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The objective of this study was to evaluate the occurrence of Clostridium perfringens in stool samples and swabs collected from wild mammals in the Amazon biome. Sixty-five faecal and swab samples were collected in situ and ex situ from 16 species and three genera of wild mammals, some of which were in good health and some of which had diarrhoea. After pre-enrichment, the samples were plated on selective agar for C. perfringens. Characteristic colonies were subjected to multiplex PCR for the detection of genes encoding the main C. perfringens toxins (alpha, beta, epsilon, and iota toxin and enterotoxin). Among the 65 samples, 40 (61.5%) were positive for the gene encoding the alpha toxin and were classified as type A, 36 of which were asymptomatic animals and four were diarrheal. No other toxinotypes were found. The findings of this study suggest that C. perfringens type A is commonly found in mammal species of the Amazon biome. This seems to be the first study to identify C. perfringens type A in species such as B. variegatus (common ground sloth), C. didactylus (two-toed sloth), P. flavus (Jupará), T. tetradactyla (anteater), S. collinsi (squirrel monkey), S. niger (black marmoset), and S. apella (Guyana capuchin) and in the genus Didelphis sp. (opossum).
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Dysbiosis corresponds to the disruption of a formerly stable, functionally complete microbiota. In the gut, this imbalance can lead to adverse health outcomes in both the short and long terms, with a potential increase in the lifetime risks of various noncommunicable diseases and disorders such as atopy (like asthma), inflammatory bowel disease, neurological disorders, and even behavioural and psychological disorders. Although antibiotics are highly effective in reducing morbidity and mortality in infectious diseases, antibiotic-associated diarrhoea is a common, non-negligible clinical sign of gut dysbiosis (and the only visible one). Re-establishment of a normal (functional) gut microbiota is promoted by completion of the clinically indicated course of antibiotics, the removal of any other perturbing external factors, the passage of time (i.e. recovery through the microbiota's natural resilience), appropriate nutritional support, and-in selected cases-the addition of probiotics. Systematic reviews and meta-analyses of clinical trials have confirmed the strain-specific efficacy of some probiotics (notably the yeast Saccharomyces boulardii CNCM I-745 and the bacterium Lactobacillus rhamnosus GG) in the treatment and/or prevention of antibiotic-associated diarrhoea in children and in adults. Unusually for a probiotic, S. boulardii is a eukaryote and is not therefore directly affected by antibiotics-making it suitable for administration in cases of antibiotic-associated diarrhoea. A robust body of evidence from clinical trials and meta-analyses shows that the timely administration of an adequately dosed probiotic (upon initiation of antibiotic treatment or within 48 h) can help to prevent or resolve the consequences of antibiotic-associated dysbiosis (such as diarrhoea) and promote the resilience of the gut microbiota and a return to the pre-antibiotic state. A focus on the prescription of evidence-based, adequately dosed probiotics should help to limit unjustified and potentially ineffective self-medication.
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Lacticaseibacillus rhamnosus , Probióticos , Saccharomyces boulardii , Adulto , Criança , Humanos , Antibacterianos/efeitos adversos , Diarreia/induzido quimicamente , Diarreia/prevenção & controle , Disbiose/induzido quimicamente , Disbiose/terapia , Probióticos/uso terapêutico , Saccharomyces cerevisiae , Metanálise como Assunto , Revisões Sistemáticas como AssuntoRESUMO
Cryptosporidium spp. are enteroparasitic protozoans that cause cryptosporidiosis in newborn calves. Clinical signs of the infection are diarrhoea and dehydration leading to decreased productivity and economic losses in cattle farms around the world. Additionally, cryptosporidiosis is a relevant zoonotic disease since the ingestion of oocysts can be fatal for children under five years of age, the elderly, and/or immunocompromised adults. This review aims to integrate existing knowledge on the epidemiological situation of calf cryptosporidiosis and associated risk factors in Argentina. In addition, the GP60 subtype diversity of the pathogen was analysed and related with the global distribution of corresponding GP60 subtypes. Depending on the study region and applied diagnostics, prevalence among calves up to 20 days of age varied between 25.2% and 42.5%, while a prevalence of 16.3-25.5% was observed at the age of 1-90 days. So far, molecular studies have determined exclusively Cryptosporidium parvum in preweaned calves. In addition, C. parvum infection was reported as the major cause of calf diarrhoea, followed by rotavirus A (RVA), while enteropathogens such as coronavirus, Escherichiacoli, and Salmonella sp. played a negligible role. Calf age of 20 days or less, incidence of diarrhoea, poorly drained soils, and large farm size were identified as risk factors for C. parvum-infection in Argentina. A total of nine GP60 subtypes (IIaAxxG1R1, xx = 16 to 24) were identified, showing a stepwise increase of the trinucleotide motif TCA, and including the zoonotic subtypes IIaA16G1R1, IIaA17G1R1, IIaA18G1R1, IIaA19G1R1, and IIaA20G1R1. We found that an increase in the A16âA24 trinucleotide repeat was accompanied by a gradual decrease in the global distribution of GP60 alleles, strongly suggesting that IIaA16G1R1 represents the primordial allelic variant of this group. Since identified GP60 alleles have a similar genetic background, we hypothesize that the continuous trinucleotide repeat array has been generated by stepwise repeat expansion of A16. The information gathered and integrated in this study contributes to an improved understanding of the epidemiological characteristics of bovine cryptosporidiosis in and beyond Argentina, which in turn can help to develop control strategies for this parasitosis of veterinary and medical relevance.
