Research Group Heussler (Malaria I) - Bernhard-Nocht-Institut für ...

More documents

Recommendations

Info

Parasitology Section Figure 4: Efficacy of paromomycin as compared with diloxanide furoate for the treatment of asymptomatic E. histolytica infection. the individuals had anti-E. histolytica serum antibodies. Interestingly, in contrast to the sex distribution of ALA patients, protozoan parasites including E. histolytica as well as anti-amoebic antibodies were significantly more prevalent in females, suggesting that gender related factors or habits are important for the outcome of E. histolytica infection. Analysis of household characteristics and living conditions identified low level of education, no access to a toilet or tapwater as well as the use of river water to be important risk factors for E. histolytica infection (Fig 3). Longitudinal follow-up of E. histolytica carriers revealed a considerable period of parasite persistance with a mean half-life of infection of more than 1 year, which is in good agreement with clinical observations indicating long latencies between infection with E. histolytica and development of ALA. 26 Treatment of Amoebiasis The high number of ALA patients and of E. histolytica carriers in Hué facilitated comprehensive studies on the treatment of amoebiasis. Treatment of ALA. In a prospective and randomized trial, it was investigated whether ALA can be sufficiently treated only with metronidazole or whether in addition to the application of antibiotics, puncture and removal of abscesses fluid is required, as it is necessary for bacterial abscesses. <strong>Group</strong>s of patients with ALA of 6 to 10 cm located in the right liver lobe were included. The results indicated that both therapeutic regimen are equally effective. All abscesses were cured within the observation period and there were no differences in the time-courses of clinical improvement and abscess resolution, which strongly support the concept that drug treatment alone is sufficient to cure uncomplicated ALAs. Treatment of Asymptomatic E. histolytica Infection. Paromomycin and diloxanide furoate are the drugs recommended for the treatment of asymptomatic E. histolytica infection. However, the efficacy of these medications was evaluated before the identification of E. dispar as a separate nonpathogenic species, which does not require treatment. To determine the efficacy of the two drugs for the treatment of E. histolytica specifically, a randomized, comparative study was performed in 72 asymptomatic carriers, which were identified during our surveys in Phu Cat. Thirty-four subjects were assigned to receive praromomycin and 37 sub-
jects were assigned to receive diloxanide furoate. The taking of medication was directly observed in 62 % of the subjects. Evaluation of stool samples for the presence of E. histolytica by fecal PCR after termination of therapy revealed a significant higher cure rate with paromomycin than with diloxanide fuorate (85% vs. 51%, P = 0.003) (Fig. 4). The findings were similar when the comparison was limited to subjects whose regular intake of medication was directly observed. Since both drugs are well tolerated, the results support the use of paromomycin as the first line agent for treatment of asymptomatic E. histolytica infection. 27 Selected Publications • Blessmann J, Pham Van L, Ton Nu PA, Hao DT, Buss H, Tannich E. 2002. Epidemiology of amebiasis in a region of high incidence of amebic liver abscess in Central Vietnam. Am J Trop Med Hyg 66:578-583 • Blessmann J, Tannich E. (2002). Treatment of asymptomatic intestinal Entamoeba histolytica infection. N Engl J Med 347:1384 • Blessmann J, Buss H, Ton Nu PA, Dinh BT, Ngo Viet QT, Le Van A, Abd Dalla MD, Jackson TFHG, Ravdin JI, Tannich E. (2002). Real time PCR for detection and differentiation of Entamoeba histolytica and Entamoeba dispar in fecal samples. J Clin Microbiol 40: 4413-4417 • Blessmann J, Le Van A, Tannich E. (2003). Hepatic ultrasound in a population with high incidence of invasive amoebiasis: evidence for subclinical, selflimited amoebic liver abscess. Trop Med Int Health 8: 231-233 • Blessmann J, Ali IKM, Ton Nu PA, Dinh BT, Viet Ngo QT, Le Van A, Clark CG, Tannich E. (2003). Longitudinal study of intestinal Entamoeba histolytica infections in asymptomatic adult carriers. J Clin Microbiol 41: 4745-4750 • Blessmann J, Binh HD, Hung DM, Tannich E, Burchard GD. (2003). Treatment of amoebic liver abscess with metronidazole alone or in combination with ultrasound guided needle aspiration: a comparastive prospective and randomised study. Trop Med Int Health 8: 1030-1034 Funding • Volkswagen Foundation Cooperating Partners • Prof. Dr. Pham Van Linh, Dr. Le Van An, Dr. Ton Nu Phuong An, Dr. Duong Thi Hao, Dr. Dinh T. Binh, Dr. Ngo Viet Quinh Tram, Medical College University of Hué, Vietnam • Dr. Ho Duy Binh, Dr. Duong Manh Hung, Hué Central Hospital, Vietnam • Dr. C. Graham Clark, London School of Hygiene and Tropical Medicine, U.K. Investigators • Egbert Tannich • Jörg Blessmann • Gerd D. Burchard • Heidrun Buß Parasitology Section
