PCR-based detection and identification of the filarial parasite Brugia timori from Alor Island, Indonesia.

Brugia timori is widely distributed on Alor Island, Indonesia, where it causes a high degree of morbidity. The HhaI tandem repeat of B. timori was found to be identical to that of B. malayi, for which sensitive PCR-based assays have already been developed. Using one of these assays, a single microfilaria (mf) of B. timori, present in a spot of dry blood on filter paper, could be detected. The assay was equally sensitive in the detection of B. timori and B. malayi. When the collected mosquitoes were pooled according to species and tested with the assay, 39 (64%) of the 61 Anopheles barbirostris pools (containing a total of 642 mosquitoes) were positive. As none of the 33 Culex pools tested (which contained 624 mosquitoes) gave a positive result, and An. barbirostris is the only Anopheles species commonly caught on human bait in Alor, An. barbirostris is assumed to be the main and perhaps only local vector. Brugia timori could be differentiated from B. malayi by restriction-endonuclease digestion of the PCR-amplified mitochondrial cytochrome oxidase subunit 2. A few distinct nucleotide exchanges were also found in the second internal transcribed ribosomal spacer of the filariae, and in the 16S rDNA and FTSZ gene of their Wolbachia endobacteria. The results show that B. timori can be effectively detected using the PCR-based assay developed for B. malayi and can then be differentiated from B. malayi by other molecular markers. PCR-based techniques targeting the HhaI repeat can therefore be employed for monitoring B. timori in the framework of the Global Programme to Eliminate Lymphatic Filariasis.

The effect of intervention methods on nutritional status and cognitive function of primary school children infected with Ascaris lumbricoides.

The prevalence rate of ascariasis in primary school children in northern Jakarta, Indonesia varies from 60% to 90%. An association between helminthic infection and educational achievement has long been recognized. This study was carried out in the northern part of Jakarta among primary school children 6-8 years of age. Treatment of ascariasis and health education were used as the interventions. Before the interventions, basic data on socioeconomic status, epidemiology, infection with Ascaris lumbricoides, nutritional status, and cognitive function were collected. After the interventions, only data on infection with A. lumbricoides, nutritional status, and cognitive function were collected. The children were divided into five groups. Group I was given an anthelminthic (mebendazole), group II was provided with health education, group III was given an antihelminthic and provided with health education, group IV was given a placebo (controls), and group V consisted of egg-negative children, who also served as controls. Data from 336 students were analyzed by analysis of covariance. Parasitologic examinations showed a mean prevalence rate of 58.4% for A. lumbricoides infection in the pre-intervention children and a mean prevalence rate of 40.6% in the post-intervention children. Concerning nutritional status, approximately 80% of the children showed good scores in the pre- and post-treatment data, and only a small percentage (0.9-16.2%) showed mild or moderate malnutrition. No significant difference was found between the pre- and post-treatment nutritional status. The results of the cognitive test showed that the group treated with mebendazole showed significant improvement in the Colored Progressive Matrices and Coding test. Children also showed an improvement in their learning ability, concentration, and eye-hand coordination after five months of receiving this intervention.

The effect of praziquantel treatment on liver and spleen size of children with schistosomiasis in Napu Valley, central Sulawesi.

Forty-six school children with japonicum schistosomiasis living in a village at Napu Valley, Indonesia were treated with praziquantel at a dosage of 70 mg/kg in two divided doses in a day. The number of children with palpable liver dropped significantly from 95.6% before treatment to 58.7% after treatment. The size of the liver was reduced in the majority of cases with a virtual disappearance of cases with very large liver (10 cm). Post-treatment increase of the liver size was observed in all 8 cases with small pre-treatment livers (0.5-1 cm). In contrast to the changes of the size of the liver after treatment, the number of children with palpable spleens before and after treatment was not significantly altered.

The impact of schistosomiasis mass treatment on hepato-splenomegaly in Napu Valley, Central Sulawesi, Indonesia.

The impact of mass treatment with praziquantel on 241 individuals, 131 males and 110 females in Napu Valley, Indonesia was studied. The pre-treatment overall stool positive cases ranged from 43% to 79%, the highest in the 20-29 age group. Post-treatment follow-up study showed that the cases dropped to 2.5%. Significant reduction was seen in liver rate from 68% to 51% and in the age groups 0-9, 10-19, there was a significant decrease in liver enlargement after treatment, but not significant differences were seen in spleen rate in all age groups. This might be due to the early stage of Schistosoma infection in younger age groups where complete resolution of fibrosis might occur.

Prevalence and treatment of intestinal helminthic infections among children in orphanages in Jakarta, Indonesia.

A survey was carried out in three orphanages in Jakarta for intestinal helminthic infections. Stool samples and anal swabs of 158 children were examined. The prevalences of intestinal helminthic infections in the Putra Utama, Muslimin and Van der Steur orphanages were respectively as follows: a lumbricoides 70.0%, 76.6% and 50.8%, T. trichiura 78.0% 93.6% and 70.5%, hookworm 20.0%, 12.7% and 3.2% and E. vermicularis 34.0% 29.8%, 59.0%. Treatment with Trivexan (100 mg of pyrantel pamoate and 150 mg of mebendazole), one tablet as a single daily dose for 3 consecutive days resulted in cure rates for A. lumbricoides 96.0%, 100% for T. trichiura 78.0%, 80.9% and 86.9% for hookworm 98.0%, 100% and 100% and for E. vermicularis 82.3% 92.9% and 97.2%. No side effects were observed, except in one child who complained of nausea.