Detection of high rates of in-village transmission of Leishmania donovani in eastern Sudan.
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Animals↗
Biomedical subjects
M M Hassan
Publications and source records attributed to M M Hassan.
Factors affecting variations in exposure to infections by Leishmania donovani in eastern Sudan.
A cross-sectional survey was carried out in Gedaref state, eastern Sudan to investigate the prevalence of positive leishmanin skin tests and environmental factors related to Leishmania donovani infection. A total of 3835 people living in 11 villages in 3 regions were screened. Soil types and tree densities were determined in 33 villages inhabited by 44 different tribes. The highest rates of positive skin tests were in Rahad region (33.9%), Atbara (21.6%) and Gedaref (10.6%), with an average of 21.1% for the state. Risk of infection by L. donovani varied significantly between different tribes. Higher densities of Acacia and Balanites spp. trees were in Masaleet villages, suggesting that the relatively high risk of L. donovani exposure in this tribe is due to environmental factors.
Acacia↗
IgG isotypes in schistosomiasis patients before and after praziquantel.
This work evaluated circulating anti-SWAP IgG1 and IgG4 in patients with active S. mansoni infection before and after PZQ and its correlation to clinical, laboratory and sonographic data. The main complaints was abdominal discomfort, pain, tensmus and bleeding per rectum, which progressive decreased after PZQ. The anti-SWAP IgGI and IgG4 were significantly higher in patients than controls. A progressive significant decrease in the level of circulating anti-SWAP IgG1 after treatment, a decrease of IgG4 three months after treatment and a decrease in the egg count after therapy. But, no significant difference in IgG1 or IgG4 was noticed between male and female patients before and after treatment. No significant difference in IgGI or IgG4 in patients having GIT manifestation and organomegalic patients and/or asymptomatic patient. No significant difference in lgG1 or IgG4 between patients with grade (o), graele (I) and grade (II) periportal fibrosis. The sensitivity of ELISA IgGI was 73.3% and specificity was 80% while ELISA IgG4 was 80%. Enlarged liver and/or spleen, periportal fibrosis, and dilated P.V detected by ultrasonography were more among patients than controls. There was no significant difference in hematological parameters and liver function tests between patients and control groups. So, ELISA is sensitive and specific for IgG1 and IgG4. Anti-SWAP IgG1 and IgG4 is useful means in diagnosis and cure, as well as significant reduction of anti-SWAP IgG1 and IgG4 after treatment. Anti-SWAP IgG1 and IgG4 are parameter for evaluating cure. Follow up of anti-schistosomal IgG1 and IgG4 is useful for assessment of treatment
Animals↗
The Egyptian mongoose, Herpestes ichneumon, is a possible reservoir host of visceral leishmaniasis in eastern Sudan.
Investigations were made on possible reservoir hosts of Leishmania donovani in 2 zoonotic foci of visceral leishmaniasis (VL) in Dinder National Park (DNP) and the peri-domestic habitats of adjacent villages of eastern Sudan. Animals were captured, in November 1997-1998 and April-May 1999 and examined for L. donovani infection using light microscopy and 2 sensitive Polymerase Chain Reaction (PCR) systems. Microscopy and PCR investigations were also used to determine the infection rates of L. donovani in Phlebotomus orientalis captured from the uninhabited site of DNP. Infections of L. donovani were detected in 2 out of 14 Egyptian mongooses (Herpestes ichneumon), 1 out of 168 Arviconthus niloticus and 1 out of 8 Mastomys natalensis. Samples from 68 other animals captured from the study area were all negative for the infection. Active zoonotic transmission of L. donovani at the time of animal sampling in the uninhabited site of DNP was demonstrated by finding the parasite in 3.4% (7 out of 184) and 3.2% (5 out of 157) of flies collected in March 1998 and May 1999, respectively. We suggest that the Egyptian mongoose is a possible reservoir host of L. donovani. The importance of other animals in maintaining the infection is also discussed.
