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Current Research in Parasitology &... 2023The miticide efficacy of a single treatment with Felpreva® (tigolaner, emodepside and praziquantel) spot-on solution for cats was evaluated in two European field...
Field efficacy and safety of Felpreva® (tigolaner, emodepside and praziquantel) spot-on for the treatment of natural ear mite infestations () and notoedric mange () in cats.
The miticide efficacy of a single treatment with Felpreva® (tigolaner, emodepside and praziquantel) spot-on solution for cats was evaluated in two European field studies. One study was conducted in cats naturally infested with . The other study was conducted in cats naturally infested with . In both studies, the presence of viable mites was confirmed prior to treatment (Day -1/Day 0) and re-evaluated on Day 14 ( study) and on Day 28 (both studies). Efficacy was calculated based on the number of viable mites found after treatment. In the study, the primary criterion was the percentage of mite-free cats after treatment with Felpreva® compared to a sarolaner/selamectin combination (Stronghold® Plus, Zoetis) as a positive control. In the study, the primary criterion was the difference between arithmetic mean mite counts of cats treated with Felpreva® and cats treated with a placebo formulation (solketal). Secondary criteria in both studies were changes in clinical lesion scores after treatment. In both studies, all Felpreva®-treated cats were mite-free (100% parasitological cure) on Day 28, 4 weeks after treatment. Signs of mange on Day 28 were clinically improved in all -infested cats (100%) and clinically cured in all -infested cats (100%). There were no records of any adverse events or application site reactions in Felpreva®-treated cats.
PubMed: 37954512
DOI: 10.1016/j.crpvbd.2023.100146 -
IDCases 2023Albendazole and praziquantel have been used to treat various parasitic infections for many years. Studies have confirmed the efficacy in the treatment of cystic...
Albendazole and praziquantel have been used to treat various parasitic infections for many years. Studies have confirmed the efficacy in the treatment of cystic echinococcosis (CE). We reported the case of a 45-year-old Chinese patient with pulmonary CE. He experienced diarrhea, stomachache, increase bilirubin, hair loss and acute fatal pancytopenia 10 days after albendazole and praziquantel treatment. We performed a literature review of severe adverse reaction caused by albendazole and praziquantel. It showed that severe adverse reactions such as bone marrow suppression caused by albendazole or praziquantel are rare, but patients with a course of treatment exceeding 10 days or with liver diseases are more likely to experience. Clinicians should pay attention to monitoring the patient's gastrointestinal tract reaction and peripheral blood cells (PBCs). If the patient showed a progressive disease, the medication should be immediately stopped. Supportive treatments should be considered, such as the administration of granulocyte colony-stimulating factor (G-CSF) against neutropenia or antibiotics to prevent infection.
PubMed: 37766815
DOI: 10.1016/j.idcr.2023.e01895 -
BioRxiv : the Preprint Server For... Apr 2024The bitter taste of medicines hinders patient compliance, but not everyone experiences these difficulties because people worldwide differ in their bitterness perception....
The bitter taste of medicines hinders patient compliance, but not everyone experiences these difficulties because people worldwide differ in their bitterness perception. To better understand how people from diverse ancestries perceive medicines and taste modifiers, 338 adults, European and recent US and Canada immigrants from Asia, South Asia, and Africa, rated the bitterness intensity of taste solutions on a 100-point generalized visual analog scale and provided a saliva sample for genotyping. The taste solutions were five medicines, tenofovir alafenamide (TAF), moxifloxacin, praziquantel, amodiaquine, and propylthiouracil (PROP), and four other solutions, TAF mixed with sucralose (sweet, reduces bitterness) or 6-methylflavone (tasteless, reduces bitterness), sucralose alone, and sodium chloride alone. Bitterness ratings differed by ancestry for two of the five drugs (amodiaquine and PROP) and for TAF mixed with sucralose. Genetic analysis showed that people with variants in one bitter receptor variant gene (38) reported PROP was more bitter than did those with a different variant (p= 7.6e-19) and that people with either an or a genotype found sucralose more bitter than did others (p=2.6e-8, p=7.9e-11, resp.). Our findings may help guide the formulation of bad-tasting medicines to meet the needs of those most sensitive to them.
