Nigel W. Beebe

Laboratory Diagnostic Techniques for Entamoeba Species

SUMMARY The genus Entamoeba contains many species, six of which (Entamoeba histolytica, Entamoeba dispar, Entamoeba moshkovskii, Entamoeba polecki, Entamoeba coli, and Entamoeba hartmanni) reside in the human intestinal lumen. Entamoeba histolytica is the causative agent of amebiasis and is considered a leading parasitic cause of death worldwide in humans. Although recent studies highlight the recovery of E. dispar and E. moshkovskii from patients with gastrointestinal symptoms, there is still no convincing evidence of a causal link between the presence of these two species and the symptoms of the host. New approaches to the identification of E. histolytica are based on detection of E. histolytica-specific antigen and DNA in stool and other clinical samples. Several molecular diagnostic tests, including conventional and real-time PCR, have been developed for the detection and differentiation of E. histolytica, E. dispar, and E. moshkovskii in clinical samples. The purpose of this review is to discuss different methods that exist for the identification of E. histolytica, E. dispar, and E. moshkovskii which are available to the clinical diagnostic laboratory. To address the need for a specific diagnostic test for amebiasis, a substantial amount of work has been carried out over the last decade in different parts of the world. The molecular diagnostic tests are increasingly being used for both clinical and research purposes. In order to minimize undue treatment of individuals infected with other species of Entamoeba such as E. dispar and E. moshkovskii, efforts have been made for specific diagnosis of E. histolytica infection and not to treat based simply on the microscopic examination of Entamoeba species in the stool. The incorporation of many new technologies into the diagnostic laboratory will lead to a better understanding of the public health problem and measures to control the disease.

The dengue vector Aedes aegypti: what comes next

Aedes aegypti is the urban vector of dengue viruses worldwide. While climate influences the geographical distribution of this mosquito species, other factors also determine the suitability of the physical environment. Importantly, the close association of A. aegypti with humans and the domestic environment allows this species to persist in regions that may otherwise be unsuitable based on climatic factors alone. We highlight the need to incorporate the impact of the urban environment in attempts to model the potential distribution of A. aegypti and we briefly discuss the potential for future technology to aid management and control of this widespread vector species.

Australia's dengue risk driven by human adaptation to climate change.

BACKGROUND The reduced rainfall in southeast Australia has placed this regions urban and rural communities on escalating water restrictions, with anthropogenic climate change forecasts suggesting that this drying trend will continue. To mitigate the stress this may place on domestic water supply, governments have encouraged the installation of large domestic water tanks in towns and cities throughout this region. These prospective stable mosquito larval sites create the possibility of the reintroduction of Ae. aegypti from Queensland, where it remains endemic, back into New South Wales and other populated centres in Australia, along with the associated emerging and re-emerging dengue risk if the virus was to be introduced. METHODOLOGY/PRINCIPAL FINDINGS Having collated the known distribution of Ae. aegypti in Australia, we built distributional models using a genetic algorithm to project Ae. aegyptis distribution under todays climate and under climate change scenarios for 2030 and 2050 and compared the outputs to published theoretical temperature limits. Incongruence identified between the models and theoretical temperature limits highlighted the difficulty of using point occurrence data to study a species whose distribution is mediated more by human activity than by climate. Synthesis of this data with dengue transmission climate limits in Australia derived from historical dengue epidemics suggested that a proliferation of domestic water storage tanks in Australia could result in another range expansion of Ae. aegypti which would present a risk of dengue transmission in most major cities during their warm summer months. CONCLUSIONS/SIGNIFICANCE In the debate of the role climate change will play in the future range of dengue in Australia, we conclude that the increased risk of an Ae. aegypti range expansion in Australia would be due not directly to climate change but rather to human adaptation to the current and forecasted regional drying through the installation of large domestic water storing containers. The expansion of this efficient dengue vector presents both an emerging and re-emerging disease risk to Australia. Therefore, if the installation and maintenance of domestic water storage tanks is not tightly controlled, Ae. aegypti could expand its range again and cohabit with the majority of Australias population, presenting a high potential dengue transmission risk during our warm summers.

