Morphological and initial molecular characterization of Clogmia albipunctatus larvae (Diptera: Psychodidae) causing urinary myiasis in Egypt.

Myiasis is the infestation of human tissues by dipterous fly larvae of the class Insecta. Clogmia albipunctatus, family Psychodidae, is one of the most medically important insects that cause human myiasis. The aim of the present study is the morphological identification and the molecular characterization of moth flies causing many cases of urinary myiasis in Egypt, based on sequencing of the mitochondrial DNA of the larvae. Seven urinary samples of patients complaining of urinary symptoms and giving a history of low socioeconomic level were examined. Recovered larvae were identified using light microscopy and SEM. For molecular identification, the mitochondrial genes Cytochrome B (cytB), NADH1, NADH1, and 16S were sequenced and phylogenetically analyzed. The morphological and molecular characterization could accurately diagnose our patients to have C. albipunctatus infestation. Such results provided the initial set of data on the molecular identification and phylogenetic analysis of moth flies based on DNA barcoding in Egypt.

Urogenital schistosomiasis and risk factors of infection in mothers and preschool children in an endemic district in Zimbabwe.

BACKGROUND: To design appropriate schistosomiasis control programmes that include women and preschool-aged children (PSAC) it is essential to assess their disease profile and the risk factors predisposing them to infection. This study aimed to determine the prevalence of urogenital schistosomiasis and the risk factors of infection among PSAC and their caregivers in an endemic area of Zimbabwe. METHODS: A cross-sectional study involving screening for urogenital schistosomiasis infections and treatment of 860 participants [535 children aged ≤ 5 years and 325 caregivers (≥ 15 years)] was carried out in five communities, namely Chihuri, Mupfure, Chakondora, Nduna and Kaziro, in February 2016. Haematuria was recorded for each participant and urine filtration was performed to determine the presence and infection intensity of Schistosoma haematobium. A pre-tested questionnaire was administered to the caregivers seeking knowledge, practices and perceptions regarding schistosomiasis. Data analysis was performed using descriptive statistics and logistic regression. RESULTS: Overall 132 (15.4%) of the 860 participants had S. haematobium infections. Among these, 61 (18.7%) of the 325 caregivers and 71 (13.3%) of the 535 children were infected. The infection prevalence was significantly different between caregivers and PSAC (χ2 = 4.7040, df = 1, P = 0.030). Children whose caregivers used river water for bathing were more likely to be infected compared to children whose caregivers used protected well water (OR: 2.2, 95% CI: 1.3-3.7). The risks of being infected with schistosomiasis were higher in children whose caregivers were infected compared to children whose caregivers had no infection (AOR: 3.9, 95% CI: 1.7-8.6). In caregivers, those who bathed in river water were at higher risk of schistosomiasis infection compared to those who used water from a protected well (AOR: 3.0, 95% CI: 1.4-6.4). CONCLUSIONS: According to the World Health Organization guidelines, the observed overall prevalence of urogenital schistosomiasis qualifies this area as a moderate risk area requiring mass chemotherapy once every two years. Water contact practices of caregivers, and their perceptions and knowledge regarding schistosomiasis are risk factors for infection in both themselves and PSAC. Thus, disease control efforts targeting caregivers or PSAC should include health education and provision of alternative clean and safe water sources.

Greetings from Africa: The Emergence of Tropical Urological Diseases in Europe. We Had Better Be Prepared!

The increasing incidence of tropical urological diseases due to migration represents a challenge for local practitioners. Face-to-face and webinar learning courses could be a simple first step in increasing awareness of this issue.

Primary hydatid cyst of the urinary bladder.

A 35-year-old man presented with poorly localised lower abdominal pain for 3 months. Abdominal examination revealed lower abdominal tenderness, with normal other parts of examination. CT scan of the abdomen showed irregular multiloculated mass related to the upper part of the urinary bladder with mild rim enhancement in the postcontrast study with no areas of calcifications. During laparotomy, we found a mass attached to the superior part of the urinary bladder and arising from its wall. Complete excision was done without opening the cavity of the bladder. The mass was opened and was a hydatid cyst of the bladder containing multiple daughter cysts.

Morphological and Molecular Characteristic of Megaselia scalaris (Diptera: Phoridae) Larvae as the Cause of Urinary Myiasis.

