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M A Miles

Publications and source records attributed to M A Miles.

At least 127 records · Page 7Linked to original sources

The ecology of Chagas disease in Chile.

Chagas disease probably affects over half a million people in Chile, principally in rural communities in the fertile valleys of the arid 'norte chico' region, north of Santiago. The main domestic vector is Triatoma infestans, but Triatoma spinolai, although mainly in rocky sylvatic and peridomestic ecotopes, also invades houses. Since the Spanish invasion in the sixteenth century, and particularly during the last 100 years, the endemic region has suffered an ecological breakdown, largely due to excessive timbering and over-grazing, which has led to a denuded landscape with severe loss of agricultural productivity. This breakdown, combined with uneconomically sized farms and poor marketing, exacerbates the poverty of the rural communities. As in other similar areas of Latin America, the combination of poverty and poor education discourages improvements in housing which would reduce the risk of vector-transmitted Chagas disease. This paper reviews the historical and ecological background of the endemic region of Chile, both as a basis for further work, and as a point of comparison with other endemic areas. The review attempts to show how the current status of Chagas disease is likely to be maintained through its association with poor quality housing, poverty and ecological degradation, drawing parallels with other endemic++ areas and suggesting ways by which the ecological damage might be reversed.

Agriculture↗

Do radically dissimilar Trypanosoma cruzi strains (zymodemes) cause Venezuelan and Brazilian forms of Chagas' disease?

316 isolates of Trypanosoma cruzi, the causative organism of Chagas' disease, were collected from three geographical areas: Venezuela, where Chagas' disease does not cause megacardia, megaoesophagus, and megacolon; the Brazilian Amazon basin, where T. cruzi is silvatic and human infection is rare; and central and eastern Brazil, where T. cruzi infection is commonly associated with "mega" syndromes. The distribution in these regions of three radically dissimilar enzymic strains or "zymodemes" of T. cruzi (Z1, Z2, and Z3) was compared. Endemic Chagas' disease in Venezuela ws predominantly due to T. cruzi Z1 and rarely to T. cruzi Z3. T. cruzi Z1 and Z3 also caused the sporadic cases of Chagas' disease in the Brazilian Amazon basin. A quite distinct T. cruzi zymodeme, Z2, not found in either Venezuela or the Amazon basin, was isolated from the vast majority of patients in central and eastern Brazil. These observations suggest that different aetiological agents might account for the difference between the Venezuelan and Brazilian forms of Chagas' disease.

Brazil↗

Chagas's disease in the Amazon Basin: Ii. The distribution of Trypanosoma cruzi zymodemes 1 and 3 in Pará State, north Brazil.

In Pará State, Brazil, 123 Trypanosoma cruzi stocks were isolated from 12 silvatic mammal species, five silvatic triatomine species and individuals with acute Chagas's disease. 100 T. cruzi stocks were identified as zymodeme (Z) 1, 17 as Z3 and 6 as Z3 with Z1 ASAT character, but none were T. cruzi Z2. Z1 was predominantly isolated from arboreal mammals, especially Didelphis marsupialis; Z3 was mainly found in terrestrial or burrowing mammals, particularly Dasypus novemcinctus and Monodelphis brevicaudata. It is not clear whether gene exchange occurs between the groups designated as zymodemes but the enzymic "distance" between T. cruzi Z1, Z2 and Z3, their different geographical distributions, host associations and local transmission cycles support the view that these zymodemes represent taxonomic units of fundamental epidemiological significance. T. cruzi (Z1) was isolated for the first time from the silky anteater (Cyclopes didactylus).

Animals↗

Leishmaniasis in Brazil: XV. Biochemical distinction of Leishmania mexicana amazonensis, L. braziliensis braziliensis and L. braziliensis guyanensis--aetiological agents of cutaneous leishmaniasis in the Amazon Basin of Brazil.

Enzymic profiles of the three known agents of human cutaneous leishmaniasis in the lower Amazon region are compared. Of 14 enzymes, 10 (ASAT, ALAT, GPI, G5PD, MDH, ACON, PEP, HK, MPI and ACP) differentiate Leishmania mexicana amazonensis from L. braziliensis braziliensis or L. braziliensis guyanensis: this supports their taxonomic status as distinct species. In contrast, only slight mobility differences of four enzymes (ASAT, ALAT, PGM, MPI) separate L. b. braziliensis and L. b. guyanensis, which are distinguished biochemically for the first time: this indicates that they are closely related. Four stocks of L. b. panamensis correspond with L. b. guyanensis on mobilities of 10 enzymes (ASAT, ALAT, PGM, GPI, G6PD, MDH, PK, HK, MPI, ACP), although these two subspecies are known to be separable by kinetoplast DNA buoyancies and the enzyme 6PGDH. The generation of practical, regional biochemical keys to the medically important leishmanias is discussed.

Animals↗

Leishmaniasis in Brazil: XVI. Isolation and identification of Leishmania species from sandflies, wild mammals and man in north Para State, with particular reference to L. braziliensis guyanensis causative agent of "pian-bois".

