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Visceral leishmaniasis (VL) is a parasitic disease endemic across multiple regions of the world and is fatal if untreated. Current therapies are unsuitable, and there is an urgent need for safe, short-course, and low-cost oral treatments to combat this neglected disease. The benzoxaborole chemotype has previously delivered clinical candidates for the treatment of other parasitic diseases. Here, we describe the development and optimization of this series, leading to the identification of compounds with potent in vitro and in vivo antileishmanial activity. The lead compound (DNDI-6148) combines impressive in vivo efficacy (>98% reduction in parasite burden) with pharmaceutical properties suitable for onward development and an acceptable safety profile. Detailed mode of action studies confirm that DNDI-6148 acts principally through the inhibition of Leishmania cleavage and polyadenylation specificity factor (CPSF3) endonuclease. As a result of these studies and its promising profile, DNDI-6148 has been declared a preclinical candidate for the treatment of VL.

Apesar do acidente vascular cerebral (AVC) ser a principal causa de morte e incapacidade em adultos no Brasil, ainda é uma doença muito negligenciada. Nesse sentido, surge a Campanha Nacional de Combate ao AVC, com o intuito de enviar uma mensagem unificada para a população, buscando a educação consistente de todo o público. Para esta finalidade, foram levantadas questões como o impacto mundial da doença, seus fatores de risco, sinais e sintomas. Este trabalho teve como objetivo descrever as atividades realizadas nos anos de 2017 a 2019 pelo NUPEDES, mostrando ações, locais visitados e levando informação para encorajar a todos a adicionar conhecimento sobre esta patologia. Foram realizadas entregas de folders, rodas de conversas com orientações, palestras e mobilizações. Estima-se que a atuação tenha alcançado cerca de 1.500 pessoas de diferentes faixas etárias. Espera-se que a campanha amenize as complicações do AVC, melhore a eficácia do atendimento e reduza fatores de risco.

Human African trypanosomiasis (HAT), a fatal infection caused by Trypanosoma brucei (T. brucei) is considered as a neglected disease in the tropical areas, and newer agents with unique mechanism of action are urgently needed. In this work, 65 Imidazopyridine analogues from known literature were selected for building statistically robust genetic algorithm (GA) based QSAR models. Furthermore, values for the various cross-validation properties supported its statistical robustness (model 1, [Formula: see text], RMSE[Formula: see text], MAE[Formula: see text], CCC[Formula: see text], and [Formula: see text]). Our in silico ADMET analysis revealed that a designed molecule, S10 may act as potent lead (T. brucei, pEC[Formula: see text] ([Formula: see text]M), [Formula: see text]) with better pharmacokinetics, no carcinogenicity, class III acute oral toxicity, minimal OCT1 and OCT2 inhibitions and no eye corrosion profiles. Our molecular docking analysis (on 42 drug targets) for a dataset and designed molecules demonstrated higher binding affinity of Imidazopyridine analogues with T. brucei farnesyl diphosphate synthase (TbFPPS) (PDB id: 2I19). This observation was further supported by 100[Formula: see text]ns molecular dynamics analysis retaining better stability of complex. Thus, imidazopyridine analogues would provide a promising scaffold for the development of anti-HAT agents.

Leishmaniasis consists of a group of neglected diseases, which affect millions of people worldwide. First- and second-line chemotherapies, which present high toxicity and variable efficacy, have been available for decades leading to the appearance of resistance. Globally, volatile oils have received much attention due to their increase use as effective bioactive compounds in folk medicine. They have been employed against Leishmania parasites with a positive impact in the treatment of this neglected disease. In this review, the leishmanicidal activity of volatile oils and their isolates have been described as promising novel candidate molecules for the development of leishmanicidal drugs. The purpose of this review is to critically discuss several works published between 2000 and 2020 that have described the utilization of volatile oils and some of their active principles from diverse plant sources against different species of Leishmania.

The search for new drugs against neglected parasitic diseases has experienced a major boost in recent years with the incorporation of bioimaging techniques. Visceral leishmaniasis, the second more neglected disease in the world, has effective treatments but with several disadvantages that make the search for new therapeutic solutions an urgent task. Animal models of visceral leishmaniasis that resemble the human disease have the disadvantage of using hamsters, which are an outbred breeding animal too large to obtain acceptable images with current bioimaging methodologies. Mouse models of visceral leishmaniasis seem, however, to be more suitable for early (acute) stages of the disease, but not for chronic ones. In our work, we describe a chronic Balb/c mouse model in which the infection primarily colonizes the spleen and well recreates the late stages of human disease. Thanks to the bioluminescent image, we have been able to identify experimentally, for the first time, a new primary lymphoid organ of colonization, the thymus, which appears infected from the beginning until the late phases of the infection.

Background: Hidradenitis suppurativa (HS) has historically been a neglected disease. However, research in this field has grown exponentially in the past decade. Methods: The top-cited HS articles from 1950 to 2020 were analyzed for authorship, study topic, study design, and senior author country of origin. Results: We found that nearly half of the top 50 cited articles were published in the last decade, with a recent increase in the number of highly cited randomized controlled trials. Medical treatment is the most cited topic, with more attention on biologics over time. The past decade has seen an increase in highly cited articles on HS comorbidities, pathogenesis, and clinical practice guidelines. There has been a predominance of highly cited HS research from Europe; highly cited studies from Africa, Asia, Australia, and South America are lacking. Conclusions: Recent advances in HS research have focused on investigating HS pathogenesis and drug development, highlighting disease comorbidities, and improving evidence-based care. Studies in pathogenesis have translated into a paradigm shift in medical treatment from antibiotics to incorporation of targeted therapies in recent years. Encouraging growth of HS research in countries outside of North America and Europe may help to optimize HS care globally.

Leishmaniasis is a neglected disease that affects 15 million people worldwide. Existing treatments are associated with limitations, including high costs and toxicity. Several classes of natural substances have been reported to display leishmanicidal activity in the literature. Isoquinoline alkaloids, which are commonly found in the Annonaceae family, represent an important skeleton for the development of anti-leishmaniasis products. This study presents an overview of the potential use of Annonaceae alkaloids to treat leishmaniasis and describes a molecular docking study examining 215 isoquinoline alkaloids. All selected compounds contain a bisbenzyltetrahydroisoquinoline, suggesting the affinity of this skeleton for the target.

Objectives To provide a spatial risk assessment for the neglected disease strongyloidiasis in the United States by prioritizing areas with high probability of Strongyloides stercoralis presence and to offer recommendations for targeted screening and surveillance. Methods The risk assessment was based on a species distribution model with parasite occurrence data and ecologically important environmental variables as input and local habitat suitability for the species as output. The model used a maximum entropy algorithm and occurrence records and environmental data from public sources. This ecological risk assessment was coupled to socioeconomic factors using multi-criteria analysis. Results The model predicts suitable habitat for the parasite in ten states beyond the southeastern United States where it has been recorded including states in the south, east and northeast, and west coasts. Conclusions We recommend strongyloidiasis should be reportable in 16 states at high risk and uniform, near universal solid organ transplant screening should be implemented alongside approaches to heighten clinical suspicion.

