Experiencias suramericanas en telemedicina de enfermedades desatendidas / South American experiences on telemedicine of neglected diseases

Las enfermedades tropicales desatendidas (ETD) son aquellas que comúnmente se encuentran en varios países de bajos ingresos en África, Asia y América Latina, provocadas básicamente, por el escaso acceso la higiene, agua limpia o sistemas de alcantarillado. Las ETD comprenden una diversidad de enfermedades de alta prevalencia en los países tropicales causadas por una variedad de patógenos, incluyendo bacterias, virus, parásitos y hongos. La epidemiología de las ETD es bastante compleja y se relacionan con las condiciones ambientales del entorno. Muchas son transmitidas por vectores, tienen un origen zoonótico con reservorios animales bien caracterizados y están asociadas con ciclos de vida complejos. Todos estos factores hacen que su control en salud pública sea un desafío; desafío que se caracteriza por la falta de financiamiento en investigación y control. En ese sentido, la telemedicina, o el uso de las telecomunicaciones para brindar servicios de salud, es una tecnología que ha venido ganando cuerpo durante los últimos veinte años, ya que ayudan, con una relativa baja inversión, el acceso a la atención médica por parte de los más necesitados o que vieven en lugares remotos. Esta investigación se centra en el estudio y conocimiento de las las enfermedades olvidadas presentes en suramérica y cómo la telemedicina ha ayudado en su prevención, diágnótico y tratamiento(AU)

Neglected topical diseases (NTDs) are those that are commonly found in several low-income countries in Africa, Asia en Latin America, basically caused by poor access to hygiene, clean water, or sewage systems. NTDs comprise a diversity of highly prevalent diseases in tropical countries caused by a variety of pathogens, including bacteria, viruses, parasites, and fungi. The epidemiology of NTDs is quite complex and is related to the surrounding environmental conditions. Many are vector-borne, zoonotic in origin with well-characterized animal reservoirs, and associated with complex life cycles. All these factors make its control in public health a challenge; challenge that is characterized by the lack of funding for research and control. In this sense, telemedicine, or the use of telecommunications to provide health services, is a technology that has been gaining ground over the last twenty years, since it helps, with a relatively low investment, access to medical care by part of those most in need or who live in remote places. In this sense, telemedicine, or the use of telecommunications to provide health services, is a technology that has been gaining ground over the last twenty years, since it helps, with a relatively low investment, access to medical care by part of those most in need or who live in remote places. This research focuses on the study and knowledge of neglected diseases present in South America and how telemedicine has helped in their prevention, diagnosis, and treatment(AU)

Evaluation of techniques for diagnosis of Trypanosoma vivax infections in naturally infected cattle in the Zona da Mata Mineira / Avaliação de técnicas para diagnóstico de infecções por Trypanosoma vivax em bovinos naturalmente infectados na Zona da Mata Mineira

Abstract This study aimed to evaluate diagnostic techniques for trypanosomiasis, caused by Trypanosoma vivax, in naturally infected cattle in Minas Gerais, Zona da Mata. The deaths of six lactating cows with similar clinical conditions—characterized by hyporexia, hypogalactia, and recumbency—had been reported from one property. Initially, two animals were examined and diagnosed with trypanosomiasis through identification of the protozoan in a blood smear. After the initial diagnosis, all lactating cows (n=37) on the property were examined, and blood samples were collected for tests including whole blood smear, buffy coat smear, Woo's technique, enzyme-linked immunosorbent assay (ELISA), and polymerase chain reaction (PCR). Woo's test, buffy coat smears, and whole blood smears indicated that 4/37 (10.81%) animals were positive for trypanosomiasis, whereas ELISA and PCR indicated that 33/37 (89.19%) and 27/37 (72.97%) animals, respectively, were positive. The agreement obtained between parasitological techniques was classified as high, while between ELISA and PCR, no agreement. In conclusion, parasitological techniques have a low capacity to identify infected animals in the chronic stage of T. vivax infection. Therefore, techniques such as PCR and/or ELISA should be used to minimize the occurrence of false negatives.

Resumo Este estudo objetiva avaliar as técnicas de diagnóstico da tripanossomíase, causada pelo Trypanosoma vivax, em bovinos naturalmente infectados, em Minas Gerais, Zona da Mata. A morte de seis vacas em lactação com condições clínicas semelhantes - caracterizadas por hiporexia, hipogalaxia e decúbito - foi relatada em uma propriedade. Inicialmente, dois animais foram examinados e diagnosticados com tripanossomíase através da identificação do protozoário em esfregaço sanguíneo. Após o diagnóstico inicial, todas as vacas em lactação (n = 37) na propriedade foram examinadas, e amostras de sangue foram coletadas para testes, incluindo esfregaço de sangue total, esfregaço de capa leucocitária, técnica de Woo, ensaio imunoenzimático (ELISA) e reação em cadeia da polimerase (PCR). O teste de Woo, os esfregaços de capa leucocitária e de sangue total indicaram que 4/37 (10,81%) animais foram positivos para tripanossomíase, enquanto ELISA e PCR indicaram que 33/37 (89,19%) e 27/37 (72,97%) animais, respectivamente, foram positivos. A concordância entre técnicas parasitológicas foi classificada como alta, enquanto entre ELISA e PCR, sem concordância. As técnicas parasitológicas apresentam baixa capacidade para identificar animais infectados na fase crônica da infecção por T. vivax. Dessa forma, técnicas como PCR e/ou ELISA devem ser utilizadas para minimizar a ocorrência de falsos negativos.

