Assessment of coverage and compliance of mass drug administration for lymphatic filariasis in Medak District-2021

In India Mass Drug Administration (MDA) drive is undertaken every year. In mass drug administra?on DEC and Albendazole combina?on is used. For the strategy to be effec?ve, more than 85% of those living in endemic areas must be covered by MDA. Methods: This is a cross-sec?onal study in which family clusters were selected from rural and urban areas. Informa?on about coverage, compliance with MDA and knowledge of filariasis was obtained using a ques?onnaire. Data were analysed using percentages and propor?ons. Results: In this study, about 92.51% of the study par?cipants received DEC and ABZ tablets during MDA, of which 95.14 % of par?cipants consumed the drugs. The most common cause of noncompliance was fear of side effects. Conclusion: Coverage of the popula?on with DEC and albendazole combina?on was good but compliance needs to be improved. IEC ac?vi?es should be intensified. Local leaders should be involved in the programme to increase compliance.

Diethylcarbamazine citrate-fortified salt for lymphatic filariasis elimination in India

Lymphatic filariasis (LF) is a vector-borne neglected tropical disease, causing permanent disability. The disease is debilitating and widespread, leading to tremendous productivity and economic loss. The Government of India (GOI) prioritized the elimination of LF through the annual mass drug administration (MDA) programme in 2004 and continued with a single dose of diethylcarbamazine citrate (DEC), 6 mg/kg of body weight, plus albendazole annually over a period of 5-6 years. The GOI had set the target to achieve LF elimination by 2015 and now by 2030. The progress so far has been suboptimal. Much remains to be done as about 84 per cent of the total 328 endemic districts are still under MDA. The major challenge in implementing MDA is poor compliance. It is necessary to have a feasible alternative strategy addressing the above challenge to achieve the desired goal of LF elimination. At this juncture, a well-researched approach, i.e. the use of DEC-fortified salt, also advocated by the World Health Organization, as a unique form of MDA, is proposed. As per this strategy, a low dose of DEC (0.2% w/w) is added to the cooking salt at the manufacturing facility of iodized salt and consumed by the LF-endemic communities for about two years. Many examples of successful use of this strategy for LF elimination in small- and large-scale trials have been documented in India and several other endemic countries in the world. Implementing DEC–iodine-fortified salt is a safe, less expensive, more efficient and prompt approach for achieving the elimination of LF in India. Adverse effects are none or minor and self-limiting. The DEC-fortified salt strategy can easily piggyback on the existing countrywide deployment of iodized salt under the National Iodine Deficiency Disorders Control Programme (NIDDCP), which has achieved a great success in reducing iodine-deficiency disorders such as hypothyroidism. This existing robust programme can be leveraged to launch DEC-fortified salt for the community. If implemented appropriately, this strategy will ensure the complete cessation of LF transmission within two years from its introduction. If the said strategy is implemented in 2022, it is expected that India will be able to achieve the LF elimination by 2024, much before the global target of 2030.

Caracterização de Escherichia coli diarreiogênica isolada de água subterrânea para consumo humano em um assentamento rural / Characterization of diarrheagenic Escherichia coli isolated from underground water for human consumption in a rural settlement

Escherichia coli diarreiogênica (DEC) é um importante agente de infecções gastrointestinais transmitidas pela água. O trabalho teve como objetivo avaliar a qualidade microbiológica e físicoquímica de 58 amostras de água subterrânea in natura para consumo de um assentamento rural e caracterizar os isolados de E. coli, genotipicamente dentro dos patotipos de DEC, pela técnica da PCR, e fenotipicamente. Todas as amostras apresentaram contaminação por coliformes totais e 36 (62,1%) por E. coli. Em células HEp-2, dos 170 isolados de E. coli, 106 (62,36%) apresentaram AA, 15 (8,82%) AD, 17 (10%) adesão não caracterizado e 32 (18,82%) foram não aderentes. Quanto à formação de biofilme, 126 (74,12%) cepas são formadoras, e 44 (25,88%) não formaram biofilme. Foram identificadas DEC em 6,89% das amostras de água: três (5,17%) ETEC e uma (1,72%) EAEC. EAEC apresentou AA e as três cepas de ETEC apresentaram AD, AA e não definida. Todas as DEC foram formadoras de biofilme. Dois isolados de ETEC apresentaram resistência à ampicilina e tetraciclina, uma ETEC à aminoglicosídeos, e EAEC foi sensível a todos os antibióticos testados. As ETEC foram classificadas no filogrupo B1 e a EAEC no E. Os sorotipos encontrados foram: O24:H21, OR:H21, O17:H46 e O6:H12. Todas as amostras estavam dentro dos parâmetros normais de flúor e 13 (22,4%) apresentaram resultados acima do padrão permitido de turbidez. A presença de E. coli e DEC nas amostras de água indica a necessidade de adoção de medidas que evitem a contaminação da água fornecida à população, evitando, assim, a transmissão de doenças.(AU)

