Urinary schistosomiasis, caused by Schistosoma haematobium is very common in Nigeria, with Ebonyi State implicated to have the highest prevalence in the southeastern part of the country. The aim of this review was to estimate the status of urinary schistosomiasis in the State with regards to the elimination goals of World Health Organization (WHO). A comprehensive search of published articles on urinary schistosomiasis in Ebonyi State, Nigeria from 2006 to 2017 was conducted using Google Scholar, PubMed and African Journals Online (AJOL) databases. Out of 26 retrieved articles, 15 met the inclusion criteria. The MetaXL software was used to compute the pooled prevalence of urinary schistosomiasis using the random effect model and results are presented as forest plot. Based on meta-analysis output, the pooled prevalence of urinary schistosomiasis was 26.02% [95% Confidence Interval (CI) = 17.91–35.04%]. The pooled prevalence was higher before 2014, the year when treatment with praziquantel (PZQ) was started. Of the senatorial zones, Ebonyi North had the highest pooled prevalence of 34.57% (95% CI = 10.50–61.32%). In addition, the prevalence of the disease was higher when all the age groups were sampled (31.33%; 95% CI = 12.75–51.98%) than when only schoolchildren were used as sampling population (25.23%; 95% CI = 15.66-35.93%). The pooled prevalence revealed that despite the mass drug distribution (MDA) of PZQ in the State, there is continued transmission of urinary schistosomiasis. Hence, if the WHO elimination goal of the disease has to be met, focused control and elimination programmes along with intense complementary public-health interventions are necessary.

Background & objectives: Mosquito surveillance is one of the critical functions of local health departments, particularly in the context of outbreaks of severe mosquito-borne viral infections. Unfortunately, some viral and parasitic infections transmitted by mosquitoes, manifests non-specific clinical symptoms which may actually be of rickettsial etiology, including Rickettsia felis infections. This study tested the hypothesis that mosquitoes from southeastern Georgia, USA may be infected with Rickettsia felis and Wolbachia, an endosymbiotic bacterium of the order Rickettsiales. Methods: Specimens of the five most common mosquito species occurring in the region were collected using gravid and light-traps and identified using morphological keys. Mosquitoes were then pooled by species, sex, trap and collection site and their DNA was extracted. Molecular methods were used to confirm mosquito identification, and presence of Wolbachia and R. felis. Results: Wolbachia DNA was detected in 90.8% of the mosquito pools tested, which included 98% pools of Cx. quinquefasciatus Say (Diptera: Culicidae), 95% pools of Ae. albopictus Skuse (Diptera: Culicidae), and 66.7% of pools of Cx. pipiens complex. Samples of An. punctipennis Say (Diptera: Culicidae) and An. crucians Wiedemann (Diptera: Culicidae) were tested negative for Wolbachia DNA. Three genotypes of Wolbachia sp. belonging to Group A (1 type) and Group B (2 types) were identified. DNA of R. felis was not found in any pool of mosquitoes tested. Interpretation & conclusions: This study provides a pilot data on the high presence of Wolbachia in Cx. quinque-fasciatus and Ae. albopictus mosquitoes prevalent in the study region. Whether the high prevalence of Wolbachia and its genetic diversity in mosquitoes affects the mosquitoes’ susceptibility to R. felis infection in Georgia will need further evaluation.

Background & objectives: Leishmania parasites cause various clinical symptoms in humans such as cutaneous ulcers and fatal visceral diseases. These parasites cannot synthesize purine rings de novo and must uptake purines from their hosts via salvage. Salvage is regulated by permeases in the cell membrane. There are hundreds of membrane transporter proteins to receive nutrients in Leishmania. Nucleoside transporter 4 (NT4) is one of the purine transporters that is involved in enhancing the uptake of adenine in Leishmania major. They are important new drug targets for the treatment of leishmaniasis because they can be used to transport toxic purine analogs to kill parasitic cells, thus preventing the progression of the infection. The present study was conducted to silence the NT4 nucleobase involved in the salvage pathway to interrupt purine nucleotide membrane transport in the cells of L. major. Methods: In this study, a 502 bp segment of NT4 gene sequence was selected and designed as antisense transcripts after insertion in the parasite. The NT4 construct was transfected into L. major promastigotes for in vitro study of gene expression. Then, BALB/c mice infected with transgenic Leishmania and wild-type strain along with the number and size of lesions were studied in vivo. Results: The study showed that relative expression of NT4 gene in mutant Leishmania was lower than in the control on Day 3 to 20. The percentages and the number of amastigotes in infected macrophages with wild-type strain L. major were more than infected macrophages with mutant parasites. Infected BALB/c mice with transgenic Leish- mania showed a lower number and size of lesions than the BALB/c mice infected with wild-type strain. Interpretation & conclusion: The results of the study indicated that the use of antisense RNA reduced NT4 gene expression in L. major. Further, studies are needed to ascertain that the use of antisense can be considered as a new treatment for leishmaniasis.

