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Deep Learning Technology: Sebastian Arnold, Betty van Aken, Paul Grundmann, Felix A. Gers and Alexander Löser. Learning Contextualized Document Representations for Healthcare Answer Retrieval. The Web Conference 2020 (WWW'20)
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Coccidiosis is a significant disease for chickens, especially affecting the young chicks. It can be fatal or leave the bird with compromised digestion. There are chick feed mixes that contain a coccidiostat to manage exposure levels and control disease. In an outbreak, coccidiocidal medications are given. Examples are toltrazuril (Baycox) or amprolium. After multiple infections, surviving chickens become resistant to the coccidia.
The most common medications used to treat coccidian infections are in the sulfonamide antibiotic family.
Depending on the pathogen and the condition of the animal, untreated coccidiosis may clear of its own accord, or become severe and damaging, and sometimes cause death.
Roughly 0.8-1.3 billion individuals are infected with this intestinal worm, primarily in Africa and Asia. About 120 to 220 million of these cases are symptomatic.
As of 2010 Ascariasis caused about 2,700 directly attributable deaths, down from 3,400 in 1990. The indirectly attributable deaths due to the malnutrition link may be much higher.
Filariasis can also affect domesticated animals, such as cattle, sheep, and dogs.
It is estimated that a third of all pregnant women in developing countries are infected with hookworm, 56% of all pregnant women in developing countries suffer from anemia, 20% of all maternal deaths are either directly or indirectly related to anemia. Numbers like this have led to an increased interest in the topic of hookworm-related anemia during pregnancy. With the understanding that chronic hookworm infection can often lead to anemia, many people are now questioning if the treatment of hookworm could effect change in severe anemia rates and thus also on maternal and child health as well. Most evidence suggests that the contribution of hookworm to maternal anemia merits that all women of child-bearing age living in endemic areas be subject to periodic anthelmintic treatment. The World Health Organization even recommends that infected pregnant women be treated after their first trimester. Regardless of these suggestions, only Madagascar, Nepal and Sri Lanka have added deworming to their antenatal care programs.
This lack of deworming of pregnant women is explained by the fact that most individuals still fear that anthelmintic treatment will result in adverse birth outcomes. But a 2006 study by Gyorkos et al. found that when comparing a group of pregnant women treated with mebendazole with a control placebo group, both illustrated rather similar rates in adverse birth outcomes. The treated group demonstrated 5.6% adverse birth outcomes, while the control group had 6.25% adverse birth outcomes. Furthermore, Larocque et al. illustrated that treatment for hookworm infection actually led to positive health results in the infant. This study concluded that treatment with mebendazole plus iron supplements during antenatal care significantly reduced the proportion of very low birth weight infants when compared to a placebo control group. Studies so far have validated recommendations to treat infected pregnant women for hookworm infection during pregnancy.
A review of effects of antihelminthics (anti-worm drugs) given in pregnancy found that there was not enough evidence to support treating pregnant women in their second or third trimesters. The women who were treated in the second trimester and the women who had no treatment showed no difference in numbers of maternal anemia, low birth weight, preterm birth or deaths of babies.
The intensity of hookworm infection as well as the species of hookworm have yet to be studied as they relate to hookworm-related anemia during pregnancy. Additionally, more research must be done in different regions of the world to see if trends noted in completed studies persist.
Because of Eustrongylides species’ complex life cycle with various host species, preventing infection and controlling outbreaks is difficult. Outbreaks of this disease are closely linked to agricultural runoff and urban development Eutrophication of water bodies supports high population levels of oligochaete worms, which causes increased numbers of infected fish that eat the worms, and then the birds who eat the fish.
One way to prevent Eustrongylidosis is to control oligochaete populations. Outbreaks of this parasite are closely linked to high numbers of oligochaete worms in the area’s waterways. This is because the worms are essential for Eustrongylides species to reproduce. Oligochaete populations can be controlled by monitoring nutrient levels in the water, because high nutrient levels support oligochaete populations. They can also be controlled by decreasing the level of oxygen in the water. Encouraging responsible farming practices in order to reduce chemical run-off will help prevent this disease from occurring.
