Special Issue "Control of Communicable Diseases in Human and in Animal Populations: 70th Anniversary Year of the Birth of Professor Rick Speare (2 August 1947 – 5 June 2016)"

A special issue of Tropical Medicine and Infectious Disease (ISSN 2414-6366).

Deadline for manuscript submissions: closed (30 April 2018).

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Special Issue Editor

Guest Editor
Dr. Jorg Heukelbach

Department of Community Health, School of Medicine, Federal University of Ceará, Fortaleza CE 60430-140, Brazil
College of Public Health, Medical and Veterinary Sciences, Division of Tropical Health and Medicine, James Cook University, Townsville, Queensland 4811, Australia
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Interests: public health; infectious diseases; epidemiology

Special Issue Information

Dear Colleagues,

text
In Memoriam Rick Speare (1947--2016)

 In the 1980s, he worked as a research fellow in Veterinary Science on diseases of amphibians. In the 1990s, Rick was transferred to the Anton Breinl Institute for Tropical Health and Medicine (and later became Director of the Institute and Deputy Head of the School of Public Health, Tropical Medicine and Rehabilitation Sciences at JCU). There he also performed high level research of human medical interest, such as epidemiology and control of head lice infestations—an important issue in times of increasing louse resistance to many pediculicides. He dedicated much of his work to Aboriginal communities, merging animal and human health, such as in the control of sarcoptic mange in dogs. Rick and his team discovered that a chytrid fungus caused the killing of frogs and amphibian mass extinction, one of the current most striking biological problems affecting biodiversity worldwide. His field work with crutches in Tuvalu (after rupture of the Achilles tendon) and the autoinfection with hookworms and production of striking images of hookworms feeding in his intestine (after swallowing a micro-camera) will always be remembered. After retirement, he established ”Tropical Health Solutions“ to work on pandemic threats, and to improve health in the tropics through research and training, mainly in Papua New Guinea and Pacific Islands. On 5 June 2016, Rick was killed in a car crash while driving to a seminar at JCU. Rick will always be remembered as an extremely competent professional, and a man of great humanity with a great sense of humor.

Dr. Jorg Heukelbach
Guest Editor

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Published Papers (18 papers)

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Editorial

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Open AccessEditorial
Control of Communicable Diseases in Human and in Animal Populations: 70th Anniversary of the Year of the Birth of Professor Rick Speare (2 August 1947–5 June 2016)
Trop. Med. Infect. Dis. 2018, 3(4), 106; https://doi.org/10.3390/tropicalmed3040106
Received: 25 September 2018 / Revised: 26 September 2018 / Accepted: 26 September 2018 / Published: 28 September 2018
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Research

