热带病学术热点追踪报告-第四期
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热带病学术热点追踪报告 2013年第4期（总第4期） |
（3） Outdoor malaria transmission in forested villages of Cambodia
（4） Characterization of a malaria outbreak in Colombia in 2010
（5） Complex environmental drivers of immunity and resistance in malaria mosquitoes
（5） The schistosome oesophageal gland: initiator of blood processing
Abstract[*]
This study suggests that in this setting of high antifolate drug resistance, three doses of sulfadoxine-pyrimethamine maintain some efficacy in suppressing microscopically detectable parasitemia, although placental infection remains frequent. Even in this urban setting, a large proportion of women have malaria infection at the time of their first antenatal care visit. Interventions to control malaria early and aggressive case detection are required to limit the detrimental effects of pregnancy-associated malaria [1].
（2） Integrated approach to malaria prevention at household level in rural communities in Uganda: experiences from a pilot project
Abstract
The integrated approach to malaria prevention at household level was well perceived by the project community, which could be scaled up to other areas. More rigorous studies such as randomized controlled trials are also recommended to further explore the public health impact of the integrated approach to malaria prevention [2].
（3） Outdoor malaria transmission in forested villages of Cambodia
Abstract
A total of 11,826 anophelines were recorded landing in 787 man-night collections. The majority (82.9 %) were the known primary and secondary vectors. Most of the variability in vector densities and early biting rates was explained by geographical factors, mainly at village level. Vector densities were similar between forest and village sites. Based on ELISA results, 29 % out of 17 Plasmodium-positive bites occurred before sleeping time, and 65 % in the forest plots. Deforestation might result in lower densities of the primary vectors, but also in higher densities of secondary vectors invading deforested areas. Therefore, additional vector control measures should be developed to target outdoor- and early-biting vectors [3].
（4） Characterization of a malaria outbreak in Colombia in 2010
Abstract
A greater incidence was found in men (65%) than in women (35%). Although about a third of cases occurred in children <15 years, most of these cases occurred in children >5 years of age. The ethnic distribution indicated that about 68% of the cases occurred in mestizos and whites, followed by 23% in Afro-descendants, and the remainder (9%) in indigenous communities. In over half of the cases, consultation occurred early, with 623 complicated and 23 fatal cases. However, the overall incidence increased, corresponding to an epidemic burst and indicating the need to strengthen prevention and control activities as well as surveillance to reduce the risk of outbreaks and the consequent economic and social impact[4].
（5） Complex environmental drivers of immunity and resistance in malaria mosquitoes
Abstract
Here, we examine how changes in mean ambient temperature, diurnal temperature fluctuation and time of day of infection affected the immunity and resistance of Anopheles stephensi to infection with Escherichia coli. Both mosquito immune parameters and resistance were directly affected by mean temperature, diurnal temperature fluctuation and time of day of infection. Furthermore, there was a suite of complex two- and three-way interactions yielding idiosyncratic phenotypic variation under different environmental conditions. The results demonstrate mosquito immunity and resistance to be strongly influenced by a complex interplay of environmental variables, challenging the interpretation of the very many mosquito immune studies conducted under standard laboratory conditions[5].
Abstract
Insecticide resistance and the efficacy of indoor residual spraying with different insecticides were determined in a Gambian village. All insecticides tested showed high residual activity up to five months after application. Mosquito house entry, estimated by light traps, was similar in all houses with metal roofs, but was significantly less in IRS houses with thatched roofs (p=0.02). Residents participating in focus group discussions indicated that IRS was considered a necessary nuisance and also may decrease the use of long-lasting insecticidal nets. Bendiocarb and microencapsulated pirimiphos methyl are viable alternatives for indoor residual spraying where resistance to pyrethroids and DDT is high and may assist in the management of pyrethroid resistance [6].
