Flukicide efficacy against Fasciola hepatica of Triclabendazole and Nitroxynil in cattle of the central valley of Chile / Avaliação da eficácia de triclabendazol e nitroxinil para o tratamento da infeção por Fasciola hepatica em bovinos do Vale Central do Chile

Abstract On a farm with permanent history of fasciolasis a study was performed aimed to know the efficacy of triclabendazole (TCBZ) and then to contrast with that of nitroxynil. Thirty-nine cattle naturally infected with Fasciola hepatica were randomly allocated into 4 experimental groups: Group 1 (control) was left untreated. Group 2 was treated with of 12 mg/kg body weight (bw) of TCBZ by oral route. Group 3 treated with 24 mg/kg bw TCBZ orally. Group 4 was treated with 10 mg/kg bw of nitroxynil subcutaneously. The anthelmintic efficacy was calculated as the percentage of reduction in faecal egg count (FEC) at 14 and 28 d post-treatment. Results indicated that there were no significant differences in the percentage of FEC reduction between control group and the groups treated with 12 or 24 mg/kg of TCBZ. On the contrary, the treatment with nitroxinyl significantly reduced the FEC and decreased the percentage of positive animals. In conclusion, Fasciola hepatica is reported for first time as resistant to TCBZ in Chile, which highlights the need of rotating drugs and assessing the efficacy of the administered drug in order to avoid the selection of resistant worms.

Resumo Em uma fazenda com histórico de fasciolose permanente, foi realizado um estudo com o objetivo de conhecer a eficácia do triclabendazol (TCBZ) e depois contrastar com o do nitroxinil. Trinta e nove bovinos naturalmente infectados com Fasciola hepatica foram distribuídos aleatoriamente em 4 grupos experimentais: Grupo 1 (controle), sem tratamento. O grupo 2 foi tratado com 12 mg/kg de peso vivo (PV) do TCBZ por via oral (VO). Grupo 3 tratado com 24 mg/kg de PV TCBZ por VO. O grupo 4 foi tratado com 10 mg /kg de PV Nitroxinil via subcutânea. A eficácia anti-helmíntica foi calculada comparando a percentagem de redução na contagem de ovos fecais (FEC) 14 e 28 dias pós tratamento. Não houve diferença significativa na porcentagem de redução FEC entre o grupo controle e os grupos tratados com 12 ou 24 mg/kg de TCBZ. Entretanto, o tratamento com nitroxinil reduziu significativamente o FEC e diminuiu a porcentagem de animais positivos. Em conclusão, a Fasciola hepatica é relatada pela primeira vez como resistente ao TCBZ no Chile, o que destaca a necessidade de realizar uma rotação em relação aos medicamentos anti-helmínticos e avaliar a eficácia do mesmo, a fim de evitar a seleção de vermes resistentes.

Collection of Clonorchis sinensis adult worms from infected humans after praziquantel treatment

A cohort was established for evaluation of cancer risk factors in Sancheong-gun, Gyeongsangnam-do, Korea. As one of the cohort studies, stools of 947 residents (403 males and 544 females, age range: 29-86 years) were screened for Clonorchis sinensis eggs using both Kato-Katz method and formalin-ether sedimentation technique. The overall egg positive rate of C. sinensis was 37.7% and individual EPG (eggs per gram of feces) counts ranged from 24 to 28,800. Eight egg positive residents voluntarily joined a process of collection of the passed worms after praziquantel treatment. A total of 158 worms were recovered from 5 of the 8 treated persons, ranged from 3 to 108 in each individual. The worms were 15-20 mm x 2-3 mm in size, and showed brown-pigmented, red, or white body colors. This is the first collection record of C. sinensis adult worms from humans through anthelmintic treatment and purgation. The adult worms of C. sinensis may be paralyzed by praziquantel and then discharged passively through bile flow in the bile duct and by peristaltic movement of the bowel.

Paragonimiasis in Yongjia County, Zhejiang Province, China: clinical, parasitological and karyotypic studies on Paragonimus westermani.

Paragonimiasis in Yongjia County, Zhejiang Province, China, has been of such public health concern that a specialized Institute for Paragonimiasis Control has been established there. The study reported here involved both parasitological research on Paragonimus westermani in the endemic areas and a clinical analysis of 94 cases of paragonimiasis. Eggs were found in sputum, feces and brain tissue in 45 cases. Twenty patients, 19 of whom where children under 10 years of age, showed hepatic injury. Treatment with praziquantel or bithionol had satisfactory results in all cases. Dimensions of the parasite eggs, metacercariae from freshwater crabs and adult flukes suggested that the form of P. westermani in Yongjia is the 'small type': a suggestion supported by karyotypic studies on gonad cells from adult flukes collected from experimentally infected animals as all were found to be diploid. In conclusion, the 'small type' or diploid form of P. westermani is the cause of paragonimiasis pulmonary symptoms in Yongjia.

