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Lemopoulos A, Miwanda B, Drebes Dörr NC, Stutzmann S, Bompangue D, Muyembe-Tamfum JJ, Blokesch M. Genome sequences of Vibrio cholerae strains isolated in the DRC between 2009 and 2012. Microbiol Resour Announc 2024; 13:e0082723. [PMID: 38345380 DOI: 10.1128/mra.00827-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 01/21/2024] [Indexed: 03/13/2024] Open
Abstract
Vibrio cholerae has caused seven cholera pandemics in the past two centuries. The seventh and ongoing pandemic has been particularly severe on the African continent. Here, we report long read-based genome sequences of six V. cholerae strains isolated in the Democratic Republic of the Congo between 2009 and 2012.
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Affiliation(s)
- Alexandre Lemopoulos
- Laboratory of Molecular Microbiology, Global Health Institute, School of Life Sciences, Ecole Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland
| | - Berthe Miwanda
- Institut National de Recherche Biomédicale (INRB), Kinshasa, Democratic Republic of Congo
| | - Natália C Drebes Dörr
- Laboratory of Molecular Microbiology, Global Health Institute, School of Life Sciences, Ecole Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland
| | - Sandrine Stutzmann
- Laboratory of Molecular Microbiology, Global Health Institute, School of Life Sciences, Ecole Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland
| | - Didier Bompangue
- Département de Microbiologie, Faculté de Médecine, Université de Kinshasa, Kinshasa, Democratic Republic of Congo
| | - Jean-Jacques Muyembe-Tamfum
- Institut National de Recherche Biomédicale (INRB), Kinshasa, Democratic Republic of Congo
- Département de Microbiologie, Faculté de Médecine, Université de Kinshasa, Kinshasa, Democratic Republic of Congo
| | - Melanie Blokesch
- Laboratory of Molecular Microbiology, Global Health Institute, School of Life Sciences, Ecole Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland
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Hounmanou YMG, Njamkepo E, Rauzier J, Gallandat K, Jeandron A, Kamwiziku G, Porten K, Luquero F, Abedi AA, Rumedeka BB, Miwanda B, Michael M, Okitayemba PW, Saidi JM, Piarroux R, Weill FX, Dalsgaard A, Quilici ML. Genomic Microevolution of Vibrio cholerae O1, Lake Tanganyika Basin, Africa. Emerg Infect Dis 2023; 29:149-153. [PMID: 36573719 PMCID: PMC9796204 DOI: 10.3201/eid2901.220641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Africa's Lake Tanganyika basin is a cholera hotspot. During 2001-2020, Vibrio cholerae O1 isolates obtained from the Democratic Republic of the Congo side of the lake belonged to 2 of the 5 clades of the AFR10 sublineage. One clade became predominant after acquiring a parC mutation that decreased susceptibility to ciprofloxacin.
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Ratnayake R, Peyraud N, Ciglenecki I, Gignoux E, Lightowler M, Azman AS, Gakima P, Ouamba JP, Sagara JA, Ndombe R, Mimbu N, Ascorra A, Welo PO, Mukamba Musenga E, Miwanda B, Boum Y, Checchi F, Edmunds WJ, Luquero F, Porten K, Finger F. Effectiveness of case-area targeted interventions including vaccination on the control of epidemic cholera: protocol for a prospective observational study. BMJ Open 2022; 12:e061206. [PMID: 35793924 PMCID: PMC9260795 DOI: 10.1136/bmjopen-2022-061206] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Cholera outbreaks in fragile settings are prone to rapid expansion. Case-area targeted interventions (CATIs) have been proposed as a rapid and efficient response strategy to halt or substantially reduce the size of small outbreaks. CATI aims to deliver synergistic interventions (eg, water, sanitation, and hygiene interventions, vaccination, and antibiotic chemoprophylaxis) to households in a 100-250 m 'ring' around primary outbreak cases. METHODS AND ANALYSIS We report on a protocol for a prospective observational study of the effectiveness of CATI. Médecins Sans Frontières (MSF) plans to implement CATI in the Democratic Republic of the Congo (DRC), Cameroon, Niger and Zimbabwe. This study will run in parallel to each implementation. The primary outcome is the cumulative incidence of cholera in each CATI ring. CATI will be triggered immediately on notification of a case in a new area. As with most real-world interventions, there will be delays to response as the strategy is rolled out. We will compare the cumulative incidence among rings as a function of response delay, as a proxy for performance. Cross-sectional household surveys will measure population-based coverage. Cohort studies will measure effects on reducing incidence among household contacts and changes in antimicrobial resistance. ETHICS AND DISSEMINATION The ethics review boards of MSF and the London School of Hygiene and Tropical Medicine have approved a generic protocol. The DRC and Niger-specific versions have been approved by the respective national ethics review boards. Approvals are in process for Cameroon and Zimbabwe. The study findings will be disseminated to the networks of national cholera control actors and the Global Task Force for Cholera Control using meetings and policy briefs, to the scientific community using journal articles, and to communities via community meetings.
