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Vongphayloth K.,Institute Of La Francophonie Pour La Medecine Tropicale | Rattanavong S.,Wellcome Trust Mahosot Hospital Oxford Tropical Medicine Research Collaboration | Moore C.E.,Wellcome Trust Mahosot Hospital Oxford Tropical Medicine Research Collaboration | Moore C.E.,University of Oxford | And 8 more authors.
American Journal of Tropical Medicine and Hygiene | Year: 2012

The causal agent of melioidosis, Burkholderia pseudomallei, has been cultured from paddy fields in the Lao PDR. We carried out a pilot study to examine the relationship between bacterial soil contamination and that of nearby surface waters in Saravane Province. Soil sampling was conducted at a depth of 30 cm (100 holes in a 45 x 45 m grid) at two sites, East and West Saravane. Moore's swabs were used for water sampling of paddy fields, lakes, rivers, boreholes, and storage tanks within 2 km of the two soil sampling sites. B. pseudomallei from soil and water were cultured on Ashdown's agar. Thirty-six percent and 6% of water samples collected around East and West Saravane, respectively, were culture positive for B. pseudomallei. Low pH and high turbidity were independently associated with culture of B. pseudomallei. Most positive water samples were from the Sedone River, downstream of the East Saravane site. Moore's swabs are simple and inexpensive tools for detecting B. pseudomallei in surface waters. Copyright © 2012 by The American Society of Tropical Medicine and Hygiene. Source


Kinkel H.-F.,Institute of Tropical Medicine | Kinkel H.-F.,University of Pretoria | Dittrich S.,Institute of Tropical Medicine | Dittrich S.,Wellcome Trust Mahosot Hospital Oxford Tropical Medicine Research Collaboration | And 4 more authors.
Clinical and Vaccine Immunology | Year: 2012

The diagnosis of schistosomiasis in individuals from countries where the disease is not endemic is challenging, and few data are available on the accuracy of serological diagnosis in those patients. We evaluated the performance of eight serological assays, including four commercial kits, in the diagnosis of imported schistosomiasis in individuals from areas where the disease is not endemic, including six enzyme-linked immunosorbent assays using three different antigens, an indirect hemagglutination assay, and an indirect immunofluorescent-antibody test. To analyze the assays, we used a total of 141 serum samples, with 121 derived from patients with various parasitic infections (among which were 37 cases of schistosomiasis) and 20 taken from healthy volunteers. The sensitivity values for detection of schistosomiasis cases ranged from 41% to 78% and were higher for Schistosoma mansoni than for S. haematobium infections. Specificity values ranged from 76% to 100%; false-positive results were most frequent for samples from patients with cestode infections. By combining two or more tests, sensitivity improved markedly and specificity decreased only moderately. Serological tests are useful instruments for diagnosing imported schistosomiasis in countries where the disease is not endemic, but due to limitations in test sensitivities, we recommend the use of two or more assays in parallel. Copyright © 2012, American Society for Microbiology. All Rights Reserved. Source


Koh G.C.K.W.,Mahidol University | Koh G.C.K.W.,University of Amsterdam | Koh G.C.K.W.,University of Cambridge | Maude R.J.,Mahidol University | And 3 more authors.
American Journal of Tropical Medicine and Hygiene | Year: 2010

Scrub typhus is transmitted by trombiculid mites and is endemic to East and Southeast Asia and Northern Australia. The clinical syndrome classically consists of a fever, rash, and eschar, but scrub typhus also commonly presents as an undifferentiated fever that requires laboratory confirmation of the diagnosis, usually by indirect fluorescent antibody (IFA) assay. We discuss the limitations of IFA, debate the value of other methods based on antigen detection and nucleic acid amplification, and outline recommendations for future study. Copyright © 2010 by The American Society of Tropical Medicine and Hygiene. Source


Slesak G.,SFE Medical Project | Inthalad S.,SFE Medical Project | Strobel M.,Institute Of La Francophonie Pour La Medecine Tropicale | Marschal M.,Interfakultares Institute For Mikrobiologie Und Infektionsmedizin | And 3 more authors.
BMC Infectious Diseases | Year: 2011

Chromoblastomycosis is a chronic mycotic infection, most common in the tropics and subtropics, following traumatic fungal implantation.Case presentation: A 72 year-old farmer was admitted to Luang Namtha Provincial Hospital, northern Laos, with a growth on the left lower leg which began 1 week after a forefoot leech bite 10 years previously. He presented with a cauliflower-like mass and plaque-like lesions on his lower leg/foot and cellulitis with a purulent tender swelling of his left heel. Twenty-two Chrysomya bezziana larvae were extracted from his heel. PCR of a biopsy of a left lower leg nodule demonstrated Fonsecaea pedrosoi, monophora, or F. nubica. He was successfully treated with long term terbinafin plus itraconazole pulse-therapy and local debridement.Conclusions: Chromoblastomycosis is reported for the first time from Laos. It carries the danger of bacterial and myiasis superinfection. Leech bites may facilitate infection. © 2011 Slesak et al; licensee BioMed Central Ltd. Source


Limmathurotsakul D.,Mahidol University | Dance D.A.B.,Wellcome Trust Mahosot Hospital Oxford Tropical Medicine Research Collaboration | Dance D.A.B.,University of Oxford | Wuthiekanun V.,Mahidol University | And 13 more authors.
PLoS Neglected Tropical Diseases | Year: 2013

Background: Burkholderia pseudomallei, a Tier 1 Select Agent and the cause of melioidosis, is a Gram-negative bacillus present in the environment in many tropical countries. Defining the global pattern of B. pseudomallei distribution underpins efforts to prevent infection, and is dependent upon robust environmental sampling methodology. Our objective was to review the literature on the detection of environmental B. pseudomallei, update the risk map for melioidosis, and propose international consensus guidelines for soil sampling. Methods/Principal Findings: An international working party (Detection of Environmental Burkholderia pseudomallei Working Party (DEBWorP)) was formed during the VIth World Melioidosis Congress in 2010. PubMed (January 1912 to December 2011) was searched using the following MeSH terms: pseudomallei or melioidosis. Bibliographies were hand-searched for secondary references. The reported geographical distribution of B. pseudomallei in the environment was mapped and categorized as definite, probable, or possible. The methodology used for detecting environmental B. pseudomallei was extracted and collated. We found that global coverage was patchy, with a lack of studies in many areas where melioidosis is suspected to occur. The sampling strategies and bacterial identification methods used were highly variable, and not all were robust. We developed consensus guidelines with the goals of reducing the probability of false-negative results, and the provision of affordable and 'low-tech' methodology that is applicable in both developed and developing countries. Conclusions/Significance: The proposed consensus guidelines provide the basis for the development of an accurate and comprehensive global map of environmental B. pseudomallei. © 2013 Limmathurotsakul et al. Source

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