Managers need to be diligent in catching the symptoms of the parasite before it can become an outbreak. Once an outbreak of Eustrongylidosis has occurred, there is little that ecosystem managers can do to stop the spread in oligochaetes, fish and birds. Traditional anthelminthics (dewormers) are not effective in fish because they kill parasites that live inside the gastrointestinal tract, whereas Eustrongylides species live outside the stomach in the body cavity. The parasites can only be removed from fish surgically, which is not feasible. In order to completely stop the Eustrongylides life cycle in fish, all fish in an affected area must be culled.
Surgical removal of the parasite from wading birds is a viable option, but this would also not be feasible for a large number of birds, and it would not stop the cycle of infection.
Eustrongylidosis is a parasitic disease that mainly affects wading birds worldwide; however, the parasite’s complex, indirect life cycle involves other species such as aquatic worms and fish. Moreover, this disease is zoonotic which means the parasite can transmit disease from animals to humans. Eustrongylidosis is named after the causative agent Eustrongylides and typically occurs in eutrophicated waters where concentrations of nutrients and minerals are high enough to provide ideal conditions for the parasite to thrive and persist. Because eutrophication has become a common issue due to agricultural runoff and urban development, cases of Eustrongylidosis are becoming prevalent and hard to control. Eustrongylidosis can be diagnosed before or after death by observing behavior, clinical signs and performing fecal flotations and necropsies. Methods to control Eustrongylidosis include preventing eutrophication and providing hosts with uninfected food sources in aquaculture farms. Parasites are known to be indicators of environmental health and stability and should therefore be studied further to better understand the parasite’s life cycle and how it affects predator-prey interactions and improve conservation efforts.
Co-infection with hookworm and "Plasmodium falciparum" is common in Africa. Although exact numbers are unknown, preliminary analyses estimate that as many as a quarter of African schoolchildren (17.8–32.1 million children aged 5–14 years) may be coincidentally at-risk of both "P. falciparum" and hookworm. While original hypotheses stated that co-infection with multiple parasites would impair the host’s immune response to a single parasite and increase susceptibility to clinical disease, studies have yielded contrasting results. For example, one study in Senegal showed that the risk of clinical malaria infection was increased in helminth-infected children in comparison to helminth-free children while other studies have failed to reproduce such results, and even among laboratory mouse experiments the effect of helminths on malaria is variable. Some hypotheses and studies suggest that helminth infections may protect against cerebral malaria due to the possible modulation of pro-inflammatory and anti-inflammatory cytokines responses. Furthermore, the mechanisms underlying this supposed increased susceptibility to disease are unknown. For example, helminth infections cause potent and highly polarized immune response characterized by increased T-helper cell type 2 (T2) cytokine and Immunoglobulin E(IgE) production. However, the effect of such responses on the human immune response is unknown. Additionally, both malaria and helminth infection can cause anemia, but the effect of co-infection and possible enhancement of anemia is poorly understood.
Parasitic worms have been used as a medical treatment for various diseases, particularly those involving an overactive immune response. As humans have evolved with parasitic worms, proponents argue they are needed for a healthy immune system. Scientists are looking for a connection between the prevention and control of parasitic worms and the increase in allergies such as hay-fever in developed countries. Parasitic worms may be able to damp down the immune system of their host, making it easier for them to live in the intestine without coming under attack. This may be one mechanism for their proposed medicinal effect.
