Seroprevalence of African swine fever in pigs for slaughter in Leyte, Philippines.

Objective: This study aims to determine the seroprevalence of African swine fever (ASF) in pigs for slaughter in Leyte, Philippines. It underpins the concept that recovered and infected pigs from ASF are likely sent for slaughter to avoid perceived economic losses. Materials and Methods: A cross-sectional study was conducted from March to June 2023 in eight abattoirs, each representing both a city and a municipality in Leyte province. A total of 218 blood samples from 78 farms were examined for ASF virus (ASFV) (VP72) antibodies using a blocking enzyme-linked immunosorbent assay (ELISA) method. Descriptive and seroprevalence analyses were performed. Results: ASF antibodies were detected in pigs for slaughter from abattoirs in Baybay and Ormoc cities, showing a seroprevalence of 3.57% (1/28 pigs) and 2.27% (1/44 pigs), respectively. An apparent absence of ASF antibodies was observed among pigs for slaughter in Isabel, Villaba, Abuyog, Kananga, Dulag, and Macarthur. The farm-level seroprevalence was 2.56% (95% CI: 0.71%-8.88%), while the pig-level seroprevalence was 0.91% (95% CI: 0.25%-3.27%). Conclusion: Detecting ASF antibodies among pigs for slaughter implies exposure to the virus from the farm of origin. This means that, on some farms, ASF remains unreported or undiagnosed. Active surveillance is needed for early case detection and rapid response to control the spread of ASF in the country.

Periodicity of Ascaridia galli egg excretion in experimentally infected chicken in the Philippines.

The periodicity of parasite egg excretion refers to variations in the number of eggs produced across time, with significant implications in optimizing diagnostic procedures and conducting the Fecal Egg Count Reduction Test (FECRT). Here, we explore whether Ascaridia galli egg excretion varies across time under Philippine conditions, thus informing the best time to collect fecal samples during flock health examination. A time-course analysis was performed in chickens (N = 12) experimentally infected with A. galli, isolated from a naturally infected Philippine native chicken. We examined the fecal egg per gram (EPG) count at 3-h intervals for 3 days, starting from 5:00-6:00 h AM to the following day at 1:00-2:00 h AM. Our results showed a consistent daily egg excretion pattern with a peak EPG count in the morning that abruptly declined in the afternoon and lowest in the evening. The EPG counts correlated with the amount of excreta produced, suggesting that A. galli fecundity corresponds to the timing of host defecation. Our results imply that the best time to collect fecal samples for A. galli diagnosis and FECRT in Philippine conditions should be from sunrise until late morning when parasite EPG count and host excreta production are at their highest.

Prevalence of Toxocara canis infection in dogs and Toxocara egg environmental contamination in Baybay City, Leyte, Philippines.

Toxocara canis is a parasitic gastrointestinal nematode of dogs causing toxocariasis in humans, a neglected tropical disease. This study examined the burden of T. canis infection in dogs and egg contamination in school playgrounds and public parks in Baybay City, Leyte, Philippines. Fecalysis and egg detection in soils were performed to determine the parasite prevalence in dogs and the environment. In addition, pet owner's survey and GIS mapping were employed to identify the risk factors of infection and map the parasite distribution. Fecalysis revealed a T. canis prevalence of 64.44% (95% CI: 48.78-78.13) at the barangay level and 17.96% (95% CI: 14.12-21.80) at the animal level. Rural areas showed a much higher T. canis prevalence than urban. Factors associated with high T. canis infection included dog's age, specifically puppy (2-8 mo) relative to young (> 8-24 mo) [Adjusted Odds Ratio (AOR): 2.282; 95% CI: 1.137-4.579; p = 0.020] and adult (> 24 mo) (AOR: 3.542; 95% CI: 1.714-7.319; p = 0.001), access to dirty water (AOR: 2.749; 95% CI: 1.575-4.798; p < 0.001), and non-deworming (AOR: 2.961; 95%: CI 1.009-8.684; p = 0.048). Furthermore, we observed high Toxocara egg contamination in school playgrounds and public parks, with a prevalence of 51.11% (95% CI: 35.77-66.3) at the barangay level and 15.45% (95% CI: 10.67-20.23) in soil samples. This epidemiological study is the first in the central Philippines to report a high burden of T. canis infection in dogs and the environment, thus providing crucial data that will help understand the epidemiology of toxocariasis. Supplementary Information: The online version contains supplementary material available at 10.1007/s12639-022-01525-y.