We report a case of urinary myiasis occurring in a 60-yr-old Iranian male patient with urinary tract problems and a history of travel to Thailand who was referred to Shafagh Medical Laboratory in Tehran (Iran). Larvae excreted in the patient's urine were confirmed by morphological identification key and DNA barcoding to belong to the species Megaselia scalaris Loew, which is known as the scuttle fly. Based on the patient's history, he was infected with M. scalaris in Thailand. To the best of our knowledge, this is the first report of urinary myiasis caused by M. scalaris in Thailand.

Use of the FLOTAC technique to diagnosing parasites of the urinary tract of dogs.

Among the nematodes that infect the urinary tract of dogs, the Dioctophyma renale and Capillaria plica are those more frequently reported. For a long time, sedimentation was the only method used to detect eggs of these parasites in urine. The aim of this study was to analyze urine samples (n = 54) of dogs, obtained by bladder catheterization or cystocentesis, by using a modified FLOTAC technique. Animals were divided into two groups, i.e., with (n = 20) and without (n = 34) suspicion of urinary disease. The overall positivity herein observed was 3.8 % (2/54), being all animals (10 %; 2/20) from the group with suspicion of urinary disease. In the first positive sample, a single egg of D. renale was detected, whereas in the second sample two trematode-like eggs were observed. This is the first short survey employed to detect eggs of parasites that inhabit the urinary tract of dogs using a modified FLOTAC technique; in addition, for the first time, eggs of D. renale have been detected using this tool.

Capillaria plica (syn. Pearsonema plica) infection in a dog with chronic pollakiuria: challenges in the diagnosis and treatment.

Capillaria plica (syn. Pearsonema plica) is a nematode parasite of the urinary tract of canids, felids and mustelids, which can cause cystitis, pollakiuria, dysuria and hematuria. An eight-month-old female crossbred dog from Switzerland presented a six-month history of frequent urination. During the first clinical examination, C. plica eggs were detected in the urine sediment. Three series of treatments with fenbendazole (50 mg/kg body weight[BW]/day, orally) for 10 days each, three single day treatments with moxidectin-imidacloprid (spot-on) and one single administration of ivermectin (0.2 mg/kg BW subcutaneously) were performed within an eight-month period. None of those treatments succeeded in eliminating the C. plica infection or in resolving the clinical signs. An endoscopic examination of the urine bladder still revealed numerous adult viable C. plica worms attached to the bladder mucosa. A two-day treatment with levamisole (7.5 mg/kg BW/day intramuscularly) was subsequently performed. An endoscopic control of the urine bladder two days after this treatment and a urine analysis after two weeks confirmed the elimination of the parasites. The clinical signs disappeared within one month. Levamisole was shown to be effective against C. plica infection in a dog, whereas previous treatments with fenbendazole, moxidectin and ivermectin had failed.

[Non-antibiotic anti-infectious treatments in urology]. / Les médicaments anti-infectieux non antibiotiques en urologie.

OBJECTIVE: To define the terms of use of pesticides, antifungal, antiviral and antiseptic treatments in urology. MATERIALS AND METHODS: A literature search was conducted on MEDLINE for all these treatments used in urology. The molecules were classified by family. Modes of action, indications in urology and adverse effects have been detailed. Authorisation files were consulted and then complemented by a literature analysis. RESULTS: Although parasitic or viral diseases are uncommon in urology, their specific treatment deserves a thorough knowledge of pesticide and antiviral molecules. Antifungal treatments are regularly used in urology with special features to know to improve the efficacy/safety ratio. Antiseptics are used daily in urology and a better understanding of these molecules allows better use. CONCLUSION: Beyond antibiotics, antiviral, antiparasitic and antifungal deserve a thorough knowledge. Antiseptic although used daily have features little known.

Clinical and demographic characteristics of patients with urinary tract hydatid disease.

