Browsing by Autor "Michele Spinicci"

Now showing 1 - 15 of 15

Canine Trypanosoma cruzi infection in the Bolivian Chaco
(BioMed Central, 2018) Simona Gabrielli; Michele Spinicci; Fabio Macchioni; David Rojo; Valentina Totino; Patricia Rojas; Mimmo Roselli; Herlan Gamboa; Gabriella Cancrini; Alessandro Bartoloni
A cross-sectional study on Trypanosoma cruzi was carried out in 2013 to evaluate the role of dogs as possible source of infection for humans in two rural communities of the highly endemic Bolivian Chaco (Bartolo, Chuquisaca Department, n = 57 dogs; and Ivamirapinta, Santa Cruz Department, n = 48 dogs). Giemsa-stained thick and thin smears, rapid immunochromatographic test (ICT) (Chagas Quick test, Cypress Diagnostic, Belgium) and polymerase chain reaction for T. cruzi on dried blood spots were performed. All smears proved negative by microscopic examination, whereas 23/103 (22%) were positive by ICT and 5/105 (5%) blood samples contained T. cruzi DNA, evidencing the potential role of dogs in the domestic transmission of the parasite.
Decline in Total Serum IgE and Soluble CD30 in the Context of Soil-Transmitted Helminth Decline in Bolivia
(American Society of Tropical Medicine and Hygiene, 2020) Chiara Della Bella; Michele Spinicci; David Rojo; Alessia Grassi; Herlan Gamboa; Marisa Benagiano; Roberto Torrez; Simona Tapinassi; Simona Gabrielli; Gabriella Cancrini
In the Bolivian Chaco, recent surveys documented a dramatic decrease in the prevalence of soil-transmitted helminth (STH) infections as compared with the 1980s after thirty years of preventive chemotherapy (PC). Concomitant immunological rearrangements are expected. Because nematode infections are associated with increased levels of circulating IgE and glycoprotein CD30 soluble form (sCD30), this study aims to evaluate changes in serological markers of T helper (Th)2-cells activity between 1987 (high STH prevalence) and 2013 (low STH prevalence) in rural communities in the Bolivian Chaco area. We collected 151 sera during two different surveys in 1987 (n = 65) and 2013 (n = 86) and measured the concentration of total IgE and sCD30 by immunoassays. We found a statistically significant age-independent decrease in the total IgE (P < 0.0001) and sCD30 (P < 0.0001) from 1987 to 2013. The significant decrease in serological Th2 markers (IgE and sCD30) between 1987 and 2013 is consistent with the drop in STH prevalence in this geographical area during the same period of time. Further studies might elucidate the clinical and epidemiological impact of these serological rearrangements.
Effect of a health education intervention on intestinal parasitic infections in Bolivian children
(Oxford University Press, 2020) Vieri Lastrucci; Michele Spinicci; Fabio Macchioni; Simona Gabrielli; Ana Liz Villagrán; H Gamboa; Christine Halleux; Piero Olliaro; M J Caldès; Alessandro Bartoloni
Abstract Backgrounds Intestinal parasitic infections (IPI) are a major health issue for children of low- and middle-income countries. Water, sanitation and hygiene (WASH) practices are crucial for preventing IPI. The aim of the study was to evaluate the effects of a school-based health education intervention on handwashing behavior and IPI prevalence in children Methods This is a randomized intervention trial in 8 primary schools in rural communities over the course of 3 school years; preliminary results from the first two years of the trial are here presented. Schools were randomly selected and assigned in a 1:1 ratio to intervention or control (no intervention) groups. For each school year, the intervention included 14 school-based educational sessions and 2 skit events, involving children aged 8-12 years. Knowledge, attitude and practice questionnaire and handwashing at key events was assessed at the beginning and end of each school year. IPI prevalence was assessed with repeated cross-sectional parasitology surveys 12 months apart, involving a minimum of 50 children for each school Results At baseline, no significant differences between intervention and control schools were present in the proportion of children who washed their hands at key events (7.2% vs 9.3%, p = 0.28), in IPI (79.4% vs 75.3%, p = 0.3) and multiple parasitic infections (MPI) prevalences (47.6 vs. 38.6; p = 0.051). At the end of the second year, the percentage of children who washed their hands at key events was significantly higher in the intervention schools (75.4% vs 12.1%, p &lt; 0.001), and the prevalence of IPI and MPI in the intervention schools were respectively about 25% and 15% lower than in the control schools (respectively, 42.9% vs 67.8%, p &lt; 0.001; 16.1% vs 31.6%, p &lt; 0.001) Conclusions A school-based health education intervention could achieve significant changes in hand-washing behaviors and reduction in the prevalence of IPI in children. The third year survey results are needed to confirm these findings Key messages An health education intervention on water, sanitation and hygiene (WASH) practices can reduce the risk of IPI infection in children. An health education intervention on water, sanitation and hygiene (WASH) practices could be configured as a sustainable long-term approach to intestinal parasitic infections control in children.