PubMed: 38712219
DOI: 10.1101/2024.04.24.590957 -
Life (Basel, Switzerland) Jul 2023Human schistosomiasis is one of neglected tropical diseases that remain highly prevalent in sub-Saharan Africa (SSA). Human schistosomiasis is mainly caused by two... (Review)
Review
Human schistosomiasis is one of neglected tropical diseases that remain highly prevalent in sub-Saharan Africa (SSA). Human schistosomiasis is mainly caused by two species, and , leading to urogenital and intestinal schistosomiasis, respectively. The World Health Organization (WHO) recommends mass drug administration (MDA) with praziquantel as the primary method of global intervention. Currently, MDA with praziquantel covers over half of the target population in endemic SSA countries. However, an accurate diagnosis is crucial for monitoring and evaluating the effectiveness of MDA. The standard diagnosis of both urogenital and intestinal schistosomiasis relies on the microscopic identification of eggs. However, the diagnostic sensitivity of this approach is low, especially for light or ultra-light infections. This is because eggs are laid inside of the venous plexus of the urinary bladder or mesenteric vein, where the adult flukes live. Approximately half of the eggs circulate in the blood vessels or are packed in neighboring tissues, while the remaining half are expelled into the lumen of the urinary bladder or intestine intermittently when the blood vessels are ruptured. In the field setting, the accuracy of any diagnostic method is critical for proper management of the intervention. The present article reviews the recent prevalence of urogenital schistosomiasis in SSA and highlights the practical limitations of diagnostic methods such as urine microscopy, urine reagent strips, molecular diagnosis, and ultrasound scanning in the field setting. Despite continuous global efforts to eliminate schistosomiasis over the past 20 years, many areas still remain endemic in SSA. No single diagnostic approach achieves acceptable sensitivity and specificity in the field setting. Therefore, any field survey should employ a combination of these methods based on the purpose of the study to accurately monitor and evaluate urogenital schistosomiasis. Based on diagnostic values and a cost-benefit analysis, a urine reagent strip test can replace urine microscopy in the field setting. The WHO criteria by ultrasound diagnosis should be updated including the echogenic snow sign and contour distortion.
PubMed: 37629527
DOI: 10.3390/life13081670 -
Parasites & Vectors Jun 2024Schistosomiasis is a debilitating neglected tropical disease endemic in sub-Saharan Africa. The role of health facilities in the prevention, diagnosis, control, and...
BACKGROUND
Schistosomiasis is a debilitating neglected tropical disease endemic in sub-Saharan Africa. The role of health facilities in the prevention, diagnosis, control, and elimination of schistosomiasis is poorly documented. In a setting targeted for schistosomiasis elimination in Zanzibar, we assessed the prevalence of Schistosoma haematobium among patients seeking care in a health facility and investigated schistosomiasis-related knowledge of staff, and health facilities' capacities and needs for schistosomiasis diagnosis and management.
METHODS
We conducted a health facility-based mixed-method study on Pemba Island from June to August 2023. Patients aged ≥ 4 years seeking care in four health facilities were screened for S. haematobium infection using urine filtration and reagent strips. Those patients aged ≥ 10 years were additionally interviewed about signs and symptoms. Staff from 23 health facilities responded to a questionnaire assessing knowledge and practices. Ten staff participated in a focus group discussion (FGD) about capacities and needs for schistosomiasis diagnosis and management.
RESULTS
The prevalence of S. haematobium infection in patients attending the health facilities, as determined by the presence of eggs in urine, was 1.1% (8/712). Microhaematuria was detected in 13.3% (95/712) of the patients using reagent strips. Among patients responding to the questionnaire, pelvic pain, pain during sex, and painful urination were reported by 38.0% (237/623), 6.3% (39/623), and 3.2% (20/623), respectively. Among the health facility staff, 90.0% (44/49) and 87.8% (43/49) identified blood in urine and pelvic pain, respectively, as symptoms of urogenital schistosomiasis, 81.6% (40/49) and 93.9% (46/49) reported collecting a urine sample and pursuing a reagent strip test, respectively, for diagnosis, and 87.8% (43/49) administered praziquantel for treatment. The most reoccurring themes in the FGD were the need for more staff training about schistosomiasis, requests for diagnostic equipment, and the need to improve community response to schistosomiasis services in health facilities.
CONCLUSIONS
The prevalence of S. haematobium infection in patients seeking care in health facilities in Pemba is very low and similar to what has been reported from recent community-based cross-sectional surveys. The health facility staff had good schistosomiasis-related knowledge and practices. However, to integrate schistosomiasis patient management more durably into routine health facility activities, scalable screening pathways need to be identified and capacities need to be improved by regular staff training, and an unbroken supply of accurate point-of-care diagnostics and praziquantel for the treatment of cases.
