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Dominique A Vuitton

Publications and source records attributed to Dominique A Vuitton.

At least 19 recordsLinked to original sources
PubMed2006

A hospital-based retrospective survey of human cystic and alveolar echinococcosis in Ningxia Hui Autonomous Region, PR China.

A retrospective study of in-patient records for the period 1985-2001 collected from 11 hospitals in Ningxia Hui Autonomous Region (NHAR), China revealed a total of 2216 cases of echinococcosis. The survey showed that cystic echinococcosis (CE) occurs throughout NHAR but that human alveolar echinococcosis (AE) cases were only located in a confluence area of three counties, Xiji, Haiyuan and Guyuan. Incidence rates between counties within southern NHAR showed a highly heterogeneous distribution of cases, suggestive of different echinococcal transmission patterns. There was a significant difference in incidence between males and females, and farm labourers accounted for the majority of cases. Radical surgery with or without albendazole/mebendazole drug treatment was the major method of treatment for CE and repeat surgery was common; drug treatment alone was used mainly for AE. Epigastric pain was the main reason for patients seeking medical advice, the liver was the primary location of echinococcosis lesions and the majority of echinococcosis cases were diagnosed by ultrasound. Over a 12 year period, the average bed utilization rate in the Second Provincial Hospital of NHAR for patients with echinococcosis was 78% and echinococcosis cases accounted, on average, for 0.7% among the total hospital in-patients. Taking inflation into account, charges for echinococcosis hospitalization and treatment increased three-fold over the period 1994-2002. This study indicates that echinococcosisis is a significant public health problem in NHAR, especially in the south. The data from the hospital retrospective study are clearly underestimates and community surveys are required to determine the true echinococcosis prevalence levels, especially in the more remote areas of NHAR.

China↗
PubMed2006

Post-survey follow-up for human cystic echinococcosis in northwest China.

In Hobukesar, Xinjiang Uygur Autonomous Region, (China), a mass-screening programme for human cystic echinococcosis (CE)was performed during 1995 and 1996. After the survey 51 cases were followed-up using ultrasound scan and serology for 1-8 years(1996-2003). These included 20 CE cases treated by surgery (endocystectomy), four CE cases treated by percutaneous drainage(PAIR), six untreated CE cases, five ultrasound 'query' cases, eight cases of isolated hepatic calcifications, four previous CE surgery cases whose ultrasound was now normal, and four seropositive cases who exhibited a normal hepatic ultrasound. Follow-up results indicated that in the untreated CE patients, one case exhibited a spontaneous cure within 4 years, another case changed from a hepatic hydatid cyst that contained a floating laminated membrane (type CE3) to a cyst that contained daughter cysts (type CE2)within 1 year of follow-up. In the 20 surgically treated cases, two recurrent CE cases occurred within 4 years, and five cases had had residual cavities for more than 4 or 8 years. Of the 4 PAIR treated cases, two recurrent cases of CE occurred within 4 or 8 years of follow-up. Serological follow-up data showed that specific IgG antibody levels were persistently positive in most CE cases, but exhibited a decreasing tendency in cases that were effectively treated by surgery; In contrast, serum IgG levels in the PAIR group or in the recurrent CE cases after surgery exhibited an increasing tendency. At least one persistent seropositive case with an isolated hepatic calcification was considered to be abortive CE.

Albendazole↗
PubMed2006

Community surveys and risk factor analysis of human alveolar and cystic echinococcosis in Ningxia Hui Autonomous Region, China.

OBJECTIVE: To determine the true community prevalence of human cystic (CE) and alveolar (AE) echinococcosis (hydatid disease) in a highly endemic region in Ningxia Hui, China, by detecting asymptomatic cases. METHODS: Using hospital records and "AE-risk" landscape patterns we selected study communities predicted to be at risk of human echinococcosis in Guyuan, Longde and Xiji counties. We conducted community surveys of 4773 individuals from 26 villages in 2002 and 2003 using questionnaire analysis, ultrasound examination and serology. FINDINGS: Ultrasound and serology showed a range of prevalences for AE (0-8.1%; mean 2%) and CE (0-7.4%; mean 1.6%), with the highest prevalence in Xiji (2% for CE, 2.5% for AE). There were significant differences in the prevalence of CE, AE and total echinococcosis between the three counties and villages (with multiple degrees of freedom). While hospital records showed 96% of echinococcosis cases attributable to CE, our survey showed a higher prevalence of human AE (56%) compared to CE (44%). Questionnaire analysis revealed that key risk factors for infection were age and dog ownership for both CE and AE, and Hui ethnicity and being female for AE. Drinking well-water decreased the risk for both AE and CE. CONCLUSION: Echinococcosis continues to be a severe public health problem in this part of China because of unhygienic practices/habits and poor knowledge among the communities regarding this disease.

