A historical review of the techniques of recovery of parasites for their detection in human stools

Abstract Since the early 20th century, the detection of intestinal parasites has improved with the development of several techniques for parasitic structures recovery and identification, which differ in sensitivity, specificity, practicality, cost, and infrastructure demand. This study aims to review, in chronological order, the stool examination techniques and discuss their advantages, limitations, and perspectives, and to provide professionals and specialists in this field with data that lays a foundation for critical analysis on the use of such procedures. The concentration procedures that constitute the main techniques applied in routine research and in parasitological kits are a) spontaneous sedimentation; b) centrifugation-sedimentation with formalin-ethyl acetate; and c) flotation with zinc sulfate solution. While selecting a technique, one should consider the purpose of its application and the technical-operational, biological, and physicochemical factors inherent in the procedures used in stool processing, which may restrict its use. These intrinsic limitations may have undergone procedural changes driven by scientific and technological development and by development of alternative methods, which now contribute to the improvement of diagnostic accuracy.

New approaches to studying morphological details of intramolluscan stages of Angiostrongylus vasorum / Novas abordagens para estudo morfológico dos estágios intramoluscos de Angiostrongylus vasorum

Abstract Angiostrongylus vasorum is a pulmonary artery parasite of domestic and wild canid. On molluscs, intermediate host, first stage larvae (L1) are found after the first day of infection, in the 8th L2 and in the 30 th L3. It was evaluated L1, L2 and L3 recovered by Baermann technique from Achatina fulica infected with 1000 L1. Fifty larvae/stage were incubated with antibodies anti-β-tubulin, anti-α-tubulin, anti- α-actin, anti-β-actin and anti-collagen, and then with Alexa 633. Fifty larvae/stage were observed with picrosirius red and Oil Red O. It was also observed in the anterior region of L1 the beginning of the chitinous stems development, in the initial portion of the intestine and genital primordium. In L2 anterior region, the papillae, chitinous canes juxtaposed to the mouth and intestines bigger than L1. The L3 musculature is well defined, next to the chitinous stems, there are two round distally arranged from each other. It was observed the whole extension of the intestine genital primordium and intense cellularity in the L3 distal portion. With the picrosirius red the L1, L2 and L3 musculature could be observed, as the nerve ganglia on L3. Oil Red O revealed that L1, L2 and L3 store energy on lipid droplets.

Resumo Angiostrongylus vasorum é um parasito de artérias pulmonares dos canídeos domésticos e silvestres. Nos moluscos, hospedeiros intermediários, encontram-se no primeiro dia após a infecção, larvas de primeiro estágio (L1), ao 8° L2 e ao 30° L3. Avaliou-se L1, L2 e L3 recuperadas pela técnica de Baermann de Achatina fulica infectada com 1.000 L1. Incubou-se 50 larvas/estádio com anticorpos anti-β-tubulina, anti-α-tubulina, anti-β-actina e anti-colágeno e, em seguida, com anticorpo Alexa 633. Observaram-se também 50 larvas/estádio com picrosirius red e Oil Red O, na região anterior da L1, o início do desenvolvimento de hastes quitinosas, a porção inicial do intestino e o primórdio genital. Na região anterior de L2, papilas, bastões quitinosos justapostos à boca e ao intestino maior que em L1. A musculatura de L3 é bem desenvolvida, próximo às hastes quitinosas, há duas estruturas redondas dispostas distalmente uma da outra. Observaram-se também toda a extensão do intestino, o primórdio genital e a intensa celularidade na porção distal da L3. Com o picrosirius red observou-se a musculatura de L1, L2 e L3, assim como, gânglios nervosos na L3. Oil Red O revelou que L1, L2 e L3 armazenam energia em gotículas lipídicas.

Comparación de métodos de extracción de ADN de Giardia spp. medidos por PCR convencional / Comparison of methods of DNA extraction from Giardia spp. measured by conventional PCR

RESUMEN Objetivos . Comparar diferentes métodos de extracción de ADN a partir de quistes y trofozoítos de Giardia spp. mediante la técnica de reacción en cadena de la polimerasa (PCR) convencional. Materiales y métodos. Se aislaron quistes de Giardia spp. a partir de 65 muestras coprológicas procedentes de hospitales de referencia nacional, obteniéndose una carga promedio de 5x104 parásitos. Asimismo, se cultivaron trofozoítos de Giardia intestinalis (ATCC® 30957™) obteniéndose una carga parasitaria de 5x106. Se compararon once métodos de extracción para quistes y seis para trofozoítos. La concentración y pureza del ADN extraído se determinó por espectrofotometría y el rendimiento de la extracción se evaluó mediante la amplificación de los genes beta giardina (bg) y glutamato deshidrogenasa (gdh) por PCR semi-anidada. Resultados. Se observó que el método I mostró la mayor concentración de ADN a partir de quistes (12,24 ng/µL), pureza (1,4) y mejor rendimiento (100% amplificación bg, 60% gdh) en comparación con los otros métodos evaluados. En el caso de los trofozoítos el método que no tuvo pretratamientos presentó la mayor concentración de ADN, pureza y rendimiento (26,56 ng/µL; 1,85; 100% amplificación bg y gdh). Conclusiones. Los pretratamientos mecánicos, de choque térmico y enzimáticos son necesarios para la ruptura de la pared quística de Giardia spp., siendo el marcador molecular bg de mayor rendimiento para detección de ADN de quistes. Los trofozoítos no requieren pretratamientos para lograr resultados satisfactorios. Se cuenta con una metodología reproducible para la extracción de ADN de Giardia spp. a partir de cualquier estadio evolutivo.

