A possible case of spontaneous Loa loa encephalopathy associated with a glomerulopathy

It is well known that renal and neurological complications may occur after antifilarial treatment of patients infected with Loa loa. Conversely, spontaneous cases of visceral complications of loiasis have been rarely reported. A 31-year-old Congolese male patient who had not received any antifilarial drug developed oedema of the lower limbs, and then transient swellings of upper limbs. Two months after, he developed troubles of consciousness within several hours. At hospital, the patient was comatose with mild signs of localization. Laboratory tests and an abdominal echography revealed a chronic renal failure due to a glomerulopathy. Three weeks after admission, Loa microfilariae were found in the cerebrospinal fluid, and a calibrated blood smear revealed a Loa microfilaraemia of 74,200 microfilariae per ml. The level of consciousness of the patient improved spontaneously, without any specific treatment, but several days after becoming completely lucid, the patient died suddenly, from an undetermined cause. Unfortunately, no biopsy or autopsy could be performed. The role of Loa loa in the development of the renal and neurological troubles of this patient is questionable. But the fact that such troubles, which are known complications of Loa infection, were found concomitantly in a person harbouring a very high microfilarial load suggests that they might have been caused by the filarial parasite. In areas endemic for loiasis, examinations for a Loa infection should be systematically performed in patients presenting an encephalopathy or a glomerulopathy

Intestinal parasites infections in hospitalized AIDS patients in Kinshasa, Democratic Republic of Congo

To determine the prevalence and the species spectrum of intestinal parasites (IP) involved in hospitalized AIDS patients, a prospective observational and cross-sectional study was carried out in the four main hospitals in Kinshasa, Democratic Republic of the Congo. From November 2006 through September 2007, a single stool sample was collected from 175 hospitalized AIDS patients older than 15 years. Parasites were detected by light microscopy, including Ziehl-Neelsen, Fungi-Fluor, modified trichrome stains, and by immunofluorescence antibody tests and PCR for species diagnosis of microsporidia. At baseline, 19 patients (10.8 %) were under antiretroviral therapy and 156 (89.2 %) were eligible for ART. The main diagnosis for justifying hospitalization was intestinal infection associated with diarrhea in 87 out of 175 (49.7 %). 47 out of 175 (26.9 %) were found to harbor an IP, and 27 out of 175 (15.4 %) were infected with at least one opportunistic IP (OIP). Prevalence rate for OIP were 9.7 %, 5.1 %, 1.7 % and 0.6 % for Cryptosporidium sp., Enterocytozoon bieneusi, Isospora belli and Encephalitozoon intestinalis respectively. Considering patients with diarrhea only, prevalence rate were 12.6 %, 4.6 %, 3.4 % and 1.1 % respectively. The other IP observed were Entamoeba histolytica/Entamoeba dispar in nine cases (5.1 %), Ascaris lumbricoïdes in seven cases (4.0 %), Giardia intestinalis in three cases (1.7 %), hookworm in two cases (1.1 %) and Trichiuris trichiura, Enterobius vermicularis, Schistosoma mansoni in one patient each (0.6 %). No significant relationship was established between any individual IP and diarrhea. These results underline the importance of OIP in symptomatic AIDS patients regardless of diarrhea at the time of the hospitalisation, and showed that routine microscopic examination using stains designed for Cryptosporidium spp. or the microsporidia should be considered due to the absence of clinical markers

Intestinal parasites infections in hospitalized AIDS patients in Kinshasa, Democratic Republic of Congo

To determine the prevalence and the species spectrum of intestinal parasites (IP) involved in hospitalized AIDS patients, a prospective observational and cross-sectional study was carried out in the four main hospitals in Kinshasa, Democratic Republic of the Congo. From November 2006 through September 2007, a single stool sample was collected from 175 hospitalized AIDS patients older than 15 years. Parasites were detected by light microscopy, including Ziehl-Neelsen, Fungi-Fluor, modified trichrome stains, and by immunofluorescence antibody tests and PCR for species diagnosis of microsporidia. At baseline, 19 patients (10.8 %) were under antiretroviral therapy and 156 (89.2 %) were eligible for ART. The main diagnosis for justifying hospitalization was intestinal infection associated with diarrhea in 87 out of 175 (49.7 %). 47 out of 175 (26.9 %) were found to harbor an IP, and 27 out of 175 (15.4 %) were infected with at least one opportunistic IP (OIP). Prevalence rate for OIP were 9.7 %, 5.1 %, 1.7 % and 0.6 % for Cryptosporidium sp., Enterocytozoon bieneusi, Isospora belli and Encephalitozoon intestinalis respectively. Considering patients with diarrhea only, prevalence rate were 12.6 %, 4.6 %, 3.4 % and 1.1 % respectively. The other IP observed were Entamoeba histolytica/Entamoeba dispar in nine cases (5.1 %), Ascaris lumbricoïdes in seven cases (4.0 %), Giardia intestinalis in three cases (1.7 %), hookworm in two cases (1.1 %) and Trichiuris trichiura, Enterobius vermicularis, Schistosoma mansoni in one patient each (0.6 %). No significant relationship was established between any individual IP and diarrhea. These results underline the importance of OIP in symptomatic AIDS patients regardless of diarrhea at the time of the hospitalisation, and showed that routine microscopic examination using stains designed for Cryptosporidium spp. or the microsporidia should be considered due to the absence of clinical markers