Adolescent↗
PubMed2006

Pasture types and Echinococcus multilocularis, Tibetan communities.

Our study showed that open pastures had more small mammal burrows than fenced pastures in Tibetan pastoralist communities in 2003. This characteristic was linked to a higher prevalence of Echinococcus multilocularis in dogs and indicates that pasture type may affect E. multilocularis transmission.

Animals↗
PubMed2006

Unique family clustering of human echinococcosis cases in a chinese community.

We have identified a significant focus and unusual clustering of human cases of cystic echinococcosis (CE) and alveolar echinococcosis (AE) in the village of Nanwan, Xiji County, Ningxia Hui Autonomous Region, in one of the most highly endemic areas for both diseases in China. The village, a Chinese Hui Islamic community, is composed of 167 members of four extended families. A total of 28 people died (12 of echinococcosis) since the village was first settled in the 1950s. Despite similar life patterns, the number of AE and CE cases occurring in each family was different. Overall, the prevalences of AE and CE were 9% (20 cases) and 5.9% (13 cases), with a combined prevalence of 14.9%. In contrast to CE, a comparison of the prevalence of AE indicated significant differences between the four family clusters. Although suggestive that host genotype might play a role in susceptibility to AE, this hypothesis requires further investigation.

Adolescent↗
PubMed2006

Socioeconomic and behavior risk factors of human alveolar echinococcosis in Tibetan communities in Sichuan, People's Republic of China.

Data from two cross-sectional investigations on 7,138 subjects were used to explore risk factors of human alveolar echinococcosis (AE) in Tibetan communities. The overall human AE prevalence was 3.1% (223 of 7,138), females had a higher prevalence (3.6%, 132 of 3,713) than males (2.7%, 91 of 3,425; P = 0.011), and herdsmen had a higher prevalence (5.2%, 154 of 2,955) than farmers (1.8%, 12 of 661; P < 0.001) and urban populations (2.1%, 49 of 2,360; P < 0.001). Age in all populations, number of dogs kept, fox skin ownership in farmers, not preventing flies from landing on food in herdsmen, using open streams as drinking water sources, and playing with dogs in urban populations were statistically significant risk factors. The results suggest that AE is highly endemic in the eastern Tibetan plateau, in Sichuan Province, the role of the dog is important for human infection, and other factors associated with environmental contamination may vary according to structure and practices of communities.

Adolescent↗
PubMed2005

Transmission ecology of Echinococcus multilocularis: what are the ranges of parasite stability among various host communities in China?

A striking feature of the transmission ecology of Echinococcus multilocularis in China is the diversity of hosts that contribute to the parasite cycle. Considering the population dynamics of key reservoir intermediate hosts and the ratio of their preferred habitat in a landscape (ROMPA) is essential to understanding transmission, but the numerous communities in which the parasite cycles and the extent of those communities is currently far from being fully documented. On the Tibetan plateau grassland management influences intermediate host species populations and the sheer size of the area could be a major contributing factor to sustaining transmission in the region. In Southern Gansu and Southern Ningxia the processes of deforestation have temporarily provided optimal habitat for key reservoir intermediate hosts of E. multilocularis, resulting in high transmission and human disease, however currently the parasite may be extinct locally. Faced with this pattern of potentially transient transmission in a diversity of communities the question of the dispersal potential of the parasite arises. The reforestation program currently active across much of Western China has the potential to give rise to a massive increase in habitat favourable to suitable intermediate hosts and emergence or re-emergence of the zoonosis alveolar echinococcosis in many areas. This potential epidemic could be mitigated by both natural and human induced parasite dispersal mechanisms including fox migration and the sale of infected dogs originating from stable endemic foci on the Tibetan plateau. However, currently the degree of genetic exchange between discrete transmission foci is unknown and it is expected that genetic techniques could provide crucial information regarding this important question.

