Multiple resistance in equine cyathostomins: a case study from military establishments in Rio Grande do Sul, Brazil / Múltipla resistência de ciatostomíneos de equinos: um estudo de caso em estabelecimentos militares no Rio Grande do Sul, Brasil

Abstract Semi-intensive equine breeding system favors gastrointestinal nematode infections. The treatment of these infections is based on the use of anthelmintics. However, the inappropriate use of these drugs has led to parasitic resistance to the available active principles. The objective of this study was to evaluate the efficacy of the main classes of antiparasitic (ATP) used in control in adult and young animals, including: benzimidazoles (fenbendazole), pyrimidines (pyrantel pamoate), macrocyclic lactones (ivermectin and moxidectin), as well as the combination of active ingredients (ivermectin + pyrantel pamoate). The study was carried out in two military establishments, located in Rio Grande do Sul (RS), from January to December, 2018. The intervals between the treatments of the animals were performed from 30 to 90 days. Coproparasitological evaluations were determined by the egg count reduction in the faeces. Cyatostomine larvae were identified in pre and post-treatment cultures. The results demonstrated the multiple parasitic resistance of cyathostomins to fenbendazole, moxidectin in young animals, and to fenbendazole, pyrantel pamoate in adult animals. Thus, it is necessary to define or diagnose parasitic resistance to assist in the creation of prophylactic parasitic control, using suppressive treatment with ATP associated with integrated alternatives. The progress of parasitic resistance can be slowed.

Resumo O sistema semi-intensivo de criação de equinos favorece infecções por nematoides gastrointestinais. O tratamento dessas infecções é baseado no uso de anti-helmínticos. No entanto, o uso inadequado desses medicamentos levou à resistência parasitária aos princípios ativos disponíveis. O objetivo deste estudo foi avaliar a eficácia das principais classes de antiparasitários (ATP), utilizados no controle em animais adultos e jovens, incluindo: benzimidazois (fenbendazol), pirimidinas (pamoato de pirantel), lactonas macrocíclicas (ivermectina e moxidectina), bem como a combinação de ingredientes ativos (ivermectina + pamoato de pirantel). O estudo foi realizado em dois estabelecimentos militares, localizados no Rio Grande do Sul (RS), de janeiro a dezembro de 2018. Os intervalos entre os tratamentos foram realizados de 30 a 90 dias. As avaliações coproparasitológicas foram determinadas pela redução da contagem de ovos nas fezes. Foram identificadas larvas de ciatostomíneos nas coproculturas pré e pós tratamentos. Os resultados demonstraram a resistência parasitária múltipla dos ciatostomíneos ao fenbendazol, moxidectina em animais jovens, febendazole e pamoato de pirantel em animais adultos. Estabelecer o diagnóstico da resistência parasitária auxiliará na elaboração de um controle parasitário profilático, reduzindo o tratamento supressivo com ATP juntamente com alternativas de controle integrado. Dessa forma, o avanço da resistência parasitária poderá ser retardado.

Control of sheep gastrointestinal nematodes using the combination of Duddingtonia flagrans and Levamisole Hydrochloride 5% / Controle de nematódeos gastrintestinais de ovinos utilizando a combinação de Duddingtonia flagrans e Cloridrato de Levamisole 5%

Abstract The objective was to evaluate the action of D. flagrans pellets in association with Levamisole Hydrochloride 5% for controlling sheep gastrointestinal nematodes in the northeastern Brazil. Three groups of six sheep each were formed: group 1 received 3 g of the pellets (0.6 g of D. flagrans mycelium) for each 10 kg b.w., twice a week for six months, and deworming with Levamisole Hydrochloride 5% when EPG ≥ 1500; group 2 received a dosage of Levamisole Hydrochloride 5% when EPG ≥ 1500; and group 3 received 3 g of pellets without fungi for each 10 kg b.w., twice a week for six months. EPG counts, larval cultures, packed cell volume (PCV) and weighing were performed every 15 days; monthly, samples of grass from each paddock were collected. The mean EPG of the groups began to statistically differ from day 30 (p < 0.05). Group 1 required less deworming with Levamisole Hydrochloride 5% and showed superiority of PCV values ​​throughout the experiment (p < 0.05). There was a significant reduction (p < 0.05) in L3 recovery in the group 1 paddock from day 30 onwards. The use of D. flagrans pellets in association with Levamisole Hydrochloride 5% was effective for controlling gastrointestinal nematodes.

