Epidemiological and Genetic Data Supporting the Transmission of Ancylostoma ceylanicum among Human and Domestic Animals

Parasitic zoonoses pose a continuing public health problem, especially in endemic developing countries where the majority of populations live in poor, overcrowded conditions, lack education, and practice poor standards of hygiene and improper sanitary disposal of feces. Close contact with domestic animals such as dogs and cats coupled with a lack of proper veterinary care and sanitation expose these communities to high risk of acquiring zoonotic infections. Our study combined the application of conventional and molecular epidemiological tools to determine the probable role of domestic animals, in particular dogs and cats, in the transmission of hookworms in parasite-endemic communities in Malaysia. Epidemiological observation such as univariate and multivariate analyses were used to identify factors associated with hookworm infection in humans, while molecular tools provided the ability to discriminate the different hookworm species, which cannot be achieved by conventional microscopic examination of feces alone. The application of these tools in this present study allowed the accurate determination of parasite species prevalence, hence confirming that Ancylostoma ceylanicum infection is common among human population in Malaysia and the close contact of human and domestic animals (i.e., dogs and cats) contributed to the propagation of this hookworm species

Laboratory evaluation of a rapid IgG4 antibody test (BLF Rapid™) for bancroftian filariasis

At the end phase of the Global Programme to Eliminate Lymphatic Filariasis, antibody testing may have a role in decision-making for bancroftian filariasis–endemic areas. This study evaluated the diagnostic performance of BLF Rapid ™ , a prototype immunochromatographic IgG4-based test using BmSXP recombinant protein, for detection of bancroftian filariasis. The test was evaluated using 258 serum samples, comprising 96 samples tested at Universiti Sains Malaysia (in-house) and 162 samples tested independently at three international laboratories in the USA and India, and two laboratories in Malaysia. The independent testing involved 99 samples from Wuchereria bancrofti microfilaria or antigen positive individuals and 63 samples from people who were healthy or had other infections. The in-house evaluation showed 100% diagnostic sensitivity and specificity. The independent evaluations showed a diagnostic sensitivity of 84–100% and 100% specificity (excluding non-lymphatic filarial infections). BLF Rapid has potential as a surveillance diagnostic tool to make “Transmission Assessment Survey”–stopping decisions and conduct post-elimination surveillance

Occurrence of Blastocystis in Water of Two Rivers from Recreational Areas in Malaysia

This study reports the occurrence of Blastocystis in water from two rivers, Sungai Congkak and Sungai Batu, located in recreational areas in Malaysia. This protozoan was detected in samples from both rivers with an average of 33.3% and 22.1%, respectively. It was detected highest at the downstream (73.8% and 33.8%) followed by midstream (17.5% and 25.0%) and upstream (8.8% and 7.5%) stations, with additionally higher detection during holidays (with average 47.5% and 30.8%) than week days (with average 19.2% and 13.3%), in both rivers, respectively. There was a strong association with the daily activities of locals and visitors, who came for water recreational activities, mainly located between midstream and downstream and was observed to be higher at Sungai Congkak. The detection of Blastocystis in these rivers' water implies that this protozoan could potentially be transmitted to humans by the waterborne route. Pearson correlation analysis showed that their occurrence was significantly correlated with faecal coliforms count; inconsistent correlation with dissolved oxygen, temperature and turbidity and no correlation with pH, conductivity and rainfall for both rivers. The correlation of coliforms and Blastocystis suggests the source of the Blastocystis in the water body is likely to be faecal

Diphyllobothriasis: the first case report from Malaysia

Diphyllobothriasis is a disease caused by infection with adult tapeworms of the genus Diphyllobothrium. Humans acquire the infection by consuming the raw or inadequately cooked flesh, roe, liver, or other organs of infected fish. Diphyllobothrium latum infection has not been reported in Malaysia; we are reporting the first case. The patient was a 62 year old Chinese male seen at the outpatient clinic with complaints of watery stools and slight abdominal discomfort for four days. Physical examination was normal. He was treated for diarrhea. Two days after treatment, he passed out intact off-white proglottids in his stool. Diphyllobothriasis was confirmed by examination of these gravid proglottids; typical operculated eggs were seen after rupturing the gravid proglottids. The patient had a history of eating sashimi (Japanese raw fish). He was treated with a single dose of praziquantel and had been well since

Serological evidence of exposure and possible Taenia solium larval infection in Orang Asli communities of Peninsular Malaysia

Orang Asli communities are known as aborigines of peninsular Malaysia who are underprivileged and also known to be carriers of many different parasitic infections. However, the possible burden of cysticercosis (caused by Taenia solium larvae or Cysticercus cellulosae) has never been explored in these communities. Objective of this study was to explore the seroprevalence of human cysticercosis among Orang Asli (subgroups: Semelai, Semai Pahang, Temuan, Orang Kuala, Temiar, Semai Perak, and Mah Meri) communities. In this preliminary study, both male and female of all age groups (1 to 68 years) were screened for T. solium larvae specific antibodies in sera employing a commercially procured IgG-ELISA kit. Sera from a total of 522 randomly chosen Orang Asli individuals were screened between July to December 2013. A total of 20 (3.8%) subjects were diagnosed positive for anti-Cysticercus antibodies (95% CI: 2.5% – 5.8%; χ2=17.8; p<0.05). The prevalence of antibody positivity ranged between 0.9% (Semelai subgroup) to 9.9% (Orang Kuala subgroup). Statistical significance was observed between the low income status of family and seropositivity for cysticercosis (p=0.041) based on univariate analysis. Present study findings indicated that exposure to T. solium larval infection might have occurred in the aborigine communities from peninsular Malaysia. Results could only suggest that cysticercosis is an under recognized health problem here. Therefore a regional public health surveillance program might help verifying further the risk factors of T. solium cysticercosis targeting a larger population in both peninsular and East Malaysia

High Seroprevalence of Echinococossis, Schistosomiasis and Toxoplasmosis among the Populations in Babati and Monduli Districts, Tanzania.

