59 research outputs found
Case Report: Autochthonous Case of Human Visceral Leishmaniasis in the West Bank, Palestine
Human visceral leishmaniasis (HVL) is a parasitic disease infecting children in the Mediterranean region.
Here,weportray a case of a 2-year-old child with an epidemiological description of the situation surrounding the case. The
patient was suffering from recurrent fever, weakness and abdominal discomfort associated with loss of appetite. Routine
blood investigations showed pancytopenia, whereas examination revealed hepatomegaly. A diagnosis of HVL was made
by demonstrating amastigotes in a Giemsa-stained smear from a bone marrow aspirate followed by genotyping by PCR
and sequencing. In conclusion, early detection of VL infection followed by appropriate treatment protocols is essential to
saving the patient
Molecular Detection of Theileria ovis and Theleiria equi in Livestock from Palestine
Theileria and Babesia are intracellular protozoan parasites infecting a wide range of animals. In Palestine,
there is limited information on the prevalence of Theileria and Babesia spp. in livestock. We used PCR of
the 18S ribosomal RNA gene followed by DNA sequencing to detect and identify parasite DNA in blood
samples from sheep (n = 49), goats (n = 48), horses (n = 40), camels (n = 34), donkeys (n = 28) and mules
(n = 2) from four districts of Palestine. DNA of T. ovis and T. equi was detected in 19 and 2 ovine blood
samples, respectively. None of the camels, donkeys, and goats were positive for T. ovis. Sheep had a
significantly higher rate of infection than other animals (P < 0.05). Theileria ovis is highly prevalent in
sheep, while T. equi DNA was detected in a small proportion of the equids in Palestine.We would like to thank all the people who helped in blood collection from the studied animals. This study was
supported financially by grant 2014·52146 funded by the Netherlands Ministry of Foreign Affairs, The Hague,
Netherlands and USAID grant MERC TAMOU-12-M32-038
Prevalence of Trypanosoma evansi in livestock in Palestine
Background: Trypanosoma evansi is the causative agent of surra, a disease that occurs in many animal species. The
disease is responsible for substantial losses in global production and can be fatal if not diagnosed early. This study
aims to determine the prevalence of T. evansi in livestock, equids and dromedary camels in Palestine.
Methods: Blood samples were collected during 2015–2017 from domesticated animals (n = 259 animals; 77%
females and 23% males) including camels (n = 87), horses (n = 46), donkeys (n = 28), mules (n = 2), sheep (n = 49)
and goats (n = 48) from eight districts: Ariha (Jericho), Nablus, Bethlehem, Deir Al Balah, Jenin, Rafah, Tubas, and Khan
Yunis. Parasite prevalence was determined using PCR and blood smear microscopy. PCR-positive samples were further
phylogenetically analyzed using DNA sequences of the 18S ribosomal RNA gene.
Results: The overall infection prevalence was 18% (46/259). The positivity rates according to PCR and microscopy
examination were 17% (45/259) and 2.7% (7/259), respectively. The infection rates were as follows: camels, 26/61
(30%); horses, 8/46 (17%); donkeys, 3/28 (11%); mules, 1/2 (50%); sheep, 2/42 (4%); and goats, 6/42 (13%). Phylogenetic
analyses of the 18S rRNA gene showed that 24 positive T. evansi samples from Palestine formed a monophyletic
cluster with seven T. evansi sequences from Africa, Asia and South America, and three T. brucei sequences from Africa
retrieved from GenBank. The spatial analysis showed three statistically significant foci of T. evansi infection in Jenin,
Tubas (P = 0.02) and Ariha (Jericho) (P = 0.04). No statistically significant foci were detected in the Gaza Strip.
Conclusions: To the best of our knowledge, this is the first confirmation of high levels of infection with T. evansi as
a causative agent of surra in Palestine. Our study emphasizes the need for a stringent surveillance system and risk
assessment studies as prerequisites for control measures. Further investigations focusing on vectors and evaluation of
risk factors are needed.Acknowledgments
Not applicable.
Authors’ contributions
AN, SE, AA-J and ZA conceived and designed the experiments. AN, SE, HA-J,
NA-L and AA-J performed the experiments. SE, AN and AA-J analyzed the data.
AN, AA-J and SE wrote the first draft of the manuscript. AN, SE, NA-L, HA, AA-J
and ZA competed the final revision of the manuscript to be published. All
authors read and approved the final manuscript.
