Gastrointestinal Helminthic Infections in Egyptian Domestic Camels, Camelus dromedarius, with a Special Reference to Trichostrongylids

In Egypt, scare literature explored the coprological examination of domestic camels. Therefore, a total of 626 fecal samples from domestic dromedaries, Camelus dromedaries, permitted to slaughtering in El-Warrak abattoir, Giza were taken. Coproparasitological investigations including sedimentation and floatation techniques, fecal culture and larval identification were done. The overall prevalence of parasitic infections was 41.53%. Fifteen species of helminth eggs/protozoan oocysts were recovered. The prevalence of helminths was 28.11% (176/626) and that of protozoa was 5.59% (35/626). Mixed infections were reported in 7.82% (49/626) of camels. The revealed trematode was Fasciola sp. (1.12%), tapeworms belonged to Anoplocephalids (5.27%), protozoan oocysts were Eimeria cameli, E. dromedarii, E. rajasthani (11.02% for all Eimeria spp.) and Buxtonella sp. (0.32%). The recovered nematodes belonged to Trichuris sp. (1.92%) and trichostrongyles (31.0%). Coproculture of the later revealed the presence of 8 species; Trichostrongylus axei, Tr. colubriformis, Chabertia ovina, Ostertagia ostertagi, Haemonchus sp., Oesophagostomum sp., Bunostomum sp. and Nematodirus sp. Morphometric characteristics of larvae were recorded. Age and seasonal variations revealed significant (P≤0.05) differences among examined camels. Animals aged more than 5 years had the highest infections rate (45.96%; 199/433) and nematodes were the significantly (P≤0.05) predominant. In winter, the highest prevalence (60.67%; 108/178) was recorded. Oppositely, sex had no significant differences. Due to the expected important role played by imported camels in transmitting various parasitic infections, veterinarians and parasitologists are extremely advised to apply further studies on the helminth fauna, particularly gastrointestinal nematodes, of both domestic and imported camels, by the use of traditional and molecular tools

The evolving SARS-CoV-2 epidemic in Africa: Insights from rapidly expanding genomic surveillance

INTRODUCTION Investment in Africa over the past year with regard to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) sequencing has led to a massive increase in the number of sequences, which, to date, exceeds 100,000 sequences generated to track the pandemic on the continent. These sequences have profoundly affected how public health officials in Africa have navigated the COVID-19 pandemic. RATIONALE We demonstrate how the first 100,000 SARS-CoV-2 sequences from Africa have helped monitor the epidemic on the continent, how genomic surveillance expanded over the course of the pandemic, and how we adapted our sequencing methods to deal with an evolving virus. Finally, we also examine how viral lineages have spread across the continent in a phylogeographic framework to gain insights into the underlying temporal and spatial transmission dynamics for several variants of concern (VOCs). RESULTS Our results indicate that the number of countries in Africa that can sequence the virus within their own borders is growing and that this is coupled with a shorter turnaround time from the time of sampling to sequence submission. Ongoing evolution necessitated the continual updating of primer sets, and, as a result, eight primer sets were designed in tandem with viral evolution and used to ensure effective sequencing of the virus. The pandemic unfolded through multiple waves of infection that were each driven by distinct genetic lineages, with B.1-like ancestral strains associated with the first pandemic wave of infections in 2020. Successive waves on the continent were fueled by different VOCs, with Alpha and Beta cocirculating in distinct spatial patterns during the second wave and Delta and Omicron affecting the whole continent during the third and fourth waves, respectively. Phylogeographic reconstruction points toward distinct differences in viral importation and exportation patterns associated with the Alpha, Beta, Delta, and Omicron variants and subvariants, when considering both Africa versus the rest of the world and viral dissemination within the continent. Our epidemiological and phylogenetic inferences therefore underscore the heterogeneous nature of the pandemic on the continent and highlight key insights and challenges, for instance, recognizing the limitations of low testing proportions. We also highlight the early warning capacity that genomic surveillance in Africa has had for the rest of the world with the detection of new lineages and variants, the most recent being the characterization of various Omicron subvariants. CONCLUSION Sustained investment for diagnostics and genomic surveillance in Africa is needed as the virus continues to evolve. This is important not only to help combat SARS-CoV-2 on the continent but also because it can be used as a platform to help address the many emerging and reemerging infectious disease threats in Africa. In particular, capacity building for local sequencing within countries or within the continent should be prioritized because this is generally associated with shorter turnaround times, providing the most benefit to local public health authorities tasked with pandemic response and mitigation and allowing for the fastest reaction to localized outbreaks. These investments are crucial for pandemic preparedness and response and will serve the health of the continent well into the 21st century