Resumo O objetivo foi avaliar a ação de péletes de Duddingtonia flagrans em associação ao Cloridrato de Levamisole 5% no controle de nematódeos gastrintestinais de ovinos no Nordeste do Brasil. Foram formados três grupos de seis animais cada: grupo 1 recebeu 3 g de péletes (0,6 g de micélio de D. flagrans) para cada 10 kg p.v., duaz vezes por semana durante seis meses, e vermifugações com Cloridrato de Levamisole 5% quando OPG > 1500; grupo 2 recebeu uma dosagem de Cloridrato de Levamisole 5% quando OPG ≥ 1500; e grupo 3 recebeu 3 g de péletes sem fungos para cada 10 kg de p.v., duas vezes por semana durante seis meses. Contagens de OPG, coproculturas, de volumes globulares (VG) e pesagens foram realizadas a cada 15 dias. Mensalmente, amostras de pasto de cada piquete eram coletadasa. A média de OPG dos grupos começou a diferir estatisticamente a partir do dia 30 (p < 0,05). O grupo 1 necessitou de menos vermifugações com Cloridrato de Levamisole 5% e demonstrou superioridade nos valores de VG durante todo o experimento (p < 0,05). Houve redução significativa (p < 0,05) nas L3 recuperadas no piquete do grupo 1 a partir do dia 30. Em conclusão, a utilização de péletes de D. flagrans em associação ao Cloridrato de Levamisole 5% foi eficaz no controle de nematódeos gastrintestinais de ovinos.

Apendicitis y parásitos: a propósito de 2 casos / Appendicitis and parasites: Reporting of 2 cases

Objetivo: Enfatizar la importancia de sospechar esta etiología en la patogenia de la apendicitis aguda, especialmente en pacientes procedentes de países endémicos. Casos clínicos: Presentamos dos casos, con cursos clínicos divergentes.

Aim: We would like to emphasize the importance of having a high grade of suspect about the parasitic etiology of appendicitis acute, especially in patients from endemic countries. Case report: We present two cases with divergent clinical evolution.

"Pós de doliarina e ferro": um dos remédios importantes da Farmácia Peckolt / "Doliarina and iron powder": an important medicine at Peckolt Pharmacy

Resumo O farmacêutico Theodoro Peckolt é uma das mais importantes figuras da história da química de produtos naturais brasileira. Como outros farmacêuticos do século XIX que atuavam no Brasil, desenvolveu formulações que comercializava em sua farmácia, localizada no Rio de Janeiro, e que tiveram grande prestígio junto à população e à classe médica. O texto apresenta a relação entre a doença identificada inicialmente como opilação e a terapêutica utilizada no século XIX, destacando uma das formulações da Farmácia Peckolt – “Pós de doliarina e ferro”. O produto tem sua origem no látex da espécie Ficus gomelleira(figueira-branca ou gameleira). O artigo tem entre seus objetivos revelar a composição química, feita por métodos modernos de análise do látex deFicus gomelleira.

Abstract The pharmacist Theodoro Peckolt was one of the most important figures in the history of the chemistry of natural Brazilian products. Like other nineteenth-century pharmacists in Brazil, he developed formulations and sold them at his pharmacy in Rio de Janeiro, and these enjoyed great prestige in the eyes both of the public and the medical community. The article discusses the relation between the illness originally called “opilação” (ancylostomiasis, or hookworm) and nineteenth-century treatment. It focuses especially on Peckolt Pharmacy’s “Doliarina and iron powder,” a formulation extracted from the Ficus gomelleira rubber plant. One of the article’s goals is to use modern methods to analyze Ficus gomelleira and identify the chemical composition of the drug.

