Plasmodium falciparum resistance to sulfadoxine/pyrimethamine in Uganda: correlation with polymorphisms in the dihydrofolate reductase and dihydropteroate synthetase genes.

The efficacy of sulfadoxine/pyrimethamine (S/P) in treatment of uncomplicated falciparum malaria in Africa is increasingly compromised by development of resistance. The occurrence of active site mutations in the Plasmodium falciparum gene sequences coding for dihydrofolate reductase (DHFR) and dihydropteroate synthetase (DHPS) is known to confer resistance to pyrimethamine and sulfadoxine. This study investigated the occurrence of these mutations in infected blood samples taken from Ugandan children before treatment with S/P and their relationship to parasite breakthrough by day 7.

Isolation of high-affinity peptide antagonists of 14-3-3 proteins by phage display.

The 14-3-3 proteins interact with diverse cellular molecules involved in various signal transduction pathways controlling cell proliferation, transformation, and apoptosis. To aid our investigation of the biological function of 14-3-3 proteins, we have set out to identify high-affinity antagonists. By screening phage display libraries, we have identified a set of peptides which bind 14-3-3 proteins.

Population structure of recrudescent Plasmodium falciparum isolates from western Uganda.

It has been proposed that polymorphisms of the Merozoite Surface Protein 1 and 2 (MSP1 and MSP2) and the Glutamate Rich Protein (GLURP) genes can be considered as genetic markers for the genotyping of field populations of Plasmodium falciparum. During a field study on in vivo drug resistance against chloroquine, sulphadoxine/pyrimethamine (S/P) and cotrimoxazole in West Uganda, sensitive and resistant isolates were collected from patients by fingerprick for genotyping. 59 (72.

Plasmodium falciparum: selection of serine 108 of dihydrofolate reductase during treatment of uncomplicated malaria with co-trimoxazole in Ugandan children.

In vivo testing for resistance of Plasmodium falciparum to co-trimoxazole (trimethoprim/sulfamethoxazole) was performed in Uganda in 41 children with uncomplicated malaria, and blood samples were screened before and after treatment for polymorphisms in the antifolate target genes for dihydrofolate reductase (DHFR) and dihydropteroate synthetase (DHPS). Selection towards a specific genotype at some codons of the DHFR and DHPS genes was observed in samples collected after exposure to co-trimoxazole drug pressure. The alleles 51-isoleucine, 59-arginine, and 108-serine of DHFR were significantly associated with clinical resistance, as was allele 581-alanine of DHPS.

[Persistent arthralgias in Ross-River-Virus disease after travel to the South Pacific].

History And Clinical Findings: A 57-year-old patient presented with malaise and severe persistent arthralgia of the left shoulder. He reported an acute illness with fever, generalized myalgia and arthralgias of the large joints which had started one month earlier during his flight back to Germany after a two weeks trip to the South Pacific. Physical examination showed extensive pain on palpation of the glenohumeral and acromioclavicular joints with impairment of active and passive mobility.

The Parent Hexacarbaborane arachno-C B H and a Methylated Pentacarbaborane arachno-CH C B H : Domains of Incipient Hydrocarbon Behavior within Borane Clusters.

Increasingly pronounced hydrocarbon character is exhibited by C H B , the first unsubstituted hexacarbaborane, and CH C B H , the first cluster pentacarbaborane. These compounds shed light on the structural dichotomy between open hydrocarbon skeletons and polyhedral borane frameworks for high-carbon carboranes.

Seroconversion to circumsporozoite antigen of Plasmodium falciparum demonstrates a high risk of malaria transmission in travelers to East Africa.

Circumsporozoite (CS) antibodies have been shown to be reliable indicators of malaria transmission in endemic areas. Their prevalence in travelers can indicate the degree of exposure to plasmodial infection. Two hundred sixty-two short-term travelers to Kenya were recruited to a prospective study to determine the incidence of CS antibody conversion.

Sensitivity and specificity of dipstick tests for rapid diagnosis of malaria in nonimmune travelers.

