A conceptual model of how mental health clubhouses impact health and quality of life among individuals with serious mental illness.

OBJECTIVE: People with serious mental illness (PWSMI) experience dramatic disparities in health, quality of life, and longevity. Mental health Clubhouses are a community-based treatment model that can positively affect health and quality of life among PWSMI. However, few studies investigate the processes within Clubhouses and what factors are related to the improvement of health and quality of life among members. To address this gap, this research offers a conceptual model of how Clubhouses contribute to health and quality of life. METHOD: This conceptual model was created using participatory qualitative methods, combining Photovoice and grounded theory. Forty-two participants (37 Clubhouse members and six staff) from four Clubhouses in Hawai'i were engaged in 22 sessions over the course of 2 years. RESULTS: The conceptual model begins with quality of participation in Clubhouse activities, which refers not only to being present in the Clubhouse but being actively and meaningfully engaged in Clubhouse activities. Engagement in Clubhouse activities and working side-by-side with members and staff led to reciprocal social support. As members were supported and supported others, they gained a sense that they mattered, and they perceived themselves as more capable, more efficacious, and less stigmatized over time. They became a contributing member of a community, which supported health and quality of life directly and indirectly. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: This work offers a novel conceptual framework of Clubhouse processes that highlights the importance and potential of empowering psychosocial treatment models. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Can Photovoice foster the development of social support?

Photovoice is a participatory, photo-based research method that differs from conventional (non-participatory) research in that the process is meant to be empowering and beneficial. However, empirical research on the Photovoice process remains very limited. Based on feedback from participants who reported Photovoice helped them develop closer relationships, we examine whether engaging in Photovoice fosters social support. Transcripts from a Photovoice study on wellness in mental health Clubhouses (voluntary, community mental health centers) were retrospectively analyzed for instrumental support, appraisal, informational support, and emotional support. Appraisal was the most common form of social support identified, and was primarily expressed through peer praise for photos and insights. Informational support included advice on managing symptoms, promoting wellness, and navigating challenges. Instrumental support was fostered by learning the tangible skill of digital photography and by supporting fellow members with physical or visual limitations to participate in the process. Emotional support was cultivated through encouragement, identification of shared experiences, and connection through humor. In sum, the findings suggest that Photovoice has the potential to foster social support, which may support relational empowerment.

Health Literacy, Social Networks, and Health Outcomes among Mental Health Clubhouse Members in Hawai'i.

Health literacy is the ability to obtain and utilize health information to make health-related decisions and to navigate health systems. Although health literacy has traditionally been understood as an individual-level construct, current research is revealing the impact that social networks can have on health literacy. To date, no studies have examined associations between health literacy and social networks among people with serious mental illness (PWSMI), who are at high risk of physical illness and premature mortality. To begin to fill this gap, this study explores associations between health literacy, relationships with health discussion partners, and self-reported health outcomes in a racially diverse sample of Clubhouse members in Hawai'i. Clubhouses are community mental health centers that promote recovery from mental illness through destigmatization, meaningful activity, and strong social relationships. Health literacy was assessed using two single-item screeners (SILS). In a sample of 163 members, 56.2% reported adequate ability to understand health-related instructions or pamphlets, and 43.3% reported adequate confidence filling out medical forms independently. This is consistent with other health literacy studies with PWSMI in the United States, and indicates lower health literacy within this group than is reported in national averages. Multivariate logistic regression revealed a larger Clubhouse staff social network and completing high school were significantly associated with requiring less help to read materials. Higher age, male gender, and being Native Hawaiian and/or Pacific Islander were associated with less confidence filling out medical forms, while higher self-efficacy was associated with higher confidence filling out medical forms. This study provides preliminary evidence that relationships fostered within Clubhouses are associated with health literacy among PWSMI, and highlights the need for more research to examine how social networks and health literacy interventions can be leveraged in community mental health settings to improve health outcomes within this vulnerable population.

Mapping community: A scoping review of clubhouse members' social networks and their impact on recovery in mental illness.

