Prevalence of intestinal parasite among patients attending two hospitals in French Guiana: A 6-year retrospective study

IntroductionIntestinal parasitic diseases are a global health problem. Due to its equatorial climate, vast territory with isolated areas and the precariousness of its population, intestinal parasitosis is considered to be a major issue in French Guiana but only few data are available and these mainly focus on specific population. We aimed at determining the parasitic index and at describing the characteristics of these infections in order to develop preventive strategies.Material and methodsWe retrospectively analysed all the parasitological samples recorded in the register of the two main laboratories of French Guiana between 2011 and 2016. The parasitic index was the percentage of parasitised patients in comparison with the total number of subjects studied. A patient who underwent several positive parasitological examinations was considered only once in the analysis at the time of the first sampling.ResultsA total of 15,220 parasitological samples of 9,555 patients were analysed and 2,916 were positive in 1,521 patients. The average infestation rate and parasitic index were 19.2% and 16.0%, respectively. The parasitic index remained stable between 2011 (18.2%) and 2016 (18.3%). The patients were mainly men (66.4%), with a median age of 33.0 years (26.3% of patients were under 18 years of age) and lived mainly in the Central Agglomeration (48.2%) and in West Guiana (37.4%). Hookworms were the most common parasite (25.2%) followed by Entamoeba coli (13.3%), Strongyloides stercoralis (10.9%) and Giardia intestinalis (10.8%). Among the infected patients, 31.0% presented mixed infections and 67.5% of them had at least one pathogenic parasite. The patients aged from 0 to 18 years presented significantly more polyparasitism (30.9%) than monoparasitism (24.3%, p<0.001). Ancylostoma sp and Strongyloides stercoralis were mainly diagnosed during the rainy season (59.5% and 64.7% respectively), in men (78.6% and 81.1% respectively) and in patients aged from 18 to 65 years (86.6% and 76.6% respectively) whereas, Giardia intestinalis infected mostly children under 5 years (59.5%) of age.ConclusionAlthough it may not be representative of the entire Guyanese population, the parasitic index remained high and stable from 2011 and 2016 and it justifies the need for an active prevention program as it was already done in the other French overseas departments such as Martinique and Guadeloupe.     

Location and density labelling of acid invertase in aging discs of Daucus carota storage tissue

Cell walls prepared from aged discs by extraction in 0·1 M acetate buffer, pH 4·8, possess ionically bound acid invertase which can be removed from the wall by incubation in 1 M sodium chloride in 0·1 M acetate buffer, pH 4·8, and more firmly attached enzyme which is not removed. Cell walls prepared in 0·195 M phosphate-0·003 M citrate-buffer, pH 8·0, do not possess ionically bound enzyme. Ionically bound invertase is density labelled when discs are aged in 90% deuterium oxide suggesting that at least part of the increase in activity observed during aging is due to de novo protein synthesis.     

A small RNA controls a protein regulator involved in antibiotic resistance in Staphylococcus aureus

The emergence of Staphylococcus aureus strains that are resistant to glycopeptides has led to alarming scenarios where serious staphylococcal infections cannot be treated. The bacterium expresses many small regulatory RNAs (sRNAs) that have unknown biological functions for the most part. Here we show that an S. aureus sRNA, SprX (alias RsaOR), shapes bacterial resistance to glycopeptides, the invaluable treatments for Methicillin-resistant staphylococcal infections. Modifying SprX expression levels influences Vancomycin and Teicoplanin glycopeptide resistance. Comparative proteomic studies have identified that SprX specifically downregulates stage V sporulation protein G, SpoVG. SpoVG is produced from the yabJ-spoVG operon and contributes to S. aureus glycopeptide resistance. SprX negatively regulates SpoVG expression by direct antisense pairings at the internal translation initiation signals of the second operon gene, without modifying bicistronic mRNA expression levels or affecting YabJ translation. The SprX and yabJ-spoVG mRNA domains involved in the interaction have been identified, highlighting the importance of a CU-rich loop of SprX in the control of SpoVG expression. We have shown that SpoVG might not be the unique SprX target involved in the glycopeptide resistance and demonstrated that the regulation of glycopeptide sensitivity involves the CU-rich domain of SprX. Here we report the case of a sRNA influencing antibiotic resistance of a major human pathogen.     

The Effect of Three-Monthly Albendazole Treatment on Malarial Parasitemia and Allergy: A Household-Based Cluster-Randomized,Double-Blind,Placebo-Controlled Trial

Background

Helminth infections are proposed to have immunomodulatory activities affecting health outcomes either detrimentally or beneficially. We evaluated the effects of albendazole treatment, every three months for 21 months, on STH, malarial parasitemia and allergy.

