Treatment of head lice with dimeticone 4% lotion: comparison of two formulations in a randomised controlled trial in rural Turkey

<p>Abstract</p> <p>Background</p> <p>Dimeticone 4% lotion was shown to be an effective treatment for head louse infestation in two randomised controlled trials in England. It is not affected by insecticide resistance but efficacy obtained (70-75%) was lower than expected. This study was designed to evaluate efficacy of dimeticone 4% lotion in a geographically, socially, and culturally different setting, in rural Turkey and, in order to achieve blinding, it was compared with a potential alternative formulation.</p> <p>Methods</p> <p>Children from two village schools were screened for head lice by detection combing. All infested students and family members could participate, giving access to treatment for the whole community. Two investigator applied treatments were given 7 days apart. Outcome was assessed by detection combing three times between treatments and twice the week following second treatment.</p> <p>Results</p> <p>In the intention to treat group 35/36 treated using dimeticone 4% had no lice after the second treatment but there were two protocol violators giving 91.7% treatment success. The alternative product gave 30/36 (83.3%) treatment success, a difference of 8.4% (95% CI -9.8% to 26.2%). The cure rates per-protocol were 33/34 (97.1%) and 30/35 (85.7%) respectively. We were unable to find any newly emerged louse nymphs on 77.8% of dimeticone 4% treated participants or on 66.7% of those treated with the alternative formulation. No adverse events were identified.</p> <p>Conclusion</p> <p>Our results confirm the efficacy of dimeticone 4% lotion against lice and eggs and we found no detectable difference between this product and dimeticone 4% lotion with nerolidol 2% added. We believe that the high cure rate was related to the lower intensity of infestation in Turkey, together with the level of community engagement, compared with previous studies in the UK.</p> <p>Trial Registration</p> <p>Current Controlled Trials ISRCTN10431107</p

Health inequities: lower socio-economic conditions and higher incidences of intestinal parasites

<p>Abstract</p> <p>Background</p> <p>Intestinal parasitic infections affect child health and development and slow down growth, while reducing adults' productivity and work capacity. The aim of the present study was to determine and compare the incidences of intestinal parasitic infections and the socio-economic status of two near primary school children in Manisa, a western city of Turkey.</p> <p>Methods</p> <p>A total of 352 children were involved a questionnaire study from a private school (Ülkem Primary School – ÜPS, 116 children) and a community-based school (Şehzadeler Primary School – ŞPS, 236 children). Of these, stool samples could be obtained from a total of 294 students; 97 (83.6%) from ÜPS, and 197 (83.5%) from ŞPS. The wet mount preparations of the stool samples were examined; samples were also fixed in polyvinyl alcohol and examined with modified formalin ethyl acetate sedimentation and trichrome staining techniques. Data were analyzed using SPSS for Windows version 10.0. The chi-squared test was used for the analytic assessment.</p> <p>Results</p> <p>The percentages of the students found to be infected with intestinal parasites, were 78 (39.6%) and 13 (13.4%) in ŞPS and ÜPS, respectively. Totally 91 (31.0%) of the students from both schools were found to be infected with at least one intestinal parasite. <it>Giardia lamblia </it>was found to be the most common pathogenic intestinal parasite and <it>Blastocystis hominis </it>was prevalent independently from the hygienic conditions. The factors which significantly (<it>p </it>< 0.05) increase the incidence of intestinal parasites were uneducated and unemployed mother, lower social status of father, living in crowded houses with insufficient indoor spaces, using the tap water as drinking water, and living at shanty areas.</p> <p>Conclusion</p> <p>Intestinal parasitic infections in school children were found to be a public health problem that increased due to lower socio-economic conditions. We conclude that organization of education seminars including the topics such as prevention of the infectious diseases, improving general hygienic conditions, and application of supportive programs for the parents may be suggested not only to reduce intestinal parasitic infections, but also to elevate the socio-cultural levels.</p

The in vitro Effects of Azithromycin and Clarithromycin on Promastigotes and Amastigotes of Leishmania tropica

Leishmania (L.) tropica is one of the most common species responsible for cutaneous leishmaniasis (CL) in the Old World including Turkey. the pentavalent antimonials are widely used as intralesional and/or intramuscular in the treatment of CL, but increase in resistance to these agents led to investigations on alternative drugs. in vitro antileishmanial activities of two macrolides, azithromycin and clarithromycin were evaluated on promastigotes in RPMI 1640 medium and amastigotes in macrophage series of L. tropica. ED50 values of azithromycin and clarithromycin were found to be 5 µg/ml and ;lt;5 µg/ml on promastigotes, and 50-75 µg/ml and ;lt;3 µg/ml on amastigotes, respectively, while ED90 values of the same drugs were 75 µg/ml and 25 µg/ml on promastigotes and 100 µg/ml and 10 µg/ml on amastigotes, respectively. Our data suggested that clarithromycin and azithromycin were effective on both L. tropica promastigotes and amastigotes in vitro. Clarithromycin was found to be more effective than azithromycin at lower concentrations on promastigotes and amastigotes. in vivo studies should be planned to detect intracellular concentrations of these drugs for the effective route and dosageLeishmania (L.) tropica, Türkiye'de dahil olmak üzere Eski Dünya'da kutanöz leishmaniasisden (KL) sorumlu en önemli türdür. KL tedavisinde intralezyoner ve intramuskuler yoldan beş değerlikli antimon bileşikleri yaygın olarak kullanılmaktadır, fakat bu ajanlara karşı artan direnç alternatif ilaçların geliştirilmesini gerekli kılmaktadır. Bu çalışmada, makrolid grubundan iki antibiyotik olan azitromisin ve klaritromisinin L. topica'nın RPMI 1640 besiyerindeki promastigotlar ve makrofaj serisindeki amastigotlar üzerine olan antileishmanial aktiviteleri değerlendirilmiştir. Azitromisin ve klaritromisinin promastigotlar üzerindeki ED50 değerleri sırasıyla 5 µg/ml ve 5 µg/ml olarak, amastigotlar üzerindeki ED50 değerleri sırasıyla 50-75 µg/ml ve 3 µg/ml olarak bulunurken ED90 değerleri promastigotlar üzerinde 75 µg/ml ve 25 µg/ml olarak, amastigotlar üzerinde ise 100 µg/ml ve 10 µg/ml olarak bulunmuştur. Bu çalışmada, azitromisin ve klaritromisinin in vitro olarak L. tropica promastigot ve amastigotları üzerine etkili olduğu gösterilmiştir. Klaritromisin her iki parazit formunda da daha düşük dozlarda azitromisinden daha etkili olduğu belirlenmiştir. Bu ilaçların kullanım şekli ve dozajlarının belirlenmesi için hücre içi konsantrasyonlarının saptanması amacıyla in vivo çalışmaların planlanması gerektiği kanısına varılmıştı