OBJECTIVE: Social support is an important component of recovery-based interventions for individuals living with severe mental illness (IWSMI). Clubhouses are local community centers that facilitate the development of meaningful relationships among IWSMI through an empowering structure and engagement with the work-ordered day. This review synthesizes research on social networks in Clubhouses to provide insights on the role of supportive relationships in mental illness recovery, including the size and features of social networks of Clubhouse members, methodological trends and gaps, and the associations between social networks and demographic variables, recovery, health, and perceived social support. METHOD: Research on social networks within Clubhouses were identified and analyzed following a systematic six-stage scoping review design. RESULTS: Twelve articles across six studies were included. Results revealed considerable variation in social network interview methods and network size and features. Overall findings suggest that network size is not consistently associated with reported loneliness, social support, recovery, or quality of life. A deep relationship with at least one supportive person, level of perceived affiliation with Clubhouses, or positive comments from network members may be more or equally valuable than a larger network. Some studies found that types of relationships were associated with unique benefits. Stronger peer networks were associated with relationship satisfaction, while increased connections with health care professionals and family were associated with reduced hospitalizations. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: Future research should diversify research designs, expand the use of social network analysis and visualization, measure additional outcomes including recovery and health, and increase sample diversity. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

COVID-19 Vaccine Hesitancy in Three Latin American Countries: Reasons Given for Not Becoming Vaccinated in Colombia, Ecuador, and Venezuela.

Although vaccines have been developed to prevent COVID-19, vaccine hesitancy is a significant barrier for vaccination programs. Most research on COVID-19 vaccine hesitancy has blamed misinformation and misstated concerns about effectiveness, safety, and side effects of these vaccines. The preponderance of these studies has been performed in the Global North. Although Latin American has been substantially and negatively impacted by COVID-19, few studies have examined COVID-19 vaccine hesitancy there. We explored reasons volunteered for COVID-19 vaccine hesitancy from a sample of 1,173 Colombians, Ecuadorians, and Venezuelans. Overall, COVID-19 vaccine hesitancy in these three countries is higher than desirable, but most people who are COVID-19 vaccine hesitant offered one reason or fewer. The reasons offered are diverse, including myths and exaggerations, but also individual-level contraindications for vaccination and structural barriers. Because of the diversity of reasons, single-issue mass campaigns are unlikely to bring about large shifts in COVID-19 vaccine hesitancy in Colombia, Ecuador, and Venezuela. Our data suggest that interpersonal communication, particularly in Ecuador, and addressing structural concerns, particularly in Venezuela, are likely to have the greatest impact on vaccine uptake.

'Hook, line, and sinker': Fluorescence in situ hybridisation (FISH) uncovers Trypanosoma noyesi in Australian questing ticks.

Trypanosomes are blood-borne parasites infecting a range of mammalian hosts worldwide. In Australia, an increasing number of novel Trypanosoma species have been identified from various wildlife hosts, some of which are critically endangered. Trypanosoma noyesi is a recently described species of biosecurity concern, due to a close relationship to the South American human pathogen, Trypanosoma cruzi. This genetic similarity increases the risk for introduction of T. cruzi via a local vector. Unfortunately, there is a lack of knowledge concerning the vectorial capacity of Australian invertebrates for native Trypanosoma species. Australian ixodid ticks (Ixodidae), which are widespread ectoparasites of mammalian wildlife, have received the most attention as likely candidates for trypanosome transmission and have been previously implicated as vectors. However, as all studies to date have focused on blood-fed ticks collected directly from infected mammalian hosts, the question of whether ticks maintain a trypanosome infection between blood meals is unknown. In this study, we investigated the presence of Trypanosoma within 148 Australian adult and nymph questing ticks of the species Amblyomma triguttatum, Ixodes australiensis, Ixodes myrmecobii and larvae Ixodes spp., collected from an endemic region of south-west Australia. Using a novel HRM-qPCR detection method that can discriminate between species of Trypanosoma based on primer melting temperature (Tm), we report the first molecular detection of Trypanosoma DNA in Australian questing ticks, with 6 ticks DNA positive for T. noyesi. Additionally, the presence of intact T. noyesi parasites within all (n = 3) smeared gut and gland contents of questing ticks was confirmed using a fluorescence in situ hybridisation (FISH) assay. Whilst this study was unable to determine the in situ tissue location of trypanosomes for the purpose of discerning a potential route of transmission, these combined molecular and FISH smear data indicate that trypanosomes can persist in ticks between blood meals and that ticks are possibly vectors in the transmission of T. noyesi between native wildlife. Transmission experiments are still required to evaluate the competency of Australian ticks as vectors for T. noyesi. Nevertheless, these novel findings warrant further investigation concerning potential life stages and the development of trypanosomes in both Australian, and other, tick species.

