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Travel Medicine and Infectious Disease 2023Few reliable data are available on Neglected Tropical Diseases (NTDs) and other infections among African refugees and asylum seekers in Italy. We aimed to estimate the... (Observational Study)
Observational Study
BACKGROUND
Few reliable data are available on Neglected Tropical Diseases (NTDs) and other infections among African refugees and asylum seekers in Italy. We aimed to estimate the prevalence of NTDs and other infections in a large cohort of African refugees and asylum seekers living in reception centers in Lazio, Italy.
MATERIAL AND METHODS
This is an observational, prospective prevalence study on infectious diseases in a large population of African refugees and asylum seekers (936 overall) consecutively enrolled for screening purpose at the Infectious and Tropical diseases outpatient clinic of the National Institute of Migrant and Poverty (INMP), Rome from August 2019 to December 2020.
RESULTS
We found a prevalence of 8.8 % and 31 % for Strongyloides and schistosoma infection, respectively, while the prevalence of human immunodeficiency virus (HIV) infection was 0.7 %, HCV antibodies 2.5%, hepatitis B virus surface antigen 10.8 % and syphilis serological tests 2.9 %.
CONCLUSION
Strongyloidiasis and schistosomiasis are highly prevalent among African refugees and asylum seekers in Italy, in contrast to communicable diseases (with the exception of hepatitis B). Raising awareness of NTDs among health professionals and implementing guidelines seems to be of paramount importance to prevent these diseases and their sufferers from becoming even more "neglected".
Topics: Humans; Refugees; Rome; Neglected Diseases; Prospective Studies; Italy; HIV Infections
PubMed: 37820947
DOI: 10.1016/j.tmaid.2023.102649 -
Heliyon Sep 2023Understanding gut bacterial composition and proteome changes in patients with early-stage chronic kidney disease (CKD) could lead to better methods of controlling the...
Understanding gut bacterial composition and proteome changes in patients with early-stage chronic kidney disease (CKD) could lead to better methods of controlling the disease progression. Here, we investigated the gut microbiome and microbial functions in patients with infection (strongyloidiasis) and early-stage CKD. Thirty-five patients with early stages (1-3) of CKD were placed in two groups matched for population characteristics and biochemical parameters, 12 patients with strongyloidiasis in one group and 23 uninfected patients in the other. From every individual, a sample of their feces was obtained and processed for 16S rRNA sequencing and metaproteomic analysis using tandem liquid chromatography-mass spectrometry (LC-MS/MS). infection per se did not significantly alter gut microbial diversity. However, certain genera (, , , , and ) were significantly more abundant in infection-free CKD patients than in infected individuals. The genera and were enriched in infected patients. Among the significantly altered genera, and were the most correlated with renal parameters. The relative abundance of members of the genus was moderately positively correlated with estimated glomerular filtration rate (eGFR) (r = 0.335, p = 0.049) and negatively with serum creatinine (r = -0.35, p = 0.039). , on the other hand, showed a near-significant positive correlation with eGFR (r = 0.296, p = 0.084). Individuals with infection had higher levels of bacterial proteins involved in amino-acid metabolism. Analysis using STITCH predicted that bacterial amino-acid metabolism may also be involved in the production of colon-derived uremic toxin (indole), a toxic substance known to promote CKD. infection is, therefore, associated with reduced abundance of and (two genera possibly beneficial for kidney function) and with increased bacterial amino-acid metabolism in the early-stages of CKD, potentially producing uremic toxin. This study provides useful information for prevention of progression of CKD beyond the early stages.
PubMed: 37809389
DOI: 10.1016/j.heliyon.2023.e19859 -
Parasites & Vectors Oct 2023The role of the domestic cat as definitive host for Echinococcus multilocularis and thus in environmental contamination with eggs has not yet been entirely resolved....
BACKGROUND
The role of the domestic cat as definitive host for Echinococcus multilocularis and thus in environmental contamination with eggs has not yet been entirely resolved. This study aimed to assess the prevalence of E. multilocularis and other gastrointestinal parasites in Swiss domestic cats and to compare the diagnostic sensitivity of different methods for the detection of intestinal taeniid infection.