Eficácia de Chenopodium ambrosioides (erva-de-santa-maria) no controle de endoparasitos de Coturnix japônica (codorna japonesa) / Effectiveness of Chenopodium ambrosioides (santa maria herb) for controlling Coturnix japonica (japanese quail) endoparasites

O objetivo foi testar in vitro e in vivo a eficácia da planta medicinal Chenopodium ambrosioidesLinnaeus, 1786 (erva-de-santa-maria), nas formas fitoterápica e homeopática, como meios alternativos para o controle de endoparasitos de Coturnix japonica Temminck & Schlegel, 1849 (codorna japonesa), um sério problema que afeta a criação e desempenho de aves domésticas, ocasionando morte quando muito intenso, retardo de crescimento, redução de índice de conversão alimentar e aumento na suscetibilidade às doenças infecciosas. As metodologias utilizadas foram preconizadas por Coles et al. (1992), creditada pela World Association for the Advancement of Veterinary Parasitology (WAAVP). A pesquisa evidenciou a presença dos gêneros Ascaridiae Eimeria. O ensaio in vitro demonstrou alta taxa de redução na inibição de eclosão de ovos de Ascaridiasp. (100,00%) e significativa taxa de redução na destruição de oocistos de Eimeriasp. (47,06%). O ensaio in vivodemonstrou alta taxa de redução na contagem de ovos de Ascaridiasp. nas fezes (100,00%) e expressiva taxa de redução na contagem de oocistos de Eimeriasp. nas fezes (60,33%). Chenopodium ambrosioides mostrou em certos momentos superioridade frente ao produto tradicional (Thiabendazole/Mebendazole) e índices superiores aos preconizados pelo Ministério da Agricultura do Brasil e Organização Mundial da Saúde como indicativos de eficácia.

The aim was in vitro and in vivo to test the effectiveness of Chenopodium ambrosioides Linnaeus, 1786 (santa maria herb) medicinal plant, in regard to phytotherapeutic and homeopathic forms as alternative methods to control Coturnix japonica Temminck & Schlegel, 1849 (japanese quail) endoparasites. The parasitosis is a serious problem affecting domestic poultry raising and performance causing death, delay in grow, food conversion rate reduction and increase of susceptibility to infectious diseases. Methodologies were advocated by Coles et al. (1992), corroborated by World Association for the Advancement of Veterinary Parasitology (WAAVP). Presence of the genera Ascaridia and Eimeria was displayed by this survey. In vitro essay demonstrated high reduction rate on eggs eclosion inhibition of Ascaridia sp. (100.00%) and significant reduction rate on oocyst destruction of Eimeria sp. (47.06%). In vivo essay demonstrated high fecal egg counting reduction rate of Ascaridia sp. (100.00%) and expressive fecal oocyst counting reduction rate of Eimeriasp. (60.33%). C. ambrosioides showed upper rates front traditional product (Thiabendalol/Mebendazol) as well as to those ones advocated by the Brazilian Ministry of Agriculturel and the World Health Organization as effectiveness indicative.

Lagochilascaris minor Leiper, 1909 (Nematoda: Ascarididae) in Mexico: three clinical cases from the Peninsula of Yucatan / Lagochilascaris minor Leiper, 1909 (Nematoda: Ascarididae) en México: tres casos clínicos de la Península de Yucatán

Human lagochilascariasis (HL) is a parasite produced by Lagochilascaris minor Leiper 1909 that also can be found in cats and dogs. HL is considered an emerging zoonosis in the Americas, spreading from Mexico to Argentina, and the Caribbean Islands. The present paper describes three HL cases from the Peninsula of Yucatan, Mexico, recorded in the last decade. It describes the characteristics of the lesions and discusses the route of transmission in humans and particularly in the observed patients.

La Lagochilascariasis humana (HL) es producida por Lagochilascaris minor Leiper, 1909; el cual es un parásito que puede ser encontrado también en gatos y perros. HL es considerada una zoonosis emergente en América distribuida desde México hasta Argentina y las islas del Caribe. El presente artículo describe tres casos de HL en la Península de Yucatán, México registrados en la última década. Se describen las características de las lesiones y se discute la ruta de transmisión en humanos y particularmente en los pacientes observados.

