A novel second instar Gasterophilus excretory/secretory antigen-based ELISA for the diagnosis of gasterophilosis in grazing horses

We have developed a novel enzyme-linked immunosorbent assay (ELISA) based on excretory/secretory antigens of second instar Gasterophilus for the diagnosis of gasterophilosis in grazing horses. Between January 2007 and January 2009, two experiments were carried out on free-ranging horses in northwest Spain. During the first year, monthly blood samples were collected from a herd of 25 horses. In the second year, a monthly serological survey was conducted for a total of 398 different horses. All the sera were analyzed by ELISA using excretory/secretory antigens from Gasterophilus intestinalis (GphiL2ES) and Gasterophilus nasalis second-stage larvae (GphnL2ES). Climatic data were collected between January 2007 and January 2009 from local meteorological automated stations to establish the weather pattern in the study area. Observations of Gasterophilus eggs on the horses' hair and third instars passed in the faeces were also done. The kinetics of IgG response decreased against GphiL2ES from January to July, increased slowly from August and rose up to January. After a slight decrease in January, the absorbances against GphnL2ES reduced from April to August, when the lowest values were observed. The IgG values rose until the end of the study in January. Third instars were observed in the faeces in March to May, and Gasterophilus eggs were seen on the horses' hair from June to September. The highest IgG seroprevalences were achieved in winter (January-February; 100%) against both antigens. The lowest percentages of seropositivity were observed in June (3%) to the GphiL2ES, and in July (9%) to the GphnL2ES. The use of antigens from G. intestinalis second-stage larvae was shown to be suitable for diagnosing infestation by G. intestinalis or G. nasalis. We concluded that under oceanic climate conditions, the egg-laying period occurs from late spring, and eggs and first instars are found in the mouth in early summer. During summer the second instars move into the stomach and intestine, where the third-stage larvae remain until the end of winter, when pupation takes place. The adult horse bot fly emerges in the spring. Two treatments for the control of gasterophilosis are suggested: a curative in the summer to eliminate the first instars and a preventive in the autumn to suppress the second instars.

Design and validation of an oligonucleotide probe for the detection of protozoa from the order Trichomonadida using chromogenic in situ hybridization

Infections with protozoal parasites of the order Trichomonadida are often observed in veterinary medicine. Based on the trichomonad species involved these infections are either asymptomatic or can lead to sometimes serious disease. To further study protozoal agents of the order Trichomonadida the establishment of a method to detect trichomonads directly in the tissue, allowing parasite-lesion correlation, is necessary. Here we describe the design and evaluation of an oligonucleotide probe for chromogenic in situ hybridization, theoretically allowing detection of all hitherto known members of the order Trichomonadida. The probe was designed on a region of the 18S ribosomal RNA gene homologue for all representatives of the order Trichomonadida available in the GenBank. Functionality of the probe was proven using protozoal cultures containing different trichomonads (Monocercomonas colubrorum, Hypotrichomonas acosta, Pentatrichomonas hominis, Trichomitus batrachorum, Trichomonas gallinae, Tetratrichomonas gallinarum, Tritrichomonas foetus, and Tritrichomonas augusta). Furthermore, three different tissue sections containing either T. gallinae, T. foetus or Histomonas meleagridis were tested positive. Additionally, to rule out cross-reactivity of the probe a large number of different pathogenic protozoal agents, fungi, bacteria and viruses were tested and gave negative results. The probe presented here can be considered an important tool for diagnosis of all to date described relevant protozoal parasites of the order Trichomonadida in tissue samples.

Parasitic infections of three Mexican howler monkey groups (Alouatta palliata mexicana) living in forest fragments in Mexico

In order to better understand how patterns of parasitism in howler monkeys are affected by forest fragmentation, we carried out a 1 year survey of gastrointestinal parasites in fecal samples from three groups of Mexican howler monkeys inhabiting different forest fragments in the Los Tuxtlas Biosphere Reserve, Mexico. The study groups were chosen because the conditions in which they lived suggested a potentially negative gradient for parasite richness and a positive gradient for levels of parasitism. We report for the first time the presence of Entamoeba coli in Alouatta palliata mexicana and of hookworms (Family Ancylostomidae) in A. palliata. A reduction in home range size and an increase in disturbance was associated with a loss of parasite richness, which in general was high. Parasite prevalence and the proportion of contaminated samples in which each parasite taxon was present was also high in general and there were no differences between groups. A factor related to the generally high levels of parasitism in our study groups could be the high humidity in the study area, because this favors the survival of parasitic free forms and increases the chances of infection. This would also account for the tendency towards higher levels of parasitism observed in the rainy season. Finally we did not find a pattern relating sex and parasitism.

Discrimination of Entamoeba moshkovskii in patients with gastrointestinal disorders by single-round PCR

Entamoeba moshkovskii and Entamoeba dispar are impossible to differentiate microscopically from the pathogenic species Entamoeba histolytica. There are limited data on the prevalence of these commensal parasites in Iran. We utilized a single-round PCR assay to determine the prevalence of E. moshkovskii, E. dispar, and E. histolytica in stool samples from Iranian patients infected with gastrointestinal disorders. After culturing of microscopy-positive isolates and extraction of DNA, PCR was carried out to differentiate the Entamoeba isolates. Out of 3,825 stool samples examined by microscopy, 58 specimens (1.52%) were infected with E. histolytica, E. dispar, or E. moshkovskii. By PCR, 2 E. histolytica (3.45%), 53 E. dispar (91.37%), 2 E. moshkovskii (3.45%), and one mixed E. dispar/E. moshkovskii infection (1.73%) were detected. In view of the reporting of E. moshkovskii in this study in Iran and the difficulty in discriminating this ameba from two similar Entamoeba spp. by microscopy, we recommend the single-round PCR assay as an alternative tool in routine diagnosis and in epidemiological studies of amebiasis.

Giardia intestinalis in Thailand: identification of genotypes

This study was undertaken to determine the genetic diversities of Giardia intestinalis isolated in Thailand. G. intestinalis cysts were collected from stool samples of 61 subjects residing in Bangkok or in rural communities of Thailand with and without gastrointestinal symptoms. All the cyst samples gave positive tpi amplicons (100% sensitivity), either of the 148- or the 81-bp tpi segments. Cyst assemblage identification of the 148- and 81-bp tpi gene segments by polymerase chain reaction showed that 8% of the cysts were assemblage A, 41% assemblage A and B combined, and 51% assemblage B. The prevalence of assemblage A was significantly lower than that of assemblage B and the mixed types. Restriction fragment length polymorphism (RFLP) of the 384-bp beta-giardin gene segment revealed that 12% and 88% of the assemblage A cysts were AI and AII respectively. RFLP, based on the 432-bp gdh gene segment, showed 45.5% of the assemblage B cysts to be BIII and 54.5% to be BIV. The AI sub-assemblage was less prevalent than the others. All subjects with AI and 50% of the subjects with BIII sub-assemblage cysts were symptomatic; 80% of symptomatic Bangkok residents were adults/elderly while 85% of the rural cases were children.

