Molecular characterisation of Echinococcus granulosus sensu lato genotypes in dromedary camels from extreme Sahara of Algeria based on analysis of nad2 and nad5 genetic markers

Cystic echinococcosis is parasitic disease caused by the metacestodes belonging to the Echinococcus granulosus sensu lato (s.l.) species complex. Cystic echinococcosis is of considerable economic and public health importance. It is endemic in both livestock and humans in North African countries, including Algeria. The present study aimed to characterize E. granulosus s.l. genotypes in dromedary camels (Camelus dromedarius) from the extreme Sahara of Algeria, using recently developed mitochondrial genetic markers (NADH dehydrogenase subunit 2 and NADH dehydrogenase subunit 5) for reliable identification of different genotypes. A total of 75 Echinococcus cysts were collected from 49 dromedary camels, including 65 and 10 cysts from 45 and four camels originating from two slaughterhouses of Tindouf and Illizi provinces, respectively. E. granulosus sensu stricto (s.s.) G1 and G3 were identified in camels from both areas based on nad5 (649 bp) gene sequences, whereas E. granulosus s.l. G6 was identified in camels from Tindouf region based on concatenated nad5 and nad2 gene sequences (total 1336 bp). Identified samples clustered into 11 different haplotypes (ALG1-ALG11) including four haplotypes (ALG8-ALG11) for E. granulosus s.s. G1, one haplotype (ALG7) for E. granulosus s.s. G3, and six haplotypes (ALG1-ALG6) for E. granulosus s.l. G6. The present study provides valuable molecular data including genotyping and haplotypic variability on E. granulosus s.l. in dromedary camels from two regions in the extreme Sahara of Algeria. Future characterization of the G1, G3 and G6 samples based on sequencing of complete mitochondrial genomes would be of considerable significance for a more comprehensive understanding of molecular epidemiology of CE in Algeria.

Algerian Registry for Inborn Errors of Immunity in Children: Report of 887 Children (1985-2021)

INTRODUCTION

Inborn errors of immunity (IEI) represent a heterogeneous large group of genetic disorders characterized by susceptibility of affected individuals to recurrent infections, autoimmune/inflammatory diseases, allergy, and malignancy. We aimed to report for the first time the Algerian registry for IEI in children.

METHODS

We described the characteristics of IEI in Algerian children from the data collected in the Algerian registry for IEI between 1985 and 2021.

RESULTS

Over a period of 37 years, we included 887 children (530 male, 59.6%) with a mean age at diagnosis of 3.23 years and a mean diagnosis delay of 2 years. The prevalence rate was estimated at 1.97/100,000 inhabitants or 5.91/100,000 children. The parental consanguinity was found in 52.6%. The most prevalent category was combined immunodeficiencies (CID) (35.5%), followed by predominantly antibody deficiencies (24.5%) and CID with syndromic features (18.3%). The most predominant diseases were severe CID (134 cases), MHC II deficiency (99 cases), agammaglobulinemia (82 cases), common variable immunodeficiency (78 cases), hyper IgE syndromes (61 patients), ataxia-telangiectasia (46 patients), Wiskott-Aldrich syndrome (40 patients) and chronic granulomatous disease (39 cases). The clinical presentation was dominated by lower respiratory tract infections (69%), failure to thrive (38.3%), and chronic diarrhea (35.2%). Genetic analysis was performed in 156 patients (17.6%). The global mortality rate was 28.4% mainly caused by CID.

CONCLUSION

This is the first report of the Algerian registry for IEI in children. Data is globally similar to that of the Middle East and North African (MENA) registries with high consanguinity, predominance of CID, and significant mortality. This registry highlights the weak points that should be improved in order to provide better patient care.

Seroprevalence of hepatitis E virus among blood donors in eastern Algeria

Hepatitis E virus (HEV) is recognized worldwide as the leading cause of orofecal-transmitted hepatitis. However, blood transmission has been increasingly implicated in recent years raising health concerns. In Algeria, updated prevalence data are lacking. We aimed to determine the prevalence of anti-HEV antibodies in the sera of volunteer blood donors from the Setif region in eastern Algeria. A total of 434 Samples were analyzed for anti-HEV IgG and IgM antibodies using an enzyme-linked immunosorbent assay (Wantai). Logistic regression modelling was used to identify associated risk factors. The IgG seroprevalence rate was 17.05%. Seven sera (0.16%) were weakly positive for IgM. No HEV RNA was detected. The IgG prevalence was significantly correlated with increasing age (p < 1p.1000). Our data demonstrate a relatively high prevalence of anti-HEV IgG, indicating a possible risk of HEV blood transmission which requires vireamic seroprevalence studies to assess the real risk.

Composition and diversity of Culicoides biting midges (Diptera: Ceratopogonidae) in rural and suburban environments of Algeria

Culicoides biting midges are well known biological vectors of several arboviruses causing more than 100 veterinary and medical diseases worldwide. In Algeria, bluetongue virus, which is transmitted by Culicoides midges, is responsible for one of the most critical insect-borne diseases of sheep. For example, this disease caused clinically severe morbidity of about 2,661 confirmed cases out of 21,175 susceptible sheep in Algeria. This study compared the abundance, richness, and diversity of Culicoides species in rural and suburban environments of semi-arid regions in North Africa. It examined the potential influence of the bio-climatic factors on the variation of population sizes and the elevation distribution of biting midges. Specimen collection was carried out from June to September during two successive years (2018 and 2019) using CDC light traps installed at 15 sites in different environments. Culicoides specimens were dissected, slide-mounted, and morphologically identified using the interactive identification key IIKC and various standard morphological criteria. A total of 1,046 Culicoides specimens (1,024 females and 22 males) were trapped and classified into 22 species, belonged to nine distinct subgenera. Two new species records for Algeria and even North Africa are reported: Culicoides albicans (Winnertz, 1852) and Culicoides nubeculosus (Meigen, 1830). Culicoides newsteadi Austen, 1921 (51.6%) was the dominant species, and it was followed by Culicoides punctatus (Meigen, 1804) (16.3%) and Culicoides odiatus Austen, 1921 (11.5%). These three species, comprising 80% of the collected Culicoides, were the most abundant both outside and inside livestock stables in rural and suburban environments. Species diversity was similar in the two settings, with a slight increase in suburban environments. None of the Culicoides species encountered correlated significantly with the climatic factors (mean temperature, precipitation, and relative humidity). Elevation was the most determinant environmental parameter that affected the abundance and distribution of Culicoides midges in the semi-arid and sub-humid areas studied. The maximum distribution of Culicoides species was detected at mid elevations (400‒800 m). Using a modeling approach, we explored for the first time the variation of composition and diversity in Culicoides communities within different climatic regions, environments and livestock settings in Algeria. This survey deepens our understanding of the relationships among environmental factors, abundance, diversity, and geographic distribution of Culicoides. This is a crucial step to assess the epidemiological situation of the diseases transmitted by these biting midges and to allow mitigation of the associated risks.

Ramadan favors first blood donation, but not frequent donation: Results of 10,145 blood donors from Algeria

CONTEXT

Frequent blood donors contribute to an important share of blood donations in many countries. In Algeria, frequent donation and its determinants, notably the place of the month of Ramadan, which plays an important role in blood donation in Muslim countries, have not been studied.

METHODS

This was a retrospective cohort study of n = 10145 Algerians who donated blood to the blood transfusion post (BTP) of Boufarik between January 2, 2008, and December 31, 2019. Donors were assessed at each donation for general clinical information, demographic information, and dates and times of donation. Donor return, defined as two or more donations to Boufarik BTP, and frequent donation, defined as three or more blood donations to Boufarik BTP, were the outcomes of interest and were analyzed using groups comparison and logistic and Cox regression analyses.

RESULTS

2.2% of donors were frequent donors and donated 9.6% of all donated blood. The volume of donated blood during Ramadan was twice the monthly volume during the rest of the year, but donation in Ramadan was associated with lower odds of return (odds ratio [OR]: 0.54, 95% confidence interval [CI]: 0.40-0.71) and frequent donation (OR: 0.41, 95% CI: 0.24-0.73). Women were underrepresented (10.9%), but they were more likely to be frequent donors (male vs. female OR: 0.55, 95% CI: 0.31-0.96; hazard ratio: 0.64, 95% CI: 0.41-0.98).

CONCLUSIONS

Reducing the gender gap and promoting return could significantly improve the volume of blood donations in Algeria.

