Protoscolices of Echinococcus granulosus were incubated in vitro with praziquantel (PZ), albendazole (ABZ), or a combination of both (PZ + ABZ). PZ and ABZ displayed slower protoscolicidal activity when applied separately than when used in combination. Despite the low PZ + ABZ concentrations used, protoscolex viability dropped rapidly (within 15 days). At this time, cysts did not develop following their inoculation into mice. The ultrastructural changes induced in the protoscolices by PZ + ABZ were (a) the loss of sucker concavity, (b tegumental contraction of the soma region, (c) the formation of digitiform tegumental extensions, (d) destruction of the tegument, and (e) the degeneration of parenchyma cells as reflected by the presence of numerous lamellar bodies. The PZ + ABZ treatment was effective only against small cysts, which had collapsed at 10 days postinoculation (p.i.). This treatment caused the following alterations: (a) loss of cyst turgidity at 6 days p.i.; (b) separation of the laminated and germinal layers; (c) loss of microtriches; (d) the appearance of numerous lipid droplets in the inner region of the germinal layer, (e) vacuolation of the cyton cytoplasm; and (f) the formation of abundant autophagosomes, which finally led to loss of the integrity of the germinal layer.
The efficacy of praziquantel against the metacestode of Echinococcus granulosus was studied by means of in vitro incubations or in vivo experiments. The results of in vitro incubations indicated that the effectiveness of praziquantel was higher when the parasite material comprised cysts from cyst masses than in the case of intact cysts that retained their adventitial layer. Ultrastructural alterations in the germinal layer of collapsed cysts incubated in vitro were detected. The results obtained in mice after 4 months of treatment demonstrated no significant difference between the control and treated groups with regard to the number and wet weight of developed cysts. However, ultrastructural alterations were detected in the cyst tissue that were similar to those described in the in vitro experiment. In contrast, the effect of chemoprophylaxis on the number and the wet weight of developed cysts was extremely significant as compared with the control value, the efficacy being 99.41% and 98.32%, respectively. Moreover, ultrastructural observations of the cyst tissue revealed loss of its integrity, and no intact cyton was observed in the germinal layer of the developed cyst.
Enteroparasites in children from three marginal urban districts of Trujillo (Peru) were studied to treat these children and to design a prevention and control programme. A total of 845 children were examined. The general prevalence of enteroparasites was of 66.3%, and 45.6% were multiparasitized. The pathogenic enteroparasite prevalence were 23.8% (Giardia lamblia), 4.6% (Iodamoeba buschlii), 2.6% (Cyclospora cayetanensis), 2.2% (Hymenolepis nana), and 2% (Cryptosporidium spp.). G. lamblia was the most frequent parasite both in diarrheic children (28.1%) as well as in nondiarrheic ones (19.5%). The G. lamblia genotypes were molecularly characterized by sequence analysis of the glutamate dehydrogenase (gdh) gene using PCR and RFLP. Sequence analysis revealed both Assemblage A (AI and AII) and Assemblage B (BIV), with the predominance of Assemblage AI. All the samples with Assemblage A were diarrheic but not those with Assemblage B. This is the first study of molecular characterization of G. lamblia in Peruvian children and confirms the importance of asymptomatic patients in the transmission of the giardiosis, especially in places with poor hygiene and sanitation.
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