Uncomplicated falciparum malaria among schoolchildren in Bajil district of Hodeidah governorate, west of Yemen: association with anaemia and underweight.

BACKGROUND: Malaria, malnutrition and anaemia are major public health problems in Yemen, with Hodeidah being the most malaria-afflicted governorate. To address the lack of relevant studies, this study was conducted to determine the prevalence of Plasmodium falciparum and its relation to nutritional status and haematological indices among schoolchildren in Bajil district of Hodeidah governorate, west of Yemen. METHODS: A cross-sectional study was conducted among 400 schoolchildren selected randomly from four schools in Bajil district. Data about demographic characteristics, risk factors and anthropometric measurements of age, height and weight were collected. Duplicate thick and thin blood films were prepared, stained with Giemsa and examined microscopically for malaria parasites. The density of P. falciparum asexual stages was estimated on thick films. EDTA-blood samples were examined for the haematological indices of haemoglobin (Hb) and blood cell counts. RESULTS: Plasmodium falciparum was prevalent among 8.0% (32/400) of schoolchildren with a mean parasite density of 244.3 ± 299.3/µL of blood and most infections showing low-level parasitaemia, whereas Plasmodium vivax was detected in one child (0.25%). Residing near water collections was a significant independent predictor of falciparum malaria [adjusted odds ratio (AOR) = 2.6, 95.0% CI 1.20-5.72; p = 0.016] in schoolchildren. Mild anaemia was prevalent among more than half of P. falciparum-infected schoolchildren and significantly associated with falciparum malaria (AOR = 5.8, 95.0% CI 2.39-14.17; p < 0.001), with a mean Hb concentration of 10.7 ± 1.0 g/dL. Although the mean values of the total white blood cells, monocytes and platelets were significantly lower in infected than non-infected schoolchildren, they were within normal ranges. More than half of the children were malnourished, with stunting (39.3%) and underweight (36.0%) being the most prevalent forms of malnutrition; 6.3% of children were wasted. Underweight (AOR = 5.3, 95.0% CI 2.09-13.62; p < 0.001) but not stunting or wasting, was a significant predictor of falciparum malaria among schoolchildren. CONCLUSION: Asymptomatic falciparum malaria is prevalent among schoolchildren in Bajil district of Hodeidah Governorate, with predominance of low parasitaemic infections and significant association with mild anaemia and underweight. Residence near water collection is a significant predictor of infection with falciparum malaria among schoolchildren. Further studies among children with severe malaria and those with high parasite densities are recommended.

Detection of low-intensity Schistosoma mansoni infection by Percoll sedimentation and real-time PCR techniques in a low-endemicity Egyptian setting.

OBJECTIVE: To evaluate the performance of Percoll sedimentation and real-time polymerase chain reaction (PCR) for the detection of S. mansoni cases previously tested as negative by Kato-Katz technique in two low-endemic areas in Alexandria, Egypt, Abis 4 and 8 villages. METHODS: Stool samples of 824 primary schoolchildren were examined by Kato-Katz technique (three slides of 41.7 mg each). After obtaining the results of this survey, stool samples were recollected from a subset of 150 students, who gave negative results after Kato-Katz. These samples were microscopically examined after the concentration with Percoll technique. Part of the 150 negative stool samples and five positive samples (used as controls) were kept at -20 °C and further processed by SYBR Green PCR. RESULTS: Prevalence of S. mansoni infection as determined by three Kato-Katz thick smears was 1.82% (15 cases). Three more cases tested positive by Percoll sedimentation among the 150 samples that were negative by Kato-Katz. Specific amplification by SYBR Green PCR was noted in all positive controls and in three cases of Kato-Katz-negative samples, two of which were also positive by Percoll. CONCLUSION: Percoll sedimentation and SYBR Green PCR proved useful in detecting low-intensity S. mansoni infections in low-endemicity areas in Egypt.

Detoxifying and anti-oxidant enzymes of Fasciola gigantica worms under triclabendazole sulphoxide (TCBZ-SX): an in vitro study.

Triclabendazole (TCBZ) is an efficient fasciolicide that affects both juvenile and adult worms. After oral administration it is rapidly metabolized to TCBZ sulphoxide and sulphone that were found responsible for its fasciolicidal activity. Parasite defense mechanisms include detoxifying and anti-oxidant enzymes that would suppress its oxidative killing. The present work aimed at evaluating these enzymes under TCBZ-SX. Thirty juvenile and 30 adult F. gigantica worms collected from the liver parenchyma and bile ducts formed the subject of the study. Levels of superoxide dismutase (SOD), glutathione peroxidase (GPx), glutathione reductase (GR), glutathione S-transferase (GST), and glutathione (GSH) were measured in juvenile and adult worms incubated, without and with 15 and 50 microg/ml TCBZ-SX for 18 hours at 37 degrees C. Results demonstrated a significant decrease in SOD activity and an increase in GST level in both juvenile and adult worms after incubation in the two concentrations. The remaining enzymes and GSH revealed variable levels.

Levels of growth hormone, albumin and ferritin in human fascioliasis and schistosomiasis.

This study assessed levels of growth hormone, albumin and ferritin in human fascioliasis and schistosomiasis. Forty three patients and ten healthy parasite free subjects were included as controls. All were subjected to clinical, parasitological, and haematological examinations. Serum growth hormone (GH) levels were measured by an immunoenzymometric assay. Statistical analysis revealed significant elevation in GH levels in acute and chronic fascioliasis patients compared to controls. Serum albumin was significantly low in schistosomiasis patients compared to controls. Non-significant changes in serum ferritin were in all patients. The results were critically discussed on the light of the work done before.

Efficacy of azithromycin, praziquantel and mirazid in treatment of cryptosporidiosis in school children.

The study was conducted at a primary school in Abis 8 village. 88 children aged eleven years consented to participate in the present study. After fecal examination, 43 (48.8%) cases were found infected with Cryptosporidium. The mean oocysts number per high power field (HPF) ranged from (1.6-48 oocysts/HPF). Azitbromycin, praziquantel (PZQ) and mirazid were given to 13, 16 and 14 infected children respectively. Three weeks after treatment, azithromycin and praziquantel gave cure rates of 91% and 56.2% respectively with a percent reduction of oocysts in stools of 99% for azithromycin and 71.5% for PZQ. Mirazid was not effective. All the three drugs were well tolerated. It was concluded that azithromycin is highly effective in the treatment of children with cryptosporidiosis: PZQ decreases the infection rate and intensity.