Ralph D Robinson

Immunodiagnosis of Strongyloides stercoralis infection: a method for increasing the specificity of the indirect Elisa

Indirect enzyme-linked immunosorbent assay (ELISA) allows sensitive detection of serum immunoglobulin (Ig) G against a soluble extract of Strongyloides stercoralis infective larvae. In this study, 40/40 (100%) human strongyloidiasis sera had high levels of anti-S. stercoralis IgG, but 30/40 (75%) filariasis sera, and 12/40 (30%) necatoriasis sera also had higher levels than control sera from UK residents. In attempts to increase the assay specificity by absorption of cross-reactive IgG, the effectiveness of pre-incubation of sera with extracts of different parasitic nematodes was investigated. One hour of incubation with 20 micrograms/ml aqueous extract of Onchocerca gutturosa absorbed cross-reactive IgG in most filariasis and necatoriasis sera, reducing the proportion with IgG levels above the positivity threshold by more than one-half. Preliminary results suggest that absorption with extracts of other filarial nematodes is equally effective, and that some of the cross-reactive IgG is directed against phosphorylcholine. Cross-reactive IgG in most necatoriasis sera was effectively absorbed with 20 micrograms/ml extract of Necator americanus. Cross-reactive IgG was not effectively absorbed with an extract of Ascaris lumbricoides. Absorption of cross-reactive IgG is an effective means of increasing the specificity of the indirect ELISA, for use in the immunodiagnosis and immuno-epidemiology of S. stercoralis infection.

Age-prevalence and household clustering of Strongyloides stercoralis infection in Jamaica

The epidemiology of Strongyloides stercoralis was studied in families of clinical (reference) cases and their neighbours at endemic foci in Jamaica. Thirteen foci were studied based on the place of residence of a reference case. For each household of a reference case, the 4 most proximal neighbourhood households (spatial controls) were included in the study. Out of 312 persons contacted 244 were followed up using questionnaires, stool examination and serology. Prevalence of infection based on stool examination was 3.5% and on ELISA 24.2%. Prevalence increased with age but was not related to gender. Reference cases were significantly older than the general study population. The prevalence of infection based on both serology and stool examination was significantly higher in reference than in neighbouring households (the reference cases, themselves, were not included in the analysis). Furthermore, prevalence of infection was highest among persons who shared a bedroom with a reference case and decreased significantly with increasing spatial separation. This is indicative of close contact transmission which has not been previously shown for a geohelminth, but which is common among microparasites.

POPULATION DISTRIBUTION AND ZOONOTIC POTENTIAL OF GASTROINTESTINAL HELMINTHS OF WILD RATS RATTUS RATTUS AND R. NORVEGICUS FROM JAMAICA

The population distribution and zoonotic potential of gastrointestinal helminths in a naturally infected population of wild rats (Rattus rattus and Rattus norvegicus) in Jamaica are described. One hundred and thirty (29.7%) of 437 rats captured in the study were infected: 104 (35%) of 297 R. rattus compared with 26 (18.6%) of 140 R. norvegicus. Nine species of gastrointestinal helminths were recovered: Raillietina sp. (0.2%), Trichuris sp. (0.2%), Rictularia sp. (0.7%), Syphacia obvelata (1.1%), Strongyloides ratti (1.4%), Hymenolepis diminuta (3.8%), Protospirura muricola (4.3%), Moniliformis moniliformis (11.2%), and Nippostrongylus brasiliensis (14.2%). In a logistic model, the single risk factor identified for both M. moniliformis and P. muricola was R. rattus, compared with R. norvegicus (OR = 8.369 and 9.714, respectively). In comparison, the risk factor predicted for infection with N. brasiliensis was the northeastern section of Jamaica (OR = 11.000) compared with western Jamaica. Rictularia sp. represents a new geographic distribution record for the Caribbean region. Hymenolepis diminuta, M. moniliformis, Raillietina sp., and Rictularia sp. are potentially zoonotic, but only human infection with H. diminuta has been previously reported in the Caribbean.

Towards effective control of Strongyloides stercoralis

Abstract A widespread intestinal parasite of humans, Strongyloides stercoralis has long been considered very difficult to control in endemic communities. This situation is now changing. In this article, David Conway, John Lindo, Ralph Robinson and Don Bundy review recent advances in diagnosis, chemotherapy and epidemiology of S. stercoralis infection, and highlight new options for control.

Human Angiostrongylus cantonensis, Jamaica

To the Editor: Angiostrongylus cantonensis is the most common cause of eosinophilic meningoencephalitis worldwide (1). The parasites presence has been well documented in Jamaica in rats (definitive host) and a variety of mollusks (intermediate hosts); infections occur in humans sporadically on the island. However, the mode of transmission of infections to humans in Jamaica, where raw or undercooked mollusks are not usually eaten, is not well understood (2).

