Acute schistosomiasis, a diagnostic and therapeutic challenge

AbstractIn non-endemic countries, acute (invasive) schistosomiasis (AS) is typically seen in non-immune travellers, whereas chronic schistosomiasis is more frequently diagnosed in immigrants. Travellers with AS initially present with non-specific signs such as fever, cough, headache, and urticaria. Life-threatening cardiac and neurological complications may occur. The positive diagnosis of AS relies on seroconversion, which appears together with hypereosinophilia approximately 3 weeks after the onset of symptoms. When prescribed during AS, praziquantel usually does not prevent the chronic phase of the disease and is associated with exacerbation of signs and symptoms in approximately 50% of cases. According to the published literature, corticosteroids may be recommended alone or in association with praziquantel. When associated with corticosteroids, pharmacokinetic interactions may impair the efficacy of praziquantel. We suggest that corticosteroids should be restricted to use in patients with systemic complications of AS, whereas praziquantel should be initiated only when ova are detected in either stools or urine, depending on the culprit species

Evaluation of the chagas western blot igg assay for the diagnosis of chagas disease

Chagas disease is a debilitating and often fatal pathology resulting from infection by the protozoan parasite Trypanosoma cruzi. In its recommendations, the World Health Organization states that the diagnosis of T. cruzi infection is usually based on the detection of antibodies against T. cruzi antigens and performed with two methodologically different assays. An inconclusive result can be resolved with a third “confirmatory” assay. The objective of this article is to evaluate the effectiveness of the Chagas Western Blot IgG assay (LDBio Diagnostics, Lyon, France) as a confirmatory serologic test. The Chagas Western Blot IgG assay was performed with native antigens derived from a T. cruzi strain of the TcVI genotype. Retrospective sera were provided by two parasitology laboratories (France and Argentina). The sensitivity, specificity, positive predictive value and negative predictive value of the Chagas blot were all 100% in our sera collection. The Chagas blot is an easy and qualitative method for the diagnosis of Chagas disease, with results in less than 2 h. This immunoblot has potential as a supplemental test for the confirmation of the presence of antibodies against T. cruzi in serum specimens. Nonetheless, the very good initial results presented here will need to be confirmed in larger studies.Fil: Brossas, Jean Yves. Sorbonne Université Hôpital Pitié-Salpêtrière; FranciaFil: Ballering, Griselda Edith. Gobierno de la Ciudad de Buenos Aires. Instituto Multidisciplinario de Investigaciones en Patologías Pediátricas. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto Multidisciplinario de Investigaciones en Patologías Pediátricas; ArgentinaFil: Bisio, Margarita María Catalina. Gobierno de la Ciudad de Buenos Aires. Instituto Multidisciplinario de Investigaciones en Patologías Pediátricas. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto Multidisciplinario de Investigaciones en Patologías Pediátricas; ArgentinaFil: Guihenneuc, Jeremy. Sorbonne Université Hôpital Pitié-Salpêtrière; FranciaFil: Gulin, Julián Ernesto Nicolás. Gobierno de la Ciudad de Buenos Aires. Instituto Multidisciplinario de Investigaciones en Patologías Pediátricas. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto Multidisciplinario de Investigaciones en Patologías Pediátricas; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Investigaciones Biomédicas. Universidad de Buenos Aires. Facultad de Medicina. Instituto de Investigaciones Biomédicas; ArgentinaFil: Jauréguiberry, S.. Sorbonne Université Hôpital Pitié-Salpêtrière; FranciaFil: Lescure, François Xavier. Hôpitaux Universitaires Paris Nord val de Seine; FranciaFil: Fekkar, Arnaud. Sorbonne Université Hôpital Pitié-Salpêtrière; FranciaFil: Mazier, Dominique. Sorbonne University; FranciaFil: Altcheh, Jaime Marcelo. Gobierno de la Ciudad de Buenos Aires. Instituto Multidisciplinario de Investigaciones en Patologías Pediátricas. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto Multidisciplinario de Investigaciones en Patologías Pediátricas; ArgentinaFil: Paris, Luc. Sorbonne Université Hôpital Pitié-Salpêtrière; Franci

Prevalence and risk factors of hepatitis B and C viruses among haemodialysis patients in Gaza strip, Palestine

<p>Abstract</p> <p>Background</p> <p>The prevalence of hepatitis B virus (HBV) and hepatitis C virus (HCV) and its associated risk factors among haemodialysis (HD) patients in Gaza strip was investigated using serological and molecular techniques.</p> <p>Results</p> <p>The overall prevalence of HBV among the four HD centers was 8.1%. The main risk factors were HD center (p = 0.05), history of blood transfusion (p < 0.01), and treatment abroad (p = 0.01). The overall prevalence of HCV among the four HD centers was 22%. The main risk factors were HD center (p < 0.01), time duration on HD (p < 0.01), history of blood transfusion (p < 0.01), treatment abroad (p < 0.01), and history of blood transfusion abroad (p < 0.01). Serum aminotransferases levels decreased in HD patients compared with normal population but still there was a direct association between the activity of liver enzymes and both HBV (p < 0.01) and HCV (p < 0.01) infection.</p> <p>Conclusion</p> <p>The much higher prevalence of Hepatitis viruses among HD patients compared to the normal population of Gaza strip indicates a causative relation between HD and hepatitis viruses transmission. Therefore extremely careful observation of preventive infection control measures is essential to limit Hepatitis viruses' transmission in HD centers.</p

e-Pilly TROP Maladies infectieuses tropicales

L’e-Pilly TROP est un ouvrage d’infectiologie tropicale destiné aux médecins et aux étudiants en médecine des pays francophones du Sud. La prise en compte des différents niveaux de la pyramide sanitaire dans ces pays le rend aussi accessible aux infirmiers des centres de santé communautaires urbains et des structures de santé intermédiaires des zones rurales. Par définition, les Pays En Développement accroissant progressivement leurs capacités de diagnostic biologique et de traitement, les outils de prise en charge correspondent aux moyens des niveaux périphériques comme à ceux des niveaux hospitaliers de référence

Plasmodium falciparum Clearance Is Rapid and Pitting Independent in Immune Malian Children Treated With Artesunate for Malaria

Background. In Plasmodium falciparum-infected patients treated with artemisinins, parasitemia declines through so-called pitting, an innate splenic process that transforms infected red blood cells (iRBCs) into onceinfected RBCs (O-iRBCs). Methods. We measured pitting in 83 French travelers and 42 Malian children treated for malaria with artesunate. Results. In travelers, O-iRBCs peaked at 107.7% initial parasitemia. In Malian children aged 1.5-4 years, OiRBCs peaked at higher concentrations than in children aged 9-13 years (91.60% vs 31.95%; P = .0097). The parasite clearance time in older children was shorter than in younger children (P = .0001), and the decline in parasitemia in children aged 1.5-4 years often started 6 hours after treatment initiation, a lag phase generally absent in infants and older children. A 6-hour lag phase in artificial pitting of artesunate-exposed iRBCs was also observed in vitro. The proportion of iRBCs recognized by autologous immunoglobulin G (IgG) correlated with the parasite clearance time (r = −0.501; P = .0006) and peak O-iRBC concentration (r = −0.420; P = .0033). Conclusions. Antimalarial immunity correlates with fast artemisinin-induced parasite clearance and low pitting rates. In nonimmune populations, artemisinin-induced P. falciparum clearance is related to pitting and starts after a 6-hour lag phase. In immune populations, passively and naturally acquired immune mechanisms operating faster than pitting may exist. This mechanism may mitigate the emergence of artemisinin-resistant P. falciparum in Africa