Page 1 and 2: BERNHARD NOCHT INSTITUTE FOR TROPIC
Page 3 and 4: Human genetic variants influencing
Page 5 and 6: Research Funding / Haushaltsmittel
Page 7 and 8: Introduction The appearance of SARS
Page 9 and 10: tive project with the Faculty of Me
Page 11 and 12: since this group headed by Dr. Chri
Page 13 and 14: Vorwort Das Erscheinen der schweren
Page 15 and 16: AIDS-Forschung hat eine lange zurü
Page 17 and 18: europäisches Konsortium mit 8 Part
Page 19 and 20: Parasitology Section Selected Scien
Page 21 and 22: Zusammenfassung des Sprechers Die S
Page 23 and 24: Research Group Clos (Leishmaniasis
Page 25: Figure 2: Incidence of ALA in Hué
Page 29 and 30: is increased in the first 24 h of h
Page 31 and 32: the populations from the endemic ar
Page 33 and 34: CQR Dd2. In order to determine whet
Page 35 and 36: Project Description and Results A g
Page 37 and 38: Project Description and Results Ado
Page 39 and 40: 39 Parasitology Section Figure 2: S
Page 41 and 42: The paraflagellar rod, a crosshatch
Page 43: Figure 1: Suggested in vivo develop
Page 46 and 47: Medical Microbiology Section Chairm
Page 48 and 49: Medical Microbiology Section Zusamm
Page 50 and 51: Medical Microbiology Section Medica
Page 54 and 55: Medical Microbiology Section Murine
Page 56 and 57: Medical Microbiology Section The ro
Page 60 and 61: Medical Microbiology Section Immunp
Page 62 and 63: Medical Microbiology Section Role o
Page 64 and 65: Medical Microbiology Section Elimin
Page 66 and 67: Medical Microbiology Section Charac
Page 68 and 69: Medical Microbiology Section Identi
Page 70 and 71: Medical Microbiology Section A dry-
Page 73 and 74: Tropical Medicine Section Selected
Page 75 and 76: Zusammenfassung des Sektionsspreche
Page 77 and 78:
Kumasi Centre for Collaborative Res
Page 79 and 80:
Data of twin studies and evidence f
Page 81 and 82:
Figure 1: Changing patterns of mala
Page 83 and 84:
Zusammenfassung In einer Studie an
Page 85 and 86:
low level chronic replication of th
Page 87 and 88:
The KCCR Team and the main laborato
Page 89 and 90:
Kooperierende Institutionen • Kwa
Page 91:
Figure 2: Study sites in and around
Page 94 and 95:
Clinical Department Department Head
Page 96 and 97:
Clinical Department Bericht des Abt
Page 98 and 99:
Clinical Department Staff Clinical
Page 100 and 101:
Clinical Department Cardiac impairm
Page 102 and 103:
Clinical Department Persistence and
Page 104 and 105:
106
Page 106 and 107:
Administration and Public Relations
Page 108 and 109:
Administration and Public Relations
Page 110 and 111:
112
Page 112 and 113:
Education and Teaching Diploma Thes
Page 114 and 115:
Education and Teaching Parasitology
Page 116 and 117:
Education and Teaching Lars Volkman
Page 118 and 119:
Education and Teaching The objectiv
Page 120 and 121:
Education and Teaching Ziel des Kur
Page 122 and 123:
Education and Teaching Institute Fa
Page 124 and 125:
Education and Teaching Lectures and
Page 126 and 127:
Education and Teaching Training for
Page 128 and 129:
Seminar Programme 2002 Prof. Aileen
Page 130 and 131:
Seminar Programme Dr. Stefan Martin
Page 132 and 133:
Symposia and Meetings 2002 Symposia
Page 134 and 135:
Symposia and Meetings 2003 May 13 t
Page 136 and 137:
138
Page 138 and 139:
Staff Activities Staff Activities A
Page 140 and 141:
Staff Activities PD Dr. Joachim Clo
Page 142 and 143:
Staff Activities Editorial Activiti
Page 144 and 145:
Staff Activities Prof. Dr. Rolf Hor
Page 146 and 147:
Staff Activities Prof. Dr. Christia
Page 148 and 149:
Staff Activities Prof. Dr. Egbert T
Page 150 and 151:
152
Page 152 and 153:
Publications Book chapters and Mono
Page 154 and 155:
Publications Herbst R, Ott C, Jacob
Page 156 and 157:
Publications Supali T, Wibowo H, Ru
Page 158 and 159:
Publications Scholze H and Tannich
Page 160 and 161:
Publications Graefe SE, Meyer BS, M
Page 162 and 163:
Publications Schulz A, Mellenthin K
Page 164 and 165:
166
Page 166 and 167:
Appendix 01. Januar 2002 Das BNI wi
Page 168 and 169:
Appendix 01. Oktober 2002 Gemeinsam
Page 170 and 171:
Appendix 01. April 2003 Ergebnis de
Page 172 and 173:
Appendix 01. Juni 2003 Fernsehrepor
Page 174 and 175:
Appendix November 2003 Inauguration
Page 176 and 177:
Appendix red by solar energy could
Page 178 and 179:
Appendix Ansprache von Dr. Thomas F
Page 180 and 181:
Diary 2004/2005 12.-14. November 20
show all

Research Group Heussler (Malaria I) - Bernhard-Nocht-Institut für ...

You also want an ePaper? Increase the reach of your titles

Delete template?

Save as template?