METHODS
Faecal samples from 146 cats were included in the study. Faecal samples only were available from 55 cats; for the other 91 cats, necropsy was performed in addition to faecal sample testing. All (n = 146) faecal samples were analysed by a combined sedimentation/flotation technique (44% ZnCl) and by the sodium acetate-acetic acid-formalin (SAF) sedimentation technique; when sufficient material was available (n = 121 samples) the Baermann-Wetzel technique was also used. Additionally, all samples were analysed by two coproantigen (copro)-quantitative PCRs (qPCR): (i) a multiplex qPCR able to detect and differentiate between E. multilocularis, Echinococcus granulosus sensu lato and Taenia spp./other cestodes (CEST-qPCR) and (ii) an E. multilocularis-specific qPCR (EM-qPCR). Finally, the intestines were examined macroscopically and microscopically for parasite stages at necropsy (n = 91) and using an intestinal scraping technique (IST) (n = 64).
RESULTS
Of the 146 cats examined, 24 (17.1%) were infected by intestinal parasites, namely Hydatigera (syn. Taenia) taeniaeformis (8.9%), Toxocara cati (6.1%), Capillaria sp. (3.4%), hookworms (3.4%), Mesocestoides litteratus (1.4%), Giardia sp. (1.4%), Cystoisospora rivolta (1.4%), Cystoisospora felis (0.7%), Toxoplasma gondii (0.7%), Hammondia hammondi (0.7%) and Strongyloides sp. (0.7%). Necropsy and the IST revealed adult H. taeniaeformis in 12 animals, of which eight faecal samples were positive by the CEST-qPCR (sensitivity = 67%) and six samples by the sedimentation/flotation technique (sensitivity = 50%). No E. multilocularis infection was detected in the sampled cats. Using Bayesian latent class analysis, the mean posterior prevalence probability was 0.0% (95% confidence interval 0-0.83%) for E. multilocularis.
CONCLUSIONS
There was no evidence of E. multilocularis infection among the 146 cats examined, suggesting that the prevalence of this parasite is low (< 1%) in the Swiss domestic cat population. Nonetheless, some of the sampled cats were infected by parasites that have rodents as intermediate hosts, demonstrating successful predation by these cats, and some were infected with zoonotic parasites. Cats therefore should not be disregarded as potential hosts for E. multilocularis and other zoonotic parasites.
Topics: Animals; Cats; Echinococcus multilocularis; Switzerland; Bayes Theorem; Intestinal Diseases, Parasitic; Parasites; Feces; Taenia; Multiplex Polymerase Chain Reaction; Cat Diseases
PubMed: 37807080
DOI: 10.1186/s13071-023-05983-y -
Tropical Diseases, Travel Medicine and... Oct 2023The COVID-19 pandemic has posed clinical and public health challenges worldwide. The use of corticosteroids has become an evidence-based practice to reduce the...
The COVID-19 pandemic has posed clinical and public health challenges worldwide. The use of corticosteroids has become an evidence-based practice to reduce the hyperinflammatory process involved in severe COVID-19 disease. However, this can result in the reactivation of parasitic infestations, even with a short course. We report the case of a 64-year-old Cuban born patient who passed away from S. stercoralis hyperinfection syndrome following treatment with dexamethasone for severe COVID-19 disease on a background of prolonged immunosuppression for rheumatoid arthritis. Clinicians should be aware of the risk of strongyloidiasis as a complication of the treatment for severe COVID-19 and other immunosuppressive therapies. We recommend empiric Strongyloides treatment for those who are from, or who have accumulated risk by travelling to endemic areas, and are being treated with corticosteroids for severe COVID-19 disease.
PubMed: 37794447
DOI: 10.1186/s40794-023-00201-0 -
JACC. Case Reports Sep 2023Parasitic constrictive pericarditis is a rare entity. We present a case of a 75-year-old man who presented with dyspnea, ascites, and pedal edema and was found to have...
Parasitic constrictive pericarditis is a rare entity. We present a case of a 75-year-old man who presented with dyspnea, ascites, and pedal edema and was found to have constrictive pericarditis on multimodality imaging with positive serology for . Treatment required ivermectin and radical pericardiectomy with significant clinical improvement. ().
PubMed: 37790764
DOI: 10.1016/j.jaccas.2023.101983 -
Journal of Parasitology Research 2023Goats are an important source of livelihood especially for smallholder communities. But gastrointestinal nematodosis is the greatest threats of goat production. A...
