High Prevalence of Tropheryma whipplei in Lao Kindergarten Children

Background

Tropheryma whipplei is a bacterium commonly found in feces of young children in Africa, but with no data from Asia. We estimated the prevalence of T. whipplei carriage in feces of children in Lao PDR (Laos).

Methods/Principal Findings

Using specific quantitative real-time PCR, followed by genotyping for each positive specimen, we estimated the prevalence of T. whipplei in 113 feces from 106 children in Vientiane, the Lao PDR (Laos). T. whipplei was detected in 48% (51/106) of children. Those aged ≤4 years were significantly less frequently positive (17/52, 33%) than older children (34/54, 63%; p< 0.001). Positive samples were genotyped. Eight genotypes were detected including 7 specific to Laos. Genotype 2, previously detected in Europe, was circulating (21% of positive children) in 2 kindergartens (Chompet and Akad). Genotypes 136 and 138 were specific to Chompet (21% and 15.8%, respectively) whereas genotype 139 was specific to Akad (10.55%).

Conclusions/Significance

T. whipplei is a widely distributed bacterium, highly prevalent in feces of healthy children in Laos. Further research is needed to identify the public health significance of this finding.     

Reflections on Grant Evans’ The Politics of Ritual and Remembrance: Laos since 1975

In this article I reflect on Grant Evans’ landmark and influential The Politics of Ritual and Remembrance: Laos since 1975, the way in which this book relates to the transformation from socialism to post‐socialism in the Lao People's Democratic Republic (LPDR), to the crisis of legitimacy of the communist regime, and to issues of social memory, Buddhism, nationalism, iconography, and ethnic minorities. I also consider how other scholars have engaged with The Politics of Ritual and Remembrance both critically and supportively since the publication of the monograph in 1998 . I include in my analysis some observations on Evans’ quite radical change in political views over his career as a student, journalist and academic, culminating in his critique of socialism in general and the LPDR in particular and his controversial sympathy for the Lao monarchy.     

The Diversity and Geographical Structure of Orientia tsutsugamushi Strains from Scrub Typhus Patients in Laos

Orientia tsutsugamushi is the causative agent of scrub typhus, a disease transmitted by Leptotrombidium mites which is responsible for a severe and under-reported public health burden throughout Southeast Asia. Here we use multilocus sequence typing (MLST) to characterize 74 clinical isolates from three geographic locations in the Lao PDR (Laos), and compare them with isolates described from Udon Thani, northeast Thailand. The data confirm high levels of diversity and recombination within the natural O. tsutsugamushi population, and a rate of mixed infection of ~8%. We compared the relationships and geographical structuring of the strains and populations using allele based approaches (eBURST), phylogenetic approaches, and by calculating F-statistics (F_ST). These analyses all point towards low levels of population differentiation between isolates from Vientiane and Udon Thani, cities which straddle the Mekong River which defines the Lao/Thai border, but with a very distinct population in Salavan, southern Laos. These data highlight how land use, as well as the movement of hosts and vectors, may impact on the epidemiology of zoonotic infections.     

Appetites and aspirations: Consuming wildlife in Laos

Research on wildlife use is strongly associated with conservation and environmental debates. Yet, popular beliefs about wildlife consumption also offer many opportunities for discussing identity and social change. To demonstrate this, I examine ideas about eating common types of wildlife in Laos in light of the dialectical contrast between civilised settlements (muang) and the wild forest (pa). The exclusion of wildlife from the widely practised baci ritual and the popularity of wildlife consumption indicate the potency of these animals as social objects. In a contemporary context of widespread social and environmental change across Laos, the practice of eating wildlife is being constructed as an assertion of Lao identity that blends an idealised tradition with a status‐conscious modernity. Ambivalent desires for social transformation draw upon ambiguous symbols to find expression in beliefs as well as in popular social practice.     

