Browsing by Author "Morakote, Nimit"
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Item Cystic echinococcosis in Thailand with a special note on detection by serology in one family.(2007-09-29) Morakote, Nimit; Thamprasert, Kamthorn; Lojanapiwat, Bannakij; Muttarak, MalaiThailand is a nonendemic area of echinococcosis. We report, herein, 3 cases with a special note on the use of serology in detection of the disease in one family. All cases were Thais. The first case was a man, having a cystic mass in the liver. He was subsequently diagnosed as having echinococcosis following positive serology. The second case, a male, had a renal hydatid cyst revealed by histopathology, and a positive serological test. The third case, a wife of case 2, was positive by serological screening for echinococcosis and subsequently proven to have splenic and liver echinococcal cysts. The present findings support the use of serology in the case detection of echinococcosis in Thailand.Item The epidemiology of Dirofilaria immitis infection in outpatient dogs at Chiang Mai University Small Animal Hospital, Thailand.(2008-01-24) Boonyapakorn, Chaovalit; Srikitjakarn, Lertrak; Morakote, Nimit; Hoerchner, FranzFive hundred eighty-nine dog blood samples from the small animal hospital of Chiang Mai University were examined for Dirofilaria immitis prevalence using a microhematocrit tube technique for microfilaria detection. In parallel, a once a month follow-up study on 36 D. immitis negative dogs was conducted to detect the time of acquiring infection in each animal. The diagnostic criteria for the incidence study was based on microfilaria detection or on positive findings against D. immitis antigen using the Witness commercial kit. The estimated prevalence was 18.2% (15-21%; 95% CI). There was no statistical difference between male and female infection rates. The age-specific prevalence of dogs under 2 years old was 6.4%, which was lower than the 2-4 year old group and all the other age groups at a 95% confidence level. In older dogs the prevalence reached 41.5%. Most of the dogs housed outdoors had a statistically higher infection rate than the dogs housed indoors (chi-square = 9.662, 1 df, p = 0.002). Only 109 dogs received chemoprophylaxis resulting in a significantly lower infection rate than in the non-heartworm prevention dogs (chi-square =14.424, 1 df, p = 0.000). The overall incidence density and the incidence during the rainy, cool and hot seasons were 5.2, 6.9, 3.5, and 2.7 animals per 100 animal-months, respectively. The incidence rate ratio between wet/dry, rainy/cool, rainy/summer, and cool/hot seasons were 2.18, 1.98, 2.59 and 1.30, respectively. The 95% confidence interval revealed no difference among seasons. In conclusion, dogs in D. immitis endemic northern Thailand contract infection in about 2 years.Item Evaluation of crude antigen of Dirofilaria immitis third-stage larva for detection of antibody against Wuchereria bancrofti infection by indirect ELISA.(2003-09-24) Riyong, Doungrat; Choochote, Wej; Morakote, Nimit; Jitpakdi, Atchariya; Pitasawat, Benjawan; Keha, Prasert; Tippawangkosol, PongsriDirofilaria immitis is an important heart worm in dogs. An immunodiagnostic test is frequently applied to use an alternative antigen from other parasites. A crude antigen from infective third stage larva (L3) of D. immitis was employed in detecting the antibody to Bancroftian filariasis in humans by indirect ELISA. It was shown that 25 cases of Bancroftian filariasis (76%) at a cut-off value of 0.230, were positive. Cross-reactivity was tested using available sera of other helminthic infections. These sera were 47% (23/49) positive. They comprised a major intestinal helminthic infection, 7 from 15 (46%) strongyloidiasis sera, none from 5 (0%) hookworm infection sera, 6 from 10 (60%) trichinosis sera, 2 from 10 (20%) cysticercosis sera and 8 from 9 (88%) gnathostomiasis sera. The mean OD of sera from Bancroftian filariasis patients was not significantly different from that of the other helminthic infections (p>0.05). In this study, crude antigen may be valuable for the serodiagnosis of Wuchereria bancrofti when subjects do not have tissue helminth infections. However, the crude antigen should be purified to obtain a better sensitivity and specificity of the test.Item Evaluation of IgG4 and total IgG antibodies against cysticerci and peptide antigens for the diagnosis of human neurocysticercosis by ELISA.(2008-12-26) Intapan, Pewpan M; Khotsri, Piyarat; Kanpittaya, Jaturat; Chotmongkol, Verajit; Maleewong, Wanchai; Morakote, NimitTo support the clinical diagnosis of human neurocysticercosis (NCC), we evaluated two peptides, HP6-3 and Ts45W-1, as well as crude saline extract (SE) of Tenia solium cysticerci as antigens for the detection of specific IgG4 subclass and total IgG antibodies by an enzyme-linked immunosorbent assay (ELISA). The sera of definitive diagnosed NCC patients, patients infected with other parasitoses and healthy controls were examined. The diagnostic sensitivity for IgG4 and total IgG detection of the ELISA against SE antigen was 100% and 64.3% with a high amount of cross-reactions to taeniasis saginata at 88.9% (8/9) and 100% (9/9), respectively. The SE-based IgG4-ELISA showed the highest specificity (80.9%). Both peptide-based IgG4-ELISAs provided a superior sensitivity (78.6%) to the total IgG tests whereas their specificity was 66.7% for HP6-3 and 69.8% for Ts45W-1 only. The SE-based ELISA for the detection of specific IgG4 antibody can be used for the diagnosis of neurocysticercosis as well as for serological surveys of NCC endemic areas. The peptide-based IgG4 ELISAs potentially provide a reliable and cost effective alternative method independent from live parasite supply.Item Hypereosinophilia and abdominopulmonary gnathostomiasis.(2008-09-09) Intapan, Pewpan M; Morakote, Nimit; Chansung, Kanchana; Maleewong, WanchaiA 16-year-old Thai male presented with sudden onset severe epigastric and right upper quadrant pain, fever (39 degrees C), chills and malaise. He gave no history of underlying disease, migratory swelling or urticarial skin rash. He had a history of frequently eating raw pork. Physical examination revealed a soft abdomen with markedly tender hepatomegaly. His blood count showed extreme leukocytosis with hypereosinophilia. After admission he developed a non-productive cough with left sided chest pain, a chest x-ray showed a left pleural effusion. Serological findings were positive for Gnathostoma larval antigen but not Fasciola antigen. The patient recovered completely after albendazole treatment. His clinical presentation is compatible with abdominopulmonary hypereosinophilic syndrome or visceral larva gnathostomiasis. The presented case is interesting not only for physicians who work in endemic areas of gnathostomiasis but also for clinicians who work in travel medicine clinics in developed countries, to consider abdominopulmonary gnathostomiasis when patients present with the signs and symptoms of visceral larva migrans.