Nanomedicine is defined as application of nanotechnology for treatment, monitoring, prevention, and control of biological diseases. To apply nanomedicine, the precise targets (cells and/or receptors) specific to the clinical disease should be identified and the suitable nanoparticles for delivery system to minimize the side effects of the original drug should be selected. One of these precise targets are macrophages, endothelial, dendritic as well as tumor cells. The main aim of the present review is to throw light on possible nanotechnology applications in parasitic diseases focusing on three main aspects: diagnosis, treatment, and vaccination.

Background Giardiasis is an important common intestinal infection that occurs as a result of ingestion of cysts of the protozoan parasite Giardia lamblia. Several medications are available to treat giardiasis. Metronidazole and other chemical drugs currently used for treatment cause side effects, whereas ginger has been used for centuries as a herbal medicine, without harmful side effects. Objective With regard to the above-mentioned properties of ginger we were prompted to evaluate its anti-Giardia activity, as compared with nitazoxanide (NTZ) and phosphate buffer saline (PBS) as controls, and to establish a G. lamblia axenic culture that yields a large number of trophozoites. Materials and methods Fresh clinical isolates of G. lamblia were obtained from different patients with acute giardiasis. Trophozoites were cultured using Stone’s modification of Locke’s solution as an axenic culture medium modified by supplementing with bovine bile and heat-inactivated bovine serum. Ginger extract was prepared to give a final concentration of 20 mg/ml. In vitro assessment of effect of ginger was carried out after 24 and 48 h. For post-treatment evaluation, the viability of G. lamblia trophozoites was tested by their morphological criteria and dye staining (eosin stain 0.01%). Results The culture yielded a rich growth of G. lamblia trophozoites. Dead trophozoites stained pink with eosin and showed loss of morphological criteria. NTZ treatment significantly lowered the number of the parasites after 48 h (mean: 42.5±3.53/ml; P≤0.002), with a reduction rate of 92.93%, compared with PBS. Ginger treatment significantly lowered the number of the parasites after 48 h (mean: 55±7.07/ml, P≤0.004), with a reduction rate of 94.4%, compared with PBS. Conclusion The present study confirmed that ginger extract is equally active against G. lamblia as NTZ. More research studies are needed to highlight the physiological and molecular mechanisms of action of ginger and provide more scientific evidence of its effectiveness. Moreover, this simple G. lamblia axenic culture medium proved beneficial for evaluation of the susceptibility of isolates to antiparasitic drugs.

Background Different diagnostic techniques have been used in the diagnosis of schistosomiasis. However, they are far from ideal regarding its early diagnosis. PCR techniques have been tried to improve the direct detection of schistosomiasis. Objective The aim of the present study was to evaluate the diagnostic performance of direct amplification of Schistosoma mansoni DNA in the early prepatent period in experimentally infected mice by PCR technique using unextracted DNA as PCR template compared with pre-extracted S. mansoni DNA samples. Materials and methods Mice were infected by 100±10 S. mansoni cercariae. Three mice were sacrificed every 3 or 4 days for 5 weeks. Whole blood samples were collected for direct amplification without prior extraction. Serum samples were pooled, and the extracted DNA was detected by using the KAPA blood PCR kit and conventional PCR methods. The diagnostic performance was compared between the two methods. Results The results showed that the diagnosis of S. mansoni utilizing pre-extracted DNA was superior to direct amplification of DNA, bypassing nucleic acid extraction which failed to detect S. mansoni DNA in any of the examined samples. Pre-extracted DNA was detected in all samples from the second day after infection by using the two PCR techniques. Conclusion These results indicate that S. mansoni infection cannot be efficiently detected directly by using the PCR technique without pre-extraction of DNA from whole blood samples using the KAPA blood PCR kit.