Animals↗
PubMed2005

WHO classification of alveolar echinococcosis: principles and application.

Alveolar echinococcosis is caused by the larval stage of the fox tapeworm (Echinococcus multilocularis) and is frequently diagnosed as a space occupying lesion in the liver. The growth pattern resembles that of a malignant tumor with infiltration throughout the liver, spreading into neighbouring organs and metastases formation in distant organs. Thus, one of the prevailing differential diagnoses is liver cancer. Guided by the Tumor-Node-Metastasis (TNM) system of liver cancer, the European Network for Concerted Surveillance of Alveolar Echinococcosis and the WHO Informal Working Group on Echinococcosis proposed a clinical classification for alveolar echinococcosis. It was designated as PNM system (P = parasitic mass in the liver, N = involvement of neighbouring organs, and M = metastasis). As for TNM in oncology, single PNM categories were combined into four stages, I to IV. The system was developed by a retrospective analysis of 97 patients' records from two treatment centers (Besançon/France and Ulm/Germany). Recently, this WHO classification was applied to 222 patients in 4 clinical centers around the world (Besançon/France, n = 26; Urumqi/China, n = 46; Sapporo/Japan, n = 58; and Ulm/Germany, n = 92). All patients could be classified who had been diagnosed in the period from January 1998 to June 2005. The stage grouping indicated center differences, but appeared to segregate patients according to various treatment regimens. The WHO classification not only serves as a tool for the international standardization of disease manifestation but also aids to evaluate the outcome of a chosen diagnostic and treatment procedure in different treatment centers in Europe and Asia.

Animals↗
PubMed2005

Simultaneous alveolar and cystic echinococcosis of the liver.

Alveolar echinococcosis (AE) and cystic echinococcosis (CE), caused by infection with the larval stages of Echinococcus multilocularis and E. granulosus, respectively, are of major clinical importance. Reports of infection with AE or CE are very common, but instances of simultaneous or dual infection are rare. We report on four cases with mixed AE/CE infections in the liver, diagnosed using retrospective surgical records and active community surveys in southern Ningxia Hui Autonomous Region (NHAR), PR China, a recognized hyperendemic area for echinococcosis.

Adolescent↗
PubMed2004

Echinococcosis and allergy.

The larval stages of Echinococcus granulosus and E. multilocularis are involved in parasitic diseases in humans: cystic echinococcosis (CE) ("hydatid disease") and alveolar echinococcosis (AE), respectively. Both diseases and parasites have tight links with allergy because of the immunological characteristics that contribute to maintain the larvae in their human host as well as their potential in inducing clinical anaphylactic reactions in some patients. Clinical observations in patients and data obtained from mass screenings in various countries have identified both forms of echinococcosis as "polar diseases," i.e., diseases where immunological background of the patients was related to the clinical presentation and course. In particular, abortive cases (i.e., spontaneous cures) have been found in many subjects in endemic areas. On the other hand, immune suppression was associated with severe disease. AE especially might be considered as an opportunistic infection. Experimental and clinical studies have shown that Th1-related immune response was associated with protection and Th2-related response was associated with parasite growth. Genetic characteristics of the host are related to both occurrence and severity of AE and are associated with the extent of IL-10 secretion, which is a major feature of chronic progressing echinococcosis. Anaphylactic reactions, including urticaria, edema, respiratory symptoms, and anaphylactic shock due to spontaneous or provoked rupture of the parasitic cyst, are well known in CE. Anaphylactic reactions in AE are far less frequent, and have been observed in rare cases at time of metastatic dissemination of the parasitic lesions. Echinococcus-specific IgE is present in most of the patients and associated with severity. Specific histamine release by circulating basophils stimulated with E. granulosus antigens is present in all patients with CE and AE. Echinococcus allergens include (1) AgB 12-kDa subunit, a protease inhibitor and a potent Th2 inducer; (2) Ag5, a serine protease; (3) EA 21, a specific cyclophilin, with a homology with other types of cyclophilins; (4) Eg EF-1 beta/delta an elongation factor, with a homology with Strongyloides stercoralis EF that shares the same IgE epitope. A clinical cross-reaction with Thiomucase, a mucopolysaccharidase used in arthritis treatment, has recently been published. However, despite the potential risk of allergic reactions, the dogma "never puncture a hydatid cyst" is no longer valid. International experience of therapeutic technique of "puncture, aspiration, injection, re-aspiration" of hydatid cysts developed at the beginning of the 1980s has proved to be successful in a variety of selected indications that have been reviewed by WHO recommendations. A better understanding of the immunological background of echinococcosis in humans has led to new therapeutic developments, such as immunomodulation using interferon alpha. Th2-driven immunological response and IL-10-related tolerance state are common characteristics of atopic allergy and echinococcosis. The example of echinococcosis stresses the ambiguous links that exist between parasitic and allergic diseases, and show the usefulness of comparing these diseases to better understand how immune deviation may lead to pathological events and to find new therapeutic and.or preventive agents.

