Publications by authors named "Ahmad Amro"

31 Publications

Knowledge and attitude of Palestinian women to contraceptives: a cross-sectional study.

Lancet 2021 Jul;398 Suppl 1:S45

Faculty of Pharmacy, Al-Quds University, Jerusalem, occupied Palestinian territory. Electronic address:

Background: Contraceptives have documented efficiency, but outcomes are highly dependent on women's understanding of how they should be used. We assessed the knowledge and attitudes of married Palestinian women about contraceptives and understanding of use of the available methods and side-effects.

Methods: This cross-sectional study involved married Palestinian women of childbearing age (18-50 years), and was done between Jan 20, 2017, and Jan, 1, 2018. A stratified random sample of 900 women was selected from each Palestinian governorate in the West Bank and East Jerusalem, with the number selected based on population size. An interviewer-assisted questionnaire was completed by each participant.

Findings: 833 women were selected to participate and 771 (93%) completed the questionnaire. 123 (16%) of women reported not using any method of contraception. Among those who used contraception, intrauterine devices were most commonly used (312 [41%] of 771), followed by oral contraceptives (162 [21%]). Progestagen-only pills were the most frequently used type of oral contraceptive (45 [28%] of 162). Female sterilisation was used as a birth control method by 19 (3%) of 771 women. Investigation of the reasons behind contraception use showed that organisation of pregnancies was most common (511 [79%] of 648), followed by having too many children (131 [20%]) and economic reasons (73 [11%]). Regarding attitudes and beliefs towards contraceptive use, of the 771 participants, 49 (6%) believed that religion forbids their use and 112 (14·5%) considered them socially unacceptable. The study revealed poor scores for knowledge about use and possible side effects of contraceptives (mean 8·2 [SD 2·9] correct answers to 14 questions).

Interpretation: Most Palestinian women have used contraceptives, but poor knowledge of how to use them and side-effects is apparent. The attitudes of Palestinian women and their partners towards contraceptives indicates general acceptance of their use. A strength of our study is that it included representative sample of Palestinian women and our results and conclusions reflect the knowledge and attitudes towards contraceptives in Palestinian society.

Funding: None.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/S0140-6736(21)01531-2DOI Listing
July 2021

Prevalence of chronic diseases in older Palestinian adults and common pharmacological interventions: a cross-sectional study.

Lancet 2021 07;398 Suppl 1:S40

Faculty of Pharmacy, Al-Quds University, Jerusalem, occupied Palestinian territory. Electronic address:

Background: Older people (aged 60 years and older) are more susceptible than younger people to multiple medical disorders and are therefore more frequently exposed to polypharmacy. We investigated prevalence of chronic diseases and medical conditions, medications used, and associated sociodemographic factors among older adults of the Palestinian population.

Methods: A cross-sectional study was done between June, 2013, and January, 2014. The study population was Palestinians aged 60 years and older living in the West Bank and East Jerusalem. Study participants were selected in a stratified random manner. The sample was selected from all governorates (strata) according to the size of the population of each governate on the basis of census data from the Palestinian Central Bureau of Statistics. The research team visited and interviewed older residents in their houses. Questionnaire items were explained in informal language to participants by the interviewer, to ensure complete understanding, and answers were recorded by the interviewer. Informed written consent was obtained from each participant. The study design and protocols were revised and approved by the Research Ethics Committee at Al-Quds University.

Findings: 1574 older Palestinian adults were invited to participate, of whom 1192 (76%) enlisted. The mean age was 70·3 years (SD 8·58, range 60-110 years). 55% (659 of 1192) were female and 45% (533) were male. The majority (84%; 996) were non-workers or retired; monthly income for 78% of participants (930) was less than 2500 NIS, which falls in the low-income group. More participants (78%; 934) had governmental health insurance than had private insurance (8%; 89) or no insurance (14%; 169). 40 chronic diseases and conditions were reported. The mean number of diseases reported per participant was 2·33 (SD 1·68, range 0-11). Cardiovascular, endocrine, and musculoskeletal conditions were the most frequently reported. 66% of participants (787 of 1192) reported at least one cardiovascular condition, 40% (480) at least one endocrine condition, and 32% (385) at least one musculoskeletal condition. The most prevalent cardiovascular condition was hypertension, which affected 54% of participants (647); the most prevalent endocrine condition was diabetes (38·2%, 455); and the most prevalent musculoskeletal condition was arthritis (13·7%, 163). The total number of different types of medication (both prescribed and over-the-counter drugs) was 175. The mean number of medications per participant was 4·54 (SD 2·83), and the highest number of different medications being taken by one participant was 17. Commonly prescribed therapeutic agents were aspirin (prescribed to 48% of participants, 575 of 1192), angiotensin-converting-enzyme inhibitors (34%, 403), diuretics (34%, 409), metformin (27%, 323), paracetamol (23%, 270), and protein pump inhibitors (23%, 275).

Interpretation: The findings provide insights into the most prevalent chronic diseases and conditions, as well as the most commonly used medications among older Palestinians. Cardiovascular, endocrine, and musculoskeletal conditions were the most prevalent diseases. Older Palestinians adults are subjected to polypharmacy, which should be assessed whenever they are evaluated for health problems, and drug interactions should be carefully checked. Physicians, pharmacists, health professionals, and health policymakers in Palestine should consider increasing citizens' health awareness and encourage healthy lifestyles to decrease the incidence of these diseases. In addition, intersectoral cooperation between the governmental and non-governmental organisations will be key in the fight against chronic diseases in older Palestinian adults.

Funding: None.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/S0140-6736(21)01526-9DOI Listing
July 2021

Recent trends in human brucellosis in the West Bank, Palestine.

Int J Infect Dis 2021 May 15;106:308-313. Epub 2021 Apr 15.

Preventive Medicine Department, Palestinian Ministry of Health, Palestine.

Objectives: To investigate the epidemiology of human brucellosis in the West Bank over the past 20 years, with a focus on recent trends in disease incidence from 2000 to 2020.

Methods: A long-term descriptive epidemiological study was conducted, based on the Palestinian Ministry of Health records from 2000 to 2020.

Results: The total number of cases was 7935 and the average annual incidence rate (AAIR) was 9.4 cases per 100 000 population. The AAIR ranged from 17.9 in 2000 to 15.7 cases per 100 000 population in 2020. The AAIR decreased markedly from 17.9 in 2000, to 2.9 cases per 100 000 population in 2012. A dramatic increase in cases started from 2013 onwards, reaching a peak in 2016. Higher incidence was reported in males (57.1%) and among the age group 11-20 years (29%). A higher number of cases was reported during April, May, and June. A total of 2850 patients (62.7%) reported contact with animals, and approximately 30% had at least one infected household member.

