Cryptosporidium spp. is under recognized as an important pathogen causing diarrhea in children and HIV-infected individuals with associated high morbidity and mortality. In endemic areas, most symptomatic infections are in childhood and in immunocompromised adults. The immune status of the host plays a critical role in determining the severity of cryptosporidiosis. Infection is self-limited in immunocompetent hosts, but can be severe and persistent in the immunocompromised such as AIDS patients or malnourished children. Cryptosporidiosis in developing countries is a major cause of acute and persistent diarrhea in children and is associated with subsequent impairment in growth, physical fitness, and cognitive function. Despite recognition of the importance of immune status, the correlates of protective immunity in cryptosporidiosis in humans are poorly understood, and treatment modalities are limited.

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Cystic echinococcosis and human cysticercosis have recently been included in the list of "neglected tropical diseases" by the World Health Organization (WHO). Both are zoonoses which are prevalent throughout the world and lead to considerable mortality, morbidity, and economic losses as well. This review deals with the disease burden of these two neglected cestode infections. Diagnostic modalities with their specific advantages and disadvantages have also been discussed. Recent developments in immunodiagnostic assays for the two diseases have been dealt with. Various control strategies including the use of veterinary vaccines have been highlighted.

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Mass Drug Administration (MDA) for Lymphatic Filariasis (LF) elimination has been implemented worldwide and in India with a goal of eliminating the disease by 2020 and 2015 respectively. Compliance to MDA is less than adequate to achieve the goal in the desired time. This study aims to identify the factors related to awareness, acceptability and attitude and the role of certain theoretical constructs of health belief model in determining the compliant behavior to MDA. Within a cross-sectional study done in Thiruvananthapuram district of Kerala, India, undertaken to determine coverage, a comparison was done between compliant and noncompliant individuals. 300 households were selected using cluster sampling technique, for estimation of coverage of MDA. From these households, 99 noncompliant and 70 compliant individuals were selected as cases and controls. The independent factors determining noncompliance were client attitude of not perceiving the need with an adjusted odds ratio (OR) of 2.52 (1.29-4.92), an unfavorable provider attitude with an adjusted OR of 2.14 (1.05-4.35) and low drug administrator acceptability with an adjusted OR of 2.01 (1.01-3.99). In MDA, the person giving the drug to the beneficiary is the most important person, whose attitude and acceptability determines compliance. More rigorous selection and training for capacity building of drug administrators are essential to enhance the compliance level. Alternate drug delivery strategies, besides house to house campaign by voluntary drug administers also needs to be implemented.

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Strongyloides stercoralis is an intestinal nematode causing endemic infection, mostly in immunocompromised individuals, in tropical and subtropical regions. Herewith, we are reporting a rare case of this kind in immunocompetent patient. A 31-year-old male patient presented with chief complaints of chronic diarrhea and loss of weight since last 4 months. He reported passing watery and foul smelling stool. He also had loss of appetite since last 2 months and was diagnosed as diabetic since last 4 months but he was not given any treatment for this and his fasting blood sugar was 110 mg/dl. His HIV status was negative. Stool examination done on three occasions showed plenty of S. stercoralis larvae. Patient responded well to albendazole therapy. Strongyloidiasis is not always associated with compromise in immune status. It should be suspected in immunocompetent individuals with history of long-term diarrhea and weight loss.

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Primary hydatid cyst of the neck is of extremely rare occurrence even in endemic regions. Clinically mimicking a cold abscess, we report such a case which was diagnosed by fine needle aspiration cytology. The lesion was removed surgically and at 6-month follow-up visit, the patient was a symptom-free.

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Cysticercosis is a common tropical disease. One of the uncommon manifestations and a rare complication is its disseminated form (DCC). Neurocysticercosis (NCC) is the common parasitic disease of the central nervous system. Human cysticercosis is caused by the dissemination of the embryo of Taenia solium in the intestine via the hepatoportal system to the tissues and organs of the body. The organs most commonly affected are the subcutaneous tissues, skeletal muscles, lungs, brain, eyes, liver, and occasionally the heart, thyroid, and pancreas. Widespread dissemination of the cysticerci can result in the involvement of almost any organ in the body. We report here a case of a 36-year-old-male with disseminated cysticercosis. He visited our hospital with symptoms of multiple palpable nodules, dementia, and confusion. After the investigations he was diagnosed with disseminated cysticercosis involving the brain, subcutaneous tissues all over the body, and the skeletal muscles. The patient was initially treated with Albendazole in a private hospital, but there was no response. Then he was treated with Praziquantel and steroids.

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Clinically, paragonimiasis is broadly classified into pulmonary, pleuropulmonary, and extrapulmonary forms. The common extrapulmonary forms are cerebral and cutaneous paragonimiasis. The cutaneous paragonimiasis is usually presented as a slowly migrating and painless subcutaneous nodule. The correct diagnosis is often difficult or delayed or remained undiagnosed until the nodule becomes enlarged and painful and the cause is investigated. We report here a case of cutaneous paragonimiasis in a male child who presented with mild respiratory symptoms. The diagnosis of paragonimiasis was based on a history of consumption of crabs, positive specific serological test, and blood eosinophilia. The swelling and respiratory symptoms subsided after a prescribed course of praziquantel therapy.