Understanding the Role of Mental Health Clubhouses in Promoting Wellness and Health Equity Using Pilinaha-An Indigenous Framework for Health.

Individuals with severe mental illness need to be engaged in defining their own vision of wellness to promote equity and reduce disparities. This photovoice study helps define what wellness is and how it is achieved in mental health Clubhouses in Hawai'i. Results from a photovoice study with 43 members and staff were analyzed using Pilinaha, a Native Hawaiian framework for health. Pilinaha envisions health through connection to place, community, past and future, and one's better self. Within Clubhouses, connection to place included connection to 'aina (land) and the access to a safe space. Connection to community occurred through reciprocal social support, which developed kuleana (responsibility), and a sense of 'ohana (family) for many members who were previously isolated. Connection to one's better self-involved positive identity change, development of hope, and pursuing opportunities within and outside the Clubhouse. Connection to past and future was described through individual narratives, remembering members who had died, and connection to cultural traditions. Overall, wellness was conceptualized as the ability to work toward dreams, engage in cultural practice, and feel accepted, respected, and valued-to be treated with aloha. Findings provide a culturally responsive perspective on wellness and illustrate the value of Clubhouses as a space for mental health recovery and transformative change.

Debilitating disease in a polyparasitised woylie (Bettongia penicillata): A diagnostic investigation.

During monitoring of critically endangered woylie (Bettongia penicillata) populations within the south-west of Western Australia, an adult female woylie was euthanased after being found in extremely poor body condition with diffuse alopecia, debilitating skin lesions and severe ectoparasite infestation. Trypanosoma copemani G2 and Sarcocystis sp. were detected molecularly within tissue samples collected post-mortem. Potorostrongylus woyliei and Paraustrostrongylus sp. nematodes were present within the stomach and small intestine, respectively. Blood collected ante-mortem revealed the presence of moderate hypomagnesaemia, mild hypokalaemia, mild hyperglobulinaemia and mild hypoalbuminaemia. Diffuse megakaryocytic hypoplasia was evident within the bone marrow. We propose various hypotheses that may explain the presence of severe ectoparasite infection, skin disease and poor body condition in this woylie. Given the potential deleterious effects of parasite infection, the importance of monitoring parasites cannot be over-emphasised.

Trypanosome co-infections increase in a declining marsupial population.

Understanding the impacts of parasites on wildlife is growing in importance as diseases pose a threat to wildlife populations. Woylie (syn. brush-tailed bettong, Bettongia penicillata) populations have undergone enigmatic declines in south-western Western Australia over the past decade. Trypanosomes have been suggested as a possible factor contributing towards these declines because of their high prevalence in the declining population. We asked whether temporal patterns of infection with Trypanosoma spp. were associated with the decline patterns of the host, or if other factors (host sex, body condition, co-infection or rainfall) were more influential in predicting infection patterns. Species-specific nested PCRs were used to detect the two most common trypanosomes (T. copemani and T. vegrandis) from 444 woylie blood samples collected between 2006 and 2012. Time relative to the decline (year) and an interaction with co-infection by the other trypanosome best explained patterns of infection for both trypanosomes. The prevalence of single species infections for both T. copemani and T. vegrandis was lower after the population crash, however, the occurrence of co-infections increased after the crash compared to before the crash. Our results suggest an interaction between the two parasites with the decline of their host, leading to a higher level of co-infection after the decline. We discuss the possible mechanisms that may have led to a higher level of co-infection after the population crash, and highlight the importance of considering co-infection when investigating the role of parasites in species declines.

The kinetoplast DNA of the Australian trypanosome, Trypanosoma copemani, shares features with Trypanosoma cruzi and Trypanosoma lewisi.

