Schistosomiasis

Preventive chemotherapy is the current global control strategy for schistosomiasis. The WHO target coverage rate is at least 75% for school-aged children. In the Philippines, the reported national coverage rate (43.5%) is far below the WHO target. This study examined the factors associated with non-compliance to mass drug administration. A cross-sectional survey was conducted in 2015 among 2189 adults in the province of Northern Samar, the Philippines using a structured face-to-face survey questionnaire. The overall rate of non-compliance to mass drug administration (MDA) in the last treatment round was 27%. Females (aOR = 1.67, P = 0.033) were more likely to be non-compliant. Respondents who believed that schistosomiasis was acquired by open defecation and poor sanitation (aOR = 1.41, P = 0.015), and by drinking unclean water (aOR = 2.09, P = 0.001) were more likely to refuse treatment. Uncertainties on whether schistosomiasis can be treated (aOR = 2.39, P = 0.033), their fear of a...

among the metaxenic parasitosis. A small area of transmission of approximately 15,000 km 2 was thought to be eradicated some years ago. However, some epidemiological characteristics of our transmission area have limited the success on the way toward eradication. Since 1945, when the Schistosomiasis Control Program started, the prevalence in the endemic area has decreased from 14% in 1943 to 1.4% in 1996. Until 1982, the surveillance of active cases was based on massive stool examination. Since then, the Schistosomiasis Research Group (SRG) recommended the additional use of serologic tests in the Control Program and the selective or massive chemotherapy depending on serological and parasitological prevalence of each community. At present, the real prevalence is underestimated due to the fact that approximately 80% of the individuals eliminate less than 100 eggs/g of feces. Those persons could be responsible for the maintenance of the foci going on and therefore limiting the impact of the control measures. Efforts of the SRG are being oriented toward improvement of immunodiagnostic tests by using defined antigens (enzymes) and chemically synthesized peptides, derived from relevant molecules of the parasite, either for antibodies or antigens search. On the other hand, introduction of snail competitors has been a biological weapon in the control of the intermediate host in certain areas. However, the recent reinfestation of water courses by Biomphalaria glabrata, the increased prevalence in some areas, together with important administrative changes at the Control Program of the Minister of Health, have arisen new questions and doubts, challenging the eradication strategy proposed during the last decade.

An efficient synthesis of antischistosomal drug praziquantel and analogues was achieved and the synthetic route designed was to afford structurally diverse analogues for better structure-activity relationship understanding. Total of nineteen PZQ analogues with structural variations at amide, piperazine and aromatic moieties have been synthesized and fully characterized. Among all the new analogues tested for antischistosomal activity, one dimethoxy tetrahydroisoquinoline analogue and two tetrahydro-b-carboline analogues exhibited moderate activity against adult Schistosoma mansoni. Tetrahydro-b-carboline analogues showed moderate activity whereas the presence of p-trifluoromethylbenzoyl and p-toluenesulphonyl moieties resulted in complete suppression of antischistosomal activity.

An essential component of integrated schistosomiasis control as promoted by WHO is adequate clinical care for patients presenting at health care facilities. We evaluated the functioning of the Ghanaian health system for diagnosis and treatment of schistosomiasis by interviewing health workers from 70 health care facilities in 4 geographical areas in April and May 2000. Results from presentation of 4 hypothetical cases and a subsequent interview demonstrated that patients presenting with symptoms related to schistosomiasis have a small chance of receiving adequate treatment: often health workers do not recognize the symptoms, especially those of Schistosoma mansoni; patients are frequently referred for a diagnostic test or treatment with a large risk of non-compliance; and praziquantel was not available in 78% of the health care facilities with reported schistosomiasis in their coverage area. The overall cost of treatment is considerable: t~2.13 for S. haematobium and t~1.81 for S. mansoni patients, with drug costs contributing approximately 40% of the total cost. To better meet WHO recommendations for passive case detection as part of integrated schistosomiasis control, the Ghanaian health system needs to emphasize training of health workers in schistosomiasis case recognition and case management and increase the availability of praziquantel. Experience from other West African countries indicate that this is feasible.