Diversity of Parasitic Diarrhea Associated with <i>Buxtonella Sulcata</i> in Cattle and Buffalo Calves with Control of Buxtonellosis

The association between parasite isolates, including Buxtonella sulcata, in suckling and post-weaning calves and diarrhea was studied with the aim to control diarrhea caused by B. sulcata. A total of 1100 diarrheic fecal samples were collected from 609 suckling calves and 491 post-weaning calves with diarrhea. Salt floatation and modified Ziehl&#8722;Neelsen techniques were applied for the microscopic examination of the presence or absence of parasite eggs and oocysts/cysts. The microscopic findings revealed that 20.36% of the calves had parasitic diarrhea, with a prevalence rate of 19.54% in suckling calves and 21.38% in post-weaning calves. The most frequently detected parasites according to morphological characters were Eimeria species, Buxtonella sulcata, Toxocara vitulorum, Cryptosporidium species, and Moneizia species. In suckling calves, Eimeria species, B. sulcata, and T. vitulorum had the highest prevalence rates of infection, corresponding to about 37.14%, 32.86%, and 20.00%, respectively. However, in post-weaning calves, B. sulcata infection was more prevalent (30.15%) than infections with Eimeria species and T. vitulorum. The highest parasite score density was found in multiple infections with B. sulcata, Eimeria species, and T. vitulorum; however, the score density of B. sulcata when present alone in the fecal specimens was higher than in specimens co-infected with other parasites. The risk factors affecting the prevalence rate of parasitic diarrhea, such as sex, season, housing system, and feed stuff, are discussed. Concerning the treatment of diarrhea caused by B. sulcata in post-weaning cattle calves, 20 calves were divided into 4 equal groups. Group A was given sulphadimidine sodium (1.0 g/10 kg body weight) and metronidazole (500 mg/40 kg body weight); group B was treated with oxytetracycline hydrochloride (500 mg/45 Kg of body weight) and metronidazole (500 mg/40 kg body weight); group C was daily administered garlizine (allicin), 2 g/ L in drinking water; group D was the untreated control group. All medications were administered orally for four successive days. The results showed that the cyst count was significantly lower in the drug-treated groups, and the metronidazole + oxytetracycline hydrochloride and metronidazole + sulphadimidine combinations achieved 98.77% and 96.44% efficacy, respectively. Garlizine had 72.22% efficacy. Intriguingly, B. sulcata infection was associated with other parasitic infections, but B. sulcata mono-infection was the most common cause of diarrhea. Moreover, the combinations of oxytetracycline hydrochloride or sulphadimidine with metronidazole are recommended to control buxtonellosis in calves. Further studies are recommended to investigate the bacterial, viral, and fungal infections associated with B. sulcata infection

Prophylactic and Therapeutic Efficacy of Prebiotic Supplementation against Intestinal Coccidiosis in Rabbits

This study was conducted to investigate the effect of prebiotic supplementation against intestinal coccidiosis in rabbits. Fifty male rabbits aged 35&ndash;60 days (1&ndash;1.5 kg) were divided into prophylactic and therapeutic experiments (five groups, 10 rabbits per group). Prophylactic experiment had prebiotic supplemented (PS-P), non-supplemented infected control (NI-P), and non-supplemented non-infected control (NN-P) groups. Ten days post-prebiotic supplementation (PPS), rabbits in groups PS-P and NI-P were infected orally with 5.0 &times; 104 sporulated oocysts of mixed Eimeria species. However, therapeutic experiment had prebiotic supplemented (PS-T) and untreated infected (UI-T) groups of naturally infected rabbits with Eimeria species. A significant reduction in oocyst count per gram feces (OPG) (p &le; 0.05) was reported in the PS-P (57.33 &times; 103 &plusmn; 2.84) and NI-P (130.83 &times; 103 &plusmn; 43.38) groups during the experiment. Additionally, rabbits in groups (PS-P, 970.33 &plusmn; 31.79 g and NI-P, 870.66 &plusmn; 6.66 g) showed weight loss after infection. However, a significant (p &le; 0.05) decrease in OPG was observed at day seven PPS in the PS-T group (4 &times; 103 &plusmn; 0.00) when compared with the UI-T group (32 &times; 103 &plusmn; 7.54). Furthermore, the PS-T group had a higher body weight than rabbits in the UI-T group. Histopathological findings of the intestinal tissues (duodenum, jejunum, and ileum) showed that the counts of the endogenous stages were significantly higher in the NI-P and UI-T groups than in the prebiotic-supplemented groups (PS-P and PS-T). Supplementation of the prebiotic did not have any adverse effects on biochemical parameters, such as AST, ALT, creatinine, total protein, and total cholesterol. In conclusion, prebiotic supplementation can be used to minimize the adverse effects of intestinal coccidiosis in rabbits, which in turn limits body weight loss, especially for the prophylaxis of coccidial infection