Molecular detection of tick-borne pathogens in Rhipicephalus sanguineus sensu stricto collected from dogs in the steppe and high plateau regions of Algeria

Epidemiology and distributions of canine tick-borne diseases as well as their veterinary and zoonotic significance are poorly understood in Algeria. The present study describes a molecular investigation of important tick-borne pathogens in Rhipicephalus sanguineus sensu stricto collected from domestic dogs in steppe and high plateau areas of central and eastern Algeria. In total, 1,043 ticks were collected from 147 domestic dogs, including 756 ticks from 124 dogs in the steppe region of Djelfa, and 287 ticks from 23 dogs in the high plateau area of Bordj Bou Arreridj. Ticks were divided into 384 pools (309 pools from Djelfa and 75 pools from Bordj Bou Arreridj) and tested for genomic materials of Crimean-Congo hemorrhagic fever virus (CCHFV) as well as DNA for Anaplasma phagocytophilum, Anaplasma platys, Ehrlichia canis, Rickettsia spp., Babesia spp., and Hepatozoon spp. using PCR, sequencing and phylogenetic analysis. Hepatozoon spp. was most prevalent, with 160 positive pools (41.70%), and 12 of these were sequenced and identified as Hepatozoon canis. Babesia spp. was detected in 50 samples (13.0%), of which 11 were sequenced and identified as Babesia vogeli. A. platys and E. canis were detected in 92 (24.0%) and 15 (3.9%) of tested samples, respectively. Rickettsia spp. were detected in 24 (6.3%) samples, including 11 samples identified as R. massiliae, 6 samples identified as R. conorii conorii, and 7 samples could not be identified to species level. All 384 pools tested negative for CCHFV and A. phagocytophilum. In addition to detection of R. conorii conorii, R. massiliae, and E. canis, the present study provides the first molecular data for occurrence of A. platys, B. vogeli, and H. canis in Rh. sanguineus s.s. infesting dogs in Algeria. Further large scale studies should be conducted to better understand the epidemiology, distributions and importance of canine tick-borne pathogens in Algeria.

Incidence rates of dysentery among humans in Lemghaier province, Algeria

Introduction

Dysentery is an infectious clinical syndrome which can cause high morbidity and mortality, especially in developing countries. This research highlights the epidemiological features of dysentery in Lemghaier province, Algeria.

Methods

A retrospective study of the incidence rates of dysentery in Lemghaier province, Algeria and overall for the whole country for the period from January 2001 to December 2018 was carried out. On a local level data were provided by the Directorate of Health and Population of El-Oued province, Algeria. At the national level data were provided by the National Public Health Institute, Algeria.

Results

An overall number of 1,786 cases of dysentery were notified, with an incidence rate of 58.5 cases per 100,000 population (mean±SD: 58.54±47.20; 95% CI: 36.73-80.35). The high incidence rate was reported in autumn and summer, respectively, with 23.4 and 20.1 cases per 100,000 population. The high incidence rate observed in the persons aged 20-44 years with 76.4 cases per 100,000 population. Females were more likely to have dysentery than males, respectively, with 63.6 against 53.7 cases per 100,000 population. The highest incidence rate was reported in Lemghaier municipality (capital of the province) with 176.9 cases per 100,000 population.

Conclusions

The results from this research showed high incidence rates of dysentery in Lemghaier province, Algeria. Тhis fact is a serious reason for national public health organizations to take adequate and timely measures to reduce the incidence rates of dysentery in this part of the country.

In vitro and in vivo bioactivities of Ambrosia maritima and Bituminaria bituminosa organic extracts from Algeria

INTRODUCTION

Two medicinal plants, Ambrosia maritima and Bituminaria bituminosa, growing in Algeria were investigated for their flavonoids content and their biological activities.

METHODOLOGY

Different organic extracts were prepared from the aerial parts of each plant using maceration method followed by liquid/liquid type extractions. The anti-antioxidant activity was tested using the β-carotene bleaching method. The anti-inflammatory activity was tested by performing the protein anti-denaturation assay. Acute toxicity and immunostimulatory effect were tested in mice, while the antimicrobial activity was tested according to the minimal inhibition concentration technique.

RESULTS

In term of flavonoids content, ethyl acetate extract of B. bituminosa was the highest (193.39 ± 24.1 µg QE/mg). Ethyl acetate extract of A. maritima showed antioxidant activity with IC50 value of 11.72 ± 0.79 µg/mL. The hydroethanolic extract of A. maritima showed the best anti-denaturation effect in a dose-dependent manner with the IC50 value of 131.07 ± 0.027 µg/mL. The studied plants showed no toxicity or mortality in vivo. Both plants showed a significant immunostimulatory effect; while the Butanolic extract of B. bituminosa demonstrated the best antimicrobial activity against Staphylococcus aureus and Candida albicans strains.

CONCLUSIONS

We recommend A. maritima and B. bituminosa as potent sources of antioxidants and as antimicrobial agents for further assays to better elucidate their actions on the immune system.

Molecular epidemiology and antimicrobial resistance patterns of Clostridioides difficile isolates in Algerian hospitals

INTRODUCTION

Clostridioides difficile is a major pathogen responsible for hospital-associated diarrhoea. This study investigated the molecular epidemiology and antibiotic resistance of C. difficile isolates in five Algerian hospitals.

METHODOLOGY

Between 2016 and 2019, faecal specimens were collected from in-patients and were cultured for C. difficile. Isolates were characterised by toxin genes detection, Polymerase Chain Reaction (PCR)-ribotyping, Multilocus Sequence Typing (MLST), antimicrobial susceptibility testing against a panel of antibiotics, and screened for antimicrobial resistance genes.

RESULTS

Out of 300 patient stools tested, 18 (6%) were positive for C. difficile by culture, and were found to belong to 11 different ribotypes (RT) and 12 sequence types (ST): RT 085/ST39, FR 248/ST259, FR 111/ST48, RT 017/ST37, RT 014/ST2, RT 014/ST14, FR 247/new ST, RT 005/ST6, RT 029/ST16, RT 039/ST26, RT 056/ST34 and RT 446/ST58. MLST analysis assigned the isolates to two clades, 1 and 4. Clade 4 was more homogeneous, as it mainly included non-toxigenic isolates. Three toxin gene profiles were detected, two toxigenic, A+B+CDT- (33.3%) and A-B+CDT- (11%); and one non-toxigenic, A-B-CDT- (55.5%). All C. difficile isolates were susceptible to metronidazole, vancomycin and moxifloxacin.

CONCLUSIONS

Overall prevalence of C. difficile in our healthcare settings was 6%. Antibiotic resistance rates ranged from 72.2% (clindamycin) to 16.6% (tetracycline). This study highlighted a relatively high genetic diversity in term of ribotypes, sequence types, toxin and antibiotic resistance patterns, in the C. difficile isolates. Further larger studies are needed to assess the true extent of C. difficile infections in Algeria.

Whole Genome Sequencing of Extended-Spectrum Beta-Lactamase-Producing Klebsiella pneumoniae Isolated from Neonatal Bloodstream Infections at a Neonatal Care Unit, Algeria

Aims: Neonatal bloodstream infections (BSIs) are an important cause of mortality among neonates. Besides, extended-spectrum beta-lactamase-producing Klebsiella pneumoniae (ESBL-Kp) is one of the most frequent pathogens causing neonatal BSIs. This study aimed to characterize ESBL-Kp strains recovered from neonatal BSI and to investigate risk factors associated with ESBL-Kp BSI at the neonatal care unit of Elmeki Hospital, Bejaia, Algeria. Methodology: After isolation, identification, and antibiotic susceptibility testing, the ESBL-Kp strains were characterized by whole genome sequencing. The genomes were then analyzed using bioinformatic tools to determine the resistome, virulome, and phylogenetic relatedness. Results: From September 2019 to May 2020, 27 (8.2%) out of 328 neonates were infected by ESBL-Kp strains. These strains displayed a multidrug-resistant phenotype, and on further investigation, were found to carry an array of antibiotic resistance genes. All ESBL-Kp strains harbored the bla_CTX-M-15 gene. Using in silico multilocus sequence typing analysis, six sequence types (STs) were detected with ST268 being the most frequent (56%, n = 15) indicating a local outbreak, confirmed by single nucleotide polymorphism analysis. The yersiniabactin and colibactin gene clusters were identified in six and two ESBL-Kp strains, respectively. Conclusion: This study showed a high prevalence of CTX-M-15-producing K. pneumoniae strains coharboring different antibiotic resistance mechanisms from neonatal BSIs in Algeria. Screening of health care personnel and mothers for ESBL carriage before delivery, isolation of carriers, barrier precautions, antimicrobial usage, and control of hygiene are needed to prevent the dissemination of these pathogens.

Prevalence of Mycoplasma bovis in Algeria and Characterisation of the Isolated Clones

Bovine respiratory disease (BRD) is common in calves in Algeria, but to date, Mycoplasma bovis has never been monitored as a potential etiological agent. Here, to assess the presence (direct detection) and circulation (indirect detection) of M. bovis, broncho-alveolar lavage fluids (BALF) and serum samples were collected from 60 veal calf farms in Algeria. A commercial ELISA kit (ID Screen^® ELISA) was used to screen for the presence of specific antibodies against M. bovis in 351 blood sera collected from both diseased and healthy calves, and 69% (241 sera) tested positive. BALFs from the 176 diseased calves were used to screen for M. bovis by real-time-PCR (rt-PCR), and 102 (58%) tested positive. A non-exhaustive set of 53 clones were isolated from 44 calves and further subtyped using polC gene sequencing. No predominant subtype was found, and two clones exhibited a new subtype. Fourteen clones were further characterized by multilocus sequence typing, and results showed a high degree of genetic diversity, with some clones having new alleles and subtypes. The minimum inhibitory concentrations (MICs) of 5 antimicrobials regularly used to treat BRD was determined on 45 clones. Susceptibility profiles showed very broad diversity, confirming the variety of clones actively circulating. We detected clones with high MICs, including increased MICs of enrofloxacin (n = 5). This is the first study to report the presence of M. bovis in Algeria in calves with BRD. This research also finds broad genetic and phenotypic diversity in the actively circulating isolates.