A total of 125 wild mammals (14 different species) were examined for evidence of infection with Leishmania in an area of primary forest highly endemic for "pian-bois", due to Leishmania braziliensis guyanensis, in north Pará State, Brazil. Parasites isolated were characterized biologically, and biochemically on enzymic profiles. L. b. guyanensis was isolated from the viscera of one lesser anteater (Tamandua tetradactyla) and one opossum (Didelphis marsupialis), and the skin of one rodent (Proechimys guyannensis). The isolates were indistinguishable from 10 others previously made from the sandfly vectors Lutzomyia umbratilis (five) and Lu. whitmani (five), and nine isolates from field-workers who became infected during these studies. Leishmania mexicana amazonensis was obtained from the skin of 21 animals, including three species of opossums (D. marsupialis, Philander opossum and Metachirus nudicaudatus) and two species of rodents (proechimys guyannensis and Dasyprocta sp.). A peripylarian Leishmania isolated from the viscera of two armadillos (Dasypus novemcinctus) was shown to be different, biologically and biochemically, from L. b. guyanensis and L. m. amazonensis. Four other isolates of Leishmania, from the rodents Rhipidomys leucodactylus (one) and P. guyannensis (three) have yet to be characterized owing to their very poor growth in both hamster skin and in vitro culture: they appear closest, however, to L. braziliensis braziliensis. The complexity of Amazonian leishmaniasis is discussed, and attention drawn to the importance of edentates as reservoir hosts of some leishmanias in the New World. Whereas L. mexicana subspecies appear largely restricted to the skin of their natural hosts, subspecies of L. braziliensis are commonly found in the viscera.

Animal Population Groups↗

The opossum, Didelphis marsupialis (Marsupialia: Didelphidae), as a reservoir host of Leishmania braziliensis guyanensis in the Amazon Basin of Brazil.

A total of 52 opossums (six species) were examined for evidence of infection with Leishmania in three different areas of forest near Manaus, Amazonas State, Brazil. No infections were detected in 27 opossums from a region of relatively undisturbed forest, including specimens of Didelphis marsupialis (18); Metachirus nudicaudatus (four); Monodelphis brevicaudata (one); Marmosa cinerea (two); M. murina (one) and M. parvidens (one). Of 15 D. marsupialis captured from a biological reserve, much disturbed by man, three were infected with L. braziliensis guyanensis: isolations were made from the skin of two of the animals, and from the viscera of the third. The isolates were biologically and biochemically indistinguishable from one isolate of L. b. guyanensis made from man and two from the sandfly vector Lutzomyia umbratilis from the same area. Two of eight D. marsupialis and both of two M. cinerea from another area of virgin forest used for army manoeuvres were infected with Leishmania mexicana amazonensis: the parasite was in all four cases isolated from normal skin. Five of nine specimens of Proechimys guyannensis, from the vicinity of Manaus, were also infected with L. m. amazonensis. A further 13 mammals (eight species) were negative for Leishmania. The importance of opossums as a reservoir of L. b. guyanensis is discussed. Although they may play only a minor role in virgin forest which is undisturbed by man, opossums (D. marsupialis) may become a significant reservoir of infection where man's activities have eliminated the major reservoir--which has yet to be incriminated.

Animals↗

Activated factor IX complex in treatment of surgical cases of hemophilia A with inhibitors.

Three patients with severe hemophilia A with inhibitors to factor VIII were treated with activated factor IX complex. Bleeding was controlled adequately during surgical procedures involving each of the three. Partial thromboplastin times showed a variable shortening and prothrombin times were significantly shortened to values less than normal. Hemostasis was substantiated by the use of epsilon aminocaproic acid. Neither anamnestic responses nor thrombotic complications were observed. A transient hypertension developed in two patients shortly after infusion with the activated factor IX complex.

Adult↗

Epidemiological aspects of three Trypanosoma cruzi zymodemes in Bahia State, Brazil.

Culture forms of 104 stocks of Trypanosoma cruzi isolated in different regions of the State of Bahia were compared by electrophoresis of six enzymes. The three distinct combinations of isoenzyme patterns seen were designated ZI, Z2 and Z3. In an area of endemic Chagas's disease in eastern Bahia, T. cruzi Z1 was associated with sylvatic mammals and sylvatic triatomines, whereas T. cruzi Z2 was associated with a separate domestic cycleof transmission. T. cruzi Z1 was also found in sylvatic triatomines from other parts of the State. In contrast, in an area of the São Francisco Valley region of western Bahia, both T. cruzi Z1 and Z2 were isolated from man, domestic animals, and peridomestic rats. T. cruzi Z3 was isolated from an armadillo and from Panstrongylus geniculatus, a triatomine commonly found in armadillo burrows. Both T. cruzi Z1 and Z2 appeared to be pathogenic in man: T. cruzi Z1 was isolated from patients with acute Chagas's disease and from a single patient with chronic cardiac manifestations. T. cruzi Z2 was isolated from some asymptomatic individuals but was also associated with acute disease and chronic cardiac and digestive syndromes.

Adult↗

Delimitation of Trypanosoma cruzi zymodemes by numerical taxonomy.