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Affiliation(s)
- Ruwan Ratnayake
- Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
- Epicentre, Paris, France
| | | | | | | | | | - Andrew S Azman
- Médecins Sans Frontières, Geneva, Switzerland
- Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | | | | | | | | | | | | | - Placide Okitayemba Welo
- Programme National d'Elimination du Choléra et de lutte contre les autres Maladies Diarrhéiques, Kinshasa, Congo (the Democratic Republic of the)
| | | | - Berthe Miwanda
- Institut National de Recherche Biologique, Kinshasa, Congo (the Democratic Republic of the)
| | | | - Francesco Checchi
- Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
| | - W John Edmunds
- Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
| | - Francisco Luquero
- Epicentre, Paris, France
- GAVI the Vaccine Alliance, Geneva, Switzerland
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Senghore M, Tientcheu PE, Worwui AK, Jarju S, Okoi C, Suso SMS, Foster-Nyarko E, Ebruke C, Sonko M, Kourna MH, Agossou J, Tsolenyanu E, Renner LA, Ansong D, Sanneh B, Cisse CB, Boula A, Miwanda B, Lo SW, Gladstone RA, Schwartz S, Hawkins P, McGee L, Klugman KP, Breiman RF, Bentley SD, Mwenda JM, Kwambana-Adams BA, Antonio M. Phylogeography and resistome of pneumococcal meningitis in West Africa before and after vaccine introduction. Microb Genom 2021; 7. [PMID: 34328412 PMCID: PMC8477402 DOI: 10.1099/mgen.0.000506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Despite contributing to the large disease burden in West Africa, little is known about the genomic epidemiology of Streptococcus pneumoniae which cause meningitis among children under 5 years old in the region. We analysed whole-genome sequencing data from 185 S. pneumoniae isolates recovered from suspected paediatric meningitis cases as part of the World Health Organization (WHO) invasive bacterial diseases surveillance from 2010 to 2016. The phylogeny was reconstructed, accessory genome similarity was computed and antimicrobial-resistance patterns were inferred from the genome data and compared to phenotypic resistance from disc diffusion. We studied the changes in the distribution of serotypes pre- and post-pneumococcal conjugate vaccine (PCV) introduction in the Central and Western sub-regions separately. The overall distribution of non-vaccine, PCV7 (4, 6B, 9V, 14, 18C, 19F and 23F) and additional PCV13 serotypes (1, 3, 5, 6A, 19A and 7F) did not change significantly before and after PCV introduction in the Central region (Fisher's test P value 0.27) despite an increase in the proportion of non-vaccine serotypes to 40 % (n=6) in the post-PCV introduction period compared to 21.9 % (n=14). In the Western sub-region, PCV13 serotypes were more dominant among isolates from The Gambia following the introduction of PCV7, 81 % (n=17), compared to the pre-PCV period in neighbouring Senegal, 51 % (n=27). The phylogeny illustrated the diversity of strains associated with paediatric meningitis in West Africa and highlighted the existence of phylogeographical clustering, with isolates from the same sub-region clustering and sharing similar accessory genome content. Antibiotic-resistance genotypes known to confer resistance to penicillin, chloramphenicol, co-trimoxazole and tetracycline were detected across all sub-regions. However, there was no discernible trend linking the presence of resistance genotypes with the vaccine introduction period or whether the strain was a vaccine or non-vaccine serotype. Resistance genotypes appeared to be conserved within selected sub-clades of the phylogenetic tree, suggesting clonal inheritance. Our data underscore the need for continued surveillance on the emergence of non-vaccine serotypes as well as chloramphenicol and penicillin resistance, as these antibiotics are likely still being used for empirical treatment in low-resource settings. This article contains data hosted by Microreact.