Fleas (Siphonaptera) of domestic and wild animals in extreme northeastern Algeria: first inventory, hosts, and medical and veterinary importance

Fleas are an important member of the North African entomofauna. An understanding of the risks of flea-borne diseases to public and veterinary health can be gained with surveys of their abundance, distribution, and hosts. The aims of this study were to make an initial assessment of flea (Siphonaptera) species collected from a selected number of mammalian hosts in Algeria and debate their medical and veterinary importance. To do so, an entomological survey was conducted on several animal species (goats, dogs, cats, rabbits, hedgehogs, and mongooses) in six localities of El Tarf region located in extreme northeastern Algeria. During the survey, flea specimens were collected from hosts, stored in alcohol, and identified using a taxonomic key. More than 1,200 specimens were collected and identified; including four species: Ctenocephalides felis, Ctenocephalides canis, Pulex irritans, and Archaeopsylla erinacei (s.l.). Goats and dogs were the most infested animals, followed by cats and hedgehogs. Ctenocephalides felis was the most prevalent flea among all infested animals, with 631 collected specimens, followed by Pulex irritans with 433 samples. Overall, this study is an initial assessment of flea species recovered from selected common mammals in northeastern Algeria.

Identification of blood source preferences and Leishmania infection in sand flies (Diptera: Psychodidae) in north-eastern Algeria

Leishmaniases are among the most neglected vector-borne diseases, infecting humans as well various animal hosts with clinical outcomes varying from cutaneous disorders to visceral and life-threatening disease. In Algeria, canine leishmaniasis (CanL) caused by Leishmania infantum is endemic mainly throughout the northern regions of the country with the Mediterranean climate that favours the occurrence of Larroussius sand flies, the vectors of the parasite. This study conducted in Bougaa and Kherrata, two regions located in north-eastern Algeria and endemic for CanL, focuses on: i) composition of sand fly fauna, ii) screening of Leishmania parasites and iii) the blood sources of engorged females. Entomological surveys were conducted between June and September 2019 using CDC light-traps in rural areas of both regions. Sand fly specimens were morphologically identified, females were screened for Leishmania DNA using kDNA and ITS1 primers, blood meals in engorged females were identified by peptide mass mapping (PMM)-based MALDI-TOF mass spectrometry and confirmed by DNA sequencing analysis. Overall, 1940 specimens (844 males, 1096 females) were collected, all belonging to the subgenus Larroussius: Phlebotomus perniciosus, (94.64%), Ph. perfiliewi (4.74%) and Ph. longicuspis (0.62%). No Leishmania DNA was detected in the evaluated pools (n = 106) (1096 females). PMM-based MALDI-TOF MS successfully identified a source of blood in 92% (141/154) of engorged females (135 Ph. perniciosus and 6 Ph. perfiliewi). All blood meals were taken from domestic cattle (Bos taurus) except for one originating from a dog (Canis lupus familiaris) and one from sheep (Ovis aries). Sequencing of host cytochrome B gene confirmed these identifications but showed lower success rate of 58% (29/50), demonstrating the high effectivity of peptide mass mapping (PMM)-based MALDI-TOF mass spectrometry for routine identification of blood meals of varying degree of digestion. Our findings represent first record of cattle and dog blood in sand flies in Algeria and striking feeding preference of local sand fly population at domestic sites of studied regions for cattle which may play an important role in parasite transmission. Further studies are needed to better understand potential contribution of cattle to ecology of sand flies and epidemiology of leishmaniasis in north-eastern Algeria.

Determinants of COVID-19 Vaccine Engagement in Algeria: A Population-Based Study With Systematic Review of Studies From Arab Countries of the MENA Region

Background

The Algerian COVID-19 vaccination campaign, which started at the end of January 2021, is marked by a slowly ascending curve despite the deployed resources. To tackle the issue, we assessed the levels and explored determinants of engagement toward the COVID-19 vaccine among the Algerian population.

Methods

A nationwide, online-based cross-sectional study was conducted between March 27 and April 30, 2021. A two-stage stratified snowball sampling method was used to include an equivalent number of participants from the four cardinal regions of the country. A vaccine engagement scale was developed, defining vaccine engagement as a multidimensional parameter (5 items) that combined self-stated acceptance and willingness with perceived safety and efficacy of the vaccine. An Engagement score was calculated and the median was used to define engagement vs. non-engagement. Sociodemographic and clinical data, perceptions about COVID-19, and levels of adherence to preventive measures were analyzed as predictors for non-engagement.

Results

We included 1,019 participants, 54% were female and 64% were aged 18-29 years. Overall, there were low rates of self-declared acceptance (26%) and willingness (21%) to take the vaccine, as well as low levels of agreement regarding vaccine safety (21%) and efficacy (30%). Thus, the vaccine engagement rate was estimated at 33.5%, and ranged between 29.6-38.5% depending on the region (p > 0.05). Non-engagement was independently associated with female gender (OR = 2.31, p < 0.001), low adherence level to preventive measures (OR = 6.93, p < 0.001), private-sector jobs (OR = 0.53, p = 0.038), perceived COVID-19 severity (OR = 0.66, p = 0.014), and fear from contracting the disease (OR = 0.56, p = 0.018). Concern about vaccine side effects (72.0%) and exigence for more efficacy and safety studies (48.3%) were the most commonly reported barrier and enabler for vaccine acceptance respectively; whereas beliefs in the conspiracy theory were reported by 23.4%.

Conclusions

The very low rates of vaccine engagement among the Algerian population probably explain the slow ascension of the vaccination curve in the country. Vaccine awareness campaigns should be implemented to address the multiple misconceptions and enhance the levels of knowledge and perception both about the disease and the vaccine, by prioritizing target populations and engaging both healthcare workers and the general population.

Emergence of Candida auris in intensive care units in Algeria

Background

Currently, Candida auris is among the most serious emerging pathogens that can be associated with nosocomial infections and outbreaks in intensive care units. Clinicians must be able to identify and manage it quickly.

Objective

Here, we report for the first time in Algeria seven cases of C. auris infection or colonisation.

Methods and Results

The strains were isolated from clinical sites including bronchial aspirates (n = 4), wound swabs (n = 1), urine sample (n = 1) and peritoneal fluid (n = 1), in patients admitted to the intensive care unit. Candida auris was identified both by MALDI‐TOF and by sequencing the ITS region and the D1/D2 domain. Antifungal susceptibility testing was performed using the E‐test method. Non‐wildtype susceptibility was observed for five strains against fluconazole, itraconazole, voriconazole and caspofungin. Genotyping showed the presence of four clades (I–IV) in one hospital.

Conclusions

Appropriate antifungal treatments with rapid and accurate microbial identification are the cornerstone for the management and control of C. auris infections.

in Farmed Marine and Wild Freshwater Fish in Central and Eastern of Algeria

PURPOSE

The present study aimed to estimate the prevalence and molecular characterization of Cryptosporidium spp. in six different fish species both from marine and freshwater environments.

METHODS

During a period of 2 years (2018-2020), a total of 415 fecal samples and 565 intestinal scrapings were collected in seven provinces from the central and eastern Algeria. From those, 860 fish belonged to six different species, two of which are cultured marine and four are wild freshwater fish. All samples were screened for Cryptosporidium spp. presence using molecular techniques. Nested PCR approach was performed to amplify partial sequences of the small subunit ribosomal RNA (SSU rRNA) and 60-kDa glycoprotein (GP60) genes for Cryptosporidium genotyping and subtyping. Detailed statistical analysis was performed to assess the prevalence variation of Cryptosporidium infection according to different risk factors.

RESULTS

Nested PCR analysis of SSU gene revealed 173 Cryptosporidium positive fish, giving an overall prevalence of 20.11% (17.5-23.0). Cryptosporidium spp. was detected in 8.93% (42/470) of cultured marine fish and 33.58% (131/390) of wild freshwater fish. Overall, the prevalence was affected by all studied risk factors, except the gender. Molecular characterization and subtyping of Cryptosporidium isolates showed occurrence of IIaA16G2R1 and IIaA17G2R1 subtypes of C. parvum in the fish species Sparus aurata.

CONCLUSION

The present study provides the first epidemiological data on the prevalence and associated risk factors of Cryptosporidium spp. in farmed marine and wild freshwater fish and the first molecular data on the occurrence of zoonotic C. parvum in fish from North Africa (Algeria).