Background: After many years of general neglect, interest has grown and efforts came under way for the mapping, control, surveillance, and eventual elimination of neglected tropical diseases (NTDs). Disease risk estimates are a key feature to target control interventions, and serve as a benchmark for monitoring and evaluation. What is currently missing is a georeferenced global database for NTDs providing open-access to the available survey data that is constantly updated and can be utilized by researchers and disease control managers to support other relevant stakeholders. We describe the steps taken toward the development of such a database that can be employed for spatial disease risk modeling and control of NTDs.

Background In Ethiopia, because of low quality drinking water supply and latrine coverage, helminths infections are the second most predominant causes of outpatient morbidity. Indeed, there is a scarcity of information on the prevalence of soil transmitted helminths and Schistosomiasis in Ethiopia, special in study area. Therefore, the aim of this study was to determine the prevalence and associated risk factors of soil transmitted helminths and intestinal Schistosomiasis. Methods Cross-sectional study was conducted among 319 school children of Zarima town from April 1 to May 25, 2009. A pre-tested structured questionnaire was used to collect socio-demographic data and possible risk factors exposure. Early morning stool samples were collected and a Kato Katz semi concentration technique was used to examine and count parasitic load by compound light microscope. Data entry and analysis was done using SPSS-15 version and p-value < 0.05 considered statistically significant. Results Out of 319 study subjects, 263 (82.4%) of the study participants infected with one or more parasites. From soil transmitted helminths, Ascaris lumbricoides was the predominant isolate (22%) followed by Hookworms (19%) and Trichuris trichiura (2.5%). Schistosoma mansoni was also isolated in 37.9% of the study participants. Hookworm and S. mansoni infections showed statistically significant associations with shoe wearing and swimming habit of school children, respectively. Conclusion Prevalence of soil transmitted helminths (STH) and S.mansoni was high and the diseases were still major health problem in the study area which alerts public health intervention as soon as possible.

Human water contact patterns were studied in two resettlement communities at the Oyan Reservoir in south-west Nigeria in all four seasons in 1991 and 1992. Water contact was most intensive in the afternoon and in the hot dry season, but different types of activities exhibited different daily and seasonal patterns. Both communities were highly endemic for urinary schistosomiasis. However, knowledge regarding schistosomiasis transmission was very limited and the infection was, in spite of a very high frequency of blood in the urine, not considered a major public health problem. Most water contacts were of either a recreational (swimming, bathing) or economic (fishing) nature, and age-and sex-related patterns were evident. The overall level of exposure peaked in the 10-14 years age group but water contact of an economic nature peaked in the 20-39 years age group. Females had generally more water contact than males.

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.

The biodegradability of water-extracted saponins of berries from the Endod plant, Phytolacca dodecandra L&#x27;Herit, was evaluated under OECD standardized conditions. Persistence of the saponins was evaluated by determination of saponin concentrations in water over a 30-day period, using a quantitative HPLC method and a semiquantitative hemolytic assay, which is considered a potential field method. The two methods were compared. Bioassays

Little is known whether and to what extent antiparasitic treatment cures female genital schistosomiasis (FGS). Using a standard protocol, of twenty-one women with FGS nine were re-examined at two to nine weeks after they had been treated with praziquantel at a single dose of 40 mg/kg. Symptoms related to pathology of the urinary tract and to a lesser extent of genital pathology subsided in most patients. Schistosoma haematobium ova were no longer detectable in urine of any of the patients post-treatment. Efficiency of chemotherapy against adult worms was confirmed by the disappearance of circulating anodic antigen (CAA) in serum. Sandy patches showed resolution in two of four cases after chemotherapy. Papillomata due to schistosomiasis alone improved, but persisted in mixed infection with human papilloma virus (HPV) or when HPV was the only underlying cause. In one patient ulcera could not be related with certainty to schistosomiasis at admission, but resolved after treatment with praziquantel. Leukoplakia (two cases) was not influenced by chemotherapy, or even increased during follow-up, regardless of whether ova had been detected or not. Although the follow-up period was rather short, time intervals were not standardized, and a relatively small number of patients was investigated, it could be shown that genital pathology due to sequestered S. haematobium ova is, at least partially, reversible already two to nine weeks after killing the adult worms by praziquantel. This is paralleled by a normalization of inflammatory immune responses detectable in histological sections and vaginal lavage.