FIOCRUZ (VMB), FAPESP Grant fellowships (2015/ 15948-5, 2016/10145-4, 2016/10345-3, 2016/11116-8 and 2017/22888-4) (FMO) and by the Coordenacao de Aperfeicoamento de Pessoal de Nivel Superior - Brazil (CAPES) - Finance Code 001. AAB, CIO and VMB are senior scientist fellows at the Conselho Nacional de Desenvolvimento Cientifico e Tecnologico (CNPq). JRS is supported by a scholarship from CAPES. PSSM holds a fellowship from Fundacao de Amparo a Pesquisa do Estado da Bahia (FAPESB).

OBJETIVO: o presente objetiva caracterizar o impacto dos óbitos em decorrência da dengue no Brasil nos últimos dez anos. MÉTODOS: para estimativa do impacto socioeconômico, utilizou-se a variável Anos Potenciais de Vida Perdidos (APVP), estabelecendo-se como limite para o cálculo a idade de 75 anos. Foram selecionados os dados referentes aos óbitos por dengue no Brasil no período de 2009 a 2018. RESULTADOS: o número de óbitos notificados de indivíduos até 75 anos, em decorrência da dengue foi de 4.295, totalizando 144.301 APVP. A dengue, apesar de ser uma doença negligenciada, gera perdas econômicas elevadas ao país, as maiores dentre o Hemisfério Ocidental. CONCLUSÃO: destarte, é imprescindível aumentar os investimentos nessa temática, de forma a permitir profilaxia e manejo adequados dessa condição, para que seja possível fortalecer estratégias com potencial para minimização da morbimortalidade pela doença.

Schistosomiasis is a neglected disease of considerable health importance in tropical and subtropical regions. Its treatment relies on the use of praziquantel or oxamniquine but there are reported cases of treatment failures due to resistance or tolerance. Again, derivatives of praziquantel and oxamniquine have not shown significant activities than their parent compounds. The study predicted approved drugs with possible antischistosomal activities. Four schistosomal drug targets were obtained from Protein Data Bank and six hundred and twelve (612) approved drugs including their isomers were selected based on their Molinspiration® bioscore similarities with reference compounds (praziquantel, oxamniquine, [(2S,3S,4S,5S,6S)-3,4,5-triacetyloxy-6-sulfanyloxan-2-yl] methyl acetate, [propylamino-3-hydroxy-buta-1,4-dionyl]-isoleucylproline). The selected drugs and drug targets were obtained and prepared for molecular docking simulations. The molecular docking simulations were performed using AutoDockvina

Background: Anaplasma phagocytophilum, a tick-borne bacterium that causes granulocytic anaplasmosis, is a neglected pathogen in Brazil, and is diagnosed in several species of domestic and wild animals as well as in humans. Objective: This study aimed to investigate the prevalence of anti-A. phagocytophilum antibodies in Equidae from the state of Rio de Janeiro and to identify possible risk factors for infection. Materials and Methods: A total of 612 blood samples were collected from horses from 15 municipalities within the state. Moreover, an epidemiological questionnaire was administered to evaluate aspects related to seroreaction, taking into account the spatial distribution (properties, municipalities, and mesoregions), management practices, signs of disease, and the individual state of the animals. For the diagnosis, indirect immunofluorescence was performed. Results: In the present study, 124 (20.26%), out of a total of 612, animals with anti-A. phagocytophilum IgG antibodies at titers of 1:80 were detected. Multivariate logistic regression analysis showed that the presence of the infection at the property (P Conclusion: This allows to infer that the bacterium is distributed in all mesoregions of the state of Rio de Janeiro and that animals from other states can introduce the infection and make a property a focus of disease; it can also be inferred that these properties are important in the maintenance of the disease and the permanence of bacteria circulating in horses. It is also noteworthy that this was the first identification of mules as hosts of A. phagocytophilum infection.

Leishmaniasis is one of the most important tropical neglected diseases according to the World Health Organization. Even after more than a century, we still have few drugs for the disease therapy and their great toxicity and side effects put in check the treatment control program around the world. Moreover, the emergence of strains resistant to conventional drugs, co-infections such as HIV/Leishmania spp., the small therapeutic arsenal (pentavalent antimonials, amphotericin B and formulations, and miltefosine), and the low investment for the discovery/development of new drugs force researchers and world health agencies to seek new strategies to combat and control this important neglected disease. In this context, the aim of this review is to summarize new advances and new strategies used on leishmaniasis therapy addressing alternative and innovative treatment paths such as physical and local/topical therapies, combination or multi-drug uses, immunomodulation, drug repurposing, and the nanotechnology-based drug delivery systems.Key points• The treatment of leishmaniasis is a challenge for global health agencies.• Toxicity, side effects, reduced therapeutic arsenal, and drug resistance are the main problems.• New strategies and recent advances on leishmaniasis treatment are urgent.• Immunomodulators, nanotechnology, and drug repurposing are the future of leishmaniasis treatment.

Leishmaniasis is the neglected disease among parasitic diseases with an increasing rate of infections. Recently, numerous studies have been conducted on the leishmanicidal properties of various essential oils (EOs). In this research, literature have been systematically reviewed, from 20 years ago, and required information have been extracted. Overally, leishmanicidal effects of ~180 EOs against promastigotes of nine species of Leishmania havebeen documented. Inhibitory concentrations 50% (IC50) of around 30 EOs were less than 10 μg.mL-1. EOs of Tetradenia riparia, Nectandra hihua, and Thymus hirtus with IC50s of 0.01,0.20, and 0.25 μg.mL-1 against Leishmania amazonensis, Leishmania infantum, and Leishmania major respectively, were identified as the most effective EOs. Furthermore, IC50 of Thymus hirtus on Leishmania infantum was 0.43 μg.mL-1. Frequently, substantial differences were found between the observed IC50s of one EO against promastigotes of different species of Leishmania. It can be concluded that the leishmanicidal activity of EOs is selective. Turning to the results,the combination of EOs for the design of multifunctional drugs can lead to excellent outcomes.Interestingly, the results have been classified by promastigote species, so this would be a valuablebenchmark for researchers.