The ecology of herd immunity

The COVID-19 pandemic that began in early 2020 is currently the subject of thousands of articles on the various aspects of its epidemiology. One recurrent theme is the phenomenon of herd immunity or herd effect. In this article, I present a short history of the concept, the arguments around its nomenclature, and the ecologist's view of the herd effect, using the case history of the sleeping sickness control in Africa.

Follow-up of dairy cattle naturally infected by Trypanosoma vivax after treatment with isometamidium chloride / Acompanhamento de bovinos leiteiros naturalmente infectados com Trypanosoma vivax após tratamento com cloreto de isometamidium

Abstract Trypanosoma vivax infections cause nonspecific clinical signs in cattle associated with aparasitemic intervals, making disease diagnosis a challenge. In Brazil, diminazene aceturate and isometamidium chloride (ISM) are available to treat bovine trypanosomosis. The objective of this study was to follow-up, by molecular and serological techniques, dairy cattle naturally infected by T. vivax after ISM treatment. Thirty cattle naturally infected with T. vivax received two applications of ISM, at a dosage of 1.0 mg/kg intramuscularly, on days 0 and 150. For T. vivax diagnosis, EDTA-blood and serum samples were evaluated on 0, 7, 15, 30, 60, 90, 120, 150, 180, 210, and 240 days after treatment PCR, Loop-mediated isothermal amplification (LAMP) and ELISA. Animals with persistent detection of T. vivax DNA by both PCR and LAMP were found and continuous detection of anti-T. vivax IgG antibodies by ELISA, suggesting the presence of T. vivax resistance to ISM. The combination of LAMP and ELISA tests can prevent misdiagnosis of the parasite clearance in treated cattle, contributing to better disease control. This is the first experiment that demonstrates the persistence infection of T. vivax under ISM treatment in a natural infected herd and evidence of ISM chemotherapy-resistant T. vivax in Brazil.

Resumo Em bovinos, infecções por Trypanosoma vivax geram sinais clínicos inespecíficos que, associados a intervalos aparasitêmicos, faz com que o diagnóstico da enfermidade seja desafiador. No Brasil, somente aceturato de diaminazeno e cloridrato de isometamidum (ISM) estão disponíveis para o tratamento da tripanossomose bovina. Este trabalho teve como objetivo acompanhar bovinos leiteiros naturalmente infectados por T. vivax, após o tratamento com ISM por meio de técnicas moleculares e sorológica. Foram utilizados 30 bovinos naturalmente infectados com T. vivax, sendo estes tratados com duas aplicações de ISM, na dosagem de 1,0 mg/kg por via intramuscular profunda, nos dias 0 e 150. Foram avaliadas, para diagnóstico de T. vivax, amostras de sangue acrescido de EDTA e soro, colhidas nos 0, 7, 15, 30, 60, 90, 120, 150, 180, 210 e 240 dias após os tratamentos pela reação em cadeia da polimerase (PCR), amplificação circular isotérmica do DNA (LAMP) e ensaio de imunoabsorção enzimático (ELISA). Verificou-se a presença de animais com persistência na detecção de DNA de T. vivax pela PCR e LAMP, bem como detecção contínua de anticorpos IgG anti-T. vivax pelo método de ELISA, sugerindo a presença de resistência de T. vivax ao ISM. A combinação dos testes LAMP e ELISA pode evitar falsos diagnósticos da eliminação do parasita nos bovinos tratados, contribuindo para um melhor controle da doença. Este é o primeiro experimento que demonstra infecção persistente do T. vivax em rebanho naturalmente infectado, tratado com ISM, e evidencia possível resistência ao quimioterápico no Brasil.

Detection of Trypanosoma vivax in tissues of experimentally infected goats: what is the role of adipose tissue in the life cycle of this protozoon? / Detecção de Trypanosoma vivax em tecidos de caprinos experimentalmente infectados: qual é o papel do tecido adiposo no ciclo de vida desse protozoário?