Drinking water turbidity and emergency department visits for gastrointestinal illness in Atlanta, 1993-2004

The extent to which drinking water turbidity measurements indicate the risk of gastrointestinal illness is not well understood. Despite major advances in drinking water treatment and delivery, infectious disease can still be transmitted through drinking water in the United States, and it is important to have reliable indicators of microbial water quality to inform public health decisions. The objective of our study was to assess the relationship between gastrointestinal illness, quantified through emergency department visits, and drinking water quality, quantified as raw water and filtered water turbidity measured at the treatment plant. We examined the relationship between turbidity levels of raw and filtered surface water measured at eight major drinking water treatment plants in the metropolitan area of Atlanta, Georgia, and over 240,000 emergency department visits for gastrointestinal illness during 1993-2004 among the population served by these plants. We fit Poisson time-series statistical regression models that included turbidity in a 21-day distributed lag and that controlled for meteorological factors and long-term time trends. For filtered water turbidity, the results were consistent with no association with emergency department visits for gastrointestinal illness. We observed a modest association between raw water turbidity and emergency department visits for gastrointestinal illness. Our results suggest that source water quality may contribute modestly to endemic gastrointestinal illness in the study area. The association between turbidity and emergency department visits for gastrointestinal illness was only observed when raw water turbidity was considered; filtered water turbidity may not serve as a reliable indicator of modest pathogen risk at all treatment plants.

[Biology, epidemiology and diagnostics of pathogenic waterborne protozoan parasites]

Cryptosporidium, Giardia intestinalis, Cyclospora cayetanensis, Isosopra belli and micropsoridia are the most important and common pathogens found in humans and many other species of vertebrates. In humans, mainly in immunocompromised patients, children, pregnant women and elderly people, they are the most frequently identified protozoan parasites causing gastrointestinal disease worldwide. These pathogens have several transmission routes, including anthroponotic and zoonotic transmission. What is more, in many cases of epidemics caused by mentioned pathogens the major cause of infection was contaminated with these organisms water and food. In spite of many existing regulations of clearing and making use of drinking water supplies and recreational water, cosmopolitan protozoan parasites are still the danger of public health. These organisms are responsible for many waterborne outbreaks worldwide. Light microscopy and immunofluorescence assay have been used to identify these organisms in most laboratories. However, these traditional techniques have major limitations in the specific diagnosis, these methods are not sensitive enough to detect cysts or oocysts in environmental samples, so the new molecular tools must be applied. Recently, PCR-based techniques have been developed for detection and genetic characterization of the different species and population variants of protozoan parasites is central to the prevention, surveillance and control of gastrointestinal diseases. In this review were characterized biology, epidemiology and the progress in technology for detection and surveillance of the most important waterborne protozoan parasites.

Prevalence of gastrointestinal parasites in working horses

Fecal samples for detection of gastrointestinal parasites were collected from 221 working horses from September 2002 to May 2003 from 14 villages in Urmia, North West of Iran. Fecal samples of 46 horses (20.8%) were negative for parasite eggs or oocysts. One hundred and seventy five positive horses (48.9%) were infected with a single parasite type and 49 (22.2%) and 18 (8.1%) of horses had multiple infections with two and three parasites, respectively. The highest prevalence and intensity rate belonged to small strongyles. The overall prevalence of intestinal parasites eggs and oocyst in the positive horses were: strongyles 72.9%, Oxyuris equi 22.6%, Parascaris equorum 12.2%, Anoplocephalidae 6.3%, Fasciola spp. 3.2% and Eimeria leuckarti 0.5%. Larval identification showed that small strongyle larvae were most frequent (97.6%) followed by Strongylus edentatus (22.6%), S. equinus (18.5%) and S. vulgaris (6.5%). This study suggests that the high rate of infection with gastrointestinal parasites could contribute to low performance and life expectancy of working horses in the region.

Pathological lesions in European bison (Bison bonasus) with infestation by Ashworthius sidemi (Nematoda, Trichostrongylidae)

Asworthius sidemi Schulz, 1933 is a blood sucking gastrointestinal nematode, primarily typical for Asiatic deer. It was found for the first time in Poland in European bison in 1997. To estimate the level of invasion of A. sidemi and histopathological changes connected with the presence of the parasite in the years 2004-2007 parasitological and histopathological examinations of 54 European bison from Białowieza Forest were carried out. Parasitological examination was carried out by the sedimentation method and A. sidemi were diagnosed under a binocular microscope. Samples for histological examination were collected from the abomasum and duodenum walls as well as from regional lymph nodes. Tissue samples were then fixed with 10% buffered formalin, embedded in paraffin, cut in to 5 microm thick sections and stained with hematoxylin and eosin (H&E). Parasitological examinations showed the presence of fourth stage larvae and juvenile forms of A. sidemi. The maximal intensity of invasion rose systematically from 4470 A. sidemi nematodes in 2004/2005 to 44310 in 2006/2007. Histopathological examinations showed infiltrations of inflammatory cells in the walls of abomasa and duodena at various levels of intensity (mainly lymphoid cells and eosinophils), hyperemiae, oedemae and lesions of mucosa and proliferation of lymphatic follicles. In individual cases of dysplasia of epithelial cells, atrophy or hyperplasia of glands and the presence of parasites in the lumen or walls of the abomasum/duodenum were observed. In one case, parasitic nodules were found. In regional lymph nodes proliferation of lymphatic follicles, presence of eosinophils and desolation of reproduction centers were observed. Intensification of histopathological changes was connected to a considerable degree with the developmental stage of A. sidemi as shown by parasitological examination.

Gastrointestinal manifestations in severe strongyloidiasis: report of 3 cases and literature review

We report here three cases of severe strongyloidiasis in normal and immunocompromised hosts. The first was a patient with a normal immune system who presented with acute severe abdominal pain. The second and third patients were immunocompromised due to steroid and chemotherapy treatment of underlying diseases. Both presented with obstructive symptoms. In all three cases, Strongyloides stercoralis larvae were detected in stool concentration samples, and in biopsied specimens from the duodenum in the first and second cases.

The pretravel consultation

The increase in travel and travel medicine knowledge over the past 30 years makes pretravel counseling an essential part of comprehensive family medicine. Effective counseling begins with assessment of individual and itinerary-based risks, using a growing body of evidence-based decision-support tools and resources. Counseling recommendations should be tailored to the patient's risk tolerance and experience. An essential component of the pretravel consultation includes reviewing routine and destination-specific immunizations. In addition to implementing behavioral adaptations, travelers can guard against vectorborne disease by using N,N-diethyl-m-toluamide (DEET, 30%), a safe and effective insect repellent. Patients should also receive malarial chemoprophylaxis when traveling to areas of risk. Proper precautions can reduce the risk of food- and waterborne disease. Travelers should take appropriate precautions when traveling to high altitudes. Strategies for minimizing the risk of deep venous thrombosis during air travel include keeping mobile and wearing compression stockings. Accident avoidance and coping strategies for health problems that occur while abroad are also important components of the pretravel consultation.