Thirty male aalbino mice of about 4-5 weeks old weighing between 20-25gm obtained from Nation Veterinary Research Institute, Vom were challenged individually with 150-200 Schistosma mansoni cercaria obtained from laboratory bred Biomphalaria pfeifferi snails by tail immersion. On fourth week post infection, animals were divided in to three batches of 10 each. The first batch were treated with Praziquantel suspension at 200mg/kg b.w orally, the second batch were treated with 1ml seed oil of Nigella sativa while the third batch remain as untreated blank control and were orally administered with 70% glyreine. All treatments were over 10 days period.100% and 42.5% cure rates with 100% and 36.19% reduction in worm burden were recorded among animal treated with Praziquantel and seed oil of N. sativa respectively. Mortality rates of 10 and 30% were recorded among the seed oil treated group and the blank control respectively. The mean liver weight of all the experimental animals showed no significant statistical difference (P<0.05), there is however significant difference in mean liver score and total worm burden between the Praziquantel , N. sativa and the Blank control.(P<0.05).

points Schistosomiasis, or bilharzia, is a common intravascular infection caused by parasitic Schistosoma trematode worms It is prevalent in Africa, the Middle East, South America, and Asia Acute schistosomiasis, or Katayama syndrome, can present as fever, malaise, myalgia, fatigue, non-productive cough, diarrhoea (with or without blood), haematuria (S haematobium), and right upper quadrant pain Chronic and advanced disease results from the host's immune response to schistosome eggs deposited in tissues and the granulomatous reaction evoked by the antigens they secrete S mansoni, S japonicum, S intercalatum, and S mekongi cause intestinal disease; S haematobium causes urinary disease Neuroschistosomiasis is arguably the most severe clinical syndrome associated with schistosome infection Microscopic examination of excreta (stool, urine) is the gold standard diagnostic test but requires the adult worms to be producing eggs; serological tests can diagnose less advanced infections Praziquantel 60 mg/kg in three doses over one day (S japonicum and S.mekongi); and 40 mg/kg in doses over one day (S mansoni, S haematobium, S intercalatum) remains the treatment of choice although others are being investigated Preventive chemotherapy is with a single oral dose of praziquantel 40 mg/kg For personal use only: See rights and reprints

The course is designed for clinicians who wish to
acquire basic skills in ultrasound of the abdomen and
a general overview of Ultrasound in Tropical
Medicine. Imaging specialists who want to acquire
knowledge in the field of Infectious Diseases and
Tropical Medicine can benefit from this course as
well.

Schistosomiasis (SCH) is one of the neglected tropical diseases, and it is endemic over 78 resource‑constrained countries. It is one the indicator of poverty as it is often ubiquitous among the poorest of the poor. A total of 172 potential articles were identified through premier academic‑scientific databases, and 86 were chosen. Human beings (permanent‑host) are often exposed to infested water (urine/stools of infected persons) that harbor susceptible snails during their routine domestic and occupational activities. The cercaria (released by snails [intermediate‑host]) infects people by penetrating into their skin. Currently, several multi‑faceted interventions are underway to combat the SCH, namely, (a) potable water, (b) environmental diagnostics, (c) prophylactic chemotherapy with praziquantel, and (d) scaling up of snail control. Although in the recent decades tremendous strides have been made to minimize the disease burden, they are so feeble to eliminate the infection in several poverty‑stricken settings. Female genital‑SCH is also one of the key parasitic cofactors of HIV transmission. However, it remains neglected in terms of priority in allocating sufficient resources to develop next‑generation tools, i.e., vaccine. Therefore, there are challenges lying ahead in achieving our ambitious goal of global elimination. Nevertheless, it can be attained through the recent medical‑technological advancements as well as by strengthening the ongoing multi‑pronged interventions such as (1) generating awareness, (2) continual surveillance, (3) early case‑detection, (4) mass deworming, (5) increasing the research funds, (6) developing sensitive diagnostic tools, (7) prophylactic vaccines, and (8) therapeutic agents. Besides, the improved disease surveillance and response systems could pave the way to build an SCH‑free world in the near future.