Eliminación de estadios juveniles de Ascaris lumbricoides (Linneo, 1758) por via oral: Reporte de un caso y algunas consideraciones epidemiológicas / Elimination of juvenile stages of Ascaris lumbricoides (Linnaeus, 1758) by mouth: Report of a case and some epidemiological considerations

Ascariosis is a parasitic disease caused by Ascaris lumbricoides, a large geohelmint endemic in our country. At present, ascariosis is a rare infection in Chile. We present a case of an adult, resident of the Villa Alemana municipality, Valparaiso Region, who spontaneously expelled two juvenile nematodes by mouth. We review the manifestations produced by the larval and adult stages of this parasite including their diagnosis, treatment, and epidemiological considerations.

La ascariosis es una parasitosis provocada por Ascaris lumbricoides, el geo-helminto de mayor tamaño que afecta al ser humano en nuestro país. En Chile, la ascariosis es una infección poco frecuente en la actualidad. Se presenta el caso de un adulto residente en la comuna de Villa Alemana, Región de Valparaíso, que eliminó en forma espontánea dos ejemplares del nemátodo en estado juvenil por vía oral. Se revisan las manifestaciones producidas por este parásito en la fase larvaria y adulta, el diagnóstico, el tratamiento y algunas consideraciones epidemiológicas.

Infección por Strongyloides stercoralis: estudio epidemiológico, clínico, diagnóstico y terapéutico en 30 pacientes / Infection due to Strongyloides stercoralis: epidemiological, clinical, diagnosis findings and outcome in 30 patients

Background: Strongyloides stercoralis is a nematode parasite, which is endemic in tropical and subtropical regions. Infection usually remains asymptomatic, but in immunocompromised hosts severe and life-threatening manifestations such as hyperinfection syndrome and disseminated disease might occur. Methods: We retrospectively analyzed the epidemiological and clinical characteristics, including HIV co-infection, microbiological findings, and outcome in 30 patients with strongyloidiasis, who attended in the Infectious Diseases F. J. Muñiz Hospital in Buenos Aires from January 2004 to December 2008. Results: The study included 20 men and 10 women with an average age of 33 years. HIV co-infection was present in 21 patients (70 percent) with a median CD4 T cell count of 50 cells/mm³ (range 7-355) (average 56 cells/mm³). Among HIV negative patients the following comorbidities were detected: tuberculosis (n = 3) and chronic alcoholism, leprosy treated with corticosteroids, immunosuppressive treatment for psoriasis, and diabetes mellitus (each in one patient). Two patients did not have any predisposing diseases or immunosuppressive treatments. Seventeen patients presented with diarrhea and were classified as chronic intestinal strongyloidiasis (57 percent), asymptomatic infection with peripheral eosinophilia was diagnosed in 7 (23 percent), and 6 patients (20 percent) developed hyperinfection syndrome. Seventeen patients (57 percent) presented peripheral eosinophilia. Diagnosis was achieved by direct visualization of larvae in feces by Baermann technique (n = 20), by multiple stool smears examinations (n = 2), by combination of both (n = 1), by visualization of the filariform larvae in duodenal fluid and stool (n = 1), and in fecal and bronchoalveolar lavage specimens (n = 6). Overall mortality in this series was 20 percent (6/30). There was no significant correlation between age and mortality. A significant inverse correlation between the survival rate and CD4 T-cell count as well as eosinophilia was observed. There was also a significant correlation between HIV co-infection and mortality. Twenty-two patients responded favorably to treatment with ivermectin.