（1） Survey of Migratory Birds (Anatidae: Anas platyrhynchos) for Schistosome Parasites from Mazandaran Province, Northern Iran
Abstract
A number of mallards were bought from the markets of hunted birds. The respiratory tracts and intestinal blood vessels were studied for adult worms. The nasal mucosa was separated and observed by a microscope. In order to separate the visceral schistosomes, after separating intestine, vessel mesenteric was studied under the lamp light and then in saline. The parasite sample was collected for subsequent observation. Fifteen (13.6%) cases out of 110 studied birds had nasal mucosa contaminated with Trichobilharzia sp. egg. Besides that, two birds had adult worms schistosome visceral i.e. Bilharziella sp. The elements that cause cercarial dermatitis in aforementioned region are Trichobilharzia sp. and Bilharziella sp. parasites. Thus, it is necessary for the authorities of health, environmental and agricultural organization of the province to cooperate in order to control this disease [7].
（2） Intestinal schistosomiasis in pre school-aged children of Lake Albert, Uganda: diagnostic accuracy of a rapid test for detection of anti-schistosome antibodies
Abstract
Upon comparison with quadruplicate Kato-Katz the sensitivity and specificity of the RDT were 75.7% and 31.1%, respectively. When using the SmSEA-ELISA as an alternate reference test, the RDT achieved 81.3% sensitivity and 61.1% specificity. Sensitivity and specificity compared to the urine-CCA test was 74.5% and 32.3% respectively. Sensitivity differed significantly according to age group.The performance of the RDT within this study appeared favourable when compared with the currently-available SmSEA-ELISA. Looking to the future a serological POC test would be particularly promising for use in disease mapping in younger children especially in guiding administration of praziquantel treatment in selective treatment settings [8].
（3） Prevalence of schistosome antibodies and hepatosplenic signs and symptoms among patients from Kaoma, Western Province, Zambia
Abstract
A symptom questionnaire, demographic survey and physical examination was conducted amongst patients presenting to Kaoma district outpatient clinics. To assess the prevalence of Schistosoma mansoni infections, blood was collected and screened for the presence of schistosoma antibodies using Enzyme linked immunosorbent assay (ELISA). Of the 110 patients screened, 97 were ELISA positive. Forty-six percent reported haematochezia and 7% experienced haematemesis. On physical examination 27% hepatomegaly and 17% splenomegaly but there were few correlations between serology and signs/symptoms. Our evidence highlights a need for mass treatment in Kaoma to address and prevent extensive pathology of hepatosplenic schistosomiasis. Safe water and health education throughout Western Province are clearly also important [9].
（4） Detectable urogenital schistosome DNA and cervical abnormalities 6 months after single-dose praziquantel in women with Schistosoma haematobium infection
Abstract
We explored response to single-dose praziquantel therapy in a cohort of 33 women with Schistosoma haematobium infection in rural Mwanza, Tanzania. Women with S. haematobium infection confirmed both by eggs in urine and by polymerase chain reaction (PCR) received single-dose praziquantel and treatment of concomitant sexually transmitted infections. Macroscopic cervical abnormalities were also quantified. After 6 months, microscopically detectable egg excretion was eliminated, but 8 of 33 women were persistently positive for S. haematobium by PCR, and 11 had cervical abnormalities potentially attributable to schistosomiasis. This suggests that praziquantel treatment more frequently than every 6 months may be necessary for complete elimination of the parasite and prevention of genital tissue pathology. This aggressive therapy may in turn play a key role decreasing HIV susceptibility in millions of people living in regions in which S. haematobium is endemic[10].
（5） The schistosome oesophageal gland: initiator of blood processing
Abstract
The feeding process was shown by video microscopy to be divided into two phases, blood first accumulating in the anterior lumen before passing as a bolus to the posterior. There it streamed around a plug of material revealed by confocal microscopy as tethered leucocytes. Two further genes, MEGs 4.2 and 14, were shown to be expressed exclusively in the esophageal gland. Bioinformatics predicted that MEGs 4.1 and 4.2 possessed a common hydrophobic region with a shared motif, while antibodies to SjMEG-4.1 showed it was bound to leucocytes in the esophageal lumen. It was also predicted that MEGs 4.1 and 14 were heavily O-glycosylated and this was confirmed for the former by 2D-electrophoresis and Western blotting.The esophageal gland and its products play a central role in the processing of ingested blood. The binding of host antibodies in the esophageal lumen shows that some constituents are antibody targets and could provide a new source of vaccine candidates [11].