Diarrheogenic Escherichia coli (DEC) is an important agent of waterborne gastrointestinal infections. The objective of this work was to evaluate the microbiological and physico-chemical quality of 58 freshwater groundwater samples for the consumption of a rural settlement and to characterize the E. coli isolates, genotyped within the DEC pathophyses, by the PCR technique, and phenotypically. All water samples presented contamination with total coliforms, and 36 (62.1%) with E. coli. In HEp-2 cells, of 170 E. coli isolates, 106 (62.36%) showed AA, 15 (8.82%) AD, 17 (10%) noncharacterized adhesion and 32 (18.82%) were non-adherent. As for biofilm formation, 126 (74.12%) strains are forming, and 44 (25.88%) did not form biofilm. DEC was identified in 6.89% of the water samples with E. coli: three (5.17%) with enterotoxigenic E. coli (ETEC), and one (1.72%) with enteroaggregative E. coli (EAEC). EAEC showed aggregative adherence, whereas various ETEC strains presented diffuse, aggregative, and non-defined adherence. All DEC strains were biofilm forming. Two isolates of ETEC showed resistance to ampicillin and tetracycline, and one isolate showed resistance to aminoglycosides. The EAEC isolate was sensitive to all antibiotics tested. All ETECs were classified into phylogenetic B1 and EAEC in E. The serotypes identified in our study were: O24:H21, ONT:H21, O17:H46, and O6:H12. All water samples were within normal fluorine parameters; however, measured turbidity was above the permitted standard in 13 (22.4%) samples. The presence of E. coli and DEC in water samples indicates the need to take action to prevent contamination of water resources accessed by people to prevent the transmission of diseases.(AU)

Chemical constituents from n-butanol parts of Lycii Cortex / 中草药

Objective: To study the chemical constituents from n-butanol-souluble part of Lycii Cortex (the root bark of Lycium chinense). Methods: The air-dried Lycii Cortex were powdered and extracted with 70% ethanol under reflux. After the removal of solvent under reduced pressure, the crude extract was extracted with petroleum ether, ethyl acetate and n-butanol successively. The compounds were isolated and purified by silica gel, Sephadex LH-20, ODS and semi-prepared high performance liquid chromatography from the n-butanol part of Lycii Cortex. The structures were identified by nuclear magnetic spectrometry, mass spectrometry and other spectral analyses. Results: Ten compounds were isolated from n-butanol parts of Lycii Cortex and characterized as (1'S,2R,5S,10R)-2-(1',2'-dihydroxy-1'-methylethyl)-6,10-dimethylspiro [4,5] dec-6-en-8-one 2'-O-β-D- glucopyranoside (1), (1'R,2R,5S,10R)-2-(1',2'-dihydroxy-1'-methylethyl)-6,10-dimethylspiro [4,5] dec-6-en-8-one 2'-O-β-D- glucopyranoside (2), (1R,6R,9S)-6,9,11-trihydroxy-4,7-megastigmadien-3-one 11-O-β-D-glucopyranoside (3), vanillic acid-4-O-β- D-glucopyranoside (4), 3,4-dihydroxyphenylpropionic acid (5), 3,4-dihydroxybenzenepropionic acid methyl ester (6), glucosyringic acid (7), dihydrophaseic acid 3'-O-β-D-glucopyranoside (8), isoscoploletin-β-D-glucoside (9) and fabiatrin (10). Conclusion: Compound 3 is isolated from Solanaceae family for the first time and compounds 1, 2 and 4 are isolated from Lycium genus for the first time. The NMR data of compound 2 is first reported as well.

