Suchergebnisse

To observe the prevalence, disease associations, and temporal trends in Trichuris trichiura (whipworm) infection in the Northern Territory between 2002 and 2012. Retrospective observational analysis of consecutive microbiologically confirmed cases of T. trichiura infection among members of the NT population from whom a faecal sample was obtained for testing by NT Government health care facilities between 1 January 2002 and 31 December 2012. Annual prevalence of T. trichiura infection; age, sex, Indigenous status and place of residence of infected patients; percentage of infected patients with anaemia (haemoglobin level, ≤ 110 g/L) and eosinophilia (eosinophil count, ≥ 0.5 × 10(9)/L). 417 episodes of T. trichiura infection were identified over the 11 years from 63 668 faecal samples. The median age of patients was 8 years (interquartile range [IQR], 3-36 years). Patients were predominantly Indigenous (95.3%; P = 0.001) and from three main geographical areas (Victoria Daly, East Arnhem Land and West Arnhem Land). Infections were associated with anaemia (40.2%) and eosinophilia (51.6%). There was a downward trend in the prevalence of T. trichiura infection diagnosed at NT Government health care facilities, from 123.1 cases (95% CI, 94.8-151.3 cases) per 100,000 Indigenous population in 2002 to 35.8 cases (95% CI, 21.8-49.9 cases) per 100,000 Indigenous population in 2011. T. trichiura is the most frequently identified soil-transmitted helminth infecting patients in NT Government health care facilities. Cases are identified predominantly in Indigenous patients in remote communities. We have observed a declining prevalence of whipworm infection in the NT.

Ross River virus, Barmah Forest virus, and Murray Valley encephalitis virus have been responsible for the majority of arbovirus infections in the Northern Territory over the past 12 years. Epidemic polyarthritis, caused by Ross River virus, was first recorded in the Northern Territory during the second World War, when troops were affected in military areas stretching from Darwin to Larrimah 400 kilometres south.[7s]. Sero prevalent surveys from 1957 [8s] to 1974 [9,10s] have suggested wide spread human exposure to Ross River virus in the Northern Territory (Doherty 1973,74). Each year from 1980 to 1989 there have been an increasing number of serologically confirmed cases of epidemic polyarthritis from widespread locations in the NT, but there has been little information on the probably vectors in the various areas. Isolations of Ross River virus from mosquitoes have been made in the Northern Territory from Darwin to Larrimah [Standfast et al 1984, Whelan and Shorthose 1982]. These isolations have been primarily from Culex annulirostris, Aedes vigilax and Aedes normanensis, with single isolation from Aedes normanensis, and Aedes vigilax. In the wet season of 1990-91, a record outbreak of epidemic polyarthritis occurred in the Northern Territory, especially in the Top End. This presented an opportunity to obtain epidemiological information, to indicate the probable vectors, and to assess the impact of mosquito control measures in various towns. Results of this outbreak are reported here.

Ross River virus, Barmah Forest virus, and Murray Valley encephalitis virus have been responsible for the majority of arbovirus infections in the Northern Territory over the past 12 years. Epidemic polyarthritis, caused by Ross River virus, was first recorded in the Northern Territory during the second World War, when troops were affected in military areas stretching from Darwin to Larrimah 400 kilometres south.[7s]. Sero prevalent surveys from 1957 [8s] to 1974 [9,10s] have suggested wide spread human exposure to Ross River virus in the Northern Territory (Doherty 1973,74). Each year from 1980 to 1989 there have been an increasing number of serologically confirmed cases of epidemic polyarthritis from widespread locations in the NT, but there has been little information on the probably vectors in the various areas. Isolations of Ross River virus from mosquitoes have been made in the Northern Territory from Darwin to Larrimah [Standfast et al 1984, Whelan and Shorthose 1982]. These isolations have been primarily from Culex annulirostris, Aedes vigilax and Aedes normanensis, with single isolation from Aedes normanensis, and Aedes vigilax. In the wet season of 1990-91, a record outbreak of epidemic polyarthritis occurred in the Northern Territory, especially in the Top End. This presented an opportunity to obtain epidemiological information, to indicate the probable vectors, and to assess the impact of mosquito control measures in various towns. Results of this outbreak are reported here.

