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8.8.11 Human African trypanosomiasis 1451 8.8.11  Human African trypanosomiasis 1451 Clinical features and treatment A non​invasive diarrhoeal illness lasting from 3 to 10 days is attrib- uted to this organism, sometimes symptoms continue for weeks or months. ...

8.8.12 Chagas disease 1459 8.8.12  Chagas disease 1459 New drug candidates Fexinidazole, a 5-​nitroimidazole, was rediscovered by the Drugs for Neglected Diseases initiative (DNDi) after having reviewed over 700 nitroheterocyclic compounds. The molecule was ab...

8.8.13 Leishmaniasis 1467 8.8.13  Leishmaniasis 1467 to divide in the blood, possibly in sequestered sites. Trypomastigotes are rarely seen in human blood: they are much larger than T. cruzi, with a small subterminal kinetoplast (Fig. 8.8.12.10). Antibodies to...

8.8.14 Trichomoniasis 1475 8.8.14  Trichomoniasis 1475 Africa with pentavalent antimonials for 30–​60 days or liposomal amphotericin B for 20 days. Supportive treatment Intercurrent infection must be sought and treated, and nutritional deficiencies corrected. ...

8.8.2 Malaria 1395 8.8.2  Malaria 1395 Shirley DA, Moonah S (2016). Fulminant amoebic colitis after cortico- steroid therapy: a review. PLos Negl Trop Dis, 10, e0004879. Entamoeba gingivalis and Dientamoeba fragilis Bonner M, et al. (2014). Detection of the am...

8.8.3 Babesiosis 1414 section 8  Infectious diseases 1414 sensitivity. When there is uncertainty, drugs effective against re- sistant P.  falciparum should be used (atovaquone–​proguanil, or doxycycline). Chemoprophylaxis is never entirely reliable, and mal- a...

8.8.4 Toxoplasmosis 1416 section 8  Infectious diseases 1416 and quinine or clindamycin alone reduces parasitaemia and pre- vents extensive haemolysis and renal failure. Exchange transfu- sion should be used in fulminating B. divergens cases. Imidocarb dipropi...

8.8.5 Cryptosporidium and cryptosporidiosis 1424 section 8  Infectious diseases 1424 Robert-​Gagneux S, Balas F (2016). Molecular diagnosis of toxo- plasmosis in immunocompromised hosts. Curr Opin Infect Dis, 29, 330–​9. Saeij JP, et al. (2006). Polymorphic se...

8.8.6 Cyclospora and cyclosporiasis 1432 section 8  Infectious diseases 1432 Control of transmission Primary control is by limiting the opportunity for faecal–​oral trans- mission, both direct and indirect. Symptom-​free subjects not in con- tact with immunoco...

8.8.7 Cystoisosporiasis 1436 section 8  Infectious diseases 1436 Prevention As with all other organisms dependent on faecal–​oral transmission, simple precautions will help prevent infection with C. cayetanensis. Water should be boiled before drinking or when ...

8.8.8 Sarcocystosis (sarcosporidiosis) 1438 section 8  Infectious diseases 1438 Polymerase chain reaction assays have been able to identify infec- tions that were negative by traditional stool microscopy. Treatment and prognosis The drug of choice for the trea...

8.8.9 Giardiasis and balantidiasis 1440 section 8  Infectious diseases 1440 Treatment There is no specific therapy for sarcocystosis in humans or ani- mals, although various compounds, including albendazole, metronidazole, cotrimoxazole, and corticosteroids, h...

8.9 Nematodes (roundworms) 1478

8.9.1 Cutaneous filariasis 1478 8.9 Nematodes (roundworms) CONTENTS 8.9.1 Cutaneous filariasis  1478 Gilbert Burnham 8.9.2 Lymphatic filariasis  1487 Richard Knight 8.9.3 Guinea worm disease (dracunculiasis)  1495 Richard Knight 8.9.4 Strongyloidiasis, hoo...

8.9.2 Lymphatic filariasis 1487 8.9.2  Lymphatic filariasis 1487 Gillette-​Ferguson I, et al. (2006). Wolbachia-​ and Onchocerca volvulus-​ induced keratitis (river blindness) is dependent on myeloid differen- tiation factor 88. Infect Immun, 74, 2442–​5. Hopk...

8.9.3 Guinea worm disease (dracunculiasis) 1495 8.9.3  Guinea worm disease (dracunculiasis) 1495 of adult worms, both within and between individuals. For tropical pulmonary eosinophilia a full 21 days of treatment is indicated, and may need to be repeated. Dox...

8.9.4 Strongyloidiasis, hookworm, and other gut strongyloid nematodes 1500 section 8  Infectious diseases 1550 and oesophageal varices. Previous episodes of haematemesis indi- cate a 70% risk of rebleeding. Urogenital schistosomiasis caused by S. haematobium m...

8.9.5 Gut and tissue nematode infections acquired by ingestion 1506 section 8  Infectious diseases 1506 worldwide may partly be a result of reduced exposure to the im- munosuppressive effects of helminths, and lead to concerns that mass deworming may have detr...