BACKGROUND: Human cystic echinococcosis (CE) is caused by flatworm larvae of Echinococcus granulosus and is endemic in many parts of the world. In humans, CE cysts primarily affect the liver and pulmonary system, but can also affect the renal system. However, the clinical manifestations of renal CE can be subtle, so healthcare professionals often overlook renal CE in differential diagnosis. In this study, we examined the clinical and demographic characteristics of patients with urinary tract CE and analyzed the diagnosis and treatment procedures for this disease. METHODS: The records of 19 consecutive renal CE patients who were admitted to the First Affiliated Hospital of Xinjiang Medical University from January 1983 to April 2011 were retrospectively reviewed. In all cases, CE of the urinary tract was confirmed by pathological examination and visual inspection during surgery. RESULTS: Fifteen patients were males and 4 were females. The most common symptoms were non-specific lower back pain and percussion tenderness on the kidney region. All patients were followed up for 9-180 months after surgery. None of the patients experienced a recurrence of renal CE, but 4 patients experienced non-renal recurrence of hydatid disease. CONCLUSIONS: Hydatid cysts from E. granulosus are structurally similar in the liver and urinary tract. Thus, the treatment regimen for liver CE developed by the World Health Organization/Informal Working Group on Echinococcosis (WHO/IWGE) could also be used for urinary tract CE. In our patients, the use of ultrasound, computed tomography, serology, and clinical characteristics provided a diagnostic accuracy of 66.7% to 92.3%.

Is there any change in the prevalence of intestinal and urinary parasitosis among "non-permanent resident" students in Tunisia ?

BACKGROUND: Intestinal parasitosis are cosmopolitan affections, often related to the fecal peril. However urinary bilharziosis is a disease eliminated in Tunisia. As part of monitoring the emergence and re-emergence of intestinal parasitosis and urinary bilharziasis, foreign students benefit from parasitological systematic monitoring stool and urine during their enrollment to the University. AIM: To study the prevalence of various intestinal parasitosis and urinary bilharziasis among non permanent resident students in Tunisia. METHODS: A retrospective survey was carried at the Laboratory of Parasitology- Mycology of Charles Nicolle Hospital of Tunis during the inscription period of 6 university years 2005-2010. 328 students profited from a parasitological examination of stool and urine. RESULTS: 144 students (43.9%) harbored intestinal parasites. More than one parasite was detected in 69 students (47.9%). Intestinal protozoa were the majority of identified parasites (96.9%). 9.7% of identified parasites were pathogenic. Three cases (0.91%) of urinary bilharziasis were diagnosed. CONCLUSION: The prevalence of intestinal and urinary parasitism among the "non-permanent residents" students in Tunisia has not changed. This justifies a systematic parasitologic monitoring for students coming from areas of high endemicity of parasitosis in order to avoid the introduction of these.

Integrated monitoring and evaluation and environmental risk factors for urogenital schistosomiasis and active trachoma in Burkina Faso before preventative chemotherapy using sentinel sites.

BACKGROUND: Over 1 billion of the world's poorest inhabitants are afflicted by neglected tropical diseases (NTDs). Integrated control programmes aimed at tackling these debilitating NTDs have been recently initiated, mainly using preventative chemotherapy. Monitoring and evaluation (M&E) of these integrated programs presents particular challenges over and above those required for single disease vertical programmes. We used baseline data from the National NTD Control Programme in Burkina Faso in order to assess the feasibility of an integrated survey design, as well as to elucidate the contribution of environmental variables to the risk of either Schistosoma haematobium, trachoma, or both among school-aged children. METHODS: S. haematobium infection was diagnosed by detecting eggs in urine. A trachoma case was defined by the presence of Trachomatous inflammation-Follicular (TF) and/or Trachomatous inflammation-Intense (TI) in either eye. Baseline data collected from 3,324 children aged 7-11 years in 21 sentinel sites across 11 regions of Burkina Faso were analyzed using simple and multivariable hierarchical binomial logistic regression models fitted by Markov Chain Monte Carlo estimation methods. Probabilities of the risk of belonging to each infection/disease category were estimated as a function of age, gender (individual level), and environmental variables (at sentinel site level, interpolated from national meteorological stations). RESULTS: Overall prevalence at the sentinel sites was 11.79% (95% CI: 10.70-12.89) for S. haematobium; 13.30% (12.14-14.45) for trachoma and 0.84% (0.53-1.15) for co-infections. The only significant predictor of S. haematobium infection was altitude. There were significant negative associations between the prevalence of active trachoma signs and minimum temperature, and air pressure. Conditional upon these predictors, these data are consistent with the two pathogens being independent. CONCLUSIONS: Urogenital schistosomiasis and trachoma constitute public health problems in Burkina Faso. Sentinel site (at school level) surveys for these two NTDs can be implemented simultaneously. However, to support MDA treatment decisions in Burkina Faso, the protocol used in this study would only be applicable to hypoendemic trachoma areas. More research is needed to confirm if these findings can be generalized to West Africa and beyond.