Animals↗
The role of hepatitis C in hepatocellular carcinoma: a case control study among Egyptian patients.
BACKGROUND: Egypt has one of the highest prevalence rates of hepatitis C virus (HCV) infection in the world; however, the risk and attribution related to HCV in Egyptian patients with hepatocellular carcinoma (HCC) remains unknown. GOALS: The current study was undertaken to estimate the risk of HCC in relation to HCV in Egypt. STUDY: Thirty-three patients with HCC and 35 healthy controls who had a similar socioeconomic status were prospectively enrolled at the University of Cairo National Cancer Institute. RESULTS: Anti-HCV antibodies were present in 75.8% of the patients and in 42.9% of the controls (p = 0.01); hepatitis B surface antigen (HBsAg) was present in 15.2% of the patients and in 2.9% of the controls (p = 0.03). In addition, the sex-and age-adjusted odds ratio (OR) for anti-HCV antibodies was 5.1 (95% CI = 1.5-17.4) and for HBsAg was 13.2 (95% CI = 1.2-148.2). Concurrent Schistosoma mansoni and anti-HCV was associated with an OR of 10.3 (95% CI = 1.3-79.8), which was higher than that for anti-HCV (6.5; 95% CI = 1.6-26.6) and S. mansoni infection (0.2; 95% CI = 0.1-6.2) alone. Finally, we estimated the attributable fraction of HCC to HCV to be 64% in this study population and 48% in the general Egyptian population. CONCLUSIONS: Both HCV and hepatitis B virus infection increase the risk of HCC in Egyptian patients, whereas isolated Schistosoma infection does not. Because of the very high prevalence rate of HCV in the general Egyptian population, it accounts for most HCC cases in Egypt.
Adult↗
Declining trend of rheumatic fever observed in Bangladesh, 1991-1997.
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Bangladesh↗
Reference value of immunoglobulins in healthy school children of Bangladesh.
The reference value of immunoglobulins (Igs) should be known for a population concerned because it is influenced by many clinical and local conditions. As yet the reference value of the Igs have not been determined in Bangladeshi children. This study determined the reference value of Igs in apparently healthy 261 rural Bangladeshi primary school children (aged 5 to 14 years, mean 9.3 years). IgG, IgM and IgA were determined by an auto-analyzer. The mean (standard deviation) value of IgG was 1728 (344) mg/dl. The corresponding values for IgM and IgA were 200 (88) and 163 (63) mg/dl, respectively. The 95% reference value calculation in all subjects showed that the range for IgG was 1103 to 2524, IgM was 92 to 390, and IgA was 72 to 325 mg/dl. These values could be used to evaluate Ig status in children with a variety of clinical conditions.
Adolescent↗
Validity and reliability for the Bruininks-Oseretsky Test of Motor Proficiency-Short Form as applied in the United Arab Emirates culture.
Validity and reliability of the Bruininks-Oseretsky Test of Motor Proficiency-Short Form were examined through factor analysis, differences in motor proficiency among age groups, and internal consistency. The sample was comprised of 194 children (96 boys and 98 girls) of ages 6 to 11 years. A principal factor analysis solution with varimax rotation produced four factors: Gross and Fine Motor Skills, Eye-Hand Coordination, Balance-Coordination and Speed, and Visual-motor Coordination. The loadings of these factors partially supported the theoretical work of Bruininks. Univariate analysis of variance showed significant differences between age groups either for each single item or for the total score. Correlation coefficients between single-item and total short form were all significant, although some values were relatively small. These results provided positive support for the construction and reliability of the test.
Child↗
Circulating filarial antigens for monitoring the efficacy of ivermectin in treatment of filariasis.