Background & objectives: Japanese encephalitis (JE) is a mosquitoe-borne viral zoonotic disease and globally around three billion people are at the risk of disease. The occurrence of JE cases has shown a rising trend during last decade in India. Pig is the amplifying host for JE virus and serves as a suitable sentinel model for the prediction of disease outbreak in humans. The development of a diagnostic test that is suitable for surveillance of JE in pigs is the need of the hour. The existing tests require elaborate laboratory facilities which make their application in rural settings difficult. Therefore, realizing the need for a rapid test, efforts were made to standardize a latex agglutination test (LAT) for serodiagnosis of JE in pigs. Methods: Standardization of LAT by physical adsorption of recombinant NS1 (non-structural) protein of JE virus onto latex beads was done by altering six different variables, namely the antigen concentration, sensitization condition, surface blocking agent, blocking condition, particle concentration and reaction time. The standardized latex-protein complex was used for screening 246 pig serum samples under optimal conditions. Results: The test was standardized with a diagnostic sensitivity and specificity of 82.24 and 87.83%, respectively. Screening of 246 field pig serum samples using standardized LAT showed a seropositivity of 50.4%. The results were available within 5 min after addition of test serum sample to the sensitized beads. Interpretation & conclusion: The findings of the study highlight the potential of LAT as a rapid on-site assay for JE diagnosis in pigs which would aid in predicting JE outbreaks in humans.

Background & objectives: Oral administration of tender leaf extract of Glycosmis pentaphylla is traditionally known to prevent the chikungunya virus infection. Even with wide usage, the antiviral components in this plant are neither identified nor characterized. This study was carried out with the objectives of profiling the phytocompounds in this plant through LC-MS/MS and to identify the active antiviral constituents and their drug-likeliness through molecular docking. Methods: Phytocompounds were extracted hydro-alcoholically from powdered plant parts and analyzed using LC-MS/MS. Based on mass-to-charge ratio from LC-MS/MS, compounds were identified and used as ligands for molecular docking against chikungunya target proteins. The active principles were subjected to ADME/T analysis to verify their drug-likeliness. Results: The docking results and ADME/T evaluation showed that the compounds, isovaleric acid and avicequinone- C have good interaction with the protein targets and hence could be the antiviral principles of the selected plant. These compounds presented acceptable drug properties and hence could be carried forward to in vivo studies for drug development. Interpretation & conclusion: The antiviral properties of G. pentaphylla are known since time-immemorial. This study revealed the probable interactions after the oral administration of tender leaves of Glycosmis in preventing the chikungunya virus infection and paves the path for designing future plant-based drugs.