Kinetoplast DNA (kDNA) is the mitochondrial genome of trypanosomatids. It consists of a few dozen maxicircles and several thousand minicircles, all catenated topologically to form a two-dimensional DNA network. Minicircles are heterogeneous in size and sequence among species. They present one or several conserved regions that contain three highly conserved sequence blocks. CSB-1 (10 bp sequence) and CSB-2 (8 bp sequence) present lower interspecies homology, while CSB-3 (12 bp sequence) or the Universal Minicircle Sequence is conserved within most trypanosomatids. The Universal Minicircle Sequence is located at the replication origin of the minicircles, and is the binding site for the UMS binding protein, a protein involved in trypanosomatid survival and virulence. Here, we describe the structure and organisation of the kDNA of Trypanosoma copemani, a parasite that has been shown to infect mammalian cells and has been associated with the drastic decline of the endangered Australian marsupial, the woylie (Bettongia penicillata). Deep genomic sequencing showed that T. copemani presents two classes of minicircles that share sequence identity and organisation in the conserved sequence blocks with those of Trypanosoma cruzi and Trypanosoma lewisi. A 19,257 bp partial region of the maxicircle of T. copemani that contained the entire coding region was obtained. Comparative analysis of the T. copemani entire maxicircle coding region with the coding regions of T. cruzi and T. lewisi showed they share 71.05% and 71.28% identity, respectively. The shared features in the maxicircle/minicircle organisation and sequence between T. copemani and T. cruzi/T. lewisi suggest similarities in their process of kDNA replication, and are of significance in understanding the evolution of Australian trypanosomes.

A comparative molecular and 3-dimensional structural investigation into cross-continental and novel avian Trypanosoma spp. in Australia.

BACKGROUND: Molecular and structural information on avian Trypanosoma spp. throughout Australia is limited despite their intrinsic value in understanding trypanosomatid evolution, diversity, and structural biology. In Western Australia tissue samples (n = 429) extracted from 93 birds in 25 bird species were screened using generic PCR primers to investigate the diversity of Trypanosoma spp. To investigate avian trypanosome structural biology the first 3-dimensional ultrastructural models of a Trypanosoma spp. (Trypanosoma sp. AAT) isolated from a bird (currawong, Strepera spp.) were generated using focussed ion beam milling combined with scanning electron microscopy (FIB-SEM). RESULTS: Here, we confirm four intercontinental species of avian trypanosomes in native Australian birds, and identify a new avian Trypanosoma. Trypanosome infection was identified in 18 birds from 13 different bird species (19%). A single new genotype was isolated and found to be closely related to T. culicavium (Trypanosoma sp. CC2016 B002). Other Trypanosoma spp. identified include T. avium, T. culicavium, T. thomasbancrofti, Trypanosoma sp. TL.AQ.22, Trypanosoma sp. AAT, and an uncharacterised Trypanosoma sp. (group C-III sensu Zidková et al. (Infect Genet Evol 12:102-112, 2012)), all previously identified in Australia or other continents. Serially-sectioning Trypanosoma sp. AAT epimastigotes using FIB-SEM revealed the disc-shaped kinetoplast pocket attached perpendicular to the branching mitochondrion. Additionally, the universal minicircle sequence within the kinetoplast DNA and the associated binding protein were determined in Trypanosoma sp. AAT. CONCLUSIONS: These results indicate that bird trypanosomes are relatively conserved across continents, while being locally diverse, which supports the hypothesis that bird trypanosomes exist as fewer species than described in the literature. Evidence exists that avian Trypanosoma spp. are infecting mammals and could be transmitted by haemadipsid leeches. Trypanosoma sp. AAT is most likely a separate species currently found only in Australia and the first 3-dimentional ultrastructural analysis of an avian trypanosome provides interesting information on their morphology and organelle arrangement.

In vitro drug susceptibility of two strains of the wildlife trypanosome, Trypanosoma copemani: A comparison with Trypanosoma cruzi.