Seventy-three asymptomatic bancroftian filariasis patients with positive microfilaria in their blood films were included. The patients were randomly divided into 2 groups: ivermectin group (50 cases) given 2 doses each of 100 ug/kg body weight, 3 months apart, and 23 cases had 2 doses of placebo. The study was run blindly for one year. The initial mean microfilaria (MF) count was 111/ml. At 3 months after ivermectin therapy, mean MF became 7.8/ml and 24% of ivermectin treated cases had no detectable MF (P <0.05). At 6, 9 and 12 months, the mean MF count became 4.1, 6.5 and 11/ml with amicrofilaria in 54%, 42% and 40% of treated cases respectively (P <0.05). On the other hand, no statistically significant change in the mean MF count in placebo group was detected. The routine laboratory investigations were unchanged or slightly improved at 3 and 6 months. Side effects after the first dose of ivermectin were mild fever in 16% and weakness in 20%. None was recorded after the second dose. Circulating filarial antigens could be detected in 66% of cases before treatment, as all cases with high microfilaremia had positive antigenemia. The mean antigen level started to decline significantly after 9 months post treatment. At the end of the study (one-year), all negative microfilaremic cases had negative antigen levels, indicating that detection of antigen in-patients sera is a very good indicator of cure and efficacy of the drug.
Adolescent↗
Phase II trial of cisplatin, interferon alpha-2b, doxorubicin, and 5-fluorouracil for biliary tract cancer.
The aim of this study was to test the efficacy of a chemotherapy combination of cisplatin, IFN alpha-2b, doxorubicin, Adriamycin, and 5-fluorouracil (PIAF) as treatment for radiologically measurable cancer of the biliary tree. Forty-one patients (19 gallbladder carcinoma and 22 cholangiocarcinoma) with unresectable, histologically confirmed adenocarcinoma were registered. Starting chemotherapy doses were as follows: cisplatin, 80 mg/m(2) i.v. over 2 h; doxorubicin, 40 mg/m(2) i.v. over 2 h; and 5-fluorouracil, 500 mg/m(2) by continuous infusion daily for 3 days. IFN alpha-2b (5 x 10(6) units/m(2)) was administered s.c. before the cisplatin and daily thereafter for a total of four doses. The overall response rate was 21.1% [95% confidence interval (CI), 10-37]. For cholangiocarcinoma and gallbladder carcinoma patients, the response rates were 9.5% (95% CI, 1-32%) and 35.3% (95% CI, 14-62%), respectively. Overall median survival time was 14 months (95% CI, 9.5-18.5), 18.1 months (95% CI, 12.1-24.1) for the cholangiocarcinoma patients, and 11.5 months (95% CI, 5.9-17.1) for the gallbladder carcinoma patients. This difference was not statistically significant. The most common grade III and IV toxicities were neutropenia (41%), thrombocytopenia (20%), nausea and vomiting (34%), and fatigue (20%). In conclusion, the PIAF combination seemed more active against gallbladder carcinoma than against cholangiocarcinoma but was associated with significant toxicity. Therefore, this regimen cannot be recommended for cholangiocarcinoma, but it may have a role in the treatment of gallbladder carcinoma, particularly among patients who were refractory to higher priority investigational agents.
Adult↗
Evaluation of circulating Fasciola antigens in specific diagnosis of fascioliasis.
Ninety-eight individuals were included in this study, 60 of them were passing Fasciola eggs, 20 were infected with other parasites but not Fasciola (infected control group) and 18 individuals were free from parasite infection (normal control group). Circulating Fasciola antigens (CFAg) and anti-Fasciola IgG were estimated by ELISA technique among all groups. Highly significant increased level of CFAg was observed among Fasciola-infected cases when compared with normal control group. The percentage positivity of CFAg was 95% among Fasciola-infected cases. Solid specificity was observed by the test. Moreover, a highly significant increase in the antigen level was detected among moderately infected patients compared with lightly infected group. The level of CFAg was significantly higher in the hepatomegalic cases than those without organomegaly. Anti-Fasciola IgG antibodies were detected in only 35% of Fasciola infected cases, which indicates much lower sensitivity of the antibody detection than antigens. No correlation between the level of the circulating antibodies and either the intensity of infection or the clinical presentations was observed.
Adult↗
Durable clinical response of refractory hepatocellular carcinoma to orally administered thalidomide.
