Effect of toxoplasma co-inefected with intestinal helminthes on cell mediated immunity to tuberculosis patients

The effect of intestinal helminthes [IH] and Toxoplasma gondii [Tox] coinfection on anti-mycobacterium tuberculosis [MTB] immunity in patients with active pulmonary tuberculosis was studied in 96 patients of 4 groups. Thirteen patients had TB+IH+Tox [Gl], 15 had TB+IH [G2], 21 had TB+Tox [G3] and 47 had TB [G4]. The mean diameter of tuberculin and toxoplasmin tests was measured to assess cell mediated immunity. Anti-Toxoplasma IgG[1] and IgG[4] antibodies were sought in toxoplasmic patients by EL1SA for Thelper[1] [Th[1]] and Th[2] cytokine responses respectively. All patients were treated by 6 months anti-MTB therapy. Specific anti-IH therapies were given for patients with concomitant IH. Sputum examination for acid fast bacilli was done 2 weeks post-treatment and duration of sputum clearance was recorded. The results showed that IH co-infection had significant negative effect on mean diameter of tuberculin test compared to.G4 [5.87 +/- 0.08 vs 8.65 +/- 0.05mm; P < 0.01]. Concurrent Tox with TB significantly increased tuberculin test mean diameter [10.89 +/- 0.11 vs 8.65 +/- 0.05mm; P < 0.05]. Mean level of anti-Tox IgG[1] among G3 was significantly higher than in Gl [0.88 +/- 0.05vs0.55 +/- 0.02; P < 0.001], but vice versa was with IgG[4]. Mean tuberculin diameter increased significantly post-treatment in all Gs except G3. Anti-Tox IgG[1] showed significant increase [0.55 +/- 10.02 to 0.82 +/- 0.03; P < 0.001] but IgG[4] showed significant decrease [0.62 +/- 0.07 to 0.45 +/- 0.06, P < 0.01] post-treatment in Gl, but G3 was insignificantly affected. The duration of sputum clearance was significantly longer in patients with IH co-infection compared to G4 [29 +/- 1 vs 21.8 +/- 4.6, days p < 0.001]

Bancroftian filariasis: Clinical parasitologic and serologic evaluation after 4 years appling two antifilarial regimens

In August 1997, 124 individuals out of 1110 were selected as being seropositive for circulating filarial antigen OG4C3 [CFA]. Ten healthy children proven negative for CFA were used as controls. The patients were classified into: G1 [28 patients, 20 asymptomatic microfilaremic [MF] and eight symptomatic amicrofilaremic [AMF]], G2 [80 patients, 22 asymptomatic MF, 48 asymptomatic AMF and 10 symptomatic AMF] and G3 [16 asymptomatic AMF]. G1 was treated by a single annual dose of diethyl carbamazine [DEC] [6 mg/kg], G2 by a single annual dose of albendazole 400 mg and DEC [6 mg/kg] and G3 remained untreated. Four years later [2001], patients were reevaluated. Microfilaremia prevalence in MF patients was lowered to 20% [G1] and 9.1% [G2]. Antigenemia prevalence was lowered to 46.4%, 17.5% and 87.5% in the three groups, respectively. The disease became manifested among the asymptomatic in 5% [G1], 10% [G2] and 25% [G3]. The four years lowered the prevalence of microfilaremia, but it was not sufficient for its elimination from the blood

Diagnosis of early prepatent schistosomiasis by cystatin capture enzyme-linked immunosorbent assay

To test the efficacy of detecting anti-Schistosoma mansoni cysteine proteinase antibodies [CP Abs] by cystatin capture [CC] ELISA in the diagnosis of prepatent schistosomiasis [before egg passing], 253 schistosome negative individuals were selected and divided into two groups. The first comprised 118 children whose first water contact occurred in March and April 1999 [primarily infected] and the second included 135 individuals previously treated for schistosomiasis [re- infected]. All the individuals were followed up tri weekly by stool for detecting schistosome eggs and by serological tests for detecting antibodies against CP and anti-soluble egg antigens [SEA] by ELISA technique. CP seropositivity was detected in 92 from all the examined individuals, 38 out of them were primarily infected [PI] children and the rest [54] were re-infected patients. Anti-SEA IgM Abs were sought in 92 CP seropositive sera and seropositivity rate was lower in 38 PI children than 54 re-infected individuals. The anti-SEA seropositivity rate in PI children was 5% in pre-patent and 94.4% in post-patent. None of the 161 CP seronegative individuals passed eggs up to 12 weeks

Role of oxyuriasis in maintenance of urinary tract infection among female children

With the fact that oxyuriasis is frequent in early childhood and that renal scarring due to urinary tract infection almost always occurs before puberty, this study investigated 451 female children [4-9 years] with urinary tract infection to assess the role of oxyuriasis in inducing and maintaining UTI among them. Oxyuris infection was detected among 242 girls by perianal adhesive tape technique. Specific antioxyuris and antimicrobial therapy was applied empirically as a first line treatment, however 42 girls [9.3%] showed recurrence of UTI, 21 of them were oxyuris re-infected. The recurrence of UTI was represented by 18 relapses detected within 7 days and 24 reinfections detected after two weeks post treatment. After culture isolation and sensitivity testing, second line specific antimicrobial therapy was applied togehter with antioxyuris therapy. After second line therapy, oxyuris infection was detected in 15 cases out of 19 reinfections [78.9%] and in 4 out of 13 relapses [30.7%], these 32 girls were subjected to intravenous urography [IVU] to detect renal scarring or anatomical abnormalities of the urinary tract, voiding cystourethrogram [VCUG] to detect vesicoureteral reflux [VUR] and to serum IgA assay. The study emphasized the significant role of vesicoureteral reflux in developing renal scarring. However the striking finding was that persistent oxyuriasis among IgA deficient girls in the absence of reflux was as significant as the reflux in developing UTI attributed renal scarring. So the study considered these young girls with combined persistent oxyuriasis and IgA deficiency being under high risk of developing UTI, renal scarring and later in life end stage renal failure. The oxyuris induced perianal pruritis should alert the parents for early detection and treatment of UTI and oxyuriasis especially in view of the high prevalence of asymptomatic IgA deficiency [1:500] together with the nonspecificity of the symptoms of UTI in childhood