Leishmaniasis is a neglected disease caused by protozoa of the genus Leishmania spp., which affects about 1.6 million individuals each year and 500,000 present themselves in the visceral form. In Brazil there are about 30,000 new cases each year. In addition, the country is responsible for 90% of reported cases of Visceral Leishmaniasis, and this is more severe form of the disease. Allied to these facts, the current treatment is ineffective, contributing to the establishment of resistant strains. Currently, the treatment has several side effects and permanent damage to the health of patients, this fact has contributed to the search for new drugs against leishmaniasis. The enzyme oligopeptidase B (OPB) has been studied as a possible therapeutic target in the development of antiparasitic agents. Thus, the objective of this work is to construct the three-dimensional model of the enzyme Oligopeptidase B of different species of Leishmania spp. and compare them to each other. For this purpose, the comparative modeling method was used. In this method, the models of the species L. brasiliensis, L. donovani, L. infantum, L. mexicana and L. panamensis were constructed using the MODELLER program. Once the models were ready, the validation process was carried out and subsequently characterized, which was possible to verify a promising degree of similarity between the models. Finally, these models were submitted to the method of analysis by normal modes, which obtained a similar movement pattern, thus it was possible to verify a movement in a specific region of an alpha-helix, consequently leading to the triad of the enzyme being exposed, which may be indicative of a mechanism of action. Finally, it is expected to use the models built to assist in the development of a promising new therapy for the treatment of leishmaniasis.

Cutaneous Leishmaniasis (CL) is a neglected disease characterized by highest morbidity rates worldwide. The available treatment for CL has several limitations including serious side effects and resistance to the treatment. Herein we aimed to evaluate the activity of essential oil from the peel of Myrciaria floribunda fruits (MfEO) on Leishmania amazonensis. The cytotoxic potential of MfEO on host mammalian cells was evaluated by MTT. The in vitro leishmanicidal effects of MfEO were investigated on the promastigote and intracellular amastigote forms. The ultrastructural changes induced by MfEO were evaluated by Scanning Electron Microscopy (SEM). The molecular docking of the major compounds δ-Cadinene, γ-Cadinene, γ-Muurolene, α-Selinene, α-Muurolene and (E)–Caryophyllene onto the enzymes trypanothione reductase (TreR) and sterol 14-alpha demethylase (C14DM) were performed. Our results showed that MfEO presented moderate cytotoxicity for Vero cells and macrophages. The MfEO inhibited the growth of promastigote and the survival of intracellular amastigotes, in a dose- and time- dependent way. The MfEO presented high selectivity towards amastigote forms, being 44.1 times more toxic for this form than to macrophages. Molecular docking analysis showed that the major compounds of MfEO interact with Leishmania enzymes and that δ-Cadinene (δ-CAD) presented favorable affinity energy values over TreR and C14DM enzymes, when compared with the other major constituents. Molecular dynamics (MD) simulation studies revealed a stable binding of δ-CAD with lowest binding free energy values in MMGBSA assay. Our results suggested that δ-CAD may be a potent inhibitor of TreR and C14DM enzymes. Communicated by Ramaswamy H. Sarma

Understanding the interactions of ecosystems, humans and pathogens is important for disease risk estimation. This is particularly true for neglected and newly emerging diseases where modes and efficiencies of transmission leading to epidemics are not well understood. Using a model for other emerging diseases, the neglected tropical skin disease Buruli ulcer (BU), we systematically review the literature on transmission of the etiologic agent, Mycobacterium ulcerans (MU), within a One Health/EcoHealth framework and against Hill's nine criteria and Koch's postulates for making strong inference in disease systems. Using this strong inference approach, we advocate a null hypothesis for MU transmission and other understudied disease systems. The null should be tested against alternative vector or host roles in pathogen transmission to better inform disease management. We propose a re-evaluation of what is necessary to identify and confirm hosts, reservoirs and vectors associated with environmental pathogen replication, dispersal and transmission; critically review alternative environmental sources of MU that may be important for transmission, including invertebrate and vertebrate species, plants and biofilms on aquatic substrates; and conclude with placing BU within the context of other neglected and emerging infectious diseases with intricate ecological relationships that lead to disease in humans, wildlife and domestic animals.

Scabies is a skin infestation from the Sarcoptes scabiei. It is considered a public health issue causing concern in developing countries and is one of the World Health Organization (WHO) Neglected Tropical Disease. Scabies skin lesions may cause severe itch and can be the portal of entry for opportunistic and pathogenic bacteria which can cause serious systemic infections. We report the case of a 3 year-old-boy with recurrent scabies infection presenting to the Emergency Department because of fever and refusal to walk. At medical examination he looked unwell, right thigh was extremely painful on palpation and blood test showed neutrophilic leucocytosis and significantly increased C reactive protein (CRP) and procalcitonin. Magnetic resonance imaging (MRI) showed an osteomyelitis of metaphysis and distal diaphysis of the right femur with associated subperiosteal purulent collection and concomitant pyomyositis and fasciitis of the distal right thigh. Blood cultures turned positive for Methicillin-Resistant Staphylococcus aureus. He received a long course of intravenous antibiotic therapy and his condition slowly improved. Follow-up femur X-ray showed a mixed pattern of erosion and sclerosis at meta-diaphyseal region and periosteal reaction at diaphyseal region. This case highlights the importance of early scabies diagnosis even in Western countries where poverty and household overcrowding are not matters of concern. Early diagnosis, timely begin of proper treatment and evidence of clinical resolution are important elements to prevent recurrence of infection and serious systemic superinfections even from multi-drug resistant bacteria. Clinical consequences from unrecognized disease or inadequate eradication are preventable.

Background Rabies, caused by a lyssavirus, is a viral zoonosis that affects people in many parts of the world, especially those in low income countries. Contact with domestic animals, especially dogs, is the main source of human infections. Humans may present with the disease only after a long period of exposure. Nearly half of rabies cases occur in children Case presentation The patient, an 11-year-old junior high school Ghanaian student from the Obuasi Municipality in Ghana, presented with aggressive behavior, which rapidly progressed to confusion and loss of consciousness within a day of onset. Her parents reported that the patient had experienced a bite from a stray dog on her right leg 5 years prior to presentation, for which no antirabies prophylaxis was given. The patient died within minutes of arrival in hospital (within 24 hours of symptom onset). Real-time polymerase chain reaction testing of cerebrospinal fluid obtained after her death confirmed the diagnosis of rabies. Subsequent phylogenetic analysis showed the virus to belong to the Africa 2 lineage of rabies viruses, which is one of the predominant circulating lineages in Ghana. Conclusion The incubation period of rabies is highly variable so patients may only present with symptoms long after the exposure incident. Appropriate molecular testing tools, when available as part of rabies control programmes, are vital in confirming cases of rabies.