BackgroundThe neglected tropical diseases, echinococcosis, schistosomiasis and toxoplasmosis are all globally widespread zoonotic diseases with potentially harmful consequences. There is very limited data available on the prevalence of these infections, except for schistosmiasis, in underdeveloped countries. This study aimed to determine the seroprevalence of Echinococcus multilocularis, Schistosoma mansoni, and Toxoplasma gondii antibodies in populations from the Monduli and Babati districts in Tanzania.MethodsA total of 345 blood samples were collected from 160 and 185 randomly selected households from Babati and Monduli districts, Tanzania between February and May of 2012 and analyzed them using the enzyme linked immunosorbent assay. The antibodies were determined using the NovaLisa® Toxoplasma gondii IgG, NovaLisa® Schistosoma Mansoni IgG, NovaLisa® Echinococcus IgG and NovaLisa® Toxoplasma gondii IgM kits (Novatec, Germany).ResultsThe seropositivity estimated for E. multilocularis, S. mansoni, and T. gondii IgG was 11.3% (95% confidence interval (CI): 7.96 - 14.6), 51.3% (95% CI: 46.0 - 56.5), and 57.68% (95% CI: 52.5 - 62.9), respectively. The seropositivity for T. gondii IgM was 11.3% (95% CI: 7.96 - 14.6). Living in the Monduli district was found to be the main risk factor for IgG seropositivity for both schistosomiasis (OR =1.94; 95% CI: 1.23 - 3.08; p =0.005) and toxoplasmosis (OR =2.09; 95% CI: 1.31-3.33; p =0.002).ConclusionsThese results suggest that restricting disease transmission, implementing control measures, and introducing training projects to increase public awareness are imperative, particularly for the Monduli district

Prevalence and associated factors of Schistosomiasis among children in Yemen: implications for an effective control programme

BACKGROUND Schistosomiasis, one of the most prevalent neglected tropical diseases, is a life-threatening public health problem in Yemen especially in rural communities. This cross-sectional study aims to determine the prevalence and associated risk factors of schistosomiasis among children in rural Yemen. METHODS/FINDINGS Urine and faecal samples were collected from 400 children. Urine samples were examined using filtration technique for the presence of Schistosoma haematobium eggs while faecal samples were examined using formalin-ether concentration and Kato Katz techniques for the presence of S. mansoni. Demographic, socioeconomic and environmental information were collected via a validated questionnaire. Overall, 31.8% of the participants were found to be positive for schistosomiasis; 23.8% were infected with S. haematobium and 9.3% were infected with S. mansoni. Moreover, 39.5% of the participants were anaemic whereas 9.5% had hepatosplenomegaly. The prevalence of schistosomiasis was significantly higher among children aged >10 years compared to those aged ≤ 10 years (P<0.05). Multivariate analysis confirmed that presence of other infected family member (P<0.001), low household monthly income (P = 0.003), using unsafe sources for drinking water (P = 0.003), living nearby stream/spring (P = 0.006) and living nearby pool/pond (P = 0.002) were the key factors significantly associated with schistosomiasis among these children. CONCLUSIONS/SIGNIFICANCE This study reveals that schistosomiasis is still highly prevalent in Yemen. These findings support an urgent need to start an integrated, targeted and effective schistosomiasis control programme with a mission to move towards the elimination phase. Besides periodic drug distribution, health education and community mobilisation, provision of clean and safe drinking water, introduction of proper sanitation are imperative among these communities in order to curtail the transmission and morbidity caused by schistosomiasis. Screening and treating other infected family members should also be adopted by the public health authorities in combating this infection in these communities

Prevalence of cryptosporidiosis in HIV-infected patients in Kajang Hospital, Selangor

A total of 66 fecal specimens obtained from patients infected with human immunodeficiency virus (HIV) from Kajang Hospital were screened for Cryptosporidium oocysts. The fecal specimens were concentrated using the formalin ethyl acetate concentration technique, stained with modified Ziehl-Neelsen and confirmed with immunofluorescence stain. It was established that 2 (3.0) were positive for Cryptosporidium. The two cases involved a Chinese local man (with diarrhea) and an Indonesian foreigner (without diarrhea). A higher index of suspicion for clinical cryptosporidiosis in HIV patients, including those with chronic weight loss with or without diarrhea, is recommended. In addition, laboratory testing for Cryptosporidium in HIV-infected patients is highly recommended in order to have a better understanding of the epidemiology and management of the disease in Malaysia

Gigantic amoebic liver abscess in pregnancy : A case report

Amoebic liver abscess in pregnancy is genuinely rare in its presentation. Yet, the main issue surrounding this agenda is the diagnostic challenge that it poses especially when symptomatology is vague and clues are subtle which altogether evades the diagnosis proper. We would like to dwell mainly on these issues in hopes of enlightening clinicians towards these diagnostic dilemmas. We report an extremely rare case of amoebic liver abscess occurring in the third trimester of pregnancy in a 29-year-old lady living in an interior village in Sabah. It was a combination of biochemical, radiographic and molecular investigations that ultimately led to the final diagnosis. In lieu of the high risk of mortality amongst pregnant mothers afflicted with amoebic liver abscess, the inherent need for early diagnosis requiring a high index of suspicion is vital. Elevated alkaline phosphatase alongside neutrophilia appears to be the most consistent liver parameters in guiding clinicians towards the presence of liver abscess