Plasmodium falciparum sexual conversion rates can be affected by artemisinin-based treatment in naturally infected malaria patients.

BACKGROUND: Artemisinins (ART) are the key component of the frontline antimalarial treatment, but their impact on Plasmodium falciparum sexual conversion rates in natural malaria infections remains unknown. This is an important knowledge gap because sexual conversion rates determine the relative parasite investment between maintaining infection in the same human host and transmission to mosquitoes. METHODS: The primary outcome of this study was to assess the impact of ART-based treatment on sexual conversion rates by comparing the relative transcript levels of pfap2-g and other sexual ring biomarkers (SRBs) before and after treatment. We analysed samples from previously existing cohorts in Vietnam, Burkina Faso and Mozambique (in total, n=109) collected before treatment and at 12 h intervals after treatment. As a secondary objective, we investigated factors that may influence the effect of treatment on sexual conversion rates. FINDINGS: In the majority of infections from the African cohorts, but not from Vietnam, we observed increased expression of pfap2-g and other SRBs after treatment. Estimated parasite age at the time of treatment was negatively correlated with the increase in pfap2-g transcript levels, suggesting that younger parasites are less susceptible to stimulation of sexual conversion. INTERPRETATION: We observed enhanced expression of SRBs after ART-based treatment in many patients, which suggests that in natural malaria infections sexual conversion rates can be altered by treatment. ART-based treatment reduces the potential of a treated individual to transmit the disease, but we hypothesise that under some circumstances this reduction may be attenuated by ART-enhanced sexual conversion. FUNDING: Spanish Agencia Estatal de Investigación (AEI), European Regional Development Fund (ERDF, European Union), Belgium Development Cooperation (DGD), Canadian University Health Network (UHN), TransGlobalHealth-Erasmus Mundus (European Union).

Transcriptional Analysis of Tightly Synchronized Plasmodium falciparum Intraerythrocytic Stages by RT-qPCR.

In Plasmodium falciparum, the parasite responsible for the most severe forms of human malaria, many fundamental processes are controlled at the transcriptional level. Studies on diverse aspects of basic parasite biology as well as molecular epidemiology studies often rely on the ability to accurately measure transcript levels, but this is complicated by the cyclic expression patterns of the majority of malaria parasite genes. Here, we provide a complete workflow to measure transcript levels in P. falciparum intraerythrocytic blood stages, overcoming the confounding factors that are commonly encountered. The method described covers all the steps from synchronization of parasite cultures to reverse transcriptase quantitative PCR (RT-qPCR) analysis.

Artemisinin exposure at the ring or trophozoite stage impacts Plasmodium falciparum sexual conversion differently.

Malaria transmission is dependent on the formation of gametocytes in the human blood. The sexual conversion rate, the proportion of asexual parasites that convert into gametocytes at each multiplication cycle, is variable and reflects the relative parasite investment between transmission and maintaining the infection. The impact of environmental factors such as drugs on sexual conversion rates is not well understood. We developed a robust assay using gametocyte-reporter parasite lines to accurately measure the impact of drugs on sexual conversion rates, independently from their gametocytocidal activity. We found that exposure to subcurative doses of the frontline antimalarial drug dihydroartemisinin (DHA) at the trophozoite stage resulted in a ~ fourfold increase in sexual conversion. In contrast, no increase was observed when ring stages were exposed or in cultures in which sexual conversion was stimulated by choline depletion. Our results reveal a complex relationship between antimalarial drugs and sexual conversion, with potential public health implications.

Reporter lines based on the gexp02 promoter enable early quantification of sexual conversion rates in the malaria parasite Plasmodium falciparum.