Abstract
A human anti-E monoclonal Ab was used as a standard in a virion-capture ELISA to measure the concentration of anti-E Abs, [anti-E Abs], in dengue-immune sera from Nicaraguan patients collected 3, 6, 12 and 18 months post-infection. The proportion of anti-FL Abs was determined by capture ELISA using virus-like particles containing mutations in FL, and the concentration of anti-FL Abs, [anti-FL Abs], was calculated. Neutralization titers (NT50) were determined using a previously described flow cytometry-based assay. Analysis of sequential samples from 10 dengue patients revealed [anti-E Abs] and [anti-FL Abs] were higher in secondary than in primary DENV infections. While [anti-FL Abs] did not correlate with NT50 against the current infecting serotype, it correlated with NT50 against the serotypes to which patients had likely not yet been exposed ("non-exposed" serotypes) in 14 secondary DENV3 and 15 secondary DENV2 cases. These findings demonstrate the kinetics of anti-FL Abs and provide evidence that anti-FL Abs play a protective role against "non-exposed" serotypes after secondary DENV infection [12].
（2） Development of post-kala-azar dermal leishmaniasis in AmBisome treated visceral leishmaniasis: A possible challenge to elimination program in India
Abstract
We report two cases, one male (33 years) and a female (14 years), that developed Post-Kala-azar Dermal Leishmaniasis (PKDL) after successful treatment for visceral leishmaniasis (VL) or Kala-azar with AmBisome, the lipid complex of Amphotericin B. Both cases presented with hypo-pigmented macular lesions all over the body. The patients responded well to AmBisome after treatment with three courses. This first ever case report from India indicates that possibly there is no effective drug for VL until date, which can prevent post-treatment development of PKDL [13].
Abstract
In this present investigation, anticestodal activity of one of the endophytic fungi Pestalotiopsis sp. from Neem plant was observed on protoscoleces of hydatid cysts of Echinococcus granulosus. Viability of protoscoleces was confirmed by 0.1% aqueous eosin red stain method, where mortality was observed at different concentrations with respect to time. An average anticestodal activity was observed with different endophytic fungal strains. These species showed significant reduction in viability of protoscoleces. We conclude that ultrastructural changes in protoscoleces were due to endophytic extract suggesting that there may be some bioactive compounds that have selective action on the tegument layer of protoscoleces. As compared with that of standard drug used, endophytic species of Neem plant shows significant anticestodal activity [14].
（4） Carcinogenic liver fluke Opisthorchis viverrini oxysterols detected by LC-MS/MS survey of soluble fraction parasite extract
Abstract
Liquid chromatography in tandem mass spectrometry (LC-MS/MS) has emerged as an informative tool to investigate oxysterols (oxidized derivatives of cholesterol) in helminth parasite associated cancers. Here, we used LC-MS/MS to investigate in soluble extracts of the adult developmental stage of Opisthorchis viverrini from experimentally infected hamsters. Using comparisons with known bile acids and the metabolites of estrogens, the LC-MS data indicated the existence of novel oxysterol derivatives in O. viverrini. Most of these derivatives were ramified at C-17, in similar fashion to bile acids and their conjugated salts. Several were compatible with the presence of an estrogen core, and/or hydroxylation of the steroid aromatic ring A, hydroxylation of both C-2 and C-3 of the steroid ring and further oxidation into an estradiol-2,3-quinone[15].
