- Home
- The American Journal of Tropical Medicine and Hygiene
- Previous Issues
- Volume 96, Issue 1, January 2017
The American Journal of Tropical Medicine and Hygiene - Volume 96, Issue 1, January 2017
Volume 96, Issue 1, January 2017
- Articles
-
-
Development of a PCR Assay for Diagnosing Trematode (Opisthorchis and Haplorchis) Infections in Human Stools
Pages: 221–228More LessAbstractWe developed a combined conventional polymerase chain reaction (PCR) and real-time PCR (qPCR)-based assay for detecting and discriminating between Opisthorchis viverrini and Haplorchis taichui parasite infections. The first PCR amplifies the mitochondrial cytochrome c oxidase subunit I (COI) genes of parasites, and differential diagnosis is achieved by performing qPCR with specific primers and SYBR Green I. The detection limit of the assay was found to be 2.0 × 102 plasmid copies in a test in which a stool sample was spiked with a single egg, which is equivalent to 5 eggs per gram (EPG). The testing of 34 clinical stool samples that had been demonstrated to contain “Opisthorchis-like” eggs by microscopy showed that the novel assay exhibited a sensitivity of 100% for “Opisthorchis-like” parasitic infections, and 71% and 91% of these samples were found to be infected with O. viverrini and H. taichui, respectively. A further four parasitic infections were diagnosed in the 16 negative samples, and the microscopic findings of these samples were confirmed to be false negatives by sequencing analysis. The assay also displayed high specificity during the testing of 10 samples containing other common parasites. The fact that our qPCR SYBR Green I–based assay detected submicroscopic traces of parasitic DNA and was able to differentiate between parasites that produce eggs with similar morphologies indicates that it has a good potential for development of diagnostic application to use in areas where multiple parasites coexist.
-
Serological Responses to Filarial Antigens in Malian Children Attending Elementary Schools
Pages: 229–232More LessAbstractDried blood spots (DBS) were collected from 805 children attending 42 elementary schools in the regions of Mopti, Sikasso, Koulikoro, and the regional capital of Bamako in Mali as part of an evaluation of a school health intervention. Eluted immunoglobulin (Ig) G from the DBS was assessed by a multiplex bead assay (MBA) for two filariasis antigens, Wuchereria bancrofti, Wb123, and Brugia malayi, Bm14, to determine the effectiveness of mass drug administration (MDA) programs to eliminate lymphatic filariasis (LF). The prevalence of positive IgG responses in the children to each antigen was less than 1%, indicating effectiveness of the MDA against LF. The MBA is an excellent serological platform that provides cost-effective opportunities to evaluate public health activities beyond the survey targets.
-
Survey of Obstetrician-Gynecologists in the United States About Taeniasis and Cysticercosis
Pages: 233–242More LessAbstractAn estimated 50 million persons worldwide are infected with cysticerci, the larval forms of the Taenia solium tapeworm. Neurocysticercosis can cause seizures, epilepsy, and hydrocephalus, and fatal cases have been reported in the United States in immigrants and in travelers returning from endemic countries. Pregnant women with symptomatic neurocysticercosis present treatment challenges, whereas those with the adult tapeworm infection (i.e., taeniasis) can put their infants and other family members, as well as obstetrician-gynecologists and their staff, at risk for cysticercosis. A questionnaire developed by the American College of Obstetricians and Gynecologists was sent to a representative sample of 1,000 physicians to assess their awareness of T. solium infection and the potential for it to be encountered in an obstetrics and gynecology setting. In total, 31.4% of respondents correctly answered that taeniasis is caused by eating undercooked pork containing T. solium cysts (95% confidence interval [CI] = 26.6–36.5). While only 14.5% (95% CI = 11.0–18.6) of respondents correctly answered that cysticercosis is acquired by ingesting tapeworm eggs shed in human stools, twice that number (30.3%; 95% CI = 25.5–35.3) correctly answered that a mother with taeniasis can cause cysticercosis in her infant. Practicing in a state in which cysticercosis was reportable at the time of the survey was not significantly associated with answering any of the 12 knowledge questions correctly. Overall, knowledge of T. solium infection among U.S. obstetricians-gynecologists is limited. This may result in missed opportunities to diagnose and treat pregnant women with taeniasis, which may put family members and obstetrics clinical staff at risk for cysticercosis.