Methods and Findings

A household-based cluster-randomized, double-blind, placebo-controlled trial was conducted in an area in Indonesia endemic for STH. Using computer-aided block randomization, 481 households (2022 subjects) and 473 households (1982 subjects) were assigned to receive placebo and albendazole, respectively, every three months. The treatment code was concealed from trial investigators and participants. Malarial parasitemia and malaria-like symptoms were assessed in participants older than four years of age while skin prick test (SPT) to allergens as well as reported symptoms of allergy in children aged 5–15 years. The general impact of treatment on STH prevalence and body mass index (BMI) was evaluated. Primary outcomes were prevalence of malarial parasitemia and SPT to any allergen. Analysis was by intention to treat. At 9 and 21 months post-treatment 80.8% and 80.1% of the study subjects were retained, respectively. The intensive treatment regiment resulted in a reduction in the prevalence of STH by 48% in albendazole and 9% in placebo group. Albendazole treatment led to a transient increase in malarial parasitemia at 6 months post treatment (OR 4.16(1.35–12.80)) and no statistically significant increase in SPT reactivity (OR 1.18(0.74–1.86) at 9 months or 1.37 (0.93–2.01) 21 months). No effect of anthelminthic treatment was found on BMI, reported malaria-like- and allergy symptoms. No adverse effects were reported.

Conclusions

The study indicates that intensive community treatment of 3 monthly albendazole administration for 21 months over two years leads to a reduction in STH. This degree of reduction appears safe without any increased risk of malaria or allergies.

Trial Registration

Controlled-Trials.com ISRCTN83830814     

Gastrointestinal disseminated histoplasmosis in HIV-infected patients: A descriptive and comparative study

Disseminated histoplasmosis is one the main AIDS-defining opportunistic infections in HIV-infected patients, notably in Latin America. The non-specific and proteiform clinical presentation leads to diagnostic delays that may lead to fatal outcomes. This retrospective multicentric study aimed to describe the frequency and manifestations of gastrointestinal histoplasmosis in French Guiana, and to compare patients with disseminated histoplasmosis with or without gastrointestinal involvement.Between January 1, 1981 and October 1, 2014 co-infections with HIV and histoplasmosis were enrolled. Inclusion criteria were: age >18 years, confirmed HIV infection; first proven episode of histoplasmosis.Among 349 cases of disseminated histoplasmosis, 245 (70%) had a gastrointestinal presentation. Half of patients with gastrointestinal signs had abdominal pain or diarrhea, mostly watery. Half of patients with abdominal pain had diarrhea (63/124) and half of those with diarrhea (63/123) had abdominal pain. A significant proportion of patients also had hepatomegaly and, to a lesser degree, splenomegaly. After adjusting for potential confounding, the presence of lymphadenopathies >2cm (AOR = 0.2, IC95 = 0.04–0.7, P = 0.01), Haitian origin (AOR = 0.04, IC95 = 0.004–0.4, P = 0.006) were associated with a lower prevalence of gastrointestinal signs and positive gastrointestinal presence of H. capsulatum. Persons with a gastrointestinal H. capsulatum were more likely to have a decreased prothrombin time, lower ferritin, lower liver enzymes, and lower concentrations of LDH than those without gastrointestinal signs and symptoms. They also had a shorter interval between symptoms onset and diagnosis. Patients with a positive gastrointestinal identification of H. capsulatum were less likely to die at 1 month than those without a gastrointestinal presentation (respectively, 4.6% vs 18.5%, P = 0.01).Subacute or chronic gastrointestinal presentations are very frequent during disseminated histoplasmosis, they seem less severe, and should lead to suspect the diagnosis in endemic areas. There were populational or geographic differences in the frequency of gastrointestinal manifestations that could not be explained.     

Regional differences in prostaglandin E2 and nitric oxide production in the knee meniscus in response to dynamic compression

Injury or loss of the knee meniscus is associated with altered joint stresses that lead to progressive joint degeneration. The goal of this study was to determine if dynamic mechanical compression influences the production of inflammatory mediators by meniscal cells. Dynamic compression increased prostaglandin E2 (PGE(2)) and nitric oxide (NO) production over a range of stress magnitudes (0.0125-0.5 MPa) in a manner that depended on stress magnitude and zone of tissue origin. Inner zone explants showed greater increases in PGE(2) and NO production as compared to outer zone explants. Meniscal tissue expressed NOS2 and NOS3 protein, but not NOS1. Mechanically induced NO production was blocked by NOS inhibitors, and the non-selective NOS inhibitor L-NMMA augmented PGE(2) production in the outer zone only. These findings suggest that the meniscus may serve as an intra-articular source of pro-inflammatory mediators, and that alterations in the magnitude or distribution of joint loading could significantly influence the production of these mediators in vivo.