspirate PCR targeting the <it>SSUrRNA </it>gene. Molecular typing was addressed by DNA sequence analysis of the PCR products obtained by <it>SSUrRNA </it>and ITS-1 PCR.</p> <p>Results</p> <p>According to clinical examination, 69.1% (76/110) of the dogs presented symptoms compatible with canine leishmaniasis. Serological analyses were positive for 43.6% (48/110) of the dogs and parasite DNA was detected in 47.3% (52/110). A total of 63 dogs (57.3%) were positive by serology and/or PCR. Molecular typing identified <it>Leishmania infantum </it>(syn. <it>Leishmania chagasi</it>) as the causative agent.</p> <p>Conclusions</p> <p>This work confirms recent findings which revealed the presence of <it>Lutzomyia longipalpis</it>, the vector of <it>L. infantum </it>in this area of South America. This new VL focus could be well established, and further work is needed to ascertain its magnitude and to prevent further human VL cases.</p