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Prichard R.K.,McGill University | Basanez M.-G.,Imperial College London | Boatin B.A.,McGill University | Boatin B.A.,University of Ghana | And 5 more authors.
PLoS Neglected Tropical Diseases | Year: 2012

Recognising the burden helminth infections impose on human populations, and particularly the poor, major intervention programmes have been launched to control onchocerciasis, lymphatic filariasis, soil-transmitted helminthiases, schistosomiasis, and cysticercosis. The Disease Reference Group on Helminth Infections (DRG4), established in 2009 by the Special Programme for Research and Training in Tropical Diseases (TDR), was given the mandate to review helminthiases research and identify research priorities and gaps. A summary of current helminth control initiatives is presented and available tools are described. Most of these programmes are highly dependent on mass drug administration (MDA) of anthelmintic drugs (donated or available at low cost) and require annual or biannual treatment of large numbers of at-risk populations, over prolonged periods of time. The continuation of prolonged MDA with a limited number of anthelmintics greatly increases the probability that drug resistance will develop, which would raise serious problems for continuation of control and the achievement of elimination. Most initiatives have focussed on a single type of helminth infection, but recognition of co-endemicity and polyparasitism is leading to more integration of control. An understanding of the implications of control integration for implementation, treatment coverage, combination of pharmaceuticals, and monitoring is needed. To achieve the goals of morbidity reduction or elimination of infection, novel tools need to be developed, including more efficacious drugs, vaccines, and/or antivectorial agents, new diagnostics for infection and assessment of drug efficacy, and markers for possible anthelmintic resistance. In addition, there is a need for the development of new formulations of some existing anthelmintics (e.g., paediatric formulations). To achieve ultimate elimination of helminth parasites, treatments for the above mentioned helminthiases, and for taeniasis and food-borne trematodiases, will need to be integrated with monitoring, education, sanitation, access to health services, and where appropriate, vector control or reduction of the parasite reservoir in alternative hosts. Based on an analysis of current knowledge gaps and identification of priorities, a research and development agenda for intervention tools considered necessary for control and elimination of human helminthiases is presented, and the challenges to be confronted are discussed. © 2012 Prichard et al. Source

Cheng Y.,Kangwon National University | Lu F.,Kangwon National University | Lu F.,Jiangsu Institute of Parasitic Diseases | Tsuboi T.,Ehime University | Han E.-T.,Kangwon National University
Acta Tropica | Year: 2013

Since the genome of Plasmodium vivax was sequenced, few proteins have been characterized as highly immunogenic and candidates for inclusion in a vivax malaria vaccine. The P. vivax 41 (Pv41) protein has a signal peptide, one glutamate-rich domain in its central region, and two sexual stage s48/45 domains, and is characterized as a gametocyte surface protein; however, this protein may be expressed principally on the merozoite surface of parasites. The previous study reported the transcription, blood-stage expression, and subcellular localization of Pv41 within the parasite. In this study, the recombinant Pv41 protein was expressed as a soluble form, of a molecular mass ~44. kDa, by a cell-free expression system and was specifically recognized by animal immune sera and vivax patient sera. Evaluation of the human humoral immune response to Pv41 indicated a high immunogenicity, with 62.5% sensitivity and 95% specificity, by protein array. Immunofluorescence assays (IFA) using polyclonal anti-Pv41 antibodies showed that Pv41 was localized on the merozoite surface. The high immunogenicity of Pv41 indicates its potential as a vivax malaria vaccine candidate antigen, particularly in light of its location on the merozoite surface of the parasite. © 2013. Source

Wang W.,Jiangsu Institute of Parasitic Diseases
Asian Pacific journal of tropical medicine | Year: 2012