Epidemiology of clonorchiasis in Ninh Binh Province, Vietnam.

Clinical and stool examinations for clonorchiasis were carried out in an endemic area, Kim Son District, Ninh Binh Province, Vietnam. Stool examination with the Kato-Katz technic revealed that in 306 residents selected randomly, 42 people (13.7%) were infected with Clonorchis sinensis. The rate was biased towards men (23.4%) as opposed to women (1.5%) and increased with age. No children younger than 10 years old were infected, reflecting difference in a chance for acquisition of infection through a habit of eating raw fish. Few clinical abnormalities were found by blood and urine examinations of the patients. Treatment with praziquantel decreased the infection rate to 5.3% at 6 weeks later. Snails, Melanoides tuberculatus, collected from ponds around the settlements were infected with cercariae at a rate of 13.3%. Farmed fish (Hypophthalmichtys molitrix) in the ponds were infected with metacercariae at rates of 56.4% in small individuals and 100% in large ones. The life cycle of C. sinensis is exclusively completed in the ponds and the traditional habit of eating raw fish in summer was thought to be a major route of infection.

Opisthorchiasis and intestinal fluke infections in northern Thailand.

Four hundred and thirty-one residents from 16 provinces in northern Thailand who had previously been found positive for Opisthorchis viverrini or Opisthorchis viverrini-like eggs were given praziquantel 40 mg/kg. The stool was collected for 4 to 6 times and examined for adult worms. The prevalence of Opisthorchis viverrini in this group was 11.6%. Intestinal flukes, Haplorchis taichui and Haplorchis yokogawai, were predominantly found in 63.11% and 10.44% respectively. Other intestinal flukes (Centrocestus caninus, Echinostoma malayanum, Haplorchis pumilio, Phaneropsolus bonnei, Plagiorchid flukes, Prosthodendrium molenkampi and Stellantchasmus falcatus) were also found in small numbers.

Fasciolasis hepática en ninos: manifestaciones clinicas poco frecuentes / Hepatic fascioliasis in children: uncommon clinical manifestations

La presente revisión tiene como objetivo identificar las características clínicas, epidemiológicas y la evolución de cuatro niños con Fasciola hepática con manifestaciones poco usuales, evaluados en el Servicio de Gastroenterología Pediátrica del Instituto de Salud del Niño, Lima-Perú, entre 1988 y 1992. El primer paciente fue una niña de 9 años de edad que tenía fiebre, edema de miembros inferiores, circulación colateral y hepatomegalia predominantemente del lóbulo derecho. El diagnóstico inicial fue un neoplasma hepático. El segundo caso fue un niño de 6 años de edad que tuvo hemorragia gastrointestinal alta y fiebre; el diagnóstico endoscópico demonstró hemobilia. El tercer caso fue un niño de 12 año de edad que presentó edema generalizado y fue diagnosticado como sindrome nefrótico pero este diagnóstico fue descartado. El cuarto paciente fue un niño de 9 años de edad que presentó ictericia, fiebre y hemorragia gastrointestinal alta. Se verificaron cirrosis y várices esofágicas. En los cuatro pacientes el diagnóstico se realizó mediante la identificación de los huevos del parásito en heces. Los tres primeros casos respondieron satisfactoriamente al tratamiento con bithionol, el cuarto paciente falleció debido a falla sistémica.

The impact of a decade long opisthorchiasis control program in northeastern Thailand.

Based on the figures obtained from a regional survey in 1981, the overall prevalence of opisthorchiasis in northeastern Thailand was as high as 34.6%. Traditional consumption of improperly cooked fish dishes and unhygienic defecating habits among rural inhabitants have been recognized as significant factors determining such high prevalence of this liver fluke in that area. Following experience of Mahidol University's Faculty of Tropical Medicine in Thailand of treating liver fluke infected individuals with praziquantel, the Ministry of Public Health started a liver fluke control program in the northeast as special service units in 1984 in 4 provinces. In 1988, the program was expanded to cover all 19 northeastern provinces, services being rendered at a community level covering stool examination and treatment of positive cases. Intensive health education was integrated as one element of liver fluke control program. During the early phase of operation (attack phase) a mobile stool examination team was the crucial strategy for active service. Following the attack phase, passive service was operated at each health service facility provided that results of population based program evaluation in each area showed a low prevalence according to the set target. Regionwide assessments in 1991 and 1992 indicated a declining trend of prevalence from 34.6% to 30.19% and 24.01%, respectively. In 1994, a population-based sampling survey was carried out to measure the effect of the liver fluke control program over 10 years operation (1984-1994) on both behavioral outcomes and prevalence impact. Sample for the assessment of behavior were 1,268 individuals, while another 1,912 samples were used for determining disease prevalence. Health related behaviors regarding frequent consumption of uncooked fish dishes decreased from 14% in 1990 to 7% in 1994 while occasional consumption remains as high as 42%. The prevalence of opisthorchiasis is 18.5% with a large variation in infection rate (5.20-56.25%).