Conclusions: The dramatic increase in human brucellosis in the West Bank was linked to the impaired control and surveillance of the disease. Mass vaccination, regular screenings, raising public health awareness, and monitoring of milk and homemade dairy products represent some recommended precautionary measures for coping with the epidemic.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.ijid.2021.04.037DOI Listing
May 2021

The prevalence of diabetes and metabolic syndrome and associated risk factors in Sudanese individuals with gallstones: a cross sectional survey.

Transl Gastroenterol Hepatol 2020 5;5:14. Epub 2020 Apr 5.

Department of Medicine and HIV Metabolic Clinic, Milton Keynes University Hospital NHS Foundation Trust, Eagelstone, Milton Keynes, UK.

Background: The gallstones are common health problem across the world with huge financial burden on health authorities. Obesity and insulin resistance are associated with risk of gallstones disease (GSD). The aim of this study was to assess the prevalence of metabolic syndrome (MetS) and diabetes and associated risk factors in Sudanese patients with gallstones.

Methods: A prospective cross-sectional study, enrolled patients with gallstones attending Ibn Sina Specialized Teaching Hospital for gastrointestinal and hepatobiliary diseases. A structured questionnaire was applied, anthropometric measures were taken, and blood tested for HbA1c, fasting glucose and lipid profile. Data was analysed using SPSS version 23.

Results: A total number of 151 participants were recruited in the study, 71 of them were ultrasound confirmed GSD patients, and the other 80 were controls without GSD over a period of six months. The prevalence of the MetS and diabetes was 30% and 23.9% respectively. Borderline diabetes was 16.9% and overweight and obesity constituted more than half of the sample 59.6%. Using Chi-Square test, a statistically significant association was found between MetS and HDL, TG, LDL level, waist circumference and blood pressure (BP). Absolute predictors and the risk factors for gallstone disease were waist circumference, age, HbA1c and LDL.

Conclusions: The prevalence of MetS and diabetes among gallstone patients was 30% and 23.9% respectively. Absolute predictors and the risk factors for gallstone disease were waist circumference, age, HbA1c and LDL.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.21037/tgh.2019.10.09DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7063511PMC
April 2020

Epidemiology of Parasitic Infections in the West Bank and Gaza Strip, Palestine.

Am J Trop Med Hyg 2020 02;102(2):313-317

Faculty of Pharmacy, Al-Quds University, Jerusalem, Palestine.

Parasitic infections are a public health problem that affects all population levels in developing countries including Palestine. The current study describes the epidemiology of parasitic infections in Palestine from 2008 to 2017. Twelve prominent parasitic infections were reported: leishmaniasis (both cutaneous and visceral), malaria, hydatid disease caused by hydatid cysts, toxoplasmosis, ascariasis, oxyuriasis, strongyloidiasis, taeniasis caused by , amebiasis, giardiasis, and scabies. A total of 137,106 cases were reported; among them, 92,494 (67%) in the Gaza Strip and 44,612 (33%) in the West Bank. This study provides baseline information for better understanding the status of parasitic infections in Palestine and compares their epidemiology between the West Bank and Gaza Strip. Appropriate control measures and health education directed to the public about preventive measures should be considered to raise awareness about parasitic infections to lower their incidences and burden in Palestine.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.4269/ajtmh.19-0545DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7008336PMC
February 2020

Epidemiology and spatiotemporal analysis of visceral leishmaniasis in Palestine from 1990 to 2017.

Authors:
Amro Ahmad

Int J Infect Dis 2020 Jan 5;90:206-212. Epub 2019 Nov 5.

Faculty of Pharmacy, Al-Quds University, Main Campus, P.O. Box 5100, Abu Dies, Jerusalem, Palestine. Electronic address:

Objectives: Visceral leishmaniasis (VL) is a deadly disease endemic in all countries around the Mediterranean Sea. In Palestine, VL is transmitted to humans from infected dogs by a sandfly bite. The aim of this study was to investigate the epidemiology and spatiotemporal pattern of VL in Palestine within a period of 27 years (1990-2017).

Methods: A long-term descriptive epidemiological study on human VL was conducted based on patient's profiles to calculated disease prevalence, geographical, spatiotemporal and seasonal distribution, distribution by age and gender, diagnosis, treatment, and treatment outcome.

Results: A total of 343 patients were reported, the average annual incidence rate was 0.73 case/100000 population. Most cases came from the western parts of the West Bank. The number of reported males was 162 (51%), and patient's age ranged from 4 months to 16 years (average 2.5 years), of which 93.3% were ≤5 years old. The annual incidence rate increased between 1993-1999, peaked in 1995, and dropped as from 2002. The future projections of VL indicate that the endemic foci in most governorates are projected to disappear in the future and only the very northwest of the West Bank will be at risk of VL.

Conclusions: Visceral leishmaniasis continues to be endemic in the West Bank but not the Gaza Strip. Pentavalent antimonial sodium stibogluconate continues to be the first line treatment and physicians are recommended to consider liposomal Amphotericin B (AmBisome) for refractory patients only. Geographical, spatiotemporal and seasonal trends of VL were identified.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.ijid.2019.10.044DOI Listing
January 2020

Urogenital Myiasis Caused by in a Female Child in Libya

Turkiye Parazitol Derg 2019 Sep;43(3):152-154

University of Tripoli, Dermatology Department, Department of Dermatology, Tripoli, Libya

Urogenital myiasis is a parasitic infestation caused by larvae of spp. and it is very rare in humans. A 10- year old female was presented with urogenital myiasis and 4 stage Larvae of (Diptera: ) were found in urine. The patient was complained of painful sensation, discomfort and burning while urination. Urinary tract antiseptics were prescribed for the patient and advised to drink plenty of water for hydration. Local health authorities should take proper measures to maintain hygienic conditions for the people under risk.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.4274/tpd.galenos.2019.6135DOI Listing
September 2019

Population genetics analysis of Phlebotomus papatasi sand flies from Egypt and Jordan based on mitochondrial cytochrome b haplotypes.

Parasit Vectors 2018 03 27;11(1):214. Epub 2018 Mar 27.

