An open label,block randomized,community study of the safety and efficacy of co-administered ivermectin,diethylcarbamazine plus albendazole vs. diethylcarbamazine plus albendazole for lymphatic filariasis in India

BackgroundBetter drug regimens for mass drug administration (MDA) could accelerate the Global Programme to Eliminate Lymphatic Filariasis (LF). This community study was designed to compare the safety and efficacy of MDA with IDA (ivermectin, diethylcarbamazine and albendazole) or DA (diethylcarbamazine and albendazole) in India.Methodology/Principal findingsThis two-armed, open-labelled, block randomised, community study was conducted in LF endemic villages in Yadgir district, Karnataka, India. Consenting participants ≥5 years of age were tested for circulating filarial antigenemia (CFA) and microfilaremia (Mf) before treatment with a single oral dose of IDA or DA. Adverse events (AEs) were monitored actively for two days and passively for five more days. Persons with positive CFA or Mf tests at baseline were retested 12-months post-treatment to assess treatment efficacy.Baseline CFA and Mf-rates were 26.4% and 6.9% in IDA and 24.5% and 6.4% in DA villages respectively. 4758 and 4160 participants received IDA and DA. Most AEs were mild after both treatments; fewer than 0.1% of participants experienced AEs with severity > grade 1. No serious AEs were observed. Fever, headache and dizziness were the most common AEs. AE rates were slightly higher after IDA than DA (8.3% vs. 6.4%, P<0.01). AEs were more frequent in females and Mf-positives after either treatment, but significantly more frequent after IDA (40.5% vs 20.2%, P < 0.001).IDA was more effective for clearing Mf than DA (84% vs. 61.8%, P < 0.001). Geometric mean Mf counts per 60μl in retested Mf-positives decreased by 96.4% from 11.8 after IDA and by 90.0% from 9.5 after DA. Neither treatment was effective for clearing CFA.Conclusions/SignificanceIDA had an acceptable safety profile and was more effective for clearing Mf than DA. With adequate compliance and medical support to manage AEs, IDA has the potential to accelerate LF elimination in India.Trial registrationClinical Trial Registry of India (CTRI No/2016/10/007399)     

An open label,randomized clinical trial to compare the tolerability and efficacy of ivermectin plus diethylcarbamazine and albendazole vs. diethylcarbamazine plus albendazole for treatment of brugian filariasis in Indonesia

Improved treatments for lymphatic filariasis (LF) could accelerate the global elimination program for this disease. A triple drug combination of the anti-filarial drugs ivermectin, diethylcarbamazine (DEC) and albendazole (IDA) has been shown to be safe and effective for achieving sustained clearance of microfilariae (Mf) of the filarial parasite Wuchereria bancrofti from human blood. However, the triple drug combination has not been previously been evaluated for treatment of brugian filariasis, which accounts for about 10% of the global LF burden. This hospital-based clinical trial compared the safety and efficacy of IDA with that of the standard treatment (DEC plus albendazole, DA) in persons with Brugia timori infections on Sumba island, Indonesia. Fifty-five asymptomatic persons with B. timori Mf were treated with either a single oral dose of IDA (28 subjects) or with DEC plus albendazole (DA, 27 subjects). Participants were actively monitored for adverse events (AE) for two days after treatment by nurses and physicians who were masked regarding treatment assignments. Passive monitoring was performed by clinical teams that visited participant’s home villages for an additional five days. Microfilaremia was assessed by membrane filtration of 1 ml night blood at baseline, at 24h and one year after treatment. IDA was more effective than DA for completely clearing Mf at 24 hours (25/28, 89% vs. 8/27, 30%, P < 0.001). By 12 months after treatment, only one of 27 IDA recipients had Mf in their blood (4%) vs. 10 of 25 (40%) in persons treated with DA (P = 0.002). Approximately 90% of participants had antibodies to recombinant filarial antigen BmR1 at baseline. Antibody prevalence decreased to approximately 30% in both treatment groups at 12 months. About 45% of persons in both treatment groups experienced AE such as fever, muscle aches, lower back, joint and abdominal pain. These were mostly mild and most common during the first two days after treatment. No participant experienced a severe or serious AE. This study showed that IDA was well-tolerated and significantly more effective for clearing B. timori Mf from the blood than DA. Larger studies should be performed to further assess the safety and efficacy of IDA as a mass drug administration regimen to eliminate brugian filariasis.Trial Registration: {"type":"clinical-trial","attrs":{"text":"NCT02899936","term_id":"NCT02899936"}}NCT02899936.     