Funding
This research received no financial support
Prevalence of selected intestinal protozoan infections in marginalized rural communities in Palestine
Background: Intestinal parasitic infections are common in rural areas with poor infrastructure and low
socioeconomic status. The aim of this study was to estimate the prevalence of selected parasitic infections in
marginalized rural areas in the northern part of the Palestinian West Bank Region, using conventional and PCRbased
methods, and also to assess risk predictors of infection.
Methods: A cross-sectional study was conducted on 104 individuals from three rural villages in the Jordan Valley.
Stool samples were collected and examined by a battery of tests that included microscopy of wet fecal samples in
normal saline with iodine, concentration by ethyl acetate sedimentation and also by zinc sulfate floatation, a
conventional PCR and a real-time PCR (qPCR). Risk factors were assessed that included demographic,
socioeconomic, and behavioral characteristics. Data on method performance was analyzed by kappa-statistic,
Cochrane’s Q, and McNemar post hoc test. Mid-P exact test and odds ratio were used to discern association
between outcome and risk predictors.
Results: The overall prevalence of intestinal parasitic infections was 48% (49/102). The predominant parasites were
Giardia lamblia at 37% (37/102) and Hymenolepis nana at 9% (9/102). To concentrate cysts and eggs, sedimentation
can be used as an alternative to floatation with a loss of 1% of positive cases. The methods employing PCRs proved
crucial as it increased the detected infection rate of G. lamblia approximately three-fold from 13% by the
conventional methods to 37% by the qPCR. Multiple infections were present in 13% (13/102) of the study group,
which included double (10%) and triple (3%) infections. Regarding the genus Entamoeba, E. dispar and E. coli were
detected at rates of 2 and 8%, respectively. While none of the individuals were infected with the pathogenic E.
histolytica, E. nana (4%) was detected for the first time in the area. Age was a risk predictor for infection (OR = 2.61,
CI 95% 1.05–6.45, P = 0.038).
Conclusions: The increased prevalence of intestinal parasitic infections in children in marginalized rural areas in
Palestine is worrying. The addition of PCR-based methods is important for the diagnosis of such infections as, with
cautious interpretation, it increases proficiency and overcomes underestimation and misdiagnosis of cases. Control
measures including education on personal hygiene and environmental sanitation, should be introduced to reduce
the prevalence of the intestinal parasites and, thus, the infections they cause in this and other areas.Acknowledgments
We thank L. F. Schnur for reviewing the manuscript.
Authors’ contributions
AA, conception of the research, study design, data analysis and drafting of
the manuscript. SE and AN, molecular biological testing and analysis. KD and
HA collection of samples and conventional examination. ZA, data analysis
and interpretation. All the authors have read and approved the final
manuscript.
Funding
This research is a self-funded work by the researchers
Incidence of Echinococcus granulosus in Domestic Dogs in Palestine as Revealed by Copro-PCR
Hydatidosis or echinococcosisis considered a neglected zoonotic disease despite its high
burden in the livestock industry and the high risk of infection by humans in endemic areas.
In a cross-sectional study we estimated the copro-Incidence and also genotyped Echinococcus
granulosus isolates from domestic dogs using polymerase chain reaction (PCR).
Medical archives in nine major hospitals in Palestine were reviewed to determine incidence
of E. granulosus infection detected in humans during surgery. Faecal samples were collected
from 93 domestic dogs in three districts with the highest number of human cases: Al-
Khalil (Hebron), Tubas and Jenin. Genomic DNA was extracted from dog faecal samples
and amplified by PCR targeting the repeat DNA sequence (EgG1 Hae III) followed by
sequencing of five positive samples. Genotyping was determined by sequencing and
BLAST searching of mitochondrial cytochrome c oxidase subunit (CO1). The incidence of
E. granulosus infection detected in humans at surgery was 1.2 per 100,000 in the West
Bank and 1.0 per 100,000 in Gaza Strip. Seventeen of 93 domestic dogs (18%) were positive,
based upon comparison with the Echinococcus DNA control. The five sequenced samples
were confirmed to be E. granulosus. Successfully genotyped sample belonged to E.
granulosus sensu stricto (formerly G1-G3 complex, sheep strain). For domestic dogs, age
group (13-24 months) and sex were identified as two risk factors for contracting E. granulosus.
The study identified the high incidence of E. granulosus sensu stricto in dogs in
Palestine.