Antecedentes: Strongyloides stercoralis, parásito endémico de áreas tropicales y subtropicales del planeta, en sujetos inmunodeprimidos puede cursar con formas graves y aun mortales como el síndrome de hiperinfestación y la enfermedad diseminada. Métodos: Análisis retrospectivo de las características epidemiológicas, manifestaciones clínicas, co-infección por virus de inmunodeficiencia humana (VIH), hallazgos microbiológicos y evolución de 30 pacientes con estrongiloidiasis, atendidos en el Hospital de Enfermedades Infecciosas F. J. Muñiz de Buenos Aires, entre enero 2004 y diciembre 2008. Resultados: Se incluyeron en la evaluación 20 hombres y 10 mujeres con una mediana de edad de 33 años. Co-infección por VIH hubo en 21 pacientes (70 por ciento); la mediana de linfocitos T CD4+ en ellos al momento del diagnóstico de la parasitosis fue de 50 céls/mm³ (rango 7 a 355), (media de 56 céls/mm³). En los pacientes seronegativos para VIH, se comprobaron las siguientes co-morbilidades: tuberculosis (n: 3) y un caso de cada una de las siguientes afecciones: alcoholismo crónico, diabetes mellitus, reacción lepromatosa bajo corticotera-pia, y psoriasis en tratamiento inmunosupresor. Hubo dos pacientes sin aparentes enfermedades de base. Diecisiete pacientes presentaron enfermedad intestinal crónica con diarrea (57 por ciento), era asintomática y fue sospechada por la eosinofilia periférica (n: 7, 23 por ciento) y se clasificó como síndrome de hiperinfestación (n: 6, 20 por ciento) diagnosticado por la identificación de larvas en la materia fecal y secreciones broncopulmonares. Diecisiete pacientes (57 por ciento) presentaron eosinofilia periférica. El diagnóstico se efectuó por la visualización directa de las larvas en muestras de heces en fresco mediante la técnica de concentración de Baer-man (n: 20); por el examen copro-parasitológico seriado (n: 2) y por ambos métodos (n: 1); en líquido duodenal y materia fecal (n: 1) y por la identificación de larvas en materia fecal y secreciones respiratorias (n: 6). Letalidad global: 20 por ciento (6/30). Los pacientes con eosinofilia tuvieron una menor letalidad que aquellos sin esta respuesta (p < 0,001). No hubo correlación estadística entre la edad y la supervivencia. Sí fue significativa la correlación entre el recuento de CD4 y la letalidad, incluyendo 18 de los 21 pacientes seropositivos para VIH (p: 0,03). Finalmente, la correlación seropositividad para VIH y letalidad también fue significativa. Veintidós pacientes respondieron a la terapia antiparasitaria con ivermectina y evolucionaron favorablemente.

Ocular angiostrongyliasis: first case report from Jamaica / La angiostrongyliasis ocular: primer caso reportado en Jamaica

A 30-year old female presented with a one-month history of blurred vision in her left eye. Examination revealed a live motile worm in the anterior chamber of the left eye. She also had retinal pigment epithelial disturbance with focal intraretinal haemorrhage. The 19.9 mm worm was surgically removed and identified as Angiostrongylus cantonesis. She was treated with oral mebendazole. Her vision improved from counting fingers in the left eye to 6/36. This is the first documented case of ocular angiostrongyliasis in Jamaica.

Una mujer de 30 años se presentó con una historia de visión borrosa en el ojo izquierdo por un mes. El examen reveló la presencia de un gusano móvil vivo en la cámara anterior de su ojo izquierdo. También presentaba una alteración del epitelio pigmentario de la retina con hemorragia intraretiniana focal. El gusano de 19.9 mm fue extraído quirúrgicamente e identificado como Angiostrongylus cantonesis. La paciente fue tratada con mebendazole oral. Su visión mejoró - pasando de poder contar sólo sus dedos con el ojo izquierdo a una visión de 6/36. Se trata del primer caso de angiostrongyliasis ocular documentado en Jamaica.

Capillariasis: chronic watery diarrhea--not only from microorganisms.