ABSTRACT Objectives. To compare different methods of DNA extraction from cysts and trophozoites of Giardia spp. using the conventional polymerase chain reaction (PCR) technique. Materials and Methods. Cysts of Giardia spp. were isolated from 65 coprological samples from national reference hospitals, obtaining an average load of 5x104 parasites. In addition, Giardia intestinalis trophozoites (ATCC® 30957™) were cultured obtaining a 5x106 parasitic load. Eleven extraction methods for cysts and six for trophozoites were compared. The concentration and purity of the extracted DNA were determined by spectrophotometry and the extraction yield was assessed by amplification of the ß-giardin (bg) and glutamate dehydrogenase (gdh) genes with a semi nested PCR assay. Results. It was observed that method 1 showed the highest concentration of DNA from cysts (12.24 ng/µL), purity (1.4) and best performance (bg: 100% amplification; gdh: 60% amplification) compared to the other methods evaluated. In the case of trophozoites, the method without pre treatment showed the highest level of DNA concentration, purity, and yield (26.56 ng/µL; 1.85; 100% amplification of bg and gdh, respectively). Conclusions . Mechanical, thermal shock, and enzymatic pre-treatments are necessary for the rupture of the cystic wall of Giardia spp. making it the highest-yielding bg molecular marker for detecting cyst DNA. Trophozoites do not require pre-treatment to achieve satisfactory results. A reproducible methodology for the extraction of DNA from Giardia spp. from any evolutionary stage is available.

Geographical distribution of Leishmania species in Colombia, 1985-2017 / Distribución geográfica de las especies de Leishmania en Colombia, 1985-2017

Abstract Introduction: Knowledge of the geographical distribution of Leishmania species allows guiding the sampling to little-studied areas and implementing strategies to define risk zones and priority areas for control. Objective: Given that there is no publication that collects this information, the search, review, and compilation of the available scientific literature that has identified species in Colombia is presented in this paper. Materials and methods: A bibliographic search was performed in PubMed, Web of Knowledge, Google Scholar, SciELO and LILACS with the terms "(Leishmania OR Leishmaniasis) AND species AND Colombia", without restrictions on publication year, language or infected organism; records of national scientific events and repositories of theses from Colombian universities were also included. Results: Eighty-six scientific documents published between 1985 and 2017 were found in which the species of Leishmania and their geographical origin were indicated. The species reported, in descending order of frequency, were: Leishmania (Viannia) panamensis, L. (V.) braziliensis, L. (V.) guyanensis, L. (Leishmania) infantum, L. (L.) amazonensis, L. (L.) mexicana, L. (V.) colombiensis, L. (V.) lainsoni and L. (V.) equatorensis; the last three were found with the same frequency. Leishmania species were reported from 29 departments. Conclusion: Information on the distribution of Leishmania species in Colombia is limited; therefore, it is necessary to gather existing data and propose studies that consolidate the distribution maps of Leishmania species in Colombia. This would allow the detection of areas where species have not been identified as well as the comparison of existing parasite and vector distributions.

Resumen Introducción. El conocimiento de la distribución geográfica de las especies de Leishmania permite orientar el muestreo hacia áreas poco estudiadas e implementar estrategias para detectar zonas de riesgo y áreas prioritarias de control. Objetivo. Dado que no existe una publicación que reúna esta información, se planteó la revisión y compilación de la literatura científica disponible de estudios de identificación de especies del país. Materiales y métodos. Se llevó a cabo una búsqueda bibliográfica en PubMed, Web of Knowledge, Google Académico, SciELO y Lilacs con los términos "(Leishmania OR Leishmaniasis) AND especie AND Colombia", así como en memorias de eventos científicos nacionales y repositorios de tesis y trabajos de grado de universidades del país. Resultados. Se encontraron 86 documentos científicos publicados entre 1985 y 2017, en los cuales se informaron la especie de Leishmania y el origen geográfico. Las especies circulantes reportadas, en su orden de frecuencia, fueron: Leishmania (Viannia) panamensis, L. (V.) braziliensis, L. (V.) guyanensis, L. (Leishmania) infantum, L. (L.) amazonensis, L. (L.) mexicana, L. (V.) colombiensis, L. (V.) lainsoni y L. (V.) equatorensis, las últimas tres, con igual frecuencia. Los reportes proceden de 29 departamentos. Conclusión. La información de la distribución de las especies de Leishmania en Colombia es limitada. Por lo tanto, se necesita reunir los datos existentes y plantear trabajos que permitan consolidar el mapa de distribución de las especies en el país, lo cual permitiría detectar las zonas sin información de las especies circulantes y establecer la concordancia entre su distribución y la de los vectores.

Developmental stages and viability of Toxocara canis eggs outside the host / Desarrollo y viabilidad de huevos de Toxocara canis

ABSTRACT Introduction: Toxocariasis is a soil-transmitted zoonotic disease caused mainly by ingestion of larvated eggs of Toxocara canis. Objectives: To study the morphology of the intraovular developmental stages of Toxocara canis in culture, characterize non-viable eggs and the sequences of larval molting and compare the viability of eggs at the early stages of division and at reaching full maturation. Material and methods: Observation of developing embryos and characterization of non-viable eggs were done using light microscope. The proportions of viable eggs during embryonation were compared to the proportions of viable mature eggs. Results: Cell division commenced after 24 hours of cultivation. Early stages were found to be present over a period of 3-5 days. The developmental stages identified were eggs with: One cell, two cells, three cells, four cells, early morula, late morula, blastula, gastrula, tadpole, pre-larva, first, second and third stage larva. Two larval molts occurred. Non-viable eggs had degenerated cytoplasm, thin or collapsed shell and the larvae did not move after exposure to light. No significant differences were found between the proportions of viable eggs from day five to day 21 as compared to viability of fully mature eggs (30 days). Conclusion: Developing embryos in the environment may be considered as a potential threat to the public health. The precise identification of developmental stages and the clear differentiation of viable and non-viable eggs can help in determining an accurate baseline rate of development that could be used in studies of ovicidal compounds.