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BACKGROUND: Probiotics are effective for treating acute infectious diarrhoea caused by bacteria, but there are inconsistent results for the effectiveness of probiotics for diarrhoea caused by viruses. In this article we want to determine whether Sb supplementation has an effect on acute inflammatory viral diarrhoea diagnosed with the multiplex panel PCR test. The aim of this study was to evaluate the efficacy of Saccharomyces boulardii (Sb) as a treatment in patients diagnosed with viral acute diarrhoea. METHODS: From February 2021 to December 2021, 46 patients with a confirmed diagnosis of viral acute diarrhoea diagnosed with the polymerase chain reaction multiplex assay were enrolled in a double-blind, randomized placebo-controlled trial. Patients received paracetamol 500 mg as a standard analgesic and 200 mg of Trimebutine as an antispasmodic treatment plus 600 mg of Sb (n = 23, 1 × 109/100 mL Colony forming unit) or a placebo (n = 23) orally once daily for eight days. The improvement in and severity of symptoms were measured using a symptom diary, the Patient Global Impression and the Patient Global Impression of Change scales (days 4 and 8), both answered and recorded by the patient. RESULTS: Of the 46 patients who completed treatment, 24 (52%) were men and 22 (48%) were women. The average age was 35.6 ± 12.28 years (range 18 to 61 years). The average duration of the evolution of illness at the time of diagnosis was 0.85 ± 0.73 days (maximum 2 days). On day 4 after the diagnosis, 20% reported pain and 2% reported fever, but on day 8, no patient reported pain or fever. On day 4, 70% of patients in the Sb group and 26% in the placebo group reported improvement (P = 0.03), based on the Patients' Global Impression of Change scale, which assesses patient's rating of overall improvement. These findings suggest that 3 to 4 days of treatment with Sb helped to improve symptoms of diarrhoea caused by a virus. CONCLUSION: Treatment with Sb on acute inflammatory diarrhoea of viral aetiology shows no changes regarding the severity of the symptoms; nevertheless, it seems to impact improvement positively. TRIAL REGISTRATION: 22CEI00320171130 dated on 16/12/2020, NCT05226052 dated on 07/02/2022.
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Enterite , Probióticos , Saccharomyces boulardii , Saccharomyces , Masculino , Humanos , Adulto , Feminino , Adolescente , Adulto Jovem , Pessoa de Meia-Idade , Resultado do Tratamento , Saccharomyces cerevisiae , Diarreia/terapia , Diarreia/microbiologia , Probióticos/uso terapêutico , Método Duplo-CegoRESUMO
El síndrome urémico hemolítico (SUH), descripto en 1955, se caracteriza por la tríada de anemia hemolítica no inmunomediada, trombocitopenia y lesión renal aguda. En su patogenia interviene la toxina Shiga, producida con mayor frecuencia por E. coli O157:H. Puede manifestarse a cualquier edad, aunque es infrecuente en adultos, y se desarrolla en forma esporádica o en brote. Se presenta con un cuadro de dolor abdominal, diarrea, fiebre y vómitos. Puede afectar el sistema nervioso central, pulmones, páncreas y corazón. En adultos, el síndrome evoluciona tras un período de incubación de 1 semana posterior a la diarrea y tiene alta morbimortalidad, a diferencia de los casos pediátricos. Presentamos el caso de una paciente adulta, que cursó internación por síndrome urémico hemolítico. (AU)
Hemolytic uremic syndrome (HUS), described in 1955, is characterized by the triad of non-immune mediated hemolytic anemia, thrombocytopenia, and acute kidney injury. Shiga toxin, produced most frequently by E coli O157:H, is involved in its pathogenesis. Hus can manifest at any age, although it is rare in adults and develops sporadically or in outbreaks. HUS presents with a picture of abdominal pain, diarrhea, fever and vomiting. It can affect the central nervous system, lungs, pancreas, and heart.In adults, the syndrome evolves after an incubation period of 1 week after diarrhea, with high morbidity and mortality, unlike pediatric cases.We present the case of an adult patient who was hospitalized for hemolytic uremic syndrome. (AU)
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Humanos , Feminino , Pessoa de Meia-Idade , Escherichia coli O157/isolamento & purificação , Infecções por Escherichia coli/complicações , Síndrome Hemolítico-Urêmica/patologia , Síndrome Hemolítico-Urêmica/diagnóstico por imagem , Reação em Cadeia da Polimerase , Diarreia/etiologia , Síndrome Hemolítico-Urêmica/dietoterapia , Síndrome Hemolítico-Urêmica/sangue , Síndrome Hemolítico-Urêmica/terapia , Infusões Parenterais , Testes de Função RenalRESUMO