A community survey of coverage and adverse events following country-wide triple-drug mass drug administration for lymphatic filariasis elimination,Samoa 2018

The Global Programme to Eliminate Lymphatic Filariasis has made considerable progress but is experiencing challenges in meeting targets in some countries. Recent World Health Organization guidelines have recommended two rounds of triple-drug therapy with ivermectin, diethylcarbamazine (DEC), and albendazole (IDA), in areas where mass drug administration (MDA) results with two drugs (DEC and albendazole) have been suboptimal, as is the case in Samoa. In August 2018, Samoa was the first country in the world to implement countrywide triple-drug MDA. This paper aims to describe Samoa’s experience with program coverage and adverse events (AEs) in the first round of triple-drug MDA. We conducted a large cross-sectional community survey to assess MDA awareness, reach, compliance, coverage and AEs in September/October 2018, 7–11 weeks after the first round of triple-drug MDA. In our sample of 4420 people aged ≥2 years (2.2% of the population), age-adjusted estimates indicated that 89.0% of the eligible population were offered MDA, 83.9% of the eligible population took MDA (program coverage), and 80.2% of the total population took MDA (epidemiological coverage). Overall, 83.8% (2986/3563) reported that they did not feel unwell at all after taking MDA. Mild AEs (feeling unwell but able to do normal everyday things) were reported by 13.3% (476/3563) and moderate or severe AEs (feeling unwell and being unable to do normal everyday activities such as going to work or school) by 2.9% (103/3563) of participants. This study following the 2018 triple-drug MDA in Samoa demonstrated a high reported program awareness and reach of 90.8% and 89.0%, respectively. Age-adjusted program coverage of 83.9% of the total population showed that MDA was well accepted and well tolerated by the community.     

The impact of a filariasis control program on Lihir Island, Papua New Guinea

Background

Annual mass drug administration (MDA) over five years is the WHO''s recommended strategy to eliminate lymphatic filariasis (LF). Some experts, however, consider that longer periods of treatment might be necessary in certain high prevalence and transmission environments based upon past unsuccessful field experience and modelling.

Methodology/Principal Findings

To evaluate predictors of success in a LF control program we conducted an ecological study during a pre-existing MDA program. We studied 27 villages in Lihir Island, Papua New Guinea, from two areas with different infection rates before MDA. We undertook surveys to collect information on variables potentially having an influence on the outcome of the program, including epidemiological (baseline prevalence of infection, immigration rate), entomological (vector density) and operational (treatment coverage, vector control strategies) variables. The success in a village was defined using variables related to the infection (circulating filarial antigenemia prevalence <1%) and transmission (antigenemia prevalence <1 in 1000 children born since start of MDA). 8709 people were involved in the MDA program and average coverage rates were around 70%. The overall prevalence of filariasis fell from an initial 17.91% to 3.76% at round 5 (p<0.001). Viewed on a village by village basis, 12/27 (44%) villages achieved success. In multivariate analysis, low baseline prevalence was the only factor predicting both success in reducing infection rates (OR 19,26; CI 95% 1,12 to 331,82) and success in preventing new infections (OR 27,44; CI 95% 1,05 to 719,6). Low vector density and the use of an optimal vector control strategy were also associated with success in reducing infection rates, but this did not reach statistical significance.

Conclusions/Significance

Our results provide the data that supports the recommendation that high endemic areas may require longer duration MDA programs, or alternative control strategies.     

Treatment of co-infection with bancroftian filariasis and onchocerciasis: a safety and efficacy study of albendazole with ivermectin compared to treatment of single infection with bancroftian filariasis

