Food web structure and microenvironment affect Chagas disease vector infection and abundance in a rural landscape

Vector-borne pathogen transmission is shaped by multiple abiotic and biotic factors. Understanding the relative importance of these factors on vector abundance and infection is important for developing vector-borne disease control strategies. The crown of the Attalea butyracea palm provides a natural arboreal mesocosm suitable for studying how food web relations and microclimate affect Chagas disease vectors of the genus Rhodnius, which feed on vertebrate blood and interact with many vertebrate and invertebrate species, vegetation, and detritus within the palm crown. We performed a cross-sectional, observational study of A. butyracea crowns using a community ecology network approach to evaluate abiotic and biotic conditions associated with Rhodnius pallescens abundance and infection with Trypanosoma cruzi, the Chagas disease etiologic agent. We collected 1098 R. pallescens from 105 A. butyracea crowns in rural landscapes of Panama. In a palm subset (N = 49), we recorded microclimate and habitat conditions and counted vertebrate and invertebrate species in order to characterize palm crown food webs. We used food web metrics, namely Generality (average number of prey per predator) and Vulnerability (average number of predators per prey) to evaluate associations between palm community trophic structure, vector predators, vector blood meal species composition, vector abundance, and vector T. cruzi infection. Field data analyzed with generalized linear models showed that vector abundance and infection in a given palm crown were influenced by a combination of geographic location, land-use type, palm crown animal community composition, and microhabitat conditions. Vector abundance was negatively associated with increased overall palm crown community diversity. However, vector abundance was positively associated with the invertebrate predator and mammal community. R. pallescens Vulnerability score, which measures predation pressure on the vector within the palm crown, was positively associated with vector abundance. Vector infection with T. cruzi was positively associated with mammal presence; vectors in palms with mammals were about 25 times more likely to be infected with T. cruzi compared with vectors in palms without mammals. Our findings suggest that a holistic study of food webs and environmental variables at the local scale can provide useful information for vector-borne disease management across a wide habitat range

When climate change couples social neglect: malaria dynamics in Panama

A major challenge of infectious disease elimination is the need to interrupt pathogen transmission across all vulnerable populations. Ethnic minorities are among the key vulnerable groups deserving special attention in disease elimination initiatives, especially because their lifestyle might be intrinsically linked to locations with high transmission risk. There has been a renewed interest in malaria elimination, which has ignited a quest to understand factors necessary for sustainable malaria elimination, highlighting the need for diverse approaches to address epidemiological heterogeneity across malaria transmission settings. An analysis of malaria incidence among the Guna Amerindians of Panama over the last 34 years showed that this ethnic minority was highly vulnerable to changes that were assumed to not impact malaria transmission. Epidemic outbreaks were linked with El Nino Southern Oscillations and were sensitive to political instability and policy changes that did not ensure adequate attention to the malaria control needs of the Gunas. Our results illustrate how the neglect of minorities poses a threat to the sustainable control and eventual elimination of malaria in Central America and other areas where ethnic minorities do not share the benefits of malaria control strategies intended for dominant ethnic groups

The calmodulin intergenic spacer as molecular target for characterization of Leishmania species

Background: Human leishmaniasis is a neglected disease caused by parasites of the genus Leishmania. Clinical aspects of this disease can vary significantly, reflecting the wide range of parasites in the genus Leishmania. Knowing accurately the Leishmania species infecting humans is important for clinical case management and evaluation of epidemiological risk. Calmodulin is an essential gene in trypanosomatids that modulates the calcium metabolism in various cellular activities. Despite its strong conservation in trypanosomatids, it has been recently observed that its untranslated regions (UTR) diverge among species. Methods: In this study we analyzed the sequences and the absolute dinucleotide frequency of the intergenic spacer of the calmodulin gene (containing both, 3′ and 5′UTR) in nine reference Leishmania species and ten clinical isolates obtained from patients with cutaneous leishmaniasis. Results: We show that the short calmodulin intergenic spacers exhibit features that make them interesting for applications in molecular characterization and phylogenetic studies of Leishmania. Dendrograms based on sequence alignments and on the dinucleotide frequency indicate that this particular region of calmodulin gene might be useful for species typing between the Leishmania and Viannia subgenera. Conclusions: Mutations and composition of the calmodulin intergenic spacer from Leishmania species might have taxonomic value as parameters to define if an isolate is identical to a certain species or belongs to one of the two current subgenera

A New Endemic Focus of Chagas Disease in the Northern Region of Veraguas Province, Western Half Panama, Central America