Management of coronary disease in patients with advanced kidney disease

BACKGROUND Clinical trials that have assessed the effect of revascularization in patients with stable coronary disease have routinely excluded those with advanced chronic kidney disease. METHODS We randomly assigned 777 patients with advanced kidney disease and moderate or severe ischemia on stress testing to be treated with an initial invasive strategy consisting of coronary angiography and revascularization (if appropriate) added to medical therapy or an initial conservative strategy consisting of medical therapy alone and angiography reserved for those in whom medical therapy had failed. The primary outcome was a composite of death or nonfatal myocardial infarction. A key secondary outcome was a composite of death, nonfatal myocardial infarction, or hospitalization for unstable angina, heart failure, or resuscitated cardiac arrest. RESULTS At a median follow-up of 2.2 years, a primary outcome event had occurred in 123 patients in the invasive-strategy group and in 129 patients in the conservative-strategy group (estimated 3-year event rate, 36.4% vs. 36.7%; adjusted hazard ratio, 1.01; 95% confidence interval [CI], 0.79 to 1.29; P=0.95). Results for the key secondary outcome were similar (38.5% vs. 39.7%; hazard ratio, 1.01; 95% CI, 0.79 to 1.29). The invasive strategy was associated with a higher incidence of stroke than the conservative strategy (hazard ratio, 3.76; 95% CI, 1.52 to 9.32; P=0.004) and with a higher incidence of death or initiation of dialysis (hazard ratio, 1.48; 95% CI, 1.04 to 2.11; P=0.03). CONCLUSIONS Among patients with stable coronary disease, advanced chronic kidney disease, and moderate or severe ischemia, we did not find evidence that an initial invasive strategy, as compared with an initial conservative strategy, reduced the risk of death or nonfatal myocardial infarction

Health status after invasive or conservative care in coronary and advanced kidney disease

BACKGROUND In the ISCHEMIA-CKD trial, the primary analysis showed no significant difference in the risk of death or myocardial infarction with initial angiography and revascularization plus guideline-based medical therapy (invasive strategy) as compared with guideline-based medical therapy alone (conservative strategy) in participants with stable ischemic heart disease, moderate or severe ischemia, and advanced chronic kidney disease (an estimated glomerular filtration rate of &lt;30 ml per minute per 1.73 m2 or receipt of dialysis). A secondary objective of the trial was to assess angina-related health status. METHODS We assessed health status with the Seattle Angina Questionnaire (SAQ) before randomization and at 1.5, 3, and 6 months and every 6 months thereafter. The primary outcome of this analysis was the SAQ Summary score (ranging from 0 to 100, with higher scores indicating less frequent angina and better function and quality of life). Mixed-effects cumulative probability models within a Bayesian framework were used to estimate the treatment effect with the invasive strategy. RESULTS Health status was assessed in 705 of 777 participants. Nearly half the participants (49%) had had no angina during the month before randomization. At 3 months, the estimated mean difference between the invasive-strategy group and the conservative-strategy group in the SAQ Summary score was 2.1 points (95% credible interval, 120.4 to 4.6), a result that favored the invasive strategy. The mean difference in score at 3 months was largest among participants with daily or weekly angina at baseline (10.1 points; 95% credible interval, 0.0 to 19.9), smaller among those with monthly angina at baseline (2.2 points; 95% credible interval, 122.0 to 6.2), and nearly absent among those without angina at baseline (0.6 points; 95% credible interval, 121.9 to 3.3). By 6 months, the between-group difference in the overall trial population was attenuated (0.5 points; 95% credible interval, 122.2 to 3.4). CONCLUSIONS Participants with stable ischemic heart disease, moderate or severe ischemia, and advanced chronic kidney disease did not have substantial or sustained benefits with regard to angina-related health status with an initially invasive strategy as compared with a conservative strategy