Schistosomiasis is a disease caused by parasitic trematode worms (schistosomes) that currently affects 200 million people living in tropical and subtropical environments. It is a chronic disease and the latest estimates for sub-Saharan Africa are that it kills > 200,000 people every year. Soil-transmitted helminthiasis (STH) is caused by intestinal nematodes. More than 2 billion people are infected worldwide and the disease burden might approach that of malaria. Recognising the enormous public health significance of schistosomiasis and STH, particularly among the poor, and in view of readily available drugs that are safe, efficacious and inexpensive, the World Health Assembly recently set forth a resolution for a combined approach for morbidity control of both diseases. This review briefly summarises the geographical distribution, life cycle and global burden of schistosomiasis and STH. The current arsenal of drugs available for morbidity control, including discovery, chemistry, pharmacological properties and aspects of therapeutic efficacy and adverse events in clinical human use is then discussed. The emphasis is on praziquantel, oxamniquine and artemisinin derivatives (against schistosomes) and albendazole, mebendazole, levamisole, pyrantel pamoate and other compounds (against intestinal nematodes). The experience gained with combination chemotherapy in schistosomiasis and STH is briefly discussed. Finally, current research needs and the critical importance for development of novel anthelmintic drugs, so that chemotherapy can continue to serve as the backbone of integrated and sustainable control of schistosomiasis and STH, is highlighted.

This literature review seeks to identify the "root causes" of several diseases that are transmitted among humans by insects and other animals, known as vectors. With an understanding of the causes underlying the occurrence of vector-borne diseases, effective approaches to their control and management are identified. The approaches suggested by this investigation attack many of the factors common to these diseases; but in order to achieve sustained positive results, a vector-borne disease management program must acknowledge and overcome a number of obstacles.

A esquistossomose mansônica (CID 10ª Rev. B65.9), também conhecida como "xistose", "xistosa", "xistosomose", "doença dos caramujos" ou "barriga d'água", é uma doença parasitária causada por um trematódeo, Schistosoma mansoni, com evolução clínica que pode variar desde formas assintomáticas até quadros graves.

The study employed a descriptive research design utilizing quantitative data collection methods. The result of the study revealed that respondents (70-90%) have adequate knowledge of schistosomiasis and possess a positive attitude about the disease. This could be attributed to the long history of control efforts and strategies implemented in the area. Though adequate knowledge was noted, this was not concomitantly translated into preventive practices, which may be due to economic and domestic reasons. Moreso, HSB is a patient and environmentally driven decision. The respondents' behavior was influenced by perceived severity of the illness, type of living environment(p=0.015), and distance to a medical facility (p=0.041). Furthermore, results showed a significant association between KAP and HSB with demographic factors.

Schistosomiasis is a chronic parasitic disease
caused by a trematode blood fluke of the genus
schistosoma which belong to the
schistosomatidae family. Five species are
human parasites, namely S. haematobium, S.
mansoni, S. japonicum, S. intercalatum, and S.
mekongi while many other species affect animals
but not man. At least 200 million individuals
are infected in 75 countries while 600 million
people are exposed to infection and are
potentially victim of this parasite (1).

Schistosomiasis affects 200 million individuals in underdeveloped and developing regions and is a growing concern for travelers worldwide. There has been evidence of resistance to the praziquantel-based therapy and reports of acute-disease manifestation; therefore, other drugs affecting different stages of the schistosome parasites life cycle and alternative therapeutic regimens should be developed and become accessible. The present review results from a comprehensive search in the scientific literature for substances and compounds tested in the past centennial for schistosomiasis therapy. We gathered over 40 drugs providing information on therapeutic action in humans or animal model, toxicity, susceptible Schistosoma stages, species, etc. The drugs were grouped according to their known metabolic effects on the parasite, whether they are on membrane structure and function, carbohydrate metabolism, protein synthesis and function, or on nucleic acid metabolism. We discuss the current knowledge of drug-target interactions, their mechanism of action and possible therapy combinations. Furthermore, based in the literature and in our own experience with large-scale Schistosoma mansoni genome and transcriptome analyses, we put forward several recently described gene products that are promising target candidates for existing or new drugs.

