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Weill FX, Domman D, Njamkepo E, Tarr C, Rauzier J, Fawal N, Keddy KH, Salje H, Moore S, Mukhopadhyay AK, Bercion R, Luquero FJ, Ngandjio A, Dosso M, Monakhova E, Garin B, Bouchier C, Pazzani C, Mutreja A, Grunow R, Sidikou F, Bonte L, Breurec S, Damian M, Njanpop-Lafourcade BM, Sapriel G, Page AL, Hamze M, Henkens M, Chowdhury G, Mengel M, Koeck JL, Fournier JM, Dougan G, Grimont PAD, Parkhill J, Holt KE, Piarroux R, Ramamurthy T, Quilici ML, Thomson NR. Genomic history of the seventh pandemic of cholera in Africa. Science 2017; 358:785-789. [DOI: 10.1126/science.aad5901] [Citation(s) in RCA: 188] [Impact Index Per Article: 26.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2017] [Accepted: 10/10/2017] [Indexed: 11/02/2022]
Abstract
The seventh cholera pandemic has heavily affected Africa, although the origin and continental spread of the disease remain undefined. We used genomic data from 1070 Vibrio cholerae O1 isolates, across 45 African countries and over a 49-year period, to show that past epidemics were attributable to a single expanded lineage. This lineage was introduced at least 11 times since 1970, into two main regions, West Africa and East/Southern Africa, causing epidemics that lasted up to 28 years. The last five introductions into Africa, all from Asia, involved multidrug-resistant sublineages that replaced antibiotic-susceptible sublineages after 2000. This phylogenetic framework describes the periodicity of lineage introduction and the stable routes of cholera spread, which should inform the rational design of control measures for cholera in Africa.
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Affiliation(s)
- François-Xavier Weill
- Institut Pasteur, Unité des Bactéries Pathogènes Entériques, Paris, 75015, France
- Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Hinxton CB10 1SA, UK
| | - Daryl Domman
- Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Hinxton CB10 1SA, UK
| | - Elisabeth Njamkepo
- Institut Pasteur, Unité des Bactéries Pathogènes Entériques, Paris, 75015, France
| | - Cheryl Tarr
- Centers for Disease Control and Prevention, Escherichia and Shigella Reference Unit, Atlanta, GA 30333, USA
| | - Jean Rauzier
- Institut Pasteur, Unité des Bactéries Pathogènes Entériques, Paris, 75015, France
| | - Nizar Fawal
- Institut Pasteur, Unité des Bactéries Pathogènes Entériques, Paris, 75015, France
| | - Karen H. Keddy
- Centre for Enteric Diseases, National Institute for Communicable Diseases, Johannesburg 2131, South Africa
- Faculty of Health Sciences, University of the Witwatersrand, Johannesburg 2193, South Africa
| | - Henrik Salje
- Institut Pasteur, Mathematical Modelling of Infectious Diseases, Paris, 75015, France
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
| | - Sandra Moore
- Laboratoire de Parasitologie-Mycologie, CHU Timone, Université de la Méditerranée, Marseille, 13385, France
| | - Asish K. Mukhopadhyay
- National Institute of Cholera and Enteric Diseases (NICED), Kolkata, West Bengal 700010, India
| | - Raymond Bercion
- Institut Pasteur de Bangui, BP 923, Bangui, Central African Republic
- Institut Pasteur de Dakar, BP 220, Dakar, Senegal
| | | | | | - Mireille Dosso
- Bacteriology and Virology Department, Institut Pasteur, Abidjan, Côte d'Ivoire
| | - Elena Monakhova
- Rostov-on-Don Research Institute for Plague Control, Rostov-on-Don, 344022, Russia
| | - Benoit Garin
- Institut Pasteur de Dakar, BP 220, Dakar, Senegal
| | | | - Carlo Pazzani
- University of Bari “A. Moro”, Department of Biology, Bari, 70126, Italy
| | - Ankur Mutreja
- Department of Medicine, University of Cambridge, Addenbrooke’s Hospital, Cambridge CB2 0SP, UK
- Translational Health Science and Technology Institute (THSTI), Faridabad, Haryana 121001, India
| | | | - Fati Sidikou
- Centre de Recherche Medicale et Sanitaire (CERMES), BP 10887, Niamey, Niger
| | | | - Sébastien Breurec
- Institut Pasteur de Bangui, BP 923, Bangui, Central African Republic
| | - Maria Damian
- Cantacuzino National Institute of Research-Development for Microbiology and Immunology, Bucharest, Romania
| | | | - Guillaume Sapriel
- Université de Versailles Saint-Quentin-en-Yvelines, UFR des sciences de la santé Simone Veil, Montigny-le-Bretonneux, 78180, France
- Atelier de Bioinformatique, ISYEB, UMR 7205, Paris, 75005, France
| | | | - Monzer Hamze