Establishment of delay eyeblink conditioned reflex and the acquisition rule in cynomolgus monkey / 中华行为医学与脑科学杂志

Objective To investigate the method of establishing a model of delay eyeblink condi-tioning ( DEC) in no surgical cynomolgus monkey and analyze the related acquisition rule.Methods Using the special monkey chairs to fix 6 adult male cynomolgus monkeys,they were sitting on the chairs and keep-ing awake,and heads could rotate freely during the whole training session.In the experiment,the 6 monkeys were trained in DEC with a tone (500 ms,85 dB) as the conditioned stimulus (CS),paired with a corneal oxygen-puff (100 ms,5 psi) as the unconditioned stimulus (US).There were 120 trials per-session,and 2 sessions per-day.During the experiments,an infrared emitter/detector attached to spectacles for eyeblink re-cording,the data of conditioned response ( CR) and startle response ( SR) were analyzed offline.Result-s Among the 6 cynomolgus monkeys,4 of them completed all of the training process of DEC and 3 monkeys had successful acquisition of DEC.The average CR rate in the last training session reached ( 64.67 ± 2.00)%,(P<0.01);1 monkey only showed a high acquisition rate( 85.00%) at the first training session, and the low CR rate in the next training sessions with the average rate of 18.16%,suggesting that the DEC model was failed to established.The SR rates in 4 cynomolgus monkeys were low with average rate of 5.47%. Conclusion Although the DEC behavior training of the cynomolgus monkey is easy to be influenced by many inside or outside factors,DEC can be obtained under the condition of non surgery and proper braking.

Evaluation of coverage and compliance of elimination of lymphatic filariasis by mass drug administration campaign in Gulbarga and Yadgiri districts of Karnataka state.

Background: Lymphatic filariasis (LF) is a mosquito-borne parasitic infection that occurs in many countries in the Globe including India. Single dose once yearly mass administration of Diethylcarbamazine citrate (DEC) 6 mg/Kg and Albendazole 400 mg to all inhabitants of filariasis endemic areas excluding children <2 years, pregnant women and seriously ill patients is the recommended strategy for elimination of LF. The mass drug administration (MDA) campaigns are carried out by the Health Departments through door to door distribution of DEC and Albendazole tablets by drug distributing teams. The objective of this study was to evaluate the coverage, compliance, effective coverage and coverage compliance gap of MDA campaigns in Gulbarga and Yadgiri districts during the 10th and 11th MDA campaigns respectively. Methods: Cross sectional population based house to house visit. Outcomes were assessed as actual coverage, compliance and effective coverage in percentages and proportions. Results: 320 households from 8 clusters in 2 districts were covered. Among the 1653 eligible population the coverage rate is 93.42% in Gulbarga and 74.12% in Yadgiri district with inter cluster variation. The compliance rate is 86.35% in Gulbarga and 75.78% in Yadgiri district. The effective coverage rate is 80.67% in Gulbarga district and 56.17% in Yadgiri district. The coverage compliance gap is 13.65% in Gulbarga district and 24.22% in Yadgiri district. Conclusions: The effective coverage in both Gulbarga and Yadgiri districts is below the target (<85%) which is essential for progression towards elimination of LF. Side effects after drug consumption were minimal.

Role of transcription factor DEC1 in the initiation and progression of malignant tumors / 中国药科大学学报

DEC1 is a basic helix-loop-helix(bHLH)transcription factor involved in the regulation of cell prolif-eration;cell differentiation;lymphocytes maturation;circadian rhythms;immune response and response to hypoxia.Recent studies have revealed that the expression of DEC1 is abnormally high in various tumor tissues and cells.In addition;the expression of DEC1 in the tumor tissue is related to the malignancy of various cancer types.This paper;therefore;focuses on the relationship between DEC1 and proliferation;apoptosis;cellular senes-cence;invasion and metastasis of tumor cells;in order to elaborate the role of DEC1 in the pathogenesis and pro-gression of tumor.