Background: Chagas disease was originally reported in Panama in 1931. Currently, the best knowledge of this zoonosis is restricted to studies done in historically endemic regions. However, little is known about the distribution and epidemiology of Chagas disease in other rural areas of the country. Methods and Findings: A cross-sectional descriptive study was carried out between May 2005 – July 2008 in four rural communities of the Santa Fe District, Veraguas Province. The study included an entomologic search to collect triatomines, bloodmeal type identification and infection rate with trypanosomes in collected vectors using a dot- blot and PCR analysis, genotyping of circulating Trypanosoma cruzi (mini-exon gene PCR analysis) and the detection of chagasic antibodies among inhabitants. The vector Rhodnius pallescens was more frequently found in La Culaca and El Pantano communities (788 specimens), where it was a sporadic household visitor. These triatomines presented darker coloration and larger sizescompared with typical specimens collected in Central Panama. Triatoma dimidiata was more common in Sabaneta de El Macho (162 specimens). In one small sub-region (El Macho), 60 % of the houses were colonized by this vector. Of the examined R. pallescens, 54.7.0 % (88/161) had fed on Didelphis marsupialis, and 24.6 % (34/138) of T. dimidiata specimens collected inside houses were positive for human blood. R. pallescens presented an infection index with T. cruzi of 17.7 % (24/ 136), with T. rangeli of 12.5 % (17/136) and 50.7 % (69/136) were mixed infections. In 117 T. dimidiata domestic specimens th

Cutaneous Leishmaniasis in dogs: is high seroprevalence indicative of a reservoir role?

American cutaneous leishmaniasis (ACL) is a complex disease with a rich diversity of animal host species. This diversity imposes a challenge, since understanding ACL transmission requires the adequate identification of reservoir hosts, those species able to be a source of additional infections. In this study we present results from an ACL cross-sectional serological survey of 51 dogs (Canis familiaris), where we used diagnostic tests that measure dog\u27s exposure to Leishmania spp. parasites. We did our research in Panama, at a village that has undergone significant ecosystem level transformations. We found an ACL seroprevalence of 47% among dogs, and their exposure was positively associated with dog age and abundance of sand fly vectors in the houses of dog owners. Using mathematical models, which were fitted to data on the proportion of positive tests as function of dog age, we estimated a basic reproductive number (R0 ± s.e.) of 1・22 ± 0・09 that indicates the disease is endemically established in the dogs. Nevertheless, this information by itself is insufficient to incriminate dogs as ACL reservoirs, given the inability to find parasites (or their DNA) in seropositive dogs and previously reported failures to experimentally infect vectors feeding on dogs with ACL parasites

Survey of Wild Mammal Hosts of Cutaneous Leishmaniasis Parasites in Panama and Costa Rica

The eco-epidemiology of American cutaneous leishmaniasis (ACL) is driven by animal reservoir species that are a source of infection for sand flies that serve as vectors infecting humans with Leishmania spp parasites. The emergence and re-emergence of this disease across Latin America calls for further studies to identify reservoir species associated with enzootic transmission. Here, we present results from a survey of 52 individuals from 13 wild mammal species at endemic sites in Costa Rica and Panama where ACL mammal hosts have not been previously studied. For Leishmania spp. diagnostics we employed a novel PCR technique using blood samples collected on filter paper. We only found Leishmania spp parasites in one host, the two-toed sloth, Choloepus hoffmanni. Our findings add further support to the role of two-toed sloths as an important ACL reservoir in Central America

Tuberculosis is associated with expansion of a motile, permissive and immunomodulatory CD16(+) monocyte population via the IL-10/STAT3 axis