Background: Cystoisospora spp. is considered a potential pathogen to cause diarrhoea in cats, and the disease occurs clinically, especially in young, weak and immunocompromised cats. The present study aimed to evaluate the clinical utility and diagnostic roles of neutrophil-to-lymphocyte ratio (NLR) and monocyte-to-lymphocyte (MLR) ratios in diarrheal cats infected with Cystoisospora spp. Materials, Methods & Results: Twenty-five cats with diarrhea due to infection caused by Cystoisospora spp. and 15 healthy cats were included in this study. The anamnesis, clinical and laboratory findings of all cats were recorded. A clinical severity score was generated for diarrheal cats, which included activity, appetite, presence of vomit, and faecal consistency. Also, cats infected with Cystoisospora spp. were classified as systemic inflammatory response syndrome (SIRS) positive (+) and SIRS (-) group according to the presence of at least 3 of the SIRS criteria. The Cystoisospora spp. oocysts were diagnosed by direct smear and simple faecal flotation. Cats found positive for other parasitic and protozoal agents by faeces examination were excluded from the study. Complete blood counts (CBC) were performed with an automated blood cell counter for all cats. Blood smears were prepared (with May-Grunwald Giemsa) from samples, and the CBC results were confirmed microscopically (obj.100x). White blood cell (WBC), neutrophil, lymphocyte and monocyte counts were recorded directly from the CBC. The neutrophil-to-lymphocyte ratio was calculated as the ratio of the absolute neutrophil count to the absolute lymphocyte count. The monocyte-to-lymphocyte was calculated as the absolute monocyte count ratio to the absolute lymphocyte count. White blood cell (P = 0.015), neutrophil (P = 0.001), monocyte (P = 0.033), NLR (P = 0.000) and MLR (P = 0.042) of diarrheal cats infected with Cystoisospora spp. were significantly higher than in the healthy group. There was no significant difference between groups in the lymphocyte counts (P > 0.05). SIRS (+) group had statistically significantly higher WBC (P = 0.014), neutrophil counts (P = 0.000), NLR (P = 0.000) and MLR (P = 0.037) than the healthy group. Also, neutrophil counts and NLR of the SIRS (+) group were statistically significantly higher than the SIRS (-) group (P = 0.032; P = 0.001, respectively). However, there was no significant difference SIRS (+), SIRS (-), and healthy groups regarding lymphocyte and monocyte counts (P > 0.05). The clinical severity of the disease positively correlated with NLR and MLR. Also, the best cut-off value of NLR to predict SIRS was > 1.67, with 92.86% sensitivity and 84.62% specificity. MLR was not a useful predictor for SIRS. Discussion: NLR and MLR are parameters derived from complete blood count. In recent years, they have been used in human and veterinary medicine as a biomarker in the diagnosis, prognosis and treatment follow-up of various diseases and provide valuable information about inflammation. In cats, there are limited studies on NLR, and to our knowledge, there are no studies on MLR. The current study suggests that NLR and MLR may be used to determine the severity of the inflammatory condition in diarrheal cats infected with Cystoisospora spp., and NLR is a useful marker for predicting SIRS status in these cats. In addition, this study also will contribute to larger-scale studies in the future.
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Animais , Gatos , Linfócitos , Monócitos , Síndrome de Resposta Inflamatória Sistêmica/veterinária , Isosporíase/veterinária , Diarreia/veterinária , NeutrófilosRESUMO
OBJECTIVE: There is still no consensus on the impact of using solar disinfection (SODIS) to reduce the prevalence of waterborne gastrointestinal diseases. The reported reduction in diarrhoea prevalence among SODIS users has been attributed to the consumption of water free of viable pathogens. However, it has also been suggested that ingestion of SODIS-inactivated pathogens may induce protective immunological changes that may also contribute to a reduction in the frequency of diarrhoea. The present study aimed to critically review the epidemiological and immunological gains of using SODIS. METHODS: We critically reviewed 22 articles published in English, selected from 2118 records systematically retrieved from the databases. RESULTS: All trials (except one) reported a significant reduction in diarrhoea prevalence among children using SODIS, but some of the data from trials report contrary findings. All in vitro and in vivo assays indicate that SODIS-inactivated pathogenic bacteria have the potential to induce immunological alterations that may result in protective immunological effects. Studies with a low risk of bias are still awaited to confirm the ability to use SODIS to reduce the prevalence of diarrhoea. CONCLUSION: Reducing the prevalence of diarrhoea depends on the success of SODIS delivery strategies in inducing behavioural changes in communities that result in the production of SODIS-compliant outcomes. The results of trials reporting a reduction in the prevalence of diarrhoea due to the use of SODIS seem to support the hypothesis of the contribution of the protective immunological effect against diarrhoea in SODIS users.