BACKGROUND: In order to use a combination of ivermectin and albendazole for the elimination of lymphatic filariasis, it is important to assess the potential risk of increased adverse events in individuals infected with both lymphatic filariasis and onchocerciasis. We compared the safety and efficacy of albendazole (400 mg) in combination with ivermectin (150 micrograms/kg), for the treatment of co-infections of Wuchereria bancrofti and Onchocerca volvulus with single infection of W. bancrofti. METHODS: The safety study on co-infections was a crossover, double blind design, while for the single infection of bancroftian filariasis an open design comparing two treatments was used. For co-infection, one group was allocated a single dose of ivermectin (150 micrograms/kg) plus albendazole (400 mg) (Group A). The other group received placebo (Group B). Five days later the treatment regime was reversed, with the Group A receiving placebo and Group B receiving treatment. For the single bancroftian filariasis infection, one group received a single dose of albendazole (400 mg) plus ivermectin (150 microg/kg) (Group C) while the other group received a single dose of albendazole (400 mg) alone (Group D). Blood and skin specimens were collected on admission day, day 0, and on days 2, 3, and 7 to assess drug safety and efficacy. Thereafter, blood and skin specimens were collected during the 12 months follow up for the assessment of drug efficacy. Study individuals were clinically monitored every six hours during the first 48 hours following treatment, and routine clinical examinations were performed during the hospitalisation period and follow-up. RESULTS: In individuals co-infected with bancroftian filariasis and onchocerciasis, treatment with ivermectin and albendazole was safe and tolerable. Physiological indices showed no differences between groups with co-infection (W. bancrofti and O. volvulus) or single infection (W. bancrofti). The frequency of adverse events in co-infected individuals was 63% (5/8, Group A, albendazole + ivermectin) and 57% (4/7, Group B, placebo) and of mild or moderate intensity. In single W. bancrofti infection the frequency of adverse events was 50% (6/12, Group C, albendazole + ivermectin) and 38% (5/13, Group D, albendazole) and of a similar intensity to those experienced with co-infection. There were no differences in adverse events between treatment groups. There was no significant difference in the reduction of microfilaraemia following treatment with albendazole and ivermectin in groups with single or co-infection. CONCLUSION: Our findings suggest that ivermectin plus albendazole is a safe and tolerable treatment for co-infection of bancroftian filariasis and onchocerciasis.     

A multicenter,community-based,mixed methods assessment of the acceptability of a triple drug regimen for elimination of lymphatic filariasis

BackgroundMany countries will not reach elimination targets for lymphatic filariasis in 2020 using the two-drug treatment regimen (diethylcarbamazine citrate [DEC] and albendazole [DA]). A cluster-randomized, community-based safety study performed in Fiji, Haiti, India, Indonesia and Papua New Guinea tested the safety and efficacy of a new regimen of ivermectin, DEC and albendazole (IDA).Methodology/Principal findingsTo assess acceptability of IDA and DA, a mixed methods study was embedded within this community-based safety study. The study objective was to assess the acceptability of IDA versus DA. Community surveys were performed in each country with randomly selected participants (>14 years) from the safety study participant list in both DA and IDA arms. In depth interviews (IDI) and focus group discussions (FGD) assessed acceptability-related themes. In 1919 individuals, distribution of sex, microfilariae (Mf) presence and circulating filarial antigenemia (CFA), adverse events (AE) and age were similar across arms. A composite acceptability score summed the values from nine indicators (range 9–36). The median (22.5) score indicated threshold of acceptability. There was no difference in scores for IDA and DA regimens. Mean acceptability scores across both treatment arms were: Fiji 33.7 (95% CI: 33.1–34.3); Papua New Guinea 32.9 (95% CI: 31.9–33.8); Indonesia 30.6 (95% CI: 29.8–31.3); Haiti 28.6 (95% CI: 27.8–29.4); India 26.8 (95% CI: 25.6–28) (P<0.001). AE, Mf or CFA were not associated with acceptability. Qualitative research (27 FGD; 42 IDI) highlighted professionalism and appreciation for AE support. No major concerns were detected about number of tablets. Increased uptake of LF treatment by individuals who had never complied with MDA was observed.Conclusions/SignificanceIDA and DA regimens for LF elimination were highly and equally acceptable in individuals participating in the community-based safety study in Fiji, Haiti, India, Indonesia, and Papua New Guinea. Country variation in acceptability was significant. Acceptability of the professionalism of the treatment delivery was highlighted.     

Impact of two rounds of mass drug administration using diethylcarbamazine combined with albendazole on the prevalence of Brugia timori and of intestinal helminths on Alor Island, Indonesia

Background

Annual mass drug administration (MDA) using diethylcarbamizine (DEC, 6 mg/kg) combined with albendazole (alb, 400 mg) is recommended by the Global Programme to Eliminate Lymphatic Filariasis (GPELF). This strategy has been shown to be efficient in the of control bancroftian filariasis, but data on brugian filariasis as well as on the positive side effects on intestinal helminths are lacking.