- Laboratoire Microbiologie Santé et Environnement (LMSE), EDST-FSP, Université Libanaise, Tripoli, Lebanon
| | | | - Goutam Chowdhury
- National Institute of Cholera and Enteric Diseases (NICED), Kolkata, West Bengal 700010, India
| | - Martin Mengel
- Agence de Médecine Préventive (AMP), Paris, 75015, France
| | - Jean-Louis Koeck
- Centre Hospitalier des Armées Bouffard, Djibouti, Republic of Djibouti
| | | | - Gordon Dougan
- Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Hinxton CB10 1SA, UK
- Department of Medicine, University of Cambridge, Addenbrooke’s Hospital, Cambridge CB2 0SP, UK
| | - Patrick A. D. Grimont
- Institut Pasteur, Unité Biodiversité des Bactéries Pathogènes Emergentes, Paris, 75015, France
| | - Julian Parkhill
- Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Hinxton CB10 1SA, UK
| | - Kathryn E. Holt
- Department of Biochemistry and Molecular Biology, Bio21 Molecular Science and Biotechnology Institute, University of Melbourne, Parkville, Victoria 3010, Australia
| | - Renaud Piarroux
- Laboratoire de Parasitologie-Mycologie, CHU Timone, Université de la Méditerranée, Marseille, 13385, France
| | | | - Marie-Laure Quilici
- Institut Pasteur, Unité des Bactéries Pathogènes Entériques, Paris, 75015, France
- Institut Pasteur, Unité du Choléra et des Vibrions, Paris, 75015, France
| | - Nicholas R. Thomson
- Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Hinxton CB10 1SA, UK
- London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK
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Rose AMC, Gerstl S, Mahamane AEH, Sidikou F, Djibo S, Bonte L, Caugant DA, Guerin PJ, Chanteau S. Field evaluation of two rapid diagnostic tests for Neisseria meningitidis serogroup A during the 2006 outbreak in Niger. PLoS One 2009; 4:e7326. [PMID: 19802392 PMCID: PMC2752163 DOI: 10.1371/journal.pone.0007326] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2008] [Accepted: 08/10/2009] [Indexed: 11/19/2022] Open
Abstract
The Pastorex((R)) (BioRad) rapid agglutination test is one of the main rapid diagnostic tests (RDTs) for meningococcal disease currently in use in the "meningitis belt". Earlier evaluations, performed after heating and centrifugation of cerebrospinal fluid (CSF) samples, under good laboratory conditions, showed high sensitivity and specificity. However, during an epidemic, the test may be used without prior sample preparation. Recently a new, easy-to-use dipstick RDT for meningococcal disease detection on CSF was developed by the Centre de Recherche Médicale et Sanitaire in Niger and the Pasteur Institute in France. We estimate diagnostic accuracy in the field during the 2006 outbreak of Neisseria meningitidis serogroup A in Maradi, Niger, for the dipstick RDT and Pastorex((R)) on unprepared CSF, (a) by comparing each test's sensitivity and specificity with previously reported values; and (b) by comparing results for each test on paired samples, using McNemar's test. We also (c) estimate diagnostic accuracy of the dipstick RDT on diluted whole blood. We tested unprepared CSF and diluted whole blood from 126 patients with suspected meningococcal disease presenting at four health posts. (a) Pastorex((R)) sensitivity (69%; 95%CI 57-79) was significantly lower than found previously for prepared CSF samples [87% (81-91); or 88% (85-91)], as was specificity [81% (95%CI 68-91) vs 93% (90-95); or 93% (87-96)]. Sensitivity of the dipstick RDT [89% (95%CI 80-95)] was similar to previously reported values for ideal laboratory conditions [89% (84-93) and 94% (90-96)]. Specificity, at 62% (95%CI 48-75), was significantly lower than found previously [94% (92-96) and 97% (94-99)]. (b) McNemar's test for the dipstick RDT vs Pastorex((R)) was statistically significant (p<0.001). (c) The dipstick RDT did not perform satisfactorily on diluted whole blood (sensitivity 73%; specificity 57%).Sensitivity and specificity of Pastorex((R)) without prior CSF preparation were poorer than previously reported results from prepared samples; therefore we caution against using this test during an epidemic if sample preparation is not possible. For the dipstick RDT, sensitivity was similar to, while specificity was not as high as previously reported during a more stable context. Further studies are needed to evaluate its field performance, especially for different populations and other serogroups.
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