Intestinal parasites infections in hospitalized AIDS patients in Kinshasa, Democratic Republic of Congo

To determine the prevalence and the species spectrum of intestinal parasites (IP) involved in hospitalized AIDS patients, a prospective observational and cross-sectional study was carried out in the four main hospitals in Kinshasa, Democratic Republic of the Congo. From November 2006 through September 2007, a single stool sample was collected from 175 hospitalized AIDS patients older than 15 years. Parasites were detected by light microscopy, including Ziehl-Neelsen, Fungi-Fluor, modified trichrome stains, and by immunofluorescence antibody tests and PCR for species diagnosis of microsporidia. At baseline, 19 patients (10.8 %) were under antiretroviral therapy and 156 (89.2 %) were eligible for ART. The main diagnosis for justifying hospitalization was intestinal infection associated with diarrhea in 87 out of 175 (49.7 %). 47 out of 175 (26.9 %) were found to harbor an IP, and 27 out of 175 (15.4 %) were infected with at least one opportunistic IP (OIP). Prevalence rate for OIP were 9.7 %, 5.1 %, 1.7 % and 0.6 % for Cryptosporidium sp., Enterocytozoon bieneusi, Isospora belli and Encephalitozoon intestinalis respectively. Considering patients with diarrhea only, prevalence rate were 12.6 %, 4.6 %, 3.4 % and 1.1 % respectively. The other IP observed were Entamoeba histolytica/Entamoeba dispar in nine cases (5.1 %), Ascaris lumbricoïdes in seven cases (4.0 %), Giardia intestinalis in three cases (1.7 %), hookworm in two cases (1.1 %) and Trichiuris trichiura, Enterobius vermicularis, Schistosoma mansoni in one patient each (0.6 %). No significant relationship was established between any individual IP and diarrhea. These results underline the importance of OIP in symptomatic AIDS patients regardless of diarrhea at the time of the hospitalisation, and showed that routine microscopic examination using stains designed for Cryptosporidium spp. or the microsporidia should be considered due to the absence of clinical markers

Sorption of phenol from aqueous solution using chicken feathers

Concern is growing over the contamination of the water environments with organic pollutants, such as phenolic compounds because of their adverse effects on health and environment. In these studies, the ability to remove phenol from aqueous solution has been achieved using chicken feathers as an adsorbent. Batch studies were performed to evaluate the effects of process parameters such as initial concentration, contact time, adsorbent dosage, and temperature. Adsorption capacity for the adsorbent was dependent on the temperature since an increase in phenol removal efficiency with an increase in temperature was observed. Results have shown that an increase in the amount of adsorbent was followed by increased efficiency in phenol removal owing to a corresponding increase in adsorption sites. The equilibrium time for phenol removal was found to be 24 h. The experimental data were well represented by the Freundlich (R2 = 0.9869) and the Langmuir (R2 = 0.9997) isotherm models with data slightly better fitted to the Langmuir than the Freundlich isotherm model. The maximum sorption capacity was found to be 16.5 mg/g at 30°C and pH 8. Chicken feathers, an inexpensive and easily available material, can be an alternative to more costly adsorbents used for the removal of phenol from wastewater

SARS-CoV-2: Molecular Structure, Pathogenesis, Potential Therapeutic Targets, and Immune Response of the Infected Subject