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Purificação da Água , Doenças Transmitidas pela Água , Criança , Diarreia/epidemiologia , Diarreia/microbiologia , Diarreia/prevenção & controle , Desinfecção/métodos , Humanos , Luz Solar , Microbiologia da Água , Purificação da Água/métodos , Abastecimento de ÁguaRESUMO
BACKGROUND: Unsafe drinking water, poor sanitation and hygiene, exposure to household air pollution and low cognitive and socio-emotional stimulation are risk factors affecting children in low- and middle-income countries. We implemented an integrated home-environmental intervention package (IHIP), comprising a kitchen sink, hygiene education and a certified improved biomass cookstove, and an early child development (ECD) programme to improve children´s health and developmental outcomes in the rural high-altitude Andes of Peru. METHODS: We conducted a one-year cluster-randomised controlled trial among 317 children < 36 months divided into 4 arms (IHIP + ECD, IHIP, ECD, and Control) and 40 clusters (10 clusters per arm). ECD status (socio-emotional, fine and gross motor, communication, cognitive skills, and an overall performance) measured with the Peruvian Infant Development Scale and the occurrence of self-reported child diarrhoea from caretakers were primary outcomes. Secondary outcomes included the occurrence of acute respiratory infections and the presence of thermo-tolerant faecal bacteria in drinking water. The trial was powered to compare each intervention against its control arm but it did not allow pairwise comparisons among the four arms. Primary analysis followed the intention-to-treat principle. For the statistical analysis, we employed generalised estimating equation models with robust standard errors and an independent correlation structure. RESULTS: We obtained ECD information from 101 children who received the ECD intervention (individually and combined with IHIP) and 102 controls. Children who received the ECD intervention performed better in all the domains compared to controls. We found differences in the overall performance (64 vs. 39%, odd ratio (OR): 2.8; 95% confidence interval (CI): 1.6-4.9) and the cognitive domain (62 vs 46%, OR: 1.9; 95% CI: 1.1-3.5). Data analysis of child morbidity included 154 children who received the IHIP intervention (individually and combined with ECD) and 156 controls. We recorded 110,666 child-days of information on diarrhoea morbidity and observed 1.3 mean episodes per child-year in the children who received the IHIP intervention and 1.1 episodes in the controls. This corresponded to an incidence risk ratio of 1.2 (95% CI: 0.8-1.7). CONCLUSIONS: Child stimulation improved developmental status in children, but there was no health benefit associated with the home-environmental intervention. Limited year-round access to running water at home and the possible contamination of drinking water after boiling were two potential factors linked to the lack of effect of the home-environmental intervention. Potential interactions between ECD and home-environmental interventions need to be further investigated. TRIAL REGISTRATION: ISRCTN, ISRCTN-26548981. Registered 15 January 2018-Retrospectively registered, https://doi.org/10.1186/ISRCTN26548981 .
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Saúde da Criança , Água Potável , Altitude , Criança , Desenvolvimento Infantil/fisiologia , Diarreia/epidemiologia , Diarreia/prevenção & controle , Água Potável/microbiologia , Humanos , Lactente , Peru/epidemiologia , População RuralRESUMO
Rotaviruses species A (RVA) are etiological agents of diarrhoea and are considered zoonotic viruses; yet the epidemiology of RVA among pet animals is largely unknown. RVA was detected in 38 of 308 faecal samples (12.3%) from pet, sheltered, or stray dogs and cats in 2 municipalities of Rio de Janeiro state, Brazil. The results indicated that these viruses are common in canine and feline populations and underscore the importance of improved monitoring of common pathogens in companion animals, with increased awareness of the potential for interspecies transmission events.
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Doenças do Gato , Doenças do Cão , Infecções por Rotavirus , Animais , Brasil/epidemiologia , Doenças do Gato/epidemiologia , Gatos , Doenças do Cão/epidemiologia , Cães , Genótipo , Filogenia , Infecções por Rotavirus/epidemiologia , Infecções por Rotavirus/veterináriaRESUMO
Incomptines A (IA) and B (IB) are two sesquiterpene lactones with antiprotozoal, antibacterial, cytotoxic, antitumor, spermicidal, and phytotoxic properties. The antibacterial activity of IA and IB against bacteria causing diarrhoea have been reported; however, no information is available regarding their antibacterial activity on Vibrio cholerae. In this work, both compounds were evaluated for their anti-diarrhoeal potential using the bacterium V. cholerae, sodium dodecyl sulphate-polyacrylamide gel electrophoresis (SDS-PAGE) analysis on cholera toxin, and a cholera toxin-induced diarrhoea model in male Balb/c mice. In addition, a molecular docking study was carried out to understand the interaction of IA and IB with cholera toxin. In terms of antibacterial activity, IB was three times more active than IA on V. cholerae. In the case of SDS-PAGE analysis and the in silico study, IA was most effective, revealing its potential binding mode at a molecular level. In terms of anti-diarrhoeal activity, IA was 10 times more active than IB and racecadotril, an antisecretory drug used as positive control; the anti-diarrheal activity of IB was also closer than racecadotril. The results obtained from in vitro, in vivo, and computational studies on V. cholerae and cholera toxin support the potential of IA and IB as new anti-diarrhoeal compounds.
