No description available.

Schistosomiasis is a parasitic disease affecting over 200 million people worldwide. This study reports the design and development of a microfiltration device for isolating schistosome eggs in urine for rapid diagnostics of urogenital schistosomiasis. The design of the device comprises a linear array of microfluidic traps to immobilize and separate schistosome eggs. Sequential loading of individual eggs is achieved autonomously by flow resistance, which facilitates observation and enumeration of samples with low-abundance targets. Computational fluid dynamics modeling and experimental characterization are performed to optimize the trapping performance. By optimizing the capture strategy, the trapping efficiency could be achieved at 100% with 300 mu l/min and 83% with 3000 mu l/min, and the filtration procedure could be finished within 10 min. The trapped eggs can be either recovered for downstream analysis or preserved in situ for whole-mount staining. On-chip phenotyping using confocal laser fluorescence microscopy identifies the microstructure of the trapped schistosome eggs. The device provides a novel microfluidic approach for trapping, counting and on-chip fluorescence characterization of urinal Schistosoma haematobium eggs for clinical and investigative application.

Thesis (Ph. D.)--University OF MICHIGAN.

DISSERTATION (PH.D.)--THE UNIVERSITY OF MICHIGAN

M.Sc. (Med.), Faculty of Health Sciences, University of the Witwatersrand, 2009 / Background Assessing risk of schistosomiasis requires knowledge of the spatial distribution of the disease and its association with demographic, socioeconomic, behavioural, and environmental factors over time and space. The objective of this study was to advance such knowledge by analyzing the spatial distribution of schistosoma haematobium infections in relation to the demographic attributes and environmental covariates of the Africa centre Demographic Surveillance Areas (DSA) in rural KwaZulu-Natal. The study also examined the association between household socio-economic conditions and rates of S. haematobium infection with particular emphasis on the impact of pipe water on rates of infection. Methods The study is a crosses sectional study, involving all 33 primary schools in Africa Centre DSA. 2110 grade five and six children took part in the study. Statistical analysis was done using chi square tests to compare statistical significant differences between sex and age groups. Bivariate and multivariate logistic regression models were used to explore factors that are significantly associated with infection. Spatial analysis was done to examine the spatial distribution of the disease using geographical information systems techniques. Microscopic analysis of the urine samples was done using the filtration technique. Results Of the 2110 school children who were screened for infection, 347 tested positive for the presence of iv S. haematobium, representing an overall prevalence of 16.6%. Prevalence levels were higher in boys (20.8%) than females (8.5%) (P<0.001). 57.6% were heavily infected (eggs ≥50 eggs per 10ml urine) as compared to 42.5% who had light infection (eggs<50 eggs/10ml of urine). Whereas, prevalence was significantly age-dependent (Pearson chi2 (3) = 28.4184, P< 0.001), intensity of infection was not significantly age dependent (Pearson chi2 (3) = 3.2579, P<0.354). Altitudinal variation, access to portable water, toilet, and distance to water bodies were significantly associated with infection. Prevalence of infection was clustered around the Eastern part of the study area. Conclusion While there may be several factors associated with schistosoma infection in the study area's school children; age, sex, water contact behaviour, homestead altitude and distance to permanent water bodies, were the most significant risk factors explaining the spatial distribution of S. haematobium infection in the Africa Centre DSA. Selective Mass treatment of S. haematobium infection in 7 clustered areas is recommended for the control of the disease.

No description available.

La plupart des études sur l’hybride naturel entre Schistosoma haematobium (S.) et S. guineensis sont réalisées sur les vers adultes et contrairement aux études expérimentales sur l’hybridation, on ne retrouve pas de vers adultes hybrides après analyse de leur ADN. Avec cette étude, nous souhaitons mettre en évidence la présence d’hybride naturel entre ces deux espèces au Gabon à partir du premier élément suspect : l’œuf. Nous avons suivi l’œuf de son observation morphologique, à sa coloration par la technique de Ziehl-Neelsen jusqu’à l’amplification par PCR de son ADN et on a pu montrer qu’un œuf de morphologie suspecte observé dans les urines est capable d’amplifier à la fois une région spécifique de S. haematobium et de S. guineensis. / Most studies on the natural hybrid between Schistosoma haematobium (S.) and S.guineensis are performed on adult worms and contrary to experimental studies of hybridization, we do not find an adult hybrid worm after analysis of their DNA. With this study, we wish to highlight the presence of a natural hybrid between these two species in Gabon from the first suspect element: the egg. We followed the egg from its morphological observation to its staining using Ziehl-Neelsen technique until PCR amplification of its DNA and it has been shown that a suspected egg morphology seen in the urine is able to amplify both a specific region of S. haematobium and S. guineensis.