Topics: Humans; Female; Health Facilities; Male; Child; Prevalence; Schistosomiasis haematobia; Adult; Schistosoma haematobium; Animals; Adolescent; Disease Eradication; Young Adult; Child, Preschool; Middle Aged; Tanzania; Surveys and Questionnaires; Schistosomiasis; Health Knowledge, Attitudes, Practice; Aged; Health Personnel
PubMed: 38886811
DOI: 10.1186/s13071-024-06311-8 -
PLoS Neglected Tropical Diseases Mar 2024Female Genital Schistosomiasis (FGS) causes intravaginal lesions and symptoms that could be mistaken for sexually transmitted diseases or cancer. In adults, FGS lesions...
OBJECTIVE
Female Genital Schistosomiasis (FGS) causes intravaginal lesions and symptoms that could be mistaken for sexually transmitted diseases or cancer. In adults, FGS lesions [grainy sandy patches (GSP), homogenous yellow patches (HYP), abnormal blood vessels and rubbery papules] are refractory to treatment. The effect of treatment has never been explored in young women; it is unclear if gynaecological investigation will be possible in this young age group (16-23 years). We explored the predictors for accepting anti-schistosomal treatment and/or gynaecological reinvestigation in young women, and the effects of anti-schistosomal mass-treatment (praziquantel) on the clinical manifestations of FGS at an adolescent age.
METHOD
The study was conducted between 2011 and 2013 in randomly selected, rural, high schools in Ilembe, uThungulu and Ugu Districts, KwaZulu-Natal Province, East Coast of South Africa. At baseline, gynaecological investigations were conducted in female learners in grades 8 to 12, aged 16-23 years (n = 2293). Mass-treatment was offered in the low-transmission season between May and August (a few in September, n = 48), in accordance with WHO recommendations. Reinvestigation was offered after a median of 9 months (range 5-14 months). Univariate, multivariable and logistic regression analysis were used to measure the association between variables.
RESULTS
Prevalence: Of the 2293 learners who came for baseline gynaecological investigations, 1045 (46%) had FGS lesions and/or schistosomiasis, 209/1045 (20%) had GSP; 208/1045 (20%) HYP; 772/1045 (74%) had abnormal blood vessels; and 404/1045 (39%) were urine positive. Overall participation rate for mass treatment and gynaecological investigation: Only 26% (587/2293) learners participated in the mass treatment and 17% (401/2293) participated in the follow up gynaecological reinvestigations. Loss to follow-up among those with FGS: More than 70% of learners with FGS lesions at baseline were lost to follow-up for gynaecological investigations: 156/209 (75%) GSP; 154/208 (74%) HYP; 539/722 (75%) abnormal blood vessels; 238/404 (59%) urine positive. The grade 12 pupil had left school and did not participate in the reinvestigations (n = 375; 16%). Follow-up findings: Amongst those with lesions who came for both treatment and reinvestigation, 12/19 still had GSP, 8/28 had HYP, and 54/90 had abnormal blood vessels. Only 3/55 remained positive for S. haematobium ova. Factors influencing treatment and follow-up gynaecological investigation: HIV, current water contact, water contact as a toddler and urinary schistosomiasis influenced participation in mass treatment. Grainy sandy patches, abnormal blood vessels, HYP, previous pregnancy, current water contact, water contact as a toddler and father present in the family were strongly associated with coming back for follow-up gynaecological investigation. Challenges in sample size for follow-up analysis of the effect of treatment: The low mass treatment uptake and loss to follow up among those who had baseline FGS reduced the chances of a larger sample size at follow up investigation. However, multivariable analysis showed that treatment had effect on the abnormal blood vessels (adjusted odds ratio = 2.1, 95% CI 1.1-3.9 and p = 0.018).
CONCLUSION
Compliance to treatment and gynaecological reinvestigation was very low. There is need to embark on large scale awareness and advocacy in schools and communities before implementing mass-treatment and investigation studies. Despite challenges in sample size and significant loss to follow-up, limiting the ability to fully understand the treatment's effect, multivariable analysis demonstrated a significant treatment effect on abnormal blood vessels.
