88 research outputs found
Risk factors for mortality of children with zoonotic visceral leishmaniasis in Central Tunisia
<div><p>Background</p><p>Zoonotic visceral leishmaniasis (ZVL) caused by <i>Leishmania infantum</i> is endemic with an epidemiological profile of a paediatric disease in Tunisia. In the context of a high fatality rate, identifying risk factors for in-hospital mortality in children treated for ZVL is of major epidemiological importance.</p><p>Design</p><p>A retrospective (case-control) study included 230 immuno-competent children diagnosed and confirmed with primary ZVL in the paediatric department of the University Hospital of Kairouan between 2004 and 2014. Forty-seven per cent (47%) were children under 18 months of age, and with a male ⁄ female ratio of 1.01:1.</p><p>Results</p><p>The overall case-fatality was 6% (n = 14). The risk factors for in-hospital death identified by a multivariate analysis were: bleeding at admission (OR = 25.5, 95% CI: 2.26–287.4; p = 0.009), white cell count less than 4000/mm3 (OR = 5.66, 95% CI: 1.16–27.6; p = 0.032), cytolysis (OR = 28.13, 95% CI: 4.55–173.6; p < 0.001), and delay between onset of symptoms and admission ≥ 15 days (OR = 11, 95% CI: 1.68–72; p = 0.012).</p><p>Conclusion</p><p>The results strongly suggest that paediatric patients admitted 15 days after onset of symptoms, with bleeding, white cell counts below 4,000/mm<sup>3</sup>, and cytolysis at admission should be considered severe cases and subsequently, they are at high risk of mortality. A better understanding of factors associated with death of children from ZVL may contribute to decrease mortality.</p></div
Univariate analysis of risk factors of mortality in children with ZVL.
<p>Univariate analysis of risk factors of mortality in children with ZVL.</p
Multivariate analysis of risk factors of mortality in children with ZVL.
<p>Multivariate analysis of risk factors of mortality in children with ZVL.</p
Representation of the categorized clinical data and variables versus morbidity in 2 dimensions resulting from the MCA, in order to describe potential grouping either for individual observations or variables.
<p>Representation of the categorized clinical data and variables versus morbidity in 2 dimensions resulting from the MCA, in order to describe potential grouping either for individual observations or variables.</p
Updating the Salivary Gland Transcriptome of <em>Phlebotomus papatasi</em> (Tunisian Strain): The Search for Sand Fly-Secreted Immunogenic Proteins for Humans
<div><h3>Introduction</h3><p>Sand fly saliva plays an important role in both blood feeding and outcome of <em>Leishmania</em> infection. A cellular immune response against a <em>Phlebotomus papatasi</em> salivary protein was shown to protect rodents against <em>Leishmania major</em> infection. In humans, <em>P. papatasi</em> salivary proteins induce a systemic cellular immune response as well as a specific antisaliva humoral immune response, making these salivary proteins attractive targets as markers of exposure for this <em>Leishmania</em> vector. Surprisingly, the repertoire of salivary proteins reported for <em>P. papatasi</em>–a model sand fly for <em>Leishmania</em>-vector-host molecular interactions–is very limited compared with other sand fly species. We hypothesize that a more comprehensive study of the transcripts present in the salivary glands of <em>P. papatasi</em> will provide better knowledge of the repertoire of proteins of this important vector and will aid in selection of potential immunogenic proteins for humans and of those proteins that are highly conserved between different sand fly strains.</p> <h3>Methods and Findings</h3><p>A cDNA library from <em>P. papatasi</em> (Tunisian strain) salivary glands was constructed, and randomly selected transcripts were sequenced and analyzed. The most abundant transcripts encoding secreted proteins were identified and compared with previously reported sequences. Importantly, we identified salivary proteins not described before in this sand fly species.</p> <h3>Conclusions</h3><p>Comparative analysis between the salivary proteins of <em>P. papatasi</em> from Tunisia and Israel strains shows a high level of identity, suggesting these proteins as potential common targets for markers of vector exposure or inducers of cellular immune responses in humans for different geographic areas.</p> </div
Multiple sequence alignment of PPTSP2.5 and the SP2.5-like proteins from <i>Phlebotomus duboscqi</i> (Pd), <i>Phlebotomus perniciosus</i> (Pr), <i>Phlebotomus tobbi</i> (Pt) and <i>Phlebotomus arabicus</i> (Pa).
<p>Underlining indicates the predicted signal peptide sequence; black shading represents identity between amino acids of the predicted mature peptide.</p
Alignment of Lufaxin, the Factor Xa inhibitor from the saliva of <i>Lutzomyia longipalpis</i>, and the PPTSP34 salivary protein from <i>Phlebotomus papatasi</i> Tunisian strain.
<p>Black background shading represents identical amino acids.</p
Multiple sequence alignment of the large OBP (D7 related proteins PPTSP30 and PPTSP28) and the small molecular weight OBP from the salivary glands of <i>Phlebotomus papatasi</i>.
<p>Multiple sequence alignment of the large OBP (D7 related proteins PPTSP30 and PPTSP28) and the small molecular weight OBP from the salivary glands of <i>Phlebotomus papatasi</i>.</p
Multiple sequence alignment of the two distinct members of the PPTSP14.2 family of proteins from the saliva of <i>Phlebotomus papatasi</i>.
<p>Black shading represents identical amino acids.</p
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