Studies on efficacy of praziquantel and mebendazole-medicated salt in treatment of Echinochasmus fujianensis infection.

The therapeutic effect of praziquantel and mebendazole-medicated salt has been studied in 109 cases with Echinochasmus fujianensis infection. These cases were randomly divided into four groups: 2 groups with a single dose of praziquantel 5 mg/kg or 2.5 mg/kg; and other 2 groups with mebendazole 800mg or 400 mg in 10d table salt. Four weeks after treatment, the egg negative conversion rates were 100%, 92.3%, 85.2% and 71.4% respectively, the egg reduction rates were 84.8-100%, and side-effects were mild. The symptoms caused by infection such as abdominal pain, diarrhea, distension and anorexia were obviously relieved. These data indicated that praziquantel is the drug of choice in the treatment of Echinochasmus fujianensis. The dosage is only 2.5 mg/kg, and its egg negative conversion rate and reduction rate reach 92.3% and 95.4%, respectively. For convenience, the dosage can be made according to their age. Children under 12 take half a tablet (100 mg), and one tablet (200 mg) for those over 12. This dosage is approximately equal to 2.5-5.0 mg/kg. Although the efficacy of mebendazole is lower than praziquantel, its egg negative conversion rate also reaches 71.4-85%. Mebendazole-medicated salt can be used for treating Echinochasmus fujianensis infection as the presence of co-infection with nematodes.

Impact mass chemotherapy with praziquantel on schistosomiasis control in Fanhu village, People's Republic of China.

The paper describes the endemic situation of schistosomiasis japonica in Fanhu village, Poyang Lake region, China and the effect of the strategy of combining annual mass chemotherapy with health education on schistosomiasis control in the community. The results showed that the prevalence of infection with schistosome reduced form 26.0% in 1992 to 10.7% in 1994, the intensity of infection in residents decreased from 1.92 in 1992 to 0.55 in 1994 and the condition of hepatomegaly, splenomegaly and liver fibrosis also improved after chemotherapy in the individuals in the case prospective study. Moreover, the future strategies of schistosomiasis control in this area have been suggested according to the transmission of schistosomiasis in the lake region and the effect of anti-schistosomiasis control indifferent populations.

Quimioterapia de la cisticercosis. Resultados de 10 años o más después del seguimiento / Chemotherapy for cysticercosis. Results of 10 or more years after follow up

La quimioterapia de la neurocisticercosis nació lógicamente por el poco éxito de la cirugía, que generalmente es paliativa y no curativa. Praxicuantel es la única droga acerca de la cual se han publicado series de más de 100 casos y con seguimiento de más de dos años. Su uso se ha hecho universal. Razones éstas para escogerlo como tema de este escrito. Se pretende contribuir a determinar su valor terapéutico en el tratamiento de la neurocisticercosis por medio del monitoreo clínico y radiológico de 50 enfermos seguidos entre 10 (72 por ciento) y más de 10 años (28 por ciento). Se les había tratado con praxicuantel a la dosis de 50mg por kilogramo de peso, durante 15 días. El 26 por ciento recibió un tratamiento, el 58 por ciento dos tratamiento y el 22 por ciento tres o más. Se les estudió una vez más clínica y radiológicamente por tomografía axial computada de cráneo o resonancia magnética, las pruebas biológicas se hicienron únicamente en los casos sospechosos de actividad. Como resultados se registró 68 por ciento de curaciones clínicas o mejorías importantes. Se hace énfasis en 6 por ciento de los casos en donde el proceso de curación clínica fue aparente. Se confirma que neurociticercosis es un padecimiento crónico generalizado, en el que la evolución se hace por períodos de actividad, alternando con períodos de recesión. Se condena el uso de testigos y se sugiere para ulteriores investigaciones el que sigan amplias series de casos durante largos lapsos. Se insiste en que el mejor tratamiento de la enfermedad es la profilaxis

Paragonimiasis in Sin Ho District, Lai Chau Province, Viet Nam.

