Efficacy and safety of praziquantel in the treatment of neurocysticercosis in Vietnam.

Neurocysticercosis (NCC) is a parasitic infection of the nervous system and is responsible for considerable morbidity and mortality. Praziquantel (PZQ) is one of the antiparasitics mostly used in managing NCC, however, there have been only a few studies on the treatment outcome of this drug. The present study aimed to evaluate the efficacy and safety of PZQ in patients with NCC. Sixty patients with typical characteristics of NCC received three 10-day cycles of PZQ and the interruption between these cycles was 10 days. Additional treatment included antiinflammation (steroids), antiepileptics and analgesics. Clinical and imaging studies were done at baseline and six months after therapy to assess the efficacy of treatment. Laboratory evaluation was done before and after each cycle to investigate laboratory safety profiles. By six months after finishing therapy, all patients had clinical improvement and 75% of them were free of symptoms. The rates of complete, partial or no resolution of cysts on brain magnetic resonance imaging were 61.7%, 28.3% and 10% respectively. The efficacy of therapy was not associated with the number of cysts. There was no difference between the levels of aspartate aminotransferase, alanine aminotransferase, urea and creatinine before and after treatment. Conclusion: Praziquantel is effective and safe in the treatment of patients with neurocysticercosis.

Efficacy and safety of praziquantel in the treatment of neurocysticercosis in Vietnam

@#Neurocysticercosis (NCC) is a parasitic infection of the nervous system and is responsible for considerable morbidity and mortality. Praziquantel (PZQ) is one of the antiparasitics mostly used in managing NCC, however, there have been only a few studies on the treatment outcome of this drug. The present study aimed to evaluate the efficacy and safety of PZQ in patients with NCC. Sixty patients with typical characteristics of NCC received three 10-day cycles of PZQ and the interruption between these cycles was 10 days. Additional treatment included antiinflammation (steroids), antiepileptics and analgesics. Clinical and imaging studies were done at baseline and six months after therapy to assess the efficacy of treatment. Laboratory evaluation was done before and after each cycle to investigate laboratory safety profiles. By six months after finishing therapy, all patients had clinical improvement and 75% of them were free of symptoms. The rates of complete, partial or no resolution of cysts on brain magnetic resonance imaging were 61.7%, 28.3% and 10% respectively. The efficacy of therapy was not associated with the number of cysts. There was no difference between the levels of aspartate aminotransferase, alanine aminotransferase, urea and creatinine before and after treatment. Conclusion: Praziquantel is effective and safe in the treatment of patients with neurocysticercosis.

Zearalenone, deoxynivalenol and aflatoxin B1 and their metabolites in pig urine as biomarkers for mycotoxin exposure.

Methods to determine zearalenone (ZEA), deoxynivalenol (DON), aflatoxins (AF) and their metabolites in pig urine were developed as biomarkers for pig exposure to the mycotoxins in feed. Urine samples were incubated with ß-glucuronidase to cleave conjugates, extracted and cleaned-up with solid phase and immunoaffinity columns, followed by HPLC with UV and fluorescence detection. Good recoveries (83-130%), low variation (2-10%), and low detection limits (0.3-9.9 ng/ml) were obtained. The results of controlled AFB1 feeding trials found no difference in urine concentrations of AFB1 or AFM1 from pigs fed three different levels (127, 227, 327 µg/kg) of AFB1 in diets. The excretion of AFB1 and AFM1 in urine was on average 30% of the oral dose and the ratio AFB1 to AFM1 was around 23%. The analysis of 15 Vietnamese pig urine samples indicate a relatively high exposure of ZEA, DON and AF, which were found as toxin or metabolites in 47, 73, and 80% of the urine samples, respectively.

In vitro evaluation of the capacity of zeolite and bentonite to adsorb aflatoxin B1 in simulated gastrointestinal fluids.

Anin vitro study using single concentration and isotherm adsorption was carried out to evaluate the capacity of Vietnamese produced zeolite and bentonite to adsorb aflatoxin B1 (AFB1) in simulated gastrointestinal fluids (SGFs), and a commercial sorbent hydrated sodium calcium aluminosilicate (HSCAS) was used as reference. In this study, AFB1 solution was mixed with sorbents (0.3, 0.4 and 0.5% w/v) in SGFs at pH 3 and pH 7 and shaken for 8 h, centrifuged and the supernatant measured by Vicam fluorometer. Adsorption of AFB1 onto zeolite and bentonite varied according to the pH of SGFs and was lower than HSCAS. Linearity between the increased amount of AFB1 adsorbed on sorbents and the decrease of sorbent concentration was observed for bentonite and HSCAS, except for zeolite in SGFs at pH 7. The observed maximum amounts of AFB1 adsorbed on bentonite and HSCAS were 1.54 and 1.56 mg/g, respectively. The adsorption capacities of bentonite and HSCAS for AFB1 were 12.7 and 13.1 mg/g, respectively, from fitting the data to the Freundlich isotherm equation. Improvement in processing and purification for bentonite is needed to enhance the surface area, which would probably result in better adsorptive capacity for this sorbent.

Accuracy of the health information system on malaria surveillance in Vietnam.

The health information system (HIS) is a key component of control programs and its accuracy is necessary for the assessment of disease risks, the formulation of priorities and the evaluation of the cost-effectiveness of different interventions. In order to assess the quality of the HIS in estimating malaria morbidity in Vietnam, we compared data obtained by a 2-year active (ACD) and passive case detection (PCD) study with those routinely collected at the local commune health centres (CHC) at three sites having different malaria epidemiology. The majority of malaria cases (80-95%) detected by ACD were missed by the HIS. Similarly, most malaria cases (50-90%) detected by PCD were also missed by the HIS, and this was proportional to the number of active private practitioners. Reasons for this low sensitivity are low CHC attendance, high attendance at private health facilities, widespread self-medication and attendance at central health facilities. In conclusion, although malaria has sharply decreased in Vietnam over the past 10 years, the current HIS greatly underestimates the malaria burden. Involvement of the private sector and the establishment of sentinel sites might improve the quality of data and the relevance of HIS in malaria control.

Prevalence of intestinal parasitic infections in northern Vietnam.

We surveyed the prevalence of parasitic infections in the mountainous province of Hoa Binh, north-west Vietnam, involving 526 households of six ethnic groups: Muong, Kinh, Dao, Thai, Tay and Hmong. Eggs or cysts of at least one parasite species were detected in 88% of stool samples (n = 2522). Prevalences of nematodes were high among all ethnic groups: hookworm (52%), Trichuris trichiura (50%) and Ascaris lumbricoides (45%). Ascaris infection appeared to be lower in households owning a latrine, was highest among children and decreased with age. Prevalence of hookworm rose during childhood, remained high until old age, was highest among adult women, but was not linked to anaemia. Eggs of Chlonorchis spp. were found in 126 (5%) individuals (of the Muong, Kinh or Thai groups only). Chlonorchiasis increased with age and was highest among adult men. Taenia eggs were found in three individuals (0.1%). Giardia lamblia was found in all districts and among all groups and the prevalence of infection was estimated at 3%.