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Theoretical and empirical issues in benefit identification, measurement and valuation related to parasitic disease control in poor countries.

Considerable resources have been allocated over the years to parasitic disease eradication or control, e.g. malaria and schistosomiasis. Decision-makers in recent years have increasingly appealed to economists seeking an economic justification in order to continue or renew support for such programmatic efforts. Often economists when facing such an analytical task have employed benefit-cost or cost-effectiveness analytical techniques. This paper reviews the theoretical and empirical rationale employed in the conduct of such studies, focusing particularly on the benefits or impact indicators used. The review identifies many problems encountered in identifying benefits, and then measuring and valuing them.

Communicable Disease Control↗

[Dynamics of intestinal parasitic diseases in a students' hospital].

The present study, carried out in 1972-1975, extends, previous investigations on the dynamics of parasitic intestinal diseases. A number of 2723 Romanian and foreign students admitted to a students' hospital were investigated, finding 402 positive cases. Blood eosinophilia was likewis determined in 227 of these cases. There was a 3% decrease in the incidence of parasitic diseases, more marked among the foreign students. The most frequently encountered parasite was Tricocephalus; lambliasis showed a slight increase. The importance of coproparasitologic and haematologic examinations for the prevention, detection and treatment of parasitic diseases in the community investigated is emphasized.

Humans↗

A mixed program for parasitic disease control.

In this paper we are concerned with the control of a parasitic disease by a permanent, time-continuous mixed program of vector reduction (reduction of the contact rate) and drug application. We shall use the model developed in [1] with two control functions: one for the reduction of the contact rate and another for the administration of drugs to the population. This model takes into account the possibility that there may by a certain fraction of the population which cannot be covered by any drug application. Optimal control policies for reduction of the contact rate and for the protected proportion of the population by drugs are derived by using Pontryagin's maximum principle. A cost-optimal strategy is deduced for the maintenance of the affected proportion of the population below a given level. Some numerical examples are computed.

Humans↗

History of human parasitic diseases.

Humans are afflicted by a number of diseases caused by parasitic protozoa and helminth worms. The first records of these ancient associations come from studies on archeologic material and the writings of the Greek, Egyptian, and Roman empires but it was not until the theory of spontaneous generation had been disproved in the nineteenth century that it became possible to incriminate parasites in the etiologies of a number of diseases that had hitherto been enigmatic. The golden age of parasitology was the nineteenth century when most of the life cycles of parasites were accurately described for the first time. The history of parasitology is not yet complete and new diseases are still being discovered.

History, 15th Century↗

[Parasite prevalence in schools with different socioeconomic status and evaluation of methods for diagnosing intestinal parasitic diseases].

In this study; the parasite prevalence of schools with different socio-economical status and three methods for diagnosing intestinal parasitosis were evaluated. Children from two primary schools and one junior high school with different socio-economical status participated in the study. The three method used for diagnosing parasitosis in this study were direct wet mounts, concentrated saline flotation technique, and zinc sulfate centrifugal flotation method. Parasitosis was found in 69 fecal samples (18%). The distribution of the parasites found were Hymenolepis nana (29%), Ascaris lumbricoides (26%), Enterobius vermicularis (23%), Trichirus trichiura (18%), taenia saginata (4%). The parasite prevalence in schools with low and high socioeconomical status differed significantly (27% vs. 5% respectively). Combined methods were superior to single methods. The combined method of direct wet mounts and zinc sulfate centrifugal flotation was the most sensitive method (diagnosis rate 90%). But we think that the combined method of direct wet mounts and concentrated saline flotation technique is a simpler method with almost equal results (86%).

Adolescent↗

Immunization against parasitic diseases of fish.