One study suggests a link between the rising rates of metabolic syndrome in the developed worlds and the largely successful efforts of Westerners to eliminate intestinal parasites. The work suggests eosinophils (a type of white blood cell) in fat tissue play an important role in preventing insulin resistance by secreting interleukin 4, which in turn switches macrophages into "alternative activation". Alternatively-activated macrophages are important to maintaining glucose homeostasis (i.e., blood sugar regulation). Helminth infection causes an increase in eosinophils. In the study, the authors fed rodents a high-fat diet to induce metabolic syndrome, and then injected them with helminths. Helminth infestation improved the rodents' metabolism. The authors concluded:
Although sparse in blood of persons in developed countries, eosinophils are often elevated in individuals in rural developing countries where intestinal parasitism is prevalent and metabolic syndrome rare. We speculate that eosinophils may have evolved to optimize metabolic homeostasis during chronic infections by ubiquitous intestinal parasites….
Helminths (), also commonly known as parasitic worms, are large multicellular organisms, which can generally be seen with the naked eye when they are mature. They are often referred to as intestinal worms even though not all helminths reside in the intestines. For example, schistosomes are not intestinal worms, but rather reside in blood vessels. The word helminth comes from Greek "hélmins", a kind of worm.
There is no consensus on the taxonomy of helminths. It is simply a commonly used term to describe certain worms with some similarities. These are flatworms (platyhelminthes), namely cestodes (tapeworms) and trematodes (flukes), and roundworms or nemathelminths (nematodes) – both of these are parasitic worm types – and the annelida, which are not parasitic or at the most ectoparasites like the leeches.
Helminths are worm-like organisms living in and feeding on living hosts. They receive nourishment and protection while disrupting their hosts' nutrient absorption. This can cause weakness and disease of the host. Those helminths that live inside the digestive tract are called intestinal parasites. They can live inside humans and other animals. In their adult form, helminths cannot multiply in humans. Helminths are able to survive in their mammalian hosts for many years due to their ability to manipulate the immune response by secreting immunomodulatory products. All helminths produce eggs (also called ova) for reproduction. These eggs have a strong shell that protects them against a range of environmental conditions. The eggs can therefore survive in the environment, outside their hosts, for many months or years.
Many, but not all, of the worms referred to as helminths belong to the group of intestinal parasites. An infection by a helminth is known as helminthiasis, helminth infection or intestinal worm infection. There is a naming convention which applies to all helminths: the ending "-asis" (or in veterinary science: "-osis") is added at the end of the name of the worm to denote the infection with that particular worm. For example, "Ascaris" is the name of a type of helminth, and ascariasis is the name of the infectious disease caused by that helminth.
Filarial diseases in humans offer prospects for elimination by means of vermicidal treatment. If the human link in the chain of infection can be broken, then notionally the disease could be wiped out in a season. In practice it is not quite so simple, and there are complications in that multiple species overlap in certain regions and double infections are common. This creates difficulties for routine mass treatment because people with onchocerciasis in particular react badly to treatment for lymphatic filariasis.
The World Health Organization recommends mass deworming—treating entire groups of people who are at risk with a single annual dose of two medicines, namely albendazole in combination with either ivermectin or diethylcarbamazine citrate. With consistent treatment, since the disease needs a human host, the reduction of microfilariae means the disease will not be transmitted, the adult worms will die out, and the cycle will be broken. In sub-Saharan Africa, albendazole (donated by GlaxoSmithKline) is being used with ivermectin (donated by Merck & Co.) to treat the disease, whereas elsewhere in the world, albendazole is used with diethylcarbamazine. Transmission of the infection can be broken when a single dose of these combined oral medicines is consistently maintained annually for a duration of four to six years. Using a combination of treatments better reduces the number of microfilariae in blood. Avoiding mosquito bites, such as by using insecticide-treated mosquito bed nets, also reduces the transmission of lymphatic filariasis.
The Carter Center's International Task Force for Disease Eradication declared lymphatic filariasis one of six potentially eradicable diseases. According to medical experts, the worldwide effort to eliminate lymphatic filariasis is on track to potentially succeed by 2020.
For similar-looking but causally unrelated podoconiosis, international awareness of the disease will have to increase before elimination is possible. In 2011, podoconiosis was added to the World Health Organization's Neglected Tropical Diseases list, which was an important milestone in raising global awareness of the condition.