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Open AccessArticle
Hospitalizations and Deaths Associated with Diarrhea and Respiratory Diseases among Children Aged 0–5 Years in a Referral Hospital of Mauritania
Trop. Med. Infect. Dis. 2018, 3(3), 103; https://doi.org/10.3390/tropicalmed3030103
Received: 29 July 2018 / Revised: 30 August 2018 / Accepted: 11 September 2018 / Published: 17 September 2018
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Abstract
Diarrhea and respiratory diseases are the leading causes of morbidity and mortality among <5-year-olds worldwide, but systematic data are not available from Mauritania. We conducted a hospital-based retrospective study. Data on admissions to Mauritania’s National Referral Hospital (the main pediatric referral center in [...] Read more.
Diarrhea and respiratory diseases are the leading causes of morbidity and mortality among <5-year-olds worldwide, but systematic data are not available from Mauritania. We conducted a hospital-based retrospective study. Data on admissions to Mauritania’s National Referral Hospital (the main pediatric referral center in the country), due to diarrhea and respiratory diseases, during 2011–2014, were analyzed. A total of 3695 children <5 years were hospitalized during this period; 665 (18.0%) due to respiratory diseases, and 829 (22.4%) due to diarrhea. Case fatality rates in the respiratory diseases and diarrhea groups were 18.0% (120/665) and 14.1% (117/829), respectively. The highest frequency of deaths due to diarrhea occurred in the age group 2–5 years (16/76; 21.0%), and due to respiratory diseases in the age group 6–12 months (32/141; 22.6%). We conclude that case fatality rates caused by respiratory diseases and diarrhea are extremely high in children hospitalized at the National Referral Hospital. These data call for intensified efforts to reduce deaths among hospitalized Mauritanian children, and also for integrated control measures to prevent and reduce the burden of both diseases. Additional studies are needed to show the effectiveness of the introduction of vaccination programs for pneumococcal diseases and rotavirus infection in the child population, which were launched in November 2013 and December 2014, respectively. Full article
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Open AccessArticle
Epidemiology and Spatiotemporal Patterns of Leprosy Detection in the State of Bahia, Brazilian Northeast Region, 2001–2014
Trop. Med. Infect. Dis. 2018, 3(3), 79; https://doi.org/10.3390/tropicalmed3030079
Received: 29 April 2018 / Revised: 12 July 2018 / Accepted: 25 July 2018 / Published: 31 July 2018
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Abstract
The detection of leprosy cases is distributed unequally in Brazil, with high-risk clusters mainly in the North and Northeast regions. Knowledge on epidemiology and spatiotemporal patterns of leprosy occurrence and late diagnosis in these areas is critical to improve control measures. We performed [...] Read more.
The detection of leprosy cases is distributed unequally in Brazil, with high-risk clusters mainly in the North and Northeast regions. Knowledge on epidemiology and spatiotemporal patterns of leprosy occurrence and late diagnosis in these areas is critical to improve control measures. We performed a study including all leprosy cases notified in the 417 municipalities of Bahia state, from 2001 to 2014. New case detection (overall and pediatric <15 years) and grade 2 disability (G2D) rates were calculated and stratified according to socio-demographic variables. Spatial analyses were performed to detect high-risk areas for occurrence and late diagnosis. A total of 40,060 new leprosy cases was reported in the period (mean = 2861 cases/year), 3296 (8.2%) in <15-year-olds, and 1921 (4.8%) with G2D. The new case detection rate was 20.41 cases/100,000 inhabitants (95% CI: 19.68–21.17). A higher risk was identified in older age groups (RR = 8.45, 95% CI: 7.08–10.09) and in residents living in the state capital (RR = 5.30, 95% CI: 4.13–6.79), in medium-sized cities (RR = 2.80; 95% CI: 2.50–3.13), and in the west (RR = 6.56, 95% CI: 5.13–8.39) and far south regions of the state (RR = 6.56, 95% CI: 5.13–8.39). A higher risk of G2D was associated with male gender (RR = 2.43, 95% CI: 2.20–2.67), older age (RR = 44.08, 95% CI: 33.21–58.51), Afro-Brazilian ethnicity (RR = 1.59; 95% CI: 1.37–1.85), living in medium-sized cities (RR = 2.60; 95% CI: 2.27–2.96) and residency in the north (RR = 5.02; 95% CI: 3.74–6.73) and far south (RR = 7.46; 95% CI: 5.58–9.98) regions. Heterogeneous space–time patterns of leprosy distribution were identified, indicating high endemicity, recent transmission, and late diagnosis. This heterogeneous distribution of the disease was observed throughout the study period. Leprosy remains a relevant public health problem in Bahia state. The disease has a focal distribution. We reinforce the importance of integrating surveillance, prevention and control actions in regions of higher risk of leprosy detection and late diagnosis, and in the most vulnerable populations. Full article
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Open AccessArticle