RESUMEN Introducción. La toxocariasis es una enfermedad zoonótica transmitida por contacto con el suelo contaminado y causada principalmente por la ingestión de huevos larvados de Toxocara canis. Objetivos. Estudiar la morfología de los estadios intraovulares en desarrollo de T. canis en cultivo, caracterizar los huevos no viables y las secuencias de las mudas larvarias, y comparar la viabilidad de los huevos en las etapas tempranas de división y al alcanzar la maduración completa. Materiales y métodos. Se observó el desarrollo de los embriones y se caracterizaron los huevos no viables, mediante microscopía de luz. Se comparó la proporción de huevos viables con embrión con la de huevos maduros viables. Resultados. La división celular comenzó 24 horas después de iniciado el cultivo. Los estadios tempranos estuvieron presentes por un periodo de tres a cinco días. Los estadios de desarrollo identificados fueron: huevos con una célula, con dos células, con tres células y con cuatro células;mórula temprana, mórula tardía, blástula, gástrula, renacuajo, prelarva, primer, segundo y tercer estado larvario. Se presentaron dos mudas larvarias. Los huevos no viables tenían el citoplasma degradado, cubierta exterior delgada o colapsada, y su larva no se movía al exponerla a la luz. No se encontraron diferencias significativas entre la proporción de huevos viables del día 5 al día 21, al compararla con la viabilidad de los huevos completamente maduros (30 días). Conclusión. Los embriones en desarrollo en el medio ambiente pueden considerarse como un riesgo potencial para la salud pública. La identificación precisa de los estadios de desarrollo y la clara diferenciación de huevos viables y no viables, pueden ayudar a determinar con exactitud una tasa basal de desarrollo, la cual sería útil en el estudio de compuestos ovicidas.

Comparación entre metodologías para el diagnóstico microscópico de malaria / Comparison of methodologies for microscopic malaria diagnosis

Resumen Introducción. Como parte del plan de eliminación de la malaria en Colombia, se propuso desarrollar actividades enmarcadas en la línea de trabajo: "Mejorar el acceso y la calidad del diagnóstico de malaria". Objetivo. Comparar la metodología recomendada por la Organización Panamericana de la Salus con la utilizada en Colombia para el diagnóstico de la malaria. Materiales y métodos. Se recolectaron muestras y se prepararon 88 láminas para el diagnóstico de malaria, bajo diferentes tratamientos según los parámetros evaluados. Después de la lectura microscópica por duplicado, se hicieron los respectivos cálculos de varianza para todas las posibles comparaciones de coloración con los dos métodos usados (gota gruesa y gota gruesa combinada), según la coloración (Romanowsky modificado o Giemsa) y el resultado del recuento parasitario (500, 1.000, 5.000 y 10.000 parásitos/µl de sangre). Resultados. Se obtuvo un coeficiente kappa de Cohen de concordancia entre observadores de 0,923 (IC95% 0,768-1,0). Ninguno de los factores (A: coloración, B: metodología) o interacciones (AB) tuvo un efecto estadísticamente significativo sobre los resultados, con un 95 % de nivel de confianza. Conclusión. Según los resultados obtenidos, la observación de dos gotas gruesas en una misma lámina y el uso de la tinción modificada de Romanowsky, continúa siendo una metodología adecuada para el diagnóstico de malaria en Colombia, por sus características técnicas, de almacenamiento, bajo costo y cuidados de uso.

Abstract Introduction: As part of the pre-elimination plan for malaria in Colombia, it has been proposed to develop activities within the line of work: "Improve access and quality of malaria diagnosis". Objective: To compare the methodology recommended by PAHO/WHO with that used in Colombia for the diagnosis of malaria. Materials and methods: Samples were collected and 88 slides were prepared for malaria diagnosis, under different scenarios according to the parameters to be evaluated. After duplicate mycroscopic reading, the respective variance calculations were performed for all possible staining comparisons with the two methods used (thick smear, combined thick smear), according to the staining (modified Romanowsky or Giemsa), with the result variable being the parasite density (500, 1,000, 5,000 and 10,000 parasites/µl of blood). Results: A Cohen kappa index of inter-rater agreement of 0.923 (95% CI: 0.768-1.078) was obtained. None of the factors (A: stain, B: methodology) or interactions (AB) had a statistically significant effect on the results with a 95% confidence level. Conclusion: Based on the results of the study, the preparation of two thick smears in the same slide stained with the modified Romanowsky stain is a suitable methodology for the diagnosis of malaria in Colombia, due to its technical characteristics, of storage, low cost, use and care.

Larva migrans visceral. Presentación de un caso / Visceral larva migrans. Report of a case

RESUMEN La larva migrans visceral es una enfermedad que se produce al ingerir huevos infectantes de nematodos parásitos de gatos y perros (Toxocaracanis y Toxocaracati); los cuales eclosionan en el intestino del hombre y las larvas se distribuyen en todo el organismo, principalmente hígado, pulmón, corazón y cerebro. Las larvas en su migración dejan trazos de hemorragias, necrosis y células inflamatorias; algunas son destruidas por la respuesta inmune del huésped y otras forman granulomas eosinofílicos. Los síntomas dependen del tejido u órgano afectado, de la intensidad de la infección y del grado de la respuesta inmunológica inducida. Se presenta un caso del sexo masculino de 72 años que ingresa en el Servicio de Medicina del Hospital Militar Docente “Dr. Mario Muñoz Monroy”, de Matanzas, por cuadro de fiebre, diarreas, tos seca, astenia, anorexia y pérdida de peso al que se le diagnosticó larva migrans visceral. Por lo atípico de la edad del paciente y la complejidad del diagnóstico decidimos presentar este caso (AU).

ABSTRACT Visceral larva migrans is a disease produced after the ingestion of infectant eggs of cat´s and dog´s nematode parasites (Toxocara canis and Toxocara cati). These parasites harch in the men´s intestines and the larvas are distributed around the organism, mainly in the following organs: liver, lungs, hearth and brain. In their migration, the larvas leave traces of hemorrhage, necrosis and inflammatory cells; several of them are destroyed by the host´s immune answer and others form eosinophilic granulomas. The symptoms depend on the affected tissue or organ, on the infection intensity and on the level of induced immunologic answer. The case of a male patient, aged 72 years-old is presented. He entered the Medicine Service of the Teaching Military Hospital “Dr. Mario Muñoz Monroy”, of Matanzas with fever, diarrhea, dry cought, asthenia, anorexia and weight loss.Visceral larva migrans was diagnosed. The presentation of the case was decided because of the atypical patient´s age and the complexity of the diagnosis (AU).