A 54-year-old male Thai patient from Prachin Buri Province presented with a history of chronic watery diarrhea for many years. He passed stool five to ten times per day with occasionally colicky pain, abdominal distension, nausea and vomiting. He had visited hospitals and private clinics and received treatment but with no improvement. He presented to the Hospital for Tropical Diseases, Bangkok, Thailand, where on physical examination, he had moderate dehydration, weakness, abdominal distension and a gurgling abdomen. The eggs, larvae and adult worms of Capillaria philippinensis were found on stool examination. The patient was admitted and treated with Mebendazole for 20 days, whereupon his symptoms resolved. Two months previously, he had ingested a raw small fresh-water fish dish called "Phra-Pla Siw/Soi". Small fresh-water fish near the patient's home were collected and examined for Capillaria philippinensis larva. The results were negative for parasitic organisms.

Prolonged irritative voiding symptoms due to Enterobius vermicularis bladder infestation in an adult patient

Enterobius vermicularis (pinworm) is one of the most prevalent intestinal parasites in the world. The urinary tract is rarely affected and few cases have been reported. We report a case of bladder infestation by mature female worms of E. vermicularis in a woman presenting with irritative voiding symptoms.

MONRATE: A descriptive tool for calculation and prediction of re-infection of Ascaris lumbricoides (Ascaridida: Ascarididae)

The study presents an interactive descriptive tool (MONRATE) for calculating and predicting reinfection rates and time of Ascaris lumbricoides following mass chemotherapy. The implementation was based on the theoretical equation published by Hayashi in 1977, for time-prevalence: Y=G [1-(1-X)N-R] as modified by Jong-Yil in 1983. Using the Psuedo-Code of the MONRATE tool, the calculated monthly reinfection rates (X) for the LGAs are (names are locations in Nigeria in a region predominately populated by the Yoruba speaking tribes of Nigeria whose traditional occupations are agriculture and commerce): Ewekoro (1.6 %), Odeda (2.3 %), Ado-odo/Otta (2.3 %), Ogun Waterside (3.8 %) and Obafemi/Owode (4.2 %). The mathematical mean of ‘X’ values in the study areas for Ogun State was 2.84. The calculated reinfection time (N months) for the LGAs are varied such as Ado-odo/Otta (12.7), Ogun Waterside (21.8), Obafemi/Owode (22.92), Odeda (25.45), and Ewekoro (25.9). The mean value for N in Ogun State was 21.75. The results obtained from MONRATE were compared with those obtained using the mathematical equation and found to be the same. Rev. Biol. Trop. 55 (3-4): 755-760. Epub 2007 December, 28.

Se presenta una herramienta descriptiva e interactiva (MONRATE) para calcular y predecir las tasas y tiempo de reinfección con Ascaris lumbricoides tras un tratamiento de quimioterapia. Nos basamos en la ecuación propuesta por Hayashi en 1977 para el tiempo de prevalencia: Y=G [1- (1-X)N-R], según la modificó Jong-Yil en 1983. Utilizando el código Psuedo de la herramienta de MONRATE, las tasas de reinfección mensuales (X) para varios sitios de Nigeria, África, son: Ewekoro (1.6 %), Odeda (2.3 %), Ado-odo/Otta (2.3 %), Ogun Waterside (3.8 %) y Obafemi/ Owode (4.2 %). El promedio matemático de los valores de "X" en el área de estudio del Estado de Ogun fue 2.84. El tiempo de reinfección calculado (N meses) para LGAs es variado: Ado-odo/Otta (12.7), Ogun Waterside (21.8), Obafemi/Owode (22.92), Odeda (25.45) y Ewekoro (25.9). El valor promedio para N en el Estado de Ogun fue 21.75. Los resultados del programa MONRATE son iguales a los producidos por la ecuación.

Instruction in behavior modification can significantly alter soil-transmitted helminth (STH) re-infection following therapeutic de-worming.