Topics: Adult; Pregnancy; Animals; Female; Adolescent; Humans; Praziquantel; South Africa; Schistosoma haematobium; Schistosomiasis haematobia; Genitalia, Female; Genital Diseases, Female; Water
PubMed: 38536861
DOI: 10.1371/journal.pntd.0011798 -
Biomedicines Aug 2023Schistosomiasis, a potentially fatal chronic disease whose etiological agents are blood trematode worms of the genus spp., is one of the most prevalent and debilitating...
Schistosomiasis, a potentially fatal chronic disease whose etiological agents are blood trematode worms of the genus spp., is one of the most prevalent and debilitating neglected diseases. The treatment of schistosomiasis depends exclusively on praziquantel (PZQ), a drug that has been used since the 1970s and that already has reports of reduced therapeutic efficacy, related with the development of -resistant or -tolerant strains. Therefore, the search for new therapeutic alternatives is an urgent need. Plumbagin (PLUM), a naphthoquinone isolated from the roots of plants of the genus , has aroused interest in research due to its antiparasitic properties against protozoa and helminths. Here, we evaluated the in vivo schistosomicidal potential of PLUM against and the in silico pharmacokinetic parameters. ADMET parameters and oral bioavailability were evaluated using the PkCSM and SwissADME platforms, respectively. The study was carried out with five groups of infected mice and divided as follows: an untreated control group, a control group treated with PZQ, and three groups treated orally with 8, 16, or 32 mg/kg of PLUM. After treatment, the Kato-Katz technique was performed to evaluate a quantity of eggs in the feces (EPG). The animals were euthanized for worm recovery, intestine samples were collected to evaluate the oviposition pattern, the load of eggs was determined on the hepatic and intestinal tissues and for the histopathological and histomorphometric evaluation of tissue and hepatic granulomas. PLUM reduced EPG by 65.27, 70.52, and 82.49%, reduced the total worm load by 46.7, 55.25, and 72.4%, and the female worm load by 44.01, 52.76, and 71.16%, for doses of 8, 16, and 32 mg/kg, respectively. PLUM also significantly reduced the number of immature eggs and increased the number of dead eggs in the oogram. A reduction of 36.11, 46.46, and 64.14% in eggs in the hepatic tissue, and 57.22, 65.18, and 80.5% in the intestinal tissue were also observed at doses of 8, 16, and 32 mg/kg, respectively. At all doses, PLUM demonstrated an effect on the histopathological and histomorphometric parameters of the hepatic granuloma, with a reduction of 41.11, 48.47, and 70.55% in the numerical density of the granulomas and 49.56, 57.63, and 71.21% in the volume, respectively. PLUM presented itself as a promising in vivo antiparasitic candidate against , acting not only on parasitological parameters but also on hepatic granuloma. Furthermore, in silico, PLUM showed good predictive pharmacokinetic profiles by ADMET.
PubMed: 37760782
DOI: 10.3390/biomedicines11092340 -
Veterinary Parasitology Dec 2023Intestinal parasites, including cestodes like Dipylidium caninum, are common in dogs in the United States of America (USA), but fecal flotation consistently, and, at...
Intestinal parasites, including cestodes like Dipylidium caninum, are common in dogs in the United States of America (USA), but fecal flotation consistently, and, at times, dramatically, fails to identify many of these infections. To determine the extent to which including coproantigen testing for D. caninum would improve the identification of dogs infected with this cestode, we evaluated fecal samples from 877 dogs (589 pet and 288 from municipal shelters) from six USA states using zinc sulfate (specific gravity 1.24) fecal flotation with centrifugation along with coproantigen detection for Giardia sp., hookworms, ascarids, and Trichuris vulpis. For D. caninum, PCR of perianal swabs was included. Intestinal parasite infections were identified, using centrifugal fecal flotation or coproantigen, in 265 dogs (13.2 % pet, 64.9 % shelter). Dipylidium caninum infection was detected in 5.6 % of dogs with the combination of coproantigen and centrifugal fecal flotation, and 7.3 % of dogs when perianal swab results were included; prevalence varied by diagnostic method, population, and geographic region. In pet dogs, D. caninum infection was identified by fecal flotation (0), coproantigen (2.2 %), or perianal swabs (1.2 %). The same methods revealed infection in 0.3 %, 12.5 %, and 11.1 % of shelter dogs, respectively. Frequent use of praziquantel in shelter dogs (116/288; 40.3 %) may have reduced prevalence. Positive and negative agreement of D. caninum coproantigen with perianal swab PCR in pet dogs was 85.7 % and 98.8 %, respectively. Multiple logistic regression analysis accounting for region, population, and age found D. caninum infection to be more common in shelter dogs relative to pet (adjusted OR 4.91 [2.48, 10.24]) and in the Southcentral and Southeast regions relative to North (adjusted OR 9.59 [1.92, 174.13] and 17.69 [3.67, 318.09] respectively). Coproantigen testing also enhanced the detection of other intestinal parasites over fecal flotation alone, including Giardia sp. (14.7 % vs 3.3 %), hookworms (13.8 % vs 8.4 %), ascarids (2.9 % vs 2.2 %), and T. vulpis (2.9 % vs 1.4 %). Together, these data indicate that the coproantigen assay employed increases detection of D. caninum infections several fold, supporting the use of this test in clinical practice, and add to a growing body of research documenting enhanced diagnosis through implementation of multiple laboratory-based methods.