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OBJECTIVE: To describe the epidemiology of laboratory-confirmed Diarrhoeagenic Escherichia coli (DEC) cases from active facility-based surveillance in Guatemala. METHODS: We collected clinical and risk factor data on enrolled patients (aged 0-52 years) with acute diarrhoea at government healthcare facilities (1 hospital and 6 clinics) in Santa Rosa, Guatemala, during 2008-2009 and 2014-2015. Stool samples were analysed, E. coli identified through culture and biochemical tests, PCR amplification of genes encoding pathotype-specific virulence factors identified specific DEC pathotypes. Healthcare-seeking adjusted incidence rates were calculated. RESULTS: A total of 3041 diarrhoea cases were captured by surveillance (647 hospitalisations (H), 2394 clinic visits (CV)); general E. coli prevalence was 17.9%. DEC pathotypes were identified in 19% (n = 95/497) and 21% (n = 450/2113) in diarrhoea H and CV, respectively. Enteropathogenic E. coli (EPEC) was most frequently isolated (8.2% (n = 41) in diarrhoea H, 12.0% (n = 255) in diarrhoea CV), followed by ETEC (6.8% (n = 34) in H, 6% (n = 128) in CV) and STEC (0.6% (n = 3) in H, 0.6% (n = 13) in CV). We did not find evidence of a difference in severity between DEC and non-DEC diarrhoea. Incidence of DEC clinic visits and hospitalisations was 648.0 and 29.3, respectively, per 10,000 persons aged ≤5 years and 36.8 and 0.4, respectively, per 10,000 persons aged >5 years. CONCLUSIONS: DEC pathotypes, especially EPEC and ETEC, were detected frequently from patients presenting with diarrhoeal illness in Santa Rosa, Guatemala. Our findings suggest that preventive interventions should be prioritised for young children.
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Infecções por Escherichia coli , Rosa , Adolescente , Adulto , Criança , Pré-Escolar , Diarreia/epidemiologia , Escherichia coli/genética , Infecções por Escherichia coli/epidemiologia , Fezes , Guatemala/epidemiologia , Humanos , Lactente , Recém-Nascido , Pessoa de Meia-Idade , Adulto JovemRESUMO
Porcine epidemic diarrhoea virus (PEDV) infects pigs of all ages causing vomiting and diarrhoea. PEDV is transmitted via the oral-faecal route, and a very low dose is enough to infect susceptible pigs, resulting in significant production losses. This short communication aims to describe the introduction of PEDV into a 10,000-sow farrow-to-wean farm located in northwest Mexico. Following the onset of clinical signs, an outbreak investigation was conducted to determine the most probable route of introduction. Based on data collected from interviews, construction of a timeline of events, and the detection of PEDV RNA in feed samples and samples collected from various surfaces of feed transport vehicles, it was concluded that the most probable route for PEDV incursion into this breeding herd was contaminated feed or a contaminated feed transport vehicle. This paper describes how feed or feed transport could serve as potential routes of PEDV infection to a farm and highlights the importance of establishing biosecurity programs to mitigate these risks.
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Ração Animal/virologia , Infecções por Coronavirus , Contaminação de Alimentos , Vírus da Diarreia Epidêmica Suína , Doenças dos Suínos , Animais , Biosseguridade , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/transmissão , Infecções por Coronavirus/veterinária , Diarreia/epidemiologia , Diarreia/veterinária , Surtos de Doenças/veterinária , Feminino , México/epidemiologia , Vírus da Diarreia Epidêmica Suína/genética , Suínos , Doenças dos Suínos/epidemiologia , Doenças dos Suínos/transmissão , Doenças dos Suínos/virologiaRESUMO
The aetiology of diarrhoea in a patient in Cuba with HIV was investigated. Although molecular diagnostics are still not used in many under-resourced settings, here traditional methods were supported by use of PCR. This approach enabled detection of a dual infection (Cystoisospora belli and Enterocytozoon bieneusi), the latter of which was not identified by microscopy with Didier's trichromic staining.
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Coccidiose/diagnóstico , Diarreia/diagnóstico , Enterocytozoon/isolamento & purificação , Microsporidiose/diagnóstico , Sarcocystidae/isolamento & purificação , Adulto , Anti-Infecciosos/uso terapêutico , Coccidiose/tratamento farmacológico , Cuba , Diarreia/microbiologia , Diarreia/parasitologia , Enterocytozoon/genética , Infecções por HIV/complicações , Infecções por HIV/tratamento farmacológico , Humanos , Hospedeiro Imunocomprometido , Masculino , Microsporidiose/tratamento farmacológico , Técnicas de Diagnóstico Molecular , Reação em Cadeia da Polimerase , Sarcocystidae/genética , Sarcoma de Kaposi/complicações , Sarcoma de Kaposi/tratamento farmacológico , Combinação Trimetoprima e Sulfametoxazol/uso terapêuticoRESUMO
PURPOSE: Blastocystis spp. are parasites of the intestinal tract found in many hosts including humans. This pathogen is commonly found in immunocompetent in asymptomatic individuals and in patients with gastrointestinal and extra-intestinal symptoms. Recently, it has been implicated as an important cause of diarrheal illness in immunocompromised individuals, including HIV-infected patients. At least six life cycle stages have been described in faeces and cultures, namely vacuolar, granular, multi-vacuolar, avacuolar, ameboid and cyst forms. The aim of the present study was to describe the histological findings of Blastocystis infection in an adult HIV-infected patient with gastrointestinal symptoms. METHODS: Parasitological techniques and PCR were applied to stool samples. Histological analysis was performed on duodenal biopsy specimens. RESULTS: Standard parasitological methods revealed vacuolar, granular, cyst and multi-vacuolar forms of Blastocystis in faecal samples with the presence of Blastocystis DNA being confirmed by PCR. DNA sequencing revealed Blastocystis subtype ST1. Histological findings in duodenal samples showed an inflammatory infiltrate with plasma cells and lymphocytes. We identified cyst, granular, ameboid and multi-vacuolar forms in the lumen. CONCLUSION: To our knowledge, there are no previous peer review reports describing these four different forms of Blastocystis in histological sections from the lumen and the brush border of the enterocytes.