Eck Institute for Global Health, Department of Biological Sciences, University of Notre Dame, Notre Dame, IN, 46556, USA.

Background: Phlebotomus papatasi sand flies are major vectors of Leishmania major and phlebovirus infection in North Africa and across the Middle East to the Indian subcontinent. Population genetics is a valuable tool in understanding the level of genetic variability present in vector populations, vector competence, and the development of novel control strategies. This study investigated the genetic differentiation between P. papatasi populations in Egypt and Jordan that inhabit distinct ecotopes and compared this structure to P. papatasi populations from a broader geographical range.

Methods: A 461 base pair (bp) fragment from the mtDNA cytochrome b (cyt b) gene was PCR amplified and sequenced from 116 individual female sand flies from Aswan and North Sinai, Egypt, as well as Swaimeh and Malka, Jordan. Haplotypes were identified and used to generate a median-joining network, F values and isolation-by-distance were also evaluated. Additional sand fly individuals from Afghanistan, Iran, Israel, Jordan, Libya, Tunisia and Turkey were included as well as previously published haplotypes to provide a geographically broad genetic variation analysis.

Results: Thirteen haplotypes displaying nine variant sites were identified from P. papatasi collected in Egypt and Jordan. No private haplotypes were identified from samples in North Sinai, Egypt, two were observed in Aswan, Egypt, four from Swaimeh, Jordan and two in Malka, Jordan. The Jordan populations clustered separately from the Egypt populations and produced more private haplotypes than those from Egypt. Pairwise F values fall in the range 0.024-0.648.

Conclusion: The clustering patterns and pairwise F values indicate a strong differentiation between Egyptian and Jordanian populations, although this population structure is not due to isolation-by-distance. Other factors, such as environmental influences and the genetic variability in the circulating Le. major parasites, could possibly contribute to this heterogeneity. The present study aligns with previous reports in that pockets of genetic differentiation exists between populations of this widely dispersed species but, overall, the species remains relatively homogeneous.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1186/s13071-018-2785-9DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5872541PMC
March 2018

Development of polymorphic EST microsatellite markers for the sand fly, Phlebotomus papatasi (Diptera: Psychodidae).

Parasit Vectors 2018 03 9;11(1):160. Epub 2018 Mar 9.

Department of Biological Sciences, Eck Institute for Global Health, Galvin Life Science, University of Notre Dame, Notre Dame, IN, 46656, USA.

Background: Phlebotomus papatasi is a widely distributed sand fly species in different tropical and sub-tropical regions including the Middle East and North Africa. It is considered an important vector that transmits Leishmania major parasites, the causative agents of cutaneous leishmaniasis. The development of microsatellite markers for this sand fly vector is of high interest to understand its population structure and to monitor its geographic dispersal.

Results: Fourteen polymorphic microsatellite markers were developed with simple di-, tri- and tetra-nucleotide repeats. The F statistics calculated for the 14 markers revealed high genetic diversity; expected heterozygosity (He) ranged from 0.407 to 0.767, while observed heterozygosity (Ho) was lower and ranged from 0.083 to 0.514. The number of alleles sampled fall in the range of 9-29. Three out of 14 markers deviated from Hardy-Weinberg expectations, no significant linkage disequilibrium was detected and high values for inbreeding coefficient (F) were likely due to inbreeding.

Conclusions: The development of these functional microsatellites enable a high resolution of P. papatasi populations. It opens a path for researchers to perform multi locus-based population genetic structure analyses, and comparative mapping, a part of the efforts to uncover the population dynamics of this vector, which is an important global strategy for understanding the epidemiology and control of leishmaniasis.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1186/s13071-018-2770-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5845265PMC
March 2018

A pyoderma gangrenous-like cutaneous leishmaniasis in a Libyan woman with rheumatoid arthritis: a case report.

BMC Res Notes 2018 Mar 1;11(1):158. Epub 2018 Mar 1.

Dermatology Department, Faculty of Medicine, University of Tripoli, Tripoli, Libya.

Background: Several case reports describe diseases presenting with skin ulcerations, which resemble pyoderma gangrenosum especially in immune-compromised patients, often proven on further workup, to have an infective or malignant etiology. However, treatment of pyoderma gangrenosum by systemic steroids or other immunosuppressive agents may worsen the condition.

Case Presentation: We report here, a 45 year-old Libyan woman with rheumatoid arthritis on low dose steroids with pyoderma gangrenosum-like skin lesions and positive pathergy. Slit-smear was positive for Leishmania amastigotes and histopathological examination confirmed the diagnosis of cutaneous leishmaniasis. The lesions healed completely by parenteral sodium stibogluconate (Pentostam) 600 mg daily.

Conclusion: We report for the first time, a rare and unusual presentation of pyoderma gangrenosum like-cutaneous leishmaniasis in a patient with rheumatoid arthritis. Atypical cutaneous leishmaniasis should not be ruled out in the differential diagnosis of unresponsive skin diseases, with slit/smear and a skin biopsy is required.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1186/s13104-018-3272-2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5831575PMC
March 2018

Knowledge and awareness of radiation hazards among Palestinian radio technologists.

East Mediterr Health J 2017 Oct 30;23(8):576-580. Epub 2017 Oct 30.

Faculty of Pharmacy, Al-Quds University, Abu-Dies, Jerusalem, Palestine.

This study investigated 94.4% of Palestinian radio technologists and the mean percentage of correct answers for knowledge and awareness questions was 26.4%. The percentage of correct answers for questions testing knowledge of the ALARA (As Low As Reasonably Achievable) principle and hormesis hypothesis was 66.5% and 17.2%, respectively. Radio technologists with education level higher than bachelor degree and < 5 years' work experience showed a significantly higher level of knowledge. The most radiosensitive organs were correctly identified as the lungs and stomach by 6.9% and 4.9%, respectively, and 2.5% correctly identified the gonads as the next most radiosensitive organ. There was a serious deficit in knowledge and awareness of radiation hazards among Palestinian radio technologists, which may expose patients to unnecessary doses of ionizing radiation. This indicates the need for mandatory training and education about radiation protection in all Palestinian healthcare institutions.
View Article and Find Full Text PDF

Download full-text PDF

Source
October 2017

The Psychometric Properties of the Arabic Preschool Activity Card Sort.

Occup Ther Int 2017 7;2017:5180382. Epub 2017 Mar 7.

Department of Physiotherapy, The University of Jordan, Amman, Jordan.