AuthorWe thank the Arab American University in
Jenin-Palestine for the fund received under grant
number 2013-104, cycle 2. Also, the study received
support from the Netherlands Ministry of Foreign
Affairs, The Hague, The Netherlands and NVHU
under grant reference number 2014.52146. The
funders had no role in study design, data collection
and analysis, decision to publish, or preparation of
the manuscript
The clinical burden of human cystic echinococcosis in Palestine, 2010-2015
Background
Cystic echinococcosis (CE) is classified by the WHO as a neglected disease inflicting economic
losses on the health systems of many countries worldwide. The aim of this caseseries
study was to investigate the burden of human CE in Palestine during the period
between 2010 and 2015.
Methodology/Principal findings
Records of surgically confirmed CE patients from 13 public and private hospitals in the
West Bank and Gaza Strip were reviewed. Patients' cysts were collected from surgical
wards and formalin-fixed paraffin-embedded (FFPE) blocks were collected from histopathology
departments. Molecular identification of CE species /genotypes was conducted
by targeting a repeat DNA sequence (EgG1 Hae III) within Echinococcus nuclear genome
and a fragment within the mitochondrial cytochrome c oxidase subunit 1, (CO1). Confirmation
of CE species/genotypes was carried out using sequencing followed by BLAST
analysis and the construction of maximum likelihood consensus dendrogram. CE cases
were map-spotted and statistically significant foci identified by spatial analysis. A total of
353 CE patients were identified in 108 localities from the West Bank and Gaza Strip. The
average surgical incidence in the West Bank was 2.1 per 100,000. Spot-mapping and
purely spatial analysis showed 13 out of 16 Palestinian districts had cases of CE, of which
9 were in the West Bank and 4 in Gaza Strip. Al-Khalil and Bethlehem were statistically
significant foci of CE in Palestine with a six-year average incidence of 4.2 and 3.7 per
100,000, respectively.
Conclusions/Significance
To the best of our knowledge, this is the first confirmation of human CE causative agent
in Palestine. This study revealed that E. granulosus sensu stricto (s.s.) was the predominating
species responsible for CE in humans with 11 samples identified as G1 genotype and 2
as G3 genotype. This study emphasizes the need for a stringent surveillance system and
risk assessment studies in the rural areas of high incidence as a prerequisite for control
measures.The research that has led to these results has been technically supported by the European Community's
Seventh Framework Programme under the grant agreement 602051 (Project HERACLES:
Human cystic Echinococcosis ReseArch in CentraL and Eastern Societies; http://www.
Heracles-fp7.eu/)
Serological and molecular survey of Leishmania parasites in apparently healthy dogs in the West Bank, Palestine
Background: Canine visceral leishmaniasis (CVL) is caused by Leishmania infantum in all Mediterranean countries.
The Leishmania parasite is transmitted by the bite of a corresponding sand fly vector and primarily maintained in
nature by wild and domestic reservoirs, including dogs, foxes and jackals. Infected dogs are the primary reservoir
host in endemic regions and are the most significant risk disposing humans to infection. The present study aimed
at assessing the prevalence of infection with Leishmania and identification of Leishmania infantum in domestic dogs
in the West Bank, Palestine.
Methods: The infection rate among domestic dogs collected from seven districts in the Palestinian West Bank was
investigated by examination of parasites in culture from the buffy coat using serological and molecular methods;
based on ELISA, internal transcribed spacer 1 (ITS1) and cysteine protease (CPB) PCR.
Results: Out of 215 dogs examined for Leishmania, 36 (16.7%) were positive in at least one method. Twenty three
animals (11.5%) were positive for Leishmania DNA, whereas, ELISA and culture revealed 16 (7.5%), and 4 (1.5%)
respectively. CPB-PCR on one of three culture-positive isolates revealed Leishmania infantum as the causative agent
for Leishmania infection in dogs.
Conclusions: Our study showed that canine leishmania infection is prevalent with varying degrees in all the seven
studied districts in Palestine despite the absence of human VL cases in 4 of these districts. The causative agent was
confirmed to be Leishmania infantum.The authors would like to thank the Palestinian Ministry of Health (PMOH)
for providing support in samples collection. Financial support is provided by
the MIDDLE EAST REGIONAL COOPERATION PROGRAM (MERC) project M27-
072, on surveillance and control of visceral leishmaniasis in the Middle East &
North Africa
Molecular Detection of Theileria, Babesia, and Hepatozoon spp. in ixodid ticks from Palestine
Ixodid ticks transmit various infectious agents that cause disease in humans and livestock worldwide.