Discovery of a Widespread Infestation of Aedes albopictus in the Torres Strait, Australia

ABSTRACT Aedes albopictus is a container-breeding Stegomyia mosquito that has dispersed widely from its origins in Southeast Asia. Because Ae. albopictus is a known dengue vector and a potential vector of a variety of arboviruses and it can tolerate cooler climates than Aedes aegypti, Australian quarantine and health authorities have strategies to detect and eliminate it from international ports. Following the detection of 42 adult Ae. albopictus in BG-Sentinel traps set on Yorke island in the Torres Strait of Australia in April 2005, extensive surveys were conducted to determine the distribution of Ae. albopictus in the Torres Strait and adjoining Cape York Peninsula. A total of 17 islands and the northern peninsula area of Cape York Peninsula were surveyed by collection of larvae and pupae from flooded containers and human bait collections of adult mosquitoes with aspirators and sweep nets. Aedes albopictus was detected on 10 islands and comprised 100% of the day-biting container-breeding mosquitoes on Yorke and Stephens Islands. No Ae. albopictus were detected in the mainland sites on Cape York. Retrospective genetic analysis of larvae collected in April 2004 and April 2005 on Yorke Island indicated that Ae. albopictus was present in low densities in 2004 and that there were 3 genetically distinct mitochondrial haplotypes on Yorke Island in April 2005. Additionally, on Yorke Island there is evidence that Ae. albopictus is displacing Aedes scutellaris.

PCR detection of Entamoeba histolytica, Entamoeba dispar, and Entamoeba moshkovskii in stool samples from Sydney, Australia.

ABSTRACT This study investigated the presence of Entamoeba histolytica, Entamoeba dispar, and Entamoeba moshkovskii in stool samples from a patient population in Sydney, Australia. Stool samples were tested by microscopy and PCR. Five patients were found with E. histolytica infections, while E. dispar and E. moshkovskii were observed in 63 (70.8%) and 55 (61.8%) patients, respectively, by PCR. This is the first study in Australia using molecular techniques to determine the presence of E. histolytica, E. dispar, and E. moshkovskii.

DNA sequence analysis of the ribosomal DNA ITS2 region for the Anopheles punctulatus group of mosquitoes.

The internal transcribed spacer 2 (ITS2) from the ribosomal DNA was sequenced and characterized for ten cryptic species in the Anopheles punctulatus group, the members of which are major vectors of malaria and filariasis in the south‐west Pacific. The length of the ITS2 ranged from 549 bp to 565 bp and displayed levels of sequence variation ranging from 2.3% to 24.3% due mainly to indels of simple sequences. The GC content varied from 61.3% to 70.9%. These values were higher than those found in other cryptic species of mosquitoes and comparable only to members of the An. dirus complex suggesting a possible link between this group of Asian mosquitoes and the An. punctulatus group. Optimal and suboptimal secondary structures were investigated and revealed structures where the 5′ region folded independently of the 3′ region. Due to the large level of sequence variation between species, the ITS2 region proved unsuitable for phylogenetic analysis.

Successful malaria elimination strategies require interventions that target changing vector behaviours

BackgroundThe ultimate long-term goal of malaria eradication was recently placed back onto the global health agenda. When planning for this goal, it is important to remember why the original Global Malaria Eradication Programme (GMEP), conducted with DDT-based indoor residual spraying (IRS), did not achieve its goals. One of the technical reasons for the failure to eliminate malaria was over reliance on a single intervention and subsequently the mosquito vectors developed behavioural resistance so that they did not come into physical contact with the insecticide.Hypothesis and how to test itCurrently, there remains a monolithic reliance on indoor vector control. It is hypothesized that an outcome of long-term, widespread control is that vector populations will change over time, either in the form of physiological resistance, changes in the relative species composition or behavioural resistance. The potential for, and consequences of, behavioural resistance was explored by reviewing the literature regarding vector behaviour in the southwest Pacific.DiscussionHere, two of the primary vectors that were highly endophagic, Anopheles punctulatus and Anopheles koliensis, virtually disappeared from large areas where DDT was sprayed. However, high levels of transmission have been maintained by Anopheles farauti, which altered its behaviour to blood-feed early in the evening and outdoors and, thereby, avoiding exposure to the insecticides used in IRS. This example indicates that the efficacy of programmes relying on indoor vector control (IRS and long-lasting, insecticide-treated nets [LLINs]) will be significantly reduced if the vectors change their behaviour to avoid entering houses.ConclusionsBehavioural resistance is less frequently seen compared with physiological resistance (where the mosquito contacts the insecticide but is not killed), but is potentially more challenging to control programmes because the intervention effectiveness cannot be restored by rotating the insecticide to one with a different mode of action. The scientific community needs to urgently develop systematic methods for monitoring behavioural resistance and then to work in collaboration with vector control programmes to implement monitoring in sentinel sites. In situations where behavioural resistance is detected, there will be a need to target other bionomic vulnerabilities that may exist in the larval stages, during mating, sugar feeding or another aspect of the life cycle of the vector to continue the drive towards elimination.