Praziquantel ist das Mittel der Wahl bei der Behandlung der Bilharziose. Für die Wirksamkeit des Medikaments spielt die Immunantwort des Wirts eine wichtige Rolle. Mikronährstoffe sind wichtig für die Funktion des Immunsystems. In Endemiegebieten der Bilharziose findet sich meist ein Mikronährstoffmangel. In dieser Studie wurde untersucht, ob ein Ausgleich des Mikronährstoffmangels das Behandlungsergebnis optimieren kann und Reinfektionen vermindert werden können. Für die randomisierte Interventionsstudie wurden 331 infizierte Kinder zwischen acht und 14 Jahren mit einer Eiausscheidung von über 30 Schistosoma haematobium Eiern pro 10 ml Urin ausgewählt. Die Kinder wurden zuvor in einer an zehn Grundschulen erhobenen Querschnittsstudie in einem blasenbilharzioseendemischen Gebiet in Tansania identifiziert. Die Interventionsgruppe erhielt vier Wochen lang ein Mikronährstoffpräparat und wurde danach mit Praziquantel behandelt, die Kontrollgruppe erhielt nur Praziquantel. Bei der Kontrolle des Therapierfolgs fanden sich keine signifikanten Unterschiede zwischen der Interventions- und der Kontrollgruppe hinsichtlich der Heilungsraten und der Infektionsstärke der Nichtgeheilten. Nach zehn Monaten wurden die Kinder nochmalig auf Eier im Urin untersucht, um Reinfektionen festzustellen. Fehlende bzw. spärliche Niederschläge machten jedoch Neuinfektionen fast unmöglich, da sich kaum Wasserstellen gebildet hatten, welche die Habitate von Bulinus nasutus - dem Zwischenwirt von S. haematobium im Untersuchungsgebiet - darstellen. Es waren nur 10 % der Kinder reinfiziert mit sehr geringen Infektionsstärken ohne signifikante Unterschiede zwischen den Studiengruppen. Es konnte nicht nachgewiesen werden, dass eine Mikronährstoffgabe den Therapieerfolg nach der Behandlung mit Praziquantel verbessern kann. Ob Reinfektionen verringert werden können, ließ sich aufgrund der anhaltenden Dürre in den Jahren 1999 und 2000 in dieser Studie nicht feststellen, sollte aber Gegenstand weiterer Studien sein. / Praziquantel is the drug of choice for schistosomiasis chemotherapy. The immune response of the host is an important factor in drug efficacy. Micronutrients are essential for an effective response of the immune system. In areas endemic for S. haematobium people often suffer from micronutrient deficiency. It was investigated whether a compensation of micronutrient deficiency can improve chemotherapy and reduce the rate and levels of reinfection. 331 children aged 8 to 14, highly infected with S. haematobium were selected for the randomised intervention-study. Children were identified in a cross-sectional study in 10 primary schools in Tanzania in an area endemic for S. haematobium. The intervention-group received a four weeks micronutrient supplementation followed by treatment with Praziquantel. The control-group was only treated with Praziquantel. The results showed no significant differences concerning cure rate and intensity of infection between the two study groups. The children were examined for reinfection ten months after treatment. Only ten percent of the children were reinfected with rather low levels of infection. There were no significant differences between the studied groups. Scarce rain during the rainy season inhibited the formation of the usual puddles, that form the essential habitat for Bulinus nasutus - the intermediate host of S. heamatobium. This substantially reduced the probability for new infections. It could not be confirmed whether micronutrient supplementation could improve the results after chemotherapy with Praziquantel. A decrease of reinfections due to micronutrient supplementations could not be confirmed due to the drought in 1999 and 2000, but should be a field for further investigations.