Five elementary ("prototypic") schools located in five districts in central Java were selected and the children examined for helminth infections (Ascaris, Trichuris, hookworm). They were de-wormed with a course of mebendazole and provided with 6-7 months of "behavioral remediation instruction" (BRI). In other ("control") schools, children were treated with mebendazole but were not provided BRI. The objective was to determine the effectiveness of BRI in minimizing infection/re-infection following deworming. After the 6-7 month course of BRI in the prototypic schools, all the children (in both the prototypic and control schools) were re-examined for geohelminth infection. The schools in two of the five districts were omitted from further analysis because the overall prevalence of infection was low (<10%) and the infections were dominated by hookworm which are only moderately susceptible to mebendazole. Comparisons of prototypic and control schools in the other three districts provided compelling evidence that BRI was quite effective in reducing both the frequency and intensity of infection with Ascaris and Trichuris. We suggest that instructing children and adults corrects personal habits which are conducive to infection and can be an effective and safe substitute for repeated deworming, reducing the opportunity for the emergence of drug-resistant helminthes, which should prolong the time benzimidazoles may be used for treatment of geohelminth infection.

A successful experience of soil-transmitted helminth control in the Republic of Korea

Soil-transmitted helminths (STH), namely Ascaris, Trichuris and hookworms (Ancylostoma and Necator), present a global health problem to about a half of the earth's population. In the Republic of Korea, STH were highly prevalent and were considered a high priority target for national control. To promote the control, a non-governmental organization named Korea Association for Parasite Eradication (currently Korea Association of Health Promotion) was founded in 1964, and mass fecal examination followed by selective mass chemotherapy with anthelmintics was performed twice a year from 1969 to 1995 targeting whole nationwide schoolchildren. Meanwhile, decreasing patterns of national STH infections have been monitored by 7 times' quinquennial national surveys targeting general population. In 1971, the overall intestinal helminth egg positive rate was 84.3% (Ascaris 58.2%, Trichuris 65.4%, and hookworms 10.7%), which became 63.2% in 1976, 41.1% in 1981, 12.9% in 1986, 3.8% in 1992, 2.4% in 1997, and 4.3% (Ascaris 0.03%, Trichuris 0.02%, and hookworms 0%) in 2004. During the control period, national economy rapidly developed, and living standards including environment, sanitation, and agricultural technology greatly improved, which undoubtedly boosted the STH control effects. Our experience indicates that social driving force to establish an eligible national control system to conduct repeated mass chemotherapy, together with improvement of environment and sanitation, is important for initiating and achieving STH control in a developing community.

Strongyloidiasis presenting as duodenal obstruction.

Small bowel obstruction due to Strongyloides stercoralis is rare especially in immunocompetent individuals. We report a case of a 45-year-old man who presented with a history of severe abdominal pain, intermittent low-grade fever and vomiting. An upper GI endoscopy revealed a diffusely edematous second portion of duodenum and narrowing in the third part of duodenum with food residue in the stomach. Barium contrast upper-GI radiography revealed partial small-bowel obstruction. Duodenal biopsy specimens revealed Strongyloides stercoralis in the submucosa with inflammatory infiltrate. The patient was treated with ivermectin and had complete resolution of symptoms.

Resolution of eosinophilia after treatment of cutaneous gnathostomiasis.

The present study was to investigate the dynamics of eosinophil in peripheral blood of patients with cutaneous gnathostomiasis before and after worm removal. The total of 28 proven cases of cutaneous gnathostomiasis treated by albendazole were included in the present study. The absolute eosinophil count (AEC) was higher than 500/ul during infestation in almost all the patients, the positive rate was 89%, and significantly decreased to normal level after receiving albendazole and worm removal within 3 months in 96%. In conclusion, an increas of AEC is another important hallmarks of cutaneous gnathostomiasis and this parameter could be the earlier indicator for responsiveness to treatment.

Púrpura em paciente com estrongiloidíase disseminada / Purpura in patient with disseminated strongiloidiasis

A infecção pelo Strongyloides stercoralis em associação com imunosupressão pode manifestar-se com lesões em múltiplos órgãos e sistemas, caracterizando a forma disseminada da doença. Lesões cutâneas não são freqüentemente relatadas e, se presentes, manifestam-se como rash e petéquias. Púrpuras bem definidas são pouco descritas. No presente trabalho é descrito um caso de estrongiloidíase disseminada, com acometimento cutâneo em forma de púrpura, que se desenvolveu em um paciente timectomizado e usuário crônico de corticosteróide devido à miastenia gravis.