Background & objectives: Plasmodiumfalciparum malaria causes wide variety of clinical symptoms ranging from a mild febrile illness to life-threatening complications. For prevention of the severity and early diagnosis, evaluation of potential biomarkers is much needed. C-reactive protein (CRP) is an acute phase protein and well-recognized marker of inflammation in the body. It is synthesized by liver in response to pro-inflammatory responses and has correlation with complications associated with malaria. The study was aimed to assess, if it could serve as a predictive marker for malaria disease severity. Methods: In the present study, 74 P. falciparum patients and 22 healthy controls were enrolled. Turbidimetric immunoassay was used to measure the CRP in serum samples of all the study participants. Mann-Whitney U-test for continuous data and chi-square test for categorical data were used to compare all malaria cases vs. healthy control group and uncomplicated vs. severe malaria groups. Using receiver operating characteristic (ROC) analysis, best threshold value was determined for CRP in severe malaria patients. Results: CRP level was significantly elevated in all malaria case groups (1.6 mg/dl IQ 1-2.6) as compared to healthy controls (0.10 mg/dl IQ 0.1-0.20), with p-value <0.0001. Further, CRP level was significantly higher in the severe malaria group (2 mg/dl IQ 1.8-3.9) as compared to the uncomplicated malaria group (1.4 mg/dl IQ 1-2.47) and healthy control group (0.10 mg/dl IQ 0.10-0.20), with p-value <0.05. Interpretation & conclusion: The present study findings suggest that CRP level can be used to differentiate severe malaria from uncomplicated malaria. Elevated CRP level could be helpful in early prediction of the disease severity in patients infected with P. falciparum and may play an important role in diagnosis of falciparum malaria where improper initial test and clinical manifestations like fever may be absent even with a high load of parasite.

Background & objectives: Cutaneous leishmaniasis (CL) is widespread in the tropical and subtropical regions of the world including, Tukey. Environmental determinants for the CL endemic areas in Turkey are relatively poorly understood. The aim of the present study was to develop a model based on ecological niche modeling (ENM) to predict the distribution of CL in endemic areas of Adana Province in Turkey. Methods: The environmental data from different sources were extracted and information on 1831 native CL cases, obtained from the Provincial Health Directorate of Adana were recorded. The location information obtained from the Ministry of Health database were used for modeling the current probability of CL occurrence and predicting its future distribution using ENM analyses. ArcGIS and MaxEnt models were used to explore the ecological conditions of the disease. Results: According to the MaxEnt model, the area under the curve (AUC) values for the current and projected future of CL were 0.868 and 0.867, respectively. The environmental variables, Bio1 (Annual mean temperature), Bio4 (Temperature seasonality) and DEM (Digital elevation model) were found to be associated with the presence of human cases of Leishmania infantum for both the time periods in the study area. Interpretation & conclusion: The AUC curves and risk map generated by the ENM model indicate that the future status of CL is likely to be stable in the northern part of Adana, but the southern part will be affected by climate changes (change of temperature) with a large number of patient-reporting. The results of the study could be used as a reference for CL and vector control studies. The ENM could be useful for researchers in vector control studies and better understanding of the epidemiology of vector-borne diseases in a specific area.

Background & objectives: Rodent species reported from Iran are subject of several studies, but the fauna called ectoparasite, infesting the rodents, along with their epidemic effects, are poorly known. In this study, ectoparasitic insect fauna of rodents found across the Iran were studied, to generate an annotated checklist of fleas and lice species. Methods: Several field expeditions focused on different habitats of northeastern Iran were conducted between January 2017 and May 2018. Rodent trapping was carried out using custom-made mesh live traps and “Faragir” live traps baited mainly with scorched sunflower and gourd seeds. The trapped rodents were examined for ectoparasites on their body, and then released at their trapping point. The rodents and ectoparasite species were identified based on available keys. Results: A total of 217 rodents belonging to 16 species of the families Calomyscidae, Cricetidae, Dipodidae, Mu- ridae and Sciuridae were captured. Five species of each fleas and lice were collected from the body of the trapped rodents. Three flea species, Ctenophthalmus pseudagyrtes, Nosopsyllus iranus and Xenopsylla buxtoni; and two louse species, Polyplax gerbilli and P. spinulosa, were recorded for the first time. Interpretation & conclusion: The study generated an annotated checklist of 79 species of fleas and 8 species of lice harboured by different species of rodents distributed in Iran which would be helpful in different taxonomic studies such as parasite-host coevolution, and also sanitation and health monitoring programs.