Background: The Preschool Activity Card Sort (PACS) is an interview-based assessment tool to measure participation of preschool children with age range from 3 to 6 years.

Objective Of Study: The purpose of this study was to establish the psychometric properties of the recently translated Arabic PACS (A-PACS).

Methods: One hundred fifty-one Jordanian parents participated in the study representing different geographical areas. Children were almost equally distributed between males and females and into three age groups. Construct and concurrent validity were examined as well as the internal consistency of the scale and the test-retest reliability.

Findings: The A-PACS was able to differentiate between the participation level of young and old children in the domains of education, community mobility, and low demand leisure of the A-PACS giving evidence to its construct validity and it significantly correlated with some aspects of the Vineland Adaptive Behavior Scale (VABS) giving evidence to its concurrent validity. The A-PACS showed excellent overall internal consistency ( = .859) for all domains and good test-retest reliability ( = .976, < .001).

Conclusion: The A-PACS can be considered as a valid and reliable tool to measure participation of preschool children with normal development from Arabic cultures. Future studies should focus on the validity of the A-PACS for use with children with disabilities.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1155/2017/5180382DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5612737PMC
May 2018

Spatiotemporal and molecular epidemiology of cutaneous leishmaniasis in Libya.

PLoS Negl Trop Dis 2017 Sep 7;11(9):e0005873. Epub 2017 Sep 7.

Molecular Biotechnology and Functional Genomics Department, Technical University of Applied Sciences Wildau, Wildau, Germany.

Background: Cutaneous leishmaniasis (CL) is a major public health problem in Libya. In this paper, we describe the eco-epidemiological parameters of CL during the armed conflict period from January 2011 till December 2012. Current spatiotemporal distributions of CL cases were explored and projected to the future using a correlative modelling approach. In addition the present results were compared with our previous data obtained for the time period 1995-2008.

Methodology/principal Findings: We investigated 312 CL patients who presented to the Dermatology Department at the Tripoli Central Hospital and came from 81 endemic areas distributed in 10 districts. The patients presented with typical localized lesions which appeared commonly on the face, arms and legs. Molecular identification of parasites by a PCR-RFLP approach targeting the ITS1 region of the rDNA was successful for 81 patients with two causative species identified: L. major and L. tropica comprised 59 (72.8%) and 22 (27.2%) cases, respectively. Around 77.3% of L. tropica CL and 57.7% of L. major CL caused single lesions. Five CL patients among our data set were seropositive for HIV. L. tropica was found mainly in three districts, Murqub (27.3%), Jabal al Gharbi (27.3%) and Misrata (13.7%) while L. major was found in two districts, in Jabal al Gharbi (61%) and Jafara (20.3%). Seasonal occurrence of CL cases showed that most cases (74.2%) admitted to the hospital between November and March, L. major cases from November till January (69.4%), and L. tropica cases mainly in January and February (41%). Two risk factors were identified for the two species; the presence of previously infected household members, and the presence of rodents and sandflies in patient's neighborhoods. Spatiotemporal projections using correlative distribution models based on current case data and climatic conditions showed that coastal regions have a higher level of risk due to more favourable conditions for the transmitting vectors.

Conclusion: Future projection of CL until 2060 showed a trend of increasing incidence of CL in the north-western part of Libya, a spread along the coastal region and a possible emergence of new endemics in the north-eastern districts of Libya. These results should be considered for control programs to prevent the emergence of new endemic areas taking also into consideration changes in socio-economical factors such as migration, conflicts, urbanization, land use and access to health care.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1371/journal.pntd.0005873DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5605087PMC
September 2017

Molecular diagnosis of Toxoplasma gondii infection in Libya.

BMC Infect Dis 2016 Apr 16;16:157. Epub 2016 Apr 16.

Libyan National Centre for Disease Control, Tripoli, Libya.

Background: Toxoplasma gondii infections are prevalent in humans and animals throughout Libya. Current diagnosis is based on detection of Toxoplasma-specific IgM and IgG. In this study, we established and optimized a diagnostic PCR assay for molecular diagnosis of T. gondii in Libya.

Methods: From January to December, 2010, 177 blood and serum samples were collected from suspected patients. This includes: 140 women who have had spontaneous abortions, 26 HIV-positive patients, nine patients with leukemia and lymphoma, and two infants with ocular infection. Samples were screened for anti-Toxoplasma IgG and IgM antibodies before DNA extraction. The surface antigen gene 2 (SAG2) was targeted in a semi-nested PCR to amplify a 999 bp and a 614 bp fragment in the first and the second run respectively.

Results: A total of 54/140 (38.5 %) women who have had spontaneous abortions, 23/26 (88 %) HIV patients, 6/9 (66.6 %) of the leukaemia and lymphoma patients, and one child with ocular infection were seropositive for anti-Toxoplasma IgG and/or IgM. Genomic DNA was extracted from 38 selected seropositive samples. The PCR was sensitive enough to detect DNA concentration of 12 ng/μL. PCR analysis was performed for 38 selected seropositive patients (16 women who have had spontaneous abortions, 15 positive HIV patients, six leukaemia patients and one child with ocular infection). Our designed primers were successfully amplified in 22/38 (57.9 %) samples; 5/12 (35.7 %) from serum and 17/26 (65.8 %) from whole blood samples. All PCR positive samples were IgG-positive except two samples which were IgM and IgG & IgM-positive serum samples respectively. The semi-nested PCR confirmed five more samples. These included two leukaemia and two HIV-positive whole blood samples and one serum sample from an aborted woman.

Conclusion: The ability of PCR to diagnose active toxoplasmosis is needed in immunocompromised patients and congenital toxoplasmosis cases, especially when serological techniques fail. For the first time in Libya, we established and optimized semi-nested PCR of SAG2 gene. The developed PCR method was able to detect as little as 12 ng/μL of T. gondii DNA and was useful to diagnose the diseases in women who have had spontaneous abortions, HIV-positive patients, patients with leukemia and lymphoma, and infants with ocular infection.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1186/s12879-016-1491-5DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4833959PMC
April 2016

Paracetamol biodegradation by activated sludge and photocatalysis and its removal by a micelle-clay complex, activated charcoal, and reverse osmosis membranes.

Environ Technol 2016 Oct 7;37(19):2414-27. Epub 2016 Mar 7.

h Faculty of Civil and Environmental Engineering , Technion-Israel Institute of Technology , Haifa , Israel.