Feasibility of a Combined Mobile-Health Electrocardiographic and Rapid Diagnostic Test Screening for Chagas-Related Cardiac Alterations
(Multidisciplinary Digital Publishing Institute, 2021) Michele Spinicci; Carlo Fumagalli; Niccolò Maurizi; Enrico Guglielmi; Mimmo Roselli; Herlan Gamboa; Marianne Strohmeyer; Veronica Poma; Roberto Vargas; Iacopo Olivotto
Combined mobile-Health and RDTs was a reliable and effective low-cost strategy to identify patients at high risk of disease needing cardiologic assessment suggesting potential future applications.
Feasibility of a combined mobile-health electrocardiographic and rapid diagnostic test screening for Chagas-related cardiac alterations
(Oxford University Press, 2020) Niccolò Maurizi; Carlo Fumagalli; Michele Spinicci; Enrico Guglielmi; Matteo Rosselli; H Gamboa; Roberto Vargas; M. Strohmeyer; Alessandro Bartoloni; Iacopo Olivotto
Abstract Background Chronic Chagas cardiomyopathy (CChC) is the most common cause of death related to Chagas disease (CD), and it develops in 20–30% of infected individuals. However, access to both CD testing and basic cardiac care is often limited in rural deprived areas, hyperendemic for CD. Purpose To assess the feasibility of a combined mobile-health (m-Health) electrocardiographic (ECG) and rapid diagnostic test (RDT) screening for Chagas-related cardiac alterations in a remote rural village of the Bolivian Chaco, where a high prevalence of CChC is expected. Methods A representative sample of 140 healthy volunteers were consecutively enrolled in a rural Bolivian Community in February 2019. Demographic and clinical data were recorded through a standardized questionnaire. All patients performed an ECG by D-Heart, a validated low-cost hospital grade 8 and 12 lead smartphone portable ECG, and a serologic testing by Chagas Stat-Pak® (CSP). RDTs were read locally while ECGs were sent to a Cardiology clinic which transmitted reports within 24 hours from recording. Results Among 140 people (54 men, median age of 38 [23–54] years), 98 (70%, 95% CI 62.4–77.6) were positive for T. cruzi infection with CSP, with a linear, age-dependent, increasing trend (p&lt;0.001). Overall, 25 individuals (18%) showed ECG abnormalities, compatible with CD. Prevalence of ECG abnormalities was significantly higher in T. cruzi infected individuals (22 vs 7%, p=0.032). None of the study participants had performed an ECG test prior to enrolment. ECG abnormalities included Bundle Branch Blocks (n=8), 1st Degree Atrioventricular blocks (n=3), rhythm disturbances (n=5), pathologic Q waves (n=2), fragmented QRS (n=5) and low QRS voltage (n=2). Twenty-two patients with a positive CSP testing and possible CD-related ECG abnormalities were recalled from Camiri Community and referred to Gutierrez Hospital for chest X-ray and treatment initiation. At multivariate analysis, positive CSP results (OR 4.75, 95% CI 1.08–20.96, p=0.039) and smoking habit (OR 4.20, 95% CI 1.18–14.92, p=0.027) were confirmed as independent predictors of ECG abnormalities. For 6-day screening for a community of 150 inhabitants, the overall start-up amount was projected to 4.82$/patient and to 8.23$/patient when operative costs (i.e. on-site nurse and healthcare assistant with remote physician on call) were included. Conclusions Combined D-Heart® ECG and RDTs screening proved a reliable and effective low-cost strategy to identify patients at high risk of disease and in need of further cardiologic assessment, in a rural, highly endemic environments of the Bolivian Chaco. Onsite and m-Health programmes should be encouraged to support early diagnosis of CD and CChC and provide access to targeted therapy to maximize treatment benefits prior to advanced cardiac involvement. Funding Acknowledgement Type of funding source: None
Frequent carriage of enterococci and other Lactobacillales with OptrA and PoxtA ribosomal protection resistance mechanisms among children from rural areas of Bolivia
(Elsevier BV, 2026) Ilaria Baccani; Alberto Antonelli; Marco Coppi; Selene Rebecca Boncompagni; Tiziana di Maggio; Michele Spinicci; Marianne Strohmeyer; Herlan Gamboa; Veronica Poma; Ana Liz Villagrán
Present findings report the highest prevalence of faecal carriage of optrA- and poxtA-positive commensals so far observed in healthy subjects, raising concerns about the potential clinical and epidemiological implications.