Paediatric Strongyloidiasis in Central Australia
Trop. Med. Infect. Dis. 2018, 3(2), 64; https://doi.org/10.3390/tropicalmed3020064
Received: 30 April 2018 / Revised: 6 June 2018 / Accepted: 6 June 2018 / Published: 13 June 2018
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Abstract
Few published studies are available describing the prevalence of paediatric strongyloidiasis in endemic areas within Australia. This literature review and exploratory clinical audit presents the first seroprevalence data for paediatric patients in Central Australia. A total of 16.1% (30/186) of paediatric inpatients tested [...] Read more.
Few published studies are available describing the prevalence of paediatric strongyloidiasis in endemic areas within Australia. This literature review and exploratory clinical audit presents the first seroprevalence data for paediatric patients in Central Australia. A total of 16.1% (30/186) of paediatric inpatients tested for Strongyloides stercoralis in 2016 were seropositive (95% CI: 11.5% to 22.1%). Eosinophilia of unknown aetiology was the most common indication for testing (91.9%). Seropositive patients were significantly more likely to reside in communities outside of Alice Springs (p = 0.02). Seropositive patients were noted to have higher mean eosinophil counts with a mean difference of 0.86 × 109/L (95% CI: 0.56 to 1.16, p < 0.0001), although the limited utility of eosinophilia as a surrogate marker of strongyloidiasis has been described previously. All seropositive patients were Indigenous. There was no significant difference in ages between groups. There was a male predominance in the seropositive group, although this was not significant (p = 0.12). Twelve patients had known human T-lymphotropic virus 1 (HTLV-1) status and all were seronegative. Further research describing the epidemiology of strongyloidiasis in Central Australia is required. Full article
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Open AccessArticle
Scabies in Resource-Poor Communities in Nasarawa State, Nigeria: Epidemiology, Clinical Features and Factors Associated with Infestation
Trop. Med. Infect. Dis. 2018, 3(2), 59; https://doi.org/10.3390/tropicalmed3020059
Received: 24 April 2018 / Revised: 25 May 2018 / Accepted: 29 May 2018 / Published: 4 June 2018
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Abstract
Epidemiology and clinical features of scabies remain largely unknown in Nigeria’s rural communities. To fill this gap, we performed a cross-sectional study in three rural communities in north central Nigeria. A total of 500 individuals were included and examined for scabies infestation; a [...] Read more.
Epidemiology and clinical features of scabies remain largely unknown in Nigeria’s rural communities. To fill this gap, we performed a cross-sectional study in three rural communities in north central Nigeria. A total of 500 individuals were included and examined for scabies infestation; a questionnaire was applied to collect socio-demographic and behavioral data. Scabies was diagnosed in 325 (65.0%) participants. Excoriations (68.6%), vesicles (61.8%), and papules (58.8%) were common skin lesions. Itching was the most common symptom (77.5%); 64% complained of sleep disturbances. Lymphadenopathy was identified in 48.3%. Lesions were most commonly encountered on the abdomen (35.5%), inguinal area (19.1%), and interdigital spaces (14.2%). Poverty-related variables, such as illiteracy (OR: 7.15; 95% CI: 3.71–13.95), low household income (7.25; 1.19–88.59), absence of a solid floor inside house (12.17; 2.83–52.34), and overcrowding (1.98; 1.08–2.81) were significantly associated with infestation. Individual behavior, such as sharing of beds/pillows (2.11; 1.42–3.14) and sharing of clothes (2.51; 1.57–3.99), was also highly significantly associated with scabies. Regular bathing habits (0.37; 0.24–0.56) and regular use of bathing soap (0.36; 0.21–0.53) were protective factors. Scabies is extremely common in the communities under study and is associated with considerable morbidity. The disease is intrinsically linked with extreme poverty. Full article
Open AccessArticle
Diagnostic Performance of Kato Katz Technique and Point-of-Care Circulating Cathodic Antigen Rapid Test in Diagnosing Schistosoma mansoni Infection in HIV-1 Co-Infected Adults on the Shoreline of Lake Victoria, Tanzania
Trop. Med. Infect. Dis. 2018, 3(2), 54; https://doi.org/10.3390/tropicalmed3020054
Received: 7 May 2018 / Revised: 21 May 2018 / Accepted: 22 May 2018 / Published: 29 May 2018
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Abstract
Background: The diagnostic performance of the Kato Katz (KK) technique and the point-of-care circulating cathodic antigen (POC-CCA) test in detecting S. mansoni infection in the presence of the human immunodeficiency virus-1 (HIV-1) infection has remained inconclusive. The present cross-sectional survey compared the diagnostic [...] Read more.