A malária causada pelo Plasmodium falciparum (P. falciparum) e a bilharzíase urogenital causada pelo Schistosoma haematobium (S. haematobium) constituem duas doenças infecciosas tropicais alarmantes, sendo ambas endêmicas no Benin. Considerando que a malária (Th1) e a esquistossomose (Th2) apresentem perfis de citocinas divergentes, na presença de co-infecção, o S. haematobium poderia modular as respostas especificamente dirigidas contra o P. falciparum. Uma vez que, os genes que codificam as moléculas nãoclássicas de histocompatibilidade (HLA-G/-E/-F) possuam propriedades imunomoduladoras, pouca atenção tem sido dedicada ao estudo desses genes em populações da África Subsaariana, que são as de maior diversidade genética. O objetivo deste estudo foi avaliar a variabilidade dos genes HLA-G/-E/-F na população Toffin do Benin, e identificar fatores genéticos de suscetibilidade/resistência à malária causada pelo P. falciparum e/ou bilharziose urogenital, usando uma coorte de crianças (de 4 a 8 anos de idade) não aparentadas. Foram avaliados os segmentos codificantes e reguladores, englobando aproximadamente 5.1 kb do HLA-G, 7.7 kb do HLA-E e 6.2 kb do HLA-F, usando sequenciamento da nova geração. As frequências alélicas e haplotípicas do HLA-G/-E/-F, a diversidade genética, a diversidade nucleotídica, o equilíbrio de Hardy-Weinberg (HW) e de Tajima\'s D foram realizados utilizando o software ARLEQUIN v3.5.2. O desequilíbrio de ligação (LD) entre sítios variáveis com frequência alélica mínima (MAF) acima de 1% foi avaliado calculando o coeficiente de correlação r2 e os gráficos de LD foram visualizados usando o software Haploview 4.2. O estudo de associação foi implementada nos softwares PLINK v1.90b4.6 e R v3.4.2, usando modelos de regressão linear ou logística múltipla. 96, 37 e 68 sítios variáveis foram detectados ao longo de HLA-G/-E- F, respectivamente. Foram identificados 16, 19 e 15 haplótipos da promotora, 19, 15 e 29 haplótipos da codificadora, 12, 7 e 2 haplótipos da região 3\' não traduzida (3\'UTR), respectivamente, e ainda, 33 , 31 e 32 haplótipos estendidos, respectivamente. Todos os haplótipos promotores/codificadores/3\'UTR respeitaram os padrões já descritos na população mundial. O HLA-E foi o mais conservado, exibindo principalmente duas proteinas (E*01:01 e E*01:03), seguido do HLA-F, três proteínas (F*01:01, F*01:02 e F*01:03) e HLA-G, quatro proteínas: três normais (G*01:01, G*01:03 eSONON, P. Resumo xi G*01:04) e uma truncada (G*01:05N). Embora os alelos do HLA-G-E/-F observados na população Toffin tenham sido os mais frequentemente observados em vários países do mundo, as frequências dos haplótipos da região codificadora foram semelhantes às descritas para outras populações africanas (Guiné-Conakry e Burkina-Faso), quando comparadas com os países não-Africanos (Brasileiros), indicando que as variações ao longo desses genes estavam presentes nos Africanos antes da dispersão humana. Foram analisados 105 polimorfismos (MAF> 5%, valor P de HW> 0.05 e qualidade de genótipos> 97%) e 56 haplótipos com frequência mínima de 5%. Consideramos significativos, apenas os resultados exibindo valores de P <0.01 para polimorfismos e valores de P <0.01 antes da correção e valores de P <0.05 após correção de Bonferroni, para haplótipos. Encontramos as seguintes associações: i) o alelo inserção de 14 pares de bases do HLA-G (14 pb Ins) (em modelo dominante) foi associado ao risco de ocorrência de infecção por P. falciparum (infecções totais como infecções sintomáticas) e ao número de episódios de infecção (número elevado de episódios de infecções totais como de infecções sintomáticas), ii) polimorfismos HLA-G (- 1155 A e +755 A, em completo LD) (em modelo recessivo), e iii) haplótipo E.01.03.05- compatível em sinergia com o alelo -1988 C do HLA-E (em modelo aditivo) foram associados à proteção contra malária (em níveis de infecção como de densidade parasitária), e iv) o haplótipo E.Promo.2 foi associado à protecção contra a co-infecção do P. falciparum em crianças infectadas por S. haematobium. Excetuando o 14 pb Ins, estudos funcionais adicionais são necessários para revelar o papel desses marcadores na expressão dos genes HLA-G, -E e -F, para entender melhor o mecanismo de associação com