Thalidomide, a sedative agent previously associated with severe fetal malformations, has anti-angiogenic activity. We describe the antitumor effects of thalidomide in a patient with hepatocellular carcinoma that was refractory to systemic and intraarterial therapy.
Administration, Oral↗
Different cytokines profiles in spleen cells and liver granuloma of Schistosoma mansoni experimentally infected mice during disease development.
To determine the importance of Th1 and Th2 cells in modulating granuloma formation, mRNA transcripts for Th1 (IL-2 and IFN-gamma) and Th2 (IL-4 and IL-5) cytokines were assessed by the molecular technique of in situ hybridization in the liver granuloma. The molecular studies showed few number of cells expressing mRNA transcripts for INF-gamma whereas, considerable number of IL-2 cells were present in the liver granuloma at 6 weeks post-infection (p.i.). Complete disappearance of IFN-gamma expressing cells were found when the disease progressed to 13 weeks p.i. Conversely, very high number of cells expressing mRNA transcripts for IL-4 and fair number of IL-5 cells were present at 7 weeks p.i. with a peak level of IL-4 cells at 13 weeks p.i. These in situ molecular studies of the liver tissues, demonstrated that Th1 cells were present at the very early granuloma development. Moreover, Th2 cells were required for its full development. The main interesting finding was the number of cells expressing mRNA for IL-4, as they were very huge and it might exceed the total number of lymphocytes per se in the granuloma. Lymphocytes from experimentally infected mice-spleen cells were also cultured in vitro with S. mansoni soluble egg antigen (SEA) and the same cytokines of lymphocyte supernatant were measured by ELISA assay. The levels of IFN-gamma and IL-2 were high to 6 wk. p.i. with a slight decline of IFN-gamma, and increasing amount of IL-2 at 10-13 wk p.i. Spleen lymphocytes of fully formed granuloma secreted high levels of IL-4 and IL-5. The results suggest that the development of schistosome egg-induced liver granuloma is a complex process and both Th1 and Th2 cell subsets sharing with other inflammatory cells (non lymphocytes), may play an important role in regulating and modulating the immuno-pathology of granuloma formation and the subsequent hepatic fibrosis.
Animals↗
Anti-fasciola IgG isotypes among patients with fascioliasis before and after treatment.
Stool examination using modified Kato thick smear method was performed to detect Fasciola eggs and other parasites. Abdominal pain was the major presenting symptom (83.3%) followed by pallor (71.6%) and fever (16.7%). Anaemia and hepatomegaly were recorded in 70% of patients compared to 25% with splenomegaly. Abdominal ultrasonography revealed hepatomegaly and common bile duct dilatation in 70% of patients. Moreover, 6 cases showed Olympic game rings which is diagnostic. All of patients had positive IgG4 levels, 58 cases were found positive for specific total IgG and IgG1, whereas, only 36 cases had positive IgG2 levels (60%). All negative control group showed no cross reactions. On the other hand, ELISA detecting IgG4 showed the highest specificity (95%), followed by IgG2 (85%) and the least specific test was obtained with detection of IgG (70%) and IgG1 (65%). One week after treatment, 90% of patients were completely cured. One and 3 months after treatment, the cure rate was 83.3%. In completely cured patients, none of anti-Fasciola isotypes was significantly changed.
Adolescent↗
Colchicine therapy for hepatic murine schistosomal fibrosis: image analysis and serological study.