Trypanosomes are blood protozoan parasites that are capable of producing illness in the vertebrate host. Within Australia, several native Trypanosoma species have been described infecting wildlife. However, only Trypanosoma copemani has been associated with pathological lesions in wildlife hosts and more recently has been associated with the drastic decline of the critically endangered woylie (Bettongia penicillata). The impact that some trypanosomes have on the health of the vertebrate host has led to the development of numerous drug compounds that could inhibit the growth or kill the parasite. This study investigated and compared the in vitro susceptibility of two strains of T. copemani (G1 and G2) and one strain of Trypanosoma cruzi (10R26) against drugs that are known to show trypanocidal activity (benznidazole, posaconazole, miltefosine and melarsoprol) and against four lead compounds, two fenarimols and two pyridine derivatives (EPL-BS1937, EPL-BS2391, EPL-BS0967, and EPL-BS1246), that have been developed primarily against T.cruzi. The in vitro cytotoxicity of all drugs against L6 rat myoblast cells was also assessed. Results showed that both strains of T. copemani were more susceptible to all drugs and lead compounds than T. cruzi, with all IC50 values in the low and sub-µM range for both species. Melarsoprol and miltefosine exhibited the highest drug activity against both T. copemani and T. cruzi, but they also showed the highest toxicity in L6 cells. Interestingly, both fenarimol and pyridine derivative compounds were more active against T. copemani and T. cruzi than the reference drugs benznidazole and posaconazole. T. copemani strains exhibited differences in susceptibility to all drugs demonstrating once again considerable differences in their biological behaviour.

Morphological and Phylogenetic Description of Trypanosoma noyesi sp. nov.: An Australian Wildlife Trypanosome within the T. cruzi Clade.

A number of trypanosome isolates from Australian marsupials are within the clade containing the human pathogen Trypanosoma cruzi. Trypanosomes within this clade are thought to have diverged from a common ancestral bat trypanosome. Here, we characterise Trypanosoma noyesi sp. nov. isolated from the critically endangered woylie (Bettongia pencillata) using phylogenetic inferences from three gene regions (18S rDNA, gGAPDH, and CytB) coupled with morphological and behavioural observations in vitro. We also investigated potential vectors and the presence of T. noyesi in the grey-headed flying fox (Pteropus poliocephalus). Phylogenetic analysis revealed T. noyesi and similar genotypes grouped at the periphery of the T. cruzi clade. T. noyesi is morphologically distinct both from other species of Australian trypanosomes and those within the T. cruzi clade. Although trypanosomes were not observed in the digestive tract of ectoparasites and biting flies collected from T. noyesi infected marsupials, tabanid and biting midges tested positive for T. noyesi DNA, indicating they are vector candidates. Tissues from flying foxes were negative for T. noyesi. This study provides novel information on the morphology and genetic variability of an Australian trypanosome within the T. cruzi clade.

Towards a Better Understanding of the Life Cycle of Trypanosoma copemani.

Trypanosoma copemani has been found infecting several threatened/endangered marsupial species within Australia and is thought to be a key player in the rapid decline of the woylie (Bettongia penicillata). To better understand the biology and life cycle of this parasite, the growth requirements, and kinetics of infection of two newly described genotypes, T. copemani G1 and G2, were investigated and compared with the T. cruzi strain-10R26 in vitro. Both G1 and G2 were able to infect all four cell lines tested. The number of infected cells where at least one intracellular amastigote of T. copemani G1 and G2 was seen was below 7% and 15% respectively in most cell lines. However, in VERO cells the rate of infection for T. copemani G2 was 70%-approximately seven and two times higher than for G1 and T. cruzi respectively. Despite the higher infection rate, the number of intracellular forms of T. copemani G2 was lower compared with T. cruzi, and intracellular replicating forms were not observed. The capability of T. copemani G2 to infect cells may have important consequences for pathogenicity and suggests it might employ similar strategies to complete its life cycle in the vertebrate host to those seen in T. cruzi.