Anaphylaxis↗
PubMed2004

Fenced pasture: a possible risk factor for human alveolar echinococcosis in Tibetan pastoralist communities of Sichuan, China.

Alveolar echinococcosis, infection caused by the parasitic helminth Echinococcus multilocularis, is a zoonosis strongly linked to climatic and ecological factors. Cross-sectional survey data were used to test a hypothesis that partial fencing of pastures could promote alveolar echinococcosis transmission in semi-nomadic pastoral communities of the Tibetan plateau, PR China. Using multiple stepwise logistic regression with consideration of factors of age and gender, it was shown that partial fencing around the settlements in winter pasture was significantly and independently associated with the risk of human alveolar echinococcosis in the surveyed villages (P = 0.021). The underlying reason may lie in overgrazing, an assumed cause of population outbreaks of small mammal intermediate hosts of the parasite on the Tibetan plateau. Overgrazing may have been exacerbated by the reduction of communal pastures nearby the settlements due to introduction of partial fencing around group tenure pastures acquired by Tibetan pastoralist families.

Adolescent↗
PubMed2004

Molecular cloning, expression, and serological evaluation of an 8-kilodalton subunit of antigen B from Echinococcus multilocularis.

Full-length cDNA and genomic DNA encoding an 8-kDa subunit of antigen B from Echinococcus multilocularis (designated EmAgB8/1) were isolated from an E. multilocularis metacestode cDNA library and a protoscolex genomic DNA library, respectively. The open reading frame of the cDNA clone encodes a polypeptide comprising 85 amino acids with a 20-amino-acid NH(2)-terminal signal sequence, which was confirmed following N-terminal sequencing of the native antigen. Reverse transcription-PCR analysis revealed that the clone encoding EmAgB8/1 is predominantly transcribed in larval E. multilocularis. The gene consists of two exons (encoding the signal sequence and mature protein) separated by a 91-bp intron. The mature form was expressed in Escherichia coli, and its antigenic reactivity was compared with that of a counterpart, an 8-kDa subunit of antigen B from Echinococcus granulosus (EgAgB8/1) by Western blotting and enzyme-linked immunosorbent assay (ELISA) with serum samples from patients confirmed to have cystic echinococcosis (CE) and alveolar echinococcosis (AE). Recombinant EmAgB8/1 showed positive reactions in Western blots with 81.3% (65 of 80) of serum samples from CE patients and 40.6% (26 of 64) of serum samples from AE patients, while recombinant EgAgB8/1 showed positive reactions with 86% (43 of 50) and 42% (19 of 45) of the serum samples from these CE and AE patients, respectively. By the ELISA, both EmAgB8/1 and EgAgB8/1 exhibited similar positive reactions with 88% (44 of 50) of serum samples from CE patients and 37.8% (17 of 45) serum samples from AE patients. Statistical analysis revealed that the sensitivity of EmAgB8/1 was comparable to that of EgAgB8/1 for the serodiagnosis of echinococcal diseases. There was no cross-reaction with sera from patients with cysticercosis, which often cross-react when native antigens are used for serodiagnosis.

Amino Acid Sequence↗
PubMed2003

Control of echinococcosis and cysticercosis: a public health challenge to international cooperation in China.