Abstract Trypanosomiasis, caused by Trypanosoma vivax, is responsible for great economic losses among livestock in Africa and South America. During the life cycle of these parasites, they may present different morphological, metabolic and physiological characteristics depending on the interactions that are encountered at each point of their life cycle. Although T. vivax is frequently reported in the circulation of its mammalian hosts, it has the ability to migrate to the tissues of these individuals. However, this characteristic is poorly understood. In this context, we aimed to investigate the presence of T. vivax and the changes caused in different tissues of experimentally infected goats. Despite the animals were not perfused before tissues collection, using different approaches, we demonstrated its presence in different samples, including in the adipose tissue and skin of infected animals. In addition, a mononuclear inflammatory reaction, mostly characterized by an infiltrate of lymphocytes, plasma cells and macrophages were observed. The results highlight the possibility that, like other trypanosomatids, T. vivax may use these tissues during its life cycle. Future studies aiming to elucidate the length of time for which T. vivax remains active in these sites, and whether it uses these sites as a refuge from trypanocidal drugs, and whether it is capable of recolonizing the blood circulation, are much needed.

Resumo A tripanossomíase, causada por Trypanosoma vivax, é responsável por grandes perdas econômicas na bovinocultura da África e da América do Sul. Durante seu ciclo de vida, o parasita pode apresentar diferentes características morfológicas, metabólicas e fisiológicas em função das interações que ele encontra em cada ponto do seu ciclo. Embora o T. vivax seja reportado, frequentemente, na circulação dos seus hospedeiros mamíferos, o protozoário tem a capacidade de migrar para os tecidos desses indivíduos. Entretanto, essa característica é pobremente conhecida. Neste contexto, o objetivo foi verificar a presença, assim como as alterações causadas pelo T. vivax nos diferentes tecidos de caprinos experimentalmente infectados. Apesar dos animais não terem sido perfundidos antes da coleta dos tecidos, utilizando-se diferentes abordagens, foi evidenciada a presença do T. vivax em diferentes amostras teciduais, incluindo no tecido adiposo e pele dos animais infectados. Além disso, foi observada reação inflamatória mononuclear, caracterizada majoritariamente por infiltrado de linfócitos, plasmócitos e macrófagos. Os resultados evidenciam a possibilidade de que, assim como outros tripanossomatídeos, T. vivax pode usar esses tecidos durante o seu ciclo de vida. São necessários futuros estudos, objetivando elucidar o período em que o T. vivax permanece ativo nesses sítios, se ele utiliza esses locais como refúgio das drogas tripanocidas, e se ele é capaz de recolonizar a circulação sanguínea.

"Hipnóticos" na metrópole: africanos no Hospital Colonial de Lisboa nas primeiras décadas do século XX / "Hypnotics" in the metropolis: Africans in the Colonial Hospital of Lisbon during the early twentieth century

Resumo No início do século XX, alguns médicos portugueses foram à África estudar a chamada doença do sono. Entre eles estava Ayres Kopke, membro da primeira missão médica à África Ocidental Portuguesa. De regresso a Lisboa, o professor da Escola de Medicina Tropical continuou suas pesquisas, inclusive por meio da observação de doentes trazidos para a metrópole. Desde 1903, as repartições de saúde nas colônias estavam incumbidas de enviar doentes com determinadas patologias exóticas para o Hospital Colonial de Lisboa. Com base em documentos desse hospital, incluindo fotografias dos doentes, então chamados de hipnóticos, o artigo aborda a importância das experiências com humanos na metrópole para o avanço da medicina tropical durante o colonialismo.

Abstract At the start of the twentieth century, some Portuguese physicians traveled to Africa to study sleeping sickness (African trypanosomiasis). One was Ayres Kopke, a member of the first medical mission to Portuguese West Africa and professor at the School of Tropical Medicine. After returning to Lisbon, Kopke continued his research, which included observation of patients brought to the metropolis. Starting in 1903, health departments in the colonies were responsible for sending patients with certain exotic diseases to the Colonial Hospital of Lisbon. Based on documents from this hospital including photographs of patients (who at that time were called "hypnotics"), this article discusses the importance of human experiments in Lisbon for advances in tropical medicine during the colonial period.

Human african trypanosomiasis: current standing and challenges

Human African trypanosomiasis (HAT) caused by the protozoan Trypanosoma brucei gambiense and Trypanosoma brucei rhodesiense, and transmitted by the tsetse fly (genus Glossina), affects 36 Sub-Saharan African countries with considerable public health impact. Despite approximately 15,000 infected individuals and 70 million at risk, in recent years the World Health Organization has mentioned removal of HAT from the list of Neglected Tropical Diseases by 2020, due to the decrease in cases over the last two decades. When untreated, the disease presents high lethality rates and the available treatments are complicated to administer, highly toxic, and do not guarantee cure, especially in the advanced stages of the disease. Further, there is no prospect for vaccine development in the near future. The present review compiles information on the history of the clinical aspects of HAT, as well as its epidemiology, diagnosis, therapy, and prophylaxis, as well as updating information on the current panorama and perspectives regarding the disease.

