Epidemiology of hookworm infection in Itagua, Paraguay: a cross sectional study

A cross-sectional study in Itagua, Paraguay tested 192 people for the presence, intensity and species of hookworm infection. Fifty-nine percent of these individuals were found to be infected. Intensity of infection was determined on 92% of infected individuals by quantitative egg counts. The high intensity hookworm infections, which cause the greatest morbidity, were clustered between the ages of five and 14 years. No differences were seen between genders. The species of hookworm was determined for parasites reared from 72% of infected individuals. Both Necator americanus and Ancylostoma duodenale were identified, although the former species predominated. We conclude that hookworm infection continues to be a public health problem in Paraguay, particularly among children and adolescents who suffer from high intensity infections. A. duodenale continues to persist in the Western Hemisphere and has not been completely displaced by N. americanus.

Interactions between learning and immunity in Drosophila melanogaster

Learning and immunity are two adaptive traits with roles in central aspects of an organism's life: learning allows adjusting behaviours in changing environments, while immunity protects the body integrity against parasites and pathogens. While we know a lot about how these two traits interact in vertebrates, the interactions between learning and immunity remain poorly explored in insects. During my PhD, I studied three possible ways in which these two traits interact in the model system Drosophila melanogaster, a model organism in the study of learning and in the study of immunity. Learning can affect the behavioural defences against parasites and pathogens through the acquisition of new aversions for contaminated food for instance. This type of learning relies on the ability to associate a food-related cue with the visceral sickness following ingestion of contaminated food. Despite its potential implication in infection prevention, the existence of pathogen avoidance learning has been rarely explored in invertebrates. In a first part of my PhD, I tested whether D. melanogaster, which feed on food enriched in microorganisms, innately avoid the orally-acquired 'novel' virulent pathogen Pseudomonas entomophila, and whether it can learn to avoid it. Although flies did not innately avoid this pathogen, they decreased their preference for contaminated food over time, suggesting the existence of a form of learning based likely on infection-induced sickness. I further found that flies may be able to learn to avoid an odorant which was previously associated with the pathogen, but this requires confirmation with additional data. If this is confirmed, this would be the first time, to my knowledge, that pathogen avoidance learning is reported in an insect. The detrimental effect of infection on cognition and more specifically on learning ability is well documented in vertebrates and in social insects. While the underlying mechanisms are described in detail in vertebrates, experimental investigations are lacking in invertebrates. In a second part of my PhD, I tested the effect of an oral infection with natural pathogens on associative learning of D. melanogaster. By contrast with previous studies in insects, I found that flies orally infected with the virulent P. entomophila learned better the association of an odorant with mechanical shock than uninfected flies. The effect seems to be specific to a gut infection, and so far I have not been able to draw conclusions on the respective contributions of the pathogen's virulence and of the flies' immune activity in this effect. Interestingly, infected flies may display an increased sensitivity to physical pain. If the learning improvement observed in infected flies was due partially to the activity of the immune system, my results would suggest the existence of physiological connections between the immune system and the nervous system. The basis of these connections would then need to be addressed. Learning and immunity are linked at the physiological level in social insects. Physiological links between traits often result from the expression of genetic links between these traits. However, in social insects, there is no evidence that learning and immunity may be involved in an evolutionary trade-off. I previously reported a positive effect of infection on learning in D. melanogaster. This might suggest that a positive genetic link could exist between learning and immunity. We tested this hypothesis with two approaches: the diallel cross design with inbred lines, and the isofemale lines design. The two approaches provided consistent results: we found no additive genetic correlation between learning and resistance to infection with the diallel cross, and no genetic correlation in flies which are not yet adapted to laboratory conditions in isofemale lines. Consistently with the literature, the two studies suggested that the positive