Background Visceral Leishmaniasis (VL) is a severely neglected disease affecting millions of people with high mortality if left untreated. In Ethiopia, the primary laboratory diagnosis of VL is by using an antigen from a 39-amino acid sequence repeat of a kinesin-related (rK39) of leishmania donovani complex (L. donovani), rapid diagnostic tests (RDT). Different rk39 RDT brands are available with very variable performance and studies from Ethiopia showed a very wide range of sensitivity and specificity. Therefore, a systematic review and meta-analysis were conducted to determine the pooled sensitivity and specificity of rk39 RDT in Ethiopia. Method PUBMED, EMBASE, and other sources were searched using predefined search terms to retrieve all relevant articles from 2007 to 2020. Heterogeneity was assessed by visually inspecting summary receiver operating curves (SROC), Spearman correlation coefficient (rs), Cochran Q test statistics, inconsistency square (I2) and subgroup analysis. The presence and statistical significance of publication bias were assessed by Egger's test at p Results A total of 664 articles were retrieved, and of this 12 articles were included in the meta-analysis. Overall pooled sensitivity and specificity of the rk39 RDT to diagnose VL in Ethiopia were 88.0% (95% CI 86.0% to 89.0%) and 84.0% (95% CI 82.0% to 86.0%), respectively. The sensitivity and specificity of the rk39 RDT commercial test kits were DiaMed: 86.9% (95% CI 84.3% to 89.1%) and 82.2% (95% CI 79.3% to 85.0%), and InBios: 80.0% (95% CI 77.0% to 82.8%) and 97.4% (95% CI 95.0% to 98.8%), respectively. Conclusion Referring to our result, rk39 RDT considered an essential rapid diagnostic test for VL diagnosis. Besides to the diagnostic accuracy, the features such as easy to perform, quick (10–20 min), cheap, equipment-free, electric and cold chain free, and result reproducibility, rk39 RDT is advisable to remains in practice as a diagnostic test at least in the remote VL endemic localities till a better test will come.

Background In Ethiopia, bovine tuberculosis (BTB) is a neglected disease that affects the economy and livelihoods of farmers. However, the available data is limited due to insufficient disease surveillance in the country. Therefore; this study aimed to assess the prevalence and distribution of lesions of BTB in cattle slaughtered at Gondar, Northwest Ethiopia. Methods Postmortem examinations were used to detect tuberculous lesions, while smear microscopy and histopathology were performed for the identification of acid-fast bacilli (AFB). Results Of 497 inspected slaughtered cattle, 45 (9.1%, 95%CI; 0.0668–0.1193) were diagnosed with BTB suggestive tuberculous lesions. A higher proportion of gross lesions was recorded in lymph nodes of lungs; at the mediastinal (14, 31.1%) and bronchial (10, 22.2%) lymph nodes, and followed by mesenteric lymph nodes (9, 20%). Of 45 tuberculous lesions; only 2 (4.4%) were identified as AFB positive by smear microscopy and histopathology. In the overall statistical analysis, body conditions of slaughtered cattle were found to be significantly associated with BTB tuberculous lesions (p < 0.05). Conclusion This finding provides the prevalence of BTB and distribution of tuberculous lesions in cattle slaughtered at the abattoir and highlights the need for a practicable control strategy of the disease in the region.

Based on its prevalence, Tourette syndrome cannot be considered a rare condition. However, in this opinion article, we make the claim that it should nonetheless be considered as an orphan or neglected disease.

Chagas disease (CD) is still a neglected disease. Infected individuals are diagnosed late, being treated in worse clinical conditions. Thus, this study aimed to analyze the prevalence and the factors associated with new confirmed cases of CD identified by serological screening in an endemic region of Minas Gerais State, Brazil. This is an analytical cross-sectional study with data from a project of the Research Center in Tropical Medicine of Sao Paulo- Minas Gerais (SaMi-Trop) conducted in two municipalities. Data collection included a questionnaire with closed questions, a venous blood collection and an ELISA serological test for CD. A total of 2,038 individuals with no previous diagnosis of CD participated in the study. The result of the serological test for CD was adopted as the dependent variable. The independent variables addressed personal issues, health conditions and lifetime housing. A descriptive analysis of individual variables was performed. Subsequently, a bivariate analysis was performed using the Pearson’s chi-square test. Households sheltering individuals positive for CD were georeferenced, and the analysis of spatial distribution was performed using the quartic function to estimate the density of the nucleus. Among the participants, 188 (9.2 %) were positive for CD. The profile of participants with CD was associated with place of residence, age, relative/family member with CD and living conditions. It is noteworthy that there are still patients with CD who are unaware of their diagnosis in both, rural and urban areas.

Chagas disease is a neglected disease caused by Trypanosoma cruzi parasites. Most diagnosis is based on serological tests, but the lack of a gold standard test complicates the measurement of test performance. To overcome this limitation, we used samples from a cohort of well-characterized T. cruzi-infected women to evaluate the reactivity of two rapid diagnostic tests and one enzyme-linked immunosorbent assay (ELISA). Our cohort was derived from a previous study on congenital transmission of T. cruzi and consisted of 481 blood/plasma samples from Argentina (n = 149), Honduras (n = 228), and Mexico (n = 104), with at least one positive T. cruzi PCR. Reactivity of the three tests ranged from 70.5% for the Wiener ELISA to 81.0% for the T-Detect and 90.4% for the Stat-Pak rapid tests. Test reactivity varied significantly among countries and was highest in Argentina and lowest in Mexico. When considering at least two reactive serological tests to confirm seropositivity, over 12% of T. cruzi infection cases from Argentina were missed by serological tests, over 21% in Honduras, and an alarming 72% in Mexico. Differences in test performance among countries were not due to differences in parasitemia, but differences in antibody levels against ELISA antigens were observed. Geographic differences in T. cruzi parasite strains as well as genetic differences among human populations both may contribute to the discrepancies in serological testing. Improvements in serological diagnostics for T. cruzi infections are critically needed to ensure an optimum identification of cases.

Visceral leishmaniasis is a neglected disease caused by protozoan parasites of the genus Leishmania. The successful control of the disease depends on its accurate and early diagnosis, which is usually made by combining clinical symptoms with laboratory tests such as serological, parasitological, and molecular tests. However, early diagnosis based on serological tests may exhibit low accuracy due to lack of specificity caused by cross-reactivities with other pathogens, and sensitivity issues related, among other reasons, to disease stage, leading to misdiagnosis. In this study was investigated the use of mid-infrared spectroscopy and multivariate analysis to perform a fast, accurate, and easy canine visceral leishmaniasis diagnosis. Canine blood sera of 20 noninfected, 20 Leishmania infantum, and eight Trypanosoma evansi infected dogs were studied. The data demonstrate that principal component analysis with machine learning algorithms achieved an overall accuracy above 85% in the diagnosis.

Chagas disease is an important neglected disease that affects 6–7 million people worldwide. The disease has two phases: acute and chronic, in which there are different clinical symptoms. Controlling the infection depends on innate and acquired immune responses, which are activated during the initial infection and are critical for host survival. Furthermore, the immune system plays an important role in the therapeutic success. Here we summarize the importance of the immune system cytokines in the pathology outcome, as well as in the treatment.