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Infecções por Blastocystis , Blastocystis , Infecções por HIV , Adulto , Animais , Blastocystis/genética , Infecções por Blastocystis/diagnóstico , Infecções por Blastocystis/parasitologia , Fezes/parasitologia , Infecções por HIV/complicações , Humanos , Intestino Delgado , Estágios do Ciclo de VidaRESUMO
The aim of this study was to assess the addition of intestinal alkaline phosphatase (IAP) to diets on the count of bacterial populations, pH of digestive organ contents, histopathological description, proinflammatory markers, hepatic glycogen reserve, and diarrhoea incidence of piglets challenged with Escherichia coli. Sixty-four crossbred piglets (7.16±0.28 kg body weight, 25-days-old) were assigned to four treatments in a completely randomised block design: negative control (NC), NC + antibiotic (ANT), NC + 15 mg IAP, or NC + 30 mg IAP kg−1 of diet, eight replications of two piglets per experimental unit. All piglets were orally challenged with 6 mL of a solution containing enterotoxigenic Escherichia coli K88 at 106 CFU mL−1 at 15 days of experimentation. The study lasted for 19 days. At the end of the experimental period, the piglets were slaughtered (six animals per treatment). Enterobacteriaceae in caecum and colon was lower in piglets on 30 mg IAP than with ANT and NC, ANT or 15 mg IAP, respectively. Enterobacteriaceae adhered to the mesenteric lymph nodes (MLN) was greater in piglets fed ANT than the other treatments. Lactic acid bacteria (LAB) count in caecum was greater in piglets fed NC and ANT. In MLN, LAB count was greater in ANT and 30 mg IAP-fed piglets compared with 15 mg IAP. Piglets in 30 mg IAP in diet showed a tendency for lowering tissue necrosis compared with NC or ANT. Piglets fed 30 mg IAP showed a reduction in diarrhoea incidence in the pre- and post-challenge compared with 15 mg IAP and all other treatments, respectively. Based on the criteria, addition of 30 mg IAP to diet inhibits Enterobacteriaceae population and suggests a potential effect in mitigating intestinal injuries, as observed in piglets in the NC for some of the parameters investigated.(AU)
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Animais , Suínos/fisiologia , Fosfatase Alcalina/efeitos adversos , Intestinos/fisiologiaRESUMO
INTRODUCTION: According to the WHO, anaemia is a severe public health problem when the prevalence is ≥ 40 %. In 2019, in Peru, 40·1 % of children (aged 6 to 35 months) are diagnosed as anaemic. This is a concern since, despite the efforts of the governments to reduce the prevalence, the problem has stagnated since 2011. The treatment applied to deal with anaemia is Fe supplementation. Although Fe is essential for cell function, an excess can produce adverse responses, such as gut inflammation affecting microbiota and resulting in diarrhoeic episodes. OBJECTIVE: To determine the association between diarrhoea and Fe supplementation in children with and without anaemia, controlling for different socio-demographic variables. DESIGN: We conducted via logistic regression to obtain diarrhoea prevalence ratios (PR), adjusted by age, sex, geographic region, water and sanitation service, and rurality. The survey asked for recent episodes of diarrhoea during the last 7 d; similarly, after the consumption of Fe supplements during the last 12 months before the survey. SETTING: Peru. PARTICIPANTS: The Demographic and Family Health Survey (DHS) is conducted annually at home among 14 202 children on average (2009-2019). RESULTS: Fe supplementation in the last 7 d (PR = 1·09) or the last 12 months (PR = 1·19) (P < 0·0001) was associated with an increased risk of diarrhoea. The same association was observed between Fe supplementation and the presence of anaemia. CONCLUSIONS: Fe supplementation is associated with diarrhoea and overuse in children should be avoided.