Based on the absence or presence of 24 isoenzyme characters, Brazilian Trypanosoma cruzi stocks can be separated by methods of numerical taxonomy into three principal, distinct groups; these groups correspond to the three T. cruzi zymodemes previously reported from north Brazil. A distinction is drawn between taxonomy, which may be of zoological interest only, and identification of medically important groups according to one or a few distinguishing characters.

Animals↗

Some methods for the enzymic characterization of Latin-American Leishmania with particular reference to Leishmania mexicana amazonensis and subspecies of Leishmania hertigi.

30 Brazilian stocks of Leishmania mexicana amazonensis and 13 stocks of subspecies of Leishmania hertigi were characterized by starch-gel electrophoresis, using 18 enzymes selected from a total of 36 investigated. L. m. amazonensis was separable from subspecies of L. hertigi by enzymic profiles of 11 enzymes. The L. m. amazonensis stocks, which were from a wide range of hosts in a large geographical area, were enzymically extremely homogeneous, and could only be subdivided on two enzymes; sub-groups did not relate to each other or to any differences in epidemiological characters, including the clinical form of the human disease. 12 stocks regarded as L. hertigi deanei, that were isolated from Coendou prehensilis prehensilis and Coendou sp. in Pará State, Brazil, were separable into two sub-groups by three enzymes. A single stock of L. hertigi hertigi from Panama was separable from both enzymic sub-groups of L. h. deanei, in each case by three enzymes. The significance of these and other characters of diversity is discussed, together with the use of enzymes for the identification of the leishmaniae.

Animals↗

Experimental Trypanosoma cruzi infection in rhesus monkeys 111. Electrocardiographic and histopathological findings.

In five rhesus monkeys surviving 'Peru strain' or 'strain 7' Trypanosoma cruzi infection for six to eight years, positive xenodiagnosis results and high indirect fluorescent antibody titres (4096 - 65536) persisted until the animals were killed. Abnormal electrocardiograph patterns in two monkeys (H and K) were possibly compatible with myocardial damage. Histopathological changes attributable to T. cruzi infection were minor in four monkeys but severe in one (R). In this animal, infected with what was judged previously to be the less virulent of the two T. cruzi stocks used ('strain 7'), there was severe myocarditis, with myofibre degeneration, and lesions of the oesophagus. Elevated serum levels of five enzymes were not detected in any of the chronically infected monkeys.

Animals↗

Chagas's Disease in the Amazon Basin: 1. Trypanosoma cruzi infections in silvatic mammals, triatomine bugs and man in the State of Pará, north Brazil.

A total of 1,197 wild animals from Pará State north Brazil, were examined for haematozoa. Trypanosoma cruzi-like parasites were found in 13 different species, and were particularly common in a variety of marsupials (Didelphidae), porcupines (Coendou spp.), armadillos (Dasypus novemcinctus) and coatimundis(Nasua nasua). Three human infections are reported, making a total of seven autochthonous cases of Chagas's disease from Pará since the first were described in 1969. A serological survey of 5,319 inhabitants from the Belém suburbs revealed 14 positive reactions with immunofluorescent antibody titres greater than 1:64, and 15 equivocal reactions at 1:16. No evidence was found of silvatic species of triatomine bugs (Hemiptera: Reduviidae) colonizing houses, but occasional infected specimens of Panstrongylus geniculatus and Rhodnius pictipes were found in suburban houses, near the forest. Human infection is considered to be silvatic in origin. Chagas's disease could become endemic in the Amazon Basin if silvatic triatomine bugs were able to adapt to a domestic habitat: the real danger, however, is in the possible importation of already domiciliated vector-species along the newly opened highways, from other endemic regions of Brazil. Other Trypanosoma species were recorded in a variety of wild animals. Haemogregarines were found in some marsupials and rodents, and piroplasms in marsupials and a single armadillo.

Adolescent↗

Biochemical characterization of some species of Trypansoma (Schizotrypanum) from bats (Microchiroptera).

Trypanosoma (Schizotryanum) species isolated from bats (Microchirotera) in Europe and Latin America were examined by determining the buoyant densities of their nuclear and kinetoplastic deoxyribonucleic acid (DNA) and the electrophoretic patterns of six isoenzymes. By these criteria they were separated into three distinct groups -- two from Europe (T. dionisii and T. vespertilionis) and one from America. T. dionisii was also separable by its morphology in vitro. Geographical location and DNA buoyant densities suggested that the American stocks were more closely related to T. cruzi than to the European species, though they differed from it marginally in kinetoplastic DNA density and in being noninfective to mice. Similar stocks studied by other workers have been shown to differ from T. cruzi also in reduced infectivity to, and lack of natural association with, Triatominae, and in antigenic composition. It is therefore proposed that trypanosomes of the subgenus Schizotryanum occuring naturally in Microchiroptera and differing from T. cruzi sensu stricto as outlined above should be treated as a distinct subspecies, T. cruzi marinkellei ssp. nov. T. cruzi sensu stricto thus becomes the nominate subspecies T. cruzi cruze Chagas 1909.

Alanine Transaminase↗