- Microfilaria and Strongyloides larva diagnosed in cerebrospinal fluid and ascitic fluid, respectively: Approach to their morphology on cytology. [Journal Article]
- DCDiagn Cytopathol 2019 Jun 18
- Filariasis and Strongyloidiasis are two endemic parasitic infections seen in any tropical country. Filariasis, commonly caused by Wuchereria bancrofti, Brugia malayi, and Brugia timori is seen often …
Filariasis and Strongyloidiasis are two endemic parasitic infections seen in any tropical country. Filariasis, commonly caused by Wuchereria bancrofti, Brugia malayi, and Brugia timori is seen often in peripheral blood and lymphoid tissue. But it can be isolated from wide variety of soft tissue sites in the body like soft tissue lumps, breast, thyroid, body fluids. Strongyloides stercoralis, a helminthic infection, usually affects the respiratory and gastrointestinal (GI) tract, and frequently picked up in GI biopsies. However, in cases of hyper infection and patients with altered immunity, it can be isolated from other rare sites like body fluid samples. Accurate morphological Identification and confirmation are important for specific management. We report a case of microfilaria isolated from cerebrospinal fluid and a case of Strongyloides larva isolated from ascitic fluid in clinically unsuspected cases of these two parasitic infestations. We have also added a brief discussion on morphological differences between the two larval forms.
- The Efficacy of Doxycycline Treatment on Mansonella perstans Infection: An Open-Label, Randomized Trial in Ghana. [Journal Article]
- AJAm J Trop Med Hyg 2019 Jun 03
- Treating Mansonella perstans is challenged by the low efficacy of registered antihelminthics. Wolbachia endobacteria provide an alternative treatment target because depletion results in amicrofilarem…
Treating Mansonella perstans is challenged by the low efficacy of registered antihelminthics. Wolbachia endobacteria provide an alternative treatment target because depletion results in amicrofilaremia in filarial infections with Wuchereria bancrofti and Onchocerca volvulus infections. This open-label, randomized study sought to confirm that i) Wolbachia are present in M. perstans in Ghana and ii) doxycycline treatment will deplete Wolbachia and cause a slow, sustained decline in microfilariae (MF). Two hundred and two Ghanaians with M. perstans infection were randomized into early (immediate) and delayed (6 months deferred) treatment groups, given doxycycline 200 mg/day for 6 weeks, and monitored for MF and Wolbachia levels at baseline, 4, 12, and 24 months after the study onset (= time of randomization and start of treatment for the early group). Per protocol analysis revealed that the median MF/mL in the early group declined from 138 at baseline to 64 at month 4 and further to 0 at month 12. In the delayed group, MF load did not change from a baseline median of 97 to 102 at month 4 but declined to 42 at month 12, that is, 6 months after receiving treatment, trailing the early group as expected. By month 24, both treatment groups had reached a median MF level of 0. After treatment, Wolbachia were depleted from MF by ≥ 1-log drop compared with baseline levels. We conclude that M. perstans in Ghana harbor Wolbachia that are effectively depleted by doxycycline with subsequent reduction in MF loads, most likely because of interruption of fertility of adult worms.
- Ocular filariasis: "Dancing sensation in the anterior chamber". [Case Reports]
- TPTrop Parasitol 2019 Jan-Jun; 9(1):57-58
- We report a case of ocular filariasis in a 28-year-old male who presented with a 2-month history of irritated acute red eye. Examination revealed a living and active large worm dancing in the anterio…
We report a case of ocular filariasis in a 28-year-old male who presented with a 2-month history of irritated acute red eye. Examination revealed a living and active large worm dancing in the anterior chamber of the left eye causing acute iridocyclitis, leading to drop in vision to 6/36. The worm whose size was approximately 33 mm in length was extracted under local anesthesia in toto using viscoelastics without damaging the ocular structures. Microscopic examination confirmed adult Wuchereria bancrofti.
- Assessment of treatment impact on lymphatic filariasis in 13 districts of Benin: progress toward elimination in nine districts despite persistence of transmission in some areas. [Journal Article]
- PVParasit Vectors 2019 May 30; 12(1):276
- CONCLUSIONS: The findings of our study indicate that Benin has made important progress towards elimination in most districts evaluated. However, this study also shows that transmission of LF is ongoing in the EU of Ouinhi, part of the Zou department. The MDA strategy needs to be strengthened in order to control the human reservoir of infection in these districts.
- Evaluation of lymphatic filariasis in endemic area of Brazil where mass drug administration is not required. [Journal Article]
- PGPathog Glob Health 2019; 113(3):143-148
- Mass drug administration (MDA) is the main counter-transmission strategy of the Global Programme to Eliminate Lymphatic Filariasis. In endemic countries, there are areas where MDA is not required. Ho…
Mass drug administration (MDA) is the main counter-transmission strategy of the Global Programme to Eliminate Lymphatic Filariasis. In endemic countries, there are areas where MDA is not required. However, there is no standard approach in these areas, and studies are important to evaluate the epidemiological status. This study aimed to investigate lymphatic filariasis and strategies developed for its control in an area where MDA is not required. Together with the 2018 morbidity evaluation, a survey was conducted using point-of-care immunochromatographic test-AD12 tests for diagnostic screening in an area where MDA is not required. The methodology also included desk research based on Health Department reports of the control activities for lymphatic filariasis during 2003-2016. Among the 934 cases investigated in 2018, there was a 0.64% prevalence of circulating filarial antigen positive, comprising five adults and one 2-year-old child. Six patients aged 39-63 years had filarial disease. Fourteen surveys have already been conducted as control activities, and since 2009, there have been no positive cases. This study showed that the prevalence of antigenemia decreased from 2.97% in 2003 to 0.64% in 2018. Moreover, the transmission of filariasis infection was under control in this area. Our study provides insights into the surveillance phase by identifying areas of low transmission and where MDA is not required. Although we have not identified cases of filarial infection, there is a need to provide services that will provide assist those already affected with morbidity and help reduce and prevent disability.
