Ann Trop Med Parasit
-
Ann Trop Med Parasit · Jun 2009
Echinococcus in the wild carnivores and stray dogs of northern Tunisia: the results of a pilot survey.
Echinococcus granulosus is endemic throughout Tunisia and E. multilocularis has previously been reported as the cause of two cases of human alveolar echinococcosis in the north-west of the country. The aim of the present study was to screen wild carnivores from the north-western Jendouba governorate and semi-stray dogs from the Siliana and Sejnane regions of northern Tunisia for these two zoonotic cestodes. The results of the coproscopy, coproELISA and coproPCR that were undertaken were compared with those of necropsy, where possible. ⋯ This is the first report from Tunisia of (coproPCR-)confirmed E. granulosus infections in golden jackals and red foxes. The possible role of such wild hosts in the transmission of E. granulosus in Tunisia should be investigated further. The possibility of the active transmission of E. multilocularis in Tunisia still remains an open question.
-
Ann Trop Med Parasit · Apr 2009
Case ReportsThe treatment pathways followed by cases of human African trypanosomiasis in western Kenya and eastern Uganda.
Although early diagnosis and treatment are key factors in the effective control of human African trypanosomiasis (HAT), many cases of the disease delay taking appropriate action, leading to untold suffering. As a better understanding of treatment-seeking behaviour should help in identifying the obstacles to early diagnosis and effective treatment, the treatment pathways followed by 203 former HAT cases in western Kenya and eastern Uganda have recently been explored. About 86% of the HAT cases had utilized more than two different healthcare options before being correctly diagnosed for HAT, with about 70% each using more than three different health facilities. ⋯ Just over half (51%) of the HAT cases had been symptomatic for >2 months before being correctly diagnosed for HAT, and such time lags in diagnosis contributed to 72% of the cases receiving their first appropriate treatment only in the late stage of the disease. The likelihood of a correct diagnosis increased with the time the case had been symptomatic. These observations indicate an urgent need to build the diagnostic capacity of the primary healthcare facilities in the study area, so that all HAT cases can be identified and treated in the early stage of the disease.
-
Ann Trop Med Parasit · Mar 2009
Prevalence of pulmonary hypertension in patients with schistosomal liver fibrosis.
Between the April and July of 2007, patients undergoing treatment for schistosomal liver fibrosis, at a university hospital in north-eastern Brazil, were examined by transthoracic Doppler echocardiography (TTE). The main aim was to determine the prevalence of pulmonary hypertension in the patients. The thorax of each patient who had such hypertension, as indicated by an estimated pulmonary arterial systolic pressure (PASP) in excess of 35 mmHg, was then investigated by contrast-enhanced multidetector-row computed tomography (MDCT). ⋯ The contrast-enhanced thoracic MDCT indicated that most of the patients with pulmonary hypertension had a pulmonary artery trunk that was unusually wide (67%) and more than 1.1-fold wider than the ascending aorta (56%), dilatation of the main pulmonary arteries (100%), a segmental artery that, in diameter, was more than 1.1-fold larger than the adjacent bronchi (89%), tapering of the peripheral pulmonary arteries (78%), and cardiac enlargement (78%). No patient suffered pulmonary embolism as a result of the investigations. The prevalence of pulmonary hypertension in the patients with schistosomal liver fibrosis (10.7%) justifies the screening of such patients by TTE.
-
Ann Trop Med Parasit · Jul 2008
Morbidity from diarrhoea, cough and fever among young children in Nigeria.
Diarrhoea, cough and fever are the leading causes of childhood morbidity and mortality in sub-Saharan Africa. Despite it being a determinant of mortality in many developing countries, geographical location has seldom been considered as an explanatory factor for the large regional variations seen in the childhood morbidity attributed to these causes in this area. The relevant data collected in two Nigerian Demographic and Health Surveys, one in 1999 and the other in 2003, have now therefore been analysed and compared. ⋯ The analysis explained a significant share of the pronounced residual spatial effects. Maps showing the prevalences of diarrhoea, cough and fever in young children across Nigeria were generated during this study. Such maps should facilitate the development of policies to fulfil the Millennium Development Goals in Nigeria and throughout sub-Saharan Africa.