Transmission of malaria parasites from humans to mosquito vectors requires that some asexual parasites differentiate into sexual forms termed gametocytes. The balance between proliferation in the same host and conversion into transmission forms can be altered by the conditions of the environment. The ability to accurately measure the rate of sexual conversion under different conditions is essential for research addressing the mechanisms underlying sexual conversion, and to assess the impact of environmental factors. Here we describe new Plasmodium falciparum transgenic lines with genome-integrated constructs in which a fluorescent reporter is expressed under the control of the promoter of the gexp02 gene. Using these parasite lines, we developed a sexual conversion assay that shortens considerably the time needed for an accurate determination of sexual conversion rates, and dispenses the need to add chemicals to inhibit parasite replication. Furthermore, we demonstrate that gexp02 is expressed specifically in sexual parasites, with expression starting as early as the sexual ring stage, which makes it a candidate marker for circulating sexual rings in epidemiological studies.

Examining community perceptions of malaria to inform elimination efforts in Southern Mozambique: a qualitative study.

BACKGROUND: In a background of renewed calls for malaria eradication, several endemic countries in sub-Saharan Africa are contemplating malaria elimination nationally or sub-nationally. In Mozambique, a strategy to eliminate malaria in the south is underway in the context of low endemicity levels and cross-border initiatives to eliminate malaria in South Africa and Eswatini. In this context, a demonstration project aiming to interrupt malaria transmission through mass antimalarial drug administrations and intensified vector control programmes accompanied by community engagement and standard case management was implemented in the Magude District. To ensure the necessary uptake of these interventions, formative qualitative research explored the perceptions, beliefs, attitudes, and practices related to malaria, its prevention and control. The current article describes the results of this study. METHODS: Seventeen focus group discussions were conducted between September and October of 2015 with the community leaders (6), adult men (5), women of reproductive age (5), and traditional healers (1) in Magude prior to the implementation of the project interventions. Respondents discussed perceptions around malaria symptoms, causes, preventions, and treatments. RESULTS: Knowledge of malaria was linked to awareness of its clinical presentation, and on-going vector control programmes. Perceptions of malaria aetiology were fragmented but related mainly to mosquito-mediated transmission. Reported preventive measures mostly involved mosquito control although participants were aware of the protective limitations of vector control tools. Awareness of asymptomatic carriers and the risk of outdoor malaria transmission were varied. Fever and malaria-like symptoms triggered immediate care-seeking community at health facilities. The identified barriers to malaria treatment included fear/mistrust in Western medicine, distance to health facilities, and lack of transportation. CONCLUSIONS: Several constraints and opportunities will potentially influence malaria elimination in Magude. Malaria awareness, trust in health institutions, and the demand for chemoprophylaxis could facilitate new interventions, such as mass drug administration. A lack of awareness of asymptomatic carriers, inadequate understanding of residual transmission, and barriers to care seeking could jeopardize uptake. Hence, elimination campaigns require strong community engagement and grassroots mobilization.

Examining community perceptions of malaria to inform elimination efforts in Southern Mozambique: a qualitative study

Background: In a background of renewed calls for malaria eradication, several endemic countries in sub-Saharan Africa are contemplating malaria elimination nationally or sub-nationally. In Mozambique, a strategy to eliminate malaria in the south is underway in the context of low endemicity levels and cross-border initiatives to eliminate malaria in South Africa and Eswatini. In this context, a demonstration project aiming to interrupt malaria transmission through mass antimalarial drug administrations and intensified vector control programmes accompanied by community engagement and standard case management was implemented in the Magude District. To ensure the necessary uptake of these interventions, formative qualitative research explored the perceptions, beliefs, attitudes, and practices related to malaria, its prevention and control. The current article describes the results of this study. Methods: Seventeen focus group discussions were conducted between September and October of 2015 with the community leaders (6), adult men (5), women of reproductive age (5), and traditional healers (1) in Magude prior to the implementation of the project interventions. Respondents discussed perceptions around malaria symptoms, causes, preventions, and treatments. Results: Knowledge of malaria was linked to awareness of its clinical presentation, and on-going vector control programmes. Perceptions of malaria aetiology were fragmented but related mainly to mosquito-mediated transmission. Reported preventive measures mostly involved mosquito control although participants were aware of the protective limitations of vector control tools. Awareness of asymptomatic carriers and the risk of outdoor malaria transmission were varied. Fever and malaria-like symptoms triggered immediate care-seeking community at health facilities. The identified barriers to malaria treatment included fear/mistrust in Western medicine, distance to health facilities, and lack of transportation...