The efforts of the Global Programme to Eliminate LF are estimated to have prevented 6.6 million new filariasis cases from developing in children between 2000 and 2007, and to have stopped the progression of the disease in another 9.5 million people who had already contracted it. Dr. Mwele Malecela, who chairs the programme, said: "We are on track to accomplish our goal of elimination by 2020." In 2010, the WHO published a detailed progress report on the elimination campaign in which they assert that of the 81 countries with endemic LF, 53 have implemented mass drug administration, and 37 have completed five or more rounds in some areas, though urban areas remain problematic.
Elephantiasis caused by lymphatic filariasis is one of the most common causes of disability in the world. A 2012 report noted that lymphatic filariasis affected 120 million people and one billion people at risk for infection. About 40 million people were disfigured or incapacitated by the disease in 2015. It is considered endemic in tropical and subtropical regions of Africa, Asia, Central and South America, and Pacific Island nations.
In areas endemic for podoconiosis, prevalence can be 5% or higher. In communities where lymphatic filariasis is endemic, as many as 10% of women can be afflicted with swollen limbs, and 50% of men can suffer from mutilating genital symptoms.
Filariasis is considered endemic in 73 countries; 37 of these are in Africa.
- In the Americas, it is present in Brazil, Costa Rica, the Dominican Republic, Guyana, Haiti, Suriname, and Trinidad and Tobago.
- In Asia, it is present in Bangladesh, Cambodia, India, Indonesia, Laos, Malaysia, Maldives, the Philippines, Sri Lanka, Thailand, Timor-Leste, and Vietnam.
- In the Middle East, it is present only in Yemen.
- In the Pacific region, it is endemic in American Samoa, the Cook Islands, Fiji, French Polynesia, Micronesia, Niue, Papua New Guinea, Samoa, Tonga, Tuvalu, and Vanuatu.
In many of these countries, considerable progress has been made towards elimination of filariasis. In July 2017, the World Health Organization (WHO) announced that the disease had been eliminated in Tonga. Elimination of the disease has also occurred in Cambodia, China, the Cook Islands, Niue, the Marshall Islands, South Korea, and Vanuatu, according to the WHO.
Strongyloidiasis is a human parasitic disease caused by the nematode called "Strongyloides stercoralis", or sometimes "S. fülleborni" which is a type of helminth. It belongs to a group of nematodes called roundworms. This intestinal worm can cause a number of symptoms in people, principally skin symptoms, abdominal pain, diarrhea and weight loss. In some people, particularly those who require corticosteroids or other immunosuppressive medication, "Strongyloides" can cause a hyperinfection syndrome that can lead to death if untreated. The diagnosis is made by blood and stool tests. The medication ivermectin is widely used to treat strongyloidiasis.
Strongyloidiasis is a type of soil-transmitted helminthiasis. It is thought to affect 30–100 million people worldwide, mainly in tropical and subtropical countries. It belongs to the group of neglected tropical diseases, and worldwide efforts are aimed at eradicating the infection.
The term waterborne disease is reserved largely for infections that predominantly are transmitted through contact with or consumption of infected water. Trivially, many infections may be transmitted by microbes or parasites that accidentally, possibly as a result of exceptional circumstances, have entered the water, but the fact that there might be an occasional freak infection need not mean that it is useful to categorise the resulting disease as "waterborne". Nor is it common practice to refer to diseases such as malaria as "waterborne" just because mosquitoes have aquatic phases in their life cycles, or because treating the water they inhabit happens to be an effective strategy in control of the mosquitoes that are the vectors.
Microorganisms causing diseases that characteristically are waterborne prominently include protozoa and bacteria, many of which are intestinal parasites, or invade the tissues or circulatory system through walls of the digestive tract. Various other waterborne diseases are caused by viruses. (In spite of philosophical difficulties associated with defining viruses as "organisms", it is practical and convenient to regard them as microorganisms in this connection.)