-
The Association Between Neurocysticercosis and Hippocampal Atrophy is Related to Age
Pages: 243–248More LessAbstractNeurocysticercosis (NCC) has been associated with hippocampal atrophy, but the prevalence and pathogenic mechanisms implicated in this relationship are unknown. Using a population-based, case–control study design, residents in a rural village (Atahualpa) aged ≥ 40 years with calcified NCC were identified as cases and paired to NCC-free individuals (control subjects) matched by age, sex, and level of education. Cases and control subjects underwent magnetic resonance imaging for hippocampal rating according to the Scheltens' scale for medial temporal atrophy and were interviewed to identify those with a clinical seizure disorder. The prevalence of hippocampal atrophy was compared between cases and control subjects by the use of the McNemar's test for correlated proportions. Seventy-five individuals with calcified NCC and their matched control subjects were included in the analysis. Hippocampal atrophy was noted in 26 (34.7%) cases and nine (12%) control subjects (odds ratio: 4.4; 95% confidence interval: 1.6–14.9, P < 0.0021). Stratification of pairs according to tertiles of age revealed an age-related trend in this association, which became significant only in those aged ≥ 68 years (P = 0.027). Only five cases and one control had recurrent seizures (P = 0.221); three of these five cases had hippocampal atrophy, and the single control subject had normal hippocampi. This study confirms an association between NCC and hippocampal atrophy, and shows that this association is stronger in older age groups. This suggests that NCC-related hippocampal atrophy takes a long time to develop.
-
Performance of Health Workers Using an Electronic Algorithm for the Management of Childhood Illness in Tanzania: A Pilot Implementation Study
Pages: 249–257More LessAbstractIn low-resource settings, where qualified health workers (HWs) are scarce and childhood mortality high, rational antimicrobial prescription for childhood illnesses is a challenge. To assess whether smartphones running guidelines, as compared with paper support, improve consultation process and rational use of medicines for children, a pilot cluster-randomized controlled study was conducted in Tanzania. Nine primary health-care facilities (HFs) were randomized into three arms: 1) paper algorithm, 2) electronic algorithm on a smartphone, and 3) control. All HWs attending children aged 2–59 months for acute illness in intervention HFs were trained on a new clinical algorithm for management of childhood illness (ALMANACH) either on 1) paper or 2) electronic support; 4 months after training, consultations were observed. An expert consultation was the reference for classification and treatment. Main outcomes were proportion of children checked for danger signs, and antibiotics prescription rate. A total of 504 consultations (166, 171, and 167 in control, paper, and phone arms, respectively) were observed. The use of smartphones versus paper was associated with a significant increase in children checked for danger signs (41% versus 74%, P = 0.04). Antibiotic prescriptions rate dropped from 70% in the control to 26%, and 25% in paper and electronic arms. The HWs–expert agreement on pneumonia classification remained low (expert's pneumonia identified by HWs in 26%, 30%, and 39% of patients, respectively).Mobile technology in low-income countries is implementable and has a potential to improve HWs' performance. Additional point-of-care diagnostic tests are needed to ensure appropriate management. Improving the rational use of antimicrobial is a challenge that ALMANACH can help to take up.