Prevalence, risk factors, and spatial distribution of Fasciola in carabao and intermediate host in Baybay, Leyte, Philippines.

Fasciolosis remains an important parasitic disease of ruminants in Southeast Asia. We investigated the prevalence and spatial distribution of Fasciola spp. in carabao (Bubalus bubalis) and snail intermediate hosts (IHs) in Baybay, Leyte, Philippines. Using one-stage cluster sampling, we examined 335 fecal samples of carabaos from 138 herds for Fasciola spp. eggs, and in parallel collected IH snail data in the area. Risk factor analyses were performed and GIS maps were created for Fasciola spp. prevalence and IH snail distribution. The prevalence of Fasciola spp. in animal and herd level was 63.58% and 86.96%, respectively. Risk factor analyses showed that increasing age and drinking from irrigation water were highly associated with Fasciola infection in carabaos. Inversely, access to wallowing ponds seemed to be a significant protective factor. Lymnaeid snail presence was higher in areas with intensive networks of irrigated water system and rivers, land elevation above sea level, and moderate vegetation. Our epidemiologic data suggest a high endemicity of Fasciola spp. in Baybay, Leyte and present essential factors to consider in implementing control measures.

Anthelmintic activity of Moringa oleifera seed aqueous and ethanolic extracts against Haemonchus contortus eggs and third stage larvae.

Haemonchus contortus is one of the prevalent and pathogenic ruminant parasites that has grown resistance to common anthelmintic treatment. This study evaluated the anthelmintic potential of Moringa oleifera seed ethanolic and aqueous extracts against H. contortus eggs and infective stage larvae (L3s). The efficacy of five extract concentrations (0.95, 1.95, 3.9, 7.8, and 15.6 mg/mL) were tested through egg hatch assay and larval motility test. Phytochemical tests were conducted to detect the different plant secondary metabolites in the extracts. In the ovicidal assay, the ethanolic and aqueous extracts showed 95.89% and 81.72% egg hatch inhibition at 15.6 mg/mL, respectively. The ovicidal activity of 15.6 mg/mL ethanolic extract was comparable with that of albendazole (p > 0.05). The LC50 against the eggs was recorded at 2.91 and 3.83 mg/mL for ethanolic and aqueous extracts, respectively. In the larvicidal assay, the ethanolic and aqueous extracts exhibited 56.94% and 92.50% efficacy at 7.8 mg/mL, respectively. The larvicidal activity of 7.8 mg/mL aqueous extract was similar statistically with that of ivermectin (p > 0.05). The LC50 against L3s was recorded at 6.96 and 4.12 mg/mL for ethanolic and aqueous extracts, respectively. The secondary metabolites detected were tannins in ethanolic extract and saponins in aqueous extract. Both extracts inhibited larvae formation inside the eggs and rendered the L3s immobile. Therefore, M. oleifera seed extracts contained plant bioactive compounds with anthelmintic property against the eggs and L3s of H. contortus.

Prevalence and risk factors associated with gastrointestinal nematode infection in goats raised in Baybay city, Leyte, Philippines.

AIM: Gastrointestinal parasitism is a serious constraint affecting goat production in the Philippines. This study aimed to determine the prevalence and associated risk factors of gastrointestinal nematode infection in goat-populated barangays of Baybay City, Leyte. MATERIALS AND METHODS: A total of 81 households or farms were interviewed, and 450 goats were sampled for fecalysis. Fecal egg count along with egg morphological identification and coproculture for third stage larvae identification were conducted. Descriptive statistics and logistic regression analyses were carried out to determine the farm- and animal-level prevalence and risk factors. RESULTS: Fecalysis revealed the presence of strongyle and Trichuris spp. with a farm-level prevalence of 100% and 4.94%, respectively; and animal-level prevalence of 96.22% and 4.44%, respectively. The identified strongyle genera per barangay were Haemonchus spp. (34.79%), Trichostrongylus spp. (33.29%), Oesophagostomum spp. (24.21%), Cooperia spp. (6.93%), and Chabertia spp. (0.79%). Goats older than 12 months were four times more likely to present high strongyle burden when compared to goats <6 months. With each month increase in goat's age, the odds of acquiring strongyle infection also increased by 1.07 times. Animals kept in goat house with cemented flooring have lower odds of acquiring strongyle (odds ratio=0.12). Goats raised for leisure purposes and fed with carabao grass (Paspalum conjugatum) were 8.12 and 5.52 times more likely to acquire Trichuris, respectively. CONCLUSION: Most of the backyard goat raisers in Baybay City, Leyte, do not practice sound helminth control measures as shown by the high prevalence of gastrointestinal nematodes. The most relevant risk factors for gastrointestinal nematode infection were the age of the goat, type of goat house's flooring, purpose of raising goats, and feeding practices.