Methods

The effect of one selective treatment and two rounds of MDA using DEC and alb on the prevalence and intensity of Brugia timori infection were studied on Alor island using a cross-sectional and a cohort approach. Before the campaign and ten months after each treatment cycle microfilariae (mf) were assessed by filtration of night blood. Before and ten months after MDA, stool samples were collected and the prevalence of intestinal helminths were determined.

Results

In all, the mf-rate dropped from 26.8% before any treatment to 3.8% following the second MDA. Almost all mf-positive, treated individuals showed very low mf densities. The crude prevalence of hookworm dropped from 25.3% to 5.9%. The reduction of prevalence of Ascaris lumbricoides (32.3% to 27.6%) and Trichuris trichiura (9.4% to 8.9%) was less pronounced. Within a cohort of 226 individuals, which was examined annually, the prevalence of A. lumbricoides dropped from 43.8% to 26.5% and of T. trichiura from 12.8% to 6.6%. The results indicate that this MDA approach reduces not only the mf prevalence of B. timori but also the prevalence of hookworm and to a lesser extent also of A. lumbricoides and T. trichiura.

Conclusion

The MDA using DEC and alb as recommended by GPELF is extremely effective for areas with brugian filariasis. The beneficial effect of MDA on intestinal helminths may strengthen the national programme to eliminate lymphatic filariasis in Indonesia and may set resources free which are otherwise used for deworming campaigns of schoolchildren.     

Effects of 5 rounds of mass drug administration with diethylcarbamazine and albendazole on filaria-specific IgG4 titers in urine: 6-year follow-up study in Sri Lanka

ELISA for filaria-specific IgG4 in urine (urine ELISA) was applied to children in 7 schools in Sri Lanka, before and after 5 rounds of annual mass drug administration (MDA). The pre-treatment IgG4 prevalence in 2002 was 3.20%, which decreased to 0.91% in 2003 after the first MDA (P<0.001), and finally to 0.36% in 2007 after the 5th MDA. Among 5-10 year-old children, the prevalence decreased from 3.37% in 2002 to 0.51% in 2003 (P=0.009). A pattern of IgG4 titer distribution according to age and its yearly change could also provide useful information in drug efficacy analysis. In 2008, new samples from eleven 2006/07 urine ELISA-positive students and their family members (total n=56) were examined by ICT antigen test, microfilaria test, and urine ELISA. No infection was confirmed among them. Urine ELISA will be useful in monitoring elimination/resurgence in a post-MDA low endemic situation.     

Caprellids (Crustacea: Amphipoda) from Papua New Guinea,with the description of a new species

This is the first study of caprellid amphipods from the coast of Papua New Guinea. Several collections from Madang Lagoon (north) and Bootless Bay (south) have been studied. Seven species in seven genera are recorded, of which Pseudoproto papua sp. nov. is described as new to science. The genus Pseudoproto Mayer, 1903 has consisted, so far, of only one species, Pseudoproto fallax Mayer, 1903. Although only a single male has been found of Pseudoproto papua sp. nov., differences in antennae, mouthparts, gnathopod 2 and pereopods 3 and 4 have revealed that it represents a new species of Pseudoproto. Lateral view figures of all species, together with a key to species level for the Caprellidea from Papua New Guinea are also included. Communicated by H.-D. Franke     

The Strongylophthalmyiidae (Diptera) of Papua New Guinea,with descriptions of five new species and a world checklist

Eight species of the Strongylophthalmyiidae are reported from Papua New Guinea. Of these, five species (Strongylophthalmyia gigantica sp. nov., S. papuana sp. nov., S. rubella sp. nov., S. sedlaceki sp. nov. and S. shatalkini sp. nov.) are described as new to science. Strongylophthalmyia puncticollis Frey is recorded for the first time from Papua New Guinea. Faunistic remarks, a key to the species of the Strongylophthalmyia in Papua New Guinea and a world checklist are provided.     

