miércoles, 13 de febrero de 2013

Primaquine to prevent transmission of falciparum malaria LancetID2013

Primaquine to prevent transmission of falciparum malaria
The Lancet Infectious Diseases, Volume 13, Issue 2, February 2013, Pages 175-181
Falciparum malaria is transmitted by anopheline mosquitoes that have fed on blood containing gametocytes of Plasmodium falciparum. In areas of low malaria transmission, where symptomatic infections contribute substantially to malaria transmission, the use of gametocytocidal drugs reduces the incidence of malaria. Artemisinin-based combination therapies provide high cure rates and substantially reduce gametocyte carriage. Artemisinin resistance in P falciparum lessens overall gametocytocidal activity, which provides a selective pressure to the spread of these resistant parasites. The 8-aminoquinoline compounds possess unique gametocytocidal properties and rapidly sterilise the mature transmissible stages of P falciparum. The addition of one dose of primaquine to artemisinin-based combination regimens could help to counter the spread of artemisinin resistance. Although primaquine is commonly recommended for falciparum and vivax malaria, concerns about drug-related haemolysis frequently prevent its administration. The limited available evidence on transmission-blocking effects of primaquine and its forerunner plasmoquine suggests that doses lower than currently recommended (0•50–0•75 mg base per kg), which would be safer, might still be very effective.
Celis Salinas Juan Carlos
Médico Infectólogo/Tropicalista
Medicina del Viajero
CMP 40900 RNE 18872
Hospital Regional de Loreto, Iquitos, Perú
Cel: 51-1-998053121  RPM: *552633
Grupo de Investigación Peruano de Enfermedades Infecciosas y Tropicales

miércoles, 6 de febrero de 2013

American Trypanosomiasis: Chagas Disease One Hundred Years of Research

American Trypanosomiasis: Chagas Disease One Hundred Years of Research 


http://ecx.images-amazon.com/images/I/51RANaxZm2L._SL500_.jpg

Chagas disease causes severe socioeconomic impact and a high medical cost in Latin America. WHO and the World Bank consider Chagas disease as the fourth most transmittable disease to have a major impact on public health in Latin America:
120 million persons are potentially exposed, 16 to 18 million of whom are presently infected, causing 45,000 to 50,000 deaths per year. It has been calculated that approximately 2.4 million potential working years are lost because of incapacity and mortality due to the disease, for an annual cost estimated at 20 billion Euros. This book provides a comprehensive overview of Chagas disease and discusses the latest discoveries concerning the three elements that compose the transmission chain of the disease: The host: human and mammalian reservoirs. The insect vectors: domestic and sylvatic vectors. The causative parasite: Trypanosoma cruzi.
descargar:

link 1 
 

Link 2 
 

saludos
Daniel
Mediante SaludLoreto

domingo, 3 de febrero de 2013

The Laboratory Diagnosis and Follow Up of Strongyloidiasis 2013

The Laboratory Diagnosis and Follow Up of Strongyloidiasis: A Systematic Review

 Requena-Méndez A, Chiodini P, Bisoffi Z, Buonfrate D, Gotuzzo E, et al. (2013) The Laboratory Diagnosis and Follow Up of Strongyloidiasis: A Systematic Review. PLoS Negl Trop Dis 7(1): e2002. doi:10.1371/journal.pntd.0002002
PLoS Negl Trop Dis 2013

Abstract Background

Strongyloidiasis is frequently under diagnosed since many infections remain asymptomatic and conventional diagnostic tests based on parasitological examination are not sufficiently sensitive. Serology is useful but is still only available in reference laboratories. The need for improved diagnostic tests in terms of sensitivity and specificity is clear, particularly in immunocompromised patients or candidates to immunosuppressive treatments. This review aims to evaluate both conventional and novel techniques for the diagnosis of strongyloidiasis as well as available cure markers for this parasitic infection.

Methodology/Principal Findings

The search strategy was based on the data-base sources MEDLINE, Cochrane Library Register for systematic review, EmBase, Global Health and LILACS and was limited in the search string to articles published from 1960 to August 2012 and to English, Spanish, French, Portuguese and German languages. Case reports, case series and animal studies were excluded. 2003 potentially relevant citations were selected for retrieval, of which 1649 were selected for review of the abstract. 143 were eligible for final inclusion.

Conclusions

Sensitivity of microscopic-based techniques is not good enough, particularly in chronic infections. Furthermore, techniques such as Baermann or agar plate culture are cumbersome and time-consuming and several specimens should be collected on different days to improve the detection rate. Serology is a useful tool but it might overestimate the prevalence of disease due to cross-reactivity with other nematode infections and its difficulty distinguishing recent from past (and cured) infections. To evaluate treatment efficacy is still a major concern because direct parasitological methods might overestimate it and the serology has not yet been well evaluated; even if there is a decline in antibody titres after treatment, it is slow and it needs to be done at 6 to 12 months after treatment which can cause a substantial loss to follow-up in a clinical trial.

Fuente:
http://www.plosntds.org/article/info%3Adoi%2F10.1371%2Fjournal.pntd.0002002;jsessionid=6D5552F83EE3A494729E6160B69554AE

 

Celis Salinas Juan Carlos
Médico Infectólogo/Tropicalista
Medicina del Viajero
CMP 40900 RNE 18872
Hospital Regional de Loreto, Iquitos, Perú
Cel: 51-1-998053121  RPM: *552633
Grupo de Investigación Peruano de Enfermedades Infecciosas y Tropicales