Comparison of conventional and molecular techniques for Trypanosoma vivax diagnosis in experimentally infected cattle / Comparação de técnicas convencionais e moleculares para diagnóstico em bovinos experimentalmente infectados por Trypanosoma vivax

Abstract Livestock infections by Trypanosoma vivax have been occurring with increasing frequency, mainly due to the presence of animals with subclinical infections and without apparent parasitaemia, making diagnosis challenging. The aim of the present study was to evaluate several techniques used for T. vivax diagnosis in order to assess the best way of using them during the course of the disease. Molecular methods demonstrated higher rates of detection than parasitological methods, detecting 33 of the 54 (61.1%) known positive samples, while the hematocrit centrifugation technique (best parasitological test) detected only 44.4%. The serological methods, IFAT and ELISA, detected seropositivity in 51 of the 54 (94.4%) and 49 of the 54 (90.7%) known positive samples, respectively. Despite being highly sensitive, the latter only demonstrates exposure to the infectious agent and does not indicate whether the infection is active. The present study was the first to use the qPCR for a South American isolate, improving disease detection and quantification. Furthermore, the analyses revealed that the patent phase of the disease may extend up to 42 days, longer than previously reported. The combination of several diagnostic techniques can lower the frequency of false negative results and contributes toward better disease control.

Resumo Infecções por Trypanosoma vivax têm ocorrido com frequência crescente em animais de produção, principalmente pela aquisição de animais com infecções subclínicas e sem aparente parasitemia, o que dificulta o diagnóstico. O objetivo do presente estudo foi avaliar várias técnicas empregadas para o diagnóstico de T. vivax, a fim de verificar a melhor maneira de utilizá-las durante o curso da doença. Os métodos moleculares demonstraram maiores taxas de detecção que os métodos parasitológicos, detectando 33 das 54 (61,1%) amostras sabidamente positivas, enquanto a técnica de hemoconcentração (melhor teste parasitológico) detectou apenas 44,4%. Os métodos sorológicos, RIFI e ELISA, detectaram soropositividade em 51 das 54 (94,4%) e 49 das 54 (90,7%) amostras sabidamente positivas, respectivamente. Apesar de serem altamente sensíveis, estes testes apenas demonstram a exposição ao agente infeccioso, e não indicam se a infecção permanece ativa. O presente estudo foi o primeiro a utilizar a qPCR para um isolado sul-americano, melhorando sua detecção e quantificação. Além disso, as análises revelaram que a fase patente da doença pode se estender por até 42 dias após a infecção, sendo maior que anteriormente relatado. A combinação de várias técnicas de diagnóstico pode evitar a frequência de resultados falso-negativos e contribuir para um melhor controle da doença.

Coxiella burnetii associated with BVDV (Bovine Viral Diarrhea Virus), BoHV (Bovine Herpesvirus), Leptospira spp, Neospora caninum, Toxoplasma gondii and Trypanosoma vivax in reproductive disorders in cattle / Coxiella burnetii associada ao BVDV (Vírus da Diarreia Viral Bovina), BoHV (Vírus do Herpes Bovino), Leptospira spp, Neospora caninum, Toxoplasma gondii e Trypanosoma vivax em distúrbios reprodutivos em bovinos

Abstract This is a cross-sectional study to assess the presence of antibodies in ruminants against selected pathogens associated with reproductive disorders in cattle in four Brazilian states, including the zoonotic agent Coxiella burnetii. The used tests were Virus Neutralization Assay for IBR and BVD, Microscopic Agglutination Test for Leptospira spp., Indirect Fluorescent Antibody Test (IFAT) for C. burnetii and Toxoplasma gondii, and Enzyme-Linked Immunosorbent Assay for Neospora caninum and Trypanosoma vivax. Seropositivity for C. burnetii was 13.7% with titers from 128 to 131,072; 57.8% for BoHV-1, with titers between 2 and 1,024; 47.1% for BVDV-1a, with titers from 10 to 5,120; 89.2% for N. caninum; 50% for T. vivax; and 52.0% for Leptospira spp., with titers between 100 to 800 (the following serovars were found: Tarassovi, Grippotyphosa, Canicola, Copenhageni, Wolffi, Hardjo, Pomona and Icterohaemorrhagiae); 19.6% for T. gondii with titer of 40. This is the first study that has identified C. burnetii in cattle associated with BoHV and BVDV, N. caninum, Leptospira spp., T. gondii and T. vivax. Thus, future studies should be conducted to investigate how widespread this pathogen is in Brazilian cattle herds.

Resumo Este é um estudo transversal para avaliar a presença de anticorpos em ruminantes contra patógenos selecionados e associados a distúrbios reprodutivos em bovinos de quatro estados brasileiros, incluindo o agente zoonótico Coxiella burnetii. Os testes utilizados foram Teste de Vírus-Neutralização para BoHV e BVDV, teste de Aglutinação Microscópica para Leptospira spp., Reação de Imunofluorescência Indireta for C. burnetii e Toxoplasma gondii, e Ensaio de Imunoabsorção Enzimática para Neospora caninum e Trypanosoma vivax. A soropositividade para C. burnetii foi de 13,7% com títulos de 128 a 131.072; 57,8% para BoHV-1, com títulos entre 2 a 1.024; 47,1% para BVDV-1a, com títulos de 10 a 5.120; 89,2% para N. caninum; 50% para T. vivax; e 52,0% para Leptospira spp., com títulos entre 100 a 800 (sorovares encontrados: Tarassovi, Grippotyphosa, Canicola, Copenhageni, Wolffi, Hardjo, Pomona e Icterohaemorrhagiae) 19,6% para T. gondii com título de 40. Este é o primeiro estudo que evidencia a participação de C. burnetii em bovinos associada ao Vírus da Rinotraqueíte bovina infecciosa e da diarreia viral bovina, N. caninum, Leptospira spp., T. gondii e T. vivax em bovinos. Desta forma, futuros estudos devem ser conduzidos a fim de investigar o quão disseminado se encontra este patógeno em rebanhos bovinos brasileiros.