In vitro efficacy of Duddingtonia flagrans against nematodes of sheep based on in vivo calculations / Eficácia in vitro de Duddingtonia flagrans contra nematoides de ovinos com base em cálculo in vivo

Abstract Duddingtonia flagrans has been tested as an alternative parasite control, but data from in vitro experiments based on in vivo calculations describing nematophagous fungi predation in nematodes are restricted. The objective of this work was to determine the efficacy of D. flagrans against sheep nematode larvae in vitro using in vivo calculations. Fecal samples were introduced to fungi in different concentrations: 0.0/control; 0.05; 0.1; 0.2; 0.4; 0.8; 1.6; 3.2; and 6.4 g corresponding, respectively, to 583.000; 1.166.000; 2.332.000; 4.664.000; 9.328.000; 18.656.000; 37.312.000 and 74.624.000 chlamydospores/kg of body weight. The material was incubated for 14 days, before the larvae recovery (Assay 1). Assay 2 was carried out with the doses of 0.00625; 0.0125; and 0.025 g. The results showed a negative correlation between fungal concentrations and larval numbers for both assays. The fungus demonstrated an efficacy above 89% in both assays. Thus, we consider that the data from in vitro studies based on in vivo calculations may optimize the fungi quantities for field experiments.

Resumo Duddingtonia flagrans tem sido testado como uma alternativa no controle de parasitos, entretanto, trabalhos in vitro da predação de nematoides por fungos nematófagos correlacionados com cálculos baseados para testes in vivo são restritos. O objetivo deste trabalho foi determinar a eficácia in vitro de D. flagrans contra larvas de nematoides de ovinos tendo como base cálculos in vivo. Amostras fecais receberam a adição do fungo em diferentes concentrações: 0.0/controle; 0,05; 0,1; 0,2; 0,4; 0,8; 1,6; 3,2 e 6,4 gramas correspondendo, respectivamente, às seguintes dosagens: 583.000; 1.166.000; 2.332.000; 4.664.000; 9.328.000; 18.656.000; 37.312.000 e 74.624.000 clamidósporos/Kg de peso vivo animal. O material foi incubado por 14 dias, para recuperação das larvas (Ensaio 1). O Ensaio 2 foi realizado com concentrações de 0,00625; 0,0125 e 0,025 g. Foi observada correlação negativa entre a concentração fúngica e o número de larvas, nos dois ensaios. O fungo demonstrou eficácia acima de 89% em ambos os ensaios. A partir destes dados, acreditamos que ensaios in vitro baseados em cálculos in vivo podem aprimorar as dosagens para a realização de experimentos a campo.

In vitro evaluation of ivermectin, moxidectin, albendazole and pyrantel against cyathostomins of horses / Avaliação in vitro da ivermectina, moxidectina, albendazole e pirantel contra ciatostomíneos de equinos

Abstract Cyathostomins are the most prevalent nematodes of horses, and multidrug resistance has been reported worldwide. There is a need to implement alternative drug monitoring analytical tests. The objective of this study was to determine the consistency (5 repetitions) of the larval migration on agar test (LMAT) using ivermectin, moxidectin, pyrantel or albendazole against cyathostomin infective-stage larvae in eight different concentrations. LMAT showed a strong coefficient of determination (R2 > 0.91), between the test repetitions (n=5). The average 50% effective concentration (EC50) for ivermectin, moxidectin, pyrantel and albendazole were 0.0404, 0.0558, 0.0864 and 0.0988 nMol, respectively. The results of the EC50 for albendazole showed the greatest range of concentration. Ivermectin and moxidectin had the lowest in between-test variation. In the future, internationally certified susceptible isolates could be used for screening new drug candidates, or to follow up the pattern of drug efficacy from field populations.

Resumo Ciatostomíneos são os nematodas mais prevalentes em equinos e a resistência múltipla foi relatada em todo o mundo. Existe a necessidade de implementar o monitoramento dos produtos com testes analíticos alternativos. O objetivo deste estudo foi determinar a consistência (5 repetições) do teste de migração larval em ágar (TMLA) usando ivermectina, moxidectina, pirantel e albendazole contra larvas infectantes de ciatostomíneos em oito concentrações diferentes. O TMLA demonstrou um coeficiente de determinação (R2) acima de 0,91 entre as repetições do teste. A concentração efetiva para 50% (CE50) para ivermectina, moxidectina, pirantel e albendazole foi de 0,0404; 0,0558; 0,0864 e 0,0988 nMol, respectivamente. A CE50 do albendazole demonstrou a maior amplitude entre os testes. A ivermectina e a moxidectina tiveram as menores variações das doses entre as repetições. No futuro, isolados certificados susceptíveis poderão ser testados com o TMLA para indicação de novos produtos e mesmo para acompanhar o perfil de eficácia de populações do campo.

Comparative study of three xenic media culture for cultivation of Balantidium coli strains / Estudo comparativo entre três meios de cultivo xênicos para o cultivo de cepas de Balantidium coli

Abstract The aim of the present study was to evaluate the growth rate of Balantidium coli in three xenic media cultures. Between 2013 and 2015, 10 B. coli isolates obtained from feces of Cynomolgus macaques, and 30 isolates from feces of pigs were studied. An inoculum of 500 trophozoites was transferred to tubes containing LES, TYSGM-9 and Pavlova media. These cultures were evaluated at incubation times of 24, 48, 72 and 96 hours. In most of strains analyzed wasn't showed significant difference in the growth rate comparing TYSGM-9 and Pavlova media (Wilcoxon p>0.016). In Pavlova medium, the trophozoites showed a maximum growth at 72 hours with significant difference when compared with the times of 24 h and 96 h (Wilcoxon <0.008). In LES, viable trophozoites were observed until 24 hours, with a significant difference (Friedman p<0.05, Wilcoxon p<0.016) in the number of parasite cells compared with Pavlova and TYSGM-9 media cultures. Thus, LES medium seemed to be less adequate than the other media for maintenance of B. coli. Despite the satisfactory results in TYSGM-9, Pavlova medium was considered ideal for the maintenance of this protozoan strain, guaranteeing the viability of the parasite with subculture every three days, presenting lower costs.