Background: The diagnostic performance of the Kato Katz (KK) technique and the point-of-care circulating cathodic antigen (POC-CCA) test in detecting S. mansoni infection in the presence of the human immunodeficiency virus-1 (HIV-1) infection has remained inconclusive. The present cross-sectional survey compared the diagnostic performance of the KK technique and the POC-CCA test in diagnosing S. mansoni infection in an adult population co-infected with HIV-1 in northwestern Tanzania. Methods: Single urine and stool samples from 979 adults were screened for S. mansoni infection using both the KK technique and POC-CCA tests. To compare the performance of the two diagnostic tests a combined artificial gold standard was created, based on either an egg-positive KK technique or a POC-CCA-positive test. Results: Based on the KK technique, the prevalence of S. mansoni was 47.3% (463/979, 95% CI: 44.2–50.4), as compared to 60.5% by the POC-CCA test (592/979; 95% CI: 57.4–63.5). The overall sensitivity and specificity of the POC-CCA test were 92.5% (95% CI: 89.4–94.9) and 73.3% (95% CI: 69.6–76.8), respectively. In the HIV-1 seropositive group, the sensitivity and specificity of the POC-CCA test were 78.1% (95% CI: 60.0–90.7) and 45.9% (95% CI: 35.8–56.3). Using a combined gold standard, the sensitivity of the POC-CCA test increased to >90% in both subgroups whereas that of the KK technique in the HIV-1 seropositive group was low (49.5%; 95% CI: 39.6–59.5). Conclusion: In the presence of HIV-1 co-infection, the KK technique attained a very low sensitivity. The POC-CCA test offers the best option for the rapid screening of S. mansoni infection in communities with a high prevalence of HIV-1 infection. Full article
Open AccessArticle
Immunisation Rates of Medical Students at a Tropical Queensland University
Trop. Med. Infect. Dis. 2018, 3(2), 52; https://doi.org/10.3390/tropicalmed3020052
Received: 25 April 2018 / Revised: 12 May 2018 / Accepted: 15 May 2018 / Published: 23 May 2018
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Abstract
Although medical students are at risk of contracting and transmitting communicable diseases, previous studies have demonstrated sub-optimal medical student immunity. The objective of this research was to determine the documented immunity of medical students at James Cook University to important vaccine-preventable diseases. An [...] Read more.
Although medical students are at risk of contracting and transmitting communicable diseases, previous studies have demonstrated sub-optimal medical student immunity. The objective of this research was to determine the documented immunity of medical students at James Cook University to important vaccine-preventable diseases. An anonymous online survey was administered thrice in 2014, using questions with categories of immunity to determine documented evidence of immunity, as well as closed-ended questions about attitudes towards the importance of vaccination. Of the 1158 medical students targeted via survey, 289 responses were included in the study (response rate 25%), of which 19 (6.6%) had documented evidence of immunity to all of the vaccine-preventable diseases surveyed. Proof of immunity was 38.4% for seasonal influenza, 47.1% for pertussis, 52.2% for measles, 38.8% for varicella, 43.7% for hepatitis A, and 95.1% for hepatitis B (the only mandatory vaccination for this population). The vast majority of students agreed on the importance of vaccination for personal protection (98.3%) and patient protection (95.9%). In conclusion, medical students have sub-optimal evidence of immunity to important vaccine-preventable diseases. Student attitudes regarding the importance of occupational vaccination are inconsistent with their level of immunity. The findings of this study were used to prompt health service and educational providers to consider their duty of care to manage the serious risks posed by occupational communicable diseases. Full article
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Open AccessArticle
Cross-Cultural, Aboriginal Language, Discovery Education for Health Literacy and Informed Consent in a Remote Aboriginal Community in the Northern Territory, Australia
Trop. Med. Infect. Dis. 2018, 3(1), 15; https://doi.org/10.3390/tropicalmed3010015
Received: 10 December 2017 / Revised: 20 January 2018 / Accepted: 20 January 2018 / Published: 29 January 2018
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Abstract
Background: Education for health literacy of Australian Aboriginal people living remotely is challenging as their languages and worldviews are quite different from English language and Western worldviews. Becoming health literate depends on receiving comprehensible information in a culturally acceptable manner. Methods: The study [...] Read more.