Nanoparticulate drug delivery systems for the treatment of neglected tropical protozoan diseases

Neglected Tropical Diseases (NTDs) comprise of a group of seventeen infectious conditions endemic in many developing countries. Among these diseases are three of protozoan origin, namely leishmaniasis, Chagas disease, and African trypanosomiasis, caused by the parasites Leishmania spp., Trypanosoma cruzi, and Trypanosoma brucei respectively. These diseases have their own unique challenges which are associated with the development of effective prevention and treatment methods. Collectively, these parasitic diseases cause more deaths worldwide than all other NTDs combined. Moreover, many current therapies for these diseases are limited in their efficacy, possessing harmful or potentially fatal side effects at therapeutic doses. It is therefore imperative that new treatment strategies for these parasitic diseases are developed. Nanoparticulate drug delivery systems have emerged as a promising area of research in the therapy and prevention of NTDs. These delivery systems provide novel mechanisms for targeted drug delivery within the host, maximizing therapeutic effects while minimizing systemic side effects. Currently approved drugs may also be repackaged using these delivery systems, allowing for their potential use in NTDs of protozoan origin. Current research on these novel delivery systems has provided insight into possible indications, with evidence demonstrating their improved ability to specifically target pathogens, penetrate barriers within the host, and reduce toxicity with lower dose regimens. In this review, we will examine current research on these delivery systems, focusing on applications in the treatment of leishmaniasis, Chagas disease, and African trypanosomiasis. Nanoparticulate systems present a unique therapeutic alternative through the repositioning of existing medications and directed drug delivery.(AU)

Global stability analysis of the disease-free equilibrium state of a mathematical model of trypanosomiasis

The global stability analysis represents a compound failure, mechanism which provides lower calculated factors of safety. In this research, the global stability analysis was used to propose a mathematically model of the transmission dynamics and control of Trypanosomiasis, known as African sleeping sickness. We obtained the Disease-free equilibrium state and present graphical profile of some of the compartments

Evaluation of clinical signs, parasitemia, hematologic and biochemical changes in cattle experimentally infected with Trypanosoma vivax / Avaliação dos sinais clínicos, parasitemia e alterações hematológicas e bioquímicas de bovinos experimentalmente infectados peloTrypanosoma vivax

Abstract Infections by Trypanosoma vivax cause great losses to livestock in Africa and Central and South Americas. Outbreaks due this parasite have been occurred with increasing frequency in Brazil. Knowledge of changes caused byT. vivax during the course of this disease can be of great diagnostic value. Thus, clinical signs, parasitemia, hematologic and biochemical changes of cattle experimentally infected by this hemoparasite were evaluated. Two distinct phases were verified during the infection – an acute phase where circulating parasites were seen and then a chronic phase where fluctuations in parasitemia were detected including aparasitemic periods. A constant reduction in erythrocytes, hemoglobin and packed cell volume (PVC) were observed. White blood cells (WBC) showed pronounced changes such as severe neutropenia and lymphopenia during the acute phase of the illness. Decreases in cholesterol, albumin, aspartate aminotransferase (AST), lactate dehydrogenase (LDH), and increases in glucose, globulin, protein, and alkaline phosphatase (ALP) were observed. The “Lins” isolate of T. vivax showed pathogenicity for cattle, and intense parasitemia was detected in the early stages of infection. Circulating parasites were detected for about two months. The most evident laboratory abnormalities were found in WBC parameters, including thrombocytopenia.

Resumo Infecções pelo Trypanosoma vivax causam grandes prejuízos à pecuária na África e Américas Central e do Sul. Surtos devido a este protozoário têm ocorrido com frequência cada vez maior no Brasil. O conhecimento das alterações provocadas pelo T. vivax durante a evolução desta enfermidade podem ser de grande valia para o auxílio no diagnóstico. Para tanto foram estudados os sinais clínicos, parasitemia, alterações hematológicas e bioquímicas em bovinos experimentalmente infectados por este hemoparasito. Foram verificadas duas fases distintas durante a infecção, uma aguda onde parasitos circulantes foram vistos durante todo o período, e posteriormente uma crônica, onde foram detectadas flutuações na parasitemia, com períodos aparasitêmicos. Foi verificada constante diminuição da contagem global de eritrócitos, teor de hemoglobina e volume globular (VG). O leucograma revelou leucopenia por neutropenia e linfopenia durante a fase aguda da enfermidade. Foram observados diminuição do colesterol, albumina, aspartato aminotransferase (AST), lactato desidrogenase (LDH) e aumento da glicose, globulinas, proteínas e fosfatase alcalina (FA). O isolado “Lins” de T. vivax apresentou patogenicidade para bovinos, verificando-se parasitemia intensa nos estágios iniciais da infecção, sendo detectados parasitas circulantes por aproximadamente dois meses. As alterações laboratoriais mais evidentes foram encontradas nos parâmetros do leucograma, ainda destacando-se um quadro de trombocitopenia.