A limnological survey of Lake Dakataua, a large caldera lake on West New Britain, Papua New Guinea, with comparisons to Lake Wisdom, a younger nearby caldera lake

SUMMARY. Lake Dakataua (5°S, 150°E) is a large freshwater lake which fills the caldera at the tip of the Willaumez Peninsula on West New Britain, Papua New Guinea. A peninsula produced by post-collapse volcanic activity divides the lake into two basins connected by a narrow channel. The surface of the lake is c. 76 m above sea level, the surface area is 48 km², and the maximum depth c. 120 m (Lowder & Carmichael, 1970). A bathymetric map of the lake has been constructed from fathometer transects. In October-November, 1974, the lake was alkaline throughout with surface pH 7.6–8.2; acidity increased with depth to pH 7.1–7.5. Surface temperatures were 30.8–31.9°C. There were thermoclines at 22 m and at 40–45 m. Minimum temperature recorded was 26.8°C (at 80 m). Oxygen saturation curves were similar to the temperature curves with sharp gradients at 22 m and 40–45 m. There was no measurable O₂ from 80 m downward. Living organisms were common in dredge hauls to 20 m but were not found in those from greater depths. Carbon dioxide concentration rose steadily from 1.4 mg I^?1 at the surface to 19.6 mg I^?1 at 80 m. Average Secchi disc transparency was 11.1 m. Shallow water areas support dense beds of mixed aquatic plants (Najas tenuifolia and Chara sp.). Invertebrates collected included two species of sponge, a rotifer, an ostracod, six species of molluscs, seven species of Cladocera, a copepod, eight species of Hemiptera, two species of Trichoptera, ten species of Odonata, two species of Coleoptera, and seven species of Chironomidae. Vertebrates included frogs (two species) and crocodiles. Water birds, including ducks, grebes, and waders, were abundant. The biota of L. Dakataua is more diverse than that of nearby Lake Wisdom probably due to the combination of greater age and greater proximity to sources of colonists. Most species found in L. Wisdom are also found in L. Dakataua.     

Control of scabies in a tribal community using mass screening and treatment with oral ivermectin -A cluster randomized controlled trial in Gadchiroli,India

BackgroundScabies is often endemic in tribal communities and difficult to control. We assessed the efficacy of a community-based intervention using mass screening and treatment with oral ivermectin in controlling scabies.Methods/ FindingsIn this cluster randomised controlled trial, 12 villages were randomly selected from a cluster of 42 tribal villages in Gadchiroli district. In these villages, trained community health workers (CHWs) conducted mass screening for scabies. The diagnosis was confirmed by a physician. Six villages each were randomly allocated to the intervention and usual care arm (control arm). In the intervention arm (population 1184) CHWs provided directly observed oral ivermectin to scabies cases and their household contacts. In the usual care arm (population 1567) scabies cases were referred to the nearest clinic for topical treatment as per the standard practice. The primary outcome was prevalence of scabies two months after the treatment. Secondary outcomes were prevalence of scabies after twelve months of treatment and prevalence of impetigo after two and twelve months of treatment. Outcomes were measured by the team in a similar way as the baseline. The trial was registered with the clinical trial registry of India, number CTRI/2017/01/007704.In the baseline, 2 months and 12 months assessments 92.4%, 96% and 94% of the eligible individuals were screened in intervention villages and 91.4%, 91.3% and 95% in the usual care villages. The prevalence of scabies in the intervention and usual care arm was 8.4% vs 8.1% at the baseline, 2.8% vs 8.8% at two months [adjusted relative risk (ARR) 0.21, 95% CI 0.11–0.38] and 7.3% vs 14.1% (ARR 0.49, 95% CI 0.25–0.98) at twelve months The prevalence of impetigo in the intervention and usual care arm was 1.7% vs 0.6% at baseline, 0.6% vs 1% at two months (ARR 0.55, 95% CI 0.22–1.37) and 0.3% vs 0.7% at 12 months (ARR 0.42, 95% CI 0.06–2.74). Adverse effects due to ivermectin occurred in 12.1% of patients and were mild.ConclusionsMass screening and treatment in the community with oral ivermectin delivered by the CHWs is superior to mass screening followed by usual care involving referral to clinic for topical treatment in controlling scabies in this tribal community in Gadchiroli.     

Geostatistical modelling enables efficient safety assessment for mass drug administration with ivermectin in Loa loa endemic areas through a combined antibody and LoaScope testing strategy for elimination of onchocerciasis

The elimination of onchocerciasis through community-based Mass Drug Administration (MDA) of ivermectin (Mectizan) is hampered by co-endemicity of Loa loa, as individuals who are highly co-infected with Loa loa parasites can suffer serious and occasionally fatal neurological reactions from the drug. The test-and-not-treat strategy of testing all individuals participating in MDA has some operational constraints including the cost and limited availability of LoaScope diagnostic tools. As a result, a Loa loa Antibody (Ab) Rapid Test was developed to offer a complementary way of determining the prevalence of loiasis. We develop a joint geostatistical modelling framework for the analysis of Ab and Loascope data to delineate whether an area is safe for MDA. Our results support the use of a two-stage strategy, in which Ab testing is used to identify areas that, with acceptably high probability, are safe or unsafe for MDA, followed by Loascope testing in areas whose safety status is uncertain. This work therefore contributes to the global effort towards the elimination of onchocerciasis as a public health problem by potentially reducing the time and cost required to establish whether an area is safe for MDA.     