Background: Education for health literacy of Australian Aboriginal people living remotely is challenging as their languages and worldviews are quite different from English language and Western worldviews. Becoming health literate depends on receiving comprehensible information in a culturally acceptable manner. Methods: The study objective was to facilitate oral health literacy through community education about scabies and strongyloidiasis, including their transmission and control, preceding an ivermectin mass drug administration (MDA) for these diseases. A discovery education approach where health concepts are connected to cultural knowledge in the local language was used. Aboriginal and non-Aboriginal educators worked collaboratively to produce an in-depth flip-chart of the relevant stories in the local language and to share them with clan elders and 27% of the population. Results: The community health education was well received. Feedback indicated that the stories were being discussed in the community and that the mode of transmission of strongyloidiasis was understood. Two-thirds of the population participated in the MDA. This study documents the principles and practice of a method of making important Western health knowledge comprehensible to Aboriginal people. This method would be applicable wherever language and culture of the people differ from language and culture of health professionals. Full article
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Open AccessArticle
Application of PCR-Based Tools to Explore Strongyloides Infection in People in Parts of Northern Australia
Trop. Med. Infect. Dis. 2017, 2(4), 62; https://doi.org/10.3390/tropicalmed2040062
Received: 12 October 2017 / Revised: 1 December 2017 / Accepted: 1 December 2017 / Published: 8 December 2017
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Abstract
Strongyloidiasis, which is caused by infection with the nematode Strongyloides stercoralis, is endemic to areas of northern Australia. Diagnosis in this region remains difficult due to the distances between endemic communities and diagnostic laboratories, leading to lengthy delays in stool processing for [...] Read more.
Strongyloidiasis, which is caused by infection with the nematode Strongyloides stercoralis, is endemic to areas of northern Australia. Diagnosis in this region remains difficult due to the distances between endemic communities and diagnostic laboratories, leading to lengthy delays in stool processing for microscopy and culture. PCR represents a viable solution to this difficulty, having potential for high sensitivity detection of S. stercoralis, even in older, unpreserved faecal samples. We prospectively collected 695 faecal specimens that were submitted to The Townsville Hospital Microbiology Laboratory from the North Queensland region for routine parasitological examination, and subjected them to a Strongyloides sp. real-time (q)PCR. Results were confirmed with a novel nested conventional PCR assay targeting the 18S rRNA gene, followed by single-strand conformation polymorphism analysis (SSCP). Of the 695 specimens tested, S. stercoralis was detected in three specimens (0.4%) by classical parasitological methods (direct microscopy and formyl-ether acetate concentration), whereas 42 positives were detected by qPCR (6.0%). Conventional PCR confirmed the real-time PCR results in 24 of the samples (3.5%). Several apparent false-positive results occurred at higher cycle times (Ct) in the qPCR. Use of real-time PCR in these populations is promising for the enhanced detection of disease and to support eradication efforts. Full article
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Open AccessArticle
A Survey of Intestinal Parasites of Domestic Dogs in Central Queensland
Trop. Med. Infect. Dis. 2017, 2(4), 60; https://doi.org/10.3390/tropicalmed2040060
Received: 20 October 2017 / Revised: 13 November 2017 / Accepted: 17 November 2017 / Published: 21 November 2017
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Abstract
Australia has a very high rate of dog ownership, which in some circumstances may lead to exposure to zoonotic parasitic diseases from those companion animals. Domestic dog faecal samples (n = 300) were collected from public spaces and private property in the [...] Read more.
Australia has a very high rate of dog ownership, which in some circumstances may lead to exposure to zoonotic parasitic diseases from those companion animals. Domestic dog faecal samples (n = 300) were collected from public spaces and private property in the greater Rockhampton (Central Queensland) region and tested for intestinal helminths and protozoa by direct microscopy, two flotation methods and a modified acid-fast stain for cryptosporidia. Intestinal parasites detected included hookworms (25%), Cystoisospora ohioensis complex (9%), Blastocystis hominis (3%), Giardia duodenalis (3%), Spirometra erinacei (1%) and Toxocara canis (1%), Sarcocystis spp. (2%), Cryptosporidium spp. (2%) and Cystoisospora canis (1%). One infection each with Trichuris vulpis, Dipylidium caninum and a protozoa belonging to the Entamoeba histolytica complex were identified. Sheather’s sucrose centrifugal flotation was more sensitive than saturated salt passive flotation, but no single test detected all cases of parasitic infection identified. The test methodologies employed are poor at recovering larva of Strongyloides stercoralis, Aleurostrongylus abstrussis and eggs of cestodes such as Echinococcus granulosis, so the potential presence of these parasites in Central Queensland domestic dogs cannot be excluded by this survey alone. Full article
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Review