Mycetoma is a chronic granulomatous infection of skin and subcutaneous tissues. It is a neglected disease with severe physical and psychological comorbidity burden as many cases end up with amputations. Proper diagnosis with tissue culture is lacking because of unavailability of facilities in remote areas. Eumycetoma by different Aspergillus species has already been reported in the literature for decades. But here, we are reporting a case of eumycetoma caused by Aspergillus niger, which is the first ever case-report to the best of our knowledge and search. Treatment with voriconazole 400 mg/day was successful without any major side-effects, and saved patient from amputation.

Introduction: Chagas disease (CD) is a neglected disease caused by the protozoan parasite Trypanosoma cruzi. In terms of novel drug discovery, there has been no progress since the 1960s with the sa...

Malignant catarrhal fever (MCF) is a fatal lymphoproliferative disease that represents a serious problem in the deer-rearing industry. To better understand an MCF-like disease that has emerged in northern China since 2015, we investigated ten cases by documenting clinical and epidemiological data and analysing causative agents and histopathological changes. In addition, a retrospective screen for Macavirus DNA and a questionnaire-based survey were conducted. Epizootic MCF in Chinese sika deer herds has emerged with a low morbidity of 3.8% (95% CI: 2.5%-5.1%) and a high mortality of 93.2% (95% CI: 86.6%-99.9%). The disease course varied from 3 to 12 days. Aetiologically, OvHV-2 was predominant in the MCFV, accounting for most MCF cases (21/23). In contrast, only two CpHV-2 isolates were phylogenetically closely related to CpHV-2. Diarrhoea and nasal discharges were the most frequent manifestations, although clinical signs varied in some cases. Pathologically typical lesions of haemorrhage, necrosis and lymphoid cell infiltration were readily observed in a variety of organs. Vasculitis caused by vascular and perivascular lymphoid cell infiltration was common. The retrospective survey suggested a low positive rate (3/275) of MCFV DNA in peripheral blood lymphocytes (PBL). The questionnaire-based survey suggested the disease was neglected by local veterinarians, who did not acknowledge the risk of co-rearing deer with reservoir species. Collectively, the emerging epizootic MCF in Chinese sika deer herds remains neglected, emphasizing the urgency of initiating full-field diagnoses and control strategies.

American Trypanosomiasis, a parasitic infection commonly named Chagas disease, affects millions of people all over Latin American countries. Presently, the World Health Organization (WHO) predicts that the number of international infected individuals extends to 7 to 8 million, assuming that more than 10,000 deaths occur annually. The transmission of the etiologic agent, Trypanosoma cruzi, through people migrating to non-endemic world nations makes it an emergent disease. The best promising targets for trypanocidal drugs may be classified into three main groups: Group I includes the main molecular targets that are considered among specific enzymes involved in the essential processes for parasite survival, principally Cruzipain, the major antigenic parasite cysteine proteinase. Group II involves biological pathways and their key specific enzymes, such as Sterol biosynthesis pathway, among others, specific antioxidant defense mechanisms, and bioenergetics ones. Group III includes the atypical organelles /structures present in the parasite relevant clinical forms, which are absent or considerably different from those present in mammals and biological processes related to them. These can be considered potential targets to develop drugs with extra effectiveness and fewer secondary effects than the currently used therapeutics. An improved distinction between the host and the parasite targets will help fight against this neglected disease.

Infections with Bartonella bacilliformis result in Carrion’s disease in humans. In the first phase of infection, the pathogen causes a hemolytic fever (“Oroya fever”) with case-fatality rates as high as ~90% in untreated patients, followed by a chronical phase resulting in angiogenic skin lesions (“verruga peruana”). Bartonella bacilliformis is endemic to South American Andean valleys and is transmitted via sand flies (Lutzomyia spp.). Humans are the only known reservoir for this old disease and therefore no animal infection model is available. In the present review, we provide the current knowledge on B. bacilliformis and its pathogenicity factors, vectors, possible unknown reservoirs, established and potential infection models and immunological aspects of the disease.

The Mediterranean area is endemic for the zoonotic form of visceral leishmaniasis (VL) caused by Leishmania infantum, a species which has been recently associated with unexpected epidemiological and clinical features. We report the result of a systematic review of the literature on VL unusually presenting with spleen focal lesions, including three previously unpublished cases. A total of 28 cases of VL with multiple spleen focal lesions were retrieved. Twenty-six (93%) were acquired in the Mediterranean area, where L. infantum is endemic. Thirteen cases were diagnosed in children, and the remaining 15 cases in middle-aged adults, of whom 9 were immunosuppressed. Four patients (14%) underwent diagnostic splenectomy, while the diagnosis was confirmed by less invasive techniques in the remaining patients. The most common radiological patterns were: multiple subcentimetric or centimetric spleen lesions (size ≤ 1 cm in 14 of 19 cases, 74%), hypoechoic at ultrasonography (25 of 26 cases, 99%) and hypodense at CT scan (9 of 10 cases, 90%). PET-CT (available for four patients) showed an intense FDG spleen uptake. MRI and contrast-enhanced ultrasonography, available for two and one cases each, showed complex patterns. VL must be added to the list of possible differential diagnosis of spleen focal lesions and health care provider awareness about this condition will avoid unnecessary invasive diagnostic procedures.

Introduction. While interscalene brachial plexus block remains the gold standard of any shoulder procedure, including shoulder manipulation in patients with adhesive capsulitis, anesthesiologists are reluctant to face the risk of phrenic nerve paresis, especially in patients with preexisting pulmonary conditions. Hence, many studies have targeted specific regional anesthesia of the shoulder low enough by the blockade level, leaving phrenic nerve function intact but still providing satisfying anesthesia for shoulder procedures. Until recently, no comparison between these regional anesthesia techniques focusing on shoulder manipulation for adhesive capsulitis has been published. Case Report. We compared the profiles between suprascapular nerve block, shoulder interfascial plane block, and superior trunk block as the sole anesthesia technique in patients with adhesive capsulitis undergoing awake shoulder manipulation. Conclusion. This report descriptively signifies superior trunk block excellence among other regional anesthesia techniques in achieving complete anesthesia for awake shoulder manipulation in patients with adhesive capsulitis while sparing the phrenic-nerve function

Cutaneous leishmaniasis (CL) is a parasitic disease that produces chronic skin ulcers. Although it has a worldwide presence, it is a neglected disease that still requires novel tools for its management. In order to study the use of optical tools in CL, this article presents a preliminary study of the correlation between CL histopathological and optical parameters. Optical parameters correspond to absorption and scattering coefficients obtained from diffuse reflectance spectra of treated CL in golden hamsters. Independently, histopathological data were collected from the same hamsters. As a result, after Spearman correlation and the Kruskal-Wallis test, inverse correlation was found between absorption/scattering optical parameters and inflammatory histopathological values, such as the scattering parameter related to the diameter of fibroblasts with the histopathological parameters of fibrosis, polymorphonuclear neutrophils, lymphocytes, plasmocytes, hyperplasia, and