Swift diagnosis of Plasmodium falciparum malaria in areas where the disease is not endemic is frequently complicated by the lack of experience on the side of involved laboratory personal. Diagnostic tools based on the dipstick principle for the detection of plasmodial histidine-rich protein 2 (HRP-2) and parasite-specific lactate dehydrogenase (pLDH), respectively, have become available for the qualitative detection of P. falciparum malaria.

Evidence of dengue virus infection in a german couple returning from hawaii.

Dengue is an acute, mosquito-transmitted viral disease characterized by fever, arthralgia, myalgia, rash, nausea, and vomiting and caused by any of four different serotypes of the virus (DEN-1, DEN-2, DEN-3, and DEN-4).1 The disease is endemic in most tropical areas of the world and has been reported in international travelers returning from such areas.2 The incidence of epidemic and endemic dengue has increased substantially in the Americas since 1977, and various epidemics have occurred.

Resistance in vivo of Plasmodium falciparum to co-trimoxazole in western Uganda.

In the context of the 'integrated management of childhood illnesses' (IMCI) programme the World Health Organization recommends treating children in malarious areas presenting with fever and respiratory symptoms with co-trimoxazole. In order to verify its effectiveness in uncomplicated Plasmodium falciparum malaria we carried out a study in vivo in western Uganda: 180 children under 5 years old were enrolled and treated with 40/8 mg/kg/d co-trimoxazole over 5 d, and 159 could be followed on days 3, 7 and 14. Effectiveness of treatment was found to be significantly different in various parts of the study area.

Polymorphisms in the dihydrofolate reductase (DHFR) and dihydropteroate synthetase (DHPS) genes of Plasmodium falciparum and in vivo resistance to sulphadoxine/pyrimethamine in isolates from Tanzania.

The efficacy of sulphadoxine/pyrimethamine (S/P) in treatment of uncomplicated falciparum malaria in Africa is increasingly compromised by development of resistance. The occurrence of mutations associated with the active site sequence in the Plasmodium falciparum genes coding for dihydrofolate reductase (DHFR) and dihydropteroate synthetase (DHPS) is associated with in vitro resistance to pyrimethamine and sulphadoxine. This study investigates the occurrence of these mutations in infected blood samples taken from Tanzanian children before treatment with S/P and their relationship to parasite breakthrough by day 7.

Assessing the incidence of infection with Plasmodium falciparum among international travelers.

Circumsporozoite (CS) antibodies, indicating plasmodial infection but not necessarily development of disease, have been shown to be reliable indicators of transmission in endemic areas. To estimate the actual rate of plasmodial infection, the prevalence of CS antibodies was investigated by an ELISA test system in a selected population of 2,131 travelers returning from areas endemic for malaria who presented to an outpatient clinic without any apparent symptom or clinical sign of malaria. Serum specimens from 104 of the investigated 2,131 patients (4.

Effectiveness of chemoprophylaxis and other determinants of malaria in travellers to Kenya.

Objective: To investigate the effectiveness of chemoprophylaxis and the determinants of malaria importation from Kenya.

Method: In a population-based case-control study, 51 travellers from Bavaria diagnosed with falciparum malaria imported from Kenya (cases) and a sample of 383 healthy Bavarian travellers returning from Kenya (controls) were interviewed. Data were analysed by multiple logistic regression.

In vivo synthesis of tumor necrosis factor-alpha in healthy humans after live yellow fever vaccination.

Most knowledge about the synthesis of human tumor necrosis factor (TNF)-alpha and its regulation derives from in vitro studies. The hypothesis that the syndrome of malaise, myalgia, and low fever observed after a vaccination with live attenuated yellow fever virus could be associated with increased synthesis of TNF was investigated. Plasma samples of 15 healthy subjects taken before and until day 2 (until day 11 in 5 of these subjects) after yellow fever vaccination, showed a significant increase of plasma TNF concentration on day 2 after vaccination and a second peak on day 7.