An unusual retroperitoneal sero-negative hydatid cyst presenting with lower urinary tract symptoms.

Hydatid cysts can be found in almost every structure in human body. Thus they can mimic numerous pathologies. Serological analyses are the best assistants in the diagnosis of hydatid cysts. But as serological investigations have limited sensitivity and specificity, they might misdirect our diagnosis. Lungs are the most common involved organ in this parasitic infection. But the brain, muscles, kidneys, bones, heart, pancreas, and rarely the retroperitoneum have also been reported to be involved. An unusual case of a sero-negative hydatid cyst located in the retroperitoneum presenting with lower urinary tract symptoms is reported in this paper.

Myxidium scripta n. sp. identified in urinary and biliary tract of Louisiana-farmed red-eared slider turtles Trachemys scripta elegans.

During a necropsy investigation of a mortality event occurring at a turtle farm in Assumption Parish, Louisiana, spores of a myxozoan were identified in the renal tubules in 3 of 6, the gall bladder lumen in 2 of 6, and the bile ductule in 1 of 6 red eared slider turtles Trachemys scripta elegans. In total, myxozoa were identified in 4 of 6 turtles. In 1 turtle, renal tubules contained numerous mature spores, had epithelial hyperplasia, granulomatous transformation, compression of adjacent tubules and interstitial lymphocytic nephritis. The genus of myxozoan was Myxidium, based on spore morphology in cytological preparations, in histologic section, and by electron microscopy. In cytological preparation the spores had mean dimensions of 18.8 x 5.1 microm and a mean polar capsule dimension of 6.6 x 3.5 microm. Electron microscopy showed renal tubules contained plasmodia with disporoblasts with spores in various stages of maturation. Ultrastructure of mature spores demonstrated a capsule containing 2 asymmetrical overlapping valves and polar capsules containing a polar filament coiled 6 to 8 times and surrounded by a membrane composed of a double layer wall. The small subunit rDNA gene sequence was distinct from all other Myxidium species for which sequences are available. Additionally, this is the first Myxidium species recovered from a North American chelonian to receive genetic analysis. Although T. s. elegans is listed as a host for Myxidium chelonarum, this newly described species of Myxidium possessed larger spores with tapered ends; thus, we described it as a new species, Myxidium scripta n. sp. This report documents a clinically significant nephropathy and genetic sequence from a Myxidium parasite affecting a freshwater turtle species in North America.

Parasites of urological importance.

With the world increasingly becoming a global village, transnational and transcontinental migration has become the order of the day. It is expected that migrants will take with them some diseases (including parasites) which are normally endemic in their countries of origin, to their host countries. Similarly, environmental changes that result from development of water resources, global warming, growth and migration of population can facilitate the spread of parasites. In this review we describe the epidemiology, presentation, diagnosis and treatment options of parasites that urologists may encounter. Notably among these parasites are Schistosoma haematobium, Echinococcus granulosus, Wuchereria bancrofti and Onchocerca volvulus.

Acaroid mite, intestinal and urinary acariasis.