Schistosomiasis continues to be a significant cause of parasitic morbidity and mortality worldwide. This review considers the basic features of the pathology and clinical outcomes of hepatointestinal and genitourinary schistosomiasis, presents an overview of the numerous studies on animal models that have clarified many of the immunopathological features, and provides insight into our current understanding of the immunopathogenesis and genetic control of human schistosomiasis. In murine schistosomiasis, pathology is induced by a CD4+ Th2 driven granulomatous response directed against schistosome eggs lodged in the host liver. The Th2 cytokines IL-4 and IL-13 drive this response, whereas IL-10, IL13Rα2, IFN-γ and a subset of regulatory T-cells act to limit schistosome induced pathology. A variety of cell types including hepatic stellate cells, alternatively activated macrophages and regulatory T-cells have also been implicated in the pathogenesis of schistosomiasis. Current knowledge suggests the immunopathogenic mechanisms underlying human schistosomiasis are likely to be similar. The review also considers the future development of anti-pathology schistosome vaccines. As fibrosis is an important feature of many other diseases such as Crohn's disease and sarcoidosis, a comprehensive understanding of the cellular and molecular mechanisms involved in schistosomiasis may also ultimately contribute to the development an effective disease intervention strategy for other granulofibrotic diseases.

Emissary of Lake Nemi: unpublished maps from the Ucelli Archives. In 1928, the ancient emissary of Lake Nemi underwent substantial structural modifications under the supervision of engineer Guido Ucelli, in connection with the draining of the lake to rescue Caligula’s two ships. Only scanty records have been available until now about the precise nature and extent of those modifications, thus preventing the archaeologists from a full interpretation of the original artefact. This lacuna has been recently filled to a large extent by the digital reorganisation of the Ucelli Archives, which has yielded a number of documents, photographs and technical surveys that help shed light on the structure of the ancient emissary. This article focuses mainly on previously unpublished maps and profiles of the tunnel, made both before and after the beginning of the 1928 works. After a short description of the documents, a major controversy on the emissary building plan is critically re-examined in the light of the new finds.

The alternating fortunes of Frontinus’ quinaria as a unit of measurement of the waters of ancient Rome. Frontinus’ estimates of the amount of water flowing in the aqueducts of ancient Rome are ostensibly based on the geometrical measurement of the cross-sectional area occupied by water flowing in closed pipes or in open channels. This is a very rough approximation, since the amount of water flowing through a given area is
crucially dependent on the velocity of flow and Frontinus makes no quantitative measurements of velocity. During the last couple of centuries, a number of authors have proposed ingenious ways of bypassing the problem of velocity and thus rescue Frontinus and the quinaria from any suspicion of inconsistency and inaccuracy, while other scholars have held totally opposed views. This note reviews the history of the controversy up to the most recent publications and concludes by taking the side of those that are skeptical about the possibility of viewing the quinaria as a precise unit of flow measurement. It is stressed, however, that –irrespective of the approximation one is willing to accept– even the most conservative estimates of the amount of water reaching ancient Rome deserve our most respectful admiration.

Schistosomiasis is a Neglected Tropical Disease (NTD) that persists in 78 countries around the world. Schistosoma japonicum infections persist as a public health concern in China, the Philippines, and Indonesia. In the Philippines, it is endemic in 1,609 barangays across 12 regions, with about 12.4 million Filipinos at risk and 2.7 million exposed to infections. Many studies have reported the disease’s epidemiology among different animal reservoirs in endemic areas in the country. High infection prevalences have also been reported among water buffaloes in endemic hotspots, suggesting that they are the major zoonotic reservoir of infections. The status of schistosomiasis in bubaline reservoir hosts remains largely unknown in the rest of the endemic foci. The adverse economic effects of livestock infections have been documented in China, but the extent and value of these production losses due to infections remain unknown in the Philippines. Schistosomiasis’ zoonotic nature highlights the importance of Veterinary Public Health with One Health in approaching its prevention, control and elimination. This article aims to collate the published literature on animal S. japonicum infections in the Philippines to draw attention to its veterinary public health importance and to mitigate the sparse attention the disease gets from the Filipino veterinary community.