Prevalence of infection with Cryptosporidium parvum and Cyclospora cayetanensis among international travellers.

Background: Cryptosporidium parvum and Cyclospora cayetanensis are recognised as possible pathogens of traveller's diarrhoea.

Aims: To identify the prevalence of C parvum and Cyc cayetanensis in travellers returning from developing countries.

Patients: Nine hundred and seventy eight stool samples wer taken from 795 patients returning from developing countries.

[Endocrinologic and metabolic complications of Alagille syndrome].

Background: Patients with gastrointestinal and hepatobiliary disorders, either congenital or acquired early in childhood, are at high risk for various endocrine and metabolic abnormalities.

Case Report: A 27-year-old woman with Alagille's syndrome presented with progressive jaundice and gait disturbances following surgery and ingestion of oral contraceptives. On physical examination, short stature, facial dysmorphism and neuromuscular symptoms such as polyneuropathy and spinocerebellar ataxia were noted.

High prevalence of mutations in the dihydrofolate reductase gene of Plasmodium falciparum in isolates from Tanzania without evidence of an association to clinical sulfadoxine/pyrimethamine resistance.

Recently the efficacy of sulfadoxine/pyrimethamine (S/P) in treatment of uncomplicated falciparum malaria in Tanzania has been seriously compromised by the development of resistance. The occurrence of active site mutations in the Plasmodium falciparum gene sequence coding for dihydrofolate reductase (DHFR) is known to confer resistance to pyrimethamine. This study investigates the occurrence of these mutations in infected blood samples taken from Tanzanian children before treatment with S/P and their relationship to parasite breakthrough by day 7.

Prevalence of infection with dengue virus among international travelers.

Background: Dengue has been recognized as a potential hazard to tourists. A prospective, controlled study in the outpatient clinic of a German infectious disease clinic was conducted to assess the prevalence of dengue virus infection among international travelers.

Methods: Serum samples from 130 patients with signs or recent history clinically compatible with dengue (fever, headache, muscle and joint pain, or rash), 95 matched controls with diarrhea, and 26 patients who never visited a country endemic for dengue were investigated.

The role of Blastocystis hominis as a possible intestinal pathogen in travellers.

The role of Blastocystis hominis as a pathogen for man has been controversially discussed, while travel history has been implicated as a risk factor of infection. Few controlled studies of the association between B. hominis and symptomatic diseases have been performed.

Japanese encephalitis vaccine in travellers. Is wider use prudent?

Vaccination against Japanese encephalitis has been carried out extensively in many Asian countries for the past 20 years and is also increasingly recommended for travellers to endemic areas. Although the currently available vaccine, manufactured from mouse brain, is generally considered to be highly effective and of low reactogenicity, approximately 50% of vaccinees report experiencing usually mild adverse effects following vaccination. Concern has been raised regarding potential neurological adverse effects but the incidence of such effects appears to be very low (around 1 to 2.

[Epidemiology and clinical aspects of imported schistosomiasis].

Patients And Methods: Travel and medical histories as well as clinical features of 62 German and 21 native patients with schistosomiasis who were presented to a German outpatient clinic for infectious and tropical diseases were investigated in order to identify the risk factor leading to infection in travellers and expatriates.

Results: All patients were able to remember the incidents which led to a likely exposure to cercariae of schistosoma spp. Fifty-nine German patients (95%) acquired infection in Africa, 2 (3%) in South America and one each (2% each) in the Euphrat and the Mekong River, respectively.

[Determination of actual risk factors for malaria infection for travelers by means of measurement of circumsporozoite antibodies].

Measurement of antibodies to circumsporozoite (CS) antigen of Plasmodium falciparum can be used as reliable indicator of malaria transmission in endemic areas. Sensitivity and specificity of an ELISA testkit for the detection of CS antibodies were assessed. In a second step, in order to estimate the actual rate of malaria infection, the prevalence of CS antibodies in serum was investigated in a selected population of travellers returning from sub-Saharan Africa and presenting without any clinical sign of malaria by use of an ELISA.