Parasitologists have not, in the past, exploited the immune system to protect fish against parasitic diseases. In the past few years, however, there has been an increased interest in adopting this strategy, and we have made steady and promising progress against a few parasites which are of economic importance. Amyloodinium ocellatum is an ectoparasitic dinoflagellate on brackish and marine fishes, which may also cause problems to aquarium fishes. Antiserum from fish inoculated intraperitoneally (i.p.) with living dinospores of the parasite immobilizes and agglutinates living dinospores; it also reduces parasite infectivity in cell culture. Cryptobia salmositica is a pathogenic haemoflagellate of salmonids on the Pacific coast of North America, causing mortality in semi-natural and intensive salmon culture facilities. A live attenuated vaccine inoculated i.p. protects susceptible juvenile and adult fish for at least 24 months. The protection involves production of complement fixing antibodies, phagocytosis, and antibody-dependent and antibody-independent T-cell cytotoxicity. A monoclonal antibody against a surface membrane glycoprotein (199-200 kDa is therapeutic in that it significantly reduces parasitaemias when inoculated into fish with acute disease. Ichthyophthirius multifiliis is an ectoparasitic ciliate of freshwater fishes with world wide distribution, usually causing disease when fish are stressed and/or when environmental conditions are favourable for parasite multiplication. Live theronts injected into the body cavity protect fish, and monoclonal antibodies with immobilizing activity upon parasites have been developed. There is some evidence of passive transfer of protective immunity from immune to naive fish, and to eggs. Diplostomum spathaceum is an intestinal parasite of gulls; the metacercaria stage of the parasite encyst and causes disease and mortality in numerous species of freshwater fish in Europe and in North America. Fish injected i.p. with sonicated/killed cercariae or metacercariae have fewer metacercariae in the eyes and survives longer. Lepeophtheirus salmonis and Caligus elongatus are parasitic copepods (sea lice), and they are important parasites of Atlantic salmon in cage cultures. A vaccine against fish lice is plausible, and the efficacy of about 20 candidate antigens in protecting fish is being tested.

Animals↗

Immune responses in parasitic diseases. Part A: general concepts.

Parasitic infections are incredibly varied and distinct in terms of interactions between hosts and pathogens as well as in complexity of life cycle, host range, vector or intermediary host requirements, forms of reproduction, and elicited response. A number of protozoan parasites are intracellular pathogens capable of surviving and multiplying within microbicidal cells such as macrophages. In contrast, nematodes generally do not multiply within the host, a trait that dramatically alters the epidemiologic, clinical, and immunologic consequences of infection. Parasites have acquired apparently effective mechanisms for escape from normal host defenses and clearance. These mechanisms may be classified as antigenic mimicry, antigenic depletion, antigenic variation, immunologic indifference, immunologic diversion, and immunologic subversion. A determination of the importance and relevance of these subterfuges to parasitic infection in humans and to therapeutic or prophylactic strategies is of the utmost urgency.

Animals↗

[Forgotten parasitic diseases].

The ecological flexibility of parasitic systems is observed in parasites, such as pentastomas of Linguatula serrata and Armillifer sp., cestodes of Spirometra erinacei europaei, and dirofilariae of D. repens, D. immitis, D. ursi in relation to ecological shifts in the areas and anthropological pressure.

Animals↗

Signs and symptoms of parasitic diseases.

This article reviewed the parasitic signs and symptoms most likely to be seen in the office setting. Particular attention has been given to the endemic parasites. The physician will be called upon increasingly to recognize the often subtle and seemingly unrelated symptom complex. Nowhere else in the animal kingdom has the need for species survival taken a more complex and imaginative route, and it will be the primary care physician who will have first chance at the diagnosis and treatment. The long history of successful parasitic adaptations and the variety of body sites infected in man provide a challenging context for the office-based physician trying to make a clinical diagnosis.

Humans↗

Lack of molluscan host diversity and the transmission of an emerging parasitic disease in Bolivia.

Fasciolosis is a re-emerging parasitic disease that affects an increasing number of people in developing countries. The most severe endemic affects the Bolivian Altiplano, where the liver fluke (Fasciola hepatica) and its hermaphroditic snail host, Lymnaea truncatula, have been introduced from Europe. To achieve a better understanding of the epidemiological situation and the consequences of the colonization event of this invasive species, genetic analysis of Bolivian snail populations was needed. Here we compare the genetic diversity and population structure of snail samples from the Bolivian Altiplano with samples from the Old World at six polymorphic microsatellite loci. Whereas some variability exists in the snail populations from the Old World, we observe only a single genotype of L. truncatula in the Bolivian Altiplano. We discuss the possible explanations for such a reduction in genetic variability, and, given the high natural parasitism pressures exerted on the snail populations, we discuss the relevance of this result for host-parasite interactions.

Animals↗