effect of infection on learning I observed might not be reflected by a positive evolutionary link between learning and immunity. Nevertheless, the existence of complex genetic relationships between the two traits cannot be excluded. - L'apprentissage et l'immunité sont deux caractères à valeur adaptative impliqués dans des aspects centraux de la vie d'un organisme : l'apprentissage permet d'ajuster les comportements pour faire face aux changements de l'environnement, tandis que l'immunité protège l'intégrité corporelle contre les attaques des parasites et des pathogènes. Alors que les interactions entre l'apprentissage et l'immunité sont bien documentées chez les vertébrés, ces interactions ont été très peu étudiées chez les insectes. Pendant ma thèse, je me suis intéressée à trois aspects des interactions possibles entre l'apprentissage et l'immunité chez la mouche du vinaigre Drosophila melanogaster, qui est un organisme modèle dans l'étude à la fois de l'apprentissage et de l'immunité. L'apprentissage peut affecter les défenses comportementales contre les parasites et les pathogènes par l'acquisition de nouvelles aversions pour la nourriture contaminée par exemple. Ce type d'apprentissage repose sur la capacité à associer une caractéristique de la nourriture avec la maladie qui suit l'ingestion de cette nourriture. Malgré les implications potentielles pour la prévention des infections, l'évitement appris des pathogènes a été rarement étudié chez les invertébrés. Dans une première partie de ma thèse, j'ai testé si les mouches, qui se nourrissent sur des milieux enrichis en micro-organismes, évitent de façon innée un 'nouveau' pathogène virulent Pseudomonas entomophila, et si elles ont la capacité d'apprendre à l'éviter. Bien que les mouches ne montrent pas d'évitement inné pour ce pathogène, elles diminuent leur préférence pour de la nourriture contaminée dans le temps, suggérant l'existence d'une forme d'apprentissage basée vraisemblablement sur la maladie générée par l'infection. J'ai ensuite observé que les mouches semblent être capables d'apprendre à éviter une odeur qui était au préalable associée avec ce pathogène, mais cela reste à confirmer par la collecte de données supplémentaires. Si cette observation est confirmée, cela sera la première fois, à ma connaissance, que l'évitement appris des pathogènes est décrit chez un insecte. L'effet détrimental des infections sur la cognition et plus particulièrement sur les capacités d'apprentissage est bien documenté chez les vertébrés et les insectes sociaux. Alors que les mécanismes sous-jacents sont détaillés chez les vertébrés, des études expérimentales font défaut chez les insectes. Dans une seconde partie de ma thèse, j'ai mesuré les effets d'une infection orale par des pathogènes naturels sur les capacités d'apprentissage associatif de la drosophile. Contrairement aux études précédentes chez les insectes, j'ai trouvé que les mouches infectées par le pathogène virulent P. entomophila apprennent mieux à associer une odeur avec des chocs mécaniques que des mouches non infectées. Cet effet semble spécifique à l'infection orale, et jusqu'à présent je n'ai pas pu conclure sur les contributions respectives de la virulence du pathogène et de l'activité immunitaire des mouches dans cet effet. De façon intéressante, les mouches infectées pourraient montrer une plus grande réactivité à la douleur physique. Si l'amélioration de l'apprentissage observée chez les mouches infectées était due en partie à l'activité du système immunitaire, mes résultats suggéreraient l'existence de connections physiologiques entre le système immunitaire et le système nerveux. Les mécanismes de ces connections seraient à explorer. L'apprentissage et l'immunité sont liés sur un plan physiologique chez les insectes sociaux. Les liens physiologiques entre les caractères résultent souvent de l'expression de liens entre ces caractères au niveau génétique. Cependant, chez les insectes sociaux, il n'y a pas de preuve que l'apprentissage et l'immunité soient liés par un compromis évolutif. J'ai précédemment rapporté un effet positif de l'infection sur l'apprentissage chez la drosophile. Cela pourrait suggérer qu'une relation génétique positive existerait entre l'apprentissage et l'immunité. Nous avons testé cette hypothèse par deux approches : le croisement diallèle avec des lignées consanguines, et les lignées isofemelles. Les deux approches ont fournies des résultats similaires : nous n'avons pas détecté de corrélation génétique additive entre l'apprentissage et la résistance à l'infection avec le croisement diallèle, et pas de corrélation génétique chez des mouches non adaptées aux conditions de laboratoire avec les lignées isofemelles. En ligne avec la littérature, ces deux études suggèrent que l'effet positif de l'infection sur l'apprentissage que j'ai précédemment observé ne refléterait pas un lien évolutif positif entre l'apprentissage et l'immunité. Néanmoins, l'existence de relations génétiques complexes n'est pas exclue.