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BACKGROUND: Nigeria is the second biggest contributor to global child mortality. Infectious diseases continue to be major killers. In Bauchi State, Nigeria, a stepped wedge cluster randomised controlled trial tested the health impacts of universal home visits to pregnant women and their spouses. We present here the findings related to early child health. METHODS: The home visits took place in eight wards in Toro Local Government Authority, randomly allocated into four waves with a delay of 1 year between waves. Female and male home visitors visited all pregnant women and their spouses every 2 months during pregnancy, with a follow up visit 12-18 months after the birth. They presented and discussed evidence about household prevention and management of diarrhoea and immunisation. We compared outcomes among children 12-18 months old born to mothers visited during the first year of intervention in each wave (intervention group) with those among children 12-18 months old pre-intervention in subsequent waves (control group). Primary outcomes included prevalence and management of childhood diarrhoea and immunisation status, with intermediate outcomes of household knowledge and actions. Generalised Estimating Equations (GEE), with an exchangeable correlation matrix and ward as cluster, tested the significance of differences in outcomes. RESULTS: The analysis included 1796 intervention and 5109 control children. In GEE models including other characteristics of the children, intervention children were less likely to have suffered diarrhoea in the last 15 days (Odds Ratio (OR) 0.40, 95% confidence interval (CI) 0.30-0.53) and more likely to have received increased fluids and continued feeding in their last episode of diarrhoea (OR 6.06, 95% CI 2.58-14.20). Mothers of intervention children were more likely to identify lack of hygiene as a cause of diarrhoea (OR 2.24, 95% CI 1.27-3.95) and their households had better observed hygiene (OR 3.29, 95% CI 1.45-7.45). Intervention children were only slightly more likely to be fully immunised (OR 1.67, 95% CI 0.78-3.57). CONCLUSIONS: Evidence-based home visits to both parents stimulated household actions that improved prevention and management of childhood diarrhoea. Such visits could help to improve child health even in settings with poor access to quality health services. TRIAL REGISTRATION: ISRCTN82954580 . Date: 11/08/2017. Retrospectively registered.
Assuntos
Saúde da Criança , Visita Domiciliar , Criança , Características da Família , Feminino , Humanos , Lactente , Masculino , Nigéria/epidemiologia , Parto , GravidezRESUMO
Pooled samples are used in veterinary and human medicine as a cost-effective approach to monitor disease prevalence. Nonetheless, there is limited information on the effect of pooling on test performance, and research is required to determine the appropriate number of samples which can be pooled. Therefore, this study aimed to evaluate the use of pooled serum samples as a herd-level surveillance tool for infectious production-limiting diseases: bovine viral diarrhoea (BVD), infectious bovine rhinotracheitis (IBR), enzootic bovine leukosis (EBL) and Neospora caninum (NC), by investigating the maximum number of samples one can pool to identify one positive animal, using commercial antibody-detection ELISAs. Four positive field standards (PFS), one for each disease, were prepared by pooling highly positive herd-level samples diagnosed using commercially available ELISA tests. These PFS were used to simulate 18 pooled samples ranging from undiluted PFS to a dilution representing 1 positive in 1,000 animals using phosphate-buffered saline as diluent. A 1:10 dilution of the PFS resulted in positive results for IBR, BVD and EBL. Moreover, for IBR and BVD, results were still positive at 1:100 and 1:30 dilutions, respectively. However, for NC, a lower dilution (8:10) was required for a seropositive result. This study indicates that, at herd-level, the use of pooled serum is a useful strategy for monitoring infectious diseases (BVD, IBR and EBL) but not NC, using readily available diagnostic assays.
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Doença das Mucosas por Vírus da Diarreia Viral Bovina , Doenças dos Bovinos , Vírus da Diarreia Viral Bovina , Leucose Enzoótica Bovina , Rinotraqueíte Infecciosa Bovina , Animais , Doença das Mucosas por Vírus da Diarreia Viral Bovina/diagnóstico , Doença das Mucosas por Vírus da Diarreia Viral Bovina/epidemiologia , Bovinos , Doenças dos Bovinos/diagnóstico , Doenças dos Bovinos/epidemiologia , Ensaio de Imunoadsorção Enzimática/veterinária , Rinotraqueíte Infecciosa Bovina/diagnóstico , Rinotraqueíte Infecciosa Bovina/epidemiologiaRESUMO
BACKGROUND AND PURPOSE: Severe diarrhoea, a common gastrointestinal manifestation of anticancer treatment with irinotecan, might involve single nucleotide polymorphisms (SNPs) of toll-like receptors (TLRs), described as critical bacterial sensors in the gut. Here, colorectal cancer patients carrying missense TLR4 A896G (rs4986790) or C1,196T (rs4986791) SNPs and Tlr4 knockout (Tlr4-/-) mice were given irinotecan to investigate the severity of the induced diarrhoea. EXPERIMENTAL APPROACH: Forty-six patients treated with irinotecan-based regimens had diarrhoea severity analysed according to TLR4 genotypes. In the experimental setting, wild-type (WT) or Tlr4-/- mice were given irinotecan (45 or 75 mg·kg-1 , i.p.) or saline (3 ml·kg-1 ). Diarrhoea severity was evaluated by measuring intestinal injury and inflammatory markers expression after animals were killed. KEY RESULTS: All patients with TLR4 SNPs chemotherapy-treated presented diarrhoea, whereas gastrointestinal toxicity was observed in 50% of the wild homozygous individuals. Mice injected with irinotecan presented systemic bacterial translocation and increased TLR4 immunostaining in the intestine. In line with the clinical findings, Tlr4 gene deficiency enhanced irinotecan-related diarrhoea and TLR9 expression in mice. An increased myeloperoxidase activity and Il-18 expression along with IL-10 decreased production in Tlr4-/- mice also indicated an intensified intestinal damage and inflammatory response. CONCLUSION AND IMPLICATIONS: TLR4 deficiency upregulates TLR9 expression and enhances intestinal damage and the severity of late-onset diarrhoea during irinotecan-based treatment. Identifying patients genetically predisposed to chemotherapy-associated diarrhoea is a strategy toward precision medicine.