Colchicine in a dose of 200 micrograms kg body weight/day (5 days/week) was administered to groups of Schistosoma mansoni infected mice 12 weeks post infection, either alone or following previous praziquantel therapy at the 8th week of infection. Certain groups received colchicine for 6 weeks and others received it for 10 weeks. Colchicine alone did not significantly change the light microscopic appearance of schistosomal liver fibrosis, or hepatic collagen content estimated histomorphometrically, and did not reduce the elevated IL-2 serum level. Colchicine induced hepatic injury consisted of intense inflammatory reaction in granuloma and portal tracts, hepatocytic degeneration, and elevation of serum AST and ALT levels. Colchicine seemed to postpone granulomatous reaction healing and collagen deposition rather than inhibiting collagen formation or degrading it. Colchicine inhibited proliferation of hepatocytes of infected mice by expanding G2-M phases of cell cycle, thus reduced Ag NOR count and raised cell ploidy and cyclic AMP serum level. Subsidence of schistosomal infection by praziquantel prior to colchicine therapy greatly reduced inflammatory cellular reaction, significantly diminished hepatic collagen deposition and serum IL-2 level, minimized the elevated nuclear ploidy and cyclic AMP serum level that followed colchicine therapy when administered alone.
Animals↗
Host feeding of mosquitoes (Diptera: Culicidae) associated with the recurrence of Rift Valley fever in Egypt.
In 1993, Rift Valley fever (RVF) virus reappeared in Egypt. We determined the prevalence and feeding patterns of mosquitoes in 5 villages where the virus was active. Of 10 species recovered, Aedes caspius (Pallas), Culex pipiens L., Cx. antennatus (Becker), and Cx. perexiguus Theobald constituted 99% of > 35,000 mosquitoes captured in dry ice-baited CDC light traps. Ae. caspius was most prevalent, except at Nag' El Hagar where it was replaced by Cx. perexiguus. Cx. pipiens ranked 2nd, except at Nag' El Ghuneimiya, where it was replaced by Cx. antennatus. Most blood meals analyzed by an enzyme-linked immunosorbent assay reacted to > or = 1 antiserum. Cx. pipiens was mainly anthropophagic, and therefore may have been the main vector of RVF virus among humans. Ae. caspius feeds were chiefly from humans, bovines, and equines. Cx. antennatus and Cx. perexiguus fed generally on bovines. Mixed blood meals from humans and RVF virus susceptible animals were identified in the predominant mosquitoes. Prevalence and host selection, as well as predicted probability for a blood meal being interrupted, indicated that Ae. caspius may have served as a bridge vector between humans and bovines in 4 of the villages. Cx. perexiguus may have played this role at Nag' El Hagar. Because potential vectors are abundant, susceptible domestic animals are associated closely with humans, and surveillance of imported livestock is not systematic, we conclude that RVF virus sporadically will recur in Egypt.
Aedes↗
Differences in spatial visualization as a function of scores on hemisphericity of mathematics teachers.
59 teachers of mathematics were administered the Your Style of Learning and Thinking-Form A and categorized as showing Left (n = 13), Right (n = 12), or Integrated (n = 15) hemisphericity. Rotations scores on the Purdue Spatial Visualization Test were not statistically significant among the three groups.
Brain↗
Relationship between circulating antigen level and morbidity in Schistosoma mansoni-infected children evaluated by ultrasonography.
Ninety-eight Schistosoma mansoni-infected children from an endemic area in Sharkia Governorate, Egypt were evaluated by abdominal ultrasonography to determine liver and spleen sizes, grade of periportal fibrosis, and splenic vein diameter. Circulating antigen levels were measured using a double sandwich ELISA in which the sensitivity was 91.8% and specificity was > 99%, with no evidence of cross-reactivity with other parasites. No significant relationship was observed between antigen level and clinical stages of the disease as assessed by physical examination (P > 0.05). When ultrasound was used to stage disease, the mean antigen level was significantly higher among hepatosplenic cases than intestinal cases (P < 0.05). No difference in mean antigen levels were found between the splenic and hepatic cases. Furthermore, a direct correlation (P < 0.01) was observed between antigen level and disease severity as monitored by ultrasonography. Antigen level showed a positive correlation with the degree of periportal fibrosis (P < 0.05). Moreover, a significant increase in the percent of children who were antigen positive (> 80 ng/ml) was found in those with more severe periportal fibrosis (P < 0.001). The findings suggest that ultrasonography along with measurement of circulating antigen levels predict morbidity in schistosomiasis mansoni.
Adolescent↗