Prevalencia de Corynebacterium spp. y factores asociados en mujeres del Valle de Aburrá / Prevalence of corynebacterium spp. and associated factors in women of Valle de Aburrá

Introducción: Corynebacterium spp. está presente en flujo vaginal de mujeres asintomáticas, perose ha encontrado asociado a procesos patológicos, generando confusión al momento de clasificarlo como microbiota o microorganismos patógenos. Nuestro objetivo fue determinar la prevalencia de Corynebacterium spp. y explorar su asociación con características clínicas y hábitos sexuales. Material y métodos: estudio descriptivo transversal en 511 mujeres del Valle de Aburrá durante 2012 y 2013. Los datos demográficos, clínicos y de comportamiento sexual se obtuvieron mediante encuestas; la información sobre el perfil microbiológico genital se obtuvo de muestra de flujo vaginal. El análisis descriptivo se hizo con frecuencias y medidas de resumen; para el análisis bivariado se usó χ cuadrado, prueba exacta de Fisher, U de Mann Whitney y se usó regresión logística para el análisis multivariado; los análisis se realizaron en el programa estadístico IBM SPSS Statistics versión 22. Resultados: la prevalencia de Corynebacterium spp fue 59%. Referente al comportamiento sexual durante el último mes previo a la toma de muestra, encontramos que las participantes tuvieron sexo con una persona en promedio (rango de 0 - 3 personas distintas); respecto a las prácticas durante el coito en el mismo mes, se observó que 58% de las mujeres tuvo sexo sin preservativo, a 61% le practicaron sexo oral y a 10% sexo anal. Se encontró asociación de Corynebacterium sppcon reacción leucocitaria. Conclusiones: la prevalencia de Corynebacterium spp. fue 59% y se encontró asociado a reacción leucocitaria; no se asoció a comportamientos sexuales específicos ni sintomatología ginecológica. (Acta Med Colomb 2015; 40: 234-240).

Introduction: Corynebacterium spp. is present in vaginal fluid of asymptomatic women, but it has been found associated with disease processes, creating confusion when classified as normal or pathogenic flora. Our objective was to determine the prevalence of Corynebacterium spp. and explore its association with clinical characteristics and sexual habits. Materials and Methods: descriptive cross-sectional study in 511 women of Valle de Aburrá in 2012 and 2013. Demographic, clinical and sexual behavioral data were obtained through surveys; information about genital microbiological profile was obtained from sample of vaginal discharge. Descriptive analysis was done with frequencies and summary measures; for bivariate analysis χ square, Fisher exact test and Mann Whitney U test were used, and logistic regression was used for multivariate analysis; analysis were performed in the statistical program SPSS Statistics version 22. Results: The prevalence of Corynebacterium spp was 59%. Regarding sexual behavior during the last pre-sampling month, we found that participants had sex with a person on average (range from 0-3 different people); regarding practices during intercourse in the same month, it was observed that 58% of women had sex without a condom, to 61% oral sex was practiced and to 10% anal sex. Association of Corynebacterium spp with leukocyte reaction was found. Conclusions: The prevalence of Corynebacterium spp was 59% and was found associated with leukocyte reaction; it was not associated to specific sexual behaviors or gynecological symptoms. (Acta Med Colomb 2015; 40: 234-240).

EFECTO DEL ALBENDAZOL Y LA VITAMINA A PERIÓDICOS SOBRE HELMINTOS INTESTINALES Y ANEMIA EN NIÑOS DEL URABÁ ANTIOQUEÑO (COLOMBIA) / EFFECT OF PERIODIC ALBENDAZOLE AND VITAMIN A TREATMENT ON INTESTINAL HELMINTHS AND ANEMIA IN CHILDREN FROM URABÁ (ANTIOQUIA, COLOMBIA)