Metastatic bone disease: Have we improved after a decade of guidelines?

OBJECTIVES: Guidelines for the management of patients with metastatic bone disease (MBD) have been available to the orthopaedic community for more than a decade, with little improvement in service provision to this increasingly large patient group. Improvements in adjuvant and neo-adjuvant treatments have increased both the number and overall survival of patients living with MBD. As a consequence the incidence of complications of MBD presenting to surgeons has increased and is set to increase further. The British Orthopaedic Oncology Society (BOOS) are to publish more revised detailed guidelines on what represents 'best practice' in managing patients with MBD. This article is designed to coincide with and publicise new BOOS guidelines and once again champion the cause of patients with MBD. METHODS: A series of short cases highlight common errors frequently being made in managing patients with MBD despite the availability of guidelines. RESULTS: Despite guidelines for the management of patients with MBD being available for more than a decade basic errors in management continue to be made, affecting patient survival and quality of life. CONCLUSIONS: It is hoped that by publicising the new BOOS guidelines the management of patients with MBD will improve over the next decade, significantly more than it has over the last decade.

Bilateral talar avulsion fractures secondary to seizure: a case report.

Musculoskeletal injury as a result of seizure activity is not uncommon, posterior shoulder dislocation being a well-described example. In this report, we describe what we believe to be the first published case of bilateral talar avulsion fractures secondary to seizure.

Computer navigated total knee arthroplasty: aspects of a single unit's experience of 777 cases.

The use of computer navigation and conventional techniques in total knee arthroplasty remains controversial. Advocates of computer navigated techniques cite better alignment of components and reduced morbidity associated with avoidance of intramedullary instrumentation as a rationale for their use. In contrast, proponents of conventional techniques argue that better alignment does not correlate with a better functional outcome and that the conventional approach avoids the perceived risk of fracture associated with bicortical insertion of navigation tracker pins. All total knee arthoplasties performed at our institution are prospectively monitored for life in a dedicated Joint Replacement Assessment Clinic (JRAC). Patients are reviewed by physiotherapists, independent of the surgeons who performed surgery, both preoperatively and at six weeks, three and six months, and one, two and five years postoperatively (and every five years thereafter). Patients are assessed using validated outcome measures (Knee Society Score, Western Ontario and McMaster Universities (WOMAC) osteoarthritis index, Short Form SF-36 Health Survey (version 2) and a patient satisfaction score). In addition, at 6 months post surgery, a CT scan of each implanted prosthesis is performed using the Perth CT knee protocol. The findings of a single unit's experience of 777 navigated primary total knee replacements are discussed and critically compared to the body of literature that currently relates to this controversial topic.

Genetic influences in the progression of tears of the rotator cuff.