Yet other important classes of water-borne diseases are caused by metazoan parasites. Typical examples include certain Nematoda, that is to say "roundworms". As an example of water-borne Nematode infections, one important waterborne nematodal disease is Dracunculiasis. It is acquired by swallowing water in which certain copepoda occur that act as vectors for the Nematoda. Anyone swallowing a copepod that happens to be infected with Nematode larvae in the genus Dracunculus, becomes liable to infection. The larvae cause guinea worm disease.
Another class of waterborne metazoan pathogens are certain members of the Schistosomatidae, a family of blood flukes. They usually infect victims that make skin contact with the water. Blood flukes are pathogens that cause Schistosomiasis of various forms, more or less seriously affecting hundreds of millions of people worldwide.
Long before modern studies had established the germ theory of disease, or any advanced understanding of the nature of water as a vehicle for transmitting disease, traditional beliefs had cautioned against the consumption of water, rather favouring processed beverages such as beer, wine and tea. For example, in the camel caravans that crossed Central Asia along the Silk Road, the explorer Owen Lattimore noted, "The reason we drank so much tea was because of the bad water. Water alone, unboiled, is never drunk. There is a superstition that it causes blisters on the feet."
Prevention can be partially achieved through limiting contact with vectors through the use of DEET and other repellents, but due to the predominantly relatively mild symptoms and the infection being generally asymptomatic, little has formally been done to control the disease.
Disseminated strongyloidiasis occurs when patients with chronic strongyloidiasis become immunosuppressed. It presents with abdominal pain, distension, shock, pulmonary and neurologic complications and septicemia, and is potentially fatal. The worms enter the bloodstream from the bowel wall, simultaneously allowing entry of bowel bacteria such as "Escherichia coli". This may cause symptoms such as sepsis (bloodstream infection), and the bacteria may spread to other organs where they may cause localized infection such as meningitis.
Dissemination can occur many decades after the initial infection and has been associated with high dose corticosteroids, organ transplant, HIV, lepromatous leprosy, tertiary syphilis, aplastic anemia, malnutrition, advanced tuberculosis and radiation poisoning. It is often recommended that patients being started on immunosuppression be screened for chronic strongyloidiasis; however, this is often impractical (screen tests are often unavailable) and in developed countries, the prevalence of chronic strongyloidiasis is very small, so screening is usually not cost-effective, except in endemic areas.
It is important to note that there is not necessarily any eosinophilia in the disseminated disease. Absence of eosinophilia may indicate poor prognosis.
Waterborne diseases can have a significant impact on the economy, locally as well as internationally. People who are infected by a waterborne disease are usually confronted with related costs and not seldom with a huge financial burden. This is especially the case in less developed countries. The financial losses are mostly caused by e.g. costs for medical treatment and medication, costs for transport, special food, and by the loss of manpower. Many families must even sell their land to pay for treatment in a proper hospital. On average, a family spends about 10% of the monthly households income per person infected.
There is no consensus on optimal therapeutic approach. The most commonly used drug is diethylcarbamazine (DEC), but it is, however, often ineffective. Although other drugs have been tried such as praziquantel, ivermectin, and albendozole, none has proven to be reliably and rapidly effective. Mebendazole appeared more active than DEC in eliminating the infection, and had comparable overall responses. Thiabendazole evidenced a small, but significant activity against the infection. A combination of treatments, DEC plus mebendazole, was much more effective than single drug doses.
Traditionally, canine transmission is directly from sandfly to dog. Cases in the United States have proven "L. infantum" transmission from dog to dog by direct contamination with blood and secretions, as well as transplacentally from an infected bitch to her pups. This mode of transmission seems to be unique to the "L. infantum" Mon1 strain found in the United States. Although "in utero" transmission is likely the predominant method of disease spread amount the "L. infantum" Mon1 strain, it is still a viable parasite (has not lost virulence factors associated with sandfly-uptake) which can be transmitted via sandfly bite. A Brazilian study of 63 puppies from 18 "L. donovani"-infected parents found no evidence of congential or transplacental infection.