Environmental strategies for achieving a new foreign direct investment golden decade in Algeria

While numerous studies have discussed the impact of economic growth on the environment, this paper advances in the empirical literature, aiming to validate the existence of an N-shaped environmental Kuznets curve (EKC) relationship between the ecological footprint and economic growth in Algeria during the period 1975-2014. The proposed empirical model includes as additional explanatory variables the foreign direct investment (FDI) and the electricity consumption aimed to increase the relevance of the results, correcting the lack of studies that have previously analyzed the EKC for the case of Algeria. Through the ARDL econometric approach, we confirm an N-shaped EKC between the per capita economic growth and ecological footprint in Algeria, reinforcing these results using the FMOLS and DOLS techniques. In the long run, the empirical results confirmed that the N-shaped EKC in Algeria is valid; electricity consumption and foreign direct investment directly impact ecological footprint. Even though the main objective of this study is to assess the N-shaped EKC, the novelty of the paper is the analysis of the interaction between FDI and electricity consumption. The empirical evidence reveals that FDI contributes to reducing the negative impact of fossil sources in the energy mix in Algeria through the transition to a cleaner energy mix pattern. In the final step of our analysis, we explore the causal nexus among variables by applying the Toda Yamamoto non-causality test. The Toda Yamamoto non-causality test reveals a unidirectional causality between economic growth and ecological footprint; one-run relationship flows from electricity consumption to ecological footprint, and economic growth leads to cause foreign-direct investment. These empirical results evidence the necessity of establishing suitable policies after the gold decade of the FDI in Algeria, being required to advance in this line to come back to ascending levels of FDI after the financial crisis of 2008 and the current COVID-19 crisis. In this sense, policymakers should consider the advantages of FDI for promoting clean foreign investment, necessary for reaching a transition to sustainable development in Algeria. In this sense, this study proposes a battery of environmental strategies to achieve this objective and sustainable growth in the country. Thus, policy implications and directions for future research are suggested.

COVID-19 Vaccine Booster Hesitancy (VBH) and Its Drivers in Algeria: National Cross-Sectional Survey-Based Study

Due to the emergence of various highly contagious variants of SARS-CoV-2, vaccine boosters were adopted as a complementary strategy in different countries. This strategy has, however, posed another challenge for the national authorities to convince their population to receive the booster after the first challenge of COVID-19 primer dose vaccines. This study was conducted to determine COVID-19 vaccine booster acceptance and its associated factors in the general population in Algeria. Using social media platforms, an online self-administered questionnaire was distributed between 28 January and 5 March 2022 for all Algerian citizens who received COVID-19 vaccines. Overall, 787 respondents were included in this study. Among them, 51.6%, 25%, and 23.8% accepted, rejected, or were hesitant about the COVID-19 vaccine booster, respectively. However, only 13.2% declared receiving the booster dose. Additionally, while 58.2% of the respondents declared being relieved after primer vaccination, 11.4% among them declared that they regretted being vaccinated. The most common reasons for acceptance were experts’ recommendations (24.6%) and the belief that COVID-19 vaccine boosters were necessary and efficient, while rejection was mainly due to the belief that primer doses are sufficient (15.5%), or that vaccination in general is inefficient (8%). Males, older individuals, those with chronic comorbidities or a history of COVID-19 infection, non-healthcare workers, and those with low educational levels were associated with significantly higher odds for booster acceptance. Moreover, belief that booster doses were necessary and efficient, disagreeing with the notion that primer doses were not sufficient, experts’ recommendations, and the desire to travel abroad were significantly associated with higher odds of COVID-19 vaccine booster acceptance.

Morphological, molecular, and biochemical study of cyanobacteria from a eutrophic Algerian reservoir (Cheffia)

The cyanobacteria management in water bodies requires a deep knowledge of the community composition. Considering the reliable and thorough information provided by the polyphasic approach in cyanobacteria taxonomy, here we assess the cyanobacterial community structure of the Cheffia reservoir from Algeria. Cyanobacteria were identified on the basis of morphological traits and next-generation sequencing (NGS); toxins-related genes were localized in addition to the identification of toxins; temperature and nutrient level of water samples were also determined. The polyphasic approach was essential for cyanobacteria investigation; 28 genera were identified through 16S rRNA metabarcoding with the dominance of taxa from Microcystis (34.2%), Aphanizomenon (20.1%), and Planktothrix (20.0%), and morphological analysis revealed the association in this water body of five species within the genus Microcystis: M. aeruginosa, M. novacekii, M. panniformis, M. ichthyoblabe, and M. flos-aquae. The presence of mcyE genotypes was detected; moreover, HPLC-PDA and LC-ESI-MS/MS revealed the production of microcystin-LR. Results obtained in our study are very important since this ecosystem is used for water supply and irrigation; as a consequence, a good water management plan is essential.

[A case of acute renal failure revealing brucellian endocarditis and neurological complications in Batna (Algeria)]

Introduction

Brucellosis is a major zoonosis affecting livestock and transmitted to humans; it is widespread worldwide with 500,000 new cases per year according to the World Health Organization. It has become rare in countries that have established an eradication policy of the disease in animals and pasteurization of milk, but remains endemo-epidemic in Algeria, where it constitutes a public health problem (incidence of 24.41 per 100,000 inhabitants in 2017). The disease is more crippling than fatal. Severe forms are exceptional, and deaths are rare, most often following endocarditis or complicated neurological damage. The biological diagnosis is made by culturing the samples (mainly blood cultures), serology or molecular biology methods. We report the case of a patient with complicated and fatal subacute multiorgan brucellosis.

Observation

A 51-year-old man is hospitalized in cardiology for endocarditis, complicated by neurovascular and skin manifestations, discovered in the stage of severe renal failure, one of the dreaded autoimmune complications of infectious endocarditis. The diagnoses were confirmed by various radiographic (echocardiography, brain computed tomography, magnetic resonance imaging) and biological examinations. The brucellian etiology was proved by bacteriological test of blood cultures (Brucella melitensis) and Wright's serodiagnosis, in the absence of the Polymerase Chain Reaction (PCR) test.

Conclusion

Brucellosis can have atypical, multiple, varied and misleading presentations, responsible for a difficult clinical diagnosis. The possibly fatal evolution of this pathology should remind practitioners to evoke it, in particular in front of a multivisceral infectious presentation, in a country where brucellosis is endemic. Clinicians must also act quickly and not hesitate to ask for at least a serological test.

Genomic Diversity of SARS-CoV-2 in Algeria and North African Countries: What We Know So Far and What We Expect?

Here, we report a first comprehensive genomic analysis of SARS-CoV-2 variants circulating in North African countries, including Algeria, Egypt, Libya, Morocco, Sudan and Tunisia, with respect to genomic clades and mutational patterns. As of December 2021, a total of 1669 high-coverage whole-genome sequences submitted to EpiCoV GISAID database were analyzed to infer clades and mutation annotation compared with the wild-type variant Wuhan-Hu-1. Phylogenetic analysis of SARS-CoV-2 genomes revealed the existence of eleven GISAID clades with GR (variant of the spike protein S-D614G and nucleocapsid protein N-G204R), GH (variant of the ORF3a coding protein ORF3a-Q57H) and GK (variant S-T478K) being the most common with 25.9%, 19.9%, and 19.6%, respectively, followed by their parent clade G (variant S-D614G) (10.3%). Lower prevalence was noted for GRY (variant S-N501Y) (5.1%), S (variant ORF8-L84S) (3.1%) and GV (variant of the ORF3a coding protein NS3-G251V) (2.0%). Interestingly, 1.5% of total genomes were assigned as GRA (Omicron), the newly emerged clade. Across the North African countries, 108 SARS-CoV-2 lineages using the Pangolin assignment were identified, whereby most genomes fell within six major lineages and variants of concern (VOC) including B.1, the Delta variants (AY.X, B.1.617.2), C.36, B.1.1.7 and B.1.1. The effect of mutations in SAR-CoV-2 genomes highlighted similar profiles with D614G spike (S) and ORF1b-P314L variants as the most changes found in 95.3% and 87.9% of total sequences, respectively. In addition, mutations affecting other viral proteins appeared frequently including; N:RG203KR, N:G212V, NSP3:T428I, ORF3a:Q57H, S:N501Y, M:I82T and E:V5F. These findings highlight the importance of genomic surveillance for understanding the SARS-CoV-2 genetic diversity and its spread patterns, leading to a better guiding of public health intervention measures. The know-how analysis of the present work could be implemented worldwide in order to overcome this health crisis through harmonized approaches.

Hashish seizures in Algeria over the 2019-2020 period: The rise of potent hashish hybrids

In Algeria, hashish is by far the most common illicit drug. This study explores Algerian hashish over a two-year period (2019-2020). A total of 2583 hashish samples from 1707 seizures for a total quantity of 108 tons were analyzed using a validated high-performance liquid chromatography-diode array detection method (HPLC-DAD). The yearly arithmetic mean tetrahydrocannabinol (THC) concentration shows relative stability-18.67% in 2019 and 19.03% in 2020 with an overall mean THC content of 18.87% and standard deviation of 10.99%. High-potency hashish (THC content > 20%) is by far the most predominant type, representing almost 50% of the total Algerian hashish seizures (mean and median around 29%). The overall mean of cannabidiol (CBD) was 2.45%, and 12% of the total studied seizures were of very low CBD concentration (CBD content<1%). Three distinct hashish chemotypes were identified: Chemotype I described the traditional Moroccan hashish with THC content ranging from 0% to 16%, Chemotype II hashish included most of the seizures and characterized by THC content ranging from 16% to 30%, and Chemotype III was characterized by hashish potency higher than 30% and very low CBD content. The identified chemotypes I, II, and III were characterized in a ternary plot, and the relative contents (THC:CBD:CBN) were about 67%:29%:4%, 88%:9%:3%, and 96%:2%:2%, respectively.