The human CD14+ monocyte compartment is composed by two subsets based on CD16 expression. We previously reported that this compartment is perturbed in tuberculosis (TB) patients, as reflected by the expansion of CD16+ monocytes along with disease severity. Whether this unbalance is beneficial or detrimental to host defense remains to be elucidated. Here in the context of active TB, we demonstrate that human monocytes are predisposed to differentiate towards an anti-inflammatory (M2-like) macrophage activation program characterized by theCD16+CD163+MerTK+pSTAT3+ phenotype and functional properties such as enhanced protease-dependent motility, pathogen permissivity and immunomodulation. This process is dependent on STAT3 activation, and loss-of-function experiments point towards a detrimental role in host defense against TB. Importantly, we provide a critical correlation between the abundance of the CD16+CD163+MerTK+pSTAT3+ cells and the progression of the disease either at the local level in a non-human primate tuberculous granuloma context, or at the systemic level through the detection of the soluble form of CD163 in human sera. Collectively, this study argues for the pathogenic role of the CD16+CD163+MerTK+pSTAT3+ monocyte-to-macrophage differentiation program and its potential as a target for TB therapy,and promotes the detection of circulating CD163 as a potential biomarker for disease progression and monitoringof treatment efficacy.Fil: Lastrucci, Claire. Centre National de la Recherche Scientifique; FranciaFil: Bénard, Alan. Centre National de la Recherche Scientifique; FranciaFil: Balboa, Luciana. Consejo Nacional de Investigaciones Científicas y Técnicas. Instituto de Medicina Experimental. Academia Nacional de Medicina de Buenos Aires. Instituto de Medicina Experimental; ArgentinaFil: Pingris, Karine. Centre National de la Recherche Scientifique; FranciaFil: Souriant, Shanti. Centre National de la Recherche Scientifique; FranciaFil: Poincloux, Renaud. Centre National de la Recherche Scientifique; FranciaFil: Al Saati, Talal. Inserm; FranciaFil: Rasolofo, Voahangy. Pasteur Institute in Antananarivo; MadagascarFil: González Montaner, Pablo. Gobierno de la Ciudad de Buenos Aires. Hospital de Infecciosas ; ArgentinaFil: Inwentarz, Sandra. Gobierno de la Ciudad de Buenos Aires. Hospital de Infecciosas ; ArgentinaFil: Moraña, Eduardo José. Gobierno de la Ciudad de Buenos Aires. Hospital de Infecciosas ; ArgentinaFil: Kondova, Ivanela. Biomedical Primate Research Centre; Países BajosFil: Verreck, Franck A. W.. Biomedical Primate Research Centre; Países BajosFil: Sasiain, María del Carmen. Consejo Nacional de Investigaciones Científicas y Técnicas. Instituto de Medicina Experimental. Academia Nacional de Medicina de Buenos Aires. Instituto de Medicina Experimental; ArgentinaFil: Neyrolles, Olivier. Centre National de la Recherche Scientifique; FranciaFil: Maridonneau Parini, Isabel. Centre National de la Recherche Scientifique; FranciaFil: Lugo Villarino, Geanncarlo. Centre National de la Recherche Scientifique; FranciaFil: Cougoule, Celine. Centre National de la Recherche Scientifique; Franci

Differential clinical characteristics and prognosis of intraventricular conduction defects in patients with chronic heart failure

Intraventricular conduction defects (IVCDs) can impair prognosis of heart failure (HF), but their specific impact is not well established. This study aimed to analyse the clinical profile and outcomes of HF patients with LBBB, right bundle branch block (RBBB), left anterior fascicular block (LAFB), and no IVCDs. Clinical variables and outcomes after a median follow-up of 21 months were analysed in 1762 patients with chronic HF and LBBB (n = 532), RBBB (n = 134), LAFB (n = 154), and no IVCDs (n = 942). LBBB was associated with more marked LV dilation, depressed LVEF, and mitral valve regurgitation. Patients with RBBB presented overt signs of congestive HF and depressed right ventricular motion. The LAFB group presented intermediate clinical characteristics, and patients with no IVCDs were more often women with less enlarged left ventricles and less depressed LVEF. Death occurred in 332 patients (interannual mortality = 10.8%): cardiovascular in 257, extravascular in 61, and of unknown origin in 14 patients. Cardiac death occurred in 230 (pump failure in 171 and sudden death in 59). An adjusted Cox model showed higher risk of cardiac death and pump failure death in the LBBB and RBBB than in the LAFB and the no IVCD groups. LBBB and RBBB are associated with different clinical profiles and both are independent predictors of increased risk of cardiac death in patients with HF. A more favourable prognosis was observed in patients with LAFB and in those free of IVCDs. Further research in HF patients with RBBB is warranted

Clinical Cutaneous Leishmaniasis Rates Are Associated with Household Lutzomyia gomezi, Lu. Panamensis, and Lu. trapidoi Abundance in Trinidad de Las Minas, Western Panama

American cutaneous leishmaniasis (ACL) transmission patterns have been increasingly associated with domestic and peridomestic environments. Here, we present results from an epidemiological survey of 94 people from 24 households in Trinidad de Las Minas, western Panama. We studied the role of sand fly abundance, housing quality, peridomicile landscape matrix, and vegetation structure on shaping household clinical ACL rate patterns at Trinidad de Las Minas. We found that sand fly abundance was significantly associated with household clinical ACL rates, with a 6% rate increase for each additional Lutzomyia gomezi sand fly found inside a domicile