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Open AccessReview
Exotic Parasite Threats to Australia’s Biosecurity—Trade, Health, and Conservation
Trop. Med. Infect. Dis. 2018, 3(3), 76; https://doi.org/10.3390/tropicalmed3030076
Received: 29 June 2018 / Revised: 11 July 2018 / Accepted: 12 July 2018 / Published: 18 July 2018
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Abstract
Parasites have threatened Australia’s biosecurity since the early days of European settlement. Tick fever in cattle and liver fluke, along with their invertebrate hosts, and hydatid disease head the list of parasites that are still impacting livestock industries. In addition, there are many [...] Read more.
Parasites have threatened Australia’s biosecurity since the early days of European settlement. Tick fever in cattle and liver fluke, along with their invertebrate hosts, and hydatid disease head the list of parasites that are still impacting livestock industries. In addition, there are many parasites that have been introduced that are of significance to public health as well as the conservation of native wildlife. As a consequence of these early arrivals, Australia has become much more aware of its vulnerability should parasites such as Trichinella and Trypanosoma evansi become established in Australia. However, recent discoveries concerning Leishmania and other trypanosomes have demonstrated that Australia must not become complacent and reliant on dogma when considering the potential emergence of new threats to its biosecurity. In this short review, the major parasite threats to Australia’s biosecurity are summarised, some misconceptions are emphasised, and attention is given to the importance of challenging dogma in the face of a dearth of information about Australian native fauna. Full article
Open AccessReview
An Overview of Brucellosis in Cattle and Humans, and its Serological and Molecular Diagnosis in Control Strategies
Trop. Med. Infect. Dis. 2018, 3(2), 65; https://doi.org/10.3390/tropicalmed3020065
Received: 28 April 2018 / Revised: 1 June 2018 / Accepted: 9 June 2018 / Published: 14 June 2018
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Abstract
Brucellosis is one of the most common contagious and communicable zoonotic diseases with high rates of morbidity and lifetime sterility. There has been a momentous increase over the recent years in intra/interspecific infection rates, due to poor management and limited resources, especially in [...] Read more.
Brucellosis is one of the most common contagious and communicable zoonotic diseases with high rates of morbidity and lifetime sterility. There has been a momentous increase over the recent years in intra/interspecific infection rates, due to poor management and limited resources, especially in developing countries. Abortion in the last trimester is a predominant sign, followed by reduced milk yield and high temperature in cattle, while in humans it is characterized by undulant fever, general malaise, and arthritis. While the clinical picture of brucellosis in humans and cattle is not clear and often misleading with the classical serological diagnosis, efforts have been made to overcome the limitations of current serological assays through the development of PCR-based diagnosis. Due to its complex nature, brucellosis remains a serious threat to public health and livestock in developing countries. In this review, we summarized the recent literature, significant advancements, and challenges in the treatment and vaccination against brucellosis, with a special focus on developing countries. Full article
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Open AccessReview
Argument for Inclusion of Strongyloidiasis in the Australian National Notifiable Disease List
Trop. Med. Infect. Dis. 2018, 3(2), 61; https://doi.org/10.3390/tropicalmed3020061
Received: 7 May 2018 / Revised: 23 May 2018 / Accepted: 31 May 2018 / Published: 5 June 2018
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Abstract
Strongyloidiasis is an infection caused by the helminth, Strongyloides stercoralis. Up to 370 million people are infected with the parasite globally, and it has remained endemic in the Indigenous Australian population for many decades. Strongyloidiasis has been also reported in other Australian [...] Read more.
Strongyloidiasis is an infection caused by the helminth, Strongyloides stercoralis. Up to 370 million people are infected with the parasite globally, and it has remained endemic in the Indigenous Australian population for many decades. Strongyloidiasis has been also reported in other Australian populations. Ignorance of this disease has caused unnecessary costs to the government health system, and been detrimental to the Australian people’s health. This manuscript addresses the 12 criteria required for a disease to be included in the Australian National Notifiable Disease List (NNDL) under the National Health Security Act 2007 (Commonwealth). There are six main arguments that provide compelling justification for strongyloidiasis to be made nationally notifiable and added to the Australian NNDL. These are: The disease is important to Indigenous health, and closing the health inequity gap between Indigenous and non-Indigenous Australians is a priority; a public health response is required to detect cases of strongyloidiasis and to establish the true incidence and prevalence of the disease; there is no alternative national surveillance system to gather data on the disease; there are preventive measures with high efficacy and low side effects; data collection is feasible as cases are definable by microscopy, PCR, or serological diagnostics; and achievement of the Sustainable Development Goal (SDG) # 6 on clean water and sanitation. Full article