Forty-four cases of pulmonary paragonimiasis, two also with evidence of cerebral infection, were found in Sin Ho District in Northern Viet Nam. There were 30 males and 14 females, 2-30 years of age. The diagnosis was made by sputum examination. Pet dogs and wild dogs in the area were also found infected and the people often eat roasted crabs.

Esquistossomose aguda com comprometimento cerebral: relato de caso / Acute schistosomiasis with brain involvement: case report

É relatado um caso de esquistossomose na fase aguda com comprometimento cerebral precoce, síndrome piramidal nos membros inferiores, líquido cefalorraquidiano (LCR) normal e lesoes com padrao desmielinizante na ressonância magnética (RM) encefálica. O diagnóstico foi comprovado através da imunofluorescência indireta para esquistossomose no LCR. O envolvimento encefálico pelo Schistosoma mansoni é menos frequente do que o medular e a resposta ao tratamento com o praziquantel e a prednisolona foi eficaz neste caso. Sao poucos os relatos de neuroesquistossomose encefálica. Devido a esse fato sua fisiopatologia e terapêutica necessitam de melhores estudos. Os aspectos imunológicos e apresentaçao na RM foram enfatizados.

Antibodies in serum of patients with clonorchiasis before and after treatment.

Sera of 31 patients infected with Clonorchis sinensis were examined using fraction 1 antigen by ELISA during a one-year observation. The results of ELISA with Igs, IgG and IgA demonstrated high sensitivity (100%, 100% and 90%) and specificity (100%, 100% and 87%). Sera specific Igs and IgG were significantly decreased in the 3rd month after treatment with praziquantel (25mg/kg body weight in one dose), and IgA was significantly decreased in the 1st month (paired t-test, p < 0.05). No eggs were found in the stool after treatment. Detection of sera specific Igs, IgG and IgA by ELISA was combined with stool examination to evaluate the effect of praziquantel and the completeness of the cure.

Esquistossomose mansônica: tratamento de crianças e adultos com praziquantel (30 ou 40 mg/kg/dia, por dois dias) / Schistosomiasis mansoni: treatment of children and adults with praziquantel (30-40 mg/kg/dia for two days)

Sessenta pacientes portadores de esquistossomose mansônica foram tratados com praziquantel, 30 ou 40 mg/Kg/dia, por dois dias consecutivos. Foram formados quatro grupos de 15 pacientes cada um. Em dois grupos (A1 e A2) situavam-se aqueles de menor idade (entre 7 e 14 anos) e nos outros dois, os pacientes com idade igual ou superior a 18 anos (B1 e B2). Os grupos com índice 1 receberam a dose menor. Os índices de cura (porcentagem) obtidos foram os seguintes: A1 = 47; A2 = 40; B1 = 67 e B2 = 80. A tolerabilidade foi considerada ótima ou boa em todos (98,3 por cento), exceto em um paciente, em que foi regular. Os sintomas anteriores ao tratamento reduziram-se acentuadamente no grupo curado e, em menor escala, também no grupo não curado.

Púrpura trombocitopénica trombótica: experiencia del Hospital General del Centro Médico Nacional, IMSS / Thrombotic thrombocytopenic purpura: experience at the Hospital General of the Centro Médico Nacional, IMSS

La púrpura trombocitopenica trombótica (PTT) es un padecimiento que consiste en la presencia de púrpura trombocitopénica, anemia hemolítica microangiopática y manifestaciones neurológicas progresivas. Se informa la experiencia obtenida en el Hospital General del Centro Médico Nacional en el diagnóstico y tratamiento de la PTT. Se han diagnosticado 14 pacientes en un lapso de 13 años. El sexo que predominó fu el femenino (nueve pacientes), y el promedio de edad fue de 29 años. Ocho pacientes están vivos, tres a 11 años después del inicio de este padecimiento. Siete de ellos fueron sometidos a esplenectomía. Todos los pacientes fueron tratados, además, con otros enfoques terapéuticos como administración de corticoesteroides, heparina a agentes antiagregantes plaquetarios, y en un caso se usaron agentes inmunosupresores. La revisión de la literatura indica que 70 por ciento de los pacientes que han sobrevivido a este padecimiento fueron esplenectomizados como parte de otras modalidades terapéuticas. Según estos resultados y la revisión de la literatura, se concluye que la esplenectomía podría considerarse como parte del tratamiento inicial de todos los pacientes de PTT