Background. The pathogenic mechanisms and immune response of COVID-19 are far from clear. Through a documentary review of literature, the authors describe virological and molecular aspects of SARS-CoV-2, the intimate mechanisms of cell infection, and potential therapeutic targets. They also analyze the characteristics of immune response of the infected subject. Objectives. Objectives of this study are to describe the state of knowledge on virological data, molecular and physiopathogenic mechanisms of SARS-CoV-2, with a view to a better understanding of the therapeutic targets, as well as the immune response of the infected subject. Methodology. This documentary review is a compilation of several meta-analyses, consistent with the methodology described in the PRISMA statement on literature data on SARS-CoV-2, published between March 22 and August 14, 2020 (Moher et al.). The search engines used for the selection of articles were as follows: PubMed, Google Scholar, Global Health, and WHO reports. Papers of interest were those addressing virological and molecular data on SARS-CoV-2, therapeutic aspects of COVID-19, and immunity of the infected subject. Of the 617 eligible papers, 417 could be retained after removing the duplicates. Ultimately, only 50 articles were retained for final evaluation. The data collected allowed the development of a two-armed model around the physiopathological aspects and potential therapeutic targets, as well as aspects of host immunity, respectively. The model was then compared to data from the HIV literature. Conclusion. Reported data could contribute to a better understanding of molecular mechanisms of cellular infection by SARS-CoV-2 as well as to a more easy explanation of the action of pharmacological agents used for the treatment, while elucidating intimate mechanisms of the immunity of infected subject

Epidemiology, clinical, immune, and molecular profiles of microsporidiosis and cryptosporidiosis among HIV/AIDS patients

Roger Wumba,1 Benjamin Longo-Mbenza,2 Jean Menotti,3,4 Madone Mandina,5 Fabien Kintoki,5 Nani Hippolyte Situakibanza,1,5 Marie Kapepela Kakicha,6 Josue Zanga,1 Kennedy Mbanzulu-Makola,1 Tommy Nseka,1 Jean Pierre Mukendi,1 Eric Kendjo,7 Jean Sala,1 Marc Thellier7,81Department of Tropical Medicine, Infectious and Parasitic Diseases, Department of Parasitology, University Clinic of Kinshasa, Faculty of Medicine, University of Kinshasa, Kinshasa, Congo; 2Faculty of Health Sciences, Walter Sisulu University, Eastern Cape, South Africa; 3Laboratory of Parasitology and Mycology, Saint-Louis Hospital, Public Assistance-Hospitals of Paris, Paris, France; 4Faculty of Medicine, Lariboisière-Saint-Louis, University of Paris VII, Paris, France; 5Department of Internal Medicine, University Clinic of Kinshasa, Faculty of Medicine, University of Kinshasa, Kinshasa, Congo; 6Department of Pediatrics, University Clinic of Kinshasa, Faculty of Medicine, University of Kinshasa, Kinshasa, Congo; 7National Center for Malaria Research, AP-HP, CHU Pitie Salpêtrière, Paris, France; 8Laboratory of Parasitology and Mycology, Pitié Salpêtrière Hospital, Public Assistance-Hospitals of Paris, Pierre and Marie Curie University, Paris, FranceBackground: The objective of this study was to determine the prevalence of intestinal parasites, with special emphasis on microsporidia and Cryptosporidium, as well as their association with human immunodeficiency virus (HIV) symptoms, risk factors, and other digestive parasites. We also wish to determine the molecular biology definitions of the species and genotypes of microsporidia and Cryptosporidium in HIV patients.Methods: In this cross-sectional study, carried out in Kinshasa, Democratic Republic of the Congo, stool samples were collected from 242 HIV patients (87 men and 155 women) with referred symptoms and risk factors for opportunistic intestinal parasites. The analysis of feces specimen were performed using Ziehl–Neelsen stainings, real-time polymerase chain reaction (PCR), immunofluorescence indirect monoclonal antibody, nested PCR-restriction fragment length polymorphism, and PCR amplification and sequencing. Odds ratio (OR) and 95% confidence intervals were used to quantify the risk.Results: Of the 242 HIV patients, 7.8%, 0.4%, 5.4%, 0.4%, 2%, 10.6%, and 2.8% had Enterocytozoon bieneusi, Encephalitozoon intestinalis, Cryptosporidium spp., Isospora belli, pathogenic intestinal protozoa, nonpathogenic intestinal protozoa, and helminths, respectively. We found five genotypes of E. bieneusi: two older, NIA1 and D, and three new, KIN1, KIN2, and KIN3. Only 0.4% and 1.6% had Cryptosporidium parvum and Cryptosporidium hominis, respectively. Of the patients, 36.4%, 34.3%, 31%, and 39% had asthenia, diarrhea, a CD4 count of <100 cells/mm³, and no antiretroviral therapy (ART), respectively. The majority of those with opportunistic intestinal parasites and C. hominis, and all with C. parvum and new E. bieneusi genotypes, had diarrhea, low CD4+ counts of <100 cells/mm³, and no ART. There was a significant association between Entamoeba coli, Kaposi sarcoma, herpes zoster, chronic diarrhea, and asthenia, and the presence of 28 cases with opportunistic intestinal parasites. Rural areas, public toilets, and exposure to farm pigs were the univariate risk factors present in the 28 cases with opportunistic intestinal parasites. In logistic regression analysis, a CD4 count of <100 cells/mm³ (OR = 4.60; 95% CI 1.70–12.20; P = 0.002), no ART (OR = 5.00; 95% CI 1.90–13.20; P < 0.001), and exposure to surface water (OR = 2.90; 95% CI 1.01–8.40; P = 0.048) were identified as the significant and independent determinants for the presence of opportunistic intestinal parasites.Conclusion: E. bieneusi and Cryptosporidium are becoming more prevalent in Kinshasa, Congo. Based on the findings, we recommend epidemiology surveillance and prevention by means of hygiene, the emphasis of sensitive PCR methods, and treating opportunistic intestinal parasites that may be acquired through fecal–oral transmission, surface water, normal immunity, rural area-based person–person and animal–human infection, and transmission of HIV. Therapy, including ART and treatment with fumagillin, is needed.Keywords: diarrhea, Enterocytozoon bieneusi, Cryptosporidium hominis, Cryptosporidium parvum, risk factors, African