Open AccessReview
The History of Bancroftian Lymphatic Filariasis in Australasia and Oceania: Is There a Threat of Re-Occurrence in Mainland Australia?
Trop. Med. Infect. Dis. 2018, 3(2), 58; https://doi.org/10.3390/tropicalmed3020058
Received: 26 April 2018 / Revised: 30 May 2018 / Accepted: 31 May 2018 / Published: 4 June 2018
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Abstract
Lymphatic filariasis (LF) infects an estimated 120 million people worldwide, with a further 856 million considered at risk of infection and requiring preventative chemotherapy. The majority of LF infections are caused by Wuchereria bancrofti, named in honour of the Australian physician Joseph [...] Read more.
Lymphatic filariasis (LF) infects an estimated 120 million people worldwide, with a further 856 million considered at risk of infection and requiring preventative chemotherapy. The majority of LF infections are caused by Wuchereria bancrofti, named in honour of the Australian physician Joseph Bancroft, with the remainder due to Brugia malayi and B. timori. Infection with LF through the bite of an infected mosquito, can lead to the development of the condition known as elephantiasis, where swelling due to oedema leads to loss of function in the affected area and thickening of the skin, ‘like an elephant’. LF has previously been endemic in Australia, although currently, no autochthonous cases occur there. Human immigration to Australia from LF-endemic countries, including those close to Australia, and the presence of susceptible mosquitoes that can act as suitable vectors, heighten the possibility of the reintroduction of LF into this country. In this review, we examine the history of LF in Australia and Oceania and weigh up the potential risk of its re-occurrence on mainland Australia. Full article
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Open AccessReview
The Unique Life Cycle of Strongyloides stercoralis and Implications for Public Health Action
Trop. Med. Infect. Dis. 2018, 3(2), 53; https://doi.org/10.3390/tropicalmed3020053
Received: 27 April 2018 / Revised: 21 May 2018 / Accepted: 21 May 2018 / Published: 25 May 2018
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Abstract
Strongyloides stercoralis has one of the most complex life cycles of the human-infecting nematodes. A common misconception in medical and public health professions is that S. stercoralis in its biology is akin to other intestinal nematodes, such as the hookworms. Despite original evidence [...] Read more.
Strongyloides stercoralis has one of the most complex life cycles of the human-infecting nematodes. A common misconception in medical and public health professions is that S. stercoralis in its biology is akin to other intestinal nematodes, such as the hookworms. Despite original evidence provided by medical and veterinary research about this unique helminth, many assumptions have entered the scientific literature. This helminth is set apart from others that commonly affect humans by (a) the internal autoinfective cycle with autoinfective larvae randomly migrating through tissue, parthenogenesis, and the potential for lifelong infection in the host, the profound pathology occurring in hyperinfection and systemic manifestations of strongyloidiasis, and (b) a limited external cycle with a single generation of free-living adults. This paper aims to review and discuss original research on the unique life cycle of S. stercoralis that distinguishes it from other helminths and highlight areas where increased understanding of the parasite’s biology might lead to improved public health prevention and control strategies. Full article
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Open AccessReview
The Health Effects of Strongyloidiasis on Pregnant Women and Children: A Systematic Literature Review
Trop. Med. Infect. Dis. 2018, 3(2), 50; https://doi.org/10.3390/tropicalmed3020050
Received: 28 April 2018 / Revised: 11 May 2018 / Accepted: 15 May 2018 / Published: 18 May 2018
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Abstract
Strongyloidiasis is a helminth infection that remains under-researched despite its ability to cause significant illness. Women and children may be at particular risk of health consequences from this parasite. This systematic literature review aims to examine research on the long-term health effects that [...] Read more.
Strongyloidiasis is a helminth infection that remains under-researched despite its ability to cause significant illness. Women and children may be at particular risk of health consequences from this parasite. This systematic literature review aims to examine research on the long-term health effects that strongyloidiasis has in pregnant women and children. We conducted a structured search using multiple databases to collect all primary studies discussing health effects of strongyloidiasis in the aforementioned groups. The review included 20 results: 16 primary studies and four case reports. The methodological quality of studies was substandard, and there was substantial heterogeneity to the statistical analysis and outcomes assessed in the literature. Statistically significant associations were found between strongyloidiasis and low birth weight, as well as wasting. No links were found between strongyloidiasis and anaemia. Due to testing methods used in the studies, the prevalence of Strongyloides stercoralis in these studies was probably under-estimated. Current research is suggestive that strongyloidiasis has long-term adverse health effects on the offspring of infected mothers and in chronically-infected children. Data analysis was hindered by both methodological and statistical flaws, and as such, reliable conclusions regarding the health impacts could not be formed. Full article