Speciation and Distribution of the Members of the Anopheles punctulatus (Diptera: Culicidae) Group in Papua New Guinea

Abstract Mosquito collections were made throughout the mainland of Papua New Guinea to identify the members of the Anopheles punctulatus group present and to determine their distribution. Identification was made using morphology, DNA hybridization, and polymerase chain reaction (PCR)-RFLP analysis. Nine members of the group were identified: An. farauti s.s. Laveran, An. farauti 2, An. koliensis Owen, and An. punctulatus Dönitz, were common and widespread; An. farauti 4 was restricted to the north of the central ranges where it was common; An. farauti 6 was found only in the highlands above 1,000 m; and An. farauti 3, An. sp. near punctulatus and An. clowi Rozeboom & Knight were uncommon and had restricted distributions. Identification of An. koliensis and An. punctulatus using proboscis morphology was found to be unreliable wherever An. farauti 4 occurred. The distribution and dispersal of the members of the An. punctulatus group is discussed in regard to climate, larval habitats, distance from the coast, elevation, and proximity to human habitation.

Prospective Study of the Prevalence, Genotyping, and Clinical Relevance of Dientamoeba fragilis Infections in an Australian Population

ABSTRACT A prospective study was conducted over a 30-month period, in which fecal specimens from 6,750 patients were submitted to the Department of Microbiology at St. Vincents Hospital, Sydney, Australia. Trophozoites of Dientamoeba fragilis were detected in 60 (0.9%) patients by permanent staining, and confirmation was performed by PCR. Gastrointestinal symptoms were present in all patients, with diarrhea and abdominal pain the most common symptoms. Thirty-two percent of patients presented with chronic symptoms. The average age of infected patients was 39.8 years. No correlation was found between D. fragilis and Enterobius vermicularis, a proposed vector of transmission for D. fragilis. The genetic diversity of 50 D. fragilis isolates was examined by PCR, and the PCR products were analyzed for the presence of restriction fragment length polymorphisms. These results showed no variation in the small-subunit rRNA gene and demonstrated a single genotype for all Australian isolates. This study shows the potential pathogenic properties of D. fragilis and the need for all laboratories to routinely test for this organism.

Field Evaluation of Repellent Formulations Against Daytime and Nighttime Biting Mosquitoes in a Tropical Rainforest in Northern Australia

Abstract Field trials to compare repellent formulations containing either picaridin or deet against rainforest mosquitoes in northern Queensland, Australia, were conducted. Three repellents were compared at night: 9.3% picaridin and 19.2% picaridin (Autan Repel and Autan Repel Army 20, respectively, Bayer, Sydney, Australia) and 35% deet in a gel (Australian Defense Force [ADF]). During the day, the following three repellents were compared: 19.2% picaridin, 20% deet in a controlled release formulation (Sawyer Controlled Release Deet), and 33% deet in a polymer formulation (U.S. Army Extended Duration Topical Insect and Arthropod Repellent [EDTIAR]). The predominant mosquito species collected was Verrallina lineata (Taylor), with smaller numbers of Ochlerotatus kochi (Donitz), Anopheles farauti s.s. Laveran, Ochlerotatus notoscriptus (Skuse), and Coquilletidia xanthogaster (Edwards). In nighttime tests, 19.2% picaridin provided >94.7% protection for at least 9 h, and ADF deet provided >95% protection for 7 h. The 9.3% picaridin formulation provided >95% protection for only 2 h, and provided 60% protection at 9 h. In daytime tests, Sawyer 20% deet provided >95% protection for 6 h, and both 19.2% picaridin and U.S. Army EDTIAR provided >95% protection for 8 h. In both nighttime and daytime tests 19.2% picaridin provided similar or better protection than deet formulations.