Studies of the antitrypanosomal and toxicological properties of Anogeissus leiocarpus (Dc.) Guill. & Perr. (Combretaceae) and Vitellaria paradoxa C. F. Gaertn (Sapotaceae) in mice / Estudios de las propiedades antitripanosómicas y toxicológicas de Anogeissus leiocarpus (Dc). Guill. & Perr. (Combretaceae) y Vitellaria paradoxa C. F. Gaertn (Sapotaceae) en ratones

African animal trypanosomosis (AAT) is a disease of concern with ravaging effects on the health of both animals and livestock in tropical Africa. This study investigates the anti-trypanosomal activities of Anogeissus leiocarpus (ALE) and Vitelleria paradoxa (VPE) stem bark extracts and also determines the toxicological profile of the active plant, with a view to establishing the anti-trypanosomal potential and safety of the plants. Laboratory mice (19 g – 26 g) and rats (140 g – 165 g) obtained from the Animal house, Faculty of Pharmacy, OAU, Ile-Ife were used for the study. The animals were treated according to the standard set criteria for animal use and care. VPE showed neither trypanocidal nor trypanostatic activities while ALE was found to be trypanostatic at 62.5 and 125 mg/kg body weight. However, the partitioned aqueous fraction of ALE was found to demonstrate comparable anti-trypanocidal effect as Diminal (standard agent). In conclusion, the ethanolic extract of A. leiocarpus possesses antitrypanosomal effect through the relative suppression or delay in parasite establishment in trypanosome-infected mice. The toxicological study of A. leiocarpus stem bark extract revealed that it is relatively safe for use in cattle and other grazing animals.

La tripanosomiasis africana de los animales es una enfermedad de preocupación que causa estragos sobre la salud de los animales y el ganado en África tropical. Este estudio investiga las actividades anti-tripanosomal de Anogeissus leiocarpus (ALE) y Vitelleria paradoxa (VPE) del tallo y extractos de corteza. También determina el perfil toxicológico de la planta activa, con el fin de establecer el potencial anti-tripanosomal y la seguridad de las plantas. Ratones de laboratorio (19 g - 26 g) y ratas (140 g - 165 g) obtenidos del Bioterio de la Facultad de Farmacia de la OUA, se utilizaron para el estudio. Los animales fueron tratados de acuerdo con los criterios estándar establecido para el uso y cuidado de animales. VPE mostró actividades no tripanocidas ni tripanostáticas mientras que en ALE se encontró que era tripanostático a 62,5 y 125 mg/kg de peso corporal. Sin embargo, se encontró que la fracción acuosa de ALE demostró un efecto anti-tripanocida comparable como Diminal (agente estándar). En conclusión, el extracto etanólico de A. leiocarpus posee efecto sobre tripanosomas a través de la supresión relativa o retraso en la creación de parásitos en ratones infectados con tripanosomosis. El estudio toxicológico del extracto de corteza del tallo A. leiocarpus reveló que es relativamente seguro para su uso en el ganado y otros animales de pastoreo.

Relationship between Neutrophil-To-Lymphocyte Ratio and Electrocardiographic Ischemia Grade in STEMI / Associação entre a Relação Neutrófilos/Linfócitos e o Grau de Isquemia Eletrocardiográfica no IAMEST

Background: Neutrophil-to-lymphocyte ratio (NLR) has been found to be a good predictor of future adverse cardiovascular outcomes in patients with ST-segment elevation myocardial infarction (STEMI). Changes in the QRS terminal portion have also been associated with adverse outcomes following STEMI. Objective: To investigate the relationship between ECG ischemia grade and NLR in patients presenting with STEMI, in order to determine additional conventional risk factors for early risk stratification. Methods: Patients with STEMI were investigated. The grade of ischemia was analyzed from the ECG performed on admission. White blood cells and subtypes were measured as part of the automated complete blood count (CBC) analysis. Patients were classified into two groups according to the ischemia grade presented on the admission ECG, as grade 2 ischemia (G2I) and grade 3 ischemia (G3I). Results: Patients with G3I had significantly lower mean left ventricular ejection fraction than those in G2I (44.58 ± 7.23 vs. 48.44 ± 7.61, p = 0.001). As expected, in-hospital mortality rate increased proportionally with the increase in ischemia grade (p = 0.036). There were significant differences in percentage of lymphocytes (p = 0.010) and percentage of neutrophils (p = 0.004), and therefore, NLR was significantly different between G2I and G3I patients (p < 0.001). Multivariate logistic regression analysis revealed that only NLR was the independent variable with a significant effect on ECG ischemia grade (odds ratio = 1.254, 95% confidence interval 1.120–1.403, p < 0.001). Conclusion: We found an association between G3I and elevated NLR in patients with STEMI. We believe that such an association might provide an additional prognostic value for risk stratification in patients with STEMI when combined with standardized risk scores. .