doenças. / Plasmodium falciparum (P. falciparum) malaria and the urogenital bilharziasis caused by Schistosoma haematobium (S. haematobium) infection constitute the two alarming tropical infectious diseases; and both are endemic in Benin. Considering that malaria (Th1) and schistosomiasis (Th2) have divergent cytokine profiles, the presence of co-infection could modulate the responses specifically directed against P. falciparum. We hypothesize that the non-classical genes and molecules (HLA-G, -E and -F) of major histocompatibility complex (MHC) could be involved in this immunomodulation. Although these molecules have well known immunomodulatory properties, little attention has been devoted to the study of these non-classical class I HLA genes in sub-Saharan African populations. This study aimed to evaluate the diversity of HLA-G, -E and -F gene variable sites in the Beninese Toffin population, and to identify susceptibility/resistance genetic factors associated with P. falciparum malaria and/or urogenital bilharziasis in a Beninese cohort of unrelated schoolaged children (4 to 8 years old). We evaluated the complete gene variability (5.1 kb for HLAG, 7.7 kb for HLA-E and 6.2 kb for HLA-F) in the Beninese Toffin population using massive parallel sequencing. HLA-G, -E and -F allele and haplotype frequencies, gene diversity, average nucleotide diversity, Tajima\'s D and Hardy-Weinberg (HW) equilibrium were performed using ARLEQUIN v3.5.2 software. The linkage disequilibrium (LD) pattern among variable sites with a minimum allele frequency (MAF) above 1% was evaluated computing the correlation coefficient r2 and the LD plots were visualized using Haploview 4.2 software. The genetic association study was implemented on PLINK v1.90b4.6 and R v3.4.2 softwares using multiple logistic or linear regression models. Overall, 96, 37 and 68 variable sites were detected along the entire HLA-G, -E and -F, respectively, arranged into regionspecific haplotypes; i.e., promoter haplotypes (16, 19, and 15, respectively), coding haplotypes (19, 15, and 29, respectively), 3\' untranslated region (3\' UTR) haplotypes (12, 7 and 2, respectively) and extended haplotypes (33, 31 and 32, respectively). All promoter/coding/3\'UTR haplotypes followed the patterns already described in worldwide populations. Among the three genes, HLA-E was the most conserved, exhibiting mainly two full-length encoded-molecules (E*01:01 and E*01:03), followed by HLA-F (three full-lengthSONON, P. Abstract xiii proteins; F*01:01, F*01:02 and F*01:03) and HLA-G (four proteins; three full-length (G*01:01, G*01:03 and G*01:04) and one truncated (G*01:05N)). Although HLA-G/E/F alleles in the Toffin population were the most frequently observed worldwide, the frequencies of the coding haplotypes were closely similar to those described for other West African populations (Guinea-Conakry and Burkina-Faso) than for non-African ones (Brazilian population), indicating that variable sites along these genes were present in Africa before human dispersion. A total of 105 polymorphisms and 56 haplotypes were analyzed in the genetic association study to malaria and schistosomiasis susceptibility. Only results exhibiting respectively P-values < 0.01 and P-values < 0.05 (after Bonferroni correction) for polymorphisms and for haplotypes were considered as significant. The following associations were observed: i) HLA-G 14 base pairs (14bp) insertion was associated (under dominant model) with the risk of the occurrence of P. falciparum infection (all infections and symptomatic infections) and with high number of infection episodes (all infections and symptomatic infections), ii) HLA-G -1155 A and +755 A alleles (under recessive model) and iii) E.01.03.05-compatible haplotype in synergy with HLA-E -1988 C allele (under additive model) were associated with protection against P. falciparum (at infection as well as parasitic levels), and finally iv) the E.Promo.2 haplotype was associated with protection against malaria-schistosomiasis co-infection. The functional role of the genetic markers (alleles or haplotypes) associated with malaria and schistosomiasis suceptibility/resistance need to be investigated to better understand the mechanism that may explain these associations.