Resumo O objetivo do presente estudo foi avaliar a taxa de crescimento de Balantidium coli em três meios de cultura xênicos. Entre 2013 e 2015 foram estudados 10 isolados de B. coli obtidos de Cynomolgus macaques e 30 isolados de suínos. Um inóculo contendo 500 trofozoítos foi transferido para tubos contendo os meios LES, TYSGM-9 e Pavlova. Os cultivos foram avaliados com tempos de incubação de 24, 48, 72 e 96 horas. Na maioria das cepas analisadas não foi observado diferença significativa na taxa de crescimento comparando TYSGM-9 e Pavlova (Wilcoxon p>0,016). Em Pavlova, os trofozoítos apresentaram máximo de crescimento a 72 h com diferença significativa quando se comparou com os tempos de 24 h e 96 h (Wilcoxon <0,008). Em LES observou-se trofozoítos viáveis até 24 horas com diferença significativa (Friedman p<0,05 e Wilcoxon p<0,016), na quantidade de células parasitárias, quando comparado com Pavlova e TYSGM-9. Dessa forma, o meio LES mostrou-se ser menos adequado do que os outros, para a manutenção de B. coli. Apesar do resultado satisfatório em TYSGM-9, Pavlova foi considerado ideal para manutenção do protozoário, por garantir a viabilidade do parasito com subcultivos a cada três dias, além de apresentar menor custo.

Concordance between the zinc sulphate flotation and centrifugal sedimentation methods for the diagnosis of intestinal parasites / Concordancia entre los métodos de flotación con sulfato de zinc y sedimentación centrífuga para el diagnóstico de parásitos intestinales

Resumen Introduction: The diagnosis of intestinal parasitic infections depends on the parasite load, the specific gravity density of the parasite eggs, oocysts or cysts, and the density and viscosity of flotation or sedimentation medium where faeces are processed. Objective: To evaluate the concordance between zinc sulphate flotation and centrifugal sedimentation in the recovery of parasites in faecal samples of children. Materials and methods: Faecal samples of 330 children from day care centers were evaluated by zinc sulphate flotation and centrifugal sedimentation techniques. The frequencies of detection of parasites by each method were determined and the agreement between the diagnostic techniques was evaluated using the kappa index, with 95% confidence intervals. Results: The faecal flotation in zinc sulphate diagnosed significantly more cases of Trichuris trichiura infection when compared to centrifugal sedimentation (39/330; 11.8% vs. 13/330; 3.9%, p<0.001), with low diagnostic concordance between methods (kappa=0.264; 95% CI: 0.102-0.427). Moreover, all positive samples for Enterobius vermicularis eggs (n=5) and Strongyloides stercoralis larvae (n=3) were diagnosed only by zinc sulphate. No statistical differences were observed between methods for protozoa identification. Conclusions: The results showed that centrifugal flotation in zinc sulphate solution was significantly more likely to detect light helminths eggs such as those of T. trichiura and E. vermicularis in faeces than the centrifugal sedimentation process.

Abstract Introducción. El diagnóstico de infecciones parasitarias intestinales depende de la carga de parásitos, la densidad de la gravedad específica de los huevos, ooquistes o quistes de parásitos, y de la densidad y viscosidad de los reactivos de flotación o sedimentación usados para procesar las heces. Objetivo. Evaluar la concordancia entre el método de flotación de sulfato de zinc y la sedimentación por centrifugación en la recuperación de parásitos en muestras fecales de niños. Materiales y métodos. Se evaluaron las muestras fecales de 330 niños de guarderías mediante las técnicas de flotación con sulfato de zinc y de sedimentación por centrifugación. Se determinó la frecuencia de detección de parásitos con cada método y se evaluó la concordancia entre las técnicas de diagnóstico mediante el índice kappa, con intervalos de confianza del 95 %. Resultados. Mediante la flotación fecal con sulfato de zinc, se diagnosticó un número significativamente mayor de casos de infección por Trichuris trichiura que con la sedimentación por centrifugación (39/330; 11,8 % Vs. 13/330; 3,9 %) (p<0,001), con poco acuerdo entre los métodos (kappa=0,264; IC95% 0,102-0,427). Además, todas las muestras positivas para huevos de Enterobius vermicularis (n=5) y larvas de Strongyloides stercoralis (n=3) se diagnosticaron solamente por sulfato de zinc. No se observaron diferencias estadísticamente significativas entre los métodos para la identificación de protozoos. Conclusiones. La flotación centrífuga en una solución de sulfato de zinc presentó una probabilidad significativamente mayor de detectar los huevos livianos de helmintos como T. trichiura y E. vermicularis en heces, que el proceso de sedimentación por centrifugación.

Comparison of five parasitological techniques for laboratory diagnosis of Balantidium coli cysts / Comparação de cinco técnicas parasitológicas para diagnóstico laboratorial de cistos de Balantidium coli

Abstract Balantidium coli is a protozoon that can cause dysentery in humans, pigs and nonhuman primates, with zoonotic potential. In the literature, there is still little information on the effectiveness of different laboratory techniques for diagnosing this disease. This study compared and evaluated the performance of the Lutz, modified Ritchie, Faust, modified Sheather and direct examination techniques for detecting cysts of this protozoon. Between 2012 and 2014, 1905 fecal samples were collected from captive animals in the state of Rio de Janeiro. Of these, 790 were obtained from the rectum of pigs and 1115 from enclosures occupied by nonhuman primates. B. coli cysts were most evident through direct examination (22.4% of the samples) and the Lutz technique (21%). Fair agreement (Kappa = 0.41; p < 0.05) was observed only between direct examination and Lutz. The flotation techniques (Faust and modified Sheather) did not show good recovery of cysts. A statistically significant difference (p < 0.05) in the frequency of cysts between pigs and nonhuman primates could only be observed through direct examination and the Lutz technique. The most efficient method for diagnosing this parasitosis was seen to an association between direct examination and the spontaneous sedimentation technique.

Resumo Balantidium coli é um protozoário que pode determinar disenteria em humanos, suínos e primatas não humanos apresentando potencial zoonótico. Na literatura ainda são escassas as informações sobre a eficiência das diferentes técnicas laboratoriais para o diagnóstico dessa parasitose. Este estudo comparou e avaliou o desempenho das técnicas de Lutz, Ritchie modificada, Faust, Sheather modificada e do exame direto para a detecção de cistos desse protozoário. Entre 2012 e 2014, foram coletadas 1905 amostras fecais de animais cativos no Estado do Rio de Janeiro. Dessas, 790 foram obtidas da ampola retal de suínos e 1115 dos recintos de primatas não humanos. Cistos de B. coli foram 22,4 % mais evidenciados pelo exame direto; e pela técnica de Lutz, 21% das amostras. Concordância regular (Kappa = 0,41; p < 0,05) foi observada somente entre exame direto e Lutz. As técnicas de flutuação, Faust et al. e Sheather modificada não apresentaram boa recuperação dos cistos. Diferença estatística significativa (p < 0,05) na frequência de cistos entre suínos e primatas não humanos pode ser observada somente no exame direto e na técnica de Lutz. A metodologia mais eficiente para diagnóstico dessa parasitose foi observada pela associação do exame direto e da técnica de sedimentação espontânea.