- Top
-
- The Tropical Bookshelf
- Letter to the Editor
-
Volumes & issues
-
Volume 104 (2021)
-
Volume 103 (2020)
-
Volume 102 (2020)
-
Volume 101 (2019)
-
Volume 100 (2019)
-
Volume 99 (2018)
-
Volume 98 (2018)
-
Volume 97 (2017)
-
Volume 96 (2017)
-
Volume 95 ([2016, 2017])
-
Volume 94 (2016)
-
Volume 93 (2015)
-
Volume 92 (2015)
-
Volume 91 (2014)
-
Volume 90 (2014)
-
Volume 89 (2013)
-
Volume 88 (2013)
-
Volume 87 (2012)
-
Volume 86 (2012)
-
Volume 85 (2011)
-
Volume 84 (2011)
-
Volume 83 (2010)
-
Volume 82 (2010)
-
Volume 81 (2009)
-
Volume 80 (2009)
-
Volume 79 (2008)
-
Volume 78 (2008)
-
Volume 77 (2007)
-
Volume 76 (2007)
-
Volume 75 (2006)
-
Volume 74 (2006)
-
Volume 73 (2005)
-
Volume 72 (2005)
-
Volume 71 (2004)
-
Volume 70 (2004)
-
Volume 69 (2003)
-
Volume 68 (2003)
-
Volume 67 (2002)
-
Volume 66 (2002)
-
Volume 65 (2001)
-
Volume 64 (2001)
-
Volume 63 (2000)
-
Volume 62 (2000)
-
Volume 61 (1999)
-
Volume 60 (1999)
-
Volume 59 (1998)
-
Volume 58 (1998)
-
Volume 57 (1997)
-
Volume 56 (1997)
-
Volume 55 (1996)
-
Volume 54 (1996)
-
Volume 53 (1995)
-
Volume 52 (1995)
-
Volume 51 (1994)
-
Volume 50 (1994)
-
Volume 49 (1993)
-
Volume 48 (1993)
-
Volume 47 (1992)
-
Volume 46 (1992)
-
Volume 45 (1991)
-
Volume 44 (1991)
-
Volume 43 (1990)
-
Volume 42 (1990)
-
Volume 41 (1989)
-
Volume 40 (1989)
-
Volume 39 (1988)
-
Volume 38 (1988)
-
Volume 37 (1987)
-
Volume 36 (1987)
-
Volume 35 (1986)
-
Volume 34 (1985)
-
Volume 33 (1984)
-
Volume 32 (1983)
-
Volume 31 (1982)
-
Volume 30 (1981)
-
Volume 29 (1980)
-
Volume 28 (1979)
-
Volume 27 (1978)
-
Volume 26 (1977)
-
Volume 25 (1976)
-
Volume 24 (1975)
-
Volume 23 (1974)
-
Volume 22 (1973)
-
Volume 21 (1972)
-
Volume 20 (1971)
-
Volume 19 (1970)
-
Volume 18 (1969)
-
Volume 17 (1968)
-
Volume 16 (1967)
-
Volume 15 (1966)
-
Volume 14 (1965)
-
Volume 13 (1964)
-
Volume 12 (1963)
-
Volume 11 (1962)
-
Volume 10 (1961)
-
Volume 9 (1960)
-
Volume 8 (1959)
-
Volume 7 (1958)
-
Volume 6 (1957)
-
Volume 5 (1956)
-
Volume 4 (1955)
-
Volume 3 (1954)
-
Volume 2 (1953)
-
Volume 1 (1952)
-
Volume s1-31 (1951)
-
Volume s1-30 (1950)
-
Volume s1-29 (1949)
-
Volume s1-28 (1948)
-
Volume s1-27 (1947)
-
Volume s1-26 (1946)
-
Volume s1-25 (1945)
-
Volume s1-24 (1944)
-
Volume s1-23 (1943)
-
Volume s1-22 (1942)
-
Volume s1-21 (1941)
-
Volume s1-20 (1940)
-
Volume s1-19 (1939)
-
Volume s1-18 (1938)
-
Volume s1-17 (1937)
-
Volume s1-16 (1936)
-
Volume s1-15 (1935)
-
Volume s1-14 (1934)
-
Volume s1-13 (1933)
-
Volume s1-12 (1932)
-
Volume s1-11 (1931)
-
Volume s1-10 (1930)
-
Volume s1-9 (1929)
-
Volume s1-8 (1928)
-
Volume s1-7 (1927)
-
Volume s1-6 (1926)
-
Volume s1-5 (1925)
-
Volume s1-4 (1924)
-
Volume s1-3 (1923)
-
Volume s1-2 (1922)
-
Volume s1-1 (1921)