A malária causada pelo Plasmodium falciparum (P. falciparum) e a bilharzíase urogenital causada pelo Schistosoma haematobium (S. haematobium) constituem duas doenças infecciosas tropicais alarmantes, sendo ambas endêmicas no Benin. Considerando que a malária (Th1) e a esquistossomose (Th2) apresentem perfis de citocinas divergentes, na presença de co-infecção, o S. haematobium poderia modular as respostas especificamente dirigidas contra o P. falciparum. Uma vez que, os genes que codificam as moléculas nãoclássicas de histocompatibilidade (HLA-G/-E/-F) possuam propriedades imunomoduladoras, pouca atenção tem sido dedicada ao estudo desses genes em populações da África Subsaariana, que são as de maior diversidade genética. O objetivo deste estudo foi avaliar a variabilidade dos genes HLA-G/-E/-F na população Toffin do Benin, e identificar fatores genéticos de suscetibilidade/resistência à malária causada pelo P. falciparum e/ou bilharziose urogenital, usando uma coorte de crianças (de 4 a 8 anos de idade) não aparentadas. Foram avaliados os segmentos codificantes e reguladores, englobando aproximadamente 5.1 kb do HLA-G, 7.7 kb do HLA-E e 6.2 kb do HLA-F, usando sequenciamento da nova geração. As frequências alélicas e haplotípicas do HLA-G/-E/-F, a diversidade genética, a diversidade nucleotídica, o equilíbrio de Hardy-Weinberg (HW) e de Tajima\'s D foram realizados utilizando o software ARLEQUIN v3.5.2. O desequilíbrio de ligação (LD) entre sítios variáveis com frequência alélica mínima (MAF) acima de 1% foi avaliado calculando o coeficiente de correlação r2 e os gráficos de LD foram visualizados usando o software Haploview 4.2. O estudo de associação foi implementada nos softwares PLINK v1.90b4.6 e R v3.4.2, usando modelos de regressão linear ou logística múltipla. 96, 37 e 68 sítios variáveis foram detectados ao longo de HLA-G/-E- F, respectivamente. Foram identificados 16, 19 e 15 haplótipos da promotora, 19, 15 e 29 haplótipos da codificadora, 12, 7 e 2 haplótipos da região 3\' não traduzida (3\'UTR), respectivamente, e ainda, 33 , 31 e 32 haplótipos estendidos, respectivamente. Todos os haplótipos promotores/codificadores/3\'UTR respeitaram os padrões já descritos na população mundial. O HLA-E foi o mais conservado, exibindo principalmente duas proteinas (E*01:01 e E*01:03), seguido do HLA-F, três proteínas (F*01:01, F*01:02 e F*01:03) e HLA-G, quatro proteínas: três normais (G*01:01, G*01:03 eSONON, P. Resumo xi G*01:04) e uma truncada (G*01:05N). Embora os alelos do HLA-G-E/-F observados na população Toffin tenham sido os mais frequentemente observados em vários países do mundo, as frequências dos haplótipos da região codificadora foram semelhantes às descritas para outras populações africanas (Guiné-Conakry e Burkina-Faso), quando comparadas com os países não-Africanos (Brasileiros), indicando que as variações ao longo desses genes estavam presentes nos Africanos antes da dispersão humana. Foram analisados 105 polimorfismos (MAF> 5%, valor P de HW> 0.05 e qualidade de genótipos> 97%) e 56 haplótipos com frequência mínima de 5%. Consideramos significativos, apenas os resultados exibindo valores de P <0.01 para polimorfismos e valores de P <0.01 antes da correção e valores de P <0.05 após correção de Bonferroni, para haplótipos. Encontramos as seguintes associações: i) o alelo inserção de 14 pares de bases do HLA-G (14 pb Ins) (em modelo dominante) foi associado ao risco de ocorrência de infecção por P. falciparum (infecções totais como infecções sintomáticas) e ao número de episódios de infecção (número elevado de episódios de infecções totais como de infecções sintomáticas), ii) polimorfismos HLA-G (- 1155 A e +755 A, em completo LD) (em modelo recessivo), e iii) haplótipo E.01.03.05- compatível em sinergia com o alelo -1988 C do HLA-E (em modelo aditivo) foram associados à proteção contra malária (em níveis de infecção como de densidade parasitária), e iv) o haplótipo E.Promo.2 foi associado à protecção contra a co-infecção do P. falciparum em crianças infectadas por S. haematobium. Excetuando o 14 pb Ins, estudos funcionais adicionais são necessários para revelar o papel desses marcadores na expressão dos genes HLA-G, -E e -F, para entender melhor o mecanismo de associação com