Topics: Animals; Dogs; Parasites; Intestinal Diseases, Parasitic; Cestode Infections; Trichuris; Giardia; Feces; Prevalence; Dog Diseases
PubMed: 37976897
DOI: 10.1016/j.vetpar.2023.110073 -
International Journal of Infectious... Oct 2023Pleural effusion caused by lung fluke is a rare etiology of exudative pleural effusion (EPE), which is often misdiagnosed or delayed. We aim to summarize the diagnosis...
OBJECTIVES
Pleural effusion caused by lung fluke is a rare etiology of exudative pleural effusion (EPE), which is often misdiagnosed or delayed. We aim to summarize the diagnosis and treatment course of EPE caused by lung fluke infection and put forward a practical diagnosis approach.
METHODS
We retrospectively analyzed the diagnosis and treatment of 14 cases of EPE caused by lung fluke infection diagnosed by enzyme-linked immunosorbent assay of serum antibodies or egg detection.
RESULTS
All patients (100%) with an absolute count of eosinophils in peripheral blood exceeded 0.5 × 10/l, and 10 patients (71.4%) had a history of special ingestion. Eosinophilic PE occurred in 11 patients (78.6%), pleural biopsy of medical thoracoscopic demonstrated eosinophils infiltration in nine patients (64.3%), and parasite eggs in one patient. All patients showed positive intradermal tests for Paragonimus-specific antigens and enzyme-linked immunosorbent assay of serum antibodies to Paragonimus.
CONCLUSION
For patients with unexplained PE, lung fluke infection should be highly suspected when pleural fluid or pleural biopsy shows eosinophilic PE or eosinophils infiltration, especially for patients with certain diet history.
Topics: Animals; Humans; Retrospective Studies; Pleural Effusion; Paragonimiasis; Eosinophilia; Paragonimus; Antibodies; Lung
PubMed: 37507085
DOI: 10.1016/j.ijid.2023.07.013 -
Journal of Veterinary Diagnostic... Nov 2023infections in dogs and cats are underestimated because of a lack of proglottid observations and poor recovery of parasite elements by centrifugal flotation. We...
infections in dogs and cats are underestimated because of a lack of proglottid observations and poor recovery of parasite elements by centrifugal flotation. We developed an immunoassay that employs a pair of monoclonal antibodies to capture specific coproantigen in fecal extracts from dogs and cats. Real-time PCR for DNA in perianal swabs and observation of proglottids were used as reference methods. In 6 experimentally infected dogs, parasite DNA, coproantigen, and proglottid segments were first detected at 22, 23, and 26 d post-infection, respectively. Praziquantel treatment of 3 experimentally infected dogs resulted in the elimination of both coproantigen and proglottid shedding within 1-5 d post-treatment; however, parasite DNA persisted for 14 d. Immunohistochemistry on immature and mature tapeworm segments using an antibody against the coproantigen supports the premise that the antigen is produced in mature segments. We assessed the performance of our coproantigen test in natural infections in 78 dogs from a flea-endemic area. Of the 12 antigen-positive samples, 11 were confirmed with a positive PCR test and/or proglottid observation. Finally, we evaluated a convenience sample set of 730 canine and 163 feline fecal samples obtained from a commercial diagnostic laboratory; antigen was detected in 4.1% of the canine and 12.9% of the feline samples, whereas parasite elements were observed in only 0.028% of samples. Our coproantigen immunoassay provides a sensitive method for the detection of infection in dogs and cats.
Topics: Animals; Cats; Dogs; Cat Diseases; Dog Diseases; Cestoda; Cestode Infections; Immunoassay; Feces; DNA
PubMed: 37491878
DOI: 10.1177/10406387231189193