（5） Behavioral and Metabolic Effects of the Atypical Antipsychotic Ziprasidone on the Nematode Caenorhabditis elegans
Abstract
We evaluated lipid accumulation and behavioral changes in a new experimental model, the nematode Caenorhabditis elegans (C. elegans). Ziprasidone did not alter behaviors related to energetic balance, such as pharynx pumping, defecation cycles and movement. There was, however, a reduction in egg-production, egg-laying and body-length in nematodes exposed to Ziprasidone without any changes in the progression of larval stages. The serotoninergic pathway did not appear to modulate Ziprasidone's effects on Nile red fluorescence. Additionally, Ziprasidone did not alter lipid accumulation in daf-16 or crh-1 deletion mutants. These results suggest that Ziprasidone alters reproductive behavior, morphology and lipid reserves in the intestinal cells of C. elegans. Our results highlight that the DAF-16 and CREB transcription factors are essential for Ziprasidone-induced fat store reduction [16].
【摘要】*
孝感市属亚热带季风气候,充足水量、适宜温度非常适合媒介按蚊孳生和疟疾传播。20世纪60年代前孝感市疟疾流行严重,通过采取综合性防治措施,至20世纪60年代末,基本控制住了疟疾流行,多数县市达到或接近基本消除疟疾标准。在当前外出务工人员大量增多形势下,为进一 步做好孝感市疟疾防控工作，巩固防治效果，本文将孝感市2004-2012年实施传染病网络直报以来的疟疾疫情进行了分析[17]。
（2） 2011年南宁市输入性疟疾流行特征分析
【摘要】
分析南宁市2011年输入性疟疾流行特征,为制定防治措施提供依据。收集南宁市2011年网报系统数据及流行病学调查资料,运用Excel 2003软件进行统计分析。分析结果为南宁市2011年共报告输入性疟疾病例65例,死亡1例(间日疟),发病率为0.84/10万,比2010年上升100.00%。发病人群以男性青壮年为主,农民占63.08%;地区分布以上林县病例最多,占病例总数的61.54%;感染疫源地以非洲国家居多,占80.00%,其次是东南亚国家,占18.46%。结论是南宁市输入性疟疾发病呈逐年上升趋势,应予高度重视。加强流动人口管理和监测,加大宣传、提高认识、开展培训、提高能力是我市当前疟疾防治工作的重点[18]。
【摘要】
了解2011年河南省疟疾疫情特征,评价疟疾防治措施,为疟疾防治提供依据。收集2011年河南省疟疾病例的资料并进行分析。分析结果为 2011年河南省共报告疟疾314例,其中本地病例为168例,输入性病例为146例。男性病例240例,女性病例74例。病例中以青壮年农民为主,全年均有病例发生,以流行季节的6～10月(153例)为发病高峰。得出的结论是 2011年河南省疟疾疫情明显下降,但是输入性疟疾呈上升趋势[19]。
（4） 1950-2012年中越边境龙州县疟疾防治效果评价
【摘要】