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Affiliation(s)
- Madikay Senghore
- WHO Collaborating Centre for New Vaccines Surveillance, Medical Research Council Unit The Gambia at London School of Hygiene and Tropical Medicine, P.O. Box 273, Banjul, The Gambia.,Center for Communicable Disease Dynamics, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA, USA
| | - Peggy-Estelle Tientcheu
- WHO Collaborating Centre for New Vaccines Surveillance, Medical Research Council Unit The Gambia at London School of Hygiene and Tropical Medicine, P.O. Box 273, Banjul, The Gambia
| | - Archibald Kwame Worwui
- WHO Collaborating Centre for New Vaccines Surveillance, Medical Research Council Unit The Gambia at London School of Hygiene and Tropical Medicine, P.O. Box 273, Banjul, The Gambia
| | - Sheikh Jarju
- WHO Collaborating Centre for New Vaccines Surveillance, Medical Research Council Unit The Gambia at London School of Hygiene and Tropical Medicine, P.O. Box 273, Banjul, The Gambia
| | - Catherine Okoi
- WHO Collaborating Centre for New Vaccines Surveillance, Medical Research Council Unit The Gambia at London School of Hygiene and Tropical Medicine, P.O. Box 273, Banjul, The Gambia
| | - Sambou M S Suso
- WHO Collaborating Centre for New Vaccines Surveillance, Medical Research Council Unit The Gambia at London School of Hygiene and Tropical Medicine, P.O. Box 273, Banjul, The Gambia
| | - Ebenezer Foster-Nyarko
- WHO Collaborating Centre for New Vaccines Surveillance, Medical Research Council Unit The Gambia at London School of Hygiene and Tropical Medicine, P.O. Box 273, Banjul, The Gambia
| | - Chinelo Ebruke
- WHO Collaborating Centre for New Vaccines Surveillance, Medical Research Council Unit The Gambia at London School of Hygiene and Tropical Medicine, P.O. Box 273, Banjul, The Gambia
| | - Mohamadou Sonko
- Hopital d'Enfants Albert Royer, BP 5297, Fann, Dakar, Senegal
| | | | - Joseph Agossou
- Department of Mother and Child, Faculty of Medicine, University of Parakou, Parakou, Benin.,Borgou Regional University Teaching Hospital, Parakou, Benin
| | - Enyonam Tsolenyanu
- Laboratoire Microbiologie, Centre Hospitalier Universitaire de Tokoin Lomé, BP 57, Lomé, Togo
| | - Lorna Awo Renner
- Central Laboratory Services, Korle-Bu Teaching Hospital, P.O. Box 77, Accra, Ghana
| | - Daniel Ansong
- Komfo Anokye Teaching Hospital, P.O. Box 1934, Kumasi, Ghana
| | - Bakary Sanneh
- Edward Francis Small Teaching Hospital, Banjul, The Gambia
| | - Catherine Boni Cisse
- Laboratoire Central du CHU de Yopougon, Institut Pasteur de Cote d'Ivoire, Abidjan, Ivory Coast
| | - Angeline Boula
- Centre Mere et Enfant de la Fondation, Chantal Biya, Yaounde, Cameroon
| | - Berthe Miwanda
- Institut National de Recherche Biomedicale, Kinshasa, Democratic Republic of Congo
| | - Stephanie W Lo
- Parasites and Microbes, Wellcome Sanger Institute, Hinxton, UK
| | | | | | - Paulina Hawkins
- Centers for Disease Control and Prevention, Atlanta, GA, USA.,Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Lesley McGee
- Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Keith P Klugman
- Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Robert F Breiman
- Rollins School of Public Health, Emory University, Atlanta, GA, USA.,Emory Global Health Institute, Atlanta, GA, USA
| | | | - Jason M Mwenda
- World Health Organization Regional Office for Africa, BP 6, Brazzaville, Republic of Congo
| | - Brenda Anna Kwambana-Adams
- WHO Collaborating Centre for New Vaccines Surveillance, Medical Research Council Unit The Gambia at London School of Hygiene and Tropical Medicine, P.O. Box 273, Banjul, The Gambia.,NIHR Global Health Research Unit on Mucosal Pathogens, Division of Infection and Immunity, University College London, London, UK
| | - Martin Antonio
- WHO Collaborating Centre for New Vaccines Surveillance, Medical Research Council Unit The Gambia at London School of Hygiene and Tropical Medicine, P.O. Box 273, Banjul, The Gambia
