NF1 optic pathway glioma: analyzing risk factors for visual outcome and indications to treat

BackgroundThe aim of the project was to identify risk factors associated with visual progression and treatment indications in pediatric patients with neurofibromatosis type 1 associated optic pathway glioma (NF1-OPG).MethodsA multidisciplinary expert group consisting of ophthalmologists, pediatric neuro-oncologists, neurofibromatosis specialists, and neuro-radiologists involved in therapy trials assembled a cohort of children with NF1-OPG from 6 European countries with complete clinical, imaging, and visual outcome datasets. Using methods developed during a consensus workshop, visual and imaging data were reviewed by the expert team and analyzed to identify associations between factors at diagnosis with visual and imaging outcomes.ResultsEighty-three patients (37 males, 46 females, mean age 5.1 ± 2.6 y; 1–13.1 y) registered in the European treatment trial SIOP LGG-2004 (recruited 2004–2012) were included. They were either observed or treated (at diagnosis/after follow-up).In multivariable analysis, factors present at diagnosis associated with adverse visual outcomes included: multiple visual signs and symptoms (adjusted odds ratio [adjOR]: 8.33; 95% CI: 1.9–36.45), abnormal visual behavior (adjOR: 4.15; 95% CI: 1.20–14.34), new onset of visual symptoms (adjOR: 4.04; 95% CI: 1.26–12.95), and optic atrophy (adjOR: 3.73; 95% CI: 1.13–12.53). Squint, posterior visual pathway tumor involvement, and bilateral pathway tumor involvement showed borderline significance. Treatment appeared to reduce tumor size but improved vision in only 10/45 treated patients. Children with visual deterioration after primary observation are more likely to improve with treatment than children treated at diagnosis.ConclusionsThe analysis identified the importance of symptomatology, optic atrophy, and history of vision loss as predictive factors for poor visual outcomes in children with NF1-OPG.     

Pro–and anti–inflammatory cytokines profiles among Nigerian children infected with Plasmodium falciparum malaria

ObjectiveTo examine array of some pro-and anti-inflammatory cytokines, namely, interleukin-4 (IL-4), interleukin-10 (IL-10), interferon-γ (IFN-γ), interleukin-5(IL-5), interleukin-6 (IL-6), interleukin-12 (IL-12) and tumor necrosis factor-α (TNF-α) concentrations in some Nigerians with falciparum malaria.MethodsSera were obtained from the blood samples of 96 Nigerian children with Plasmodium falciparum infection. The sera were subjected to cytokine evaluation using commercial standard enzyme linked immunosorbent assay kits (Abcam, UK).ResultsMean pro-inflammatory cytokines in serum of children with uncomplicated and complicated malaria were IL-5 482.2 pg/mL versus 526.7 pg/mL, IL-6 98.8 pg/mL versus 82.6 pg/mL, IL-12 24.1 pg/mL versus 15.9 pg/mL, TNF-α 107 pg/mL versus 511.7 pg/mL and IFN-γ 2.1 pg/mL versus 2.5 pg/mL. The anti-inflammatory cytokines status of IL-4 were 4.7 pg/mL versus 20.3 pg/mL, and IL-10 were 216 pg/mL versus 143.8 pg/mL in uncomplicated versus complicated/severe malaria cases. Participants with uncomplicated malaria had mean parasitaemia level of 3 158.9 parasites/μL while mean parasitaemia level for participants with complicated malaria was 12 550.5 parasite/μL and this difference was statistically significant (χ² = 5 614.6, P < 0.05). The difference between mean haemoglobin level for uncomplicated malaria (9.6 g/dL) and severe malaria (3.9 g/dL) was statistically significant (χ² = 2.3, P < 0.05). The relationship between serum level of IL-6, IL-12, IFN-γ, IL-10 and IL-4 and ages showed positive correlation at r=0.92, 0.99, 0.86, 0.95 and 0.85, respectively; while IL-5 and TNF-α had negative correlation at r=?0.99 and ?0.99, respectively.ConclusionIL-4, IL-5, IL-6, IL-10, IL-12, TNF-α and IFN-γ are involved in the immunopathology and immunoregulation of uncomplicated and complicated malaria infections. IL-6, IL-12, IFN-γ and IL-10 depressed in complicated/severe malaria may not provide any protective immunity and may be indicators of poor prognosis in Plasmodium falciparum infected Nigerian children.     