A cross-sectional survey on the presence of protozoan pathogens in ticks was carried out to assess the
impact of tick-borne protozoa on domestic animals in Palestine. Ticks were collected from herds with
sheep, goats and dogs in different geographic districts and their species were determined using morphological
keys. The presence of piroplasms and Hepatozoon spp. was determined by PCR amplification of a
460–540 bp fragment of the 18S rRNA gene followed by RFLP or DNA sequencing. A PCR-RFLP method
based on the 18S rRNA was used in order to detect and to identify Hepatozoon, Babesia and Theileria spp.
A total of 516 ticks were collected from animals in six Palestinian localities. Five tick species were found:
Rhipicephalus sanguineus sensu lato, Rhipicephalus turanicus, Rhipicephalus bursa, Haemaphysalis parva
and Haemaphysalis adleri. PCR-based analyses of the ticks revealed Theileria ovis (5.4%), Hepatozoon canis
(4.3%), Babesia ovis (0.6%), and Babesia vogeli (0.4%). Theileria ovis was significantly associated with ticks
from sheep and with R. turanicus ticks (p < 0.01). H. canis was detected only in R. sanguineus s.l. and was
significantly associated with ticks from dogs (p < 0.01).
To our knowledge, this is the first report describing the presence of these pathogens in ticks collected
from Palestine. Communicating these findings with health and veterinary professionals will increase
their awareness, and contribute to improved diagnosis and treatment of tick-borne diseases.This study was supported financially by grant 2014.52146
funded by the Netherlands Ministry of Foreign Affairs, The Hague,
Netherlands and USAID grant MERC TA-MOU-12-M32-038. We
thank Mr. Samir Sawalha, Taher Zaid and Ahmad Abdelkader for
their kind help during sample collection
First-Time Detection of Mycobacterium bovis in Livestock Tissues and Milk in the West Bank, Palestinian Territories
Background: Bovine tuberculosis, bTB, is classified by the WHO as one of the seven neglected zoonontic diseases that cause
animal health problems and has high potential to infect humans. In the West Bank, bTB was not studied among animals and
the prevalence of human tuberculosis caused by M. bovis is unknown. Therefore, the aim of this study was to estimate the
prevalence of bTB among cattle and goats and identify the molecular characteristics of bTB in our area.
Methodology/principal findings: A total of 208 tissue samples, representing 104 animals, and 150 raw milk samples,
obtained from cows and goats were examined for the presence of mycobacteria. The tissue samples were collected during
routine meat inspection from the Jericho abattoir. DNA was extracted from all samples, milk and tissue biopsies (n = 358),
and screened for presence of TB DNA by amplifying a 123-bp segment of the insertion sequence IS6110. Eight out of 254
animals (3.1%) were found to be TB positive based on the IS6110-PCR. Identification of M. bovis among the positive TB
samples was carried out via real time PCR followed by high resolution melt curve analysis, targeting the A/G transition along
the oxyR gene. Spoligotyping analysis revealed a new genotype of M. bovis that was revealed from one tissue sample.
Significance: Detection of M. bovis in tissue and milk of livestock suggests that apparently healthy cattle and goats are a
potential source of infection of bTB and may pose a risk to public health. Hence, appropriate measures including meat
inspection at abattoirs in the region are required together with promotion of a health campaign emphasizing the
importance of drinking pasteurized milk. In addition, further studies are essential at the farm level to determine the exact
prevalence of bTB in goats and cattle herds in the West Bank and Israel.Financial support was provided by the Dutch government; project M27-072NVHU 2009 02 ‘Vector-Borne Pathogens in Israel and the Palestinian Authority.’ The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript
Molecular Detection and Identification of Spotted Fever Group Rickettsiae in Ticks Collected from the West Bank, Palestinian Territories
Tick-borne rickettsioses are caused by obligate intracellular bacteria belonging to the spotted
fever group (SFG) rickettsiae. Although Spotted Fever is prevalent in the Middle East,
no reports for the presence of tick-borne pathogens are available or any studies on the epidemiology
of this disease in the West Bank. We aimed to identify the circulating hard tick
vectors and genetically characterize SFG Rickettsia species in ixodid ticks from the West
Bank-Palestinian territories.This study was funded by the Netherlands
Ministry of Foreign Affairs, The Hague, The
Netherlands and NVHU under grant reference
number 2014.52146 and USAID grant MERC TAMOU-
12-M32-038. The funders had no role in the
study design, data collection and analysis, decision to
publish, or preparation of the manuscript
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