Kinetic studies on the stability of the pain killer paracetamol in Al-Quds activated sludge demonstrated that paracetamol underwent biodegradation within less than one month to furnish p-aminophenol in high yields. Characterizations of bacteria contained in Al-Quds sludge were accomplished. It was found that Pseudomonas aeruginosa is the bacterium most responsible for the biodegradation of paracetamol to p-aminophenol and hydroquinone. Batch adsorptions of paracetamol and its biodegradation product (p-aminophenol) by activated charcoal and a composite micelle (octadecyltrimethylammonium)-clay (montmorillonite) were determined at 25°C. Adsorption was adequately described by a Langmuir isotherm, and indicated better efficiency of removal by the micelle-clay complex. The ability of bench top reverse osmosis (RO) plant as well as advanced membrane pilot plant to remove paracetamol was also studied at different water matrixes to test the effect of organic matter composition. The results showed that at least 90% rejection was obtained by both plants. In addition, removal of paracetamol from RO brine was investigated by using photocatalytic processes; optimal conditions were found to be acidic or basic pH, in which paracetamol degraded in less than 5 min. Toxicity studies indicated that the effluent and brine were not toxic except for using extra low energy membrane which displayed a half maximal inhibitory concentration (IC-50) value of 80%.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1080/09593330.2016.1150355DOI Listing
October 2016

Knowledge and Adherence to Medications among Palestinian Geriatrics Living with Chronic Diseases in the West Bank and East Jerusalem.

PLoS One 2015 5;10(6):e0129240. Epub 2015 Jun 5.

Faculty of Pharmacy, Al-Quds University, Jerusalem, Palestine.

Background: Adequate patient knowledge about medications is essential for appropriate drug taking behavior and patient adherence. This study aims to assess and quantify the level of knowledge and adherence to medications among Palestinian geriatrics living with chronic diseases and to investigate possible associated socio-demographic characteristics.

Methods And Findings: We conducted a cross-sectional study during June 2013 and January 2014 among Palestinian geriatrics ≥ 60 years old living with chronic disease in the West Bank and East Jerusalem. A stratified random sample was selected and a questionnaire-assisted interview was applied for data collection. T-test was applied for bivariate analyzing and one-way ANOVA test was applied for multivariate analyses.

Results: A total of 1192 Palestinian geriatrics were studied. The average age was 70.3 (SD = 8.58) years and ranged from 60-110 years. The sample comprised 659 (55.3%) females and 533 (44.7%) males. The global knowledge and global adherence scores were (67.57%) and (89.29%), respectively. Adequate levels of knowledge were 71.4%, and of adherence 75%, which were recorded for 705 (59.1%) and 1088 (91.3%) participants, respectively. Significant higher levels of global knowledge and global adherence were recorded for males, and for participants who hold a Bachelor's degree, those who live on their own, and did physical activity for more than 40 hours/week (p-value < 0.05). Furthermore, workers, participants with a higher monthly income, and non-smokers have a higher knowledge level with (p-value < 0.05). We found positive correlation between participants' global adherence and global knowledge (r = 0.487 and p-value < 0.001). Negative correlation was found between participants' global knowledge and adherence with age (r = -0.236, p-value < 0.001 and r = -0.211 and p-value < 0.001, respectively. Negative correlation between global knowledge and the number of drugs taken (r = -0.130, p-value < 0.001) was predicted.

Conclusion: We concluded that patients with a higher level of knowledge are more adherent to their medications and that better understanding of socio-demographic factors has a clear influence on the level of knowledge and adherence to medications and thus contributes to the development of guidelines for treatment and may consequently lead to favourable clinical outcomes and savings of health care costs.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0129240PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4457851PMC
April 2016

Contact dermatitis-like cutaneous leishmaniasis in a Libyan HIV patient.

Parasit Vectors 2014 Aug 29;7:401. Epub 2014 Aug 29.

Faculty of Pharmacy, Alquds University, Main Campus, P,O, Box 5100, Abu Dis, Jerusalem, Palestine.

Background: Cutaneous leishmaniasis (CL) is one of the common tropical protozoal diseases caused by various Leishmania species, and transmitted by the sand-fly vectors, Phlebotomus and Lutzomyia species. Herein, we report for the first time a case of CL that presented as large eczematous plaques occurring on the dorsi of both feet in a Libyan drug addicted, alcoholic patient with HIV infection.

Findings: A 34 year-old HIV-positive, alcoholic, drug addicted Libyan male presented to us with a history of a non-itchy skin lesions on the dorsi of both feet of 5-weeks duration. Systemic and topical antibiotics were given without improvement. Diagnosis of this patient was confirmed by observation of Leishmania amastigote bodies in stained slit-skin smear skin biopsy. After parenteral administration of sodium stiboglyconate (Pentostam) (20 mg/kg/day) for 28 days the lesions did not show any marked improvement. Concurrently, combination therapy of oral rifampicin (600 mg/day) and isoniazide (300 mg/day) was given for 8 weeks. Complete healing of lesions was achieved after this treatment and skin-slit smears turned negative.

Conclusions: Localized cutaneous leishmaniasis should be remembered in deferential diagnosis of unresponsive contact dermatitis especially for HIV-positive patients in CL endemic areas.This patient was not responding to Pentostam therapy, which is not very common in Libya. Interestingly, combination of oral rifampicin (600 mg/day) and isoniazide (300 mg/day) can be a successful alternative therapy.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1186/1756-3305-7-401DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4155076PMC
August 2014

Moroccan Leishmania infantum: genetic diversity and population structure as revealed by multi-locus microsatellite typing.

PLoS One 2013 17;8(10):e77778. Epub 2013 Oct 17.

Faculty of Pharmacy, Alquds University, Jerusalem, Palestine ; Institute of Microbiology and Hygiene, Charité University Medicine, Berlin, Germany.