AIM: To investigate epidemiology and pathogenic mite species of intestinal and urinary acariasis in individuals with different occupations. METHODS: A total of 1994 individuals were tested in this study. History collection, skin prick test and pathogen identification were conducted. The mites were isolated from stool and urine samples by saturated saline flotation methods and sieving following centrifugation, respectively. RESULTS: Among the 1994 individuals examined, responses to the skin prick test of "+++", "++", "+","+/-" and "-" were observed at frequencies of 3.96 % (79), 3.21 % (64), 2.31 % (46), 1.25 % (25) and 89.27 % (1780), respectively. A total number of 161 (8.07 %) individuals were shown to carry mites, with 92 (4.61 %) positive only for stool samples, 37 (1.86 %) positive only for urine samples and 32 (1.60 %) for both. The positive rate of mites in stool samples was 6.22 % (124/1994), being 6.84 % (78/1140) for males and 5.39 % (46/854) for females. No gender difference was observed in this study (chi(2)=1.77, P>0.05). The mites from stool samples included Acarus siro, TyroPhagus putrescentiae, Dermatophagoides farinae, D. pteronyssinus, Glycyphagus domesticus, G. ornatus, Carpoglyphus lactis and Tarsonemus granaries. The positive rate of mites in urine samples was 3.46 % (69/1994). The positive rates for male and female subjects were found to be 3.95 % (45/1140) and 2.81 % (24/854) respectively, with no gender difference observed (chi(2)=1.89, P>0.05). Mites species in urine samples included Acarus siro, Tyrophagus putrescentiae, T. longior, Aleuroglyphus ovatus, Caloglyphus berlesei, C. mycophagus, Suidasia nesbitti, Lardoglyphus konoi, Glycyphagus domesticus, Carpoglyphus lactis, Lepidoglyphus destructor, Dermatophagoides farinae, D. pteronyssinus, Euroglyphus magnei, Caloglyphus hughesi, Tarsonemus granarus and T. hominis. The species of mites in stool and urine samples were consistent with those separated from working environment. A significant difference was found among the frequencies of mite infection in individuals with different occupations (chi(2)=82.55, P<0.001), with its frequencies in those working in medicinal herb storehouses, those in rice storehouse or mills, miners, railway workers, pupils and teachers being 15.89 % (68/428), 12.96 % (53/409), 3.28 % (18/549), 2.54 % (6/236), 5.10 % (13/255) and 2.56 % (3/117), respectively. CONCLUSION: The prevalence of human intestinal and urinary acariasis was not associated with gender, and these diseases are more frequently found in individuals working in medicinal herb, rice storehouses or mills and other sites with high density of mites. More attention should be paid to the mite prevention and labor protection for these high-risk groups.

Randomized comparison of low-dose versus standard-dose praziquantel therapy in treatment of urinary tract morbidity due to Schistosoma haema tobium infection.

At present, anthelmintic therapy with praziquantel at a dose of 40 mg/kg of body weight is the recommended treatment for control of urinary tract morbidity caused by Schistosoma haematobium. Although this standard regimen is effective, drug cost may represent a significant barrier to implementation of large-scale schistosomiasis control programs in developing areas. Previous comparison trials have established that low-dose (20-30 mg/kg) praziquantel regimens can effectively suppress the intensity of S. haematobium infection in endemic settings. However, the efficacy of these low-dose regimens in controlling infection-related morbidity has not been determined in a randomized field trial. The present random allocation study examined the relative efficacy of a 20 mg/kg dose versus a 40 mg/kg dose of praziquantel in control of hematuria and bladder and renal abnormalities associated with S. haematobium infection in an endemic area of Coast Province, Kenya. After a nine-month observation period, the results indicated an advantage to the standard 40 mg/kg praziquantel dose in terms of reduction of infection prevalence and hematuria after therapy (P < 0.01 and P < 0.005, respectively). However, the two treatment groups were equally effective in reducing structural urinary tract morbidity detected on ultrasound examination. We conclude that in certain settings, a 20 mg/kg dose of praziquantel may be sufficient in providing control of morbidity due to urinary schistosomiasis in population-based treatment programs.

Hydatid disease of the urinary tract: review of the management of 9 cases.

The aim of this study is to review 9 cases with urinary tract hydatid disease in terms of symptoms, findings, laboratory tests, radiological findings and treatment modalities. There were 7 males and 2 females with a mean age of 33.6 years (range from 7 to 67 years). In 6 patients hydatid cyst was located in the kidney (1 involved the liver), in 2 the cysts were in the paravesical and retrovesical region (1 coexisted bladder tumor) and 1 the cyst was located adrenal gland. The investigations included urinalysis, eosinophil count, Casoni skin test, indirect haemagglutination test (IHA), transabdominal ultrasonography (TAUS), intravenous urography (IVU) and computed tomography (CT). All patients underwent various surgical procedures and were followed-up for an average of 3 years (range: 1 month to 5 years) period in terms of complications and recurrence rates. The most common symptom was lumbar or abdominal pain. Eosinophilia was seen in 4 patients (44.4%), IHA positivity in 3 patients (33.3%) and Casoni skin test were positive in 3 patients (33.3%). The most diagnostic method of radiological investigations was abdominal pelvic CT (100%). After surgical treatment, in mean a 3 year (range: 1 month to 5 years) follow-up period, no complication and recurrence were seen. Hydatid disease of the urinary tract is relatively uncommon and is likely to cause considerable diagnostic difficulties for clinicians and radiologists: therefore, it should be born in mind in the differential diagnosis of space-occupying lesions of the urinary tract.