In-vitro anthelminthic activity of crude aqueous extracts of Aloe ferox, Leonotis leonurus and Elephantorrhiza elephantina against Haemonchus contortus

Aloe ferox (Mill), Leonotis leonurus (L) R. BR; and Elephantorrhiza elephantina (Burch.) Skeels are plants frequently used by resource-limited farmers in the Eastern Cape Province to control gastrointestinal parasites in goats. A study was conducted to validate their anthelminthic activities in-vitro on the egg and larvae of the nematode parasite Haemonchus contortus. The crude aqueous extracts of leaves of A. ferox and L. leonurus; and roots of E. elephantina were used. Eggs and larvae of the parasite were incubated at 25 degrees C in aqueous extracts at concentrations of 0.625-20 mg/ml for 48 h and 7 days for the egg hatch and larval development assays respectively. Albendazole and water were the positive and negative controls respectively. Inhibition of egg hatching and larval development increased significantly (P < 0.05) with increasing concentrations of the extracts. E. elephantina and L. leonurus extracts had 100% egg hatch inhibition at concentration as low as 2.5 mg/ml and 1.25 mg/ml respectively, whereas A. ferox extracts had 100% inhibition at concentrations of 20 mg/ml. At the lowest concentration tested (0.625 mg/ml), E. elephantina inhibited egg hatching >96% and this was comparable to albendazole at the same concentration. E. elephantina and L. leonurus also totally inhibited larval development at concentrations of 1.25 mg/ml. The study provided evidence that A. ferox, E. elephantina and L. leonurus extracts possess anthelminthic activity, thus justifying their use in the treatment of GI helminthosis. There is however need to assess the safety of these plants in vivo and also to undertake in vivo efficacy studies.

A survey of gastrointestinal pig parasites on free-range, organic and conventional pig farms in The Netherlands

The prevalence of gastrointestinal parasites in suckling piglets, weaners, fattening pigs and sows was studied from November 2001 to October 2002 on 16 free-range farms (FRF), 11 organic farms (OF) and 9 conventional farms (CF) by means of faecal examinations of composite samples. Each farm was visited four times with a 3-month interval. Infections with coccidia were found on 43.8% of the FRF, 90.9% of the OF and 66.7% of the CF. Sows had the highest prevalence, particularly on FRF (87.5%) and OF (80%). Ascaris suum was present on 50% of the FRF, 72.7% of the OF and 11.1% of the CF, whereas fattening pigs on FRF (42.9%) and OF (54.5%) had the highest prevalence. Oesophagostomum spp. were observed on 25% of the FRF, 27.2% of the OF and 22.2% of the CF. The infection was most prevalent in the sows on all farm types: 37.5% on FRF, 30% on OF and 22.2% on CF.Trichuris suis was found on 37.5% of the FRF, 36.4% of the OF and 11.1% of the CF. Again, this infection was most prevalent in the sows, particularly on the FRF (50%) and OF (30%). No other gastrointestinal parasite species were found and no clinical signs were observed. No seasonal trends could be distinguished. In many cases, when an age group on a farm was positive for a certain parasite, it remained so during the whole study. This indicates that this parasite was really 'endemic' on that farm. The results of this study demonstrate that the prevalence of helminth infections of pigs on farms with outdoor facilities is higher than in pigs on conventional farms.

Effect of concommitant Helicobacter pylori infection in patients with Giardiasis lamblia in Egypt

Giardiasis is one of the most common enteroprotozoal diseases; its association with Helicobacter pylori is a common clinical finding. This work studied the impact of such association. Fifty giardiasis patients were classified into two groups according to the concomitant presence of H. pylori and ten normal healthy controls were also included. All patients were subjected to complete history taking, thorough clinical and stool examination, endoscopy, and biopsy of gastric and duodenal mucosa as well as histopatological examination. Results revealed significant upper gastrointestinal symptoms (epigastric pain and anorexia) in giardiasis patients with H. pylori. Also, endoscopic and histopathologic examination showed significant gastric lesions in this group of patients as compared to those suffering only G. lamblia.

Gastrointestinal parasites of working donkeys of Ethiopia

The general prevalence and population composition of gastrointestinal and pulmonary helminths of working donkeys were studied. For the purpose 2935 working donkeys were coprologically examined for nematode and cestode, and 215 donkeys for trematode infections. Seven donkeys that died due to various health problems or were euthanased on a welfare ground were necropsied and the parasites were recovered and identified to the species level. The study was conducted during the periods 1996-1999.Coprological examination revealed 99% strongyle, 80% Fasciola, 51% Parascaris, 30% Gastrodiscus, 11% Strongyloides westeri, 8% cestodes and 2% Oxyuris equi infection prevalence. Over 55% of donkeys had more than 1000 eggs per gram of faeces (epg). Forty two different species of parasites consisting of 33 nematodes, 3 trematodes, 3 cestodes and 3 arthropod larvae were identified from postmortem examined donkeys. Among the nematodes 17 species of Cyathostominae and 7 species of Strongylinae were identified. Other parasites identified include, Habronema muscae, Draschia megastoma, Trichostrongylus axei, Strongyloides westeri, Anoplocephala perfoliata, Anoplocephala magna, Anoplocephaloides (Paranoplocephala) mamillana, Parascaris equorum, Fasciola hepatica, Fasciola gigantica, Gastrodiscus aegyptiacus, Dictyocaulus arnfieldi, Oxyuris equi, Probstmayria vivipara, Gasterophilus intestinalis, Gasterophilus nasalis, Rhinoestrus uzbekistanicus and Setaria equina. This study revealed that working donkeys in Ethiopia are infected with a range of helminths and arthropod larvae, which are representatives of the important pathogenic parasites found in equids worldwide.

A report on the prevalence of gastrointestinal parasites in yaks (Bos poephagus) in the cold desert area of North Sikkim, India

Faecal samples were collected from 348 yaks(Bos poephagus) in and around Gurudogmer Plateau, a cold desert area in North Sikkim, India. The prevalence of gastrointestinal parasitic infection was recorded at 10.05% in both the organized and traditionally managed farms of yak. The pattern of infection was either single (2.58%) or mixed (7.47%) with a faecal egg count range of 100-200 eggs per gram of faeces in positive animals. Among the helminths, Haemonchus spp. infection was predominant (6.89%) followed by Nematodirus spp. (1.72%), Cooperia spp. (1.43%) and Dicrocoelium spp. (0.29%).