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Mbala-Kingebeni P, Vogt F, Miwanda B, Sundika T, Mbula N, Pankwa I, Lubula L, Vanlerberghe V, Magazani A, Afoumbom MT, Muyembe-Tamfum JJ. Sachet water consumption as a risk factor for cholera in urban settings: Findings from a case control study in Kinshasa, Democratic Republic of the Congo during the 2017-2018 outbreak. PLoS Negl Trop Dis 2021; 15:e0009477. [PMID: 34237058 PMCID: PMC8266059 DOI: 10.1371/journal.pntd.0009477] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2020] [Accepted: 05/15/2021] [Indexed: 11/19/2022] Open
Abstract
Background Behavioural risk factors for cholera are well established in rural and semi-urban contexts, but not in densely populated mega-cities in Sub-Saharan Africa. In November 2017, a cholera epidemic occurred in Kinshasa, the Democratic Republic of the Congo, where no outbreak had been recorded for nearly a decade. During this outbreak, we investigated context-specific risk factors for cholera in an urban setting among a population that is not frequently exposed to cholera. Methodology/Principal findings We recruited 390 participants from three affected health zones of Kinshasa into a 1:1 matched case control study. Cases were identified from cholera treatment centre admission records, while controls were recruited from the vicinity of the cases’ place of residence. We used standardized case report forms for the collection of socio-demographic and behavioural risk factors. We used augmented backward elimination in a conditional logistic regression model to identify risk factors. The consumption of sachet water was strongly associated with the risk of being a cholera case (p-value 0.019), which increased with increasing frequency of consumption from rarely (OR 2.2, 95% CI 0.9–5.2) to often (OR 4.0, 95% CI 1.6–9.9) to very often (OR 4.1, 95% CI 1.0–16.7). Overall, more than 80% of all participants reported consumption of this type of drinking water. The risk factors funeral attendance and contact with someone suffering from diarrhoea showed a p-value of 0.09 and 0.08, respectively. No socio-demographic characteristics were associated with the risk of cholera. Conclusions/Significance Drinking water consumption from sachets, which are sold informally on the streets in most Sub-Saharan African cities, are an overlooked route of infection in urban cholera outbreaks. Outbreak response measures need to acknowledge context-specific risk factors to remain a valuable tool in the efforts to achieve national and regional targets to reduce the burden of cholera in Sub-Saharan Africa. Cholera is a diarrheal disease caused by ingestion of the Vibrio cholerae bacterium. Outbreaks in urban areas are becoming increasingly frequent in Sub-Saharan Africa. Risk factors for cholera have been studied in rural settings but not sufficiently in urban areas. Understanding context-specific risk factors is key for successful outbreak response. During a cholera outbreak in Kinshasa, the Democratic Republic of the Congo we were able to identify a previously unknown behavioural risk factor of particular relevance in urban settings–the consumption of drinking water from plastic sachets. Water sachets are sold on the streets of all major cities in Sub-Saharan Africa. It requires biting off an edge and sucking out the water, and we think that external contamination of these sachets was an important transmission route in the Kinshasa outbreak. Water sachets are predominantly consumed by socio-economically disadvantaged groups who lack piped water supply in their homes and have poor access to sanitary infrastructure. This makes our findings particularly relevant because these are the very populations who are at increased risk of getting and transmitting cholera. Health messaging and response measures should include consumption of water sachets as a potential risk factor during future cholera outbreaks in urban low-resource settings.