doenças. / Plasmodium falciparum (P. falciparum) malaria and the urogenital bilharziasis caused by Schistosoma haematobium (S. haematobium) infection constitute the two alarming tropical infectious diseases; and both are endemic in Benin. Considering that malaria (Th1) and schistosomiasis (Th2) have divergent cytokine profiles, the presence of co-infection could modulate the responses specifically directed against P. falciparum. We hypothesize that the non-classical genes and molecules (HLA-G, -E and -F) of major histocompatibility complex (MHC) could be involved in this immunomodulation. Although these molecules have well known immunomodulatory properties, little attention has been devoted to the study of these non-classical class I HLA genes in sub-Saharan African populations. This study aimed to evaluate the diversity of HLA-G, -E and -F gene variable sites in the Beninese Toffin population, and to identify susceptibility/resistance genetic factors associated with P. falciparum malaria and/or urogenital bilharziasis in a Beninese cohort of unrelated schoolaged children (4 to 8 years old). We evaluated the complete gene variability (5.1 kb for HLAG, 7.7 kb for HLA-E and 6.2 kb for HLA-F) in the Beninese Toffin population using massive parallel sequencing. HLA-G, -E and -F allele and haplotype frequencies, gene diversity, average nucleotide diversity, Tajima\'s D and Hardy-Weinberg (HW) equilibrium were performed using ARLEQUIN v3.5.2 software. The linkage disequilibrium (LD) pattern among variable sites with a minimum allele frequency (MAF) above 1% was evaluated computing the correlation coefficient r2 and the LD plots were visualized using Haploview 4.2 software. The genetic association study was implemented on PLINK v1.90b4.6 and R v3.4.2 softwares using multiple logistic or linear regression models. Overall, 96, 37 and 68 variable sites were detected along the entire HLA-G, -E and -F, respectively, arranged into regionspecific haplotypes; i.e., promoter haplotypes (16, 19, and 15, respectively), coding haplotypes (19, 15, and 29, respectively), 3\' untranslated region (3\' UTR) haplotypes (12, 7 and 2, respectively) and extended haplotypes (33, 31 and 32, respectively). All promoter/coding/3\'UTR haplotypes followed the patterns already described in worldwide populations. Among the three genes, HLA-E was the most conserved, exhibiting mainly two full-length encoded-molecules (E*01:01 and E*01:03), followed by HLA-F (three full-lengthSONON, P. Abstract xiii proteins; F*01:01, F*01:02 and F*01:03) and HLA-G (four proteins; three full-length (G*01:01, G*01:03 and G*01:04) and one truncated (G*01:05N)). Although HLA-G/E/F alleles in the Toffin population were the most frequently observed worldwide, the frequencies of the coding haplotypes were closely similar to those described for other West African populations (Guinea-Conakry and Burkina-Faso) than for non-African ones (Brazilian population), indicating that variable sites along these genes were present in Africa before human dispersion. A total of 105 polymorphisms and 56 haplotypes were analyzed in the genetic association study to malaria and schistosomiasis susceptibility. Only results exhibiting respectively P-values < 0.01 and P-values < 0.05 (after Bonferroni correction) for polymorphisms and for haplotypes were considered as significant. The following associations were observed: i) HLA-G 14 base pairs (14bp) insertion was associated (under dominant model) with the risk of the occurrence of P. falciparum infection (all infections and symptomatic infections) and with high number of infection episodes (all infections and symptomatic infections), ii) HLA-G -1155 A and +755 A alleles (under recessive model) and iii) E.01.03.05-compatible haplotype in synergy with HLA-E -1988 C allele (under additive model) were associated with protection against P. falciparum (at infection as well as parasitic levels), and finally iv) the E.Promo.2 haplotype was associated with protection against malaria-schistosomiasis co-infection. The functional role of the genetic markers (alleles or haplotypes) associated with malaria and schistosomiasis suceptibility/resistance need to be investigated to better understand the mechanism that may explain these associations.