Rheumatic heart disease (RHD) is the most common cause of acquired heart disease in children and young adults. It continues to be prevalent in many low- and middle-income countries where it causes significant morbidity and mortality. Following the 2017 Cairo conference “Rheumatic Heart Disease: from Molecules to the Global Community,” experts from 21 countries formulated an approach for addressing the problem of RHD: “The Cairo Accord on Rheumatic Heart Disease.” The Accord attempts to set policy priorities for the eradication of acute rheumatic fever (ARF) and RHD and builds on a recent series of policy initiatives and calls to action. We present an update on the recommendations of the Cairo Accord and discuss recent progress toward the eradication of RHD, including contributions from our own Aswan Rheumatic Heart Disease Registry (ARGI).

Plasmodium ovale malaria is often neglected due to its less severe course compared to Plasmodium falciparum. In 2011–2012, Belgian Armed Forces identified a cluster of P. ovale cases among military personnel after deployment in the Democratic Republic of Congo (DRC). In this retrospective, monocentric, observational study, clinical and biological features of soldiers diagnosed with P. ovale after deployment in DRC were reviewed. Species diagnosis was based on polymerase chain reaction (PCR) and/or thick blood smear. Medical records of 149 soldiers screened at the Queen Astrid Military Hospital after deployment were reviewed. Eight cases (seven P. ovale infections and one P. ovale—falciparum coinfection) were identified. All had positive thick smears, and seven were confirmed by PCR. Chemoprophylaxis was mefloquine in all subjects. Median time of disease onset was 101 days after return from the endemic region. Median delay between return and diagnosis was 103 days. All P. ovale bouts were uncomplicated. None had relapses after primaquine treatment. This military cohort highlights a hotspot of P. ovale in Eastern DRC. Non-specific symptoms, the less severe presentation, the lack of sensitive parasitological tools in the field and long delays between infection and symptoms probably lead to underestimation of P. ovale cases.

Introduction Chagas disease (CD) is classically reported as a neglected disease of vectorial transmission and is endemic in 21 Latin America countries. While it has long been stigmatized as a mere tropical pathology, CD has recently gained prominence, since new means of infection have become more common, including blood transmission and consumption of food contaminated with feces from a given vector. Taking immigration into account, the disease is currently spreading beyond the limits of endemic areas and has become a [...]

Studies performed during the 1940s–1960s continue to serve as the foundation of the epidemiology of histoplasmosis given that many knowledge gaps persist regarding its geographic distribution, prevalence, and burden in the United States. We explore 3 long-standing, frequently cited, and somewhat incomplete epidemiologic beliefs about histoplasmosis: (1) histoplasmosis is the most common endemic mycosis in the United States, (2) histoplasmosis is endemic to the Ohio and Mississippi River Valleys, and (3) histoplasmosis is associated with bird or bat droppings. We also summarize recent insights about the clinical spectrum of histoplasmosis and changes in underlying conditions associated with the severe forms. Continuing to identify prevention opportunities will require better epidemiologic data, better diagnostic testing, and greater awareness about this neglected disease among health care providers, public health professionals, and the general public.

Schistosomiasis is a parasitic disease endemic to freshwater areas of Southeast Asia, Africa, and South America that is capable of causing serious damage to the internal organs. Recent studies have linked exosomes to the progression of schistosomiasis. These structures are important mediators for intercellular communication, assist cells to exchange proteins, lipids, and genetic material and have been shown to play critical roles during host–parasite interactions. This review aims to discuss the pathophysiology of exosomes in schistosomiasis and their roles in regulating the host immune response. Understanding how exosomes are involved in the pathogenesis of schistosomiasis may provide new perspectives in diagnosing and treating this neglected disease.

Visceral leishmaniasis (VL) is one of the most prevalent parasitic diseases worldwide. In 2019, 97% of the total numbers of cases in Latin America were reported in Brazil. In São Paulo state, currently 17.6% of infected individuals live in the western region. To study this neglected disease on a regional scale, we describe the spread of VL in 45 municipalities of the Regional Network for Health Assistance11(RNHA11). Environmental, human VL (HVL), and canine VL (CVL) cases, Human Development Index, and Lutzomyia longipalpis databases were obtained from public agencies. Global Moran’s I index and local indicators of spatial association (LISA) statistics were used to identify spatial autocorrelation and to generate maps for the identification of VL clusters. On a local scale, we determined the spread of VL in the city of Teodoro Sampaio, part of the Pontal of Paranapanema. In Teodoro Sampaio, monthly peri-domicile sand fly collection; ELISA, IFAT and Rapid Test serological CVL; and ELISA HVL serum surveys were carried out. In RNHA11 from 2000 to 2018, Lu. longipalpis was found in 77.8%, CVL in 69%, and HVL in 42.2% of the 45 municipalities, and 537 individuals were notified with HVL. Dispersion occurred from the epicenter in the north to Teodoro Sampaio, in the south, where Lu. longipalpis and CVL were found in 2010, HVL in 2018, and critical hotspots of CVL were found in the periphery. Moran’s Global Index showed a weak but statistically significant spatial autocorrelation related to cases of CVL (I = 0.2572), and 11 municipalities were identified as priority areas for implementing surveillance and control actions. In RNHA11, a complex array of socioeconomic and environmental factors may be fueling the epidemic and sustaining endemic transmission of VL, adding to the study of a neglected disease in a region of São Paulo, Brazil., Author summary Visceral leishmaniasis (VL) is considered the second most important disease caused by a protozoan worldwide. Currently, 97% of the cases in Latin America are in Brazil. In São Paulo state, since 1997, the disease has been found in an increasing number of municipalities, mainly in the western region. The reasons why VL is spreading in a crescent shape in this region is not well understood, however, socioeconomic and environmental risk factors that increase vulnerability to the disease may be involved. From 2000 to 2018, vectors of Lutzomyia longipalpis were found in 77.8%, canine VL in 69%, and human VL in 44.4% of the 45 municipalities of the western region. Dispersion occurred from the epicenter in the north and followed central and radial highways, reaching Teodoro Sampaio in the south. Among the 45 municipalities, 11 were identified as priority areas for implementing surveillance and control actions. Considered the last frontier and one of the poorest regions of São Paulo, our findings are relevant for planning interventions aimed at reducing the cases of VL in the region.