In light of the World Health Organization's initiative to extend schistosomiasis morbidity and mortality control programs by including a disease elimination strategy in low endemic settings, this paper reviews diagnostic tools described during the last decades and provide an overview of ongoing efforts in making an efficient diagnostic tool available worldwide. A literature search on PubMed using the search criteria schistosomiasis and diagnosis within the period from 1978 to 2013 was carried out. Articles with abstract in English and that used laboratory techniques specifically developed for the detection of schistosomiasis in humans were included. Publications were categorized according to the methodology applied (parasitological, immunological, or molecular) and stage of development (in house development, limited field, or large scale field testing). The initial research generated 4,535 publications, of which only 643 met the inclusion criteria. The vast majority (537) of the publications focused on immunological techniques; 81 focused on parasitological diagnosis, and 25 focused on molecular diagnostic methods. Regarding the stage of development, 307 papers referred to in-house development, 202 referred to limited field tests, and 134 referred to large scale field testing. The data obtained show that promising new diagnostic tools, especially for Schistosoma antigen and deoxyribonucleic acid (DNA) detection, which are characterized by high sensitivity and specificity, are being developed. In combination with international funding initiatives these tools may result in a significant step forward in successful disease elimination and surveillance, which is to make efficient tests accessible and its large use self-sustainable for control programs in endemic countries.

Chemotherapy for blood-dwelling schistosomes kills the worms and exposes parasite antigen to the circulation. In many people from areas of endemicity, this treatment increases parasite-specific immunoglobulin E (IgE) and other Th2 responses in the months following therapy, responses that have been associated with subsequent resistance to reinfection. Here we investigate much earlier changes in immune reactions after praziquantel therapy in Schistosoma mansoni-infected fishermen working in an area of high transmission in Uganda. The subjects gave blood before treatment and at 1 and 21 days posttreatment. Blood cultures were incubated with schistosome soluble worm antigen (SWA) or soluble egg antigen (SEA). Interleukin-4 (IL-4), IL-5, IL-10, IL-13, gamma interferon, and transforming growth factor ␤ levels were measured in the cultures and in plasma. A marked transient increase in plasma IL-5 levels was observed in 75% of the subjects (n ‫؍‬ 48) by 1 day posttreatment. This response was dependent on pretreatment intensity of infection and was accompanied by a transient decrease in eosinophil numbers. One day posttreatment, blood cultures from the 16 subjects with the greatest increase in plasma IL-5 level (>100 pg/ml) displayed reduced IL-5, IL-13, and IL-10 responses to SWA, and in contrast to the rest of the cohort, these high-IL-5 subjects displayed reduced levels of SWA-specific IgE in plasma 21 days posttreatment. Twenty months after treatment, the intensity of reinfection was positively correlated with the increase in plasma IL-5 level seen 1 day posttreatment. These studies describe the heterogeneity in early immune reactions to treatment, identifying subgroups who have different patterns of reaction and who may have different capacities to mount the responses that have been associated with resistance to reinfection.

A total of 51 women with urinary schistosomiasis haematobium were examined in order to identify diagnostic indicators for female genital schistosomiasis (FGS). Patients were selected at random from the outpatient department of the Mangochi District Hospital, Malawi. The medical histories were recorded according to a pre-designed questionnaire and the women were subjected to a thorough gynaecological examination including colposcopy and photographic documentation of lesions. Microscopy of genital biopsies revealed that 33 of the 51 women had S. haematobium ova in cervix, vagina and/or vulva in addition to the presence of ova in urine. The most sensitive diagnostic procedure was bedside microscopic examination of a wet cervix biopsy crushed between two glass slides, which revealed 25 of the 33 genital infections. There was a significant correlation between the size of genital lesions and the number of ova counted per mm 2 of crushed tissue. Women with FGS had significantly more tumours in the vulva than women with schistosomiasis limited to the urinary tract. Most of the observed genital pathology could easily be identified by the naked eye, but colposcopic examination yielded valuable additional information like the demonstration of * Corresponding author. Fax +4722119181. neovascularisation around cervical sandy patches. Few of the symptoms previously regarded as indicators for FGS could be linked to the presence of schistosome ova in genital tissue. Husbands of infertile women with FGS had children with other women significantly more often than husbands of women who only had urinary schistosomiasis. This, together with the finding that the majority of the divorced women had FGS, indicates that the manifestation of this disease may have implications for the marital and sexual life of the affected women.