Growth in a Cross-Section of Cities: Location, Increasing Returns or Random Growth?

This article analyzes empirically the main existing theories on income and population city growth: increasing returns to scale, locational fundamentals and random growth. To do this we implement a threshold nonlinearity test that extends standard linear growth regression models to a dataset on urban, climatological and macroeconomic variables on 1,175 U.S. cities. Our analysis reveals the existence of increasing returns when per-capita income levels are beyond $19; 264. Despite this, income growth is mostly explained by social and locational fundamentals. Population growth also exhibits two distinct equilibria determined by a threshold value of 116,300 inhabitants beyond which city population grows at a higher rate. Income and population growth do not go hand in hand, implying an optimal level of population beyond which income growth stagnates or deteriorates

Evolution of the clinical and epidemiological knowledge about Chagas disease 90 years after its discovery

Three different periods may be considered in the evolution of knowledge about the clinical and epidemiological aspects of Chagas disease since its discovery: (a) early period concerning the studies carried out by Carlos Chagas in Lassance with the collaboration of other investigators of the Manguinhos School. At that time the disease was described and the parasite, transmitters and reservoirs were studied. The coexistence of endemic goiter in the same region generated some confusion about the clinical forms of the disease; (b) second period involving uncertainty and the description of isolated cases, which lasted until the 1940 decade. Many acute cases were described during this period and the disease was recognized in many Latin American countries. Particularly important were the studies of the Argentine Mission of Regional Pathology Studies, which culminated with the description of the Romaña sign in the 1930 decade, facilitating the diagnosis of the early phase of the disease. However, the chronic phase, which was the most important, continued to be difficult to recognize; (c) period of consolidation of knowledge and recognition of the importance of Chagas disease. Studies conducted by Laranja, Dias and Nóbrega in Bambuí updated the description of Chagas heart disease made by Carlos Chagas and Eurico Villela. From then on, the disease was more easily recognized, especially with the emphasis on the use of a serologic diagnosis; (d) period of enlargement of knowledges on the disease. The studies on denervation conducted in Ribeirão Preto by Fritz Köberle starting in the 1950 decade led to a better understanding of the relations between Chagas disease and megaesophagus and other visceral megas detected in endemic areas.

IPH response to the Joint Committee on Health and Children and members of the Northern Ireland Assembly on “Cross-border cooperation on healthcare”

The Institute of Public Health in Ireland were asked to submit a paper on 'Cross-border cooperation on healthcare' for a joint meeting between the Oireachtas Joint Committee on Health and Children and the Northern Ireland Assembly Health Committee which took place in Leinster House on 1 March 2012. Key points from the submission included: o    The Institute of Public Health in Ireland (IPH) is an all-island organisation which promotes cooperation between the Republic of Ireland and Northern Ireland with the aim of improving population health on the island and tackling health inequalities. IPH work is focused on addressing the causes of ill health rather than the design and delivery of treatment services. o    North/South cooperation on health was mandated under the Belfast Agreement in 1998 in five domains, including health promotion. IPH has supported the North South Ministerial Council (NSMC) in respect of the health promotion strand since inception. o    The Department of Health and Department of Health, Social Services and Public Safety North-South Feasibility Study (December 2011) states that mutual benefits are most evident from cooperation in the areas of (i) anticipating trends and illnesses in a collective manner (ii) public health issues (iii) specialised services where the population or activity required to sustain the service cannot be met by either jurisdiction alone and (iv) in relation to those areas adjacent to the border. o    The European Directive on Cross-Border Healthcare will be implemented in the next few years which will have implications in relation to patients travelling for healthcare across the Republic of Ireland/Northern Ireland border. o    IPH is supporting the development of new public health strategies in the Republic of Ireland and Northern Ireland which are both due for publication this year. o    There are tangible benefits from cross-border cooperation in the health sector, both in public health and in health service planning and delivery and there are many examples of successful initiatives. However, developments are not occurring in the context of an agreed plan or overall strategic context and tend to be project-based and concentrated in border counties. o    Successful cross-border cooperation requires high level support and integration into departmental policy cycles. The provision of data on an all-island basis supports cross-border cooperation as does the operation of sustainable all-island organisations which can support research, evaluations and programmes. o    In the future, cross-border cooperation in health will be more effective if developed with a strategic planning process intrinsically linked to Departmental priorities. o    North-South cooperation in the areas of alcohol, obesity, tobacco health surveys and rare diseases will be particularly beneficial.