Early exposure of infants to GI nematodes induces Th2 dominant immune responses which are unaffected by periodic anthelminthic treatment

We have previously shown a reduction in anaemia and wasting malnutrition in infants <3 years old in Pemba Island, Zanzibar, following repeated anthelminthic treatment for the endemic gastrointestinal (GI) nematodes Ascaris lumbricoides, hookworm and Trichuris trichiura. In view of the low intensity of worm infections in this age group, this was unexpected, and it was proposed that immune responses to the worms rather than their direct effects may play a significant role in morbidity in infants and that anthelminthic treatment may alleviate such effects. Therefore, the primary aims of this study were to characterise the immune response to initial/early GI nematode infections in infants and the effects of anthelminthic treatment on such immune responses. The frequency and levels of Th1/Th2 cytokines (IL-5, IL-13, IFN-γ and IL-10) induced by the worms were evaluated in 666 infants aged 6–24 months using the Whole Blood Assay. Ascaris and hookworm antigens induced predominantly Th2 cytokine responses, and levels of IL-5 and IL-13 were significantly correlated. The frequencies and levels of responses were higher for both Ascaris positive and hookworm positive infants compared with worm negative individuals, but very few infants made Trichuris-specific cytokine responses. Infants treated every 3 months with mebendazole showed a significantly lower prevalence of infection compared with placebo-treated controls at one year following baseline. At follow-up, cytokine responses to Ascaris and hookworm antigens, which remained Th2 biased, were increased compared with baseline but were not significantly affected by treatment. However, blood eosinophil levels, which were elevated in worm-infected children, were significantly lower in treated children. Thus the effect of deworming in this age group on anaemia and wasting malnutrition, which were replicated in this study, could not be explained by modification of cytokine responses but may be related to eosinophil function.

Infants and very young children commonly become infected with intestinal nematode infections. However, the worm burdens are generally very light, so a beneficial effect of deworming on wasting malnutrition and anaemia in this age group which we have demonstrated was unexpected and the mechanism unclear. To investigate this, we have, for the first time, determined whether such worm infections in infants induce significant immune reactions which might be detrimental to nutrition and growth e.g. by inducing inflammation in the gut or by cytokine effects on erythropoiesis. We also determined if such responses are modulated by regular deworming over a 9 month period. Peripheral blood cells from infants infected with Ascaris and hookworms in particular responded to stimulation with worm antigens, producing predominantly Th2 cytokines. Although the Th2 cytokine responses in the periphery were not significantly altered by deworming, the levels of eosinophils, which are regulated by the Th2 cytokine, IL-5, were lower after treatment. It is possible that eosinophils play a role in gut pathology leading to wasting malnutrition and anaemia in the very young and that this effect is reduced by deworming.

Feeding practices and effects of gastrointestinal parasite infections on live weight gain of small ruminants in smallholder mixed farms in Kenya

The objective of this study was to quantify the effects of gastrointestinal nematodosis on live weight gain (LWG) of sheep and goats kept in smallholder farms in Kenya. A total of 307 sheep and goats from smallholder farms were sampled using a 2-stage cluster and systematic random approach. Sampled farms were visited once a month for nine months during which a health and production survey questionnaire was administered, animals weighed and fecal samples taken for fecal egg count. Descriptive statistics and a generalized linear mixed model were performed in SAS. The mean LWG of suckling kids and lambs was low (mean=46 g/day). High fecal egg count and lack of feed supplementation were identified as the main factors limiting growth. Improved helminth control and nutrition are required to optimize production.

[Haptoglobin, serum amyloid-a and ceruloplasmin concentrations in goats with mixed helminth infection]

In this study, the concentrations of haptoglobin, serum amyloid A and ceruloplasmin were measured in goats with mixed gastrointestinal infections of nematodes and liver trematodes. Twelve patients who were diagnosed as having mixed helminth infection after detection of Trichuris spp., Trichostrongylidae spp. and Fasciola spp. and six healthy controls participated in the study. The concentrations of the acute phase proteins (haptoglobin p< or =0.001; serum amyloid-A p< or =0.05) were significantly higher in the goats with mixed gastrointestinal infection with nematodes and liver trematodes than the control goats. As a result of this study, we determined that the concentrations of haptoglobin and serum amyloid-A increased in goats with mixed helminth infection but further studies of the clinical importance of those increases in relation to prognosis and monitoring therapy of helminthic infections in goats should be made.

Nitazoxanide: a review of its use in the treatment of gastrointestinal infections

Nitazoxanide (Alinia, Daxon, Dexidex, Paramix, Kidonax, Colufase, Annita) has in vitro activity against a variety of microorganisms, including a broad range of protozoa and helminths. Nitazoxanide is effective in the treatment of protozoal and helminthic infections, including Cryptosporidium parvum or Giardia lamblia, in immunocompetent adults and children, and is generally well tolerated. Nitazoxanide is a first-line choice for the treatment of illness caused by C. parvum or G. lamblia infection in immunocompetent adults and children, and is an option to be considered in the treatment of illnesses caused by other protozoa and/or helminths.

The dynamic influence of genetic variation on the susceptibility of sheep to gastrointestinal nematode infection

The interaction between sheep and the nematode Teladorsagia circumcincta is one of the best understood of all host-parasite interactions. Following infection, there is considerable variation among lambs in the number of nematode eggs produced, the number of early fourth-stage larvae and the number of adult worms in the mucosa. These traits have a high variance to mean ratio (i.e. they are overdispersed or aggregated among hosts), they are skewed and approximately negative binomially distributed. The sources of overdispersion are differences among lambs in the ingestion of infective larvae and the immune response. Both forces can produce aggregation but their relative importance is unknown. The key components of variation can be identified by variance analysis. The sum of the average effects of polymorphic genes is known as additive genetic variation and this increases essentially from zero at one month of age to quite high values at six months of age. The major mechanism underlying genetic variation appears to be the differences among individuals in immune responses. Two of the major sources of variation in immune responses are differences in antigen recognition and differences in the type of cytokines produced. Genes that influence both these sources of variation are associated with differences in resistance to nematode infection. Therefore, much of the heterogeneity among animals in parasite transmission appears to be due to genetic variation in immune responsiveness.

Identification of immuno-reactive proteins from a sheep gastrointestinal nematode, Trichostrongylus colubriformis, using two-dimensional electrophoresis and mass spectrometry

Gastrointestinal nematode infections of livestock animals are prevalent and costly problems worldwide. Currently, infections are controlled by anthelmintic chemicals but increasing drug resistance has prompted research interest to shift towards alternative methods of control such as vaccine development and selection of worm-resistant animals. The present study analyses proteins from Trichostrongylus colubriformis infective L3s that are recognised by IgG of immune sheep. Following protein separation via two-dimensional electrophoresis and Western blot probing with plasma from sheep resistant to T. colubriformis, mass spectrometry-based proteomic analyses were used to identify immuno-reactive protein spots. We were able to identify 28 immune targets, including aspartyl protease inhibitor, enolase, chaperone proteins, galectin, glycolytic enzymes, kinase, phosphatase and structural muscle proteins such as myosin, paramyosin, calponin and DIM-1. The data suggest that immune responses to T. colubriformis are dispersed over a relatively large number of parasite antigens, including several cytoplasmically expressed proteins. The results have new implications for understanding the molecular mechanisms that underpin host-parasite interaction during gastrointestinal nematode infections.