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Affiliation(s)
| | - Florian Vogt
- Institute of Tropical Medicine Antwerp, Antwerp, Belgium
- National Centre for Epidemiology and Population Health, Research School of Population Health, College of Health and Medicine, Australian National University, Canberra, Australia
- The Kirby Institute, University of New South Wales, Sydney, Australia
- * E-mail:
| | - Berthe Miwanda
- Institut National de la Recherche Biomédicale, Kinshasa, Democratic Republic of the Congo
| | | | - Nancy Mbula
- FELTP DRC, Kinshasa, Democratic Republic of the Congo
| | - Isaac Pankwa
- Institut National de la Recherche Biomédicale, Kinshasa, Democratic Republic of the Congo
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Ingelbeen B, Hendrickx D, Miwanda B, van der Sande MA, Mossoko M, Vochten H, Riems B, Nyakio JP, Vanlerberghe V, Lunguya O, Jacobs J, Boelaert M, Kebela BI, Bompangue D, Muyembe JJ. Recurrent Cholera Outbreaks, Democratic Republic of the Congo, 2008-2017. Emerg Infect Dis 2019; 25:856-864. [PMID: 31002075 PMCID: PMC6478228 DOI: 10.3201/eid2505.181141] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
In 2017, the exacerbation of an ongoing countrywide cholera outbreak in the Democratic Republic of the Congo resulted in >53,000 reported cases and 1,145 deaths. To guide control measures, we analyzed the characteristics of cholera epidemiology in DRC on the basis of surveillance and cholera treatment center data for 2008–2017. The 2017 nationwide outbreak resulted from 3 distinct mechanisms: considerable increases in the number of cases in cholera-endemic areas, so-called hot spots, around the Great Lakes in eastern DRC; recurrent outbreaks progressing downstream along the Congo River; and spread along Congo River branches to areas that had been cholera-free for more than a decade. Case-fatality rates were higher in nonendemic areas and in the early phases of the outbreaks, possibly reflecting low levels of immunity and less appropriate prevention and treatment. Targeted use of oral cholera vaccine, soon after initial cases are diagnosed, could contribute to lower case-fatality rates.
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7
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Sauvageot D, Njanpop-Lafourcade BM, Akilimali L, Anne JC, Bidjada P, Bompangue D, Bwire G, Coulibaly D, Dengo-Baloi L, Dosso M, Orach CG, Inguane D, Kagirita A, Kacou-N’Douba A, Keita S, Kere Banla A, Kouame YJP, Landoh DE, Langa JP, Makumbi I, Miwanda B, Malimbo M, Mutombo G, Mutombo A, NGuetta EN, Saliou M, Sarr V, Senga RK, Sory F, Sema C, Tante OV, Gessner BD, Mengel MA. Cholera Incidence and Mortality in Sub-Saharan African Sites during Multi-country Surveillance. PLoS Negl Trop Dis 2016; 10:e0004679. [PMID: 27186885 PMCID: PMC4871502 DOI: 10.1371/journal.pntd.0004679] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2015] [Accepted: 04/09/2016] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Cholera burden in Africa remains unknown, often because of weak national surveillance systems. We analyzed data from the African Cholera Surveillance Network (www.africhol.org). METHODS/ PRINCIPAL FINDINGS During June 2011-December 2013, we conducted enhanced surveillance in seven zones and four outbreak sites in Togo, the Democratic Republic of Congo (DRC), Guinea, Uganda, Mozambique and Cote d'Ivoire. All health facilities treating cholera cases were included. Cholera incidences were calculated using culture-confirmed cholera cases and culture-confirmed cholera cases corrected for lack of culture testing usually due to overwhelmed health systems and imperfect test sensitivity. Of 13,377 reported suspected cases, 34% occurred in Conakry, Guinea, 47% in Goma, DRC, and 19% in the remaining sites. From 0-40% of suspected cases were aged under five years and from 0.3-86% had rice water stools. Within surveillance zones, 0-37% of suspected cases had confirmed cholera compared to 27-38% during outbreaks. Annual confirmed incidence per 10,000 population was <0.5 in surveillance zones, except Goma where it was 4.6. Goma and Conakry had corrected incidences of 20.2 and 5.8 respectively, while the other zones a median of 0.3. During outbreaks, corrected incidence varied from 2.6 to 13.0. Case fatality ratios ranged from 0-10% (median, 1%) by country. CONCLUSIONS/SIGNIFICANCE Across different African epidemiological contexts, substantial variation occurred in cholera incidence, age distribution, clinical presentation, culture confirmation, and testing frequency. These results can help guide preventive activities, including vaccine use.