Environmental regionalization and endemic plant distribution in the Maghreb

Clustering methods based on environmental variables are useful in the planning of conservation strategies for species and ecosystems. However, there is a lack of work on the regionalization of the vast space of North Africa and the distribution of plant species. The current lists of endemic plants are focused mostly on an occurrence at the country level and not on regions with different conditions. The aim of this work was to lay out an environmental scheme for northwest Africa and to collect data about the occurrence of endemic plants in this area. Clustering with 12 of 33 tested environmental rasters was performed to divide the Maghreb into environmental clusters. Then, a list of 1618 endemic plant taxa (1243 species and 375 subspecies) was prepared and their distribution in estimated environmental clusters was examined. Eleven clusters with different conditions were estimated. The main drivers of regionalization were temperature amplitude, precipitation seasonality, and precipitation of the warmest quarter. According to the occurrence of endemic plants, northwest Africa may be divided into three zones: Atlas, Mediterranean (two environmental clusters), and southern zone (eight environmental clusters). The presented results provide a good basis for understanding the spatial patterns of the Maghreb, including its environment and species diversity. A designed list of endemic plant species together with environmental data may facilitate the planning of future research in north Africa and arranging methods of biodiversity protection.

Epidemiological and clinical characteristics of COVID-19 in Eastern Algeria

INTRODUCTION

COVID-19 is a highly transmissible and pathogenic viral infection caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Algeria was also affected by the COVID-19, it was considered the third most affected country in Africa.

AIM

The main aim of the study was to identify risk factors and the impact of risk factors on the incidence SARS-CoV-2 infection and the clinical course of the COVID-19, through a behavioral survey on a representative sample of the people who have been previously diagnosed with COVID-19.

MATERIALS AND METHODS

A partial cross-sectional study of 808 people from a population of both sexes, aged 1 to 90 years allowed the description of the epidemiological profile of patients in the city of Oum-El-Bouaghi in eastern Algeria.

RESULTS

The results of the study shows that the SASR-CoV-2 infection appears to be very strongly related to social and biological factor. The relationship between different BMI classes and the pandemic is confirmed by a significant difference (p.

Algeria's preparedness for Omicron variant and for the fourth wave of COVID-19

The world has been confronting a health crisis for two years because of the COVID-19 pandemic. The context of the crisis has the form of the first wave and subsequent waves that varied depending on the country. Undoubtedly, Algeria is one of the countries that have suffered severely from this pandemic. The recent wave has been marked with the huge number of casualties given the poor preparation. The country's preparation issue will be more complicated. In other words, in the context of an expected 4th wave that is characterized with the appearance of the new Omicron variant B.1.1.529. Thus, this news will consider the situation comprehensively and will provide recommendations to minimize the potential damage that will result from the fourth wave, and to attempt to limit the spread of the virus. The updated measures aim at rising the opportunities of improving the health situation in the country in the near future.

Medicinal Plants Used by Traditional Healers in Algeria: A Multiregional Ethnobotanical Study

Traditional medicine is the cornerstone that boosts scientific research to explore new therapeutic approaches. The study aimed to assess the traditional knowledge and use of medicinal plants to treat various ailments by Algerian traditional healers. Forty traditional healers were face-to-face interviewed in three different Algerian areas (West, Kabylia, and Sahara). The data collected were analyzed using quantitative indices such as fidelity level (FL) and informant consensus factor (F_IC). A total of 167 species belonging to 70 families were recorded. Lamiaceae (13%), Asteraceae (13%), Apiaceae (7%), and Rosaceae and Fabaceae (5% each) were the most cited families. The survey revealed that leaves were the most used parts of the plants (29%). Furthermore, decoction (35%), raw (24%), and infusion (19%) were the common modes for the remedies’ preparation. Here, 15% of the total species were newly reported as medicinal plants. Besides, it was reported for the first time a total of 47 new therapeutic uses for 20 known plant species. Of 17 ailments categories, cancer was presented by 44 species, showing the highest F_IC of 0.46. Marrubium vulgare L., Artemisia herba-alba Asso., Zingiber officinale Roscoe., and Juniperus phoenicea L. recorded the maximum fidelity value of 100%. Therefore, our study reveals strong ethnomedicinal knowledge shared by local populations living in the three regions studied. The medicinal species with a high FL could be promising candidates for identifying new bioactive molecules.

Epidemiological situation analysis of cutaneous leishmaniasis in Batna (northeast): An important focus in Algeria

Cutaneous leishmaniasis (CL) is a parasitic infection which poses a real public health problem in various countries, including Algeria. We aimed in this study to investigate the current epidemiological situation of CL in the wilaya of Batna (northeastern Algeria) during 2010-2020 and to discuss some control measures used to combat the disease in the most endemic foci. Data on CL cases and control measures were obtained from the "Direction de la Santé et de la Population (DSP) of Batna" and the "Etablissement Public de la Santé de Proximité (EPSP) of Barika". Data were analyzed and mapped using Microsoft Office Excel 2007, SPSS.21, and ArcGIS 10.3. A total of 9259 cases were notified, with a peak incidence of 1924 cases in 2010. The annual evolution of the disease showed decreasing and increasing trends during the study period. Cases were detected year-round, with a peak notification in November (1957 cases) and January (1663 cases). CL affects both genders and all age groups with predominance for males (58.6%) and infants less than 9 years old (54.4%). Most cases have occurred in western areas of the wilaya especially in the commune of Barika with 2979 cases (32.17%), followed by Abdelkader Azil (13.37%), Bitam (12.32%), Djezzar (8.67%), Ouled Ammar (7.07%), and Amdoukal (4.36%) communes. Spatiotemporal analysis showed that the highest frequencies of CL were exclusively reported in the western regions. There was no evidence of a possible relationship between Deltamethrin house spraying and leishmaniasis incidence. This study revealed that CL is highly endemic in the western areas of Batna, especially in Barika, with children less than 9 years old as the most age group at risk. The development of control measures and the selection of appropriate strategies are necessary to prevent, control, and eradicate the disease.

Enterobacter cloacae Complex and CTX-M Extended-Spectrum β-Lactamases in Algeria

We evaluated the β-lactam resistance phenotypes of clinical and environmental strains of the Enterobacter cloacae complex (ECC) isolated from three Algerian hospitals. The first combination of API 20E, matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS), and hsp60 genetic clustering methodologies were carried out for the identification of ECC strains. Our research showed that API 20E and MALDI TOF MS are satisfactory in genus identification of ECC strains, but sequence-based methods are then necessary to discriminate the species and subspecies levels. Among 36 ECC strains, 94.44% belonged to Enterobacter hormaechei species. Twenty-five isolates clustered with the reference strain of E. hormaechei subsp. xiangfangensis, making it the most frequently isolated subspecies. Enterobacter kobei was found only once (2.77%). All ECC isolates were phenotypically extended-spectrum β-lactamase (ESBL) producers and were resistant to ticarcillin, piperacillin, cefoxitin, cefotaxime, ceftazidime, ceftriaxone, and aztreonam, but susceptible to ertapenem and imipenem. The genetic analyses only allowed the detection of resistance genes of the CTX-M-1 group (32 strains, 88.9%), including CTX-M-15 (30 strains), CTX-M-3 (1 strain), and CTX-M-22 (1 strain). We report for the first time the detection of CTX-M-22 among ECC strains in an Algerian hospital (Tlemcen hospital). None of the isolated strains harbored CTX-M-2, CTX-M-9, or CTX-M-8/25 group genes. In this review, we address recent comparison in the identification methods of multidrug-resistant E. cloacae complex in Algeria, focusing also on the CTX-M ESBLs. This represents a serious public health challenge, which requires the clarification of the current situation and warrants the reinforcement of hygiene measures in the Algerian hospitals.

Characterization and biological activities of carotenoids produced by three haloarchaeal strains isolated from Algerian salt lakes

Halophilic archaea represent a promising natural source of carotenoids. However, little information is available about these archaeal metabolites and their biological effects. In the present work, carotenoids of strains Haloferax sp. ME16, Halogeometricum sp. ME3 and Haloarcula sp. BT9, isolated from Algerian salt lakes, were produced, extracted and identified by high-performance liquid chromatography-diode array detector and liquid chromatography-mass spectrometry. Analytical results revealed a variation in the composition depending on the strain with a predominance of bacterioruberin. The evaluation of antioxidant capacity using ABTS [(2,2'-azino-bis(3-ethylbenzothiazoline-6-sulfonic acid)] and DPPH (2,2-diphenyl-1-picrylhydrazyl) assays showed that these extracts have a strong antioxidant potential, in particular those of Haloferax sp. ME16 which displayed antioxidant power significantly higher than that of ascorbic acid used as standard. Antibacterial activity of carotenoid extracts against four human-pathogenic strains and four fish-pathogenic strains was evaluated by agar disk diffusion method. The results showed a good antibacterial activity. These findings suggest that the C₅₀ carotenoids from the studied strains offer promising prospects for biotechnological applications.

Fluoride concentration in bottled drinking water from a fluoride endemic area: A market-based survey

Drinking water is the primary source of fluoride intake for humans around the world. In southern Algeria, dental fluorosis is considered an epidemic that is spreading among the population by health professionals. Thus, the consumption of bottled water is important because it is considered safer for health.