Leishamniose tegumentar americana: um desafio diagnóstico na prática pediátrica / Leishamniose american cutaneous: challenging diagnosis in pediatric practice

O objetivo deste artigo foi descrever as particularidades clínicas da leishmaniose tegumentar americana (LTA) e as dificuldades em realizar o diagnóstico dessa doença em Pediatria. Serão relatados três casos clínicos provenientes de serviço de referência no atendimento de doenças infecciosas para o estado de Minas Gerais, de janeiro a março de 2011, com as seguintes formas de manifestação da doença: lesão cutânea localizada e lesão cutânea disseminada. Um dos casos evidencia lesão cicatricial mutiladora. Os três casos relatados revelam a dificuldade do diagnóstico precoce de LTA. Em todos eles os pacientes foram examinados por vários pediatras e receberam tratamento empírico com antibioticoterapia, sem sucesso. Devido ao aumento da incidência da doença próximo dos grandes centros urbanos, é de suma importância que o pediatra se familiarize com os aspectos clínicos e epidemiológicos da leishmaniose para realizar um diagnóstico mais precoce, minimizando as sequelas para o paciente.

The purpose of this article is to describe the clinical characteristics of American Cutaneous Leishmaniasis ( ACL) and the difficulties in making a diagnosis of this disease in pediatrics. Three clinical cases from reference service in the care of infectious diseases in the state of Minas Gerais, January-March 2011, with the following manifestations of the disease are reported: localized cutaneous lesion and skin disseminada. An injury casesshows mutilating scar tissue. The three reported cases show the difficulty of early diagnosis of ATL. In all cases, the patients were examined for various pediatric and received empirical treatment with antibiotics without success. Due to the increased incidence of disease close to large urban centers is of paramount importance that pediatricians become familiar with the clinical and epidemiological aspects of leishmaniasis to make an earlier diagnosis minimizing the consequences for the patient.

Comparative study of five techniques for the diagnosis of canine gastrointestinal parasites / Estudo comparativo de cinco técnicas para o diagnóstico de parasitos gastrointestinais caninos

Differences in the efficacy of diagnostic techniques employed in the parasitological examination of feces are a limiting factor of this laboratory procedure in the field of Veterinary Parasitology. To verify advances in this type of examination in dogs, we conducted a study using a new technique (TFGII/Dog). Fifty naturally infected dogs were housed in individual stalls, and their feces were evaluated comparatively using this technique and four other conventional techniques. The TFGII/Dog showed high levels of sensitivity and efficiency, surpassing the diagnostic accuracy of the other techniques with a kappa concordance index of 0.739 (Substantial), as opposed to 0.546 (Moderate), 0.485 (Moderate), 0.467 (Moderate), and 0.325 (Fair) of the Spontaneous-Sedimentation, Centrifugal-Flotation in Saturated Zinc Sulfate Solution, Centrifugal-Flotation in Saturated Sugar Solution, and Spontaneous-Flotation in Saturated Sodium Chloride Solution techniques, respectively. The combination of positive results of all techniques comprises eight genera of parasites, with Ancylostoma spp. predominating among helminths, and Cystoisospora spp. among protozoa. The TFGII/Dog technique showed better diagnostic performance, and can therefore be considered an important tool for optimizing the results of laboratory routines and for the control of canine gastrointestinal parasites.

As diferenças na eficácia de técnicas de diagnóstico empregadas no exame parasitológico das fezes é um factor limitante desse procedimento de laboratório no campo da Medicina Veterinária. Com o objetivo de confirmar avanços desse tipo de examinação em cães, a abordagem desse trabalho foi apresentar um estudo com o uso de uma nova técnica (TFGII/Dog). Cinquenta cães naturalmente infectados foram alojados em baias individuais, e suas fezes foram avaliadas comparativamente, usando-se a nova técnica e outras quatro técnicas convencionais. O TFGII/Dog apresentou altos níveis de sensibilidade e eficiência, superando o diagnóstico de outras técnicas com um índice de concordância kappa de 0,739 (Substancial), em oposição a 0,546 (Moderado), 0,485 (Moderado), 0,467 (Moderado) e 0,325 (Pobre) de Sedimentação-Espontânea, Centrífugo-Flutuação em Solução Saturada de Sulfato de Zinco, Centrífugo-Flutuação em Solução Saturada de Açúcar, e Flutuação-Espontânea em Solução Saturada de Cloreto de Sódio, respectivamente. A combinação de resultados positivos das técnicas mostrou oito gêneros de parasitos, com Ancylostoma spp. predominando entre helmintos, e Cystoisospora spp. entre os protozoários. A técnica de TFGII/Dog apresentou melhor desempenho diagnóstico e, portanto, pode ser considerada uma importante ferramenta para otimizar os resultados de rotinas de laboratório e o controle de parasitos gastrintestinais de cães.

Pathological and parasitological aspects of the peacock (Pavo cristatus) infection by Tanaisia (Paratanaisia) bragai / Aspectos patológicos e parasitológicos da infecção por Tanaisia (Paratanaisia) bragai em pavões (Pavo cristatus)

Trematodes belonging to the family Eucotylidae, including Tanaisia (Paratanaisia)bragai Santos, 1934are parasites of the kidney and ureter that affect several species of domestic and wild birds. Tanaisia bragai is considered a low pathogenic parasite, but high worm burdens may determine clinical complications, including signs of apathy, weight loss, diarrhea and death...

Os trematódeos da família Eucotylidae, incluindo Tanaisia (Paratanaisia)bragai Santos, 1934, são parasitos de rins e ureteres de várias espécies de aves domésticas e silvestres. Tanaisia bragai é considerada uma espécie pouco patogênica, mas que pode determinar complicações clínicas como apatia, perda de peso, diarreia e morte, quando em cargas parasitárias elevadas...