Goats are an important source of livelihood especially for smallholder communities. But gastrointestinal nematodosis is the greatest threats of goat production. A repeated cross-sectional and field experimental study design was conducted from December 2020 to August 2021 in Mirab Abaya district, with the aim of seasonal prevalence gastrointestinal nematode infection and assessment of anthelmintic resistance. A systematic random sampling strategy was used to select the study goats. The overall prevalence of gastrointestinal nematode infections of goats in the study area was 57.9% (95% CI: 54.4-61.4), of which 48.7% (95% CI: 43.7-53.7) and 67.2% (95% CI: 62.3-71.7) accounted to dry and wet seasons, respectively. The multivariable logistic regression analysis showed that season, age, sex, and flock size were significantly ( < 0.05) influenced the prevalence of gastrointestinal nematode infection of goats. The number of eggs per gram of faeces (EPG) was ranged from 100 to 2500. The overall mean egg per gram of faeces (EPG) was 461.1 ± 20.9. The mean EPG of wet season (532.7 ± 28.6) was higher than the dry season (362.3 ± 29.1). From faecal culture, 552 nematode larvae were recovered, and the most commonly identified nematode genera were (36.4%) that followed by (28.1%), (15.4%), (11.4), (5.4%), and (3.0%) species. From the anthelmintic resistance test in the field, the percentage reduction and 95% confidence limit of albendazole were 96% (84.2-99.0) and 97.0% (84.6-99.4) in dry and wet seasons, respectively. Here, the lower limit of 95% CI was less than 90% both in dry and wet seasons; and hence, albendazole was suspected for resistance development by gastrointestinal nematode. From a pooled faecal culture that collected from albendazole-treated goats, species was recovered. Therefore, due attention shall be by animal health professionals in the area in the use of albendazole. Animal health extension work to create awareness of how anthelmintic is used is helpful in reducing the risk. Changing the type of anthelmintic drug after using for some period will minimize the risk of anthelmintic resistance development.
PubMed: 37790288
DOI: 10.1155/2023/9945998 -
Journal of Tropical Medicine 2023Vegetable and fruit consumptions are important for health as they are good sources of carbohydrates, vitamins, minerals, and fiber. However, contamination of vegetables...
BACKGROUND
Vegetable and fruit consumptions are important for health as they are good sources of carbohydrates, vitamins, minerals, and fiber. However, contamination of vegetables and fruits is indicated as the main contributing factor to parasitic contamination.
OBJECTIVE
This study aims to assess the prevalence and associated factors of intestinal parasites among fruits and vegetables collected from local markets in Bule Hora Town, Southeast Ethiopia.
METHODS
A cross-sectional assessment was carried out on 391 raw fruits and vegetables from the market in Bule Hora Town from July 29 to August 17, 2022. After being soaked in physiological saline and vigorously shaken for 15 minutes with the help of a mechanical shaker, a total of 391 samples taken from various fruits and vegetables were evaluated using the sedimentation concentration technique. Software SPSS version 25 was used to analyze the data after it had been entered using EpiData version 3.1. To assess various associated factors, binary and multivariable logistic regression was employed.
RESULTS
142 (36.3%) of the 391 samples analyzed had at least one species of parasite. The parasite (40.1%) was found the most frequently, whereas spp. was found the least frequently. Variables such as fingernail trimming (AOR = 1.99; 95% CI: 1.274-3.108), hand washing habit with soap after using toilet (AOR = 2.912; CI: 1.896-4.47), and eating raw vegetables or fruits (AOR = 0.604; CI: 0.394-0.925) were associated with parasitic contamination.
CONCLUSIONS
The results of this study show that eating vegetables that are raw in the study area carries a potentially significant risk of contracting parasitic illnesses. Therefore, the appropriate bodies should make an effort to lower the rate of product contamination with intestinal parasites by educating vendors and the general public.
PubMed: 37781133
DOI: 10.1155/2023/1861919 -
Retinoic acid drives intestine-specific adaptation of effector ILC2s originating from distant sites.The Journal of Experimental Medicine Dec 2023Adaptation of immune cells to tissue-specific microenvironments is a crucial process in homeostasis and inflammation. Here, we show that murine effector type 2 innate...
Adaptation of immune cells to tissue-specific microenvironments is a crucial process in homeostasis and inflammation. Here, we show that murine effector type 2 innate lymphoid cells (ILC2s) from various organs are equally effective in repopulating ILC2 niches in other anatomical locations where they adapt tissue-specific phenotypes of target organs. Single-cell transcriptomics of ILC2 populations revealed upregulation of retinoic acid (RA) signaling in ILC2s during adaptation to the small intestinal microenvironment, and RA signaling mediated reprogramming of kidney effector ILC2s toward the small intestinal phenotype in vitro and in vivo. Inhibition of intestinal ILC2 adaptation by blocking RA signaling impaired worm expulsion during Strongyloides ratti infection, indicating functional importance of ILC2 tissue imprinting. In conclusion, this study highlights that effector ILC2s retain the ability to adapt to changing tissue-specific microenvironments, enabling them to exert tissue-specific functions, such as promoting control of intestinal helminth infections.