OBJECTIVES

This study aims to determine the fluoride concentrations of bottled water commercially available in southern Algeria and report the non-carcinogenic health risk via daily human intake.

MATERIAL AND METHODS

By 2021, 28 commercial brands were obtained from different supermarkets in Ouargla, Algeria. Fluoride was measured using a validated spectrophotometric method. The fluoride risk quotient (HQ) and the estimated daily intake (EDI) were calculated.

RESULTS

All the brands did not mention the fluoride content on the label. The mean level was 0.40 ± 0.42 mg/L, and a wide range was found [0.00-1.65 mg/L]. The average was below the WHO standard. Most samples (75%, n = 21) contained less than 0.50 mg/L, which can cause dental caries. The HQ values average were less than 1, suggesting no health risk associated with drinking bottled water.

CONCLUSION

With the increasing consumption of bottled water, this work is important for primary prevention programs for dental caries. The main contribution is the constitution of a database concerning the fluoride levels in bottled water marketed in southern Algeria. Labelling of fluoride concentrations by manufacturers should be mandatory.

Molecular Characterization of Clinical Carbapenem-Resistant Enterobacteriaceae Isolates from Sétif, Algeria

This study aimed to determine the incidence and the molecular mechanisms of carbapenem-resistant Enterobacteriaceae in patients from the Sétif University Hospital, Algeria. Nonduplicate clinical bacterial isolates recovered from patients attending the University Hospital of Sétif were collected between April and October 2018. Species identification was performed by MALDI-TOF/MS (matrix-assisted laser desorption ionization-time of flight mass spectrometry) method. The susceptibility of the isolates to carbapenems was determined using the disc diffusion method. The carbapenem resistant isolates were screened for the presence of common carbapenemase genes (bla_KPC, bla_OXA-48, bla_VIM, bla_IMP, and bla_NDM) and extended-spectrum β-lactamase (bla_CTX, bla_TEM, and bla_SHV) using PCR and sequencing technique. A total of 123 nonrepetitive Enterobacteriaceae isolates were obtained. Klebsiella pneumoniae (n = 52/42.28%), Escherichia coli (n = 24/19.51%), and Enterobacter cloacae (n = 19/15.45%) were the most prevalent species. The Carba-NP test showed that 6 out of 123 isolates carried carbapenemase enzymes. OXA-48 was found in five isolates (four K. pneumoniae and one E. coli) and NDM-5 in one E. cloacae isolate. We reported for the first time in Algeria the presence of NDM-5 carbapenemase enzyme in a clinical E. cloacae isolate.

Implementation of a prospective study for enhancing surveillance of invasive bacterial infections in North Africa

OBJECTIVES

We implemented a project named MENINGSTOP in three countries of North Africa (Algeria, Morocco and Tunisia). The main objective was to use real-time PCR to detect, identify and type the three main agents (Neisseria meningitidis, Streptococcus pneumoniae and Haemophilus influenzae) responsible for invasive bacterial infections (IBI).

METHODS

The protocol of WHO and US CDC for real-time PCR was used to detect and type the three bacterial agents in clinical samples. We also designated two quality exercises using an external interlaboratory study and cross-testing of 10% of randomly selected samples.

RESULTS

Among the 752 samples tested, 18% were positive for one of the three agents. N. meningitidis was the most frequent globally reaching 9% of all samples (7% to 17% range) followed by S. pneumoniae 8% of all samples (6% to 15%). Group B meningococci was the most frequent (74% of all positive samples for meningococci and ranging from 50% to 90%). Quality assurance showed >85% correlation scores.

CONCLUSIONS

Real-time PCR can help improving epidemiological surveillance. Data confirm the prevalence of meningococci B. Our project adds a reliable tool to enhance surveillance and to help decision making in vaccination strategies against IBI.

Microorganisms associated with the North African hedgehog Atelerix algirus and its parasitizing arthropods in Algeria

Hedgehogs are small mammals. They are potential reservoirs of various zoonotic agents. This study was conducted in Bouira, a north-central region of Algeria. A total of 21 Atelerix algirus corpses were picked up on roadsides and gardens. Hedgehog kidneys, spleens and ectoparasites were collected. Twelve hedgehogs were infested with ectoparasites, including Archaeopsylla erinacei, Rhipicephalus sanguineus s.l. and Haemaphysalis erinacei. Hedgehog organs and randomly selected arthropods were screened for microorganisms using molecular methods. Coxiella burnetii was detected in kidneys, spleens, A. erinacei, Hae. erinacei and Rh. sanguineus s.l. Leptospira interrogans was detected in kidneys. Rickettsia felis and Rickettsia massiliae were detected respectively in A. erinacei and in Rh. sanguineus s.l. DNA of an uncultivated Rickettsia spp. was found in Hae. erinacei. Wolbachia spp. DNA was detected in fleas. The DNA of potential new Bartonella and Ehrlichia species were found respectively in fleas and ticks. This study highlights the presence of DNA from a broad range of microorganisms in hedgehogs and their ectoparasites that may be responsible for zoonoses in Algeria.

Molecular and MALDI-TOF MS characterisation of Hyalomma aegyptium ticks collected from turtles and their associated microorganisms in Algeria

The identification of ticks and their associated pathogens is important for knowledge on tick-borne diseases. The objective of this study was to use morphological, matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS) and/or molecular biology tools to identify ticks collected from turtles in north-eastern Algeria, as well as to investigate the microorganisms associated with these ticks. A total of 471 adult ticks were collected and identified morphologically as Hyalomma aegyptium, of which 248 (52.7%) were female and 223 (47.3%) were male. amongst them, 230 specimens were randomly selected for molecular and MALDI-TOF MS analysis. Molecular biology confirmed that our ticks were Hy. aegyptium. MALDI-TOF MS analysis revealed that 100% of the spectra were of excellent quality. Four spectra were selected to update our own database MALDI-TOF MS arthropod. The blind test of the 226 remaining spectra showed that all ticks were correctly identified, with scores ranging from 1.774 to 2.655 with a mean of 2.271 ± 0.16 of which, 223 (98.6%) had log score value (LSV)>1.8. Molecular biology screening showed that the ticks carried the DNA of Borrelia turcica, Rickettsia africae, Rickettsia aeschlimannii, Rickettsia sibirica mongolitimonae and with the Anaplasmataceae were close to a potentially new, undescribed Ehrlichia sp. This study confirms that MALDI-TOF MS is a reliable tool for the identification of ticks and that ticks collected from turtles in Algeria are carriers of several species of microorganisms which may be responsible for diseases in humans and animals.

Genetic algorithm with cross-validation-based epidemic model and application to the early diffusion of COVID-19 in Algeria

A dynamical epidemic model optimized using a genetic algorithm and a cross-validation method to overcome the overfitting problem is proposed. The cross-validation procedure is applied so that available data are split into a training subset used to fit the algorithm's parameters, and a smaller subset used for validation. This process is tested on Italy, Spain, Germany, and South Korea cases before being applied to Algeria. Interestingly, our study reveals an inverse relationship between the size of the training sample and the number of generations required in the genetic algorithm. Moreover, the enhanced compartmental model presented in this work has proven to be a reliable tool to estimate key epidemic parameters and the non-measurable asymptomatic infected portion of the susceptible population to establish a realistic nowcast and forecast of the epidemic's evolution. The model is employed to study the COVID-19 outbreak dynamics in Algeria between February 25th, 2020, and May 24th, 2020. The basic reproduction number and effective reproduction number on May 24th, after three months of the outbreak, are estimated to be 3.78 (95% CI 3.033-4.53) and 0.651 (95% CI 0.539-0.761), respectively. Disease incidence, CFR, and IFR are also calculated. Numerical programs developed for this study are made publicly accessible for reproduction and further use.

Medicinal plants used by patients to fight cancer in northwestern Algeria

Cancer is among the deadliest diseases in the world, especially in developed countries where modern treatments are not available to everyone. In North Africa, and especially in Algeria, few herbal treatments against cancer have been documented despite the richness of flora in these countries. This research aim to documents the medicinal plants used by patient to fight cancer in the northwest of Algeria. Data were collected through ethnobotanical surveys engaging 211 cancer patients in hospitals (departments of medical oncology) in two of the largest provinces in northwest Algeria (Tiaret and Tlemcen). The data were organized into usage reports (UR), while the Informant Consensus Factor (ICF) was calculated to evaluate agreement among informants. The patients investigated were mainly women, of middle age (41-50 years) and illiterate. In total, 53 medicinal plants used against several types of cancer have been identified. These plants are dominated by Lamiaceae, Apiaceae and Rosaceae. The leaves and powder of plants are most often used in traditional preparations often mixed with honey. The plants most often cited in the survey were Aristolochia longa, Aquilaria malaccensis, Ephedra alata subsp. alenda, while the most often treated cancer were breast, cervical, colorectal and stomach. 23 plants are not known as a treatment against cancers in North Africa, while 25 plants already known as treatment for cancer were cited here to treat specific new types of this disease.