Background & objectives: The alarming failure in malaria treatment using conventional drugs calls for urgent search of alternatives; one of which is to exploit natural products such as plants. This study evaluated the effects of three selected commercial herbal preparations on albino mice infected with Plasmodium berghei NK65, a lethal strain of rodent malaria. Methods: This study was conducted in the University of Nigeria, Nsukka between February and September 2017. A total of 30 adult albino mice were randomized into six groups of five mice each. Group 1 served as normal control. Mice in Groups 2-6 were parasitized with P. berghei. Group 2 mice were untreated while mice in Groups 3, 4, 5 and 6 were treated with 20 mg/kg body weight of artesunate; and 5 ml/kg body weight of the seleceted commercial herbal preparations designated as HA, HB and HC, respectively. The percent malaria parasitaemia, haematological parameters, lipid profile, liver function markers, antioxidant status and lipid peroxidation index were evaluated using standard protocol. Results: It was observed that mice in Group 2 had significantly higher percentage of malaria parasitaemia when compared to mice in parasitized and treated groups. Also, haematological dysfunctions, dyslipidaemia, oxidative stress and hepatotoxicity seen in parasitized and untreated mice were restored in parasitized and artesunate- and herbal preparations-treated mice. Interpretation & conclusion: Findings from the present study revealed that oxidative stress, characterized by low antioxidant status and high lipid peroxidation, contributes to complications in malaria. The results also indicate that the studied commercial herbal preparations possess good antimalarial and ameliorative effects on malaria-induced haematological, lipid, antioxidant and liver aberrations in mice. The acute toxicity profiles of the commercial herbal preparations suggested that they are tolerable and safe at the doses administered.

Background & objectives: Cattle population is relatively dense in Nasarawa State (Nigeria) particularly in Keffi and its environs, where there are more Hausa/Fulani settlers whose main occupation is farming and herding. Unfortunately, the area is purportedly described as a “horde of tsetse fly species” which transmits trypanosomes that cause severe disease in humans, livestock and wildlife species. This study was targeted at examining trypanosome species prevalent among cattle breeds reared in Keffi metropolis. Methods: A total of 110 cattle, purely based on availability were screened within five working days for trypanosomes infestation using haematocrit centrifugation technique and buffy coat technique. The breeds of cattle examined included White Fulani (64), Sokoto Gudali (26), N’dama (16) and Muturu (4); reared in Jarmai, Gauta and Keffi North districts of Keffi Local Government Area, Nasarawa State, Nigeria. Data collected were analysed using simple descriptive statistics. Results: It was observed that 18 (16.4%) out of 110 cattle screened were infested with 5 (4.55%) Trypanosoma con- golense and 13 (11.82%) T. vivax. The T. congolense positive cases were 4 (3.64%) in White Fulani and 1(0.91%) in Sokoto Gudali breeds whereas, T. vivax occurrence was 9 (8.18%) in White Fulani breed and 4 (3.64%) in Sokoto Gudali breed. The N’dama and Muturu breeds were absolutely not infested and no mixed infestation was recorded in any of the breeds. Interpretation & conclusion: Trypanosoma vivax and T. congolense are the predominant trypanosome species in the study area affecting mainly Sokoto Gudali and White Fulani breeds. Since, N’dama and Muturu breeds were observed to be trypano-tolerant; intensive breeding strategy, strain upgrading mechanisms and genetic modifications could be adopted to ensure other cattles’ survival and prevent disease transmission in the area and beyond.

Background & objectives: Clinical diagnosis of cutaneous leishmaniasis (CL) may bear a high rate of false diagnosis. This study assessed CL-suspected episodes, in an attempt to differentiate confirmed CL and non-CL diagnoses. Methods: In this retrospective, case-control study, medical files of CL-suspected episodes, tested by a biopsy for Leishmania-PCR, from 2013 to 2016, were collected and analysed statistically. Results: Of 324 suspected CL episodes, 48.8% were PCR-confirmed CL (96.2% Leishmania major) and 51.2% were non-CL (57.1% bacterial infections). Overall, 59.3% episodes were in males. Mean (± SD) duration until diagnosis was 3.7 ± 7.2 months. Lesions (mean 2.9 ± 3.8 per episode) were mostly (60.8%) sampled from September through February. Ulcer, pain, itching, purulent discharge and fever were recorded in 55.2, 47, 42.9, 18.2 and 4.7% of episodes, respectively. Univariate analysis showed that male gender, multiple lesions, ulcer, >1-month duration until diagnosis, and seasonality were associated with CL. Empiric CL treatment was recorded in 63.4 and 16% of CL-confirmed and non-CL episodes, respectively (p <0.001); and was observed to be associated with Jewish ethnicity, seasonality, multiple lesions, ulcer, absence of fever and duration of >1-month until diagnosis. In multivariate analysis, seasonality (odds ratio, OR = 2.144), empiric CL treatment (OR = 5.144) and ulcer (OR = 2.459) were associated with CL. Empiric CL treatment was associated with Jewish ethnicity (OR = 2.446) and duration of >1-month until diagnosis (OR = 3.304). Interpretation & conclusion: CL diagnosis should be laboratory confirmed, as clinical appearance is often misleading. Seasonality, ulcer appearance and gender may aid in correct identification and treatment of CL cases.