A cross-cultural study of the higher-order structures underlying personality disorders in French-speaking Africa and Switzerland

Most studies about the higher-order dimensions to be considered in order to parsimoniously describe Personality Disorders (PDs) have identified between two and four factors but there is still no consensus about their exact number. In this context, the cultural stability of these structures might be a criterion to be considered. The aim of this study was to identify stable higher-order structures of PD traits in a French-speaking African and Swiss sample (N = 2,711). All subject completed the IPDE screening questionnaire. Using Everett's criterion and conducting a series of principal component analyses, a cross-culturally stable two- and four-factor structure were identified, associated with a total congruence coefficient of respectively .98 and .94 after Procrustes rotation. Moreover, these two structures were also highly replicable across the four African regions considered, North Africa, West Africa, Central Africa, and Mauritius, with a mean total congruence coefficient of respectively .97 and .87. The four-factor structure presented the advantage of being similar to Livesely's four components and of describing the ten PDs more accurately.

Discovery of new intracellular pathogens by amoebal coculture and amoebal enrichment approaches.

Intracellular pathogens such as legionella, mycobacteria and Chlamydia-like organisms are difficult to isolate because they often grow poorly or not at all on selective media that are usually used to cultivate bacteria. For this reason, many of these pathogens were discovered only recently or following important outbreaks. These pathogens are often associated with amoebae, which serve as host-cell and allow the survival and growth of the bacteria. We intend here to provide a demonstration of two techniques that allow isolation and characterization of intracellular pathogens present in clinical or environmental samples: the amoebal coculture and the amoebal enrichment. Amoebal coculture allows recovery of intracellular bacteria by inoculating the investigated sample onto an amoebal lawn that can be infected and lysed by the intracellular bacteria present in the sample. Amoebal enrichment allows recovery of amoebae present in a clinical or environmental sample. This can lead to discovery of new amoebal species but also of new intracellular bacteria growing specifically in these amoebae. Together, these two techniques help to discover new intracellular bacteria able to grow in amoebae. Because of their ability to infect amoebae and resist phagocytosis, these intracellular bacteria might also escape phagocytosis by macrophages and thus, be pathogenic for higher eukaryotes.

Mexican Trypanosoma cruzi stocks: analysis of minicircle kDNA homologies by cross-hybridization

Homologies of minicircle kDNA of 27 Mexican stocks were studied by cross-hybridization with four kDNA probes derived from three reference stocks belonging to groups Trypanosoma cruzi I (SO34 cl4 and Silvio) and T. cruzi II (MN) and one Mexican stock. High homologies were only observed with Silvio (six stocks) and Mexican probes (11 stocks). After 30 min exposure (low homology) additional stocks were recognized with SO34 cl4 (three stocks) and Silvio (six stocks) probes; with the Mexican probe only five stocks remained non-reactive. All the stocks were typed by isoenzyme (16 loci) and Mexican stocks belonged to T. cruzi I. Hybridization patterns were not strictly correlated with the observed clustering and cross-hybridization of kDNA minicircles is not available to distinct Mexican stocks.