- Indocyanine green - guided laparoscopic renal pedicle lymphatic disconnection: A novel, targeted treatment for chyluria. [Video-Audio Media]
- IBInt Braz J Urol 2019 Mar 20; 45
- Chyluria, or the passage of chyle into the urine from anomalous lymphatic connections, results in a characteristic milky urine. In severe cases, it can cause signifi cant morbidity from nutritional l…
Chyluria, or the passage of chyle into the urine from anomalous lymphatic connections, results in a characteristic milky urine. In severe cases, it can cause signifi cant morbidity from nutritional losses and immune suppression. Although predominantly associated with Wuchereria bancrofti infections, non-parasitic cases have also been described. Traditionally, surgical treatment has involved renal lymphatic disconnection using open or minimally invasive methods, occasionally aided by pre-operative imaging techniques like lymphangiography, or by identifi cation of structures with laparoscopic magnifi cation.
- How Thailand eliminated lymphatic filariasis as a public health problem. [Journal Article]
- IDInfect Dis Poverty 2019 May 27; 8(1):38
- CONCLUSIONS: Thailand over the years 2002 to 2011 conducted extensive MDA with high coverage rates. Through periodic and regular monitoring surveys it delineated LF transmission areas at sub-village level and demonstrated through its evaluation surveys - the Stop-MDA surveys and TAS, below transmission threshold rates that enabled its validation of LF elimination. In September 2017, World Health Organization acknowledged the Ministry of Health Thailand had eliminated lymphatic filariasis as a public health problem.
- Wuchereria bancrofti-infected individuals harbor distinct IL-10-producing regulatory B and T cell subsets which are affected by anti-filarial treatment. [Journal Article]
- PNPLoS Negl Trop Dis 2019; 13(5):e0007436
- Despite worldwide mass drug administration, it is estimated that 68 million individuals are still infected with lymphatic filariasis with 19 million hydrocele and 17 million lymphedema reported cases…
Despite worldwide mass drug administration, it is estimated that 68 million individuals are still infected with lymphatic filariasis with 19 million hydrocele and 17 million lymphedema reported cases. Despite the staggering number of pathology cases, the majority of LF-infected individuals do not develop clinical symptoms and present a tightly regulated immune system characterized by higher frequencies of regulatory T cells (Treg), suppressed proliferation and Th2 cytokine responses accompanied with increased secretion of IL-10, TGF-β and infection-specific IgG4. Nevertheless, the filarial-induced modulation of the host`s immune system and especially the role of regulatory immune cells like regulatory B (Breg) and Treg during an ongoing LF infection remains unknown. Thus, we analysed Breg and Treg frequencies in peripheral blood from Ghanaian uninfected endemic normals (EN), lymphedema (LE), asymptomatic patent (CFA+MF+) and latent (CFA+MF-) W. bancrofti-infected individuals as well as individuals who were previously infected with W. bancrofti (PI) but had cleared the infection due to the administration of ivermectin (IVM) and albendazole (ALB). In summary, we observed that IL-10-producing CD19+CD24highCD38dhigh Breg were specifically increased in patently infected (CFA+MF+) individuals. In addition, CD19+CD24highCD5+CD1dhigh and CD19+CD5+CD1dhighIL-10+ Breg as well as CD4+CD127-FOXP3+ Treg frequencies were significantly increased in both W. bancrofti-infected cohorts (CFA+MF+ and CFA+MF-). Interestingly, the PI cohort presented frequency levels of all studied regulatory immune cell populations comparable with the EN group. In conclusion, the results from this study show that an ongoing W. bancrofti infection induces distinct Breg and Treg populations in peripheral blood from Ghanaian volunteers. Those regulatory immune cell populations might contribute to the regulated state of the host immune system and are probably important for the survival and fertility (microfilaria release) of the helminth.
- Influence of seasonal variation on reported filarial attacks among people living with lymphedema in Ghana. [Journal Article]
- BIBMC Infect Dis 2019 May 20; 19(1):442
- CONCLUSIONS: Findings from the present study show compelling evidence that the frequency and the prevalence of filarial attacks is significantly increased during wet seasons compared to the dry season.
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- Pharmacokinetics, safety, and efficacy of a single co-administered dose of diethylcarbamazine, albendazole and ivermectin in adults with and without Wuchereria bancrofti infection in Côte d'Ivoire. [Journal Article]
- PNPLoS Negl Trop Dis 2019; 13(5):e0007325
- CONCLUSIONS: Moderate to heavy W. bancrofti infection did not affect PK parameters for IVM, DEC or ALB following a single co-administered dose of these drugs compared to uninfected individuals. The drugs were well tolerated. This study confirmed the efficacy of the triple-drug therapy for clearing W. bancrofti Mf and has added important information to support the use of this regimen in LF elimination programs in areas of Africa without co-endemic onchocerciasis or loiasis.