Epidemiological analysis of human fascioliasis in northeastern Punjab, Pakistan.

A coprological study was performed to assess human fascioliasis in 7200 subjects inhabiting rural communities of localities close to the capital city of Lahore in the northeastern part of the very highly populated Punjab province, Pakistan, a country where human infection had never been reported before 2005. The analysis of 1200 subjects including 50 subjects/month throughout a two-year study in each of six localities surveyed provided an overall prevalence of 1.18%, with a range between 0.67% and 1.75% according to localities. Infection rates did not differ according to gender, excepting a higher rate in females (1.13% vs 0.77%) in one locality. Prevalences according to age groups proved to be higher in 11-20 years with 1.57%, followed by 1.18% in 0-10 years and 0.47% in 21-30 years, while no infection above 30 years. Seasonal prevalences proved to be significantly different when comparing summer and autumn with winter and spring. Monthly prevalences showed two peaks, the highest in August (4.67%) and another in January (2.17%). Correlation studies of monthly prevalences with temperature, humidity, rainfall, and pan evaporation showed significant results only with humidity. Despite prevalences being low, the very high number of inhabitants and population densities of the areas surveyed suggest a wide public health problem potentially infecting up to 150,000 rural people, children included, only in the respective districts. Additionally, the situation becomes of more concern when considering the present climate change trend affecting the Punjab, which indicates a progressively increasing fascioliasis transmission risk in that animal endemic area in the near future.

Pfcrt Gene in Plasmodium falciparum Field Isolates from Muzaffargarh, Pakistan.

BACKGROUND: The aim of the study was to identify the prevalence of different species of Plasmodium and haplotypes of pfcrt in Plasmodium falciparum from the selected area. METHODS: Overall, 10,372 blood films of suspected malarial patients were examined microscopically from rural health center Sinawan, district Muzaffargarh, Pakistan from November 2008 to November 2010. P. falciparum positive samples (both whole blood and FTA blood spotted cards) were used for DNA extraction. Nested PCR was used to amplify the pfcrt (codon 72-76) gene fragment. Sequencing was carried out to find the haplotypes in the amplified fragment of pfcrt gene. RESULT: Over all slide positivity rate (SPR), P. vivax and P. falciparum positivity rate was 21.40 %, 19.37 % and 2.03% respectively. FTA blood spotted cards were equally efficient in the blood storage for PCR and sequencing. Analysis of sequencing results of pfcrt showed only one type of haplotype SagtVMNT (AGTGTAATGAATACA) from codon 72-76 in all samples. CONCLUSION: The results show high prevalence of CQ resistance and AQ resistant genes. AQ is not recommended to be used as a partner drug in ACT in this locality, so as to ward off future catastrophes.

Morphological and molecular characterisation of Echinococcus granulosus in livestock and humans in Punjab, Pakistan.

Cystic echinococcus poses an important economic and public health problem to Pakistan. Our study determined the prevalence and genotypes of Echinococcus present in domestic livestock and humans in Punjab, Pakistan. Out of 39,738 animals examined, 6.67% of animals were found infected. The prevalence and fertility of hydatid cysts was highest in camels (prevalence 17.29%; proportion fertile 95%), followed by sheep (prevalence 7.52%; proportion fertile 86.4%), buffalo (prevalence 7.19%; proportion fertile 84.3%), goats (prevalence 5.48%; proportion fertile 79.09%) and cattle (prevalence 5.18%; proportion fertile 75.25%). Phylogenetic analysis of the cytochrome oxidase-1 gene revealed that the common sheep strain (G1) and buffalo strain (G3) are cycling among livestock in Punjab and that these strains are highly adapted to goats, camels and cattle. Both human cysts were found to belong to the common sheep strain (G1) of E. granulosus, reinforcing this strain has the most potential for zoonotic transfer. Both morphological and molecular results support earlier studies suggesting that Echinococcus of sheep and buffalo origin is phenotypically and genetically similar which adds further evidence to support its recognition as one species viz, Echinococcus granulosus sensu stricto.

Chloroquine resistance and Plasmodium falciparum in Punjab, Pakistan during 2000-2001.

During the years 2000-2001, the rural populations of 5 districts in Punjab were examined for malarial parasites. The incidence of Plasmodium falciparum was more than double (8.98%) that of P. vivax (4.06%). The incidence was higher among male subjects (53.5%) than females (46.9%). The largest number of infected male subjects was found in Sheikhupura district (77.78%). Chloroquine resistance was only checked in the subjects harboring P. falciparum, using in vivo techniques. Overall chloroquine sensitivity was 63.8%. Overall frequency of chloroquine resistance in the 5 Punjabi districts was 35%, with 30.6% RI and 4.4% RII. It is important that RIII was not found in the present study. Among the five districts, maximum RI (35.1%) and RII (5.4%) were noted in Multan. By age, maximum chloroquine resistance was noted in the 1-5 year age group (ie RI, 41%; RII 8%). A similar RI value (41%) was noted for the 6-14 age group, but with a low RII (3%) value. Although, the present finding is an outcome of a survey conducted in only 5 districts of Punjab, it reflects an alarming situation, as not only RI and RII resistance against chloroquine is increasing, but at the same time the incidence of P. falciparum is increasing two-fold that of P. vivax. The findings warrant that top priority be given to determining the exact status of chloroquine resistance among P. falciparum in this region, which is now hosting a heavy influx of refugees from Afghanistan, a country endemic for P. falciparum.