The regulatory landscape of biosimilars: Algeria's efforts and progress made from 2006 to 2021

Biologics are tremendously efficacious biological molecules that have enabled the treatment of many life-threatening diseases, which have previously been hard to treat. Biosimilars, also known as "follow-on biologics", are highly similar versions of another already approved biologic, called the Reference Product. The European Union has been a pioneer in the regulation of biosimilars. WHO guideline on evaluation of biosimilars published in 2009 was an important landmark in biosimilar regulations worldwide, and several countries have adopted its principles in the development of their own regulatory pathway for the approval of biosimilars. Most countries in the Middle East North Africa (MENA) region still lack official and scientific guidelines for biosimilar approval pathways. This article explores the regulatory situation of biosimilar registration pathways in Algeria and describes the progress made and the regulatory landscape changes for biosimilars in Algeria during the past ten years. Our findings indicate that the development of biosimilar regulation in Algeria went through three major phases between 2006 and 2021, during which there has been much progress in drafting guidance documents for biosimilars. Since 2016, Algeria has used the EMA, FDA and WHO guidelines as the basis for approval of several biosimilars and no national guidelines or regulations have been adopted to date. Additionally, there has been no regulation on substitution/interchangeability. The Algerian regulatory authority has gained considerable experience with approval and use of increasingly complex biosimilars over the past 5 years and has the potential to create its own biosimilar-specific regulatory pathway in the near future.

Occurrence of Marek's disease in vaccinated Algerian broiler breeder flocks: A histopathological survey

BACKGROUND AND AIM

Marek's disease (MD) is a lymphoproliferative disease that occurs in chickens. In the absence of control measures, MD causes devastating losses to commercial poultry flocks. Vaccination has enabled dramatic success in the prevention and control of MD. However, the MD vaccination program has failed frequently, and occasional clinical outbreaks have been reported in the vaccinated flocks as well. The present study aimed to describe the clinical and histopathological characteristics of the field cases of MD in broiler breeder flocks.

MATERIALS AND METHODS

A survey on the update of MD occurrence in Algerian broiler breeder flocks was conducted from June 2020 to September 2020. Ten vaccinated broiler breeder flocks located in Central Algeria and having progressive tumors in different visceral organs were evaluated for MD virus infection by conducting a histopathological examination of the birds.

RESULTS

The age of the birds affected with MD ranged from 13 to 22 weeks. The mortality rate varied sensitively from 4% to 10%. The clinical symptoms reported in the affected flocks included locomotor, nervous, digestive, and respiratory symptoms. Necropsy of the dead or euthanized birds revealed visceral lymphomatosis in several organs and macroscopic changes in the peripheral nerves (including loss of longitudinal striation, color change [grayish], and volume increase). The histopathological findings included the infiltration and proliferation of lymphocytes and blast cells (lymphoblasts) in various organs of the birds, which are the typical characteristics of MD and, therefore, confirmed the field infection of MD in these birds.

CONCLUSION

The present study provided evidence for the high prevalence of MD in the broiler breeder flocks vaccinated with a bivalent vaccine (turkey herpesvirus+Rispens) at the hatchery. The findings of the present study may indicate high-level failure of vaccination in these birds.

First Report of CC5-MRSA-IV-SCCfus "Maltese Clone" in Bat Guano

Methicillin-resistant Staphylococcus aureus (MRSA) is a widespread pathogen that could cause different illnesses in both human and animals. Presence of MRSA in animals raises concerns of their capacity to act as reservoirs, particularly in wild animals. This study aimed to characterize the resistance and virulence patterns of S. aureus strains isolated from bat guano in Algeria. From March to May 2016, 98 bat guano samples from Aokas’s cave (Bejaia, Algeria) were collected. Swabs were taken for microbiological studies. Isolates were identified by Vitek^® MS system, and antibiotic susceptibility was determined by disk diffusion method. The clonal origin, virulence and antibiotic resistance profiles of S. aureus isolates were characterized by whole genome sequencing. Eleven S. aureus strains were obtained from the 98 guano samples. Seven isolates were sensitive to all antibiotics tested and four (36.3%) were resistant to penicillin G, cefoxitin and fusidic acid. The four MRSA isolates were assigned to the sequence type ST149 and related to spa type t010. These isolates harbored a SCCmecIV element and the fusidic acid resistance element Q6GD50 (fusC). They carried different virulence genes including several enterotoxins (sea, egc enterotoxin locus, sec, sel), and the toxic shock syndrome toxin (tst). Our results highlight that bat guano may constitute an important reservoir of MRSA strains.

Composition of Algerian Propolis, Plant Origin, and Its Antiangiogenic Activity In Vitro

The antiangiogenic activity of the ethanol extract of propolis collected from different regions in western Algeria was investigated using in vitro human umbilical vein endothelial cells (HUVECs). The ethanol extract with the strongest activity, i.e., Algerian propolis 1 (EEPA1), inhibited the formation of capillary networks in a dose-dependent manner (6.25–50 μg/mL) within 12 h and induced cell fragmentation of HUVECs at 50 μg/mL after treatment for 24 h. To identify the active compounds in EEAP1, a high-performance liquid chromatography (HPLC) analysis was performed, revealing that EEAP1 contains two major compounds. Both compounds were isolated by repeated column chromatography and identified as ω-hydroxyferulenol (1) and ferulenol (2), which have a coumarin structure conjugated with a farnesyl group according to NMR, high-resolution electrospray ionization mass spectroscopy, and chemical modification. Compounds 1 and 2 inhibited the tube-forming activity of HUVECs, especially 2, which exhibited a stronger antiangiogenic effect even at a low concentration of 3.31 μg/mL. Moreover, 2 suppressed the elongation and induced cell fragmentation at the same dose. The molecular changes in tube-forming HUVECs induced by 2 were found to be related to the activation of the caspase signals. To confirm the plant origin of propolis, an HPLC comparative analysis of the ethanol extracts of some plants near beekeeping areas and that of Algerian propolis (EEAP1) was performed, and similar chromatographic patterns were observed. This result suggests that the plant origin of this Algerian propolis is the resin of Ferula communis.

MCR-5-Producing Colistin-Resistant Cupriavidus gilardii Strain from Well Water in Batna, Algeria

This paper presents the first description of the mcr-5.1 gene in a colistin-resistant Cupriavidus gilardii isolate from well water that supplies a maternity hospital in Algeria. The whole-genome sequence of this strain showed the presence of putative β-lactamase, aac(3)-IVa, and multidrug efflux pump-encoding genes, which could explain the observed multidrug resistance phenotype. Our findings are of great interest, as we highlight a potential contamination route for the spread of mcr genes.

IMPORTANCE Colistin resistance mediated by mcr genes in Gram-negative bacteria has gained significant attention worldwide. This is due to the ability of these genes to be horizontally transferred between different bacterial genera and species. Aquatic environments have been suggested to play an important role in the emergence and spread of this resistance mechanism. Here, we describe the first report of an mcr-5-positive Cupriavidus gilardii aquatic isolate through its isolation from well water in Algeria. The significance of our study is in shedding the light on an important environmental reservoir of mcr genes.

Abortive diseases and their various associated risk factors in small ruminants in Algeria: a systematic review

Abortive infections are a major health challenge affecting productive and reproductive performance of sheep and goats. However, there is no comprehensive summary on the occurrence and distribution of these infections in Algeria. This systematic review provides a comprehensive summary on the prevalence of different abortive diseases and assesses potential risk factors in small ruminants in Algeria. Five databases were used to search epidemiological data on the prevalence of different abortive diseases (bacterial, parasitic, and viral). Data were collected from 25 papers published between 2003 and 2020. The total mean sample size was 53,080 small ruminants. The majority of the diseases/infections were diagnosed by serological and molecular tests. The overall prevalence of brucellosis was 0.39% in sheep and 5.31% in goats. Chlamydia and Q fever were observed in 32.72% and 20.62% of small ruminants, respectively. The prevalence of peste des petits ruminants was 15.76% and the overall prevalence of bluetongue in sheep and goats was, respectively, 13.41% and 44.50%. Border disease and bovine viral diarrhea were detected in 22.68% and 1.01% of sheep examined, respectively. Toxoplasma gondii infection prevalence among sheep and goats was 21.43% and 32.31% respectively. This study is a comprehensive epidemiological analysis of abortion diseases in small ruminants in Algeria and will therefore be a useful tool for researchers. Larger and more robust prevalence studies are needed to adequately support risk assessment and management of animal and public health threats.

Genomic basis of syndromic short stature in an Algerian patient cohort

Short stature is one of the most common reasons for a referral to the pediatric endocrinology clinic. Thousands of patients with short stature are assessed annually at the Department of Endocrine and Metabolic Diseases (DEMD) at Bab el Oued University Hospital in Algiers, Algeria. However, diagnostic rates in patients with syndromic short stature are not optimal due to the unavailability of next generation sequencing (NGS) technology. Here, we enrolled 10 Algerian patients with syndromic short stature in a pilot study to test the impact of genetic and genomic approaches in the DEMD. Using a combination of two different NGS modalities, namely exome sequencing and the Mendeliome (TruSight™ One sequencing panel) along with single gene testing, we were able to establish a confirmed molecular diagnosis in 7/10 patients (70%) and to identify strong likely disease-causing variants in a further two patients. Novel variants in NPR2 and VPS13B were identified. Using copy number variation analysis on the exome data, we also identified a de novo deletion of the short arm of chromosome X. These definitive diagnoses have made a substantial impact on patient treatment, management and genetic counseling. Genomic testing has the ability to transform clinical practice, and is an essential diagnostic tool in any tertiary pediatric clinic, particularly in resource limited settings.

