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   2012| April-June  | Volume 4 | Issue 2  
    Online since May 30, 2012

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Knockdown resistance, Rdl alleles, and the annual entomological Inoculation rate of wild mosquito populations from Lower Moshi, Northern Tanzania
Aneth M Mahande, Isabelle Dusfour, Jonathan R Matias, Eliningaya J Kweka
April-June 2012, 4(2):114-119
Aim: Understanding vector behavioral response due to ecological factors is important in the control of disease vectors. This study was conducted to determine the knockdown resistance (kdr) alleles, dieldrin resistance alleles, and entomological inoculation rates (EIRs) of malaria vectors in lower Moshi irrigation schemes for the mitigation of disease transmission. Materials and Methods: The study was longitudinal design conducted for 14 months. Mosquitoes were collected fortnightly by using a CDC miniature light trap in 20 houses. Mosquitoes were identified morphologically in the field, of which 10% of this population was identified to species level by using molecular techniques. Samples from this study population were taken for kdr and resistance to dieldrin (rdl) genes detection. Results: A total of 6220 mosquitoes were collected by using a light trap, of which 86.0% (n=5350) were Anopheles gambiae sensu lato and 14.0% (n=870) were Culex quinquefasciatus. Ten percent of the An. gambiae s.l. (n=535) collected were taken for species identification, of which 99.8% (n=534) were identified as An. arabiensis while 0.2% (n=1) were An. gambiae sensu stricto. Of the selected mosquitoes, 3.5% (n=19) were sporozoite positive. None of the mosquitoes tested had the kdr gene. The rdl resistant allele was detected at a frequency of 0.48 throughout the year. EIR was determined to be 0.54 ib/trap/year. Conclusion: The findings of this study suggest that the homozygous and the heterozygous resistance present in rdl genes demonstrated the effect of pesticide residues on resistance selection pressure in mosquitoes. A better insecticide usage protocol needs to be developed for farmers to use in order to avoid excessive use of pesticides. Key words: An. arabiensis, EIR, Knockdown mutation, Moshi, rdl locus, Tanzania
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Agreement rate of rapid urease test, conventional PCR, and scorpion real-time PCR in detecting Helicobacter pylori from tonsillar samples of patients with chronic tonsillitis
Reza Najafipour, Taghi Naserpour Farivar, Ali Akbar Pahlevan, Pouran Johari, Farshid Safdarian, Mina Asefzadeh
April-June 2012, 4(2):106-109
Background: Helicobacter pylori is capable of inducing systemic inflammatory reactions through immunological processes. There are several methods to identify the presence of H. pylori in clinical samples including rapid urease test (RUT), conventional polymerase chain reaction (PCR), and the Scorpion real-time PCR. Aim: The aim of the present study is to compare the agreement rate of these tests in identifying H. pylori in tonsillar biopsy specimens collected from patients with chronic tonsillitis. Materials and Methods: A total of 103 tonsil biopsy samples from patients with clinical signs of chronic tonsillitis were examined with RUT, PCR, and Scorpion real-time PCR. The degree of agreement between the three tests was later calculated. Results: There was a poor degree of agreement between RUT and PCR and also RUT and Scorpion real-time PCR (Kappa=0.269 and 0.249, respectively). In contrast with RUT, there was a strong degree of agreement between PCR and Scorpion real-time PCR (Kappa=0.970). Conclusion: The presence of a strong agreement between the Scorpion real-time PCR and PCR as well as its technical advantage over the conventional PCR assay, made the Scorpion real-time PCR an appropriate laboratory test to investigate the presence of H. pylori in tonsillar biopsy specimens in patients suffering from chronic tonsillitis.
  4 3,183 22
Honey as an antimicrobial agent against Pseudomonas aeruginosa isolated from infected wounds
Vishnu Prasad Shenoy, Mamatha Ballal, PG Shivananda, Indira Bairy
April-June 2012, 4(2):102-105
Background: As natural products garner attention in the medical field due to emergence of antibiotic resistant strains of bacteria, honey is valued for its antibacterial activity. Objective: Fifty strains of Pseudomonas aeruginosa isolated from infected wounds were evaluated for their antibacterial action using honey in comparison with different antibiotics and Dettol. Methodology and Results: All the strains were found to be sensitive to honey at a minimum inhibitory concentration of 20% in comparison with Dettol at 10% using agar dilution method. In the second step, the time kill assay was performed on five isolates of P. aeruginosa to demonstrate the bactericidal activity of honey at different dilutions of honey ranging from 20% to 100% at regular time intervals. All the isolates of P. aeruginosa tested were killed in 12-24 h depending on the dilutions of the honey tested. Thus, honey could prevent the growth of P. aeruginosa even if it was diluted by deionized water by fivefolds in vitro. Honey had almost uniform bactericidal activity against P. aeruginosa irrespective of their susceptibility to different classes of antibiotics. Conclusion: Honey which is a natural, non-toxic, and an inexpensive product has activity against the P. aeruginosa isolated from infected wounds may make it an alternative topical choice in the treatment of wound infections.
  3 18,607 46
Multisystem sarcoidosis in a patient on interferon-α therapy for chronic hepatitis C
Bouchra Oudghiri, Mohammed Benzagmout, Saïd Boujraf, Faouzi Belahcen, Adil Ibrahimi
April-June 2012, 4(2):128-131
Sarcoidosis is a chronic multisystemic granulomatous disease that is triggered by an autoimmune process. Nowadays, this pathology represents a well-recognized but uncommon complication for antiviral treatment in hepatitis C virus (HCV) infection. Herein, we report a remarkable case of 47-year-old woman treated for chronic HCV infection; the patient has developed interferon alfa-induced sarcoidosis involving the central nervous system. The evolution was fatal despite disrupting the antiviral therapy and initiating a high-dose corticotherapy. This complication of interferon alfa treatment was reported in the literature in only one case. Through this case and a review of the literature, we aim to underline the importance of screening for sarcoidosis before and during the follow-up of HCV patients undergoing antiviral therapy.