To assess the diagnostic efficacy of the currently most widely used indirect hemagglutination assay (IHA) and enzyme-linked immunosorbent assay (ELISA) for detection of Schistosoma japonicum human infections. A comprehensive search was undertaken from China National Knowledge Infrastructure, Wanfang Database, VIP Database, PubMed, Cochrane Library, Science Citation Index Expanded, Proquest, and the inclusion and exclusion criteria were strictly settled. The funnel plot was used to assess the publication bias, Cochran's Q test was employed to measure the homogeneity between studies, a summary receiver operating characteristic (SROC) curve was used to compare the diagnostic accuracy between the IHA and ELISA qualitatively by means of the Weighted Least Square method, the Ordinary Least Square method and the Robust regression method, and the diagnostic odds ratio (DOR) was drawn to compare the accuracy quantitatively. Out of 785 publications, 19 papers were eventually selected for analysis. Literature quality assessment indicated that minor publication bias existed in studies pertaining IHA test, but no bias was found in literatures regarding ELISA test. The heterogeneity test showed a heterogeneity between studies was present (χ(2)=466.07 and 34.67, both P values<0.0001). The areas under the SROC curves of IHA were all higher than that of ELISA test using the three methods (Weighted Least Square method: 0.766 vs. 0.695, Ordinary Least Square method: 0.826 vs. 0.741, Robust regression: 0.815 vs. 0.715). The TPR* values for IHA and ELISA were 0.710, 0.759, 0.749, and 0.650, 0.686 and 0.666, respectively, and OR values were 5.997, 9.937, 8.893, and 3.432, 4.784 and 3.959, respectively. The DOR of IHA was 9.41 (95% CI: 4.88-18.18), and 4.78 (95% CI: 3.21-7.13) for ELISA. All above results revealed that the diagnostic performance of IHA is better than that of ELISA. However, taking into account their unsatisfactory diagnostic value in areas with low infection intensity, a search for a better diagnostic test that can be applied in field situations in China should be given high priority. Copyright © 2012 Hainan Medical College. Published by Elsevier B.V. All rights reserved. Source

Gazzinelli A.,Federal University of Minas Gerais | Gazzinelli A.,Instituto Nacional Of Ciencia E Tecnologia Em Doencas Tropicais Inct Dt | Correa-Oliveira R.,Instituto Nacional Of Ciencia E Tecnologia Em Doencas Tropicais Inct Dt | Yang G.-J.,Jiangsu Institute of Parasitic Diseases | And 2 more authors.
PLoS Neglected Tropical Diseases | Year: 2012

In this paper, the Disease Reference Group on Helminth Infections (DRG4), established in 2009 by the Special Programme for Research and Training in Tropical Diseases (TDR), with the mandate to review helminthiases research and identify research priorities and gaps, focuses on the environmental, social, behavioural, and political determinants of human helminth infections and outlines a research and development agenda for the socioeconomic and health systems research required for the development of sustainable control programmes. Using Stockols' social-ecological approach, we describe the role of various social (poverty, policy, stigma, culture, and migration) and environmental determinants (the home environment, water resources development, and climate change) in the perpetuation of helminthic diseases, as well as their impact as contextual factors on health promotion interventions through both the regular and community-based health systems. We examine these interactions in regard to community participation, intersectoral collaboration, gender, and possibilities for upscaling helminthic disease control and elimination programmes within the context of integrated and interdisciplinary approaches. The research agenda summarises major gaps that need to be addressed. © 2012 Gazzinelli et al. Source

White N.J.,Mahidol University | Qiao L.G.,Guangzhou University of Chinese Medicine | Qi G.,Jiangsu Institute of Parasitic Diseases | Luzzatto L.,Istituto Toscano Tumori
Malaria Journal | Year: 2012

In areas of low malaria transmission, it is currently recommended that a single dose of primaquine (0.75 mg base/kg; 45 mg adult dose) be added to artemisinin combination treatment (ACT) in acute falciparum malaria to block malaria transmission. Review of studies of transmission-blocking activity based on the infectivity of patients or volunteers to anopheline mosquitoes, and of haemolytic toxicity in glucose 6-dehydrogenase (G6PD) deficient subjects, suggests that a lower primaquine dose (0.25 mg base/kg) would be safer and equally effective. This lower dose could be deployed together with ACTs without G6PD testing wherever use of a specific gametocytocide is indicated. © 2012 White et al.; licensee BioMed Central Ltd. Source

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