Topics: Mice; Animals; Immunity, Innate; Tretinoin; Lymphocytes; Intestines; Inflammation; Cytokines
PubMed: 37773047
DOI: 10.1084/jem.20221015 -
BMJ Paediatrics Open Dec 2022Evaluate the Unity Clinic's infectious disease screening programme for unaccompanied asylum-seeking children (UASC), calculate rates of infection and identify further...
OBJECTIVE
Evaluate the Unity Clinic's infectious disease screening programme for unaccompanied asylum-seeking children (UASC), calculate rates of infection and identify further health needs.
DESIGN
Retrospective audit of electronic patient data.
SETTING AND PATIENTS
UASC who attended the Unity Clinic between 1 November 2019 and 22 March 2022.
MAIN OUTCOME MEASURES
Baseline demographics, social, mental health and journey details, infection screening and investigation results.
RESULTS
155 UASC were reviewed: 89% (138 of 155) male, median age 17 years (IQR 16-17). Most frequent countries of origin were Sudan, Eritrea and Afghanistan. Median duration of travel to the UK (n=79) was 2 years (IQR 0.5-4); 35.6% (47 of 132) arrived by boat and 54.5% (72 of 132) by road. 44.8% (69 of 154) had one or more positive infection screening results: 22.7% (35 of 154) and 1.3% (2 of 154) positive for latent and active tuberculosis, respectively; 4.6% (7 of 152) chronic active hepatitis B and 17.1% (26 of 152) for past infection; 1.3% (2 of 154) for HIV; 13.0% (19 of 146) for . There were three cases of syphilis (n=152; 2.0%) and one chlamydia (n=148; 0.7%)-none of whom disclosed prior sexual activity during screening. 39.6% (61 of 154) and 27.9% (43/154) reported disturbances to mood or sleep, respectively. 55.2% (85 of 154) disclosed traumatic incidents during and/or prior to their journey, including physical and sexual assault.
CONCLUSIONS
The Unity Clinic provides a thorough infectious disease screening service for UASC following national guidance. Results highlight the need for universal, non-judgemental screening for sexually transmitted infections, as targeted screening would not identify positive cases. High rates of well-being issues and previous abuse emphasise the need for multidisciplinary, collaborative approaches to care.
Topics: Humans; Child; Male; Adolescent; Retrospective Studies; Affect; Afghanistan; Syphilis; Health Services Accessibility
PubMed: 37737254
DOI: 10.1136/bmjpo-2022-001664 -
Parasitology Research Dec 2023Strongyloidiasis is a clinical issue both in humans and in dogs. Moreover, there are concerns about its zoonotic potential. We aimed to explore Strongyloides stercoralis... (Observational Study)
Observational Study
Strongyloidiasis is a clinical issue both in humans and in dogs. Moreover, there are concerns about its zoonotic potential. We aimed to explore Strongyloides stercoralis epidemiology in Southern Italy in humans and dogs sharing the same environment in three different settings: (1) kennels (group K); (2) livestock farms (group L) and (3) agricultural farms (group A). For humans, a commercial ELISA test was used for screening. RT-PCR on faecal samples was done for people testing positive or equivocal at serology. On dog's faecal samples, Baermann test and RT-PCR were performed. A total of 145 dogs and 139 persons were tested. Based on faecal tests in dogs and serology in humans, a S. stercoralis positivity of 4.1% and 6.5% was revealed, respectively. The sites where cases were found were different for animals and humans. In dogs the highest positivity was in group K (6.7% against 2% and 0% in L and A). Differently, in humans the proportion of positive results was similar between the groups (p = 0.883). Fifty percent (3/6) of positive dogs were healthy; the other dogs presented weight loss and/or diarrhoea. ELISA-positive persons (n=9) were all in health, but abdominal pain (37.5%), urticaria (22.2%) and asthma (22.2%) were reported, resolving after treatment with oral ivermectin 200 μg/kg. RT-PCR performed on 13 human faecal samples resulted negative. These findings suggest that strongyloidiasis is present in humans and dogs in Southern Italy, and screening in larger cohorts would be needed for more accurate estimates.
Topics: Animals; Dogs; Humans; Feces; Italy; Ivermectin; Strongyloides stercoralis; Strongyloidiasis
PubMed: 37735273
DOI: 10.1007/s00436-023-07978-1