High prevalence of carriage of mcr-1-positive enteric bacteria among healthy children from rural communities in the Chaco region, Bolivia, September to October 2016
(European Centre for Disease Prevention and Control, 2018) Tommaso Giani; Samanta Sennati; Alberto Antonelli; Vincenzo Di Pilato; Tiziana Di Maggio; Antonia Mantella; Claudia Niccolai; Michele Spinicci; Joaquín Monasterio; Paul Castellanos
BackgroundThe mcr-1 gene is a transferable resistance determinant against colistin, a last-resort antimicrobial for infections caused by multi-resistant Gram-negatives.AimTo study carriage of antibiotic-resistant bacteria in healthy school children as part of a helminth control and antimicrobial resistance survey in the Bolivian Chaco region.MethodsFrom September to October 2016 we collected faecal samples from healthy children in eight rural villages. Samples were screened for mcr-1- and mcr-2 genes. Antimicrobial susceptibility testing was performed, and a subset of 18 isolates representative of individuals from different villages was analysed by whole genome sequencing (WGS).ResultsWe included 337 children (mean age: 9.2 years, range: 7-11; 53% females). The proportion of mcr-1 carriers was high (38.3%) and present in all villages; only four children had previous antibiotic exposure. One or more mcr-1-positive isolates were recovered from 129 positive samples, yielding a total of 173 isolates (171 Escherichia coli, 1 Citrobacter europaeus, 1 Enterobacter hormaechei). No mcr-2 was detected. Co-resistance to other antimicrobials varied in mcr-positive E. coli. All 171 isolates were susceptible to carbapenems and tigecycline; 41 (24.0%) were extended-spectrum β-lactamase producers and most of them (37/41) carried blaCTX-M-type genes. WGS revealed heterogeneity of clonal lineages and mcr-genetic supports.ConclusionThis high prevalence of mcr-1-like carriage, in absence of professional exposure, is unexpected. Its extent at the national level should be investigated with priority. Possible causes should be studied; they may include unrestricted use of colistin in veterinary medicine and animal breeding, and importation of mcr-1-positive bacteria via food and animals.
Hymenolepis nana—An Emerging Intestinal Parasite Associated with Anemia in School Children from the Bolivian Chaco
(American Society of Tropical Medicine and Hygiene, 2018) Michele Spinicci; Fabio Macchioni; Simona Gabrielli; David Rojo; Herlan Gamboa; Ana Liz Villagrán; Yolanda Vallejos; Marianne Strohmeyer; Mimmo Roselli; Gabriella Cancrini
Tropical anemia can have multiple causes, whether socioeconomic, dietary, or infectious. In the Bolivian Chaco, soil-transmitted helminthiases (STH), malaria, and Chagas disease are potential infectious causes of anemia among school-aged children (SAC). Following years of preventive chemotherapy with mebendazole, the prevalence of STH among SAC living in that area is now negligible, whereas protozoan infections are still highly prevalent (81%); Hymenolepis nana is the most frequent intestinal helminth (∼13%). We present results of hemoglobin (Hb) assessment and the association between parasitic infections and Hb levels of that SAC population. Overall, 511 SAC (girls:boys ratio 1:1, mean age 9.4 years [95% confidence interval {CI}: 9.3-9.5]) had Hb levels measured by using a point of care testing (HemoCue® Hb 301 System; HemoCue, Angelhome, Sweden). The prevalence of anemia was 23% (117/511), with mean and median Hb level = 12.2 g/dL (95% CI: 12.1-12.3; range 9.2-15.4 g/dL). By multivariate analysis, H. nana infection was associated with an increased risk of anemia (odds ratio 2.9, 95% CI: 1.5-5.7, P = 0.002). Two samples (0.5%) were positive for Trypanosoma cruzi and none for Plasmodium spp. by polymerase chain reaction of the 439 children tested. Anemia is still a concern among SAC living in the Bolivian Chaco. Our findings call for a greater attention to fecal-oral emerging pathogens, such as H. nana, and highlight the importance of water, sanitation, and hygiene improvements for disadvantaged population such as those living in the Bolivian Chaco.
Long-Standing International Cooperation in Parasitology Research: A Summary of 35 Years of Activities in the Bolivian Chaco
(Multidisciplinary Digital Publishing Institute, 2022) Simona Gabrielli; Fabio Macchioni; Michele Spinicci; Marianne Strohmeyer; Mimmo Roselli; Alessandra Nicoletti; Calogero Edoardo Cicero; Veronica Poma; David Rojo; Yunni Lara
The Bolivian Chaco is a semiarid region with a low population density, situated in the southeast part of the Plurinational State of Bolivia. Here, despite the improvements of the last 15 years, poverty remains high in rural areas, where social vulnerability is widespread. The Guaraní ethnic group often lives in isolated communities with a low standard of hygiene and sanitation. This epidemiological scenario favors the spread of transmissible diseases, including several parasitic infections belonging to the neglected tropical diseases (NTDs) group. In this area, a long-standing research activity, built upon the synergism between local and foreign institutions, has been established since the late 1980s and helps to fill in the knowledge gap about the epidemiology dynamics of soil-transmitted helminths, vector-borne parasites, and other parasitic diseases. A 35-year history of cooperation programs in parasitology research has contributed to informing local health authorities of the NTD burden in the Bolivian Chaco and, ultimately, supports local healthcare providers in the management of parasitic diseases.
