Anophelines collected indoors and in the peri-domiciliary area in 3 localities in the Amazon region, state of Acre, Brazil, from August 1990 to January 1991 were examined by enzyme-linked immunosorbent assay (ELISA) using specific monoclonal antibodies directed against the repeats of the circumsporozoite proteins of Plasmodium falciparum, P. vivax, P. vivax V247, and P. malariae. Of the 3056 specimens collected, 2610 were Anopheles oswaldoi, 362 A. deaneorum, 60 A. triannulatus and 24 were A. darlingi. The infection rates of A. oswaldoi were 3.41% for P. falciparum, 2.26% for P. vivax, 1.22 for P. vivax VK247, and 0.42% for P. malariae. For A. deaneorum, the infection rates were 2.76% for P. falciparum, 0.55% for P. vivax, and 0.82% for P. vivax VK247. All samples of the other 2 species collected (A. triannulatus and A. darlingi) were negative in the ELISA. There were certain differences in the anopheline distribution and infection rates between these localities, and in one only A. oswaldoi was found to be infected. These results strongly point to A. oswaldoi as the main malaria vector in the region. No difference was found between the potential vectors of P. vivax and P. vivax VK247. The significance of these findings for malaria control is discussed.
The kinetics of indicators of lymphocyte activation were determined in non- and semiimmune patients with uncomplicated Plasmodium falciparum infection and in control subjects in Acre, Brazil. Delayed type hypersensitivity (DTH) to seven recall antigens was weakest in nonimmune patients. Both patient groups differed significantly from controls on admission (P less than .001 for both) and improved considerably after clindamycin therapy. Total serum IgG and IgM, but not antimalarial antibodies, were highest in nonimmune patients compared with semiimmune patients and controls during acute malaria. Immunoglobulin levels normalized after chemotherapy. A striking decrease of CD4+ peripheral blood lymphocytes, normalizing after chemotherapy, was seen in both patient groups, and was more pronounced in nonimmune patients. A slight increase in interleukin-2 receptor (IL-2R)-bearing cells was found in nonimmune patients. In addition, soluble plasma IL-2R was significantly elevated in them (P less than .001) and to a lesser extent in semiimmune patients. These findings were paralleled by significantly decreased IL-2 concentrations in plasma (P less than .001) during the acute phase of malaria, suggesting pronounced general immunosuppression in nonimmune malaria patients.
São apresentados os resultados obtidos na investigação entorno-epidemiológica realizada no estudo do primeiro caso humano autóctone de tripanossomíase americana no Estado do Acre (Brasil). A investigação demonstrou ausência de domiciliação triatomínea, ficando descartada totalmente a possibilidade de transmissão congênita ou transfusional. Não foi possível verificar se a transmissão foi metaxênica através da invasão domiciliar de barbeiro silvestre, ou se por via digestiva através de alimentos contaminados. Foram isoladas duas cepas de Trypanosoma cruzi, uma do caso humano chamada Acre-Humana (AH) e outra de Rhodnius robustus coletados em palmeiras uricuri (Attalea sp) nas proximidades da casa, chamada Acre-Silvestre (AS). Ficou comprovada a existência de correlação entre os caracteres morfobiológicos e patogênicos das duas amostras estudadas: mostraram-se patogênicas para camundongos, infectando 100% dos animais, quer com formas metacíclicas de triatomíneos, quer com formas sanguícolas de doadores em fase aguda. A infecção dos camundongos nas duas amostras é grave com curto período pré-patente, parasitemia elevada e taxa de letalidade alta. Em ambas as cepas, em fase aguda, são abundantes ninhos de amastigotas, principalmente no coração e fígado. As amostras AH e AS conferem aos animais que sobrevivem boa resistência contra infecções pela amostra Y. Cultivaram-se facilmente em meios líquidos e semi-sólidos e infectaram experimentalmente seis espécies de triatomíneos. Os resultados comprovam mais uma vez a presença de focos naturais desta parasitose na região.
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