The aim of this study was to investigate genetic influences on the development and progression of tears of the rotator cuff. From a group of siblings of patients with a tear of the rotator cuff and of controls studied five years earlier, we determined the prevalence of tears of the rotator cuff with and without associated symptoms using ultrasound and the Oxford Shoulder Score. In the five years since the previous assessment, three of 62 (4.8%) of the sibling group and one of the 68 (1.5%) controls had undergone shoulder surgery. These subjects were excluded from the follow-up. Full-thickness tears were found in 39 of 62 (62.9%) siblings and in 15 of 68 (22.1%) controls (p = 0.0001). The relative risk of full-thickness tears in siblings as opposed to controls was 2.85 (95% confidence interval (CI) 1.75 to 4.64), compared to 2.42 (95% CI 1.77 to 3.31) five years earlier. Full-thickness tears associated with pain were found in 30 of 39 (76.9%) tears in the siblings and in eight of 15 (53.3%) tears in the controls (p = 0.045). The relative risk of pain associated with a full-thickness tear in the siblings as opposed to the controls was 1.44 (95% CI 2.04 to 8.28) (p = 0.045). In the siblings group ten of 62 (16.1%) had progressed in terms of tear size or development compared to one of 68 (1.5%) in the control group which had increased in size. Full-thickness rotator cuff tears in siblings are significantly more likely to progress over a period of five years than in a control population. This implies that genetic factors have a role, not only in the development but also in the progression of full-thickness tears of the rotator cuff.

The treatment of femoral neuropathy due to pseudotumour caused by metal-on-metal resurfacing arthroplasty.

Concerns now exist about the long-term biological effects of exposure to orthopaedic metal alloys, particularly serum cobalt and chromium ions derived from metal-on-metal wear debris in these patients. A pseudotumour mass complicating metal-on-metal resurfacing arthroplasty has been recognized by orthopaedic oncologists and specialist hip units. Pseudotumours may also present with a major nerve palsy. Two cases of femoral neuropathy due to pseudotumour masses caused by metal-on-metal resurfacing arthroplasty are presented. Preoperative neurophysiological studies showed severe and irreversible pathological changes to nerve function with neurohistopathological evidence of complete nerve destruction with a previously unreported pathological appearance. This may represent a previously unrecognized pathological process, possibly 'toxic' in nature, resulting from metal-on-metal wear debris. Prolonged follow-up and detailed clinical assessment of patients after hip resurfacing arthroplasty is advocated with planned and expeditious revision of any patient in whom evidence of femoral neuropathy develops.

The Bristol regional pelvic and acetabular fracture service: workload implications of managing the polytraumatised patient.

Pelvic and acetabular injury may occur in isolation, or, in two-thirds of cases be associated with other significant injuries to the skeleton or other body systems. Most unstable pelvic and acetabular injuries require specialist surgical treatment which often means transfer to a specialist centre. The associated injuries also require assessment and treatment by appropriate specialists. It is believed patients treated in specialist centres for these injuries have an improved outcome. Costing implications therefore exist for hospitals purchasing such services from specialist pelvic units. This paper presents a review of the multidisciplinary specialty surgical workload generated by offering a regional pelvic and acetabular service in Bristol over a 1-year period. It suggests previous reports documenting the number of patients suffering pelvic and acetabular injuries associated with other significant injuries, may have been underestimated. This information informs health care purchasers of the real extent of the surgical and other services needed and the resources required to treat patients with unstable pelvic and acetabular injuries.

Fracture of the hydroxyapatite-ceramic-coated JRI-Furlong femoral component: body mass index and implications for selection of the implant.

We describe three cases of fracture of the titanium JRI-Furlong hydroxyapatite-ceramic (HAC)-coated femoral component. We have examined previous case reports of failure of this stem and conclude that fracture may occur in two places, namely at the neck-shoulder junction and at the conical-distal cylindrical junction. These breakages are the result of fatigue in a metallurgically-proven normal femoral component. All the cases of failure of the femoral component have occurred in patients with a body mass index of more than 25 in whom a small component, either size 9 or 10, had been used. In patients with a body mass index above normal size 9 components should be avoided and the femoral canal should be reamed sufficiently to accept a large femoral component to ensure that there is adequate metaphyseal fixation.

The Trident constrained acetabular (bipolar) component for recurrent dislocation. New mode of liner failure.

Recurrent dislocation after reconstructive hip surgery remains a challenging problem to treat. Constrained acetabular components can provide an excellent solution, in selected patients. Failure of constrained components may still occur despite excellent component implantation and occurs at the liner-shell and shell-bone interfaces usually as a result of trauma or aseptic loosening. We describe the failure of a Trident bipolar acetabular component at its bipolar/insert interface, a previously unreported mode of failure.