Effects of supplemental feeding on gastrointestinal parasite infection in elk (Cervus elaphus): Preliminary observations

The effects of management practices on the spread and impact of parasites and infectious diseases in wildlife and domestic animals are of increasing concern worldwide, particularly in cases where management of wild species can influence disease spill-over into domestic animals. In the Greater Yellowstone Ecosystem, USA, winter supplemental feeding of Rocky Mountain elk (Cervus elaphus) may enhance parasite and disease transmission by aggregating elk on feedgrounds. In this study, we tested the effect of supplemental feeding on gastrointestinal parasite infection in elk by comparing fecal egg/oocyst counts of fed and unfed elk. We collected fecal samples from fed and unfed elk at feedground and control sites from January to April 2006, and screened all samples for parasites. Six different parasite types were identified, and 48.7% of samples were infected with at least one parasite. Gastrointestinal (GI) nematodes (Nematoda: Strongylida), Trichuris spp., and coccidia were the most common parasites observed. For all three of these parasites, fecal egg/oocyst counts increased from January to April. Supplementally fed elk had significantly higher GI nematode egg counts than unfed elk in January and February, but significantly lower counts in April. These patterns suggest that supplemental feeding may both increase exposure and decrease susceptibility of elk to GI nematodes, resulting in differences in temporal patterns of egg shedding between fed and unfed elk.

Field study on nematode resistance in Nelore-breed cattle

The present study evaluated Nelore cattle with different degrees of resistance to natural infections by gastrointestinal nematodes. One hundred weaned male cattle, 11-12 months of age, were kept on the same pasture and evaluated from October 2003 to February 2004. Faecal and blood samples were collected for parasitological, haematological and immunological tests. In February 2004, the 10 most resistant and the 10 most susceptible animals were selected based on individual means of nematode faecal egg counts (FEC). Such animals were slaughtered for worm burden determination and nematode species identification. The repeatability estimates for FEC (+/-S.D.), log-transformed FEC and packed-cell volume (PCV) in all animals were 0.3 (+/-0.05), 0.26 (+/-0.04) and 0.42 (+/-0.05), respectively. The resistant group showed lower FEC and worm burdens than the susceptible group (P<0.05). There were no significant differences between groups regarding mean body weight, weight gain, PCV and total serum protein values (P>0.05). The resistant group showed higher total serum IgE levels (P<0.05) and higher mean eosinophil blood counts. However, the latter was statistically significant only 42 days after the beginning of the study. Nematodes Cooperia punctata and Haemonchus placei were predominant and the correlation between Cooperia and Haemonchus burdens was 0.64 (P<0.05), which indicated that animals presenting increased numbers of one of those genera probably had increased numbers of the other. The current study provides further evidence of IgE active role in nematode immunity and suggests that total serum IgE level might serve as an additional marker to select Nelore cattle that are responsive to H. placei and C. punctata infections.

Immunogenomic approaches to study host immunity to enteric pathogens

With increasing consumer demands for safe poultry products, effective control of disease-causing pathogens is becoming a major challenge to the poultry industry. Many chicken pathogens enter the host through the gastrointestinal tract, and over the past few decades, in-feed antibiotics and active vaccination have been the 2 main mechanisms of disease control. However, increasing public concerns are prompting government regulations on the use of growth-promoting drugs in animal production, and the ability of current vaccines to protect against emerging hypervirulent strains of pathogens is becoming an issue. Therefore, there is a need to develop alternative control strategies against poultry pathogens of economic importance as well as to carry out basic research to enhance understanding of host-pathogen interactions at local sites of infection. Effective control strategies against pathogens can only be accomplished by comprehensive analysis of the basic immunobiology of host-pathogen interactions. Recent sequencing of the poultry genome and the availability of several tissue-specific cDNA microarrays are facilitating the rapid application of functional immunogenomic technologies to poultry disease research. Studies using functional genomic, immunology, and bioinformatic approaches have provided novel insights into disease processes and protective immunity to chicken pathogens. In this review, we summarize recent published literature concerning the host response to Eimeria and Salmonella infections with emphasis on our studies using immunogenomic tools to investigate and characterize the mechanisms of avian immunity to these mucosal pathogens. The results clearly indicate that this immunogenomic approach will lead to increased understanding of immune responses to infectious agents that will enable the development of effective prevention strategies against mucosal pathogens.

Dairy goat production and the importance of gastrointestinal strongyle parasitism

In recent years, demand for goat products has increased in both developing and developed countries. Goat production (particularly dairy), however, is negatively affected by several factors, including infectious and parasitic diseases. Among the latter, gastrointestinal strongyle infection remains one of the main constraints to dairy goat production. In this mini-review, we emphasize the negative influence of these parasites, associated with subclinical production losses and depressive impacts upon long-term animal productivity, as well as the scarcity of studies on this topic. Finally, the necessity of reducing the use of anthelminthics and thus minimizing residues in food and the environment is stressed.

Three surface antigens dominate the mucosal antibody response to gastrointestinal L3-stage strongylid nematodes in field immune sheep

Although gastrointestinal nematode parasites are a major human and veterinary health problem, little is known about how the host is sometimes able to mount an effective immune rejection response. In previous work, we identified a carbohydrate larval surface antigen (CarLA) as the target of mucosal antibodies that can elicit rejection of Trichostrongylus colubriformis L3s in sheep. Here we characterise the natural mucosal antibody responses to L3s from three major strongylid gastrointestinal parasites of sheep, Trichostrongylus colubriformis, Haemonchus contortus and Teladorsagia circumcincta. The mucosal antibody repertoire of naturally field-immune sheep was displayed on bacteriophage as single-chain antibodies (scFvs) and phage were selected for the ability to bind to the surface of living L3s of the three nematode species. All nematode-binding scFvs were found to recognize one of three different antigen classes that are each found in the three strongylid species. These three antigen classes appear to represent all of the major antigens recognized on Western blots by pooled mucosal antibodies from field-immune sheep. One of the antigen classes is a heterogeneous, high molecular weight molecule that is protease-sensitive. The scFvs recognizing this surface antigen also recognize a similar antigen in all strongylids tested. A second antigen class is a protease-insensitive, low molecular weight antigen found only in sheaths and scFvs recognizing this antigen cross-react with a similar molecule found in all strongylids tested. The third surface antigen class is CarLA and all of the anti-CarLA scFvs obtained from the field-immune sheep repertoire were specific to L3s of only one species and often recognized only a subset of the worms. Thus three different L3-stage surface antigens, two that lack a protein component, dominate the natural mucosal antibody response to L3-stage gastrointestinal strongylid nematodes in sheep.

Immunological aspects of nematode parasite control in sheep

Gastrointestinal nematode parasitism is arguably the most serious constraint affecting sheep production worldwide. Economic losses are caused by decreased production, the costs of prophylaxis and treatment, and the death of the infected animals. The nematode of particular concern is Haemonchus contortus, which can cause severe blood loss resulting in anemia, anorexia, depression, loss of condition, and eventual death. The control of nematode parasites traditionally relies on anthelmintic treatment. The evolution of anthelmintic resistance in nematode populations threatens the success of drug treatment programs. Alternative strategies for control of nematode infections are being developed, and one approach is to take advantage of the host's natural or acquired immune responses, which can be used in selection programs to increase the level of resistance in the population. Vaccination can also be used to stimulate or boost the host's acquired immunity. The induction of protective resistance is dependent on the pattern of cytokine gene expression induced during infection by two defined CD4+ T-helper cell subsets, which have been designated as Th1 or Th2. Intracellular parasites most often invoke a Th1-type response, and helminth parasites a Th2-type response. Breeds of sheep resistant to infection have developed resistance over a much longer term of host-parasite relationship than genetically selected resistant lines. The immune components involved in these different responses and types of host-parasite relationships will be reviewed. The potential for using vaccines has been investigated, with variable results, for several decades. The few successes and potential new antigen candidates will also be reviewed.