Background Cutaneous leishmaniasis (CL) comprises a major parasitic health problem worldwide, particularly in Libya where the prevalence of CL continues to re-emerge. Objective The aim of the present study was to determine the clinical patterns and demographic criteria of CL among cases with suspected skin lesions, prophylactically treated as a routine by intra-lesion injection of pentostam in the outpatient polyclinic in Sirte, Libya. Participants and methods This cross-sectional study was conducted on a total of 84 patients attending the dermatology clinic in the outpatient polyclinic at Sirte, Libya, during the period from March 2010 to January 2011; 40 (47.6%) females and 44 (52.4%) males. Age of the participants ranged from 12 to 40 years, with a mean age of 27±7.24 years. Cutaneous lesions were diagnosed microscopically by using the slit smear technique after staining with Giemsa stain for the amastigote forms of Leishmania spp. Results The infection rate was 63/84 (75%) among the studied group. Sex was significantly associated with acquisition of CL, with more males being at risk (60.3 vs. 39.7%; P=0.01). Occupation as a farmer posed a greater risk for infection (P=0.0004). Among the positive cases, the number of lesions ranged from three to five on lower limbs and were ulcerative in type (P=0.02, 0.01, and 0.0004, respectively). Conclusion Our results were in agreement with those of the previous studies about the prevalence of CL in Sirte, Libya. CL was found to be more common among male farmers, and most lesions were on the lower limb and were of the ulcerative type.

Background Toxoplasmosis is a widespread disease caused by the opportunistic parasite Toxoplasma gondii, with variable overall prevalence according to the different geographical areas. Blood donors pose as possible contributors for transfer of infection. Objective The aim of this study was to estimate the prevalence of exposure to Toxoplasma in blood donors using sensitive techniques in a cross-sectional study. Materials and methods An aggregate of 150 blood donors from the blood donation center of Alexandria University participated in this study. The blood samples were tested for the presence of T. gondii immunoglobulin (Ig) G antibody and target gene B1 using enzyme-linked immunosorbent assay and real-time PCR, respectively. Results Of 150 participants, 65.3% tested were positive for anti-Toxoplasma IgG, and 10% showed parasitemia as B1 gene was successfully amplified in nine seropositive samples and in six seronegative samples. Conclusion The recorded IgG seropositivity in this selected group of individuals may be considered an indication of the general prevalence of toxoplasmosis in Alexandria. Detected parasitemia using real-time PCR draws attention to the possibility of transmission through blood transfusion even from seronegative donors and emphasizes the importance of specialized Toxoplasma DNA screening before donation of blood.

Background Mirazid (MZD) was licensed in Egypt for treatment of schistosomiasis in the year 2002; the drug gained much attention experimentally and clinically, with conflicting views on its efficacy. Objective The study aimed to evaluate MZD anti-schistosomal activity in an animal model at a selected dose. Materials and methods Swiss albino mice (n=36) were infected with Schistosoma mansoni and divided into two equal groups of 18 mice each: group 1 was the nontreated infected control group given only the vehicle; gourp 2 was infected and treated with MZD at a dose of 500 mg/kg for 5 days per os 7 weeks postinfection. Efficacy of the drug was assessed parasitologically with fecal egg counts evaluated every other day until the animal was euthanized at 1, 2, and 4 weeks post-treatment (WPT); worm burden, tissue egg count and oogram pattern were studied at 1, 2, and 4 WPT. Results MZD reduced fecal egg counts in infected mice (69.6%) and reduced total worm load (71.9%) and tissue egg counts in the intestine and the liver (66 and 77.4%, respectively) at 4 WPT. The drug changed oogram pattern with progress of treatment. Conclusion MZD has moderate antischistosomal activity in animal models.