Human African trypanosomiasis in endemic focus of Abraka,Nigeria

ObjectiveTo investigated the prevalence of human African trypanosomiasis (HAT), a neglected tropical disease caused by Trypanosoma brucei gambiens in an endemic focus of Nigeria, as it relates to age, sex and occupational differences.MethodsA total of 474 human subjects were screened using card agglutination test for trypanosomiasis kit. Positive samples were further investigated for parasite positivity in blood/serum and cerebrospinal fluid (CSF).ResultsOf the 474 screened, 44(9.3%) were seropositive with seroprevalence of 22(9.6%) in Urhouka, 14(9.5%) in Umeghe and 8(7.9%) for Ugonu. The number of seropositives, observed for weakly, moderately and strongly positives for the three communities were 4, 7 and 11 in Urhouka, 4, 5 and 5 in Umeghe and 3, 2 and 3 in Ugonu respectively. Among the 16 volunteers with detected parasite in their blood, 4 of them were weakly positive, 5 of them were moderately positive and 7 of them strongly positive. 4 volunteers from Urhouka community were found parasites in their CSF and they were all strongly positive. The difference between the seroprevalence of males and females was not statistically significant (OR=1.14, 95% CI=0.37–3.4, P>0.05). The prevalence difference between age group 21–30 years old and the youngest and oldest age groups was statistically significant (OR=3.5, 95% CI=1.08–12.57, P<0.05) but not significant for other age categories (P>0.05). It was observed that farmers had significantly higher prevalence of HAT infection as well as greater risk of Trypanosoma brucei gambiense infection than inhabitants with other occupations (OR=3.25, 95% CI=0.99–11.79, P<0.05).ConclusionsHuman activities such as farming and visits to the river have been identified as major risk factors to HAT. Also the breakdown of HAT control program has been advanced for the rise in HAT in Abraka, an endemic focus in Nigeria.     

Eye lesions and onchocerciasis in a rural farm settlement in Delta state,Nigeria

A study of 326 volunteers from a rural farm settlement in Aniocha North, Delta State, Nigeria, was conducted between December 1999 and September 2000. Volunteers were screened for eye lesions and onchocerciasis. Microfilariae were found in the skin tissues of 134 (41.1%) inhabitants; of these, males had greater microfiladermia (49.9%) than females (33.3%). The percentage prevalence of the clinical signs of onchocerciasis in the farm settlement were: hanging groin 14.1%, onchocercal nodules 25.1%, onchocercal dermatitis 27.6%, scrotal enlargement 3.7%. The percentage prevalence of the eye lesions among those with onchocerciasis were: cataract 24 (7.4%), glaucoma 12 (3.7%), optic atrophy 2 (0.6%) and uveitis 18 (5.5%). Impaired vision was found in 80 (24.5%) inhabitants and blindness was suffered by 2(0.6%) inhabitants.     

Some aspects of epidemiology of filth flies: Musca domestica, Musca domestica vicina, Drosophilia melanogaster and associated bacteria pathogens in Ekpoma, Nigeria

Between January 2005 and December 2005, including the wet and dry seasons, 1,358 filth flies (Musca domestica, 737 [54.3%]; M. domestica vicina 556 [41%]; and Drosophilia melanogaster 65 [5%]) were caught by quadrant samplings using nets twice each month (early and later) in each of the various sites with varying sanitary conditions in Ekpoma, Nigeria. These sites were markets, hospitals, houses/human habitations, pit latrines, stalls of local food vendors, abattoirs/slaughterhouses, and dairy farms. These filth flies were studied for their potential to carry bacterial species. The identified filth flies were found to carry bacterial pathogens, with each harboring 2-10 bacteria. Seven bacterial species and their load namely, Escherichia coli (189 x 10(10) organisms per milliliter), Proteus species (210 x 10(10) organisms per milliliter), Streptococcus species (192 x 10(10) organisms per milliliter), Klebsiella species (213 x 10(10) organisms per milliliter), Salmonella species (386 x 10(10) organisms per milliliter), Staphylococcus species (163 x 10(10) organisms per milliliter), and Serratia macenscens (5.0 x 10(10) organisms per milliliter) were isolated. The highest mean bacterial load for all bacteria isolated from pooled flies was 200 x 10(10) organisms per milliliter. The mean bacterial loads of 150, 90, and 10 x 10(10) organisms per milliliter were recorded for M. domestica, M. domestica vicina, and D. melanogaster, respectively. Approximately 15(4)-23(6) bacterial colonies per fly were recorded. The total number of bacteria isolated from flies caught in the dairy farms were higher than those isolated from flies caught in any other studied sites. Lower prevalence of associated bacterial pathogens was established from flies caught in areas where hygienic conditions prevailed. Salmonella species was the most prevalent bacterial pathogen isolated amongst the flies that perched on dairy products sampled. Bacterial load was most prevalent during the wet season. Resistances of some bacterial pathogens to common available antibiotic drugs shown by zone of inhibition (相似文献   