  2 2,835 21
Clinical, epidemiological, and microbiological profile of patients with vancomycin-resistant Enterococci from a Tertiary Care Hospital
PR Vidyalakshmi, R Gopalakrishnan, V Ramasubramanian, K Abdul Ghafur, P Senthur Nambi, MA Thirunarayana
April-June 2012, 4(2):137-138
  2 2,769 22
Monitoring data quality in syndromic surveillance: Learnings from a resource limited setting
E Venkatarao, Rajan R Patil, Deepa Prasad, Anita Anasuya, Reuben Samuel
April-June 2012, 4(2):120-127
Background: India is in the process of integrating all disease surveillance systems with the support of a World Bank funded program called the Integrated Disease Surveillance System. In this context the objective of the study was to evaluate the components of the Orissa Multi Disease Surveillance System. Materials and Methods: Multistage sampling was carried out, starting with four districts, followed by sequentially sampling two blocks; and in each block, two sectors and two health sub-centers were selected, all based on the best and worst performances. Two study instruments were developed for data validation, for assessing the components of the surveillance and diagnostic algorithm. The Organizational Ethics Group reviewed and approved the study. Results: In all 178 study subjects participated in the survey. The case definition of suspected meningitis in disease surveillance was found to be difficult, with only 29.94%, who could be correctly identified. Syndromic diagnosis following the diagnostic algorithm was difficult for suspected malaria (28.1%), 'unusual syndrome' (28.1%), and simple diarrhea (62%). Only 17% could correctly answer questions on follow-up cases, but only 50% prioritized diseases. Our study showed that 54% cross-checked the data before compilation. Many (22%) faltered on timeliness even during emergencies. The constraints identified were logistics (56%) and telecommunication (41%). The reason for participation in surveillance was job responsibility (34.83%). Conclusions: Most of the deficiencies arose from human errors when carrying out day-to-day processes of surveillance activities, hence, should be improved by retraining. Enhanced laboratory support and electronic transmission would improve data quality and timeliness. Validity of some of the case definitions need to be rechecked. Training Programs should focus on motivating the surveillance personnel.
  2 3,859 27
State of the globe: Diagnostic tests to detect Helicobacter pylori tonsillitis
Asghar Fazaeli
April-June 2012, 4(2):99-101
  1 2,762 16
An interesting case of Empedobacter brevis bacteremia after right knee cellulitis
Sivakumar Raman, Hamid Shaaban, John W Sensakovic, George Perez
April-June 2012, 4(2):136-137
  1 4,023 22
Spinal epidural abscess caused by Bacteroides fragilis group after dilation and curettage for incomplete abortion
Masaki Ohyagi, Takuya Ohkubo, Takashi Taniyama, Shoji Tomizawa, Atsushi Okawa, Takanori Yokota, Hidehiro Mizusawa
April-June 2012, 4(2):132-134
Spinal epidural abscess (SEA) is a rare infection complicated in patients who have some risk factors such as injection-drug use, diabetes mellitus, and several illnesses. However, no case of SEA associated with abortion has been reported. Here we report a case of SEA in a 30-year-old woman after dilation and curettage for incomplete abortion. The diagnosis of SEA was done by MRI and pus was drained after the cervical discectomy. Bacteroides fragilis group was cultured from the aspirated pus sample. The patient responded to surgical drainage and antibiotics.
  - 3,796 16
Subcutaneous cervical cysticercosis in a child
Ira Shah
April-June 2012, 4(2):135-135
  - 1,875 13
African eye worm
Etienne Rivière, Julien Kerautret, France Combillet, Denis Malvy
April-June 2012, 4(2):135-136
  - 1,036 4
Polymorphisms of HIV RT gene among the ART naïve native drug exposed rural PLHA
K Mohana Krishnan, SK Amsavathani
April-June 2012, 4(2):110-113
Background: The number of people living with human immunodeficiency virus (HIV) is increasing day by day in India. The disease has now spread from urban areas to rural areas. The proof reading of the reverse transcriptase enzyme is poor, which may lead to genetic diversity within the HIV strains, which in turn leads to problems like failure or resistance in antiretroviral treatment. This study is designed to find out the polymorphisms of the reverse transcriptase gene of HIV, after the native drug pressure among antiretroviral therapy (ART) naïve rural people living with HIV/AIDS (RPLHA). Materials and Methods : A total of 207 HIV-Reactive patients were allowed to take native drugs from the local area and were advised to attend the center for HIV after six months for a follow-up. At the time of the follow-up visit, a second blood sample was taken from 20 reactive native-drug exposed ART-naïve patients. The plasma was separated and transported at 20°C to the YRG Care Center for genotyping. Results: Among the 20 HIV-reactive samples processed for gene sequencing analysis to detect the genotypic variations, only one sample (5%) showed high-level mutational resistance variations and the predominant polymorphisms detected were V35T (100%), K122E (94.44%), and V60I (88.88%). Conclusions: The presence of drug-resistance mutations, although minimal, was important, as the drug-resistant strains could spread among the RPLHA and to their sexual partners. There was a definite need to generate a drug resistance database and the polymorphic pattern of Indian strains concern to the future clinical management of the disease, and a vaccine design to contain the disease.
  - 2,705 18
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