Effect of DEC1 gene over-expression on proliferation and invasion abili-ties of human esophageal cancer ECA109 cells / 中国病理生理杂志

[ ABSTRACT] AIM:To investigate the effect of DEC1 gene over-expression on the proliferation and invasion abili-ties of human esophageal cancer ECA109 cells.METHODS: ECA109 cells were transfected with plasmid pcDNA3.1 (-)/DEC1 (DEC1 group) or pcDNA3.1 (-) (vector group).The mRNA and protein levels of DEC1, cyclin D1 and MMP-9 were evaluated by real-time PCR and Western blot, respectively.The effects of DEC1 over-expression on the prolif-eration and invasion abilities of the ECA109 cells were evaluated by CCK-8 assay, colony formation assay and Transwell test respectively.RESULTS:The DEC1 expression level in ECA109 cells in DEC1 group was significantly higher than that in vector group (P<0.01), but the levels of MMP9 and cyclin D1 expression were opposite (P<0.01).However, both the proliferation and invasion abilities of ECA109 cells in DEC1 groups decreased significantly as compared with those in vector group (P<0.05).CONCLUSION:The over-expression of DEC1 significantly inhibits the proliferation and invasion of ECA109 cells, which may be involved in the expression of cyclin D1 and MMP9.

Coverage and Compliance of Mass Drug Administration for Elimination of Lymphatic Filariasis in Bijapur District, Karnataka.

Background: Lymphatic Filariasis (LF) is the world's second leading cause of long-term disability. The current estimate reveals that 120 million people in 83 countries of the world are infected with LF parasites and more than 20% of the world's population are at risk of acquiring infection. The present study was con-ducted to assess the program effectiveness of the 2-drug strategy in terms of actual coverage, compliance rates of MDA against filariasis in the district along with the reasons for non-compliance. Objectives: To eval-uate independently the MDA Programme against Filariasis with respect to its coverage and compliance among the community. To know the reasons for non-compliance. Materials and Methods: A Community based Cross-Sectional Study was conducted in Bijapur District. A total of four clusters, one urban and three rural clusters were selected randomly. All the sampled eligible population who belong to the MDA campaign area were included. The eligible population did not include pregnant and lactating women, children below two years of age and seriously ill persons. The data were collected in pretested Performa, tabulated using Microsoft Excel 2013 and analysed using OPENEpi software. Results: The demographic profile of the study sample is as follows, 67.6% of the population were in the age group of 14-60 years. Male to female ratio was equal. 66.48% of the study population were from rural area and 33.52% were from urban area. 81.63% of the population received the drugs. 79.21% of the population consumed the DEC and Albendazole tablets. 14.60% of the sample population did not consume. Major reasons for not taking tablets were fear of side effects (56.67%) and 22.50% forgotten to take the tablets. Conclusions: The effective coverage was below the target (85%). The overall coverage was better in rural areas compared with urban areas.

Direcionamento de antígenos para células dendríticas in vivo: uma nova estratégia para o desenvolvimento de vacina na paracoccidioidomicose / Targeting antigens to dendritic cells in vivo: a new strategy for vaccine development in Paracoccidioidomycosis