Leishmaniasis and trypanosomiasis are endemic neglected disease in South America and Africa and considered a significant public health problem, mainly in poor communities. The limitations of the current available therapeutic options, including the lack of specificity, relatively high toxicity, and the drug resistance acquiring, drive the constant search for new targets and therapeutic options. Advances in knowledge of parasite biology have revealed essential enzymes involved in the replication, survival, and pathogenicity of Leishmania and Trypanosoma species. In this scenario, cysteine proteases have drawn the attention of researchers and they are being proposed as promising targets for drug discovery of antiprotozoal drugs. In this systematic review, we will provide an update on drug discovery strategies targeting the cysteine proteases as potential targets for chemotherapy against protozoal neglected diseases.

BACKGROUND: Helminth infections caused by parasitic worms, including nematodes (roundworms), cestodes (tapeworms) and trematodes (flukes), can cause chronic symptoms and serious clinical outcomes if left untreated. The US military frequently conducts activities in helminth-endemic regions, particularly Africa, the Middle East and Southeast Asia. However, the military does not currently screen for these infections, and to date, no comprehensive surveillance studies have been completed to assess the frequency of helminth diagnoses in the military personnel and their families. METHODS: To determine the burden of helminth infections in the US Military Health System (MHS), we conducted a retrospective analysis of International Classification of Diseases (ICD)-9/10 diagnosis codes from all medical encounters in the MHS Data Repository (MDR) from fiscal years (FY) 2012 to 2018. Chart reviews were conducted to assign ICD diagnoses as incorrect, suspected, probable or confirmed based on the laboratory results and symptoms. RESULTS: Abstraction of MHS data revealed over 50 000 helminth diagnoses between FY 2012 and FY 2018. Of these, 38 445 of diagnoses were amongst unique subjects. After chart review, we found there were 34 425 validated helminth infections diagnosed amongst the unique subjects of US military personnel, retirees and dependents. Nearly 4000 of these cases represented infections other than enterobiasis. There were 351 validated strongyloidiasis diagnoses, 317 schistosomiasis diagnoses and 191 diagnoses of cysticercosis during the study period. Incidence of intestinal nematode infection diagnoses showed an upward trend, whilst the incidence of cestode infection diagnoses decreased. CONCLUSIONS: The results of this study demonstrate that helminth infections capable of causing severe morbidity are often diagnosed in the US military. As helminth infections are often asymptomatic or go undiagnosed, the true burden of helminth infections in US military personnel and dependents may be higher than observed here. Prospective studies of US military personnel deployed to helminth-endemic areas may be indicated to determine if post-deployment screening and/or empirical treatment are warranted.

Cutaneous leishmaniasis (CL) is an infectious and neglected disease caused by parasites of the genus Leishmania, which produces a wide spectrum of cutaneous manifestations. CL research has shown that the innate immune activity of cells such as neutrophils, natural killers, macrophages, dendritic cells and the complement system are capable of controlling this infection. However, Leishmania can also modulate the immune activity of these cells to promote its own survival and proliferation at the intracellular level. This review discusses the role of the innate immune response in the control and spread of this infection.

Leishmaniasis is a neglected tropical disease that affects people living in tropical and subtropical areas of the world. There are few therapeutic options for treating this infectious disease, and available drugs induce severe side effects in patients. Different communities have limited access to hospital facilities, as well as classical treatment of leishmaniasis; therefore, they use local natural products as alternative medicines to treat this infectious disease. The present work performed a bibliographic survey worldwide to record plants used by traditional communities to treat leishmaniasis, as well as the uses and peculiarities associated with each plant, which can guide future studies regarding the characterization of new drugs to treat leishmaniasis. A bibliographic survey performed in the PubMed and Scopus databases retrieved 294 articles related to traditional knowledge, medicinal plants and leishmaniasis; however, only 20 were selected based on the traditional use of plants to treat leishmaniasis. Considering such studies, 378 quotes referring to 292 plants (216 species and 76 genera) that have been used to treat leishmaniasis were recorded, which could be grouped into 89 different families. A broad discussion has been presented regarding the most frequent families, including Fabaceae (27 quotes), Araceae (23), Solanaceae and Asteraceae (22 each). Among the available data in the 378 quotes, it was observed that the parts of the plants most frequently used in local medicine were leaves (42.3% of recipes), applied topically (74.6%) and fresh poultices (17.2%). The contribution of Latin America to studies enrolling ethnopharmacological indications to treat leishmaniasis was evident. Of the 292 plants registered, 79 were tested against Leishmania sp. Future studies on leishmanicidal activity could be guided by the 292 plants presented in this study, mainly the five species Carica papaya L. (Caricaceae), Cedrela odorata L. (Meliaceae), Copaifera paupera (Herzog) Dwyer (Fabaceae), Musa × paradisiaca L. (Musaceae), and Nicotiana tabacum L. (Solanaceae), since they are the most frequently cited in articles and by traditional communities.

Cutaneous leishmaniasis (CL) is a neglected disease that represents a serious global public health concern. We performed a systematic review with meta-analysis targeting the use of light-based therapies on CL in preclinical studies since they are essential to identify the benefits, challenges, and limitations of proposing new technologies to fight CL. We searched Pubmed and Web of Science to include original preclinical researches in English that used light-based technologies to fight CL. Inclusion criteria encompassed any animal model for CL induction, an untreated infected group as the comparator, reliable and consistent methodology to develop and treat CL, focus on an antimicrobial therapeutic approach, and data for lesion size and/or parasite load in the infection site. We identified eight eligible articles, and all of them used photodynamic therapy (PDT). For the meta-analysis, three studies were included regarding the parasite load in the infection site and four comprised the lesion size. No overall statistically significant differences were observed between untreated control and PDT groups for parasite load. Differently, PDT significantly reduced the lesion size regardless of the protocol used to treat CL (in mm, SMD: -1.90; 95% CI: −3.74 to −0.07, p = 0.04). This finding is particularly encouraging since CL promotes disfiguring lesions that profoundly affect the quality of life of patients. We conclude that PDT is a new promising technology able to be topically used against CL if applied in more than one session, making it a promising ally for the management of CL.