Persistence of Trypanosoma cruzi vector-borne transmission among school-age children in the Bolivian Chaco documented by 24-month longitudinal serosurveillance
(Oxford University Press, 2022) Michele Spinicci; Fabio Macchioni; Herlan Gamboa; Veronica Poma; Ana Liz Villagrán; Marianne Strohmeyer; Mimmo Roselli; Roberto Vargas; Alessandro Bartoloni; Simona Gabrielli
Our findings support the persistence of vector-borne T. cruzi transmission in this area, highlighting the need for strengthening multidisciplinary efforts against Chagas disease.
Relevant increase of CTX-M-producing Escherichia coli carriage in school-aged children from rural areas of the Bolivian Chaco in a three-year period
(Elsevier BV, 2022) Selene Rebecca Boncompagni; Maria Micieli; Tiziana Di Maggio; Antonia Mantella; Anna Liz Villagrán; Tatiana Briggesth Miranda; Carmen Revollo; Veronica Poma; Herlan Gamboa; Michele Spinicci
Scaling down of a deworming programme among school‐age children after a thirty‐year successful intervention in the Bolivian Chaco
(Wiley, 2018) Michele Spinicci; Fabio Macchioni; David Rojo; Herlan Gamboa; Ana Liz Villagrán; Yolanda Vallejos; Marianne Strohmeyer; Mimmo Roselli; Simona Gabrielli; Gabriella Cancrini
Our findings support the role of preventive chemotherapy in reducing soil-transmitted helminthiases transmission, as otherwise poor hygienic and health conditions persist in the Bolivian Chaco. A national survey, involving areas from all the ecological zones of Bolivia, is now warranted.
Seroepidemiological trend of strongyloidiasis in the Bolivian Chaco (1987–2013) in the absence of disease‐specific control measures
(Wiley, 2017) Michele Spinicci; Fabio Macchioni; Antonia Mantella; Simona Gabrielli; Mimmo Roselli; David Rojo Mayaregua; Joaquín Monasterio Pinckert; Herlan Gamboa Barahona; Grover Adolfo Paredes; Percy Halkyer
The significant reduction in S. stercoralis seroprevalence in Bolivian Chaco cannot be explained by preventive chemotherapy or improved social-sanitary conditions. As the drop is seen in younger generations, it is consistent with little transmission occurring. However, the risk of transmission still exists, as prevalence is persistently high in older individuals, who present a potential reservoir due to the lifelong nature of S. stercoralis infections.
Seroprevalence of Hepatitis A Virus, Hepatitis E Virus, and Helicobacter pylori in Rural Communities of the Bolivian Chaco, 2013
(American Society of Tropical Medicine and Hygiene, 2018) Irene Campolmi; Michele Spinicci; David Rojo Mayaregua; Herlan Gamboa Barahona; Antonia Mantella; Yunni Lara; Mimmo Roselli; Marianne Strohmeyer; Giampaolo Corti; Francesco Tolari
In the Bolivian Chaco, south-east of Bolivia, studies conducted over the past three decades reported hepatitis A virus (HAV) and Helicobacter pylori seroprevalences above 90% and 60%, respectively. Hepatitis E virus (HEV) prevalence was previously found to be 6-7% but is probably an underestimate because of the poor sensitivity of the assays used. In November 2013, we conducted a cross-sectional study of 263 healthy volunteers from two rural communities of the Bolivian Chaco, aiming to reassess HAV, HEV, and H. pylori seroprevalence 10-20 years following the previous surveys. Hepatitis A virus seroprevalence was 95%, with universal exposure after the first decade of life; HEV seroprevalence was considerably higher (31-35%) than that previously reported; H. pylori seroprevalence was 59%, with an age-dependent distribution. The high prevalence of these infections suggests that major efforts are still needed to reduce fecal-oral transmission and to improve human health in the Bolivian Chaco.
Trypanosoma cruzi infection in the human population of the Bolivian Chaco: four serosurveys over a 26-year period (1987-2013)
(Open Learning on Enteric Pathogens, 2020) Michele Spinicci; Simona Gabrielli; David Rojo; Herlan Gamboa; Fabio Macchioni; Antonia Mantella; Yunni Lara; Ana Liz Villagrán; Mimmo Roselli; Marianne Strohmeyer
T. cruzi transmission is still active and CD remains a concern throughout the Bolivian Chaco. More efforts are needed in order to achieve a sustainable interruption of vector-borne CD transmission in this area.