Gastrointestinal parasite egg excretion in young calves in periurban livestock production in Mali

To acquire the information needed to improve parasite control in periurban cattle production in Mali, repeated sampling of faeces of 694 calves kept around Bamako was done in 2003/2004. The effects of season, age, breed, management type, parasite control and presence of sheep on egg and oocyst counts were determined. A Bayesian model was used with a negative binomial distribution and herd and individual effects, to account for the clustering of calves in herds and the repeated sampling. Interviews were conducted to report the current control strategies. We found eggs of Strongyloides papillosus (Age class 0-1 month: prevalence 39%, 2-3 months: 59%, 5-6 months: 42%), strongyles (14%, 24%, 36%), coccidian oocysts (37%, 68%, 64%) and at low prevalence eggs of Toxocara vitulorum, Moniezia sp., Trichuris sp. and Paramphistomum sp. Season and age effects occurred. Reported utilisation of parasite control was high (92%) but monthly recorded use was significantly lower (61%).

The effects of short-term feeding of fresh cassava (Manihot esculenta) foliage on gastrointestinal nematode parasite infections in goats in Cambodia

The antiparasitic effect of cassava (Manihot esculenta Crantz) was tested in goats artificially infected with gastrointestinal parasitic nematodes. Each experimental group consisted of 6 pen-fed goats kept on a slatted floor. The treatments compared were: 1) controls fed grass only, 2) cassava replaced grass for 3 weeks from the commencement of larval dosing period, and 3) cassava replaced grass for 3 weeks after the worm infection was patent. A total of 2000 mixed-species infective nematode larvae (L3) were administered to each goat in four doses of 500 L3/day, commencing 5 weeks after removal of previously acquired infections with ivermectin. The faecal egg counts (FEC) reduced in both cassava fed groups during the time of feeding, compared to the controls. Although, FEC increased differently with time (P < 0.05), total adult worm burdens at slaughter (week 15) were not different between the treatment groups. No differences in live weight gain, or packed cell volume, between treatments were found. Whilst these results show limited evidence of an anthelmintic effect of cassava in the diet, they do suggest that feeding, or supplementation, of cassava over an extended period may prove beneficial.

Prevention of changes in airway function facilitates Strongyloides venezuelensis infection in rats

Alterations in lung function and pulmonary symptoms have been described in patients infected with helminths with a lung cycle. We have previously shown that infection with the nematode Strongyloides venezuelensis induced a significant increase in airway hyperreactivity in infected rats. The aim of the present study was to test the hypothesis that bronchodilation during the lung phase of parasite migration would favor completion of the life cycle and infection indices. For this purpose, S. venezuelensis infected rats were treated with salbutamol during the first 48 h after the nematode infection. At the dose used (0.25 mg/mL for 10 min every 4 h), treatment with salbutamol prevented changes in lung function during the parasite migration. This was accompanied by a significant increase in parasite burden, as assessed in the lung and the small intestine. Parasite infected and salbutamol-treated animals also showed a significant increase in concentration of IL-10 and IL-4 in homogenates of lungs during the worm migration that was followed by stronger lung eosinophilic inflammation at 5 dpi, after the larvae had left the host lung. Our data indicates that airway hyperactivity reduce parasite progression through the lung, facilitating the action of innate or adaptive immune mechanisms.

Vaccination of goats with recombinant galectin antigen induces partial protection against Haemonchus contortus infection

The efficacy of vaccination against Haemonchus contortus infection with two recombinant proteins, rHco-gal-m and rHco-gal-f, was studied in 9-10-month-old goats. Vaccination with 100 microg protein reduced faecal egg output and worm burdens by 37.25% and 41.1%, respectively. Corresponding reductions with 200 microg protein were 48.03% and 46.19%. Vaccinated groups had significantly higher IgG levels than the negative and positive controls. Significant negative correlations were detected between IgG level, mucosal homogenate IgA concentration, haemoglobin and abomasal worm burden at necropsy. By contrast a positive correlation was found between the percentage of B cells, monocytes and abomasal worm burden. These findings suggested that vaccination with a combination of recombinant rHco-gal-m/f proteins had a role in protecting goats against H. contortus infection.

Gastrointestinal helminth parasitism in fruit-eating bats (Chiroptera, Stenodermatinae) from western Amazonian Brazil

In this paper we report endoparasites from a sample of 50 stenodermatine bats collected mainly over lick sites at the Parque Nacional da Serra do Divisor, westernmost extremity of Amazonian Brazil. Four helminth species were recovered (Hasstilesia tricolor, Vampirolepis elongatus, Cheiropteronema globocephala. and Capillaria sp.), most of them from small intestines. Overall helminth prevalence achieved 26% (13/50) and the more prevalent species was H. tricolor (20%). Previously unknown in bats and reported for the first time in Brazil, this digenetic trematode was found in seven of the 18 bat species studied here. We argue that the drinking behaviour of stenodermatines at lick sites may be implicated in the dissemination of helminth infection among these bats.

Control of gastrointestinal nematodes with copper oxide wire particles in a flock of lactating Polypay ewes and offspring in Iowa, USA

Copper oxide wire particles (COWP) have been used to reduce infection of Haemonchus contortus in hair breed lambs in southeastern USA without signs of copper toxicity. However, copper sensitivity among breeds and regions varies. The objective was to determine the effectiveness and safety of COWP in lactating Polypay ewes and their offspring grazing alfalfa/bluegrass pasture in a rotational grazing system. Mature Polypay ewes were administered 0, 0.5, 1, or 2 g (n=8 or 9/dose) COWP approximately 60 days after lambing in mid-July 2005. Their offspring were administered 0 (n=6), 0.5 or 0.75 g (n=9), 1 or 2 g (n=6) COWP 2 weeks later in late July. The primary gastrointestinal nematode was H. contortus (70%). Between Days 7 and 35, FEC were greater in 0 and 0.5 g COWP groups compared with ewes administered 2 g COWP (COWP x day, P<0.004). PCV decreased in all groups of ewes between Days 0 and 21 (day, P<0.001). Aspartate aminotransferase (AST) activity, a measure of liver copper levels, and body weight was similar among groups of ewes. FEC decreased within 7 days in COWP-treated compared with untreated lambs and remained low throughout experiment (COWP x day, P<0.05). PCV increased in COWP-treated lambs between Days 7 and 35 and decreased in untreated lambs between Days 0 and 21 (COWP x day, P<0.009). AST activity was similar among groups of lambs. Administration of 2 g COWP to ewes prevented a rise in FEC, but a dose of 0.5 g was ineffective as an anthelmintic. Administration of all doses of COWP to lambs decreased FEC and increased PCV compared to untreated lambs. There were no signs of copper toxicity in ewes or lambs. Alternative suppression of H. contortus infections may be necessary in ewes, but COWP was effective in H. contortus management for lambs.