Objective: Scabies is one of the diseases that can be minimized with preventive health measures. Accurate diagnosis of scabies is important for both patient and public health. Diagnosis of scabies in children can be challenging, since the clinical features in children may differ from those of adults. The aim of the present study was to investigate the demographic and clinical characteristics of the patients with scabies in childhood. Material and Methods: The patients aged 0-18 years, who were diagnosed with scabies and presented to the dermatology outpatient clinic of our hospital, were included in the study. The demographic characteristics of the patients, time of admission, duration of symptoms, family history, the presence of specific lesions, and any lesions on the scalp, face, palmoplantar region, laboratory findings (if any), previous hospital admissions, treatment, and complications were recorded retrospectively.Results: Fifty six of the 104 patients were male (53.8%) and 48 were female (46.2%). The mean age was 5.82±5.21 years. The mean duration of symptoms was 2.41±2.24 months. Eighty four patients had a family history of scabies (80.7%). Seventy patients (67.3%) had at least one specific lesion of scabies. Atypical sites of involvement were palmoplantar region (33.6%), head (6.7%), and face (2.8%). The most commonly used diagnostic tool was dermatoscopy. Forty-one patients were treated with permethrin 5% lotion (39.4%) and 63 with sulfur ointment (60.5%). Of all admissions to the hospital, admissions were highest in fall (40.4%), followed by winter (30.8%), summer (18.2%), and spring (10.6%). Eight patients developed complications (7.6%), including 5 with impetigo and 3 with paronychia.Conclusion: Scabies is an important health issue that can be treated with an accurate and prompt diagnosis. It was observed that the head, face, palms, and soles often are involved in infants and very young children, unlike adults. Therefore, clinicians should consider the clinical differences between adults and children in the management of scabies in children. Also, dermatoscopy is a practical and effective diagnostic tool especially in infants and young children with scabies., Amaç: Skabiyes, koruyucu sağlık önlemleri ile azaltılabilecek hastalıklardandır. Skabiyesin doğru teşhisi, hem hasta hem de halk sağlığı için önemlidir. Skabiyesin çocuklardaki klinik özellikleri yetişkinlerden farklı olabileceğinden çocuklarda skabiyes tanısı zor olabilir. Bu çalışma ile çocukluk çağında saptanan skabiyes olgularının demografik ve klinik özelliklerin araştırılması amaçlandı. Gereç ve Yöntemler: Hastanemiz dermatoloji polikliniklerine başvuran, 0-18 yaş arası skabiyes tanısı alan hastalar çalışmaya dahil edildi. Hastaların demografik özellikleri, başvuru zamanı, semptomların süresi, aile hikayesi, spesifik lezyon varlığı, saçlı deri, yüz, palmoplantar bölgede lezyon varlığı, varsa laboratuar bulguları, önceki hastane başvurusu, tedavi ve komplikasyon gelişimi retrospektif olarak kaydedildi.Bulgular: Yüz dört hastanın 56’si erkek (%53.8), 48’i kızdı (%46.2). Yaş ortalaması 5.82±5.21 yıldı. Hastaların ortalama semptom süresi 2.41±2.24 aydı. Seksen dört olgunun aile hikayesi vardı (%80.7). Yetmiş hasta en az bir spesifik lezyona sahipti (%67.3). Atipik tutulum bölgeleri palmoplantar bölge (%33.6), baş (%6.7) ve yüz (%2.8)’di. En sık kullanılan tanısal araç dermatoskopiydi. Kırk bir olgu permetrin %5 losyon (%39.4) ile 63 olgu sülfürlü merhemle (%60.5) tedavi edildi. Hastaneye yapılan başvuruların en yüksek olduğu dönem sonbahar (%40.4), ardından kış (%30.8), yaz (%18.2) ve ilkbahardı (%10.6). Beşi impetigo ve 3’ü paronişi olmak üzere 8 hastada komplikasyon (%7.6) gelişti. Sonuç: Skabiyes, doğru ve hızlı bir tanı ile tedavi edilebilen önemli bir sağlık sorunudur. Yetişkinlerin aksine baş, yüz, avuç içi ve ayak tabanlarının sıklıkla bebeklerde ve çok küçük çocuklarda tutulduğu görülmüştür. Klinisyenler, çocuklarda skabiyesin yönetiminde erişkinler ve çocuklar arasındaki klinik farklılıkları dikkate almalıdır. Ayrıca dermatoskopi özellikle skabiyesli bebekler ve küçük çocuklarda pratik ve etkili bir tanı aracıdır.

The increasing expansion of visceral leishmaniasis (VL) in the Brazilian territory evidences the need for studies focused on the main reservoir of this parasite: the dog. This study aimed to conduct an epidemiological survey in the municipality of Barão de Melgaço, Pantanal region of the state of Mato Grosso (MT), Brazil. Conventional polymerase chain reaction (PCR) and qualitative SYBR®Green real-time PCR (qPCR) were used to diagnose canine VL (CVL) and characterize the factors associated with this infection. Of the 402 dogs that had blood samples collected, 31 presented the parasite DNA, representing a prevalence of 7.71% in the population studied. Positivity indices for PCR and qPCR were 3.48 (14/402) and 7.21% (29/402), respectively. Comparison of the results obtained by both techniques showed moderate agreement (Kappa = 0.5364). Of the independent variables analyzed, presence of clinical signs (p≤0.05) was the only one associated with CVL. Based on this study, we conclude that VL is a circulating disease, with relatively low prevalence, in dogs of Barão de Melgaço/MT, and that the presence of clinical signs is the only variable associated with canine infection. RESUMO: A crescente expansão da leishmaniose visceral (LV) no território brasileiro evidencia a necessidade de estudos voltados ao principal reservatório doméstico do parasito: o cão. Sendo assim, o objetivo deste estudo foi realizar um inquérito epidemiológico no município de Barão de Melgaço, região do Pantanal Mato-grossense, utilizando as técnicas de reação em cadeia pela polimerase convencional (PCR) e teste qualitativo SYBR®Green real-time PCR (qPCR) para o diagnóstico da LV canina (LVC), além de caracterizar os fatores associados a infecção. Do total de 402 cães que tiveram amostras sanguíneas coletadas, 31 apresentaram o DNA do parasito, perfazendo uma prevalência de 7,71% na população estudada. Os índices de positividade para a PCR e qPCR foram de 3,48% (14/402) e 7,21% (29/402), respectivamente. A comparação dos resultados obtidos por ambas técnicas apresentou moderada concordância (Kappa = 0,5364). Das variáveis independentes analisadas, a presença de sinais clínicos (p≤0,05) foi a única associada a ocorrência de LVC. Com base neste estudo, concluímos que a LV está circulando, com prevalência relativamente baixa, em cães de Barão de Melgaço/MT, sendo a presença de sinais clínicos a única variável associada à infecção canina.

The protozoan parasite Trypanosoma brucei causes human African trypanosomiasis (HAT), a fatal and neglected disease in the tropic areas. Owing to the scarcity of investments, new drug approvals, and resistance development to the current drugs, novel and selective targets are urgently needed to be explored. Trypanothione reductase, nitro-reductase, pteridine reductase 1, methionyl-tRNA synthetase, phosphodiesterases, and rhodesain represent emerging and attractive enzymes for the development of alternative anti-parasitic agents. The structure-activity relationships for each target were discussed as well as the correlation between in vitro and cell-based assays. These compounds could provide new therapeutic options for the limited arsenal of antitrypanosomal agents and are characterized by a good selectivity profile in terms of cytotoxicity against mammalian cells.