Neorickettsia sennetsu as a Neglected Cause of Fever in South-East Asia

Neorickettsia sennetsu infection is rarely recognized, with less than 100 globally reported patients over the last 50 years. The disease is thought to be contracted by eating raw fish, a staple of many South-East Asian cuisines. In 2009, the first patient with sennetsu was identified in the Lao PDR (Laos), raising the question as to how common this organism and related species are in patients presenting with fever. We investigated the frequency of N. sennetsu infection at hospitals in diverse areas of Laos. Consenting febrile hospital inpatients from central (Vientiane: n = 1,013), northern (Luang Namtha: n = 453) and southern (Salavan: n = 171) Laos were screened by PCR for N. sennetsu, if no previous positive direct diagnostic test was available. A PCR-restriction fragment length polymorphism assay was developed to differentiate between N. sennetsu, Ehrlichia chaffeensis and Anaplasma phagocytophilum. To allow more detailed studies of N. sennetsu, culture was successfully established using a reference strain (ATCC VR-367), identifying a canine-macrophage cell line (DH82) to be most suitable to visually identify infection. After screening, N. sennetsu was identified and sequence confirmed in four (4/1,637; 0.2%) Lao patients. Despite the previously identified high seroprevalence of N. sennetsu antibodies in the Lao population (~17%), acute N. sennetsu infection with sufficient clinical signs to prompt hospitalization appears to be rare. The reservoir, zoonotic cycle and pathogenicity of N. sennetsu remain unclear and require further investigations.     

Lao peasants on the move: Pathways of agrarian change in Laos

Grant Evans’ body of work on Laos consistently sought to understand how peasant society responded to political, social and economic change. As the Lao peasantry became ever more integrated both nationally and within the wider Southeast Asian region, and relations of market exchange came to dominate rural life, Evans maintained the need to reflect on Laos’ peasant roots to understand resulting pathways of agrarian change. This paper reconnects with this discussion in the contemporary Lao context, focusing on three dimensions of mobility: the widening spatial and sectoral ‘footprints’ of rural livelihoods; physical movement within and beyond rural settings in Laos; and reflections on issues of differentiation. We first track the political and policy changes that have most strongly influenced rural life since Evans’ early research on collectivisation, before exploring ways in which spatial integration, subsistence‐to‐commercial transition and migration have situated the remnants of Lao peasant society in a world of flows.     

Hoya aphylla (Apocynaceae,Asclepiadoideae), a new leafless species from Laos

The leafless species Hoya aphylla Aver. N.S. Khang & Averyanova (Apocynaceae) is described and illustrated as a new species for science from Hin Nam No National Protected Area of Laos (central Laos, Khammoune province). In its floral morphology, this new species may be similar to H. lyi, H. carnosa and H. multiflora, but it differs in corona color and shape of corona segments. Like the first two mentioned species, the new species may be referred to the type section of the genus, but in terms of it its leafless habit it exhibits an isolated position.     

New species of Peliosanthes,Rohdea and Tupistra (Asparagaceae) from Laos and Vietnam

We describe and illustrate four new species, Peliosanthes choriandra, P. tatianae and Tupistra orlovii from central to northern Laos, and Rohdea filosa from northern Vietnam. These are all very local in distribution and endemic to the respective countries. We also report new localities and their ecological conditions for five other species of Peliosanthes (P. argenteostriata, P. hirsuta, P. irinae, P. micrantha and P. nivea) recently described from Laos and/or Vietnam. Furthermore, Peliosanthes nivea is recorded as new to the flora of Laos.     

中国及老挝果实蝇属一新种及一新记录种（双翅目：实蝇科）

记述果实蝇属Bactrocera Macquart 1新种:甘肃果实蝇Bactrocera(Zeugodacus)gansuica Chen,Han et Zhousp.nov.及老挝果实蝇属1新记录种:黑颜果实蝇B(Z.)vultus(Hardy,1973),并附形态特征图。新种和盾条果实蝇B.(Z.)adusta(Wang & Zhao)及塔帕果实蝇Bactrocera(B.)tappanus(Shiraki)相似,均仅具1对小盾鬃,中胸盾片除2侧纵条及1中纵条外,余均黑色,以及小盾片具1黑色宽纵条。主要区别在于:1)前足股节端半深棕色,而非几乎全黑;2)中、后足股节端部约1/3深棕色;3)翅前缘带与端斑明显相连,而非与端斑明显分离。     