Marine brown algae (Phaeophyta) from the north coast of Papua New Guinea,with a description of Dictyota magneana sp. nov.

The marine benthic brown algae of the north coast of Papua New Guinea (mainly from Madang province) are documented, based on collections made by the first author, between 1980 and 1990. All records [34 identified taxa (+Sargassum spp.)] are listed with bibliographic, taxonomic, nomenclatural and biogeographical notes. The specimens belonging to the genus Dictyota are identified according to recent species definitions. D. magneana De Clerck et Coppejans is described as new to science. Only some representatives of the genus Sargassum have been identified to species level. The phaeophycean flora of the north coast is very similar to that of the south coast (Port Moresby area); nevertheless some differences can be observed.     

Tolerability and efficacy of single dose albendazole,diethylcarbamazine citrate (DEC) or co-administration of albendazole with DEC in the clearance of <Emphasis Type="Italic">Wuchereria bancrofti</Emphasis>in asymptomatic microfilaraemic volunteers in Pondicherry,South India: a hospital-based study

Background  

The tolerability and efficacy of single dose albendazole (400 mg), diethylcarbamazine citrate (DEC) (6 mg/kg bodyweight) or co-administration of albendazole (400 mg) + DEC (6 mg/kg bodyweight) was studied in 54 asymptomatic Wuchereria bancrofti microfilaraemic volunteers in a double blind hospital-based clinical study.     

A taxonomic study of Strongyloides Grassi, 1879 (Nematoda) with special reference to Strongyloides fuelleborni von linstow, 1905 in man in Papua New Guinea and the description of a new subspecies

The taxonomic position of a Strongyloides species parasitic in man in Papua New Guinea (PNG) that apparently resembled S. fuelleborni (a parasite of man and other primates in tropical Africa) has not been resolved since its discovery in 1973. The results of a morphological (by scanning electron microscopy) and morphometric study were considered together with the results of a separate isoenzyme electrophoretic study of the same material. The nature of the peri-vulval cuticle of the parasitic female and the position of the phasmidial pore of the free-living male were found to be of particular use in addressing this taxonomic problem. We concluded that the Strongyloides in Africa and PNG are subspecies of S. fuelleborni. We propose the name S. fuelleborni kellyi n. subsp. for the Strongyloides found in man in PNG.     

A new species of Copepoda Harpacticoida, Xylora calyptogenae spec. n., with a carnivorous life-style from a hydrothermally active submarine volcano in the New Ireland Fore-Arc system (Papua New Guinea) with notes on the systematics of the Donsiellinae Lang, 1948

A new species of harpacticoid copepods, Xylora calyptogenae spec. n., from Edison Seamount, a hydrothermally active submarine volcano in the New Ireland Fore-Arc system (Papua New Guinea) is described. The new species belongs to the Donsiellinae Lang, 1944, a highly specialised taxon, the members of which have previously been encountered only in association with decaying wood and/or wood-boring isopods. A closer relationship of the Donsiellinae with the Pseudotachidiidae Lang, 1936, can be stated on the basis of characteristics concerning the setation and/or segmentation of A1, A2, Mxl, Mxp, the shape of the female P5, anal somite, sexual dimorphisms on P2 and P3 and missing caudal seta I. Within the Pseudotachidiidae, the Donsiellinae again can be well characterized, e.g. by the setation and segmentation of A2, Mxl, swimming-legs, the shape of P1, female P5, male P2, sexual dimorphism and male P5. The Donsiellinae share some apomorphies with the pseudotachidiid subtaxon Paranannopinae Por, 1986: setation/segmentation of Mx, P1, A1. X. calyptogenae spec. n. is more closely related to Xylora bathyalis Hicks 1988 living in the deep sea wood substrata in New Zealand waters. Some traits of the evolutionary history of the Donsiellinae become evident, probably starting from the more primitive deep sea taxa X .calyptogenae spec. n., which lives in the hydrothermal seafloor in the absence of decaying wood, and X. bathyalis, which is found in decaying wood but not necessarily associated with the wood-boring isopod Limnoria Leach, 1814, towards the more advanced genera such as Donsiella Stephensen, 1936, which invades shallow waters and, further, clings to Limnoria, forming a close and, for the copepod, probably obligatory association. The specialised mouthparts of X. calyptogenae spec. n. seem to facilitate the grabbing and fixing of larger and/or active food items. This is confirmed by the presence of a large prey organism, presumably a copepod, consumed either alive or dead, in the gut of one of the available specimens. This morphology of the mouthparts is also shared by the closely related X. bathyalis.     