Xenomonitoring of Different Filarial Nematodes Using Single and Multiplex PCR in Mosquitoes from Assiut Governorate, Egypt

Wuchereria bancrofti, Dirofilaria immitis, and Dirofilaria repens are filarial nematodes transmitted by mosquitoes belonging to Culex, Aedes, and Anopheles genera. Screening by vector dissection is a tiresome technique. We aimed to screen filarial parasites in their vectors by single and multiplex PCR and evaluate the usefulness of multiplex PCR as a rapid xenomonitoring and simultaneous differentiation tool, in area where 3 filarial parasites are coexisting. Female mosquitoes were collected from 7 localities in Assiut Governorate, were microscopically identified and divided into pools according to their species and collection site. Detection of W. bancrofti, D. immitis, and D. repens using single PCR was reached followed by multiplex PCR. Usefulness of multiplex PCR was evaluated by testing mosquito pools to know which genera and species are used by filarial parasites as a vector. An overall estimated rate of infection (ERI) in mosquitoes was 0.6%; the highest was Culex spp. (0.47%). W. bancrofti, D. immitis, and D. repens could be simultaneously and differentially detected in infected vectors by using multiplex PCR. Out of 100 mosquito pools, 8 were positive for W. bancrofti (ERI of 0.33%) and 3 pools each were positive for D. immitis and D. repens (ERI 0.12%). The technique showed 100% sensitivity and 98% specificity. El-Nikhila, El-Matiaa villages, and Sahel Seleem district in Assiut Governorate, Egypt are still endemic foci for filarial parasites. Multiplex PCR offers a reliable procedure for molecular xenomonitoring of filariasis within their respective vectors in endemic areas. Therefore, it is recommended for evaluation of mosquito infection after lymphatic filariasis eradication programs.

Xenomonitoring of Different Filarial Nematodes Using Single and Multiplex PCR in Mosquitoes from Assiut Governorate, Egypt

Wuchereria bancrofti, Dirofilaria immitis, and Dirofilaria repens are filarial nematodes transmitted by mosquitoes belonging to Culex, Aedes, and Anopheles genera. Screening by vector dissection is a tiresome technique. We aimed to screen filarial parasites in their vectors by single and multiplex PCR and evaluate the usefulness of multiplex PCR as a rapid xenomonitoring and simultaneous differentiation tool, in area where 3 filarial parasites are coexisting. Female mosquitoes were collected from 7 localities in Assiut Governorate, were microscopically identified and divided into pools according to their species and collection site. Detection of W. bancrofti, D. immitis, and D. repens using single PCR was reached followed by multiplex PCR. Usefulness of multiplex PCR was evaluated by testing mosquito pools to know which genera and species are used by filarial parasites as a vector. An overall estimated rate of infection (ERI) in mosquitoes was 0.6%; the highest was Culex spp. (0.47%). W. bancrofti, D. immitis, and D. repens could be simultaneously and differentially detected in infected vectors by using multiplex PCR. Out of 100 mosquito pools, 8 were positive for W. bancrofti (ERI of 0.33%) and 3 pools each were positive for D. immitis and D. repens (ERI 0.12%). The technique showed 100% sensitivity and 98% specificity. El-Nikhila, El-Matiaa villages, and Sahel Seleem district in Assiut Governorate, Egypt are still endemic foci for filarial parasites. Multiplex PCR offers a reliable procedure for molecular xenomonitoring of filariasis within their respective vectors in endemic areas. Therefore, it is recommended for evaluation of mosquito infection after lymphatic filariasis eradication programs.

Importancia de la vigilancia sanitaria de los parásitos en la calidad del agua, según su uso / Importance of health surveillance of parasites in water quality according to use

El agua contaminada puede transmitir infinidad de patógenos con comportamientos y resistencias diversas. Dentro de los patógenos a determinar los parásitos son de especial relevancia pues se destacan por su alta resistencia a los diversos factores ambientales además se encuentran relacionados con altos índices de morbilidad y mortalidad en los países en desarrollo, especialmente en la población infantil. El objetivo de este trabajo es destacar la importancia de la vigilancia sanitaria de los parásitos en la calidad del agua según su uso y en su relación con el ambiente. Los huevos de helmintos son el principal riesgo a la salud debido al uso seguro del agua residual o lodos en la agricultura. Los quistes de los protozoarios como Giardia y Cryptosporidium, son difíciles de eliminar del agua de consumo sin tratar, debido a su pequeño tamaño y resistencia a oxidantes usados comúnmente como el cloro. Aunque no se recomienda su monitoreo de rutina en el agua, sí es necesario realizar investigaciones para detectar su presencia y establecer normativas propias adecuadas a nuestras condiciones(AU)

Polluted water can transmit lots of pathogens with various behaviors and resistances. Among the pathogens, the parasites are particularly important since they stand out for their high resistance to various environmental factors in addition to being associated to high morbidity and mortality rates in the developing countries, particularly children. The objective of this paper was to highlight the importance of health surveillance of parasites in water quality according to use and its relationship with the environment. The helminth eggs are the main health risk due to the safe use of wastewater or sludge in agriculture. Protozoan cysts like Cryptosporidium and Giardia, are difficult to remove from untreated drinking water due to its small size and resistance to commonly used oxidants such as chlorine. Although the routine monitoring of these cysts in water is not recommended, it is necessary to conduct research to detect its presence and to establish suitable guidelines according to our conditions(AU)

Comparación de dos protocolos de extracción de ADN de Trypanosoma cruzi cultivados en medio axénico / Comparing two protocols of DNA extraction of Trypanosoma cruzi cultured in axenic medium

Objetivos. Comparar dos protocolos de extracción de ADN de Trypanosoma cruzi para su uso en la amplificación de ADN de minicírculos de kinetoplasto (ADNk) mediante la técnica de Reacción en Cadena de Polimerasa (PCR). Materiales y métodos. Se cultivaron epimastigotas de T. cruzi en condiciones exénicas obteniéndose masas entre 1,5 hasta 100 x 10(6) parásitos. A partir de estas se procedió a la extracción de ADN mediante dos protocolos: extracción con solventes orgánicos (fenol/cloroformo), y empleo de resina (Chelex®100), a partir de los diferentes sedimentos parasitarios. La concentración y pureza del ADN se determinó por espectrofotometría y la integridad se evaluó mediante electroforesis en geles de agarosa. Se realizó el análisis de varianza y comparaciones de medias mediante la prueba de Tukey, utilizando el software Statistix 8.0. Resultados. Se realizaron diez extracciones de ADN de cada una de las diferentes cantidades de parásitos sedimentados. En la extracción de ADN con la resina Chelex®100 se obtuvo mayor rendimiento, pero menor pureza e integridad respecto a la extracción con solventes orgánicos. Sin embargo, permitió la amplificación del producto de 330 pb de ADNk de T. cruzi. Conclusiones. Aun cuando la técnica de Chelex®100 proporcionó menor pureza e integridad del ADN, permitió la amplificación con éxito de ADNk por PCR, evitando el uso de técnicas laboriosas y solventes orgánicos tóxicos.

