A fouryear followup of school children after masstreatment for Schistosomiasis and Soil Transmitted Helminths in Mwea, Central Kenya

Poly-parasitism infections are common in school children in tropical regions, especially in Africa. In a school based schistosomiasis and soil-transmitted helminths de-worming model project in Mwea, Kenya, approximately 40,000 school age children from 86 schools were treated annually with a standard dose of praziquantel (40mg/kg body weight) and albendazole (400mg). A cohort of approximately 2,300 children from 5 sentinel schools were followed up at multiple time points each year for four years and examined for intestinal helminths (Schistosoma mansoni, Trichuris trichiura, Hookworm (Necator americanus) and Ascaris lumbricoides). The overall prevalence of infection in the five schools before treatment was 47.4% for S. mansoni, 16.7% for N. americanus, 0.8% for T. trichiura and 1.7% for A. lumbricoides. The mean intensity of infection, as measured by eggs per gram of faeces (epg) was 146.2 for S. mansoni, 36.3 for N. americanus 1.0 for T. trichiura and 35.8 for A. lumbricoides. After 4 rounds of treatment, prevalence of S. mansoni reduced significantly by 88.7% to 5.4% (95%CI=3.6% -7.1%), a 97.1% reduction. The prevalence and intensity of S. mansoni infection varied by school according to its proximity to irrigated area, with those schools closest to the irrigated areas presenting higher infection prevalence and intensity. Re-infection with schistosomiasis following treatment was observed and is likely to reflect continued environmental transmission due to non-treatment of the adult population. Soil-transmitted helminths are less prevalent in the cohort, with corresponding lower intensity. This may allow albendazole treatment to be reduced to every 2 or 3 years. This study has shown that periodic administration of anthelminthic drugs reduces the prevalence and intensity (which is likely to be a close proxy of morbidity) of intestinal parasitic infections in school-age children. Adults in the community could also be targeted where resources allow in order to further increasing the effectiveness of de-worming programmes. Keywords: Soil transmitted helminths, Schistosomiasis, school age, prevalence, Intensity, mass de-worming, school childre

Risk profiles and one-year outcomes of patients with newly diagnosed atrial fibrillation in India: Insights from the GARFIELD-AF Registry.

BACKGROUND: The Global Anticoagulant Registry in the FIELD-Atrial Fibrillation (GARFIELD-AF) is an ongoing prospective noninterventional registry, which is providing important information on the baseline characteristics, treatment patterns, and 1-year outcomes in patients with newly diagnosed non-valvular atrial fibrillation (NVAF). This report describes data from Indian patients recruited in this registry. METHODS AND RESULTS: A total of 52,014 patients with newly diagnosed AF were enrolled globally; of these, 1388 patients were recruited from 26 sites within India (2012-2016). In India, the mean age was 65.8 years at diagnosis of NVAF. Hypertension was the most prevalent risk factor for AF, present in 68.5% of patients from India and in 76.3% of patients globally (P < 0.001). Diabetes and coronary artery disease (CAD) were prevalent in 36.2% and 28.1% of patients as compared with global prevalence of 22.2% and 21.6%, respectively (P < 0.001 for both). Antiplatelet therapy was the most common antithrombotic treatment in India. With increasing stroke risk, however, patients were more likely to receive oral anticoagulant therapy [mainly vitamin K antagonist (VKA)], but average international normalized ratio (INR) was lower among Indian patients [median INR value 1.6 (interquartile range {IQR}: 1.3-2.3) versus 2.3 (IQR 1.8-2.8) (P < 0.001)]. Compared with other countries, patients from India had markedly higher rates of all-cause mortality [7.68 per 100 person-years (95% confidence interval 6.32-9.35) vs 4.34 (4.16-4.53), P < 0.0001], while rates of stroke/systemic embolism and major bleeding were lower after 1 year of follow-up. CONCLUSION: Compared to previously published registries from India, the GARFIELD-AF registry describes clinical profiles and outcomes in Indian patients with AF of a different etiology. The registry data show that compared to the rest of the world, Indian AF patients are younger in age and have more diabetes and CAD. Patients with a higher stroke risk are more likely to receive anticoagulation therapy with VKA but are underdosed compared with the global average in the GARFIELD-AF. CLINICAL TRIAL REGISTRATION-URL: http://www.clinicaltrials.gov. Unique identifier: NCT01090362

Beclin–phosphatidylinositol 3-kinase complex functions at the trans-Golgi network

Autophagy is an intracellular bulk protein degradation system. Beclin is known to be involved in this process; however, its role is unclear. In this study, we showed that Beclin was co-immunoprecipitated with phosphatidylinositol (PtdIns) 3-kinase, which is also required for autophagy, suggesting that Beclin is a component of the PtdIns 3-kinase complex. Quantitative analyses using a cross-linker showed that all Beclin forms a complex with PtdIns 3-kinase, whereas ∼50% of PtdIns 3-kinase remains free from Beclin. Indirect immunofluorescence microscopy demonstrated that the majority of Beclin and PtdIns 3-kinase localize to the trans-Golgi network (TGN). Some PtdIns 3-kinase is also distributed in the late endosome. These results suggest that Beclin and PtdIns 3-kinase control autophagy as a complex at the TGN