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Neurocysticercosis (NCC) is one of the most common parasitic diseases affecting the central nervous system. Typically spinal NCC involvement has a concomitant cranial involvement. Spinal involvement by NCC, either intramedullary or extramedullary is very uncommon. The authors report a case of D12-L1 intradural extramedullary lesion in a 38-year-old female patient who presented with complaints of back pain and weakness of lower limbs. She underwent laminectomy and excision of the lesion. Histopathology revealed extramedullary cysticercal abscess. Post-operatively she was treated with albendazole. She had a successful recovery post-operatively and at 8 months follow up had no neurological deficits. This current case presents a very rare case of cysticercal abscess of dorsolumbar spine, without any evidence of cranial involvement. This report is to reemphasize the importance of including NCC as a differential diagnosis in intradural extramedullary lesion at the conus level in endemic areas like India.

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Background and Objectives: Serological diagnosis of hydatidosis is usually performed by detecting the circulating antibodies in serum by ELISA. The present study was carried out to standardize and evaluate procedure of the ELISA using elute from dried blood spots (DBS) on filter paper and blood stored at different temperatures and at different durations for its further application under field conditions. Materials and Methods: Dried blood spots were collected from fifty study subjects and fifty control subjects and evaluated for the detection of IgG antibodies against hydatid. Samples were stored at room temperature and 4°C and tested by ELISA at 0, 15 and 30 days. Results: The present study shows that elute of DBS on filter paper can be stored at room temperature for a maximum of 30 days without a decrease in antibody titer as compared to serum samples tested by ELISA. Conclusions: The collection of blood sample on filter paper may serve useful purpose in resource limited countries for carrying out sero-epidemiological surveys at a cost effective level.

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Enterobius vermicularis is one of the most common intestinal nematode worldwide. Enterobius rarely causes a symptomatic disease. We report here an unusual case of a 60-year old man who came with a polypoidal growth in the anal canal increasing in size for past 20 years. He had pain and intense itching over the mass. The differential diagnosis of squamous papilloma, fibroma and foreign body granuloma were considered. The mass lesion was excised surgically and sent to the pathology laboratory. The mass turned out to be an "E. vermicularis worm granuloma" by histopathologic examination. Thus, timely reporting and surgical resection of such lesion is necessary to prevent further complications. This case is reported here for the unusual presentation of pinworm as a pseudoneoplasm in the anal canal. Incidence of these cases reflected the poor personal hygiene and improper disposal of human excreta in the rural areas. We insist that health education is the only way to control the spread of helminthic infections that causes a heavy disease burden to our country.

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Background: This study was carried out in Mahasarakham Primary Healthcare Center, Mahasarakham province in the area of Northeastern of Thailand. The experiment was randomized control trial clinical study in order to examine the side effects of Areca catechu Linn., Thai traditional formulae medicine, mebendazole in the treatment of anti-helmintic activity of mixed worms infection in human. Materials and Methods: The experimental group consisted of 15 patients and 5 patients for control group with inclusion and exclusion criteria, which were screened by parasitologist with the selection of mixed worm infection patient samples. The investigation of side effects was recorded after the treatment of each group of patient with different kinds of 4 group of medicine. Results: The percentage of side effects was collected by nurses and confirmed by the physician at Mahasarakham Health Center, which were diarrhea and nausea side effects. The percentage of side effects by the treatments of Areca catechu Linn., Thai traditional formulae medicine, mebendazole were investigated by the physician and the pharmacist, which the result showed 20% of diarrhea in Areca catechu Linn., 20% of nausea in Areca catechu Linn, 20% in side effect of diarrhea in mebendazole treatment, and no side effects were found by the treatment of TTFM. The result showed that Areca catechu Linn. had higher side effects among the 3 anti-helmintic drugs. Conclusion: The findings indicate to increase the numbers of samples of worm-infected patients, which the samples can be identified with the specification of helminthes genus and species in order to obtain the efficacy by the treatment using Areca catechu Linn and also indicates to increase various forms of dosage preparations and various demographic locations in Thailand.

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Amoebic liver abscess is a common problem in tropical countries. However, its protean manifestations sometimes pose diagnostic dilemma leading to delay in starting appropriate therapy. We report here one interesting case of an amoebic liver abscess where the patient developed some uncommon features like bilateral pedal edema and bilateral pleural effusion. Although unilateral effusion is well known in such patients, the cause of bilateral involvement of pleura in this patient remained largely unknown. The cause of edema turned out to be compression of inferior vena cava by the large-sized abscess, rather than any cardiopulmonary abnormality. This case has global relevance because many of the migrant populations from tropical countries are settled all over the world, particularly in Europe and America. It would only be appropriate that the treating physicians are aware of this unfamiliar association.

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