Open AccessReview
A Community-Directed Integrated Strongyloides Control Program in Queensland, Australia
Trop. Med. Infect. Dis. 2018, 3(2), 48; https://doi.org/10.3390/tropicalmed3020048
Received: 15 March 2018 / Revised: 17 April 2018 / Accepted: 27 April 2018 / Published: 4 May 2018
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Abstract
This paper describes two phases of a community-directed intervention to address strongyloidiasis in the remote Aboriginal community of Woorabinda in central Queensland, Australia. The first phase provides the narrative of a community-driven ‘treat-and-test’ mass drug administration (MDA) intervention that was co-designed by the [...] Read more.
This paper describes two phases of a community-directed intervention to address strongyloidiasis in the remote Aboriginal community of Woorabinda in central Queensland, Australia. The first phase provides the narrative of a community-driven ‘treat-and-test’ mass drug administration (MDA) intervention that was co-designed by the Community Health Service and the community. The second phase is a description of the re-engagement of the community in order to disseminate the key factors for success in the previous MDA for Strongyloides stercoralis, as this information was not shared or captured in the first phase. During the first phase in 2004, there was a high prevalence of strongyloidiasis (12% faecal examination, 30% serology; n = 944 community members tested) that resulted in increased morbidity and at least one death in the community. Between 2004–2005, the community worked in partnership with the Community Health Service to implement a S. stercoralis control program, where all of the residents were treated with oral ivermectin, and repeat doses were given for those with positive S. stercoralis serology. The community also developed their own health promotion campaign using locally-made resources targeting relevant environmental health problems and concerns. Ninety-two percent of the community residents participated in the program, and the prevalence of strongyloidiasis at the time of the ‘treat-and-test’ intervention was 16.6% [95% confidence interval 14.2–19.3]. The cure rate after two doses of ivermectin was 79.8%, based on pre-serology and post-serology tests. The purpose of this paper is to highlight the importance of local Aboriginal leadership and governance and a high level of community involvement in this successful mass drug administration program to address S. stercoralis. The commitment required of these leaders was demanding, and involved intense work over a period of several months. Apart from controlling strongyloidiasis, the community also takes pride in having developed and implemented this program. This appears to be the first community-directed S. stercoralis control program in Australia, and is an important part of the national story of controlling infectious diseases in Indigenous communities. Full article
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Open AccessCase Report
Echinococcus Granulosus Infection in Two Free-Ranging Lumholtz’s Tree-Kangaroo (Dendrolagus lumholtzi) from the Atherton Tablelands, Queensland
Trop. Med. Infect. Dis. 2018, 3(2), 47; https://doi.org/10.3390/tropicalmed3020047
Received: 19 April 2018 / Revised: 1 May 2018 / Accepted: 1 May 2018 / Published: 3 May 2018
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Abstract
Infection with the larval stage of the cestode, Echinococcus granulosus sensu lato (s.l.), causes hydatid disease (hydatidosis) in a range of hosts, including macropods and other marsupials, cattle, and humans. Wild macropods are an important sylvatic reservoir for the life cycle of [...] Read more.
Infection with the larval stage of the cestode, Echinococcus granulosus sensu lato (s.l.), causes hydatid disease (hydatidosis) in a range of hosts, including macropods and other marsupials, cattle, and humans. Wild macropods are an important sylvatic reservoir for the life cycle of E. granulosus (s.l.) in Australia, and so provide a conduit for transmission of hydatid disease to domestic animals and humans. Two Lumholtz’s tree-kangaroos (Dendrolagus lumholtzi) from the Atherton Tablelands of Far North Queensland were recently found to have hydatid cysts in both liver and lung tissues. Tree-kangaroos may travel across the ground between patches of forest but are primarily arboreal leaf-eating macropods. The finding of hydatid cysts in an arboreal folivore may indicate that the area has a high level of contamination with eggs of E. granulosus (s.l.). This finding may be of significance to human health as well as indicating the need for further investigation into the prevalence of hydatid disease in domestic stock, wildlife and humans living in this rapidly urbanizing region. Full article
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