A paracoccidioidomicose (PCM) é a micose sistêmica mais frequente no Brasil. Na última década, foi demonstrado que é possível enviar antígenos diretamente para as células dendríticas utilizando o anticorpo αDEC205 e na presença de um estímulo de maturação, o resultado é a indução de uma resposta imunológica. Verificamos que o anticorpo αDEC fusionado ao peptídeo P10 induziu uma resposta por células produtoras de IFN-γ após uma única dose em relação à administração de P10, mesmo tendo sido administrado em uma concentração menor. Entretanto, essa resposta não se manteve após segunda dose do anticorpo. Após desafio dos animais com P. brasiliensis, imunizados com duas doses do anticorpo quimérico, detectamos níveis de IFN-γ e IL-4 no tecido pulmonar estatisticamente maiores no grupo αDEC/P10 e ISO/P10 em relação à administração de P10, todos em presença de Poly I:C. Em ensaios de terapia, verificamos no pulmão de camundongos tratados com o anticorpo quimérico, principal órgão envolvido em modelo animal de PCM, baixa concentração de IFN-γ e IL-10 em relação aos controles. Em adição, ficou evidente que nos animais tratados com o anticorpo αDEC/P10 o tecido pulmonar está compatível com o tecido de animais não infectados, enquanto que na ausência de tratamento adequado encontramos aglomerados de leveduras e um tecido com aumento no infiltrado celular. Esses achados indicam uma boa evolução clínica em animais tratados e indicam que o direcionamento do P10 através do anticorpo quimérico αDEC/P10, na presença de Poly I:C, é uma estratégia promissora para terapia contra P. brasiliensis

Paracoccidioidomycosis (PCM) is the most common systemic mycosis in Brazil. In the last decade, it was demonstrated that antigens can be directly target to the dendritic cells using the antibody αDEC205 in the presence of a maturation stimulus, resulting in the induction of a strong immune response. We found that αDEC205 antibody fused to peptide P10 induced great response by IFN-γ producing cells after a single dose in relation to the administration of P10, although it has been administered in a lower concentration. However, this response was not maintained after second dose of antibody. Animals challenge with P. brasiliensis, after immunization with two doses of the chimeric antibody, produced high levels IFN-γ and IL-4 in lung tissue significantly higher in αDEC/P10 group in relation to the administration of P10, all in the presence of Poly I:C. In therapy assays, we found in the lungs of mice treated with the chimeric antibody, the main organ involved in an animal model of PCM, low concentration of IFN-γ and IL-10 compared to controls. In addition, it became evident that animals treated with αDEC/P10 antibody have a lung tissue much closer to that of non-infected tissue, while in the absence of suitable treatment we find clusters of yeasts and tissue filled with cellular infiltrates. Altogether, these findings show a clinical improvement in treated animals and indicate that targeting of P10 through the chimeric antibody αDEC/P10 in the presence of Poly I:C, is a promising strategy for therapy against P. brasiliensis

Tropical pulmonary eosinophilia - A review.

Tropical pulmonary eosinophilia (TPE) is a syndrome of wheezing, fever and eosiniphilia seen predominantly in the Indian subcontinent and other tropical areas. Its etiological link with Wuchereria bancrofti and Brugia malayi has been well established. The pathogenesis is due to an exaggerated immune response to the filarial antigens which includes type I, type III and type IV reactions with eosinophils playing a pivotal role. Peripheral blood eosinophilia is usually striking with levels over 3000/μl being common. High serum levels of IgE and filarial-specific IgE and IgG are also found. The pathology may vary from an acute eosinophilic alveolitis to histiocytic infiltration depending on the stage of the disease. While earlier studies had suggested that the disease runs a benign course, more recent work has shown that untreated TPE could result in a fair degree of respiratory morbidity. Pulmonary function tests may show a mixed restrictive and obstructive abnormality with a reduction in diffusion capacity. The bronchoalveolar lavage (BAL) eosinophil count has a negative correlation with the diffusion capacity. Treatment consists of diethylcarbamazine (DEC) for at least three weeks. Despite treatment with DEC, about 20 per cent of patients may relapse. Steroids have shown to have a beneficial effect but the exact dose and duration is yet to be confirmed by randomized controlled trials. A specific and easily available marker is required for TPE in order to distinguish it from other parasitic and non-parasitic causes of pulmonary eosinophilia.

A new essential oil component from Datura stramonium / 中草药

Objective: To study the chemical constituents of the medicinal halophyte Datura stramonium. Methods: The compounds were isolated and purified by silica gel, Sephadex LH-20, and ODS column chromatography, and their structures were elucidated on the basis of spectroscopic analyses. Results: Six compounds were isolated from the aerial parts of D. stramonium and their structures were identified as (3R, 5R, 7Z)-3-hydroxy-5-dec-7-enolide (1), (R)-tuberolactone (2), daturadiol (3), monolinoleoyl glycerol (4), linoleic acid (5), and lutein (6). Conclusion: Compound 1 is a new essential oil component with a δ-lactone unit, named stramenlactone. Compounds 1 and 2 are isolated from the plants in genus Datura L. for the first time.