Congrès AFMED 2017 : Co-infection VIH-Helminthiases intestinales à Kinshasa (RD Congo) : fréquence et facteurs associés: HIV-Helminthiasis co-infection in Kinshasa (DR Congo): frequency and associated factors

Objectifs. Montrer l‟ampleur des helminthiases intestinales chez les PVVs adultes en milieu de soins à Kinshasa et en identifier les facteurs associés.Méthodes. Étude transversale à visée analytique réalisée dans 8 structures de prise en charge des PVVs à Kinshasa choisies de manière aléatoire. Quatre cent vingt-deux PVVs adultes ont été incluses dans l‟étude selon une approche probabiliste. Un questionnaire pré-testé leur a été administré. Chaque patient avait remis un échantillon de selle conservé dans du formol à 10% pour examen par la méthode de RITCHIE. Les données ont été analysées l‟aide du logiciel SPSS version 21. La régression logistique a servi à identifier les facteurs associés à l‟infection helminthique chez les PVVs.Résultats. Sur 422 PVV, 324 étaient des femmes, soit un sex ratio de 1H/3,3F ; soit 10 H pour 33 F. L‟âge moyen était de 42 ans (ET =10 ans).La fréquence globale des helminthiases intestinales était de 22% (93/422). L‟helminthe le plus retrouvé était Ascaris lumbricoides 44/422 (10,4%) suivi de Trichuris trichiura (Trichocéphale) 33/422 (7,8%), et de Strongyloides stercoralis (Anguillule) 14/422 (3,3%). Ce dernier helminthe était associé à un taux de LT CD4 bas. Aucune infection helminthique mixte n‟a été détectée. Le taux de lymphocytes T CD4 médian était de 388 éléments/mm3 (EIQ : 342-412) pour toutes les PVVs de l‟étude, et 425 éléments/mm3 (EIQ : 373-456) pour les co-infectées, avec comme extrêmes : 13-1421 éléments/mm3. Plus de 70% de PVV étaient atteints d‟infections à faible intensité. Après ajustement, l‟utilisation d‟eau de robinet [OR ajusté 3,62 IC95% (1,04-12,58), p=0,018], la consommation des légumes crus ou fruits frais [OR ajusté 1,80 IC95% (1,11-2,92), p=0,018], la non consommation d‟eau traitée [OR ajusté 2,84 IC95% (1,81-4,72), p=0,018], le non lavage hygiénique des mains après usage de toilettes [OR ajusté 2,65 IC95% (1,14-8,21), p=0,010] et avant de manger [OR ajusté 2,01 IC95% (1,09-6,73), p=0,004] étaient les facteurs associés à l‟helminthiase intestinale.Conclusion. La co-infection VIH-helminthiasiase intestinale est fréquente à Kinshasa. Ascaris lumbrocoides est l‟helminthe le plus retrouvé. L‟immunodépression avancée favorise la strongyloïdose. Les campagnes de sensibilisation sur l‟éducation sanitaire et le déparasitage intermittent de masse chez les PVVs devraient être à envisagés