Initial invasive or conservative strategy for stable coronary disease

BACKGROUND Among patients with stable coronary disease and moderate or severe ischemia, whether clinical outcomes are better in those who receive an invasive intervention plus medical therapy than in those who receive medical therapy alone is uncertain. METHODS We randomly assigned 5179 patients with moderate or severe ischemia to an initial invasive strategy (angiography and revascularization when feasible) and medical therapy or to an initial conservative strategy of medical therapy alone and angiography if medical therapy failed. The primary outcome was a composite of death from cardiovascular causes, myocardial infarction, or hospitalization for unstable angina, heart failure, or resuscitated cardiac arrest. A key secondary outcome was death from cardiovascular causes or myocardial infarction. RESULTS Over a median of 3.2 years, 318 primary outcome events occurred in the invasive-strategy group and 352 occurred in the conservative-strategy group. At 6 months, the cumulative event rate was 5.3% in the invasive-strategy group and 3.4% in the conservative-strategy group (difference, 1.9 percentage points; 95% confidence interval [CI], 0.8 to 3.0); at 5 years, the cumulative event rate was 16.4% and 18.2%, respectively (difference, 121.8 percentage points; 95% CI, 124.7 to 1.0). Results were similar with respect to the key secondary outcome. The incidence of the primary outcome was sensitive to the definition of myocardial infarction; a secondary analysis yielded more procedural myocardial infarctions of uncertain clinical importance. There were 145 deaths in the invasive-strategy group and 144 deaths in the conservative-strategy group (hazard ratio, 1.05; 95% CI, 0.83 to 1.32). CONCLUSIONS Among patients with stable coronary disease and moderate or severe ischemia, we did not find evidence that an initial invasive strategy, as compared with an initial conservative strategy, reduced the risk of ischemic cardiovascular events or death from any cause over a median of 3.2 years. The trial findings were sensitive to the definition of myocardial infarction that was used

Health-status outcomes with invasive or conservative care in coronary disease

BACKGROUND In the ISCHEMIA trial, an invasive strategy with angiographic assessment and revascularization did not reduce clinical events among patients with stable ischemic heart disease and moderate or severe ischemia. A secondary objective of the trial was to assess angina-related health status among these patients. METHODS We assessed angina-related symptoms, function, and quality of life with the Seattle Angina Questionnaire (SAQ) at randomization, at months 1.5, 3, and 6, and every 6 months thereafter in participants who had been randomly assigned to an invasive treatment strategy (2295 participants) or a conservative strategy (2322). Mixed-effects cumulative probability models within a Bayesian framework were used to estimate differences between the treatment groups. The primary outcome of this health-status analysis was the SAQ summary score (scores range from 0 to 100, with higher scores indicating better health status). All analyses were performed in the overall population and according to baseline angina frequency. RESULTS At baseline, 35% of patients reported having no angina in the previous month. SAQ summary scores increased in both treatment groups, with increases at 3, 12, and 36 months that were 4.1 points (95% credible interval, 3.2 to 5.0), 4.2 points (95% credible interval, 3.3 to 5.1), and 2.9 points (95% credible interval, 2.2 to 3.7) higher with the invasive strategy than with the conservative strategy. Differences were larger among participants who had more frequent angina at baseline (8.5 vs. 0.1 points at 3 months and 5.3 vs. 1.2 points at 36 months among participants with daily or weekly angina as compared with no angina). CONCLUSIONS In the overall trial population with moderate or severe ischemia, which included 35% of participants without angina at baseline, patients randomly assigned to the invasive strategy had greater improvement in angina-related health status than those assigned to the conservative strategy. The modest mean differences favoring the invasive strategy in the overall group reflected minimal differences among asymptomatic patients and larger differences among patients who had had angina at baseline