Melioidosis is a tropical infection caused by the soil bacterium Burkholderia pseudomallei. Despite the substantial impact of this often overlooked pathogen on both the health-care systems and economies of numerous low-income and middle-income countries around the world, melioidosis is not officially classified as a neglected tropical disease (NTD) by WHO. Melioidosis causes a higher estimated disease burden and mortality than many other recognised NTDs, with deaths primarily occurring among rural poor populations in low-income and middle-income countries. Fortunately, the impact of melioidosis in a region can be reduced once awareness is established of its known or suspected endemicity. In this Personal View, we provide evidence in support of official recognition of melioidosis as an NTD. We urge member states to request that WHO revisit their NTD list and appeal to government and philanthropic organisations to establish programmes in endemic countries to control melioidosis in order to reduce its global health burden.

Melioidosis is a disease of significant public health importance that is being increasingly recognized globally. The majority of cases arise through direct percutaneous exposure to its etiological agent, Burkholderia pseudomallei. In the Lao People's Democratic Republic (Laos), the presence and environmental distribution of B. pseudomallei are not well characterized, though recent epidemiological surveys of the bacterium have indicated that B. pseudomallei is widespread throughout the environment in the center and south of the country and that rivers can act as carriers and potential sentinels for the bacterium. The spatial and genetic distribution of B. pseudomallei strains within Vientiane Capital, where the majority of cases diagnosed to date have originated, remains an important knowledge gap. We sampled surface runoff from drain catchment areas throughout urban Vientiane to determine the presence and local population structure of the bacterium. B. pseudomallei was detected in drainage areas throughout the capital, indicating that it is widespread in the environment and that exposure rates in urban Vientiane are likely higher than previously thought. Whole-genome comparative analysis demonstrated that Lao B. pseudomallei isolates are highly genetically diverse, suggesting that the bacterium is well established and not a recent introduction. Despite the wide genome diversity, one environmental survey isolate was highly genetically related to a Lao melioidosis patient isolate collected 13 years prior to the study. Knowledge gained from this study will augment understanding of B. pseudomallei phylogeography in Asia and enhance public health awareness and future implementation of infection control measures within Laos. IMPORTANCE The environmental bacterium B. pseudomallei is the etiological agent of melioidosis, a tropical disease with one model estimating a global annual incidence of 165,000 cases and 89,000 deaths. In the Lao People's Democratic Republic (Laos), the environmental distribution and population ...

Melioidosis is a disease of significant public health importance that is being increasingly recognized globally. The majority of cases arise through direct percutaneous exposure to its etiological agent, Burkholderia pseudomallei In the Lao People's Democratic Republic (Laos), the presence and environmental distribution of B. pseudomallei are not well characterized, though recent epidemiological surveys of the bacterium have indicated that B. pseudomallei is widespread throughout the environment in the center and south of the country and that rivers can act as carriers and potential sentinels for the bacterium. The spatial and genetic distribution of B. pseudomallei within Vientiane Capital, from where the majority of cases diagnosed to date have originated, remains an important knowledge gap. We sampled surface runoff from drain catchment areas throughout urban Vientiane to determine the presence and local population structure of the bacterium. B. pseudomallei was detected in drainage areas throughout the capital, indicating it is widespread in the environment and that exposure rates in urban Vientiane are likely more frequent than previously thought. Whole-genome comparative analysis demonstrated that Lao B. pseudomallei isolates are highly genetically diverse, suggesting the bacterium is well-established and not a recent introduction. Despite the wide genome diversity, one environmental survey isolate was highly genetically related to a Lao melioidosis patient isolate collected 13 years prior to the study. Knowledge gained from this study will augment understanding of B. pseudomallei phylogeography in Asia and enhance public health awareness and future implementation of infection control measures within Laos.IMPORTANCE The environmental bacterium B. pseudomallei is the etiological agent of melioidosis, a tropical disease with one model estimating a global annual incidence of 165,000 cases and 89,000 deaths. In the Lao People's Democratic Republic (Laos), the environmental distribution and population structure of B. pseudomallei remain relatively undefined, particularly in Vientiane Capital from where most diagnosed cases have originated. We used surface runoff as a proxy for B. pseudomallei dispersal in the environment and performed whole-genome sequencing (WGS) to examine the local population structure. Our data confirmed that B. pseudomallei is widespread throughout Vientiane and that surface runoff might be useful for future environmental monitoring of the bacterium. B. pseudomallei isolates were also highly genetically diverse, suggesting the bacterium is well-established and endemic in Laos. These findings can be used to improve awareness of B. pseudomallei in the Lao environment and demonstrates the epidemiological and phylogeographical insights that can be gained from WGS.