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Affiliation(s)
| | | | | | | | | | - Didier Bompangue
- Universite de Kinshasa, Kinshasa, Republique Democratique du Congo
| | | | | | | | | | | | | | - Atek Kagirita
- Central Public Health Laboratory, Ministry of Health, Kampala, Uganda
| | | | - Sakoba Keita
- Ministere de la sante publique et de l’hygiene publique, Conakry, Guinea
| | | | | | | | | | | | - Berthe Miwanda
- Institut National de Recherche Biomedicale, Kinshasa, Republique Democratique du Congo
| | | | - Guy Mutombo
- Ministere de la santé, Division Provinciale de la santé, Goma, Republique Democratique du Congo
| | - Annie Mutombo
- Ministère de la santé, Kinshasa, Republique Democratique du Congo
| | | | | | - Veronique Sarr
- Ministere de la sante publique et de l’hygiene publique, Conakry, Guinea
| | | | - Fode Sory
- Ministere de la sante publique et de l’hygiene publique, Conakry, Guinea
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Miwanda B, Moore S, Muyembe JJ, Nguefack-Tsague G, Kabangwa IK, Ndjakani DY, Mutreja A, Thomson N, Thefenne H, Garnotel E, Tshapenda G, Kakongo DK, Kalambayi G, Piarroux R. Antimicrobial Drug Resistance of Vibrio cholerae, Democratic Republic of the Congo. Emerg Infect Dis 2016; 21:847-51. [PMID: 25897570 PMCID: PMC4412219 DOI: 10.3201/eid2105.141233] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
We analyzed 1,093 Vibrio cholerae isolates from the Democratic Republic of the Congo during 1997–2012 and found increasing antimicrobial drug resistance over time. Our study also demonstrated that the 2011–2012 epidemic was caused by an El Tor variant clonal complex with a single antimicrobial drug susceptibility profile.
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Moore S, Miwanda B, Sadji AY, Thefenne H, Jeddi F, Rebaudet S, de Boeck H, Bidjada B, Depina JJ, Bompangue D, Abedi AA, Koivogui L, Keita S, Garnotel E, Plisnier PD, Ruimy R, Thomson N, Muyembe JJ, Piarroux R. Relationship between Distinct African Cholera Epidemics Revealed via MLVA Haplotyping of 337 Vibrio cholerae Isolates. PLoS Negl Trop Dis 2015; 9:e0003817. [PMID: 26110870 PMCID: PMC4482140 DOI: 10.1371/journal.pntd.0003817] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2015] [Accepted: 05/06/2015] [Indexed: 11/29/2022] Open
Abstract
Background Since cholera appeared in Africa during the 1970s, cases have been reported on the continent every year. In Sub-Saharan Africa, cholera outbreaks primarily cluster at certain hotspots including the African Great Lakes Region and West Africa. Methodology/Principal Findings In this study, we applied MLVA (Multi-Locus Variable Number Tandem Repeat Analysis) typing of 337 Vibrio cholerae isolates from recent cholera epidemics in the Democratic Republic of the Congo (DRC), Zambia, Guinea and Togo. We aimed to assess the relationship between outbreaks. Applying this method, we identified 89 unique MLVA haplotypes across our isolate collection. MLVA typing revealed the short-term divergence and microevolution of these Vibrio cholerae populations to provide insight into the dynamics of cholera outbreaks in each country. Our analyses also revealed strong geographical clustering. Isolates from the African Great Lakes Region (DRC and Zambia) formed a closely related group, while West African isolates (Togo and Guinea) constituted a separate cluster. At a country-level scale our analyses revealed several distinct MLVA groups, most notably DRC 2011/2012, DRC 2009, Zambia 2012 and Guinea 2012. We also found that certain MLVA types collected in the DRC persisted in the country for several years, occasionally giving rise to expansive epidemics. Finally, we found that the six environmental isolates in our panel were unrelated to the epidemic isolates. Conclusions/Significance To effectively combat the disease, it is critical to understand the mechanisms of cholera emergence and diffusion in a region-specific manner. Overall, these findings demonstrate the relationship between distinct epidemics in West Africa and the African Great Lakes Region. This study also highlights the importance of monitoring and analyzing Vibrio cholerae isolates. Cholera is caused by the toxigenic bacterium Vibrio cholerae. Since cholera was imported into the West African country of Guinea in 1970, cases have been reported on the continent every year. In Sub-Saharan Africa, cholera occurs in a heterogeneous manner; outbreaks primarily cluster at certain hotspots including the African Great Lakes Region and West Africa. To gain further insight into the mechanisms by which cholera outbreaks emerge and diffuse, we performed genetic analyses of 337 Vibrio cholera isolates from the Democratic Republic of the Congo (DRC), Zambia, Guinea and Togo. Isolates from both patients and environmental samples were examined. Our findings demonstrate the relationship between distinct epidemics in West Africa and the African Great Lakes Region. For example, certain strains in the DRC have circulated in the region over a period of several years, occasionally giving rise to expansive epidemics. We also found that the six environmental isolates in our panel were unrelated to the epidemic isolates. Such insight into the country- and region-specific dynamics of the disease is critical to implement optimized public health strategies to control and prevent cholera epidemics. This study also highlights the importance of analyzing Vibrio cholerae isolates to complement epidemiological studies.