Leishmania infantum causes Visceral and cutaneous leishmaniasis in northern Morocco. It predominantly affects children under 5 years with incidence of 150 cases/year. Genetic variability and population structure have been investigated for 33 strains isolated from infected dogs and humans in Morocco. A multilocus microsatellite typing (MLMT) approach was used in which a MLMtype based on size variation in 14 independent microsatellite markers was compiled for each strain. MLMT profiles of 10 Tunisian, 10 Algerian and 21 European strains which belonged to zymodeme MON-1 and non-MON-1 according to multilocus enzyme electrophoresis (MLEE) were included for comparison. A Bayesian model-based approach and phylogenetic analysis inferred two L.infantum sub-populations; Sub-population A consists of 13 Moroccan strains grouped with all European strains of MON-1 type; and sub-population B consists of 15 Moroccan strains grouped with the Tunisian and Algerian MON-1 strains. Theses sub-populations were significantly different from each other and from the Tunisian, Algerian and European non MON-1 strains which constructed one separate population. The presence of these two sub-populations co-existing in Moroccan endemics suggests multiple introduction of L. infantum from/to Morocco; (1) Introduction from/to the neighboring North African countries, (2) Introduction from/to the Europe. These scenarios are supported by the presence of sub-population B and sub-population A respectively. Gene flow was noticed between sub-populations A and B. Five strains showed mixed A/B genotypes indicating possible recombination between the two populations. MLMT has proven to be a powerful tool for eco-epidemiological and population genetic investigations of Leishmania.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0077778PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3798341PMC
June 2014

Serological and molecular survey of Leishmania parasites in apparently healthy dogs in the West Bank, Palestine.

Parasit Vectors 2012 Aug 31;5:183. Epub 2012 Aug 31.

Department of Biological Sciences, Faculty of Science and Technology, Al-Quds University, P.O. Box 51000, Jerusalem, Palestine.

Background: Canine visceral leishmaniasis (CVL) is caused by Leishmania infantum in all Mediterranean countries. The Leishmania parasite is transmitted by the bite of a corresponding sand fly vector and primarily maintained in nature by wild and domestic reservoirs, including dogs, foxes and jackals. Infected dogs are the primary reservoir host in endemic regions and are the most significant risk disposing humans to infection. The present study aimed at assessing the prevalence of infection with Leishmania and identification of Leishmania infantum in domestic dogs in the West Bank, Palestine.

Methods: The infection rate among domestic dogs collected from seven districts in the Palestinian West Bank was investigated by examination of parasites in culture from the buffy coat using serological and molecular methods; based on ELISA, internal transcribed spacer 1 (ITS1) and cysteine protease (CPB) PCR.

Results: Out of 215 dogs examined for Leishmania, 36 (16.7%) were positive in at least one method. Twenty three animals (11.5%) were positive for Leishmania DNA, whereas, ELISA and culture revealed 16 (7.5%), and 4 (1.5%) respectively. CPB-PCR on one of three culture-positive isolates revealed Leishmania infantum as the causative agent for Leishmania infection in dogs.

Conclusions: Our study showed that canine leishmania infection is prevalent with varying degrees in all the seven studied districts in Palestine despite the absence of human VL cases in 4 of these districts. The causative agent was confirmed to be Leishmania infantum.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1186/1756-3305-5-183DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3453513PMC
August 2012

Epidemiological and clinical features of cutaneous leishmaniases in Jenin District, Palestine, including characterisation of the causative agents in clinical samples.

Trans R Soc Trop Med Hyg 2012 Sep 24;106(9):554-62. Epub 2012 Jul 24.

Al-Quds Nutrition and Health Research Institute, Faculty of Medicine, Al-Quds University, Abu-Deis, P.O. Box 20760, West Bank, Palestine. Kifaya

During 2002-2009, 466 cases of cutaneous leishmaniasis (CL) were reported from Jenin District, Palestine, affecting both genders. The average annual incidence was 23 cases per 100000 inhabitants, increasing with age in children. Most cases presented a single lesion, generally on the face. Diagnosis and species identification was done by applying internal transcribed spacer 1 (ITS1) RFLP analysis to 47 isolates, of which 44 (93.6%) were Leishmania tropica and 3 (6.4%) were L. major. RFLP analysis was also performed on 256 skin tissue scrapings spotted onto filter papers, showing that 138 (53.9%) were positive, of which 50.7% were infected with L. tropica, 17.4% with L. major and 2.9% with L. donovani s.l., and 29.0% could not be identified. This is the first report from Palestine on human CL caused by L. infantum. Nine of the strains of L. tropica were subjected to multilocus enzyme electrophoresis, six of which belonged to the zymodeme MON-137 and three to a new zymodeme (MON-307). This separation was corroborated by excreted factor serotyping. This observation modifies the classical epidemiological view of CL in Palestine. Jenin District is an active focus of CL caused by L. tropica, where Phlebotomus sergenti, the putative vector, is abundant. These data suggest that CL is a zoonotic infection, but an animal reservoir has not been found.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.trstmh.2012.06.005DOI Listing
September 2012

First molecular epidemiological study of cutaneous leishmaniasis in Libya.

PLoS Negl Trop Dis 2012 19;6(6):e1700. Epub 2012 Jun 19.

Faculty of Pharmacy, Al-Quds University, Abu-Dies, Jerusalem, Palestine.

Background: Cutaneous leishmaniasis (CL) is a major public health problem in Libya. The objective of this study was to investigate, for the first time, epidemiological features of CL outbreaks in Libya including molecular identification of parasites, the geographical distribution of cases and possible scenarios of parasite transmission.

Methodology/principal Findings: We studied 450 patients that came from 49 areas distributed in 12 districts in north-west Libya. The patients' ages ranged from 9 months to 87 years (median age 25 years); 54% of the cases were males. Skin scrapings spotted on glass slides were collected for molecular identification of causative agent. The ribosomal internal transcribed spacer 1 (ITS1) was amplified and subsequently characterized by restriction fragment length polymorphism (RFLP) analysis. In total, 195 samples were successfully identified of which 148 (75.9%) were Leishmania major, and 47 (24.1%) Leishmania tropica. CL cases infected with L. major were found in all CL areas whereas L. tropica cases came mainly from Al Jabal Al Gharbi (46.4%), Misrata (17.8%) and Tarhuna districts (10.7%). A trend of seasonality was noticed for the infections with L. major which showed a clear peak between November and January, but was less pronounced for infections by L. tropica.

Conclusion: The first molecular study on CL in Libya revealed that the disease is caused by L. major and L. tropica and the epidemiological patterns in the different foci were the same as in other Mediterranean foci of CL.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1371/journal.pntd.0001700DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3378605PMC
September 2012

Multilocus microsatellite typing (MLMT) of strains from Turkey and Cyprus reveals a novel monophyletic L. donovani sensu lato group.

PLoS Negl Trop Dis 2012 14;6(2):e1507. Epub 2012 Feb 14.

Laboratory of Molecular Parasitology, Hellenic Pasteur Institute, Athens, Greece.