Problema: En Colombia no hay informes sobre efectos en humanos del tratamiento periódico antihelmíntico-vitamina A. Objetivo: Evaluar efectos de albendazol/pamoato de pirantel-vitamina A trimestrales sobre Ascaris lumbricoides, Trichuris trichiura, Necator americanus y sobre niveles séricos de retinol y hemoglobina, en niños del Urabá antioqueño. Metodología: Estudio clínico, aleatorio, con grupos paralelos, cerrado, intervenidos y evaluados cada 3-4 meses por 4 veces, seguidos 12 meses. Intervención: suministro de pamoato de pirantel (pamoato) (< 2 años) o albendazol (≥ 2 años), con o sin vitamina A oral. Resultados: Ingreso: 25% presentó desnutrición crónica y hemoglobina (g/L), 106 g/L en < 2 años y 115 g/L en ≥ 2 años. A) Prevalencias: estrongiloides 7%, uncinarias 29%, áscaris 45%, tricocéfalos 45%. Cambios postratamiento: pamoato únicamente causó reducción de áscaris y, en general, aumentó tricocéfalos y uncinarias. Albendazol: redujo cada helminto, como lo hicieron tratamientos sin este medicamento, pero fue mayor con albendazol. B) Cambio en carga parasitaria: únicas diferencias significativas fueron para tricocéfalos con pamoato-vitamina y albendazol-vitamina, por aumento, y áscaris con albendazol-vitamina, por reducción. No hubo diferencia significativa entre ingreso y egreso en niveles de hemoglobina ni retinol en ninguno de los cuatro tratamientos. Conclusiones: En general, no hubo efecto del albendazol sobre la carga helmintiana, pero sí efecto moderado sobre la prevalencia de uncinarias, áscaris y tricocéfalos. Quizás la desparasitación de solo parte de la población < 15 años, sin tratar el resto de convivientes, y el mantenimiento de muy deficientes condiciones de vida expliquen estos resultados.

Problem: There are no reports about the effect of periodic anthelminthic-vitamin A treatment in humans In Colombia. Objective: To evaluate effects of albendazole/ pamoate pyrantel-vitamin A administered quarterly on Ascaris lumbricoides, Trichuris trichiura, Necator americanus, and on serum retinol and hemoglobin levels in children from Urabá (Antioquia, Colombia). Methodology: Clinical, randomized, controlled trial with parallel groups intervened and evaluated each 3-4 months for 4 times, followed 12 months. Intervention: administration of pyrantel pamoate (pamoate) (< 2 years) or albendazole (≥ 2 years), with or without oral vitamin A. Results: Entry: 25% presented chronic malnutrition and hemoglobin, 10.6 g/L (< 2 years) and 11.5 g/L (≥ 2 years). A) Prevalence: strongyloides 7%, uncinaria 29%, ascaris 45%, whipworms 45%. Post-treatment changes: pamoate only caused reduction of ascaris and, in general, increased whipworms and uncinarias. Albendazole: reduced the prevalence of each helminth, as treatments without this medication did, but it was higher in treatments with albendazole. B) Change in parasite load: only significant differences were for whipworms with pamoate-vitamin and albendazole-vitamin, because of increase, and ascaris with albendazole-vitamin, because of reduction. No significant difference between entry and leave in hemoglobin or retinol levels in any of the four treatment groups. Conclusions: Overall, there was no effect of albendazole on helminth communities, but there was moderate effect on prevalence of uncinaria, ascaris and whipworms. Possibly deworming only part of the population < 15 years without treating the rest of cohabitants, and the maintenance of very poor living conditions can explain these results.

Two analogues of fenarimol show curative activity in an experimental model of Chagas disease.

Chagas disease, caused by the protozoan parasite Trypanosoma cruzi (T. cruzi), is an increasing threat to global health. Available medicines were introduced over 40 years ago, have undesirable side effects, and give equivocal results of cure in the chronic stage of the disease. We report the development of two compounds, 6 and (S)-7, with PCR-confirmed curative activity in a mouse model of established T. cruzi infection after once daily oral dosing for 20 days at 20 mg/kg 6 and 10 mg/kg (S)-7. Compounds 6 and (S)-7 have potent in vitro activity, are noncytotoxic, show no adverse effects in vivo following repeat dosing, are prepared by a short synthetic route, and have druglike properties suitable for preclinical development.

Morphological polymorphism of Trypanosoma copemani and description of the genetically diverse T. vegrandis sp. nov. from the critically endangered Australian potoroid, the brush-tailed bettong (Bettongia penicillata (Gray, 1837)).