Rural-urban Population Movement, Community Context and Impact on DEC Fortified Salt Program to Eliminate Lymphatic Filariasis.

Diethylcarbamazinecitrate (DEC) salt in conjunction with annual singledose mass drug administration (MDA) with DEC tablets can be considered as potential option to hasten the process of Lymphatic Filariasis (LF) elimination. Consumption of DEC tablet/salt by at least 80% of the endemic population is crucial in achieving elimination in five years. This study examines the determinants of rural-urban population movement and its implication on DEC fortified salt program to control LF. Data was collected through questionnaire from 150 each movers and non-movers from 10 randomly selected villages and also using Key informant (KI) interviews in Villupuram district in Tamil Nadu. Households with at least one family member engaged in movement at any point of time in the previous year, range from 24 - 43% in different villages. Knowledge on cause, control, ongoing LF elimination programs and compliance with DEC tablets (28.7%) and salt (30%) were significantly higher (p<0.05) among non-movers than movers (4.7% and 3.3%respectively). In order to achieve the goal of elimination of LF by 2020, measures need to be undertaken to ensure that the social mobilization activities and LF intervention programs need to cover the 24 - 43% of mobile population.

Interruption of Annual Single Dose DEC Regimen Administration : Impact on Wuchereria Bancrofti Microfilaraemia, Vector Infection and Infectivity Rates.

The effect of single dose diethylcarbamazine regimen (6mg/ kg body wt.) in comparison to standard DEC regimen i.e; 72mg/kg body wt (administered in 12 consecutive days) in clearing Wuchereria bancrofti microfilariae from low density micro filariae carriers (1- 8 mf per 20 μl) and its impact on vector infection rate were studied in an urban region endemic for bancroftian filariasis. The efficacy of DEC regimens were determined by assessing the rate of successful treatment, percentage cure rate and percentage decrease in microfilariae count in treated subjects. The 12 days regimen was found very effective with 100% cure rate even after 4 years of drug therapy. In subjects, who received single dose DEC regimen, the rate of successful treatment, cure rate and percent decrease in micro filariae count was significantly low when assessed 24 hour after therapy. Reexamination of subjects in this group at 6, 12, 24 and 48 months after therapy showed a sharp decline in all therapeutic indices and the microfilariae count reached pretreatment levels by 4th year of drug therapy. The single dose regimen had a marginal impact on vector infection and infectivity rates in Culex quinquefasciatus. A marked increase of vector infection and infectivity rates in parallel to human microfilaraemia rate was recorded from the same households when examined after 4th yr after therapy. Thus the single dose 6mg/kg body wt. DEC regimen (administered only once) failed to clear microfilariae even in a situation of filarial low endemicity and did not influence the transmission potential of C. quinquefasciatus.

Improving vaccines by targeting antigens to dendritic cells

A new approach to enhancing the effectiveness of vaccines is to deliver antigens selectively to dendritic cells (DC) in situ, via monoclonal antibodies specific for particular DC surface molecules. This can markedly enhance CTL responses and, via helper T cells, also enhance antibody responses. DC activation agents or adjuvants must also be administered for effective CTL responses, but in some cases good antibody responses can be obtained without adjuvants. Here we review the role of different DC subsets and different DC target molecules in obtaining enhanced immune responses.

Improving vaccines by targeting antigens to dendritic cells

A new approach to enhancing the effectiveness of vaccines is to deliver antigens selectively to dendritic cells (DC) in situ, via monoclonal antibodies specific for particular DC surface molecules. This can markedly enhance CTL responses and, via helper T cells, also enhance antibody responses. DC activation agents or adjuvants must also be administered for effective CTL responses, but in some cases good antibody responses can be obtained without adjuvants. Here we review the role of different DC subsets and different DC target molecules in obtaining enhanced immune responses.