分析评价中越边境原为疟疾高度流行区的龙州县历年的疟疾防治效果,为该县消除疟疾提供科学依据。方法:查阅收集全县1950-2012年的疟疾防治资料,包括历年疟疾疫情报告、防治方案、各乡镇卫生院疟疾患者诊断和治疗资料等,采用Excel软件进行统计和分析。分析后得出的结论是，该县自1993年达到基本消灭疟疾后,疟疾在当地居民中得到了有效控制,但流动人口中的疟疾患者呈现增多趋势,应该继续加强监测[20]。
2. 血吸虫相关
【摘要】
为2013年全省实现血吸虫病传播控制标准提供依据。依照《2012年湖北省血吸虫病防治工作目标任务考核评估方案》,在全省开展人、畜(耕牛)血吸虫病情、螺情现场评估、质量控制及疫情档案资料等考核。得出的结论为全省63个县(市、区)实现了2012年血防工作目标。通过考核评估发现的3个危险因素将是全省下步工作重点[21]。
【摘要】
昆山曾是血吸虫病的高发地区，虽然1993年昆山已达到了当时国家制定的消灭血吸虫病标准，但目前晚期血吸虫性肝硬化患者在中老年人群中仍占一定的比例，昆山市第三人民医院作为江苏省昆山地区血吸虫唯一防治单位，收治的晚期血吸虫肝硬化患者298例，其中发现晚期血吸虫肝硬化合并肝癌20例，约占10.1%[22]。
【摘要】
系统评价糖皮质激素治疗神经囊虫病(NCC)的疗效,为指导临床治疗提供循证医学证据。检索Cochrane图书馆、MEDLINE、EMBASE、万方数据库、中国学术期刊网全文数据库(CNKI),检索文献发表时间为1995年1月—2012年2月,筛选所有糖皮质激素治疗(包括联合驱虫药物阿苯达唑治疗)NCC的随机对照试验。由两名文献评价员独立并交叉评价文献质量和提取资料,并对纳入文献采用Rev Man 5.0软件进行统计学分析。结论为糖皮质激素可降低6～12个月随访期间的癫痫复发率和影像学病变进展程度。但鉴于目前评价糖皮质激素疗效和安全性的临床试验和样本量较少,仅弱推荐糖皮质激素治疗NCC。仍需要多中心、大样本、双盲的临床随机对照试验,以比较糖皮质激素或安慰剂、驱虫剂、联合用药治疗NCC的疗效[23]。
（2） 65例临床疑似华支睾吸虫病的超声诊断分析及评价
【摘要】
探讨超声检查用于华支睾吸虫病的诊断效果,为该病的临床诊断提供依据。收集华支睾吸虫疑似患者65例,采用东芝240型超声诊断仪(探头频率3.75MHz)行肝胆系统各切面连续扫查,详细观察及分析华支睾吸虫病的肝胆道系统的声像表现。结果为 65例疑似患者中有45例经粪检和手术确诊为华支睾吸虫病患者,确诊的45例中有38例超声检查肝胆系统有特异性改变,表现为肝内中小胆管弥漫性轻度扩张,管壁不均匀性增厚,回声增强,不同切面呈现小点状、小等号状、斑状、条索状等强回声。超声诊断方法的敏感性为84.44%,特异性为58.46%。结论是超声检查方法简单、易操作,对辅助提高华支睾吸虫病的诊断具有重要的临床意义[24]。
【摘要】
棘球蚴病是由棘球绦虫的幼虫寄生于人体内所引起的一种人畜共患寄生虫病,主要流行于畜牧业发达的地区,严重影响了人类的健康,也是世界范围的一个重要的公共卫生和经济问题。目前,棘球蚴病的治疗主要还是以手术治疗为主,药物治疗及免疫预防等为辅。随着临床治疗经验的不断积累和对棘球蚴病发病机制的进一步认识,棘球蚴病的手术治疗、药物治疗及免疫预防都已有了一定程度的进展[25]。
（4） 2012年汉台区人群土源性线虫感染现状调查
【摘要】
了解汉台区人群土源性线虫感染现状,为制定防治对策提供依据。按照分层随机抽样原则,在全区11个乡镇和5个城区社区中各随机抽取1～2个村或居委会为调查点,3周岁及以上的常住人口为调查对象,每个点随机调查人数不少于100人,采用改良加藤氏厚涂片法粪检虫卵。共调查1 597人,土源性线虫感染率为6.14%,其中蛔虫、鞭虫、钩虫、蛲虫感染率依次为5.39%、0.38%、0.31%、0.06%;感染病例在30～39岁、中小学生、医生、工人、商人人群中比较多见。结论为汉台区人群土源性线虫感染以蛔虫为主,采取加强健康教育,改变人们不良卫生生活习惯为主的综合防治措施,降低感染率[26]。
【参考文献】
（如需参考文献中论文全文，请发送论文标题至yaoyaoyu1987@163.com）
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编辑：中国疾病预防控制中心寄生虫病预防控制所
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