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Affiliation(s)
- Sandra Moore
- Department of Parasitology and Mycology, Assistance Publique—Hôpitaux de Marseille/Aix-Marseille University, UMR MD3, Marseille, France
| | - Berthe Miwanda
- Institut National de Recherche Biomédicale, Ministry of Public Health, Kinshasa, Democratic Republic of the Congo
| | - Adodo Yao Sadji
- Department of Bacteriology, National Institute of Hygiene, Lomé, Togo
| | | | - Fakhri Jeddi
- Department of Parasitology and Mycology, Assistance Publique—Hôpitaux de Marseille/Aix-Marseille University, UMR MD3, Marseille, France
| | - Stanislas Rebaudet
- Department of Parasitology and Mycology, Assistance Publique—Hôpitaux de Marseille/Aix-Marseille University, UMR MD3, Marseille, France
| | - Hilde de Boeck
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Bawimodom Bidjada
- Department of Bacteriology, National Institute of Hygiene, Lomé, Togo
| | | | - Didier Bompangue
- Institut National de Recherche Biomédicale, Ministry of Public Health, Kinshasa, Democratic Republic of the Congo
- Department of Microbiology, Faculty of Medicine, University of Kinshasa, Kinshasa, Democratic Republic of the Congo
- Laboratoire Chrono-Environnement, UMR 6249, CNRS, University of Franche-Comte, Besançon, France
| | | | - Lamine Koivogui
- Institut National de Santé Publique, Conakry, Republic of Guinea
| | - Sakoba Keita
- Division Prévention et Lutte contre la Maladie, Ministère de la Santé Publique et de l’Hygiène Publique, Conakry, Republic of Guinea
| | - Eric Garnotel
- Hôpital d'Instruction des Armées Laveran, Marseille, France
| | | | - Raymond Ruimy
- Clinical Research Department, Nice University Hospital, Nice, France
| | - Nicholas Thomson
- Pathogen Genomics, Wellcome Trust Sanger Institute, Hinxton, Cambridge, United Kingdom
- London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Jean-Jacques Muyembe
- Institut National de Recherche Biomédicale, Ministry of Public Health, Kinshasa, Democratic Republic of the Congo
- Department of Microbiology, Faculty of Medicine, University of Kinshasa, Kinshasa, Democratic Republic of the Congo
| | - Renaud Piarroux
- Department of Parasitology and Mycology, Assistance Publique—Hôpitaux de Marseille/Aix-Marseille University, UMR MD3, Marseille, France
- * E-mail:
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Muyembe JJ, Bompangue D, Mutombo G, Akilimali L, Mutombo A, Miwanda B, Mpuruta JDD, Deka KK, Bitakyerwa F, Saidi JM, Mutadi AL, Kakongo RS, Birembano F, Mengel M, Gessner BD, Ilunga BK. Elimination of Cholera in the Democratic Republic of the Congo: The New National Policy. J Infect Dis 2013; 208 Suppl 1:S86-91. [DOI: 10.1093/infdis/jit204] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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De Boeck H, Miwanda B, Lunguya-Metila O, Muyembe-Tamfum JJ, Stobberingh E, Glupczynski Y, Jacobs J. ESBL-positive Enterobacteria isolates in drinking water. Emerg Infect Dis 2012; 18:1019-20. [PMID: 22608263 PMCID: PMC3358152 DOI: 10.3201/eid1806.111214] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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