During zika and dengue viruse (ZIKV and DENV) outbreaks, the majority of the infected individuals remain clinically asymptomatic. Such asymptomatic individuals may occasionally acquire both arboviruses, donate blood, and contaminate haemoderivatives. The aim of this study was to characterize a ZIKV/DENV-4 coinfection in asymptomatic blood donor who donated blood during a large mixed ZIKV/DENV outbreak in the Säo Paulo State, Brazil. On the basis of post-donation information, one blood donor sample was found positive for ZIKV and DENV RNA. The DENV molecular serotyping was performed by molecular testing. The sample was also titrated on VERO E6 cells in order to define the presence of infectious arboviruses. The real-time PCR testing of the blood donor sample demonstrated very high viral load for both ZIKV and DENV. Further, molecular serotyping of DENV showed that the presence of DENV-4. The viral titration in cell culture indicated a titre of 2.75x10^[6] PFU/ml which was concordant with the presence of infectious viruses in the blood donation. This is an interesting report for the simultaneous presence of infectious ZIKV and DENV-4 in asymptomatic blood sample. Special attention must be paid during mixed arboviral outbreaks for the possibility of transfusion-transmission of multiple arboviral agents.

Molecular analysis of antifolate resistance-associated genes—dihydrofolate reductase (dhfr) and dihydropteroate synthetase (dhps) of Plasmodium vivax is important in predicting the emergence of drug resistance to sulphadoxine-pyrimethamine (SP). The present study aimed to determine the polymorphism of dhfr and dhps genes in P. vivax field isolates. Samples from 80 microscopically diagnosed vivax malaria cases were collected from endemic areas of malaria in Hormozgan Province of Iran, from June 2010 to November 2015. The two sets of codons at position 33, 57, 58, 117, 173 of dhfr and 382, 383, and 553 of dhps genes were analysed by direct sequencing of PCR products. The majority of the isolates (70%) harboured a wild-type allele for P. vivax dhfr (Pvdhfr) and P. vivax dhps (Pvdhps). Mutations were detected in three codons of Pvdhfr (P33L, S58R and S117N) and single codon in Pvdhps (A383G). Novel mutations that have not been identified previously at codon 459 (D459A) of Pvdhps were also observed. The high prevalence of point mutation as well as the rising triple mutation of Pvdhfr and Pvdhps genotypes necessitate change in programmes and guidelines to eliminate P. vivax in future.

Crimean-Congo haemorrhagic fever (CCHF) is a zoonotic viral haemorrhagic disease. This disease is more common in people who work with animals infected with CCHF virus. The aim of this study was to evaluate the CCHF exposure in high-risk occupational groups in Kurdistan Province in the west of Iran. This cross-sectional study was conducted in 2014 in three counties of Kurdistan Province, viz. Sanandaj, Marivan and Sarvabad. About 50 butchers and slaughterhouse workers, 50 hunters, 50 health care workers and 100 subjects referred to clinical laboratories were sampled and examined for the diagnosis of IgG antibodies against the CCHF using ELISA method. The serum sample of one of the butchers and slaughterhouse workers was positive for CCHF virus. No positive case was found in any other studied groups. The study findings indicate that although CCHF is an endemic disease in different parts of Iran, there is a low rate of seropositivity among high-risk occupations in the west of Iran. Therefore, it is not probably a serious public health problem in this area.