Risk factors of gastrointestinal nematode parasite infections in small ruminants kept in smallholder mixed farms in Kenya

BACKGROUND

Helminth infections in small ruminants are serious problems in the developing world, particularly where nutrition and sanitation are poor. This study investigated the burden and risk factors of gastrointestinal nematode parasite infections in sheep and goats kept in smallholder mixed farms in the Kenyan Central Highlands. Three hundred and seven small ruminants were sampled from 66 smallholder mixed farms in agro-ecological zones 1 (humid) and 3 (semi-humid) in the Kenyan Central highlands. The farms were visited once a month for eight months during which a health and production survey questionnaire was administered. Fecal samples were collected at each visit from each animal. Fecal egg counts (FEC) were performed using the modified McMaster technique. Associations between potential risk factors and FEC were assessed using 3-level Poisson models fit in SAS using GLIMMIX macro. Correlations among repeated observations were adjusted for using three different correlation structures.

RESULTS

A rise in FEC was observed two months after the onset of rains. Farmer education, age category, de-worming during the preceding month and grazing system were significant predictors of FEC. Additionally, there were significant interactions between grazing system and both de-worming and age category implying that the effect of grazing system is dependent on both de-worming status and age category; and that the effect of de-worming depends on the grazing system. The most important predictors of FEC in the study area were grazing system, de-worming status and education of the farmers.

CONCLUSION

Since several factors were important predictors of FEC, controlling gastrointestinal helminths of small ruminants in these resource-poor smallholder mixed farms requires a sustainable integrated helminth control strategy that includes adoption of zero-grazing and more farmer education probably through extension services. Achieving improved helminth controls in these resource-poor farming systems offers an opportunity to increase small ruminant productivity and hence has a potential of improving the livelihood of the resource-poor farmers.

A model to account for the consequences of host nutrition on the outcome of gastrointestinal parasitism in sheep: model evaluation

This paper describes sensitivity analyses and expectations obtained from a mathematical model developed to account for the effects of host nutrition on the consequences of gastrointestinal parasitism in sheep. The scenarios explored included different levels of parasitic challenge at different planes of nutrition, for hosts differing only in their characteristics for growth. The model was able to predict the consequences of host nutrition on the outcome of parasitism, in terms of worm burden, number of eggs excreted per gram faeces and animal performance. The model outputs predict that conclusions on the ability of hosts of different characteristics for growth to cope with parasitism (i.e. resistance) depend on the plane of nutrition. Furthermore, differences in the growth rate of sheep, on their own, are not sufficient to account for differences in the observed resistance of animals. The model forms the basis for evaluating the consequences of differing management strategies and environments, such as breeding for certain traits associated with resistance and nutritional strategies, on the consequences of gastrointestinal parasitism on sheep.

Combining the effects of supplementary feeding and copper oxide needles for the control of gastrointestinal nematodes in browsing goats

The aim was to assess the benefits obtained from combining supplementary feeding and copper needles (COWP), compared to the use of both approaches independently, for the control of gastrointestinal nematode (GIN) infections in browsing kids. Forty-four nematode free Criollo kids were exposed to natural parasite infection. The kids were divided into six experimental groups: not treated, supplemented (NT-S), not treated, not supplemented (NT-NS), moxidectin treated, supplemented (M-S), moxidectin treated not supplemented (M-NS), copper treated, supplemented (COWP-S) and copper treated, non-supplemented (COWP-NS). Copper treated groups received Copinox (2 g capsules) on day 0 and on day 60 of the trial. Moxidectin treated groups received Cydectin (0.2 mg/kg of body weight s.c.) every 28 days. Three of the groups received individual supplementation (100 g of feed/day fresh basis; 74% sorghum: 26% soybean meal; NT-S, M-S and COWP-S) and the other three groups were not supplemented (NT-NS, M-NS and COWP-NS). Animals browsed native vegetation (6.5 h/day) during the wet season (154 days). Kids were weighed every 14 days to determine live weight gain (LWG) and blood and faecal samples were obtained to determine packed cell volume (PCV), haemoglobin (Hb), peripheral eosinophil counts (PEC) and faecal egg counts (FEC). At the end of the trial, four kids of each group were euthanatized (six kids in each COWP treated group). Worm burdens, female worm lengths and prolificacy were determined. Liver samples were used to determine copper concentration and were stained with haematoxylin-eosin to determine microscopic lesions. Animals receiving the combination of supplementary feeding and COWP improved their LWG, PCV and Hb to similar levels of animals with suppressive AH treatment. This was not the case when COWP was used without supplementation. Liver copper concentration in COWP treated groups increased significantly especially in the COWP-NS kids but this was not associated with liver lesions or clinical signs. Post-mortem Haemonchus contortus and Trichostrongylus colubriformis worm counts had a tendency to be reduced in the different groups (66-35% reduction) compared to NT-NS group at the end of the trial (P>0.05). Also, COWP treatment and/or supplementation reduced female worm length of T. colubriformis and prolificacy of H. contortus and T. colubriformis. This study, confirmed the value of nutritional supplementation in the control of GIN in growing kids. The use of COWP in addition to supplementation had a limited contribution on the kids' resilience against GIN. This may be due to the reduced infection of H. contortus during this trial.

A model to account for the consequences of host nutrition on the outcome of gastrointestinal parasitism in sheep: logic and concepts

A deterministic, dynamic simulation model is developed to account for the interactions between gastrointestinal parasitism and host nutrition, and predict their consequences on performance and level of parasitism of sheep. Larval intake and established adult worms are assumed to result in nutrient loss for the host. In order to reduce this loss the host will mount an immune response, which will affect the establishment rate of incoming larvae, mortality rate of adult worms, and fecundity of female worms, as well as nutrient loss caused by larval intakeper se. Host anorexia is modelled as a function of worm mass. Parasitism is also assumed to affect the allocation of ingested nutrients to the host's bodily functions, with maintenance getting absolute priority, and protein allocated to immunity and production proportionally to their requirements. Inputs to the model include the expected growth attributes of the animal, feed quality, various parasitological parameters and daily larval intake. Outputs include feed intake, growth rate and body composition, as well as worm burden and faecal egg counts. The model allows exploration of the consequences of gastrointestinal parasitism on sheep of different growth characteristics, kept under environments that vary in the provision of nutrients and exposure to parasites.