Fundamento: A relação neutrófilos/linfócitos (N/L) tem sido descrita como boa preditora de eventos cardiovasculares adversos futuros em pacientes com infarto agudo do miocárdio com elevação do segmento ST (IAMEST). Mudanças na porção terminal do complexo QRS também têm sido associadas a eventos adversos após IAMEST. Objetivo: Investigar a associação entre o grau de isquemia no ECG e a relação N/L em pacientes com IAMEST para determinar fatores de risco convencionais adicionais na estratificação precoce de risco. Métodos: Pacientes com IAMEST foram investigados. O grau de isquemia foi analisado a partir do ECG obtido à admissão. A contagem de leucócitos e seus subtipos foi realizada a partir de hemograma automatizado. De acordo com o grau de isquemia presente no ECG de admissão, os pacientes foram classificados em dois grupos, isquemia grau 2 (IG2) e isquemia grau 3 (IG3). Resultados: Pacientes com IG3 apresentaram valores médios significativamente menores de fração de ejeção do ventrículo esquerdo do que os pacientes com IG2 (44,58 ± 7,23 versus 48,44 ± 7,61; p = 0,001). Como esperado, a taxa de mortalidade intra-hospitalar aumentou proporcionalmente com o aumento no grau de isquemia (p = 0,036). Houve diferenças significativas nas porcentagens de linfócitos (p = 0,010) e de neutrófilos (p = 0,004) e, portanto, a relação N/L diferiu significativamente entre pacientes com IG2 e IG3 (p < 0,001). À análise de regressão logística multivariada, apenas a relação N/L emergiu como variável independente com efeito significativo sobre o grau de isquemia no ECG (odds ratio = 1,254; intervalo de confiança de 95% 1,120-1,403; p < 0,001). Conclusão: Nós encontramos uma associação entre IG3 e relação N/L aumentada em pacientes com IAMEST. Acreditamos que esta associação possa oferecer um valor prognóstico adicional para estratificação de risco em pacientes com IAMEST quando usado em combinação com escores de risco padronizados. .

Public health and tropical modernity: the combat against sleeping sickness in Portuguese Guinea, 1945-1974 / Saúde pública e modernidade tropical: o combate à doença do sono na Guiné Portuguesa, 1945-1974

Until the establishment of the “Commission for the study of and combat against sleeping sickness” (Missão de estudo e combate à doença do sono) in 1945, underfunded and understaffed health services had not been a priority for the colonial administration in Portuguese Guinea. The Commission not only implemented endemic disease control in the territory under the auspices of metropolitan institutions, but also provided preventive public healthcare to the local population. Its relative success in reducing the negative impact of Human African Trypanosomiasis turned the colony into an apparent model of tropical modernity. In the process, the local evolution of the disease was marginalized, despite the tacit but contested recognition by some health professionals of the role of popular healthcare.

Os serviços de saúde que sofreram de uma crónica falta de recursos humanos e materiais nunca foram uma prioridade para a administração colonial na Guiné Portuguesa até a criação da Missão de Estudo e Combate à Doença do Sono em 1945. Além de introduzir o controlo de doenças endémicas sob a tutela de instituições metropolitanas, a Missão também providenciou cuidados preventivos de saúde pública para as populações locais. O sucesso relativo da redução do impacto nocivo da tripanossomíase africana parece ter transformado a colónia num modelo de modernidade tropical. Porém, as trajetórias locais da doença foram marginalizadas, apesar do reconhecimento tácito mas contestado por profissionais de saúde do papel de cuidados populares de saúde.

Effect of diminazene aceturate, levamisole and vitamin C combination therapy in rats experimentally infected with Trypanosoma brucei brucei

OBJECTIVE@#To investigate the effect of diminazene aceturate (DA) alone or in combination with either levamisole and/or Vitamin C in albino rats experimentally infected with Trypanosoma brucei brucei.@*METHODS@#Thirty adult male albino rats, randomly assigned into 6 groups (A-F) of 5 rats each were used. They were either infected with 1×10(6) trypanosomes intraperitoneally (groups A-E) or uninfected (group F). The different groups were treated respectively as follows: group A-with 3.5 mg/kg DA; group B-3.5 mg/kg DA and 7.5 mg/kg levamisole; group C-3.5 mg/kg DA and 100 mg/kg vitamin C; and group D-3.5 mg/kg DA and 7.5 mg/kg levamisole and 100 mg/kg vitamin C. Group E was left untreated. Parameters assessed include: rectal temperature, body weight changes, packed cell volume (PCV), Haemoglobin concentration (Hb), total leucocyte count (TLC) differential leucocyte count (DLC), parasitaemia, clinical signs and survivability.@*RESULTS@#Average pre-patent period of 5 days was recorded. Parasites in the blood were cleared in all treated groups (A-D) within 48 hours post treatment (PT). Untreated rats in group E died between 25 and 32 days post infection (PI). Relapse was not recorded in all the treated groups (A-D). The initial reduction in PCV, Hb, TLC and increases in rectal temperature following infection were reversed by the treatments. The rats that received drug combinations (groups B, C and D) showed faster and higher recovery rates than the uninfected control and group A.@*CONCLUSIONS@#Levamisole and/or Vitamin C combination with DA were more effective in the treatment of rats infected with Trypanosoma brucei brucei.