Background: New foci of human CL caused by strains of the Leishmania donovani (L. donovani) complex have been recently described in Cyprus and the Çukurova region in Turkey (L. infantum) situated 150 km north of Cyprus. Cypriot strains were typed by Multilocus Enzyme Electrophoresis (MLEE) using the Montpellier (MON) system as L. donovani zymodeme MON-37. However, multilocus microsatellite typing (MLMT) has shown that this zymodeme is paraphyletic; composed of distantly related genetic subgroups of different geographical origin. Consequently the origin of the Cypriot strains remained enigmatic.

Methodology/principal Findings: The Cypriot strains were compared with a set of Turkish isolates obtained from a CL patient and sand fly vectors in south-east Turkey (Çukurova region; CUK strains) and from a VL patient in the south-west (Kuşadasi; EP59 strain). These Turkish strains were initially analyzed using the K26-PCR assay that discriminates MON-1 strains by their amplicon size. In line with previous DNA-based data, the strains were inferred to the L. donovani complex and characterized as non MON-1. For these strains MLEE typing revealed two novel zymodemes; L. donovani MON-309 (CUK strains) and MON-308 (EP59). A population genetic analysis of the Turkish isolates was performed using 14 hyper-variable microsatellite loci. The genotypic profiles of 68 previously analyzed L. donovani complex strains from major endemic regions were included for comparison. Population structures were inferred by combination of bayesian model-based and distance-based approaches. MLMT placed the Turkish and Cypriot strains in a subclade of a newly discovered, genetically distinct L. infantum monophyletic group, suggesting that the Cypriot strains may originate from Turkey.

Conclusion: The discovery of a genetically distinct L. infantum monophyletic group in the south-eastern Mediterranean stresses the importance of species genetic characterization towards better understanding, monitoring and controlling the spread of leishmaniasis in this region.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1371/journal.pntd.0001507DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3279343PMC
June 2012

Epidemiology of scabies in the West Bank, Palestinian Territories (Occupied).

Int J Infect Dis 2012 Feb 3;16(2):e117-20. Epub 2011 Dec 3.

Faculty of Pharmacy, Al-Quds University, Jerusalem, Palestine.

Background: Scabies is a disease that is considered a public health problem in the Palestinian Territories and in other countries around the world. Scabies causes skin lesions leading to substantial morbidity, and is also associated with social stigma. In this study we describe the epidemiology of scabies in the West Bank, Palestine during the years 2005-2010.

Methods: We examined the records and profiles of a total of 1734 patients who were admitted to the dermatology clinics of the Palestinian Ministry of Health in 2005-2010.

Results: The disease was found to be prevalent in all governorates. The average annual incidence of scabies in the West Bank for 2005-2010 was 17/100,000 population. The average number of scabies patients per year in the West Bank was 26.3 per governorate, with a significant increase in the years 2009 and 2010 (p<0.001). Disease occurrence was significantly higher among children aged ≤ 10 years than in the other age groups, in adult females in the age groups of 31-40 and 41-50 years compared to males in these age groups, and in males in the age group of 11-20 years compared to females in that age group.

Conclusions: Scabies was found in all governorates of the Palestinian West Bank. Individuals under 20 years of age are particularly at risk. Compulsory reporting of scabies to the Palestinian Ministry of Health would be expected to increase awareness of the disease, which is crucial for the prevention and control of scabies in the Palestinian Territories.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.ijid.2011.10.005DOI Listing
February 2012

Characterization of simple sequence repeats (SSRs) from Phlebotomus papatasi (Diptera: Psychodidae) expressed sequence tags (ESTs).

Parasit Vectors 2011 Sep 29;4:189. Epub 2011 Sep 29.

Department of Biological Sciences, Faculty of Science and Technology, Al-Quds University, PO Box 51000, Jerusalem, Palestine.

Background: Phlebotomus papatasi is a natural vector of Leishmania major, which causes cutaneous leishmaniasis in many countries. Simple sequence repeats (SSRs), or microsatellites, are common in eukaryotic genomes and are short, repeated nucleotide sequence elements arrayed in tandem and flanked by non-repetitive regions. The enrichment methods used previously for finding new microsatellite loci in sand flies remain laborious and time consuming; in silico mining, which includes retrieval and screening of microsatellites from large amounts of sequence data from sequence data bases using microsatellite search tools can yield many new candidate markers.

Results: Simple sequence repeats (SSRs) were characterized in P. papatasi expressed sequence tags (ESTs) derived from a public database, National Center for Biotechnology Information (NCBI). A total of 42,784 sequences were mined, and 1,499 SSRs were identified with a frequency of 3.5% and an average density of 15.55 kb per SSR. Dinucleotide motifs were the most common SSRs, accounting for 67% followed by tri-, tetra-, and penta-nucleotide repeats, accounting for 31.1%, 1.5%, and 0.1%, respectively. The length of microsatellites varied from 5 to 16 repeats. Dinucleotide types; AG and CT have the highest frequency. Dinucleotide SSR-ESTs are relatively biased toward an excess of (AX)n repeats and a low GC base content. Forty primer pairs were designed based on motif lengths for further experimental validation.

Conclusion: The first large-scale survey of SSRs derived from P. papatasi is presented; dinucleotide SSRs identified are more frequent than other types. EST data mining is an effective strategy to identify functional microsatellites in P. papatasi.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1186/1756-3305-4-189DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3191335PMC
September 2011

What practicing cardiologists need to know about radiation exposure in cath. Lab?

Authors:
Ahmad Amro

J Saudi Heart Assoc 2010 Jul 11;22(3):153-4. Epub 2010 May 11.

Nuclear Cardiology Division, Prince Sultan Cardiac Center, Riyadh, Saudi Arabia.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.jsha.2010.04.003DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3727465PMC
July 2010

Population genetics of Leishmania infantum in Israel and the Palestinian Authority through microsatellite analysis.

Microbes Infect 2009 Apr;11(4):484-92

Institute of Microbiology and Hygiene, Charité Universitätsmedizin Berlin, Berlin, Germany.