Mathevotaenia niuguiniensis n. sp. (Cestoda: Anoplocephalidae: Linstowiinae) from the water-rat Parahydromys asper (Thomas) in Papua New Guinea, with a list of species of Mathevotaenia Akumyan, 1946

A new species of cestode, Mathevotaenia niuguiniensis n. sp. (Anoplocephalidae: Linstowiinae), is described from the hydromyine rodent Parahydromys asper (Thomas) in Papua New Guinea. This is the third species of the genus reported from the Australasian region. The new species differs from all congeners in rodents by having an elongate cirrus-sac, which crosses the osmoregulatory canals and extends into the medulla, compared with a short, ovoid cirrus-sac which does not penetrate into the medulla in congeners. It differs from the known Australian species, M. antechini (Beveridge, 1977) and M. nyctophili (Hickman, 1954), found in dasyurid marsupials and bats respectively, by lacking a complex of anastomosing osmoregulatory canals in each segment. A list of all known species of Mathevotaenia Akumyan, 1946, their host genera, host families and geographical distribution is provided. New combinations proposed in this report are: M. dipodomi (Bienek & Grundmann, 1973) n. comb. (transferred from Schizorchodes Bienek & Grundman, 1973), M. genettae (Ortlepp, 1937) n.comb., M. mephitis (Skinker, 1935) n. comb., M. pedunculata (Chandler, 1952) n. comb., M. wallacei (Chandler, 1952) n. comb. (transferred from Oschmarenia Spasskii, 1951) and M. oedipomidatis (Stunkard, 1965) n. comb. (transferred from Paratriotaenia Stunkard, 1965).     

Two new genera and species of Nippostrongylinae (Nematoda: Heligmonellidae) parasites of two murine rodents (Muridae): from the Moluccas,Indonesia and Papua New Guinea with a comment on a pentastomatid

Systematic Parasitology - Bisastrongylus multiovorum gen. nov., sp. nov. (Nematoda: Heligmonellidae: Nippostrongylinae) is described from a murid, Melomys obiensis, from the Moluccas, Indonesia....     

Bilateral administration of autologous CD133+ cells in ambulatory patients with refractory critical limb ischemia: lessons learned from a pilot randomized,double-blind,placebo-controlled trial

Background aimsCD133+ cells confer angiogenic potential and may be beneficial for the treatment of critical limb ischemia (CLI). However, patient selection, blinding methods and end points for clinical trials are challenging. We hypothesized that bilateral intramuscular administration of cytokine-mobilized CD133+ cells in ambulatory patients with refractory CLI would be feasible and safe.MethodsIn this double-blind, randomized sham-controlled trial, subjects received subcutaneous injections of granulocyte colony-stimulating factor (10 μg/kg per day) for 5 days, followed by leukapheresis, and intramuscular administration of 50–400 million sorted CD133+ cells delivered into both legs. Control subjects received normal saline injections, sham leukapheresis and intramuscular injection of placebo buffered solution. Subjects were followed for 1 year. An aliquot of CD133+ cells was collected from each subject to test for genes associated with cell senescence.ResultsSeventy subjects were screened, of whom 10 were eligible. Subject enrollment was suspended because of a high rate of mobilization failure in subjects randomly assigned to treatment. Of 10 subjects enrolled (7 randomly assigned to treatment, 3 randomly assigned to control), there were no differences in serious adverse events at 12 months, and blinding was preserved. There were non-significant trends toward improved amputation-free survival, 6-minute walk distance, walking impairment questionnaire and quality of life in subjects randomly assigned to treatment. Successful CD133+ mobilizers expressed fewer senescence-associated genes compared with poor mobilizers.ConclusionsBilateral administration of autologous CD133+ cells in ambulatory CLI subjects was safe, and blinding was preserved. However, poor mobilization efficiency combined with high CD133+ senescence suggests futility in this approach.