Assuntos
Diarreia , Irinotecano , Mucosite , Receptor 4 Toll-Like , Receptor Toll-Like 9 , Animais , Diarreia/induzido quimicamente , Diarreia/genética , Humanos , Irinotecano/toxicidade , Camundongos , Mucosite/induzido quimicamente , Mucosite/genética , Receptor 4 Toll-Like/genética , Receptor Toll-Like 9/genéticaRESUMO
BACKGROUND: In some areas of the world, breast milk is seen as a potential source of child diarrhoea. While this belief has been explored in African and Southeast Asian countries, it remains vastly understudied in Latin American contexts. We investigate socio-cultural factors contributing to breastfeeding cessation in rural high-altitude populations of the Peruvian Andes. The role of socio- cultural factors in the local explanatory model of child diarrhoea, and whether these perceptions were integrated in the local healthcare system were assessed. METHODS: Within the framework of a randomised controlled trial, we conducted semi-structured interviews with 40 mothers and 15 health personnel from local healthcare centres involved in the trial. RESULTS: Cultural beliefs on breastfeeding cessation included the perception that breast milk turned into "blood" after six months and that breastfeeding caused child diarrhoea. We identified eight local types of child diarrhoea, and women linked six of them with breastfeeding practices. "Infection" was the only diarrhoea mothers linked to hygiene and the germ disease concept and perceived as treatable through drug therapy. Women believed that other types of diarrhoea could not be treated within the formal healthcare sector. Interviews with health personnel revealed no protocol for, or consensus about, the integration of the local explanatory model of child diarrhoea in local healthcare and service provision. CONCLUSIONS: The local explanatory model in rural Andean Peru connected breastfeeding with child diarrhoeas. Cultural beliefs regarding diarrhoea management may increase home treatments, even in cases of severe diarrhoeal episodes. Future national breastfeeding support programmes should promote peer-counselling approaches to reduce negative attitudes towards breastfeeding and health practitioners. Local explanatory models should be incorporated into provincial and regional strategies for child diarrhoea management to promote equity in health and improve provider-patient relationships.
RESUMEN: ANTECEDENTES: En diferentes partes del mundo, la leche materna es percibida como una fuente potencial de diarreas infantiles. Mientras que estas creencias se han estudiado en África o el Sudeste Asiático, su análisis en el contexto latinoamericano es limitado. Esta investigación se centra en el estudio de los factores culturales que contribuyen al cese de la lactancia materna en poblaciones rurales de los Andes peruanos. Al mismo tiempo, también se analiza el papel de estos factores culturales en el modelo explicativo local de diarreas infantiles y la integración de las creencias en los servicios locales de salud. MéTODOS: Dentro de un ensayo clínico aleatorizado, se llevaron a cabo entrevistas semi-estructuradas con 40 mujeres y 15 trabajadores de salud de centros participantes en el ensayo. RESULTADOS: Las creencias culturales en torno a la lactancia maternal incluían la percepción de que la leche materna se convierten en "sangre" a los seis meses del parto y que la leche materna causaba diarreas en los niños lactantes. Identificamos ocho tipos de diarreas locales, seis de las cuales fueron asociadas con la lactancia por las madres participantes. "Infección" resultó ser el único tipo de diarrea que las madres asociaron con los principios de la higiene y la teoría microbiana de la enfermedad y percibían como curable por medio de medicamentos. Las mujeres creían que el resto de diarreas locales no podían ser tratadas dentro del sistema de salud. Las entrevistas con el personal sanitario indicaron una falta de protocolos y consenso sobre cómo integrar el sistema de creencias locales en torno a las diarreas infantiles en los servicios de salud. CONCLUSIONES: El modelo explicativo local en zonas rurales de los Andes peruanos asocia la lactancia con las diarreas infantiles. Estas creencias culturales dan lugar a prácticas de manejo de diarreas infantiles que pueden incrementar los tratamientos domiciliarios, incluso en episodios de diarrea severos. Futuros programas nacionales de apoyo a la lactancia materna deben promover la consejería y apoyo de pares y profesionales de salud con la finalidad de reducir las actitudes negativas hacia la lactancia materna y el personal de salud. Los modelos explicativos locales de las diarreas infantiles deberían incorporarse a las estrategias provinciales y regionales con la finalidad de promover la equidad en salud y mejorar las relaciones médico-paciente.