Molecular Epidemiology of Rabies Viruses Circulating in Two Rabies Endemic Provinces of Laos, 2011–2012: Regional Diversity in Southeast Asia

BackgroundAlthough rabies is endemic in Laos, genetic characterization of the viruses in this country is limited. There are growing concerns that development in the region may have increased transport of dog through Laos for regional dog meat consumption, and that this may cause spillover of the viruses from dogs brought here from other countries. This study was therefore undertaken to evaluate the current rabies situation and the genetic characteristics of rabies viruses currently circulating in Laos.MethodsWe determined the rate of rabies-positive samples by analyzing data from animal samples submitted to the Lao Ministry of Agriculture and Forestry’s National Animal Health Centre rabies laboratory from 2004 through 2011. Twenty-three rabies-positive samples were used for viral genetic characterization. Full genome sequencing was performed on two rabies viruses.ResultsRabies-positive samples increased substantially from 40.5% in 2004 to 60.2% in 2009 and continued at this level during the study period. More than 99% of the samples were from dogs, followed by cats and monkeys. Phylogenetic analyses showed that three rabies virus lineages belonging to the Southeast Asian cluster are currently circulating in Laos; these are closely related to viruses from Thailand, Cambodia and Vietnam. Lineages of the circulating Laos rabies viruses diverged from common ancestors as recently as 44.2 years and as much as 55.3 years ago, indicating periodic virus invasions.ConclusionThere is an increasing trend of rabies in Laotian animals. Similar to other rabies-endemic countries, dogs are the main viral reservoir. Three viral lineages closely related to viruses from neighboring countries are currently circulating in Laos. Data provide evidence of periodic historic exchanges of the viruses with neighboring countries, but no recent invasion.     

The Economic Impact of Pig-Associated Parasitic Zoonosis in Northern Lao PDR

The parasitic zoonoses human cysticercosis (Taenia solium), taeniasis (other Taenia species) and trichinellosis (Trichinella species) are endemic in the Lao People’s Democratic Republic (Lao PDR). This study was designed to quantify the economic burden pig-associated zoonotic disease pose in Lao PDR. In particular, the analysis included estimation of the losses in the pork industry as well as losses due to human illness and lost productivity. A Markov-probability based decision-tree model was chosen to form the basis of the calculations to estimate the economic and public health impacts of taeniasis, trichinellosis and cysticercosis. Two different decision trees were run simultaneously on the model’s human cohort. A third decision tree simulated the potential impacts on pig production. The human capital method was used to estimate productivity loss. The results found varied significantly depending on the rate of hospitalisation due to neurocysticerosis. This study is the first systematic estimate of the economic impact of pig-associated zoonotic diseases in Lao PDR that demonstrates the significance of the diseases in that country.     

China in Laos: Enclave spaces and the transformation of borders in the Mekong Region

Where China Meets Southeast Asia: Social and Cultural Change in the Border Regions edited by Grant Evans et al., is among the few works that take borderlands between China and mainland Southeast Asia seriously. A major contribution of this collection of border studies is its attempt to understand how border experiences and the process of bordering have changed since the early 1990s. Various Chinese–local interactions are explored in this book, with an emphasis on complex local responses to border transformations and diverse forms of mobility and network building. This article further examines the role of China and the Lao state, and the new wave of Chinese movement at the border. In establishing an economic integration that spills across the region, the penetration of Chinese power has been effective. The consequent retreat of the Lao state at the border has not only put an end to the old frontier but turned various borderlands into an estranged space of neoliberal enclave.     