Numerous strains and subgenus strains of "Leishmania" exist; with sandfly genome projects still underway, strains are still being discovered.
In the Old World, leishmaniasis transmitted by sandflies of the genus "Phlebotomus" documented in dogs are:
- "L. donovani" in Sri Lanka
- "L. infantum" (began appearing dogs in the United States in 2000)
New World leishmaniasis strains are spread by "Lutzomyia"; however, research speculates the North American sandfly could be capable of spreading, but this is to date unconfirmed. Dogs are known resorvoirs of "L. infantum", and the spread of disease from dog to dog has been confirmed in the United States.
- Suspected causes of canine visceral leishmaniasis are geographic variants of the "Leishmania donovani" complex, including "L. infantum, L. chagasi" and "L. donovani".
The Mexicana ("L. mexicana, L. amazonensis, L. venezuelensis", and "L. pifanoi") and Viannia ("L. braziliensis, L. guyanensis, L. panamensis" and "L. peruviana") strains are not commonly found in dogs. Subgenus Viannia strains are found only in Central and South America, all of which cause leishmaniasis in humans.
A canine vector-borne disease (CVBD) is one of "a group of globally distributed and rapidly spreading illnesses that are caused by a range of pathogens transmitted by arthropods including ticks, fleas, mosquitoes and phlebotomine sandflies." CVBDs are important in the fields of veterinary medicine, animal welfare, and public health. Some CVBDs are of zoonotic concern.
Many CVBD infect humans as well as companion animals. Some CVBD are fatal; most can only be controlled, not cured. Therefore, infection should be avoided by preventing arthropod vectors from feeding on the blood of their preferred hosts. While it is well known that arthropods transmit bacteria and protozoa during blood feeds, viruses are also becoming recognized as another group of transmitted pathogens of both animals and humans.
Some "canine vector-borne pathogens of major zoonotic concern" are distributed worldwide, while others are localized by continent. Listed by vector, some such pathogens and their associated diseases are the following:
- Phlebotomine sandflies (Psychodidae): "Leishmania amazonensis", "L. colombiensis", and "L. infantum" cause visceral leishmaniasis (see also canine leishmaniasis). "L. braziliensis" causes mucocutaneous leishmaniasis. "L. tropica" causes cutaneous leishmaniasis. "L. peruviana" and "L. major" cause localized cutaneous leishmaniasis.
- Triatomine bugs (Reduviidae): "Trypanosoma cruzi" causes trypanosomiasis (Chagas disease).
- Ticks (Ixodidae): "Babesia canis" subspecies ("Babesia canis canis", "B. canis vogeli", "B. canis rossi", and "B. canis gibsoni" cause babesiosis. "Ehrlichia canis" and "E. chaffeensis" cause monocytic ehrlichiosis. "Anaplasma phagocytophilum" causes granulocytic anaplasmosis. "Borrelia burgdorferi" causes Lyme disease. "Rickettsia rickettsii" causes Rocky Mountain spotted fever. "Rickettsia conorii" causes Mediterranean spotted fever.
- Mosquitoes (Culicidae): "Dirofilaria immitis" and "D. repens" cause dirofilariasis.
Ehrlichiosis is a nationally notifiable disease in the United States. There have been cases reported in every month of the year, but most cases are reported during April–September. These months are also the peak months for tick activity in the United States.
From 2008-2012, the average yearly incidence of ehrlichiosis was 3.2 cases per million persons. This is more than twice the estimated incidence for the years 2000-2007. The incidence rate increases with age, with the ages of 60–69 years being the highest age-specific years. Children of less than 10 years and adults aged 70 years and older, have the highest case-fatality rates. There is a documented higher risk of death among persons who are immunosuppressed.
Tick control is the most effective method of prevention, but tetracycline at a lower dose can be given daily for 200 days during the tick season in endemic regions.