BACKGROUND: The trypanosome diversity of the Brush-tailed Bettong (Bettongia penicillata), known locally as the woylie, has been further investigated. At a species level, woylies are critically endangered and have declined by 90% since 1999. The predation of individuals made more vulnerable by disease is thought to be the primary cause of this decline, but remains to be proven. METHODS: Woylies were sampled from three locations in southern Western Australia. Blood samples were collected and analysed using fluorescence in situ hybridization, conventional staining techniques and microscopy. Molecular techniques were also used to confirm morphological observations. RESULTS: The trypanosomes in the blood of woylies were grouped into three morphologically distinct trypomastigote forms, encompassing two separate species. The larger of the two species, Trypanosoma copemani exhibited polymorphic trypomastigote forms, with morphological phenotypes being distinguishable, primarily by the distance between the kinetoplast and nucleus. The second trypanosome species was only 20% of the length of T. copemani and is believed to be one of the smallest recorded trypanosome species from mammals. No morphological polymorphism was identified for this genetically diverse second species. We described the trypomastigote morphology of this new, smaller species from the peripheral blood of the woylie and proposed the name T. vegrandis sp. nov. Temporal results indicate that during T. copemani Phenotype 1 infections, the blood forms remain numerous and are continuously detectable by molecular methodology. In contrast, the trypomastigote forms of T. copemani Phenotype 2 appear to decrease in prevalence in the blood to below molecular detectable levels. CONCLUSIONS: Here we report for the first time on the morphological diversity of trypanosomes infecting the woylie and provide the first visual evidence of a mixed infection of both T. vegrandis sp. nov and T. copemani. We also provide supporting evidence that over time, the intracellular T. copemani Phenotype 2 may become localised in the tissues of woylies as the infection progresses from the active acute to chronic phase. As evidence grows, further research will be necessary to investigate whether the morphologically diverse trypanosomes of woylies have impacted on the health of their hosts during recent population declines.

Trypanosomes genetic diversity, polyparasitism and the population decline of the critically endangered Australian marsupial, the brush tailed bettong or woylie (Bettongia penicillata).

While much is known of the impact of trypanosomes on human and livestock health, trypanosomes in wildlife, although ubiquitous, have largely been considered to be non-pathogenic. We describe the genetic diversity, tissue tropism and potential pathogenicity of trypanosomes naturally infecting Western Australian marsupials. Blood samples collected from 554 live-animals and 250 tissue samples extracted from 50 carcasses of sick-euthanized or road-killed animals, belonging to 10 species of marsupials, were screened for the presence of trypanosomes using a PCR of the 18S rDNA gene. PCR results revealed a rate of infection of 67% in blood and 60% in tissues. Inferred phylogenetic trees using 18S rDNA and glycosomal glyceraldehyde phosphate dehydrogenase (gGAPDH) sequences showed the presence of eight genotypes that clustered into three clades: a clade including Trypanosoma copemani, a new clade closely related to Trypanosoma gilletti, and a clade including Trypanosoma H25 from an Australian kangaroo. Trypanosome infections were compared in a declining and in a stable population of the endangered Australian marsupial, the brush tailed bettong or woylie (Bettongia penicillata). This marsupial showed high rates of infection with Clade A genotypes (96%) in the declining population, whereas in the stable population, Clade B genotypes were predominant (89%). Mixed infections were common in woylies from the declining but not from the stable population. Histopathological findings associated with either mixed or single infections involving Clade A genotypes, showed a strong inflammatory process and tissue degeneration predominantly in heart, oesophagus and tongue. Trypanosomes were successfully grown in culture and for the first time we demonstrate that a genotype within Clade A has the capacity to not only colonize different tissues in the host but also to invade cells in vitro. These results provide evidence for the potential role of trypanosomes in the decline of a formerly abundant marsupial that is now critically endangered.

Analogues of fenarimol are potent inhibitors of Trypanosoma cruzi and are efficacious in a murine model of Chagas disease.

We report the discovery of nontoxic fungicide fenarimol (1) as an inhibitor of Trypanosoma cruzi ( T. cruzi ), the causative agent of Chagas disease, and the results of structure-activity investigations leading to potent analogues with low nM IC(50)s in a T. cruzi whole cell in vitro assay. Lead compounds suppressed blood parasitemia to virtually undetectable levels after once daily oral dosing in mouse models of T. cruzi infection. Compounds are chemically tractable, allowing rapid optimization of target biological activity and drug characteristics. Chemical and biological studies undertaken in the development of the fenarimol series toward the goal of delivering a new drug candidate for Chagas disease are reported.