Molecular Characterization of Staphylococcus aureus Isolated from Human and Food Samples in Northern Algeria

Staphylococcus aureus is a commensal resident of the skin and nasal cavities of humans and can cause various infections. Some toxigenic strains can contaminate food matrices and cause foodborne intoxications. The present study aimed to provide relevant information (clonal complex lineages, agr types, virulence and antimicrobial resistance-associated genes) based on DNA microarray analyses as well as the origins and dissemination of several circulating clones of 60 Staphylococcus aureus isolated from food matrices (n = 24), clinical samples (n = 20), and nasal carriers (n = 16) in northern Algeria. Staphylococcus aureus were genotyped into 14 different clonal complexes. Out of 60 S. aureus, 13 and 10 isolates belonged to CC1-MSSA and CC97-MSSA, respectively. The CC 80-MRSA-IV was the predominant S. aureus strain in clinical isolates. The accessory gene regulator allele agr group III was mainly found among clinical isolates (70.4%). Panton–Valentine leukocidin genes lukF/lukS-PV were detected in 13.3% of isolates that all belonged to CC80-MRSA. The lukF/S-hlg, hlgA, and hla genes encoding for hemolysins and leucocidin components were detected in all Staphylococcusaureus isolates. Clinical and food isolates harbored more often the antibiotic resistance genes markers. Seventeen (28.3%) methicillin-resistant Staphylococcus aureus carrying the mecA gene localized on a SCCmec type IV element were identified. The penicillinase operon (blaZ/I/R) was found in 71.7% (43/60) of isolates. Food isolates belonging to CC97-MSSA carried several antibiotic resistance genes (blaZ, ermB, aphA3, sat, tetM, and tetK). The results of this study showed that all clones were found in their typical host, but interestingly, some nasal carriers had isolates assigned to CC705 thought to be absent in humans. The detection of MRSA strains among food isolates should be considered as a potential public health risk. Therefore, controlling the antibiotics prescription for a rational use in human and animal infections is mandatory.

[On Professor Jean-Antoine Rioux' Phlebotomine sand flies collection (Diptera: Psychodidae)]

Background

Professor Jean-Antoine Rioux (1925-2017) has spent much of his long and fruitful scientific career exploring and understanding the functioning of leishmaniasis foci in several regions of the Mediterranean, the Near and Middle East and Africa. Phlebotomine sand flies study was an important part of his work in the foci studied and a large number of specimens have been collected by himself and stored in his collection, detailed in this note.

Materials and Methods

His collection has been completely inventoried. Phlebotomine sand flies have been classified here by species and by country. Each specimen is mounted individually in toto between slide and cover-slip in Canada balsam.

Results

The collection includes 130 840 specimens coming from 10 countries: France (mainland and Corsica), Italy, Spain, Algeria, Tunisia, Morocco, Yemen, Syria, Sudan, and Republic of Congo. These specimens belong to 26 species: Phlebotomus (Artemievus) alexandri, Ph. (Larroussius) ariasi, Ph. (Phlebotomus) bergeroti, Ph. (Paraphlebotomus) chabaudi, Ph. (Lar.) chadlii, Ph. (Par.) kazeruni, Ph. (Lar.) longicuspis, Ph. (Transphlebotomus) mascittii, Ph. (Par.) mongolensis, Ph. (Lar.) orientalis, Ph. (Phl.) papatasi, Ph. (Lar.) perfiliewi, Ph. (Lar.) perniciosus, Ph. (Par.) riouxi, Ph. (Par.) sergenti, Sergentomyia (Parrotomyia) africana, Se. (Sergentomyia) antennata, Se. (Sintonius) christophersi, Se. (Sin.) clydei, Se. (Ser.) fallax, Se. (Ser.) minuta, Se. (Ser.) schwetzi, Se. (Ser.) silva, Se. (Ser.) taizi, Se. (Sin.) tiberiadis and Grassomyia dreyfussi.

Discussion

The collection was transferred to the Platform of Reims Biological Resource Centers (PF CRBs Reims) located at the Biology Department of the Reims University Hospital in order to be curated and stored physically and electronically in a secure manner. In a near future, it will be made available to scientists wishing to access it for all purposes.In addition to Ph. chabaudi and Ph. chadlii topotypes, the collection includes many specimens from North Africa, mainly from Morocco (53% of the collection is originated from this country where Professor Rioux worked during 30 years) but also specimens from Syria or Yemen, the interest of which is obvious given the current geopolitical context.

Predictive models for COVID-19 cases, deaths and recoveries in Algeria

This study was conducted to predict the number of COVID-19 cases, deaths and recoveries using reported data by the Algerian Ministry of health from February 25, 2020 to January 10, 2021. Four models were compared including Gompertz model, logistic model, Bertalanffy model and inverse artificial neural network (ANNi). Results showed that all the models showed a good fit between the predicted and the real data (R2>0.97). In this study, we demonstrate that obtaining a good fit of real data is not directly related to a good prediction efficiency with future data. In predicting cases, the logistic model obtained the best precision with an error of 0.92% compared to the rest of the models studied. In deaths, the Gompertz model stood out with a minimum error of 1.14%. Finally, the ANNi model reached an error of 1.16% in the prediction of recovered cases in Algeria. .

Dietary Diversity as a Risk Factor for Obesity in Algerian Patients with Type 2 Diabetes Mellitus

Although the incidence of "diabesity" (coexistence of type 2 diabetes and obesity) is alarmingly increasing in Algeria, the diet-diabesity link has not been well defined. This study aimed to explore the association between dietary diversity score (DDS) and obesity among Algerian type 2 diabetic patients. It was a cross-sectional observational study involving 390 type 2 diabetic patients. Anthropometric data were gathered, and dietary intake information was obtained through a 24-h dietary recall method, which was used to calculate DDS. Potential confounders such as age, sex, smoking, physical activity and energy intake were controlled for using multivariate logistic regression. A total of 160 patients (41.3%) were classified as obese. As expected, obese patients had a higher body mass index, waist circumference, hip circumference, body fat and fat mass index. Furthermore, obese patients more frequently met carbohydrate recommendations and had a higher intake of meat and protein. Female sex, hypertension, low physical activity and high meat and protein intake were positively associated with diabesity. Additionally, higher DDS was positively associated with diabesity after adjusting for confounders. Thus, a more diversified diet may be a risk factor for obesity among Algerian type 2 diabetic patients.

Spatiotemporal analysis and seasonality of tuberculosis in Algeria

Background

This study aimed to describe the spatiotemporal distribution, to build a forecasting model, and to determine the seasonal pattern of tuberculosis (TB) in Algeria.

Methods

The Box-Jenkins methodology was used to develop predictive models and GeoDa software was used to perform spatial autocorrelation.

Results

Between 1982 and 2019, the notification rate per 100,000 population of smear-positive pulmonary TB (SPPTB) has dropped 62.2%, while that of extrapulmonary TB (EPTB) has risen 91.3%. For the last decade, the mean detection rate of PTB was 82.6%. At around, 2% of PTB cases were yearly reported in children under 15 years old, a peak in notification rate was observed in the elderly aged 65 and over, and the sex ratio was in favor of men. Between 52% and 59% of EPTB cases were lymphadenitis TB and between 15% and 23% were pleural TB. About two-third of EPTB cases were females and around 10% were children under the age of 15. The time series analysis showed that (1,1, 2) × (1, 1, 0)4 (respectively (0, 1, 2) × (1, 1, 0)4, (3, 1, 0) × (1, 1, 0)4) offered the best forecasting model to quarterly TB (respectively EPTB, SPPTB) surveillance data. The most hit part was the Tell followed by high plateaus which accounted for 96.6% of notifications in 2017. Significant hot spots were identified in the central part for EPTB notification rate and in the northwestern part for SPPTB.

Conclusions

There is a need to reframe the set objectives in the state strategy to combat TB taking into account seasonality and spatial clustering to ensure improved TB management through targeted and effective interventions.

Public-private differentials in health care delivery: the case of cesarean deliveries in Algeria

Akin to other developing countries, Algeria has witnessed an increasing role of the private health sector in the past two decades. Our study sheds light on the public-private overlap and the phenomenon of physician dual practice in the provision of health care services using the particular case of cesarean deliveries in Algeria. Existing studies have reported that, compared to the public sector, delivering in a private health facility increases the risk of enduring a cesarean section. While confirming this result for the case of Algeria, our study also reveals the existence of public-private differentials in the effect of medical variables on the probability of cesarean delivery. After controlling for selection in both sectors, we show that cesarean deliveries in the private sector tend to be less medically justified compared with those taking place in the public sector, thus, potentially leading to maternal and neonatal health problems. As elsewhere, the contribution of the private health sector to the unmet need for health care in Algeria hinges on an appropriate legal framework that better coordinates the activities of the two sectors and reinforces their complementarity.