Echinococcosis, both cystic and alveolar, and Taenia solium cysticercosis are the most serious zoonotic cestodoses worldwide. Because of the emerging importance of these diseases in China, several international workshops and meetings were held in this country from 1998 to 2001. Based on round table discussions in Chengdu 2000, the proposal of a strategy to control echinococcosis and cysticercosis has been prepared in China. It includes a comprehensive approach based on a careful analysis of the local situations (particularly concerning the particularities of the cycle, ecology, and ethology of the animal hosts, and behavioral characteristics of the population at risk), the use of newly developed tools both in animals and human (immunology, molecular biology, and imaging), and the association of the traditional control measures (control of slaughtering, antiparasitic treatment and control of the definitive hosts, and health education) with more recent developments such as vaccination of the intermediate hosts. Plans on for the control of echinococcosis and cysticercosis in China are summarized.

Animals↗
PubMed2003

IFN alpha-2a protects mice against a helminth infection of the liver and modulates immune responses.

BACKGROUND & AIMS: Hepatic alveolar echinococcosis (AE), caused by the larval growth of Echinococcus multilocularis, is one of the most lethal helminthic diseases with no satisfactory treatment. Advances in the understanding of the host's immune response (Th2 responses associated with a progressive form of AE), have driven the research towards immune stimulation as an alternative possibility to treat patients. We previously reported clinical stabilization associated with a shift from a Th2 to a Th1 cytokine profile in an AE patient treated with interferon (IFN)alpha. METHODS: The effects of recombinant IFN alpha-2a were analyzed in the susceptible C57BL/6J E. multilocularis infected mice. Parasitic burden, macrophage functions, and specific T-cell responses were studied 15, 45, and 90 days postinfection. RESULTS: After 90 days postinfection, 75% of infected IFN alpha-2a-treated mice had no hepatic lesions and half were fully protected. IFN alpha-2a treatment markedly decreased the abnormally elevated production of IL-10 in both spleen cell cultures and peritoneal macrophage cultures from infected mice and restored phagocytosis and oxidative metabolism of macrophages. It also inhibited IL-6 and IL-13 antigen-induced secretions in spleen cell cultures. CONCLUSIONS: Through its immunoregulatory properties, IFN alpha-2a may be effective in a helminthic liver infection and is a promising candidate for clinical application in AE.

Animals↗
PubMed2003

European echinococcosis registry: human alveolar echinococcosis, Europe, 1982-2000.

Surveillance for alveolar echinococcosis in central Europe was initiated in 1998. On a voluntary basis, 559 patients were reported to the registry. Most cases originated from rural communities in regions from eastern France to western Austria; single cases were reported far away from the disease-"endemic" zone throughout central Europe. Of 210 patients, 61.4% were involved in vocational or part-time farming, gardening, forestry, or hunting. Patients were diagnosed at a mean age of 52.5 years; 78% had symptoms. Alveolar echinococcosis primarily manifested as a liver disease. Of the 559 patients, 190 (34%) were already affected by spread of the parasitic larval tissue. Of 408 (73%) patients alive in 2000, 4.9% were cured. The increasing prevalence of Echinococcus multilocularis in foxes in rural and urban areas of central Europe and the occurrence of cases outside the alveolar echinococcosis-endemic regions suggest that this disease deserves increased attention.

Adolescent↗
PubMed2002

Evaluation of an enzyme-linked immunosorbent assay (ELISA) with affinity-purified Em18 and an ELISA with recombinant Em18 for differential diagnosis of alveolar echinococcosis: results of a blind test.

Alveolar echinococcosis (AE) is the most potentially lethal parasitic zoonosis of the nontropical areas in the northern hemisphere, where cystic echinococcosis (CE) is also endemic. Both AE and CE are highly endemic in China, and both serologic detection of echinococcosis, either AE or CE, and differentiation of AE from CE are crucial problems. Evaluation of Western blot analysis (WB) and enzyme-linked immunosorbent assay (ELISA) for the Em18 antigen, using affinity-purified and recombinant Em18, was carried out "blindly" using 60 human sera from patients diagnosed in France. The results were compared with those obtained using a commercially available Echinococcus WB immunoglobulin G (IgG) kit developed in France. The Em18 WB and Echinococcus WB IgG showed very similar results for detection of AE. Both affinity-purified Em18 or a recombinant Em18 WB and Echinococcus WB IgG seem useful for identification of AE, and the latter seems appropriate for both AE and CE, whereas affinity-purified Em18 ELISA and the newly developed recombinant Em18 ELISA appear to be suitable for detection of AE, especially for epidemiological surveys.

Animals↗