Evaluation of Molecular Methods To Improve the Detection of Burkholderia pseudomallei in Soil and Water Samples from Laos

Burkholderia pseudomallei is the cause of melioidosis, a severe and potentially fatal disease of humans and animals. It is endemic in northern Australia and Southeast Asia and is found in soil and surface water. The environmental distribution of B. pseudomallei worldwide and within countries where it is endemic, such as the Lao People''s Democratic Republic (Laos), remains unclear. However, this knowledge is important to our understanding of the ecology and epidemiology of B. pseudomallei and to facilitate public health interventions. Sensitive and specific methods to detect B. pseudomallei in environmental samples are therefore needed. The aim of this study was to compare molecular and culture-based methods for the detection of B. pseudomallei in soil and surface water in order to identify the optimal approach for future environmental studies in Laos. Molecular detection by quantitative real-time PCR (qPCR) was attempted after DNA extraction directly from soil or water samples or after an overnight enrichment step. The positivity rates obtained by qPCR were compared to those obtained by different culture techniques. The rate of detection from soil samples by qPCR following culture enrichment was significantly higher (84/100) than that by individual culture methods and all culture methods combined (44/100; P < 0.001). Similarly, qPCR following enrichment was the most sensitive method for filtered river water compared with the sensitivity of the individual methods and all individual methods combined. In conclusion, molecular detection following an enrichment step has proven to be a sensitive and reliable approach for B. pseudomallei detection in Lao environmental samples and is recommended as the preferred method for future surveys.     

Dasyatis laosensis,a new whiptailed stingray (family Dasyatidae), from the Mekong River of Laos and Thailand

Synopsis Dasyatis laosensis, a new species, is described from the Mekong River where it forms the border between Laos and Thailand. It is the first member of the genus Dasyatis to be described as an endemic freshwater species from Southeast Asia. Bright orange color on the ventral surface of the disc and similar meristic characters indicate that it may be closely related to Dasyatis akajei, a marine species from southern Japan and China, and to Dasyatis sp. undetermined, from the West River in Guangxi, southern China.     

An Epidemic of Dengue-1 in a Remote Village in Rural Laos

In the Lao PDR (Laos), urban dengue is an increasingly recognised public health problem. We describe a dengue-1 virus outbreak in a rural northwestern Lao forest village during the cool season of 2008. The isolated strain was genotypically “endemic” and not “sylvatic,” belonging to the genotype 1, Asia 3 clade. Phylogenetic analyses of 37 other dengue-1 sequences from diverse areas of Laos between 2007 and 2010 showed that the geographic distribution of some strains remained focal overtime while others were dispersed throughout the country. Evidence that dengue viruses have broad circulation in the region, crossing country borders, was also obtained. Whether the outbreak arose from dengue importation from an urban centre into a dengue-naïve community or crossed into the village from a forest cycle is unknown. More epidemiological and entomological investigations are required to understand dengue epidemiology and the importance of rural and forest dengue dynamics in Laos.     

Snakebites in Two Rural Districts in Lao PDR: Community-Based Surveys Disclose High Incidence of an Invisible Public Health Problem

BackgroundThe Lao PDR (Laos) is one of the least developed countries in Asia with an estimated 25% of the population living in poverty. It is the habitat of some highly venomous snakes and the majority of the population earns their living from agricultural activities. Under these circumstances the incidence of snakebites is expected to be high.MethodsTwo cross-sectional, community-based surveys were performed in Champone and Phin district, Savannakhet province, Lao PDR to estimate snakebite incidence. Multistage random sampling was used. In the first stage approximately 40% of all villages in each district were randomly selected. In the second stage 33% of all households in each village were randomly chosen. Members of the selected households were interviewed about snakebites during the previous 12 months.ResultsThirty-five of 9856 interviewees reported a snakebite in a 12 month period in Champone district and 79 of 7150 interviewees in Phin district. The estimated incidence is 355 snakebites per 100,000 persons per year and 1105 per 100,000 in Champone and Phin district respectively. All snakebite victims received treatment by traditional healers or self-treatment at home and nobody went to a hospital. Incidence of snakebites, calculated on the basis of hospital records of 14 district hospitals and Savannakhet provincial hospital, ranged from 3 to 14 cases per 100,000 persons per year between 2012 and 2014.ConclusionIncidence of snakebites is high in rural communities in Laos with significant regional differences. Poverty most likely contributes significantly to the higher number of snakebites in Phin district. Hospital statistics profoundly underestimates snakebite incidence, because the majority of snakebite victims receive only treatment by traditional healers or self-treatment in their village. There is an urgent need to train medical staff and students in management of snakebite patients and make snake antivenom available to cope effectively with this important public health problem in order to prevent fatalities and disabilities.