Objectives. To compare two extraction protocols of Trypanosoma cruzi DNA for use in DNA amplification of kinetoplast minicircles (kDNA) through the technique of Polymerase Chain Reaction (PCR). Materials and methods. Epimastigotes of T. cruzi were cultured in axenic conditions and masses from 1.5 to 100 x 106 parasites were obtained. DNA extraction was performed using two protocols: extraction with organic solvents (phenol/chloroform), and with resin (Chelex®100), from different parasitic sediments. Concentration and purity of DNA was determined by spectrophotometry, and integrity was assessed by agarose gel electrophoresis. Analysis of variance and comparisons of means were performed through Tukey’s test, using the Statistix 8.0 software. Results. Ten DNA extractions were done of each one of the different amounts of parasitic sediments. In the DNA extraction with Chelex®100 resin, a higher performance was obtained but a lower purity and integrity compared to the extraction with organic solvents. However, it allowed a product amplification of 330 bp of T. cruzi kDNA. Conclusions. Although the technique of Chelex®100 provided less purity and integrity of DNA, it allowed a successful amplification of kDNA by PCR, avoiding the use of laborious techniques and toxic organic solvents.

Comparative evaluation of several methods for Canine Visceral Leishmaniasis diagnosis / Avaliação comparativa entre vários métodos para o diagnóstico da Leishmaniose Visceral Canina

The aim of the present study was to evaluate the serological methods using ELISA with recombinant-rK39 (ELISA-rK-39) and soluble extract-SE (ELISA-SE) antigens, the indirect fluorescence antibody test (IFAT) in comparison to an immunochromatography rapid diagnostic test (RDT-rK39) and with a direct parasitological exam (PA) for Canine Visceral Leishmaniasis (CVL) diagnosis. The results showed that 89% (60/67) of the dogs were positive for at least one serological diagnostic test. ELISA-SE was the test that detected anti-Leishmania antibodies in the serum of the highest number of dogs (71.6%) followed by ELISA-rK39 (65.7%), IFAT (65.7%) and RDT-rK39 (55.2%). PA detected the lowest numbers (40.3%) of positive dogs. In relation to the total of examined dogs, the Kappa indexes (p ≤ 0.05) showed a good agreement between ELISA-SE and IFAT (88.1%; k = 0.7237), and it was also observed in the comparison of RDT-rK39 with ELISA-SE (83.6%, k= 0.6561), IFAT (83.5%, k= 0.6605) and PA (85.0%, k= 0.7074). A bad agreement was detected in any association of ELISA-rk39 with the other tests in either symptomatic or asymptomatic animals. ELISA as well as RDT using recombinant antigenic protein (rK39) were the methods that detected the lowest prevalence rates (33.3%) of CVL in asymptomatic dogs. In conclusion, only one test does not adequately identify dogs with CVL and it is necessary the association of two or more diagnostic tests. Because of the good agreement indexes of RDT-rK39 when evaluated with ELISA-SE, IFAT and PA it was suggested as a complementary method to be used in association with either ELISA-SE or IFAT, particularly in the symptomatic dogs. Furthermore, new studies are recommended in order to improve the sensitivity of tests mainly for asymptomatic dogs.

O objetivo do presente estudo foi avaliar os métodos sorológicos usando ELISA (Ensaio Imunoenzimático Indireto) com o antígeno recombinante rK39 (ELISA-rK39) e o antígeno extrato solúvel bruto (ELISA-ES) e a RIFI (Reação de Imunofluorescência Indireta) em comparação com o método imunocromatográfico rápido (RDT-rK39) e o parasitológico direto (PA), para o diagnóstico da Leishmaniose Visceral Canina (LVC) em cães de Ilha Solteira, São Paulo, Brasil. Os resultados mostraram que 89% (60/67) dos cães foram positivos por pelo menos um teste diagnóstico sorológico (RIFI, ELISA-ES, ELISA-rk39 ou RDT-rK39) e somente 40,3% (27/67) foram positivos pelo PA. O ELISA-ES foi o teste que detectou anticorpos anti-Leishmania em maior número de cães (71,6%) seguido por ELISA-rK39, RIFI (65,7%) e por RDT-rK39 (55,2%). No total de cães analisados (assintomáticos e sintomáticos), o índice Kappa de concordância (p ≤ 0,05) foi considerado de boa concordância entre ELISA-ES e IFAT (88,1%; k= 0,7237) e entre RDT-rK39 com ELISA-ES (83,6%, k= 0,6561), RIFI (83,5%, k= 0,6605) e PA (85,0%, k= 0,7074). O índice de concordância ruim foi observado em qualquer associação de ELISA-rk39 com todos os outros testes nos animais sintomáticos e nos assintomáticos. Tanto o ELISA como o RDT com proteínas recombinantes (rK39) detectaram a menor porcentagem de cães assintomáticos (33,3%) em relação aos outros testes sorológicos. Em conclusão, somente um método diagnóstico não foi suficiente para identificar todos os cães positivos com LVC, principalmente os assintomáticos e por isso foi necessário a associação de dois ou mais métodos. Em função da boa concordância do teste RDT-rK39 com ELISA-ES, RIFI e PA, o mesmo foi sugerido como um teste complementar ao ELISA-ES ou RIFI para o diagnóstico da LVC, principalmente dos cães sintomáticos. No entanto, novos estudos são recomendados para melhorar a sensibilidade dos testes principalmente para cães assintomáticos.