Urinary tract pathology in Schistosoma haematobium infected rural Nigerians

Parasitological investigation assessing the ova of Schistosoma haematobium in the urine of 138 volunteers in Ihieve-Ogben, Edo State, Nigeria revealed 43 positive results (31.2%). Children had a higher prevalence of urinary schistosomiasis 30 (41.1%) than their adult counterparts 13 (20.0%) and this difference was statistically significant (t = 8.89, p > 0.01). More volunteers had light intensity of infection 27 (19.6%) than heavy infection 16 (11.6%) and this difference was statistically significant (chi2 = 22.90, p>0.05). Ultrasonographic investigations carried out on these 43 S. haematobium infected volunteers revealed ten pathological conditions, including abnormal wall thickness 24 (55.8%), abnormal shape 30 (69.8%), irregular bladder wall 12 (27.9%), masses 10 (23.3%), pseudopolyps 2 (4.7%), echogenic particles 30 (69.8%), residual volume 12 (27.9%), calcifications 24 (55.8%), hydroureter 10 (23.3%) and hydronephrosis 8 (18.6%) when compared to control subjects which lacked bladder and kidney abnormalities. These pathological conditions were slightly more common in the volunteers with heavy infection than those with light infection, but this difference was not statistically significant (t = -2.19, p < 0.02). More pathological conditions were found in children than in adults; this finding was statistically significant (t = 3.23, p > 0.03). Hydronephrosis and hydroureter were not found in the volunteers with light intensity of infection.     

Molluscicidal effect of Piper guineense

The study was undertaken to assess the dosage-mortality ratio and toxic effects of Piper guineense fruit extracts on the adults of Biomphalaria pfeifferi, the snail intermediate host of Schistosoma mansoni, which causes intestinal schistosomiasis. The result showed significant toxic effects with crude ethanol and hot water fruits extracts. The estimated lethal dose concentration by arithmetic method (LC(50) and LC(90)) using both crude ethanol and hot water fruit media extracts were found to be (0.10 ± 0.04, 0.9 ± 0.2) mgl(-1) respectively for ethanolic extract and (5.0 ± 1.4, 8.5 ± 0.7) mgl(-1) respectively for hot water extract. Ethanolic extract was more potent than hot water extract. An all or none phenomenon appeared characteristic of the biological activity of these extracts. There was significant decrease in oviposition rate (p < 0.02). The extract from the fruits of this tropical plant holds promise in the control of Biomphalaria pfeifferi.     

Relationship between pro-and anti-inflammatory cytokines profiles and some haematological parameters in some Cameroonians infected with Onchocerca volvulus

ObjectiveTo investigate the relationship between white blood cells, lymphocytes, monocytes, and Interleukin(IL)-1 α, IL-6, IL-10 and IL-13 production in Cameroonians with Onchocerca volvulus (O. volvulus) infection.MethodsA total of 357 individuals from five sites at Upper Sanga, Lekkie, Nyong, Kelle and Sanaga Maritime divisions and located along Sanaga valley of Sanaga River in South Cameroon were screened for the presence of O. volvulus using the skin snip. The levels of the interleukins (IL-) namely IL-1 α, IL-6, IL-10 and IL-13 were evaluated using enzyme linked immunoabsorbent assay techniques. Haematological parameters were evaluated using standard laboratory automated analyser.ResultsO. volvulus microfilariae were found in skin tissues of 85 (23.81%) volunteers. The mean interleukin (IL-) levels in the O. volvulus control and infected individuals were IL-1 α in (1.65±0.79 and 2.31±0.5) pg/mL; IL-6 in (278.36±55.34 and 201.74±34.56) pg/mL; IL-10 in (436.03±208.64 and 418.49±147.88) pg/mL and IL-13 in (8.98±7.28 and 38.06±11.92) pg/mL. There was a negative correlation between monocyte counts and IL-10 concentration in positive individuals. A negative correlation of IL-6 with white blood cell and lymphocyte counts was observed (P<0.05). The level of IL-13 was positively associated with microfilarial load (P<0.05).ConclusionsWe observed depressed IL-6 and raised IL-13 concentrations in the sera of individuals with onchocerciasis which implicate these interleukins in the immunological responses of the disease. Therefore, these IL-6 and IL-13 are associated with O. volvulus infection among Cameroonians.     

Schistosoma haematobium infections in two rural communities of Edo State, Nigeria

An epidemiological study of 1,136 inhabitants from two rural communities in Owan East local government area of Edo State, Nigeria was investigated to ascertain the prevalence, intensities and urinary symptoms in Schistosoma haematobium infections. In both communities, 371 (32.6%) of the villagers screened, excreted S. haematobium with a mean of 40.1 ova per 10 ml of their urine. The pattern of infection was highest among the school children, moderate among the farmers and least among the civil servants. The sensitivities of their urinary symptoms associated with this parasitic infection in these communities are 78.7% hematuria, 71.9% proteinuria, 70.4% supra public pain/discomforts and 59.6% dysuria. These foci of infections will broaden the epidemiological picture of urinary schistosomiasis in this part of the globe.