Comparative efficacy of different anthelmintics against fenbendazole-resistant nematodes of pashmina goats

A trial using albendazole, albendazole plus rafoxanide combination, ivermectin and doramectin was conducted in Pashmina goats having history of fenbendazole resistance to Haemonchus spp. and maintained at high altitude (>2350 m above sea level). Day 0 infection level was variable in different groups of animals and their larval cultures indicated Haemonchus, Trichostrongylus, Ostertagia and Oesophagostomum spp. infection, in addition to Nematodirus spp. as observed in egg counts. Efficacy of drugs was calculated on day 14 post treatment by faecal egg count reduction test (FECRT). Albendazole was least effective (14%) followed by its combination with rafoxanide (54%). However, ivermectin and doramectin were 96% and 94% effective against gastrointestinal nematodes of Pashmina goats. It was concluded that use of albendazole and its combination with rafoxanide are ineffective in controlling the nematodes of goats at this farm; hence, future use must be avoided. However, regular monitoring of the efficacy of ivermectin and doramectin is needed.

Health issues in newly arrived African refugees attending general practice clinics in Melbourne

OBJECTIVE

To identify the most common health issues diagnosed by general practitioners in newly arrived African refugees.

DESIGN

Descriptive study based on a purposive sample of six GPs to collate data from medical records of patients from African countries who had attended their clinics for the first time between 1 January and 30 June 2005.

SETTING

Two community health centres and two private general practices in metropolitan Melbourne.

PARTICIPANTS

African refugee patients who arrived in Australia after 1 June 2004 and were seen by the six participating GPs between 1 January and 30 June 2005.

MAIN OUTCOME MEASURES

Demographic characteristics, laboratory test results and final diagnoses.

RESULTS

Data were collected from 258 patient files. Most patients were from Sudan (57%) or Liberia (17%). Half were aged under 15 years. The most common health problems identified were inadequate vaccinations, nutritional deficiencies (vitamin D and iron), infectious diseases (gastrointestinal infections, schistosomiasis, and latent tuberculosis) and dental disease. Musculoskeletal, psychological and social problems were common in adults. 37% of patients were tested for latent tuberculosis, and 25% of these tested positive.

CONCLUSIONS

African refugees require comprehensive health assessments for undiagnosed and untreated health problems. While most of the common diseases identified are non-communicable, if left untreated they will affect the long-term health and productivity of new settlers.

Duration of anthelmintic effect of three formulations of ivermectin (oral, injectable and pour-on) against multiple anthelmintic-resistant haemonchus contortus in sheep

We report the results of investigations that were conducted in a sheep flock in Uttaranchal, India where repeated failure of anthelmintic medication was noted. The study revealed that Haemonchus contortus in sheep had developed resistance to benzimidazoles (fenbendazole, mebendazole and albendazole), imidazothiazole (levamisole) and salicylanide (rafoxanide), while it was fully susceptible to avermectins (ivermectin). Further, the suppression of nematode egg output in faeces of sheep naturally infected with multiple anthelmintic-resistant H. contortus following treatment with ivermectin tablet (0.4 mg/kg body weight (bw), orally), ivermectin injection (1% w/v, 0.2 mg/kg bw, subcutaneously) and ivermectin pour-on (0.5 w/v, 0.5 mg/kg bw) was also studied over a period of 10 weeks post treatment. It was noted that ivermectin tablet after initial clearance of infection (faecal egg count reduction 100%), could not prevent establishment of new patent natural infection for even a single day, while ivermectin pour-on and injection prevented the establishment of new infection for 7 and 14 days post treatment, respectively. Maximum protection period (duration for which mean faecal egg count of sheep reaches 500 eggs per gram of faeces or more) of 68 days was recorded in sheep treated with injectable ivermectin, followed by pour-on (60 days) and oral (53 days) preparations.

A novel approach for combining the use of in vitro and in vivo data to measure and detect emerging moxidectin resistance in gastrointestinal nematodes of goats

Ivermectin and moxidectin are closely related avermectin/milbemycin anthelmintics and available data suggest that side resistance occurs with these two drugs. However, moxidectin remains effective against many species of ivermectin-resistant worms due to its higher potency. The larval development assay (LDA) is routinely used to diagnose ivermectin resistance in Haemonchus contortus but laboratory diagnosis of moxidectin resistance is hampered by the lack of any validated in vitro tests. The objective of this study was to measure the relative susceptibility/resistance of H. contortus to moxidectin on goat farms in Georgia, and to validate the DrenchRite LDA for detecting resistance to moxidectin. Fecal egg count reduction tests (FECRT) were performed at five different moxidectin dose levels and DrenchRite LDAs were performed in duplicate on nine meat goat farms in Georgia, USA. To improve our ability to make inferences on the relative levels of resistance between farms, FECRT data were first analysed using a linear mixed model, and then Tukey's sequential trend test was used to evaluate the trend in response across dose levels. LDA data were analysed using log-dose logit-response and probit models. Using these statistical results, we were able to rank the nine farms from the least to the most resistant, and to develop a set of criteria for interpreting DrenchRite LDA results so that this assay can be used to diagnose both clinically apparent moxidectin resistance, as well as sub-clinical emerging resistance. These results suggest that our novel approach for examining these types of data provides a method for obtaining an increased amount of information, thus permitting a more sensitive detection of resistance. Based on results of the LDA, moxidectin-resistant farms had resistance ratios, compared with an ivermectin-sensitive farm, ranging from 32 to 128, and had resistance ratios of 6-24 compared with an ivermectin-resistant/moxidectin naive farm. Moxidectin resistance was diagnosed both in Haemonchus and Trichostrongylus on almost half of the farms tested, despite this drug only being used on these farms for 2-3 years.

Incidence of cyclosporiasis in patients with gastrointestinal symptoms in western Turkey

BACKGROUND

This study was designed to investigate the distribution of cyclosporiasis between October 2003 and October 2004 and the relationship between Cyclospora infection and seasonal as well as patient factors in western Turkey.

MATERIAL/METHODS

Stool samples from 4660 immunocompetent patients with gastrointestinal symptoms and 326 immunocompetent patients with allergic symptoms from western Turkey were examined between October 2003 and October 2004 using wet preparation, formalin-ethyl acetate concentration, Trichrome stain, and modified Kinyoun's acid-fast staining methods.

RESULTS

Twenty-three patients were found to be infected with Cyclospora oocysts. Parasites such as Cryptosporidium, Giardia intestinalis, Entamoeba histolytica/dispar, Blastocystis hominis and others were also observed. The incidence of cyclosporiasis was higher in summer and early autumn and most of the Cyclospora-infected patients were without diarrhea.

CONCLUSIONS

Clinicians with patients from Turkey and abroad who have intestinal symptoms after visiting the country should be aware that Cyclospora infections could be considered as a possible cause of gastrointestinal symptoms in the absence of diarrhea in immunocompetent patients during the summer period in Turkey.

Treatment of Dientamoeba fragilis infection with paromomycin

Treatment with paromomycin (25-35 mg/kg/d for 7 days) was evaluated prospectively in 15 children with Dientamoeba fragilis infection after 1-month follow-up. At the end of the study, parasitologic effectiveness and clinical improvement were observed in 12/15 (80%) and 13/15 (87%) patients, respectively. Paromomycin appears to be an effective drug for treatment of D. fragilis infection in children.