Bactéria ou parasita? a controvérsia sobre a etiologia da doença do sono e a participação portuguesa, 1898-1904 / Bacteria or parasite? the controversy over the etiology of sleeping sickness and the Portuguese participation, 1898-1904

A etiologia da doença do sono era desconhecida até o início do século XX. Essa doença tipicamente africana em breve se tornaria o principal obstáculo à colonização europeia. O envio de missões científicas às colônias para seu estudo in loco tornou-se inevitável. Portugal enviou a primeira missão de estudo, a Angola, em 1901, e a Royal Society of London apoiou duas missões britânicas de estudo da doença, em Entebe. O resultado dessas investigações estabeleceu uma controvérsia, na qual Portugal esteve envolvido de 1898 a 1904, no circuito nacional e internacional, objeto de análise deste artigo.

The etiology of sleeping sickness was unknown until the early twentieth century. This African disease soon became the main obstacle to European colonization. Sending scientific missions to the colonies to monitor its progression in loco thus became inevitable. Portugal sent the first research mission to Angola in 1901, and the Royal Society of London sponsored two British missions to study the disease in Entebbe (1902 and 1903). Their results led to a controversy in which Portugal was involved from 1898 to 1904, on the national and international circuits, analysed in this article.

Pharmacotherapy for imported parasitic diseases with drugs reserved by the government

Parasitic diseases are widely distributed throughout the world. Recently, travel abroad and migration from abroad are increasing in Korea. Therefore, it is necessary to appropriately control imported parasitic disease. The drugs for the treatment of the parasitic diseases that can be imported from abroad are reserved by the government. To guide proper treatment of parasitic diseases, recommended chemotherapy focused on these reserved drugs has been introduced. The diseases reviewed in this article include malaria, babesiosis, toxoplasmosis, leishmaniasis, Chagas disease, African sleeping sickness, filariasis, angiostrongyliasis, and fascioliasis. Because most of the parasitic diseases produce severe illness or fatal results, rapid and accurate diagnosis is important and following fully the recommended therapy is needed. The recommended drug therapy changes from time to time due to various factors, so always recognizing and applying the latest therapy and is very important.

Aldo Castellani y las expediciones de la Royal Society al país del sueño negro / Aldo Castellani and the expeditions of the Royal Society to the black sleep's country

At the beginning the investigation on infectious diseases was plenty of adventures in exotic countries. The efforts of the English investigators, headed by Patrick Manson, gave birth to the "tropical" medicine and "tropical" diseases, like the sleeping sickness, which was sweeping the country north to the Victoria Lake in 1901. The Royal Society of London sent two Commissions in search of the etiological agent. Aldo Castellani was decisive for the failure of the first - Low, Castellani, Christy,1902 - because even he saw Trypanosoma in samples of some patients, he did not appreciate his discovery; and decisive also for the success of the second -Bruce, Nabarro, Greig, 1903 - when he and Bruce recognized this Trypanosoma as the etiological agent. Following these expeditions, Low developed a brilliant career in England, Christy a life of investigation mixed up with adventures through Asia and Africa and Castellani a long life of lights and shadows in many lands.

En un comienzo la investigación sobre enfermedades infecciosas estuvo llena de aventuras en países exóticos. Impulsada por los investigadores ingleses, encabezados por Patrick Manson, nacieron la medicina y las enfermedades "tropicales", entre las cuales se encontraba la enfermedad del sueño, que a comienzos del siglo XX hacía estragos al norte del lago Victoria. La Real Sociedad de Londres envió dos Comisiones a Uganda para determinar el agente etiológico. Aldo Castellani fue decisivo para el fracaso de la primera, que incluía también a Low y Christy, en 1902, pues aunque vio tripanosomas en LCR de enfermos, no les otorgó valor y prefirió postular un diplococo como agente causal; y decisivo también para el éxito de la segunda, de Bruce, Nabarro y Greig, en 1903, al concordar con Bruce en que el tripanosoma era realmente el causante de la enfermedad. Después de estas expediciones, Low desarrolló una brillante carrera en Inglaterra, Christy una vida que combinaba investigación con aventura en Asia y África, y Castellani una larga vida de éxitos, oscurecida por sus ideas políticas, que lo ligaban a Mussolini.