Background Congenital toxoplasmosis may be without an obvious clinical picture at birth and later present with variable signs and symptoms, mostly related to the central nervous system. Cryptogenic epilepsy in children is one of those conditions without obvious etiology and in which latent toxoplasmosis may be implicated. Soluble cell adhesion molecules (sICAM-1) are circulating biomarkers of DNA shed by living organisms and of pathogenic processes. Aim The present study aimed to investigate the possible association of Toxoplasma gondii infection with cryptogenic epilepsy and to determine the increase in sICAM-1 level as an indicator of the possible role of T. gondii in the pathogenesis of cryptogenic epilepsy. Materials and methods Ninety children (40 with cryptogenic epilepsy, 30 with noncryptogenic epilepsy, and 20 healthy controls) were evaluated to determine exposure to T. gondii by means of specific immunoglobulin (Ig) G seropositivity and the corresponding sICAM-1 serum levels. Respective specific enzyme-linked immunosorbent assay kits were used. Results The level of T. gondii IgG antibody seropositivity was significantly higher among children with cryptogenic epilepsy (20%) than among noncryptogenic epileptic children (0%). In healthy controls, seropositivity was 10%. sICAM-1 was recorded with variable levels, in all cases and controls (90%). In the cryptogenic group, the level ranged from 3.13 to more than 50 ng/ml, whereas it was lower in the noncryptogenic control group, with a maximum sICAM-1 level of 25 ng/ml. In the healthy control group, only one case presented a sICAM-1 level of 25–50 ng/ml. In addition, among IgG-seropositive cases, five cases showed a high sICAM-1 level of 25–50 ng/ml, whereas the remaining three IgG-seropositive cases showed lower sICAM-1 level (12.6–25 ng/ml). In healthy children, the two Toxoplasma IgG-seropositive cases showed a sICAM-1 level of 3.13–25 ng/ml. Conclusion The statistically significant results of IgG positivity among the crytptogenic cases supported the possible association between toxoplasmosis infection and cryptogenic epilepsy and revealed the associated upregulation of sICAM-1 level in this condition, thus suggesting that toxoplasmosis should be taken into consideration as a predisposing factor in cryptogenic epilepsy.

Background Schistosomulum stage is believed to be the target of protective immunity. Over the past two decades, several investigators have demonstrated the antigenic communion between Schistosoma mansoni and Biomphalaria alexandrina. Objective The present study aimed to evaluate the effect of combining S. mansoni schistosomal lung antigen preparations and B. alexandrina antigen preparations for use as antischistosomal vaccination in murine models, and to compare their efficacy with and without the use of complete Freund’s adjuvant (CFA). Materials and methods Seventy laboratory-bred Swiss albino male mice were used in this study. They were classified into seven groups (10 mice each). Each mouse was sensitized with an initial subcutaneous injection of the extracted antigens. After 2 weeks, a second subcutaneous injection of the same antigen dose was given. Two weeks after the last dose of vaccination, all mice groups were infected with 100 S. mansoni cercariae subcutaneously. Mice were sacrificed by rapid decapitation 7 weeks post-infection for assessment of the inoculated antigens by parasitological (stool egg count, worm burden, tissue egg load, and oogram pattern) and histopathological (hepatic sections stained with hematoxylin and eosin for detection of granuloma number and diameter) studies. Results The data showed that vaccination with combined antigens (S. mansoni schistosomal lung antigen prepations + B. alexandrina antigen preparations with CFA) had the best protective effect. Conclusion The single antigen vaccination did not protect against infection by antigenically complexed S. mansoni. The cocktail vaccine apparently induced an agreeable immune response against many of the antigenic components. This new cocktail represents a promising approach toward the future development of vaccine strategy.

Background Microscopic examination of blood films is accepted as the universal ‘gold-standard’ for the diagnosis of malaria. However, low parasitemia accounting for false-negative results and time consumption for declaring results are limiting factors for smear microscopy. The quantitative buffy coat (QBC) technique is a more rapid test and can detect malarial parasites (MP) in the condition of low parasitemia. Aim The aim of this study was to show the usefulness of an ‘in-house’ QBC method in the diagnosis of MP. Patients and methods One hundred positive smear samples of patients diagnosed with malaria were subjected to analysis by both the ‘in-house’ QBC and the commercial QBC technique. Two hundred samples negative for malaria on microscopic smear examination were also tested using the ‘in-house’ QBC method. Results The 100 smear positive samples tested positive for MP with both commercial QBC testing and the ‘in-house’ QBC technique. Of the 200 samples that tested negative on smear examination, 16 were positive for malaria on testing with the ‘in-house’ QBC technique. Conclusion The described ‘in-house’ QBC technique provides an additional advantage of being cost-effective in comparison with the available commercial QBC kits.