The authors report the case history of a patient with symptoms and signs suggestive of endometriosis, who was found to have Schistosomiasis. The laparoscopic appearance was of gelatinous deposits throughout the pelvis which were thought to be``non-pigmented'' endometriosis. However, histological examination of the biopsy specimens revealed Schistosomiasis. #

Eumycetoma is a morbid chronic granulomatous subcutaneous fungal disease. Despite high environmental exposure to this fungus in certain regions of the world, only few develop eumycetoma for yet unknown reasons. Animal studies suggest that co-infections skewing the immune system to a Th2-type response enhance eumycetoma susceptibility. Since chronic schistosomiasis results in a strong Th2-type response and since endemic areas for eumycetoma and schistosomiasis do regionally overlap, we performed a serological case-control study to identify an association between eumycetoma and schistosomiasis. Compared to endemic controls, eumycetoma patients were significantly more often sero-positive for schistosomiasis (p = 0.03; odds ratio 3.2, 95% CI 1.18-8.46), but not for toxoplasmosis, an infection inducing a Th1-type response (p = 0.6; odds ratio 1.5, 95% CI 0.58-3.83). Here, we show that schistosomiasis is correlated to susceptibility for a fungal disease for the first time.

Schistosomiasis (SCH) in The Philippines is caused by Schistosoma japonicum and remains endemic in 28 provinces in 12 regions. Effective SCH control requires describing areas at risk where control efforts may be focused. This study aims at demonstrating the utility of geographical information system (GIS) as a tool for SCH surveillance in the province of Davao del Norte. Qualitative and quantitative data on SCH determinants, obtained from local government offices, partner agencies and institutions, were standardised, formatted and incorporated into a GIS map. Atrisk areas are described in terms of determinants and (variables), which included geography and climate (topography, temperature and flood-prone areas), agriculture (irrigation and land use), poverty (percentage of households with income below the poverty threshold), sanitation level (percentage of households with sanitary toilets), intermediate and reservoir hosts (presence of snail colonies and reservoir hosts) as well as p...

Background: Given that increase in temperature may alter host-parasite relationships, the anticipated rise in temperature due to global warming might change transmission patterns of certain diseases. However, the extent to which this will happen is not well understood.

Methods: Using a host-parasite system involving Bulinus globosus and Schistosoma haematobium, we assessed the effect of temperature on snail fecundity, growth, survival and parasite development under laboratory conditions.

Results: Our results show that temperature may have a non-linear effect on snail fecundity and snail growth. Snails maintained at 15.5 °C and 36.0 °C did not produce egg masses while those maintained at 25.8 °C laid 344 and 105 more egg masses than snails at 31.0 °C and 21.2 °C, respectively. Attainment of patency led to a reduction in egg mass production among the snails. However, the reduction in fecundity for snails maintained at 21.2 °C occurred before snails started shedding cercariae. Parasite development was accelerated at high temperatures with snails maintained at 31.0 °C reaching patency after three weeks. Furthermore, snail growth rate was highest at 25.8 °C while it was inhibited at 15.5 °C and reduced at 31.0 °C. Increase in temperature increased snail mortality rates. Snails maintained at 36.0 °C had the shortest survival time while those maintained at 15.5 °C had the longest survival time.

OBJETIVOS: Descrever as características clínicas dos pacientes com hipertensão pulmonar de dois centros de referência para tratamento de HP no país. MÉTODOS: Análise retrospectiva de prontuários. RESULTADOS: Foram incluídos no estudo 123 pacientes com diagnóstico de HP; 62% destes apresentavam classe funcional III e IV (NYHA). A média da pressão sistólica do ventrículo direito (PSVD) encontrada nos pacientes estudados foi de 83,48±24,61 mmHg. Não houve correlação entre a classe funcional dos pacientes e o valor da PSVD. Cerca de 50% dos pacientes tinham o diagnóstico de HAPI, 30% tinham doença associada à esquistossomose e 10% tinham HP associada a doença do tecido conectivo. O tempo de dispnéia até o diagnóstico foi variável e não houve correlação com a classe funcional dos pacientes (p>0,05). Apesar das diferentes etiologias, os pacientes apresentaram características semelhantes. CONCLUSÃO: Baseando-se em nossos achados, reforça-se a necessidade de investigação ativa para o diagnóstico definitivo antes da instituição de quaisquer alternativas terapêuticas para o tratamento da hipertensão pulmonar. Ressalta-se, ainda, a necessidade de um maior entendimento da hipertensão pulmonar associada à esquistossomose, em virtude da prevalência desse diagnóstico em nosso meio.