Multilocus microsatellite typing (MLMT) was used to investigate the genetic variation among 44 Israeli and Palestinian strains of L. infantum isolated from infected dogs and human cases to determine their population structure and to compare them with strains isolated from different European countries. Most of the Israeli and Palestinian strains had their own individual MLMT profiles; a few shared the same profile. A Bayesian model-based approach and phylogenetic reconstructions based on genetic distances inferred two main populations that were significantly different from the European strains: population A, containing 16 strains from places in the West Bank and 11 strains from central Israel;and population B, containing 7 strains from northern Israel, 9 from central Israel, and one Palestinian strain from the Jenin District.Geographically distributed sub-populations were detected within population B. These results demonstrate similar disease dynamics in Israel and the Palestinian Authority. The re-emergence of VL in the case of population A is more likely owing to increased dog and human contact with sylvatic cycles of parasitic infection rather than to recent introduction from the older foci of northern Israel. The latter scenario could be true for population B found in few foci of Central Israel.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.micinf.2009.02.001DOI Listing
April 2009

Molecular markers for Phlebotomus papatasi (Diptera: Psychodidae) and their usefulness for population genetic analysis.

Trans R Soc Trop Med Hyg 2009 Nov 19;103(11):1085-6. Epub 2009 Mar 19.

Department of Biological Sciences, Al-Quds University, P.O. Box 51000, Jerusalem, Palestine.

Three molecular typing tools: multilocus microsatellite typing, cytochrome b sequence analysis and internal transcribed spacer 2 (ITS2) sequence analysis, were evaluated for their usefulness in inferring the population structure of Phlebotomus papatasi sand flies. ITS2 sequence analysis did not prove suitable for inferring phylogenetic and population genetic relationships across P. papatasi sand flies. Microsatellite markers showed high resolution in differentiating globally distributed P. papatasi populations, whereas cytochrome b sequence analysis provided insight into the relationships between closely related populations from the Mediterranean. Population structure, differentiation and demographic history among P. papatasi are important for understanding patterns of dispersal in this species and for planning appropriate control measures.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.trstmh.2009.02.011DOI Listing
November 2009

Population structure of Tunisian Leishmania infantum and evidence for the existence of hybrids and gene flow between genetically different populations.

Int J Parasitol 2009 Jun 12;39(7):801-11. Epub 2009 Jan 12.

Laboratoire de Parasitologie-Mycologie à la Faculté de Pharmacie, 99-UR/08-05 Monastir, Tunisia.

Twenty-seven strains of Leishmania infantum from north and central Tunisia belonging to the three main MON zymodemes (the MON-typing system is based on multilocus enzyme electrophoresis (MLEE) of 15 enzymes) found in this country (MON-1, MON-24 and MON-80) and representing different pathologies (visceral, cutaneous and canine leishmaniasis) have been studied to understand the genetic polymorphism within this species. Intraspecific variation could be detected in L. infantum by the use of 14 hypervariable microsatellite markers. In addition to microsatellite repeat length variation, a high degree of allelic heterozygosity has been observed among the strains investigated, suggestive of sexual recombination within L. infantum groups. The two major clusters found by using Bayesian statistics as well as distance analysis are consistent with the classification based on isoenzymes, dividing Tunisian L. infantum into MON-1 and MON-24/MON-80. Moreover, the existence of hybrid strains between the MON-1 and the non-MON-1 populations has been shown and verified by analysis of clones of one of these strains. Substructure analysis discriminated four groups of L. infantum. The major MON-1 cluster split into two groups, one comprising only Tunisian strains and the second both Tunisian and European strains. The major MON-24 cluster was subdivided into two groups with geographical and clinical feature correlations: a dermotropic group of strains mainly from the north, and a viscerotropic group of strains from the centre of Tunisia. The four viscerotropic hybrid strains all originated from central Tunisia and were typed by MLEE as MON-24 or MON-80. To our knowledge, this is the first report describing relationships between clinical picture and population substructure of L. infantum MON-24 based on genotype data, as well as the existence of hybrids between zymodemes MON-1 and MON-24/MON-80, and proving one of these hybrid strains by molecular analysis of the parent strain and its clones.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.ijpara.2008.11.016DOI Listing
June 2009

Kinetoplast DNA heterogeneity among Leishmania infantum strains in central Israel and Palestine.

Vet Parasitol 2009 Apr 11;161(1-2):126-30. Epub 2008 Dec 11.

Al-Quds University, Leishmaniasis Research Center, Abu-Deis, P.O. Box 20760, Palestine.

Leishmania infantum is the causative agent of canine and human visceral leishmaniasis in Israel and Palestine. Amplification of the kinetoplast DNA (kDNA), followed by restriction fragment length polymorphism (RFLP) analysis with restriction enzymes was used to examine the genotypic association between L. infantum strains isolated from 22 dogs and 2 humans from these adjoining regions. Results showed wide kDNA heterogeneity in these strains. Two main clusters (A and B) were identified. Cluster A was restricted to central Israel and was mainly found in strains isolated after 2002 whereas cluster B included parasites from central Israel and the West Bank. The kDNA microheterogeneity in L. infantum parasite populations as shown by genotyping with the kDNA-PCR and RFLP provided a tool to study the epidemiology of the disease and track its spread in central Israel and Palestine.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.vetpar.2008.12.003DOI Listing
April 2009

Epidemiology of paediatric visceral leishmaniasis in Hebron district, Palestine.

Trans R Soc Trop Med Hyg 2009 Jul 20;103(7):731-6. Epub 2008 Nov 20.

Institute of Microbiology and Hygiene, Charité University Medicine Berlin, Berlin, Germany.

Seventy-six cases of visceral leishmaniasis (VL) were reported from the Hebron district of the West Bank, Palestine between 1993 and 2007. All cases were in children less than 9 years old (median age 2 years). The average number of cases was 5.06/year and the average annual incidence was 3.02/100000 children. Ribosomal internal transcribed spacer 1 (ITS1) PCR-RFLP was performed using DNA extracted from two cultures and 36 archived Giemsa-stained slides from VL patients. Leishmania infantum was revealed as the causative agent of VL in the focus. Isoenzyme analysis identified two isolates as zymodeme MON-1. A serological survey of 455 children screened for serum anti-Leishmania antibodies revealed 8.4% seropositivity. Seropositivity was highest for children in households of previous VL cases [odds ratio (OR) 7.5; 95% CI 3.17-17.61; P<0.001] and among people who had domestic dogs and/or other animals (OR 2.4; 95% CI 1.19-4.68; P=0.017). No difference was seen between males and females (P=0.073). A preliminary survey of sand fly distribution showed the abundance of two putative vector species: Phlebotomus syriacus (45%) and Ph. tobbi (10%). The focus of VL in Hebron district was shown to follow the epidemiological pattern of paediatric disease characteristic of the Mediterranean region.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.trstmh.2008.10.008DOI Listing
July 2009
-->