Leishmania kinetoplast DNA contributes to parasite burden in infected macrophages: Critical role of the cGAS-STING-TBK1 signaling pathway in macrophage parasitemia

Leishmania parasites harbor a unique network of circular DNA known as kinetoplast DNA (kDNA). The role of kDNA in leishmania infections is poorly understood. Herein, we show that kDNA delivery to the cytosol of Leishmania major infected THP-1 macrophages provoked increased parasite loads when compared to untreated cells, hinting at the involvement of cytosolic DNA sensors in facilitating parasite evasion from the immune system. Parasite proliferation was significantly hindered in cGAS- STING- and TBK-1 knockout THP-1 macrophages when compared to wild type cells. Nanostring nCounter gene expression analysis on L. major infected wild type versus knockout cells revealed that some of the most upregulated genes including, Granulysin (GNLY), Chitotriosidase-1 (CHIT1), Sialomucin core protein 24 (CD164), SLAM Family Member 7 (SLAMF7), insulin-like growth factor receptor 2 (IGF2R) and apolipoprotein E (APOE) were identical in infected cGAS and TBK1 knockout cells, implying their involvement in parasite control. Amlexanox treatment (a TBK1 inhibitor) of L. major infected wild type cells inhibited both the percentage and the parasite load of infected THP-1 cells and delayed footpad swelling in parasite infected mice. Collectively, these results suggest that leishmania parasites might hijack the cGAS-STING-TBK1 signaling pathway to their own advantage and the TBK1 inhibitor amlexanox could be of interest as a candidate drug in treatment of cutaneous leishmaniasis

Okullarda Düzenli Aralıklarla Gerçekleştirilen Kontroller Saç Biti (Pediculus capitis) İnsidansını Düşürmekte Yeterli Olabilir mi?

In the present study, school children of similar age-groups from two villages of Manisa province, namely Osmancalı and Maldan, were examined in regular time periods to monitorize the changes in the incidence of head lice (Pediculus capitis). A total of 2091 children (1565 in Osmancalı and 526 in Maldan) were combed with a newly-designed lice comb (PDC;reg;, KSL Consulting, Helsinge, Denmark) four times in May and November in 2008 and 2009. The assessment of the results was conducted with SPSS;reg; v.15 program using CHAID and logistic regression analysis. The results of the periodic examinations of the children showed that the infestation rate of girls were found to be higher significantly compared to boys (P;lt;0.001), and the incidence of head lice infestation in boys from Osmancalı was found three times higher than the incidence in boys in Maldan (P=0.002). In addition, regular dry combing and treatment lowered the infestation rates among girls significantly (P=0.001). According to the results of the study, regular dry combing of school children with specially-designed lice combs may be essential for the control of this common infestation, especially in rural areasÇalışmamızda Manisa'nın Osmancalı ve Maldan köylerindeki ilköğretim okullarında aynı yaş grubundaki çocuklarda belirli aralıklarla saç biti (Pediculus capitis) taramaları yapılmış ve çocuklardaki bit varlığındaki değişimler izlenerek kaydedilmiştir. Bu bağlamda, 2008 ve 2009 yıllarının Mayıs ve Kasım aylarında o zaman için yeni geliştirilmiş bir bit tarağı (PDC®, KSL Consulting, Helsinge, Danimarka) kullanılarak yapılan düzenli taramalarda, (1565'i Osmancalı, 526'sı Maldan'dan) toplam 2091 çocuk çalışmaya dâhil edilmiştir. Sonuçların değerlendirilmesi SPSS® v.15 programının CHAID ve lojistik regresyon analizi kullanılarak yapılmıştır. Düzenli aralıklarla toplam 4 kez gerçekleştirilen taramalar sonucunda, kızlarda saç biti infestasyonunun erkeklerden çok daha yüksek düzeylerde olduğu (P0.001), Osmancalı'daki erkek öğrencilerdeki insidansın Maldan'daki erkeklerin yaklaşık 3 katı olduğu (P=0.002) gözlenmiştir. Ayrıca, düzenli tarama ve tedaviler sonucunda kızlardaki saç biti infestasyonunun anlamlı düzeyde azaldığı belirlenmiştir (P=0.001). Bu çalışmanın sonuçları, saç biti infestasyonunun kontrol altına alınmasında düzenli aralıklarla yapılan muayene ve tedavilerin özellikle kırsal kesimde başarılı olabileceğini göstermişti