Seroepidemiology of Helicobacter pylori infection in a Jamaican community.

Summary We researched epidemiologic associations between environmental and demographic factors and prevalence of Helicobacter pylori infection in a suburban Jamaican community. Using a clustered sampling technique, 22 domestic yards enclosing 60 separate households were randomly selected from a local community. All household members (n = 346) were invited to participate following informed consent; the overall compliance rate was 58.9%. A commercial enzyme immunoassay (HMáCAP) was used to detect IgG antibodies raised against H. pylori. Environmental and demographic information was obtained by questionnaire. The seroprevalence of H. pylori was 69.9% (n = 202). Analysis of the independent variables revealed three major components: Component 1 described, collectively, good personal hygiene and sanitation, indoor water supply and absence of straying animals in the peridomestic area; Component 2 included older age, good personal hygiene and large yard size; Component 3 the presence of domestic animals (cats and dogs) and, again, large yard size. These three complexes explained 42.2% of the variability in the data set. Logistic regression showed that Components 2 and 3 were independently associated with H. pylori seropositivity, indicating that a combination of demographic, environmental and zoonotic factors is involved in the spread of H. pylori infections at the tropical community level.

Chromosome Complement, Gametogenesis, and Development of Strongyloides stercoralis

Gametogenesis and development were studied in free-living adults of the human parasitic nematode Strongyloides stercoralis. The diploid chromosome number is 6 in germ-line tissue of females and in embryos that will develop into parasitic females. Reproduction appears to be by meiotic parthenogenesis and pseudogamy, as in other species in the genus. Fecundity may be limited by the short lifespan of males. Newly hatched larvae contain about 500 cells, whereas adult females have about 840 somatic cells and a variable number of germ-line cells. The apical vegetative zones of both ovary and testis are occupied by cells with large amounts of DNA in their nuclei.

Workshop on research priorities for management and treatment of angiostrongyliasis(1).

In a concluding session of the workshop, the participants developed a list of 115 research and outreach needs, outlining the top 5-7 needs in each of 8 areas (Table). For complete information, including presenter details and abstracts, visit the workshop website at www.hawaii.edu/cowielab/Angio%20website%20home.htm.

A survey of intestinal helminths of well-cared-for dogs in Jamaica, and their potential public health significance

This study investigates the level of helminthic infestation in better-cared-for dogs in a middle-class community in suburban Kingston. A canine zoographic study was conducted, and fresh faecal deposits were collected and analysed for helminth life-cycle stages. The survey indicated that 73% (n = 93) of households in the study area owned one dog or more (mean = 1.4). Residents attitudes towards canine management suggested that the dog population was, in general, restricted to the residential estate, and most owners claimed to have dewormed their dogs at least as young animals. Of 141 faecal specimens, 58% contained eggs or larvae of one or more of eight helminths: Uncinaria stenocephala (26%), Ancylostoma sp. (23%), Trichuris vulpis (9%), Toxocara canis (8%), Spirocerca lupi (6%), Strongyloides sp. (6%), Apophallus sp. (4%) and taeniids (1%). There was a high level of multiple infection in the host animals, with approximately one fifth of the infected samples containing three or more helminth types. Infection intensity was apparently low, but some dogs harboured heavy worm loads.

Associations Between Two Trematode Parasites, an Ectosymbiotic Annelid, and Thiara (Tarebia) Granifera (Gastropoda) in Jamaica

abstract:  This work describes associations of Thiara (Tarebia) granifera, its larval trematode community, and Chaetogaster limnaei limnaei at a freshwater reservoir in Jamaica. Larvae of 2 trematodes were present, i.e., a notocotylid (15.3%) and Philophthalmus sp. (1.3%), in 3,575 T. granifera examined. The prevalence of both infections increased with snail shell length (H  =  56, P < 0.01, H  =  23.1, P < 0.01, respectively). Only 3.0% (n  =  595) of infected snails possessed reproductive stages, compared with 90.3% (n  =  2,980) of uninfected snails (&khgr;2  =  2,059.8, df  =  1, P < 0.001); both trematodes negatively impacted snail reproduction. Chaetogaster l. limnaei occurred within the mantle cavity of T. granifera with a prevalence of 2.3% (n  =  3,575); intensity ranged from 1 to 6 annelids. Notocotylid larvae occurred in 32.5% (n  =  83) of snails also harboring C. l. limnaei, compared with 14.9% (n  =  3,492) of snails lacking the annelid (&khgr;2  =  18.127; P < 0.001). Chaetogaster l. limnaei appears not to influence the recruitment of egg-transmitted, notocotylid infections to snails. Ingestion of emergent cercariae by the annelid was observed; this may impact transmission of the parasite. The article presents the first report of a notocotylid and C. l. limnaei in T. granifera, and of Philophthalmus sp. in Jamaica.